Acute gangrenous cholecystitis: radionuclide diagnosis
Brachman, M.B.; Tanasescu, D.E.; Ramanna, L.; Waxman, A.D.
1984-04-01
Radionuclide hepatobiliary imaging with Tc-99m IDA is a useful procedure for the diagnosis of acute cholecystitis. Visualization of the gallbladder essentially rules out acute cholecystitis. Nonvisualization suggest acute cholecystitis but may also be associated with chronic gallbladder disease or other conditions. The authors recently observed five patients in whom a rim of increased parenchymal liver activity was seen adjacent to the gallbladder fossa. All five patients had acute gangrenous cholecystitis. The rim of increased activity appears to be a useful secondary sign of acute cholecystitis.
Acute acalculous cholecystitis.
Barie, Philip S; Eachempati, Soumitra R
2010-06-01
Acute acalculous cholecystitis (ACC) can develop with or without gallstones after surgery and in critically ill or injured patients. Diabetes mellitus, malignant disease, abdominal vasculitis, congestive heart failure, cholesterol embolization, shock, and cardiac arrest also have been associated with AAC. The pathogenesis of AAC is complex and multifactorial. Ultrasound of the gallbladder is most accurate for the diagnosis of AAC in the critically ill patient. CT is probably of comparable accuracy, but carries both advantages and disadvantages. Rapid improvement may be expected when AAC is diagnosed correctly and cholecystostomy is performed timely. PMID:20478490
Normal gallbladder scintigraphy in acute cholecystitis
Ohrt, H.J.; Posalaky, I.P.; Shafer, R.B.
1983-03-01
Normal gallbladder scintigraphy occurs in 2 to 5% of reported patients with acute cholecystitis. Gallbladder visualization is found in patients with acalculous cholecystitis and in those with recent relief of cystic duct obstruction but persistence of inflammation. A patient is reported who had clinical and pathologic findings of acute cholecystitis but normal gallbladder visualization. This reemphasizes that the diagnosis of acute cholecystitis cannot be excluded by normal gallbladder scintigraphy.
Rim sign: association with acute cholecystitis
Bushnell, D.L.; Perlman, S.B.; Wilson, M.A.; Polcyn, R.E.
1986-03-01
In a retrospective analysis of 218 hepatobiliary studies in patients clinically suspected of acute cholecystitis, a rim of increased hepatic activity adjacent to the gallbladder fossa (the rim sign) has been evaluated as a scintigraphic predictor of confirmed acute cholecystitis. Of 28 cases with pathologic confirmation of acute cholecystitis in this series, 17 (60%) demonstrated this sign. When associated with nonvisualization of the gallbladder at 1 hr, the positive predictive value of this photon-intense rim for acute cholecystitis was 94%. When the rim sign was absent, the positive predictive value of nonvisualization of the gallbladder at 1 hr for acute cholecystitis was only 36%. As this sign was always seen during the first hour postinjection, it can, when associated with nonvisualization, reduce the time required for completion of an hepatobiliary examination in suspected acute cholecystitis.
Dengue fever with acute acalculous cholecystitis.
Wu, Keng-Liang; Changchien, Chi-Sin; Kuo, Chung-Mou; Chuah, Seng-Kee; Lu, Sheng-Nan; Eng, Hock-Liew; Kuo, Chung-Huang
2003-06-01
Dengue fever (DF) with acute acalculous cholecystitis is rarely reported. To investigate the incidence, treatment, and prognosis of acute acalculous cholecystitis in DF patients, we retrospectively studied 10 patients with DF and acute acalculous cholecystitis. From October 2001 to July 2002, 131 patients were diagnosed with DF. Ten of 131 DF patients (7.63%) had complications of acute acalculous cholecystitis. Two patients underwent cholecystectomy and one underwent percutaneous transhepatic gallbladder drainage due to poor resolution of acute acalculous cholecystitis. We found acute acalculous cholecystitis in a small proportion of patients with DF. In our experience, closely monitoring vital signs to avoid shock and correct thrombocytopenia to avoid bleeding could be adequate for most patients. In some cases, surgical treatment may be needed for DF fever patients with complications of diffuse peritonitis.
Knab, Lawrence M; Boller, Anne-Marie; Mahvi, David M
2014-04-01
Acute cholecystitis is defined as inflammation of the gallbladder and is usually caused by obstruction of the cystic duct. Cholescintigraphy is the most sensitive imaging modality for cholecystitis. The gold standard treatment of acute cholecystitis is laparoscopic cholecystectomy. Operating early in the disease course decreases overall hospital stay and avoids increased complications, conversion to open procedures, and mortality. Cholecystitis during pregnancy is a challenging problem for surgeons. Operative intervention is generally safe for both mother and fetus, given the improved morbidity of the laparoscopic approach compared with open, although increased caution should be exercised in women with gallstone pancreatitis. PMID:24679431
2016 WSES guidelines on acute calculous cholecystitis.
Ansaloni, L; Pisano, M; Coccolini, F; Peitzmann, A B; Fingerhut, A; Catena, F; Agresta, F; Allegri, A; Bailey, I; Balogh, Z J; Bendinelli, C; Biffl, W; Bonavina, L; Borzellino, G; Brunetti, F; Burlew, C C; Camapanelli, G; Campanile, F C; Ceresoli, M; Chiara, O; Civil, I; Coimbra, R; De Moya, M; Di Saverio, S; Fraga, G P; Gupta, S; Kashuk, J; Kelly, M D; Koka, V; Jeekel, H; Latifi, R; Leppaniemi, A; Maier, R V; Marzi, I; Moore, F; Piazzalunga, D; Sakakushev, B; Sartelli, M; Scalea, T; Stahel, P F; Taviloglu, K; Tugnoli, G; Uraneus, S; Velmahos, G C; Wani, I; Weber, D G; Viale, P; Sugrue, M; Ivatury, R; Kluger, Y; Gurusamy, K S; Moore, E E
2016-01-01
Acute calculus cholecystitis is a very common disease with several area of uncertainty. The World Society of Emergency Surgery developed extensive guidelines in order to cover grey areas. The diagnostic criteria, the antimicrobial therapy, the evaluation of associated common bile duct stones, the identification of "high risk" patients, the surgical timing, the type of surgery, and the alternatives to surgery are discussed. Moreover the algorithm is proposed: as soon as diagnosis is made and after the evaluation of choledocholitiasis risk, laparoscopic cholecystectomy should be offered to all patients exception of those with high risk of morbidity or mortality. These Guidelines must be considered as an adjunctive tool for decision but they are not substitute of the clinical judgement for the individual patient. PMID:27307785
Elwood, David R
2008-12-01
Cholecystitis is the most prevalent surgical condition affecting populations in industrialized countries. Rather than a single clinical entity, cholecystitis is a class of related disease states with different causes, degrees of severity, clinical courses, and management strategies. Appropriate care of the patient who has a diseased gallbladder requires a broad understanding of the acute, chronic, and acalculous cholecystitis syndromes, and awareness of their particular clinical nuances and potential complications. PMID:18992593
Technology Transfer Automated Retrieval System (TEKTRAN)
Cholecystitis is an acute or chronic inflammatory disease of the gallbladder that may be classified as calculous or acalculous, based on the presence or absence of gallstones. In developed countries, gallstones occur in 50% to 70% of children who have cholecystitis, but in developing countries, a ca...
Indium-111-leukocyte imaging in acute cholecystitis
Fink-Bennett, D.; Clarke, K.; Tsai, D.; Nuechterlein, P.; Gora, G. )
1991-05-01
Eleven patients with suspected acute cholecystitis underwent sequential {sup 99}mTc-iminodiacetic derivative (IDA) and {sup 111}In-white blood cell (WBC) imaging to determine if {sup 111}In-WBCs accumulate within an acutely inflamed hemorrhagic gallbladder wall and, thus, could be employed as a reasonable alternative to {sup 99}mTc-IDA scintigraphy in detecting acute cholecystitis. Seven patients had surgically confirmed acute cholecystitis. Of these cases, five had a true-positive {sup 99}mTc-IDA and {sup 111}In-WBC, one an indeterminate {sup 111}In-WBC and true-positive {sup 99}mTc-IDA, and one a true-positive {sup 111}In-WBC and false-negative {sup 99}mTc-IDA scan. The remaining four patients did not have acute cholecystitis. All visualized their gallbladder within 1 hr after {sup 99}mTc-IDA administration and none had {sup 111}In-WBC gallbladder wall uptake. Both {sup 111}In-WBC and {sup 99}mTc-IDA scintigraphy accurately detected acute cholecystitis: hepatobiliary scintigraphy demonstrated a cystic duct obstruction and {sup 111}In-WBC imaging detected the inflammatory infiltrate within the gallbladder wall. The sensitivity and specificity of each was 86% and 100%, respectively.
[Endoscopic gallbladder stenting for acute cholecystitis].
Maekawa, Satoshi; Nomura, Ryosuke; Murase, Takayuki; Ann, Yasuyoshi; Oeholm, Masayuki; Harada, Masaru
2014-12-01
Acute cholecystitis is an inflammatory disease of the gallbladder. Inflammation often remains in the gallbladder, but some patients may take a fatal course with exacerbation of inflammation. Although laparoscopic cholecystectomy is recommended for moderate and severe acute cystitis, sometimes cholecystectomy is impossible in elder patients. Because many elder patients have bad general conditions, cholecystectomy should not be performed. Such patients are generally treated by percutaneous transhepatic gallbladder drainage (PTGBD), but PTGBD has the risk of intra-abdominal bleeding. In previous reports, endoscopic gallbladder stenting (EGBS) has been shown to be an effective strategy in cirrhosis patients with symptomatic cholelithiasis as a bridge to transplantation. Recent studies on EGBS have demonstrated an effective long-term management of acute cholecystitis in elderly patients who are poor surgical candidates. Here, we reviewed EGBS for the management of acute cholecystitis.
[Acute cholecystitis in the elderly].
Kunin, N; Letoquart, J P; La Gamma, A; Chaperon, J; Mambrini, A
1994-05-01
We retrospectively studied 150 patients aged over 65 years who had been operated for acute cholecystitis in order to define the surgical results and evaluate this treatment as a function of age. The patients were divided into two groups. Group I included patients between the age of 65 and 79 years, n = 99 (53 males and 46 females). Group II included patients aged 80 years and over, n = 51 (14 males and 37 females). The data were compared with the chi 2 test and the Kruskall and Wallis test. Associated affections were observed in 69 patients in group I and in 36 patients in group II (NS). The clinical picture was similar in the 2 groups with manifestations of pain in the right hypochondral region (group I, n = 97; group II, n = 50), fever (group I, n = 73; group 2, n = 38) and abdominal defence (group I, n = 62; group II, n = 35). Echography revealed the diagnosis in almost all cases in both groups. There was no statistical difference between the two groups in terms of mean operative delay and length of hospital stay. Age increased significantly the risk of exploration of the main bile duct (group I, n = 14; group II, n = 15, p < 0.05). Nevertheless, this exploration did not affect post-operative follow-up. Mortality was 6.7% with 4 deaths in group I and 6% in group II (NS). Post-operative complications were observed in 36 patients in group I and 28 in group II (p < 0.05) (43% overall including deaths).(ABSTRACT TRUNCATED AT 250 WORDS)
Acute and chronic acalculous cholecystitis associated with aortic dissection.
Inagaki, Fuyuki F; Hara, Yoshiaki; Kamei, Masako; Tanaka, Michio; Yasuno, Masamichi
2015-01-01
Acalculous cholecystitis is a rare but life-threatening disease, but its pathogenesis is not fully revealed yet. We experienced two acalculous cholecystitis cases associated with aortic dissection. In Case 1, acalculous cholecystitis occurred just after the exacerbation of the aortic dissection. Laparotomy showed necrotized cholecystitis with fresh thrombi formation. Case 2 developed acalculous cholecystitis on the 65th hospital day of aortic dissection. Laparotomy revealed the perforation of the gallbladder. Histological study revealed fibrosis and hemosiderosis in the subserosal layer. The histological findings of these two patients are quite different: Case 1 is acute ischemic and Case 2 is chronic ischemic. While a few cases of acute ischemic cholecystitis have been reported previously, chronic acalculous cholecystitis (CAC) has not been documented. History of aortic dissection could be a risk factor of acute and CAC due to relatively decreased splanchnic blood flow. PMID:26232599
Computed tomography in acute cholecystitis: new observations
Kane, R.A.; Costello, P.; Duszlak, E.
1983-10-01
The computed tomographic CT findings in five patients with acute cholecystitis were analyzed. Common findings included thickening and nodularity of the gallbladder wall, cholelithiasis, and dilatation of the gallbladder lumen. Other more specific findings included poor definition of the gallbladder wall, pericholecystic fluid collections, and gas collections within the gallbladder wall. Most of the CT findings are suggestive but not pathognomonic, and correlation with the clinical, scintigraphic, and sonographic findings is necessary.
Percutaneous gallbladder aspiration for acute cholecystitis
Rassameehiran, Supannee; Nugent, Kenneth
2016-01-01
Early cholecystectomy for patients with acute cholecystitis may not be possible in some clinical settings. Percutaneous gallbladder aspiration (PGBA) offers an alternative approach, but the benefits and risks of this procedure are unclear. We synthesized data on the outcomes of PGBA in acute cholecystitis patients using data sources from online databases, including MEDLINE and EMBASE, and bibliographies of included studies from January 2000 through December 2015. Two reviewers independently reviewed and critiqued the quality of each study. Seven eligible studies met our criteria. The success rates in single PGBA and repetitive PGBA (2–4 times) were 50% to 93% and 76% to 96%, respectively. Complication rates were 0% to 8% and were unrelated to the size of needle gauge used for aspiration and the number of aspirations. Salvage percutaneous cholecystostomy (PC) and urgent surgery were required in 0% to 43% of patients and 0% to 4% of patients, respectively. Two studies with antibiotic instillation had clinical success rates of 95% and 96%. In conclusion, repetitive PGBA combined with antibiotic instillation and salvage PC are useful alternatives to early cholecystectomy in patients with acute cholecystitis. PMID:27695167
Percutaneous gallbladder aspiration for acute cholecystitis
Rassameehiran, Supannee; Nugent, Kenneth
2016-01-01
Early cholecystectomy for patients with acute cholecystitis may not be possible in some clinical settings. Percutaneous gallbladder aspiration (PGBA) offers an alternative approach, but the benefits and risks of this procedure are unclear. We synthesized data on the outcomes of PGBA in acute cholecystitis patients using data sources from online databases, including MEDLINE and EMBASE, and bibliographies of included studies from January 2000 through December 2015. Two reviewers independently reviewed and critiqued the quality of each study. Seven eligible studies met our criteria. The success rates in single PGBA and repetitive PGBA (2–4 times) were 50% to 93% and 76% to 96%, respectively. Complication rates were 0% to 8% and were unrelated to the size of needle gauge used for aspiration and the number of aspirations. Salvage percutaneous cholecystostomy (PC) and urgent surgery were required in 0% to 43% of patients and 0% to 4% of patients, respectively. Two studies with antibiotic instillation had clinical success rates of 95% and 96%. In conclusion, repetitive PGBA combined with antibiotic instillation and salvage PC are useful alternatives to early cholecystectomy in patients with acute cholecystitis.
Diagnostic utility of cholescintigraphy and ultrasonography in acute cholecystitis
Zeman, R.K.; Burrell, M.I.; Cahow, C.E.; Caride, V.
1981-04-01
When faced with a patient with possible acute cholecystitis, technetium-99m-HIDA scintigraphy should be the primary diagnostic procedure performed. If scintigraphy reveals a normal gallbladder, acute cholecystitis is excluded. If the scintigram fails to visualize the gallbladder, ultrasonography is deemed advisable to exclude potential false-positive scintigrams and confirm the presence of cholelithiasis.
Gallbladder torsion with acute cholecystitis and gross necrosis.
Alkhalili, Eyas; Bencsath, Kalman
2014-01-01
A 92-year-old woman presented to the emergency department with a 2-week history of worsening right-sided abdominal pain. On examination she had right mid-abdominal tenderness. Laboratory studies demonstrated leukocytosis with normal liver function tests. A CT of the abdomen was remarkable for a large fluid collection in the right abdomen and no discernible gallbladder in the gallbladder fossa. An ultrasound confirmed the suspicion of a distended, floating gallbladder. The patient was taken to the operating room for laparoscopic cholecystectomy. The gallbladder was found to have volvulised in a counter -clockwise manner around its pedicle, with gross necrosis of the gallbladder. She underwent laparoscopic cholecystectomy. Pathological examination revealed acute necrotising calculus cholecystitis.
Acute calculous cholecystitis with patent cystic duct
Massie, J.D.; Moinuddin, M.; Phillips, J.C.
1983-07-01
In the diagnosis of acute cholecystitis, the interpretation of cholescintigraphy is usually not difficult. It is conceivable, however, that wth unusual location of obstructing calculi atypical images could result. Three cases were studied with cholescintigraphy and one with cholecystography in which more distal locations of obstructing calculi resulted in partial visualization of the gallbladder and erroneous interpretations were possible. Nuclear medicine radiologists should, therefore, be aware that atypical gallbladder images may be the result of unexpected location of obstructing calculi. Clues for assisting in interpretation are offered.
Unusual presentation of carcinoid tumor as acute cholecystitis
Saxton, C.R.
1983-07-01
The patient described had signs, symptoms, and laboratory data consistent with acute cholecystitis. A sonogram also suggested cholecystitis, and the gallbladder was not displayed by nuclear imaging. Cholecystectomy revealed the absence of stones but showed carcinoid tumor metastatic to the gallbladder.
Laparoscopic Cholecystectomy for Acute Cholecystitis in Elderly Patients
Filho, Euler de Medeiros Ázaro; Galvão, Thales Delmondes; Ettinger, João Eduardo Marques de Menezes; Silva Reis, Jadson Murilo; Lima, Marcos; Fahel, Edvaldo
2006-01-01
Background: Acute cholecystitis is the major complication of biliary lithiasis, for which laparoscopic treatment has been established as the standard therapy. With longer life expectancy, acute cholecystitis has often been seen in elderly patients (>65 years old) and is often accompanied by comorbity and severe complications. We sought to compare the outcome of laparoscopic treatment for acute cholecystitis with special focus on comparison between elderly and nonelderly patients. Method: This study was a prospective analysis of 190 patients who underwent laparoscopic cholecystectomy due to acute cholecystitis or chronic acute cholecystitis, comparing elderly and nonelderly patients. Results: Of 190 patients, 39 (21%) were elderly (>65 years old) and 151 (79%) were not elderly (≤65 years), with conversion rates of 10.3% and 6.6% (P=0.49), respectively. The incidence of postoperative complications in elderly and nonelderly patients were the following, respectively: atelectasis 5.1% and 2.0% (P=0.27); respiratory infection 5.1% and 2.7% (P=0.6); bile leakage 5.1% and 2.0% (P=0.27), and intraabdominal abscess 1 case (0.7%) and no incidence (P=1). Conclusion: According to our data, laparoscopic cholecystectomy is a safe and efficient procedure for the treatment of acute cholecystitis in patients older than 65 years of age. PMID:17575761
Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis
Ohtaka, Kazuto; Shoji, Yasuhito; Ichimura, Tatsunosuke; Fujita, Miri; Senmaru, Naoto; Hirano, Satoshi
2016-01-01
Background and Objectives: Factors that contribute to difficult laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) that would affect the performance of early surgery remain unclear. The purpose of this study was to identify such risk factors. Methods: One hundred fifty-four patients who underwent LC for AC were retrospectively analyzed. The patients were categorized into early surgery and delayed surgery. Factors predicting difficult LC were analyzed for each group. The operation time, bleeding, and cases of difficult laparoscopic surgery (CDLS)/conversion rate were analyzed as an index of difficulty. Analyses of patients in the early group were especially focused on 3 consecutive histopathological phases: edematous cholecystitis (E), necrotizing cholecystitis (N), suppurative/subacute cholecystitis (S). Results: In the early group, the CDLS/conversion rate was highest in necrotizing cholecystitis. Its rate was significantly higher than that of the other 2 histopathological types (N 27.9% vs E and S 7.4%; P = .037). In the delayed-surgery group, a higher white blood cell (WBC) count and older age showed significant correlations with the CDLS/conversion rate (P = .034 and P = .004). Conclusion: In early surgery, histopathologic necrotizing cholecystitis is a risk factor for difficult LC in AC. A higher WBC count and older age are risk factors for delayed surgery.
Cholescintigraphy in acute cholecystitis: use of intravenous morphine
Choy, D.; Shi, E.C.; McLean, R.G.; Hoschl, R.; Murray, I.P.C.; Ham, J.M.
1984-04-01
Conventional cholescintigraphy (60 patients) and a modified protocol (59 patients) were compared in 74 females and 45 males with acute cholecystitis. In the modified protocol, intravenous morphine was administered whenever the gallbladder was not seen 40 minutes after injection of Tc-99m-pyroxylidene-glutamate. Accuracy was 98% with morphine, compared with 88% for the conventional protocol; specificity improved from 83% to 100% with no loss of sensitivity. Low doses of morphine are well tolerated and can result in a highly accurate diagnosis of acute cholecystitis without the need for delayed imaging.
Acute cholecystitis or metastatic renal cell carcinoma? a diagnostic dilemma.
Finkelstein, L H; Coffman, L M
1996-05-01
Renal cell carcinoma is known to metastasize to many different organ systems. Lung and bone are clearly the most common sites of metastasis, but the symptoms at presentation may simulate those of other diseases of the organ system involved. The patient with metastatic renal cell carcinoma described here had symptoms of acute cholecystitis.
Beyazal Polat, Hatice; Beyazal Çeliker, Fatma
2014-01-01
Acute acalculous cholecystitis and acute hemorrhagic cystitis due to Salmonella Typhi are a rare condition. A 24-year-old female patient was admitted to our clinic with abdominal pain, nausea, fever, headache, urinary burning, and bloody urine. Based on clinical, laboratory, and radiological evaluations, the patient was diagnosed with acute acalculous cholecystitis and acute hemorrhagic cystitis due to Salmonella Typhi. The patient was treated with intravenous ceftriaxone for two weeks. After the treatment, the patient's clinical and laboratory findings improved. Acute acalculous cholecystitis due to Salmonella Typhi concomitant with acute hemorrhagic cystitis is very rare and might be difficult to diagnose. Infectious agents such as Salmonella Typhi should be considered when acute acalculous cholecystitis and acute hemorrhagic cystitis are detected in adult patients with no underlying diseases. PMID:25161668
Endoscopic Gallbladder Drainage for Acute Cholecystitis
Widmer, Jessica; Alvarez, Paloma; Sharaiha, Reem Z.; Gossain, Sonia; Kedia, Prashant; Sarkaria, Savreet; Sethi, Amrita; Turner, Brian G.; Millman, Jennifer; Lieberman, Michael; Nandakumar, Govind; Umrania, Hiren; Gaidhane, Monica
2015-01-01
Background/Aims Surgery is the mainstay of treatment for cholecystitis. However, gallbladder stenting (GBS) has shown promise in debilitated or high-risk patients. Endoscopic transpapillary GBS and endoscopic ultrasound-guided GBS (EUS-GBS) have been proposed as safe and effective modalities for gallbladder drainage. Methods Data from patients with cholecystitis were prospectively collected from August 2004 to May 2013 from two United States academic university hospitals and analyzed retrospectively. The following treatment algorithm was adopted. Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and cystic duct stenting was initially attempted. If deemed feasible by the endoscopist, EUS-GBS was then pursued. Results During the study period, 139 patients underwent endoscopic gallbladder drainage. Among these, drainage was performed in 94 and 45 cases for benign and malignant indications, respectively. Successful endoscopic gallbladder drainage was defined as decompression of the gallbladder without incidence of cholecystitis, and was achieved with ERCP and cystic duct stenting in 117 of 128 cases (91%). Successful endoscopic gallbladder drainage was also achieved with EUS-guided gallbladder drainage using transmural stent placement in 11 of 11 cases (100%). Complications occurred in 11 cases (8%). Conclusions Endoscopic gallbladder drainage techniques are safe and efficacious methods for gallbladder decompression in non-surgical patients with comorbidities. PMID:26473125
Hepatobiliary scanning with 99mTc-PIPIDA in acute cholecystitis
Mauro, M.A.; McCartney, W.H.; Melmed, J.R.
1982-01-01
Ninety-five patients with clinically suspected acute cholecystitis underwent hepatobiliary scanning with 99mTc-PIPIDA. A positive scan (nonvisualization of the gallbladder with visualization of the common bile duct and gut) was found in 29 patients; 25 of them (86%) had surgically proven acute cholecystitis and 4 (14%) had chronic cholecystitis. Five of the 25 with acute cholecystitis had acalculous disease. A negative examination (gallbladder visualization) occurred in 63 patients; 18 (29%) had chronic cholecystitis and 45 (71%) were subsequently found to have nonbiliary disease. Three indeterminate studies (nonvisualization of both the gallbladder and gut) were obtained in patients with choledocholithiasis and chronic cholecystitis. In the evaluation of acute cholecystitis, the 99mTc-PIPIDA hepatobiliary scan was 100% sensitive and 94% specific.
Hepatobiliary scanning with /sup 99//sup m/Tc-PIPIDA in acute cholecystitis
Mauro, M.A.; McCartney, W.H.; Melmed, J.R.
1982-01-01
Ninety-five patients with clinically suspected acute cholecystitis underwent hepatobiliary scanning with /sup 99//sup m/Tc-PIPIDA. A positive scan (nonvisualization of the gallbladder with visualization of the common bile duct and gut) was found in 29 patients; 25 of them (86%) had surgically proven acute cholecystitis and 4(14%) had chronic cholecystitis. Five of the 25 with acute cholecystitis had acalculous disease. A negative examination (gallbladder visualization) occurred in 63 patients; 18 (29%) had chronic cholecystitis and 45 (71%) were subsequently found to have nonbiliary disease. Three indeterminate studies (nonvisualization of both the gallbladder and gut) were obtained in patients with choledocholithiasis and chronic cholecystitis. In the evaluation of acute cholecystitis, the /sup 99//sup m/Tc-PIPIDA hepatobiliary scan was 100% sensitive and 94% specific.
Leptospirosis mimicking acute cholecystitis among athletes participating in a triathlon.
Guarner, J; Shieh, W J; Morgan, J; Bragg, S L; Bajani, M D; Tappero, J W; Zaki, S R
2001-07-01
Leptospirosis, a disease acquired by exposure to contaminated water, is characterized by fever accompanied by various symptoms, including abdominal pain. An acute febrile illness occurred in athletes who participated in an Illinois triathlon in which the swimming event took place in a freshwater lake. Of 876 athletes, 120 sought medical care and 22 were hospitalized. Two of the athletes had their gallbladders removed because of abdominal pain and clinical suspicion of acute cholecystitis. We applied an immunohistochemical test for leptospirosis to these gallbladders and demonstrated bacterial antigens staining (granular and filamentous patterns) around blood vessels of the serosa and muscle layer. Rare intact bacteria were seen in 1 case. These results show that leptospirosis can mimic the clinical symptoms of acute cholecystitis. If a cholecystectomy is performed in febrile patients with suspicious environmental or animal exposure, pathologic studies for leptospirosis on formalin-fixed, paraffin-embedded tissues may be of great value.
Laparoscopic management of a cystic artery pseudoaneurysm in a patient with calculus cholecystitis
Loizides, Sofronis; Ali, Asad; Newton, Richard; Singh, Krishna Kumar
2015-01-01
INTRODUCTION Pseudoaneurysm of the cystic artery is very rare. In the majority of cases it has been reported as a post-operative complication of laparoscopic cholecystectomy, however it has also been associated with the presence of acute cholecystitis or pancreatitis. When these pseudoaneurysms rupture they can lead to intraperitoneal bleeding, haemobilia and upper gastrointestinal haemorrhage. Radiological as well as open surgical approaches have been described for control of this rare pathology. PRESENTATION OF CASE We report the laparoscopic surgical management of an incidental, unruptured cystic artery pseudoaneurysm in a patient presenting with acute cholecystitis. DISCUSSION Cystic artery pseudoaneurysm is a rare entity and as such there is no consensus on the clinical management of this condition. A variety of treatment strategies have been reported in the literature including radiological selective embolisation and coiling, open cholecystectomy with ligation of the aneurysm, or a two-step approach involving radiological management of the pseudoaneurysm followed by an elective cholecystectomy. CONCLUSION In this report we have demonstrated that laparoscopic management of a cystic artery pseudoaneurysm with simultaneous laparoscopic cholecystectomy is feasible and safe. This avoids multiple invasive procedures and decreases morbidity associated with open surgery. PMID:26291047
Albarrak, Abdullah A.; Khairy, Sami; Ahmed, Alzahrani Mohammed
2015-01-01
Management of patients who have ventriculoperitoneal shunt presenting with acute calcular cholecystitis has remained a clinical challenge. In this paper, the hospital course and the follow-up of a patient presenting with acute calcular cholecystitis and ventriculoperitoneal shunt managed with laparoscopic cholecystectomy are presented followed by literature review on the management of acute calcular cholecystitis in patients who have ventriculoperitoneal shunts. PMID:26798543
Acute acalculous cholecystitis in systemic lupus erythematosus: a rare initial manifestation.
Manuel, Valdano; Pedro, Gertrudes Maria; Cordeiro, Lemuel Bornelli; de Miranda, Sandra Maria da Rocha Neto
2016-01-01
Acute acalculous cholecystitis is a very rare gastrointestinal manifestation in systemic lupus erythematosus and becomes rarer as an initial manifestation. There are only two cases reported. The authors report a 20-year-old black woman that presented acute acalculous cholecystitis revealed by abdominal computed tomography. During hospitalization, she was diagnosed systemic lupus erythematosus. Conservative treatment with antibiotics was performed with complete remission of the symptoms. Corticosteroid was started in ambulatory. Cholecystectomy has been the treatment of choice in acute acalculous cholecystitis as a complication of systemic lupus erythematosus. The patient responded well to conservative treatment, and surgery was not required. This case is unique in the way that corticosteroid was started in ambulatory care. We should not forget that the acute acalculous cholecystitis can be the initial presentation of systemic lupus erythematosus although its occurrence is very rare. Conservative treatment should be considered. Abdominal computed tomography was a determinant exam for better assessment of acute acalculous cholecystitis. PMID:27267533
Acute acalculous cholecystitis in systemic lupus erythematosus: a rare initial manifestation.
Manuel, Valdano; Pedro, Gertrudes Maria; Cordeiro, Lemuel Bornelli; de Miranda, Sandra Maria da Rocha Neto
2016-01-01
Acute acalculous cholecystitis is a very rare gastrointestinal manifestation in systemic lupus erythematosus and becomes rarer as an initial manifestation. There are only two cases reported. The authors report a 20-year-old black woman that presented acute acalculous cholecystitis revealed by abdominal computed tomography. During hospitalization, she was diagnosed systemic lupus erythematosus. Conservative treatment with antibiotics was performed with complete remission of the symptoms. Corticosteroid was started in ambulatory. Cholecystectomy has been the treatment of choice in acute acalculous cholecystitis as a complication of systemic lupus erythematosus. The patient responded well to conservative treatment, and surgery was not required. This case is unique in the way that corticosteroid was started in ambulatory care. We should not forget that the acute acalculous cholecystitis can be the initial presentation of systemic lupus erythematosus although its occurrence is very rare. Conservative treatment should be considered. Abdominal computed tomography was a determinant exam for better assessment of acute acalculous cholecystitis.
[Toxocarosis and acalculous acute cholecystitis: Consequence or coincidence?].
Strickler, Alexis; Vásquez, Natalia; Maggi, Leonardo; Hernández, Juvenal; Hidalgo, Ximena
2016-06-01
Human toxocarosis is a chronic larval parasitosis listed as one of the five most important neglected diseases by the CDC. The larvae can spread systemically and migrate to different tissues including liver and gallbladder. Acalculous acute cholecystitis (AAC) is a rare disease in children. The diagnosis is based on clinical parameters and imaging criteria. It has been reported in relation to sepsis, shock, trauma, burns, severe systemic diseases, congenital anomalies, infections and also in healthy children. We report a pediatric case of toxocarosis, with clinical symptoms and imaging criteria compatible with AAC treated medically, and discuss the relationship between toxocarosis and AAC based on published evidence.
[Toxocarosis and acalculous acute cholecystitis: Consequence or coincidence?].
Strickler, Alexis; Vásquez, Natalia; Maggi, Leonardo; Hernández, Juvenal; Hidalgo, Ximena
2016-06-01
Human toxocarosis is a chronic larval parasitosis listed as one of the five most important neglected diseases by the CDC. The larvae can spread systemically and migrate to different tissues including liver and gallbladder. Acalculous acute cholecystitis (AAC) is a rare disease in children. The diagnosis is based on clinical parameters and imaging criteria. It has been reported in relation to sepsis, shock, trauma, burns, severe systemic diseases, congenital anomalies, infections and also in healthy children. We report a pediatric case of toxocarosis, with clinical symptoms and imaging criteria compatible with AAC treated medically, and discuss the relationship between toxocarosis and AAC based on published evidence. PMID:27598288
Acute acalculous cholecystitis simulating Mirizzi syndrome: a very rare condition.
Ahlawat, Sushil K
2009-02-01
Mirizzi syndrome, a rare complication of chronic cholelithiasis, is caused by an impacted stone in the cystic duct or the neck of the gallbladder. Patients present with abdominal pain, fever, and obstructive jaundice. The cholangiographic finding is a smooth stricture caused by lateral compression of the common hepatic duct. A similar appearance on cholangiogram can result from carcinoma of the gallbladder, carcinoma of the cystic duct, or hilar adenopathy. Acute acalculous cholecystitis simulating Mirizzi syndrome is extremely rare. This is the report of such a case in which marked inflammatory changes around the neck of the gallbladder likely caused significant mechanical obstruction of the common hepatic duct. PMID:19139716
Kottanattu, Lisa; Lava, Sebastiano A G; Helbling, Rossana; Simonetti, Giacomo D; Bianchetti, Mario G; Milani, Gregorio P
2016-09-01
Acute pancreatitis and acalculous cholecystitis have been occasionally reported in primary acute symptomatic Epstein-Barr virus infection. We completed a review of the literature and retained 48 scientific reports published between 1966 and 2016 for the final analysis. Acute pancreatitis was recognized in 14 and acalculous cholecystitis in 37 patients with primary acute symptomatic Epstein-Barr virus infection. In all patients, the features of acute pancreatitis or acalculous cholecystitis concurrently developed with those of primary acute symptomatic Epstein-Barr virus infection. Acute pancreatitis and acalculous cholecystitis resolved following a hospital stay of 25days or less. Acalculous cholecystitis was associated with Gilbert-Meulengracht syndrome in two cases. In conclusion, this thorough analysis indicates that acute pancreatitis and acalculous cholecystitis are unusual but plausible complications of primary acute symptomatic Epstein-Barr virus infection. Pancreatitis and cholecystitis deserve consideration in cases with severe abdominal pain. These complications are usually rather mild and resolve spontaneously without sequelae. PMID:27434148
Acute acalculous cholecystitis in a patient with juvenile dermatomyositis
Sanches, Bruno Fernandes; Martins, Teresa; Santos, Maria José; Azeredo, Paula
2014-01-01
Juvenile dermatomyositis (JDM) is a rare autoimmune disease, characterised by a systemic capillary vasculopathy that typically affects skin and muscle. Gastrointestinal involvement is relatively rare. We report the case of an 11-year-old girl admitted for investigation of skin rash, progressive symmetric proximal muscle weakness, dysphagia and weight loss. The diagnosis of JDM was confirmed and during hospitalisation the patient developed abrupt and intense right hypocondrium pain associated with nausea and vomiting. Abdominal ultrasound revealed a thick gallbladder wall (8 mm) with pericholecystic fluid and no evidence of gallstones. An acute acalculous cholecystitis was assumed and the patient was started on intravenous fluids, prednisolone and analgaesic therapy. Clinical resolution was verified after 48 h. We hypothesised that the vasculitic process of JDM could have been the basis for this complication as described in other autoimmune diseases. PMID:25239990
Suspected acute cholecystitis. Comparison of hepatobiliary scintigraphy versus ultrasonography
Freitas, J.E.; Mirkes, S.H.; Fink-Bennett, D.M.; Bree, R.L.
1982-08-01
One hundred ninety-five patients with suspected acute cholecystitis (AC) underwent both hepatobiliary scintigraphy (HBS) and static gray-scale ultrasonography (US) to assess the relative value of each imaging modality in this clinical setting. HBS was performed after the intravenous injection of 5 mCi /sup 99m/Tc iprofenin. Abnormal HBS indicative of AC visualized the common bile duct, but not the gallbladder, within 1 to 4 hours after tracer administration. Abnormal US indicative of AC demonstrated cholelithiasis and/or gallbladder wall edema. In this series, HBS surpassed US in sensitivity (98.3% versus 81.4%), specificity (90.2% versus 60.2%), predictive value of an abnormal test (91.4% versus 51.6%), and predictive value of a normal test (100% versus 92%), HBS should be the procedure of choice for the rapid detection of AC.
Miyayama, Shiro Yamashiro, Masashi; Takeda, Taro; Aburano, Hiroyuki; Komatsu, Tetsuya; Sanada, Taku; Kosaka, Shotaro; Toya, Daisyu; Matsui, Osamu
2008-07-15
We report the successful management of acute cholecystitis using cystic duct stent placement in 3 patients with inoperable malignant cystic duct obstruction (2 cholangiocarcinoma and 1 pancreatic carcinoma). All patients underwent stent placement in the bile duct, using an uncovered stent in 2 and a covered stent in 1, to relieve jaundice occurring 8-184 days (mean 120 days) before the development of acute cholecystitis. The occluded cystic duct was traversed by a microcatheter and a stent was implanted 4-17 days (mean 12 days) after cholecystostomy. Acute cholecystitis was improved after the procedure in all patients. Two patients died 3 and 10 months later, while 1 has survived without cholecystitis for 22 months after the procedure to date.
Update on bedside ultrasound (US) diagnosis of acute cholecystitis (AC).
Zenobii, Maria Francesca; Accogli, Esterita; Domanico, Andrea; Arienti, Vincenzo
2016-03-01
Acute cholecystitis (AC) represents a principal cause of morbidity worldwide and is one of the most frequent reasons for hospitalization due to gastroenteric tract diseases. AC should be suspected in presence of clinical signs and of gallstones on an imaging study. Upper abdominal US represents the first diagnostic imaging step in the case of suspected AC. Computed tomography (CT) with intravenous contrast (IV) or magnetic resonance imaging (MRI) with gadolinium contrast and technetium hepatobiliary iminodiacetic acid (Tc-HIDA) can be employed to exclude complications. US examination should be performed with right subcostal oblique, with longitudinal and intercostal scans. Normal gallbladder US findings and AC major and minor US signs are described. Polyps, sludge and gallbladder wall thickening represent the more frequent pitfalls and they must be differentiated from stones, duodenal artifacts and many other non-inflammatory conditions that cause wall thickening, respectively. By means of bedside ultrasound, the finding of gallstones in combination with acute pain, when the clinician presses the gallbladder with the US probe (the sonographic Murphy's sign), has a 92.2 % positive predictive value for AC. In our preliminary experience, bedside US-performed by echoscopy (ES) and/or point-of-care US (POCUS) demonstrated good reliability in detecting signs of AC, and was always integrated with physical examination and performed by a skilled operator.
Acute acalculous cholecystitis and cardiovascular disease: a land of confusion.
Tana, Marco; Tana, Claudio; Cocco, Giulio; Iannetti, Giovanni; Romano, Marcello; Schiavone, Cosima
2015-12-01
Acute acalculous cholecystitis (AAC) can be defined as acute inflammatory disease of the gallbladder without evidence of gallstones. The first case was reported in 1844 by Duncan et al.; however, some cases may have been missed previously in view of the complexity of the diagnosis. Several risk factors have been identified, and cardiovascular disease (CVD), in view of its multiple mechanisms of action, seems to play a key role. Atypical clinical onset, paucity of symptoms, overlap with comorbidities, and lack of robust, controlled trials result often in under or misdiagnosed cases. Moreover, laboratory results may be negative or not specific in the late stage of the disease, when a surgical treatment cannot be longer helpful if complications arise. A rapid diagnosis is therefore essential to achieve a prompt treatment and to avoid further clinical deterioration. In this short review, we would present the current evidence regarding epidemiology, pathophysiology, and clinical presentation of the complex relation between AAC and CVD. Then, we fully emphasize the role of ultrasound to achieve an early diagnosis and an appropriate treatment in suspected cases, reducing mortality and complications rates.
Percutaneous Cholecystostomy for Patients with Acute Cholecystitis and an Increased Surgical Risk
Overhagen, Hans van; Meyers, Hjalmar; Tilanus, Hugo W.; Jeekel, Johannes; Lameris, Johan S.
1996-03-15
Purpose: To evaluate percutaneous cholecystostomy in patients with acute cholecystitis and an increased surgical risk. Methods: Thirty-three patients with acute cholecystitis (calculous, n= 22; acalculous, n= 11) underwent percutaneous cholecystostomy by means of a transhepatic (n= 21) or transperitoneal (n= 12) access route. Clinical and laboratory parameters were retrospectively studied to determine the benefit from cholecystostomy. Results: All procedures were technically successful. Twenty-two (67%) patients improved clinically within 48 hr; showing a significant decrease in body temperature (n= 13), normalization of the white blood cell count (n= 3), or both (n= 6). There were 6 (18%) minor/moderate complications (transhepatic access, n= 3; transperitoneal access, n= 3). Further treatment for patients with calculous cholecystitis was cholecystectomy (n= 9) and percutaneous and endoscopic stone removal (n= 8). Further treatment for patients with acalculous cholecystitis was cholecystectomy (n= 2) and gallbladder ablation (n= 2). There were 4 deaths (12%) either in hospital or within 30 days of drainage; none of the deaths was procedure-related. Conclusions: Percutaneous cholecystostomy is a safe and effective procedure for patients with acute cholecystitis. For most patients with acalculous cholecystitis percutaneous cholecystostomy may be considered a definitive therapy. In calculous disease this treatment is often only temporizing and a definitive surgical, endoscopic, or radiologic treatment becomes necessary.
Morphine-augmented cholescintigraphy in the diagnosis of acute cholecystitis
Kim, E.E.; Pjura, G.; Lowry, P.; Nguyen, M.; Pollack, M.
1986-12-01
Cholescintigraphy is a sensitive procedure for diagnosing or excluding acute cholecystitis. However, when rapid diagnosis is critical, the requirement for delayed images (4 hr or more after injection) to minimize the false-positive rate diminishes its utility. We prospectively evaluated 40 cholescintigraphic examinations that did not visualize the gallbladder 1 hr after injection of 99mTc diisopropyliminodiacetic acid. These examinations were then augmented by administration of IV morphine, followed by an additional 30 min of imaging. After the morphine, 18 of these examinations demonstrated visualization of the gallbladder; none subsequently required surgical exploration. Of the remaining 22, who demonstrated persistent nonvisualization of the gallbladder post-morphine, 11 were explored surgically and found to be abnormal. The 11 others were treated medically. Low-dose morphine administered when the gallbladder fails to visualize after 1 hr is a useful adjunct to conventional cholescintigraphy because it reduces the time required to obtain a diagnostic result and decreases the number of false-positive results.
Kim, Jung-Chul; Jin, Hye-Mi; Cho, Young-Nan; Kwon, Yong-Soo; Kee, Seung-Jung; Park, Yong-Wook
2015-05-01
Mucosal-associated invariant T (MAIT) cells and natural killer T (NKT) cells are known to play crucial roles in a variety of diseases, including autoimmunity, infectious diseases, and cancers. However, little is known about the roles of these invariant T cells in acute cholecystitis. The purposes of this study were to examine the levels of MAIT cells and NKT cells in patients with acute cholecystitis and to investigate potential relationships between clinical parameters and these cell levels. Thirty patients with pathologically proven acute cholecystitis and 47 age- and sex-matched healthy controls were enrolled. Disease grades were classified according to the revised Tokyo guidelines (TG13) for the severity assessment for acute cholecystitis. Levels of MAIT and NKT cells in peripheral blood were measured by flow cytometry. Circulating MAIT and NKT cell numbers were significantly lower in acute cholecystitis patients than in healthy controls, and these deficiencies in MAIT cells and NKT cell numbers were associated with aging in acute cholecystitis patients. Notably, a reduction in NKT cell numbers was found to be associated with severe TG13 grade, death, and high blood urea nitrogen levels. The study shows numerical deficiencies of circulating MAIT and NKT cells and age-related decline of these invariant T cells. In addition, NKT cell deficiency was associated with acute cholecystitis severity and outcome. These findings provide an information regarding the monitoring of these changes in circulating MAIT and NKT cell numbers during the course of acute cholecystitis and predicting prognosis.
Ferahman, Sina; Demiryas, Süleyman; Samanci, Cesur
2016-01-01
Pseudoaneurysm of a cystic artery is a rare entity that commonly occurs secondary to biliary procedures. Most of the cases in literature are consisted of ruptured aneurysms and to our knowledge, except our case, there were only 3 cases with unruptured aneurysms, which incidentally were detected by radiological methods. When cystic artery pseudoaneurysm is present with acute cholecystitis, most of the reports in literature suggested open cholecystectomy with the ligation of the cystic artery as a main treatment option. In this paper we present a case of acute cholecystitis with unruptured cystic artery pseudoaneurysm that incidentally was detected by computed tomography (CT). Cystic artery pseudoaneurysm was handled laparoscopically with simultaneous cholecystectomy. Due to high risk of rupture, surgeons have evaded laparoscopic approach to acute cholecystitis, which accompanied cystic artery pseudoaneurysm. However herein, we proved that laparoscopic management of cystic artery pseudoaneurysm with simultaneous cholecystectomy is feasible and reliable method. PMID:27635274
Surgical management of acute cholecystitis. Results of a nation-wide survey among Spanish surgeons.
Badia, Josep M; Nve, Esther; Jimeno, Jaime; Guirao, Xavier; Figueras, Joan; Arias-Díaz, Javier
2014-10-01
There is a wide variability in the management of acute cholecystitis. A survey among the members of the Spanish Association of Surgeons (AEC) analyzed the preferences of Spanish surgeons for its surgical management. The majority of the 771 responders didn't declare any subspecialty (41.6%), 21% were HPB surgeons, followed by colorectal and upper-GI specialities. Early cholecystectomy during the first admission is the preferred method of management of 92.3% of surgeons, but only 42.7% succeed in adopting this practice. The most frequent reasons for changing their preferred practice were: Patients not fit for surgery (43.6%) and lack of availability of emergency operating room (35.2%). A total of 88.9% perform surgery laparoscopically. The majority of AEC surgeons advise index admission cholecystectomy for acute cholecystitis, although only half of them succeed in its actual implementation. There is room for improvement in the management of acute cholecystitis in Spanish hospitals.
Alis, Deniz; Ferahman, Sina; Demiryas, Süleyman; Samanci, Cesur; Ustabasioglu, Fethi Emre
2016-01-01
Pseudoaneurysm of a cystic artery is a rare entity that commonly occurs secondary to biliary procedures. Most of the cases in literature are consisted of ruptured aneurysms and to our knowledge, except our case, there were only 3 cases with unruptured aneurysms, which incidentally were detected by radiological methods. When cystic artery pseudoaneurysm is present with acute cholecystitis, most of the reports in literature suggested open cholecystectomy with the ligation of the cystic artery as a main treatment option. In this paper we present a case of acute cholecystitis with unruptured cystic artery pseudoaneurysm that incidentally was detected by computed tomography (CT). Cystic artery pseudoaneurysm was handled laparoscopically with simultaneous cholecystectomy. Due to high risk of rupture, surgeons have evaded laparoscopic approach to acute cholecystitis, which accompanied cystic artery pseudoaneurysm. However herein, we proved that laparoscopic management of cystic artery pseudoaneurysm with simultaneous cholecystectomy is feasible and reliable method. PMID:27635274
Ferahman, Sina; Demiryas, Süleyman; Samanci, Cesur
2016-01-01
Pseudoaneurysm of a cystic artery is a rare entity that commonly occurs secondary to biliary procedures. Most of the cases in literature are consisted of ruptured aneurysms and to our knowledge, except our case, there were only 3 cases with unruptured aneurysms, which incidentally were detected by radiological methods. When cystic artery pseudoaneurysm is present with acute cholecystitis, most of the reports in literature suggested open cholecystectomy with the ligation of the cystic artery as a main treatment option. In this paper we present a case of acute cholecystitis with unruptured cystic artery pseudoaneurysm that incidentally was detected by computed tomography (CT). Cystic artery pseudoaneurysm was handled laparoscopically with simultaneous cholecystectomy. Due to high risk of rupture, surgeons have evaded laparoscopic approach to acute cholecystitis, which accompanied cystic artery pseudoaneurysm. However herein, we proved that laparoscopic management of cystic artery pseudoaneurysm with simultaneous cholecystectomy is feasible and reliable method.
State of the art in the diagnosis and management of acute cholecystitis.
Reiss, R; Deutsch, A A
1993-01-01
The analysis of 664 cases operated upon for acute cholecystitis as well as a review of the literature indicate the dramatic increase in the age of patients presenting with this complication. Other obvious changes: increasing rate of diabetes mellitus and acalculous cholecystitis. The development of preoperative and operative sonography has contributed greatly to the safety of surgery for acute cholecystitis. The majority of patients classified as having low risks should, at the present state of our knowledge, undergo early and definitive surgery. This approach has shown to be the most beneficial from both the medical and economic standpoint. High risk patients as well as patients refusing surgery are optimally treated by sonar-guided percutaneous transhepatic cholecystostomy. Among the recent changes observed over the last 5 years, a marked decrease in septic complications as well as in the length of hospital stay was noted. Both changes improve the cost-benefit ratio of early surgery in this condition.
First report of acute cholecystitis with sepsis caused by Cellulomonas denverensis.
Ohtaki, Hirofumi; Ohkusu, Kiyofumi; Sawamura, Haruki; Ohta, Hirotoshi; Inoue, Rina; Iwasa, Junpei; Ito, Hiroyasu; Murakami, Nobuo; Ezaki, Takayuki; Moriwaki, Hisataka; Seishima, Mitsuru
2009-10-01
Cellulomonas denverensis is a small and thin gram-positive rod-shaped bacterium that was proposed as a new species in 2005. Here we report a female case of acute cholecystitis and sepsis in which C. denverensis was determined to be causative.
Determination of optimal operation time for the management of acute cholecystitis: a clinical trial
Ucar, Ahmet Deniz; Yakan, Savas; Carti, Erdem Baris; Coskun, Ali; Erkan, Nazif; Yildirim, Mehmet
2014-01-01
Introduction Although all studies have reported that laparoscopic cholecystectomy (LC) is a safe and effective treatment for acute cholecystitis, the optimal timing for the procedure is still the subject of some debate. Aim This retrospective analysis of a prospective database was aimed at comparing early with delayed LC for acute cholecystitis. Material and methods The LC was performed in 165 patients, of whom 83 were operated within 72 h of admission (group 1) and 82 patients after 72 h (group 2) with acute cholecystitis between January 2012 and August 2013. All data were collected prospectively and both groups compared in terms of age, sex, fever, white blood count count, ultrasound findings, operation time, conversion to open surgery, complications and mean hospital stay. Results The study included 165 patients, 53 men and 112 women, who had median age 54 (20–85) years. The overall conversion rate was 27.9%. There was no significant difference in conversion rates (21% vs. 34%) between groups (p = 0.08). The operation time (116 min vs. 102 min, p = 0.02) was significantly increased in group 1. The complication rates (9% vs. 18%, p = 0.03) and total hospital stay (3.8 days vs. 7.9 days, p = 0.001) were significantly reduced in group 1. Conclusions Early LC within 72 h of admission reduces complications and hospital stay and is the preferred approach for acute cholecystitis. PMID:25097711
Evaluation of affecting factors for conversion to open cholecystectomy in acute cholecystitis
Ucar, Ahmet Deniz; Aydogan, Serdar; Sari, Erdem; Erkan, Nazif; Yildirim, Mehmet
2014-01-01
Introduction Laparoscopic cholecystectomy has become the gold standard for the surgical treatment of gallbladder disease. Severe inflammation makes laparoscopic dissection technically more demanding in acute cholecystitis. Conversion to open cholecystectomy due to adverse conditions is still required in some patients. Aim To evaluate predictive risk factors associated with conversion to open cholecystectomy in acute cholecystitis. Material and methods A retrospective analysis was performed on 165 patients who underwent a laparoscopic cholecystectomy for acute cholecystitis in our clinic. Patients who completed laparoscopic cholecystectomy and required conversion to open cholecystectomy were compared in terms of age, sex, fever, laboratory and USG findings, operation timing, complications, and duration of hospital stay. Results There were 53 (32%) male and 112 (68%) female patients; the mean age was 52.4 ±12.5 years. Forty-six (27.9%) of the 165 patients were converted to open cholecystectomy. Male sex of the patients who underwent conversion (47.1%) was found to be statistically significant (p < 0.001). Preoperative white blood count, blood glucose and amylase values, morbidity rate, and hospital stay were raised in patients who underwent conversion, and all were found to be statistically significant (p < 0.05). Conclusions Male sex, blood leucocyte, glucose, and raised amylase emerged as the effective factors for conversion cholecystectomy in our study. These factors should help the clinical decision-making process when planning laparoscopic cholecystectomy in acute cholecystitis. By predicting these risk factors for conversion, preoperative patient counselling can be improved. PMID:25653728
Signal Intensity of Superb Microvascular Imaging Correlates with the Severity of Acute Cholecystitis
Tomizawa, Minoru; Shinozaki, Fuminobu; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki
2016-01-01
Evaluation of the severity of acute cholecystitis is critical for the management of this condition. Superb microvascular imaging (SMI) enables the assessment of slow blood flow of small vessels without any contrast medium. An 84-year-old man visited our hospital with right upper abdominal pain. Computed tomography and abdominal ultrasonography showed a slight thickening of the gallbladder. White blood cell count and C-reactive protein levels were elevated. He was diagnosed with acute cholecystitis and treated conservatively with antibiotics. Two days later, his condition worsened and percutaneous transhepatic gallbladder drainage (PTGBD) was performed. The patient recovered and was discharged, and his drainage was withdrawn 7 days later. On admission, color-coded SMI (cSMI) showed pulsatory signals on the slightly thickened gallbladder wall. On the day of PTGBD, the intensity of the signal on cSMI had increased. Once the patient was cured, no further signal was observed on the gallbladder wall with either cSMI or mSMI. In conclusion, the strong pulsatory signal correlated with the severity of acute cholecystitis observed with cSMI and mSMI. Illustrating the signal intensity is useful for the evaluation of the severity of acute cholecystitis. PMID:27721732
First Report of Acute Cholecystitis with Sepsis Caused by Cellulomonas denverensis▿
Ohtaki, Hirofumi; Ohkusu, Kiyofumi; Sawamura, Haruki; Ohta, Hirotoshi; Inoue, Rina; Iwasa, Junpei; Ito, Hiroyasu; Murakami, Nobuo; Ezaki, Takayuki; Moriwaki, Hisataka; Seishima, Mitsuru
2009-01-01
Cellulomonas denverensis is a small and thin gram-positive rod-shaped bacterium that was proposed as a new species in 2005. Here we report a female case of acute cholecystitis and sepsis in which C. denverensis was determined to be causative. PMID:19656981
Ergas, David; Abdul-Hai, Ali; Sthoeger, Zev Moshe
2008-10-01
We report here a patient with acute Q fever-related acalculous cholecystitis, who presented with prolonged fever, valvular abnormalities, and positive serology for Q fever phase 1 antigens, features suggesting chronic Q fever endocarditis. The pathogenesis of this rare presentation of Q fever is discussed. PMID:18854682
Peñas-Herrero, Irene; de la Serna-Higuera, Carlos; Perez-Miranda, Manuel
2015-01-01
Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has been introduced as an alternative to percutaneous transhepatic gallbladder drainage for the treatment of acute cholecystitis in non-surgical candidates. A systematic review of the English language literature through PubMed search until June 2014 was conducted. One hundred and fifty-five patients with acute cholecystitis treated with EUS-GBD in eight studies and 12 case reports, and two patients with EUS-GBD for other causes were identified. Overall, technical success was obtained in 153 patients (97.45%) and clinical success in 150 (99.34%) patients with acute cholecystitis. Adverse events developed in less than 8% of patients, all of them managed conservatively. EUS-GBD has been performed with plastic stents, nasobiliary drainage tubes, standard or modified tubular self-expandable metal stents (SEMS) and lumen-apposing metal stents (LAMS) by different authors with apparently similar outcomes. No comparison studies between stent types for EUS-GBD have been reported. EUS-GBD is a promising novel alternative intervention for the treatment of acute cholecystitis in high surgical risk patients. Feasibility, safety and efficacy in published studies from expert centers are very high compared to currently available alternatives. Further studies are needed to establish the safety and long-term outcomes of this procedure in other practice settings before EUS-GBD can be widely disseminated.
A rare case of listeriosis, acute cholecystitis and multiple myeloma
Polanco, Thais O.; Alothman, Sara; Depaz, Hector; Ramcharan, Alexius
2016-01-01
Listeria monocytogenes (LM) is an aerobic, motile, intracellular gram-positive bacterium. Most invasive systemic infections caused by LM are commonly seen in patients at both extremes of age, during pregnancy or in immunocompromised hosts. Common clinical manifestations of LM infection in immunocompromised adults are bacteremia, infections of central nervous system, such as meningitis, and self-limiting febrile gastroenteritis. Focal infections of listeria are rare, especially cholecystitis, with only few cases reported in the last 33 years. A 62-year-old man presented with multiple myeloma, cholecystitis and LM bacteremia. Due to prompt surgical treatment and antibiotics (amoxicillin plus clavulanic acid and gentamycin), this high-risk patient recovered without any complications. PMID:27170703
Acute Cholecystitis Following Total Knee Replacement: A Case Report and Literature Review
Ghalimah, Bayan; Hamdi, Amre
2016-01-01
Introduction: Infection poses a substantial challenge after joint replacement. Case Presentation: We report a 53-year-old female with multiple co-morbidities, who underwent unilateral total knee arthroplasty. Her postoperative course was complicated by acute cholecystitis necessitating cholecystectomy. Conclusion: In patients who require joint replacement surgery, careful and detailed preoperative assessment is important to identify those at risk for this complication in order to provide timely treatment. PMID:27703950
Acute Cholecystitis with Significantly Elevated Levels of Serum Carbohydrate Antigen 19-9
Akimoto, Shuji; Banshodani, Masataka; Nishihara, Masahiro; Nambu, Junko; Kawaguchi, Yasuo; Shimamoto, Fumio; Dohi, Kiyohiko; Sugino, Keizo; Ohdan, Hideki
2016-01-01
Serum carbohydrate antigen 19-9 (CA 19-9), a marker of malignant tumors, is generally slightly elevated in benign conditions. We report a case of acute cholecystitis with a significantly elevated level of serum CA 19-9 based on positron emission tomography (PET)-computed tomography (CT) findings. A 65-year-old woman presented with abdominal pain and fever. A CT image revealed an enlarged gallbladder without tumor shadows. The C-reactive protein (CRP) level was elevated to 7.66 mg/dl. Moreover, the serum CA 19-9 level was significantly elevated to 19,392 U/ml. We started antibiotic treatment, because we suspected acute cholecystitis, but still, we could not ignore the possible presence of malignant tumors. After 11 days of antibiotic treatment, serum CRP and CA 19-9 levels decreased to 0.11 mg/dl and 1,049 U/ml, respectively. There was an accumulation of fluorine 18-labeled fluorodeoxyglucose (maximum standardized uptake value, 9.3) without tumor shadows in the liver, near the gallbladder, on the PET-CT examination. We considered the possibility that the inflammation had spread from the gallbladder to the liver, made a diagnosis of acute cholecystitis, and performed a cholecystectomy 33 days after treatment initiation. The serum CA 19-9 level decreased to 45 U/ml after the surgery. One year after the surgery, the patient was alive, and the serum CA 19-9 level was 34 U/ml. Acute cholecystitis with a significantly high elevation of the serum CA 19-9 level is rare. In such cases, it is important to confirm the change in the serum CA 19-9 level over time after antibiotic treatment and perform imaging studies to distinguish between inflammation and malignancy. PMID:27721726
[Treatment of acute cholecystitis in a third-trimester pregnant women].
Eller, Asger; Shim, Susy; Sigvardt, Louise; Rask, Peter; Nielsen, Michael Festersen
2016-04-18
This case report describes a 35-year-old female with acute cholecystitis 36 weeks into her pregnancy. Laparoscopic cholecystectomy was assessed not to be possible. An ultrasonic guided percutaneous transhepatic gall bladder drainage was performed resulting in immediate pain relief. The patient was discharged two days later, and the drain sat in place until a caesarian section was per--formed. A post-surgery cholangiography demonstrated stones in the gall bladder but no stones in the common bile duct. An uneventful laparoscopic cholecystectomy was carried out three months after surgery. The case report demonstrates that percutaneous transhepatic gall bladder drainage is a safe procedure to be considered in women with cholecystitis in which cholecystectomy is not possible or assumed to be associated with an unacceptable high risk. PMID:27094635
Gumus, Burcak
2011-04-15
Purpose: The purpose of this article was to share midterm results of percutaneous cholecystostomy (PC) as a first-line therapy in chronic hemodialysis patients with acute cholecystitis. Methods: Fourteen chronic hemodialysis patients with acute cholecystitis underwent PC between March 2007 and May 2009 at our institute. On preoperative assessment, the patients were classified into the ASA score by the anesthesiology team. All patients were class IV because of severe underlying comorbidities. The patients were referred to interventional radiology unit for PC by consensus of the multidisciplinary team. Results: The PC was technically successful in all the patients without minor or major complications related to the procedure. Clinical symptoms in three patients who presented with sepsis and multiorgan failure did not resolve after PC, and these patients died following urgent surgery, including open cholecystectomy and common bile duct exploration. A new cholecystitis attack was detected in one patient in the acalculous group at the sixth month of the follow-up period. The mean catheterization time was 31.7 (range, 28-41) days. The mean follow-up time was 13.3 (range 4-21) months. Conclusions: The PC may come into consideration as a first-line treatment modality in the management of acute cholecystitis in poor surgical candidate chronic hemodialysis patients. This is the first report focusing on the midterm results of PC as a first-line therapy in hemodialysis patients with acute cholecystitis who could be operated on.
Kaida, Shogo; Arahata, Kyouko; Itou, Asako; Takarabe, Sakiko; Kimura, Kayoko; Kishikawa, Hiroshi; Nishida, Jiro; Fujiyama, Yoshiki; Takigawa, Yutaka; Matsui, Junichi
2016-09-01
A cystic artery aneurysm is a rare cause of hemobilia. Herein, we report two cases of acute cholecystitis with a ruptured cystic artery pseudoaneurysm. Two patients (a 69-year-old man and an 83-year-old man) were admitted to our hospital because of acute cholecystitis with gallstone impaction in the neck. Percutaneous transhepatic gallbladder drainage (PTGBD) was performed for both patients. After a few days of PTGBD, gallbladder hemorrhage was observed. Abdominal angiography showed cystic artery aneurysm. A transcatheter arterial embolization was therefore performed, followed by an open cholecystectomy. PMID:27593367
Rodríguez-Sanjuán, Juan C.; Martín-Acebes, Fernando; Llorca-Díaz, Francisco J.; Gómez-Fleitas, Manuel; Zambrano Muñoz, Rocío; Sánchez-Manuel, F. Javier
2016-01-01
Objective. To evaluate if early cholecystectomy (EC) is the most appropriate treatment for acute cholecystitis compared to delayed cholecystectomy (DC). Patients and Methods. A retrospective cohort study of 1043 patients was carried out, with a group of 531 EC cases and a group of 512 DC patients. The following parameters were recorded: (1) postoperative hospital morbidity, (2) hospital mortality, (3) days of hospital stay, (4) readmissions, (5) admission to the Intensive Care Unit (ICU), (6) type of surgery, (7) operating time, and (8) reoperations. In addition, we estimated the direct cost savings of implementing an EC program. Results. The overall morbidity of the EC group (29.9%) was significantly lower than the DC group (38.7%). EC demonstrated significantly better results than DC in days of hospital stay (8.9 versus 15.8 days), readmission percentage (6.8% versus 21.9%), and percentage of ICU admission (2.3% versus 7.8%), which can result in reducing the direct costs. The patients who benefited most from an EC were those with a Charlson index > 3. Conclusions. EC is safe in patients with acute cholecystitis and could lead to a reduction in the direct costs of treatment. PMID:27803512
Gallbladder Metastasis of Non-small Cell Lung Cancer Presenting as Acute Cholecystitis.
Jeong, Yu-Sook; Han, Hye-Suk; Lim, Sung-Nam; Kim, Mi-Jin; Han, Joung-Ho; Kang, Min-Ho; Ryu, Dong-Hee; Lee, Ok-Jun; Lee, Ki-Hyeong; Kim, Seung-Taik
2012-09-01
Although non-small cell lung cancer (NSCLC) can metastasize to almost any organ, metastasis to the gallbladder with significant clinical manifestation is relatively rare. Here, we report a case of gallbladder metastasis of NSCLC presenting as acute cholecystitis. A 79-year-old man presented with pain in the right upper quadrant and fever. A computed tomography (CT) scan of the chest and abdomen showed a cavitary mass in the right lower lobe of the lung and irregular wall thickening of the gallbladder. Open cholecystectomy and needle biopsy of the lung mass were performed. Histological examination of the gallbladder revealed a moderately-differentiated squamous cell carcinoma displaying the same morphology as the lung mass assessed by needle biopsy. Subsequent immunohistochemical examination of the gallbladder and lung tissue showed that the tumor cells were positive for P63 but negative for cytokeratin 7, cytokeratin 20 and thyroid transcription factor-1. A second primary tumor of the gallbladder was excluded by immunohistochemical methods, and the final pathological diagnosis was gallbladder metastasis of NSCLC. Although the incidence is extremely rare, acute cholecystitis can occur in association with lung cancer metastasis to the gallbladder. PMID:23358590
Weissmann, H.S.; Gold, M.; Goldstein, R.D.; Sugarman, L.A.; Freeman, L.M.
1981-09-01
An unusual case of malignant degeneration of a choledochal cyst is presented. The presence of acute cholecystitis with the cystic duct originating from the cyst as well as the subsequent obstruction of the cyst-jejunal surgical anastomosis was readily detected with Tc-99m-dimethyl-iminodiacetic (Tc-99m-HIDA) cholescintigraphy.
Ejduk, Anna; Wróblewski, Tadeusz; Szczepanik, Andrzej B.
2014-01-01
Acute acalculous cholecystitis (ACC) is most frequently reported in critically ill patients following sepsis, extensive injury or surgery. It is rather uncommon as a chemotherapy-induced complication, which is usually life-threatening in neutropenic patients subjected to myelosuppressive therapy. A 23-year-old patient with acute lymphoblastic leukemia was subjected to myelosuppressive chemotherapy (cyclophosphamide, cytarabine, pegaspargase). After the first chemotherapy cycle the patient was neutropenic and feverish; she presented with vomiting and pain in the right epigastrium. Ultrasound demonstrated an acalculous gallbladder with wall thickening up to 14 mm. The ACC was diagnosed. Medical therapy included a broad spectrum antibiotic regimen and granulocyte-colony stimulating factors. On the second day after ACC diagnosis the patient's general condition worsened. Laparoscopic cholecystectomy was performed. The resected gallbladder showed no signs of bacterial or leukemic infiltrates. The postoperative course was uneventful. In the management of neutropenic patients with ACC surgical treatment is as important as pharmacological therapy. PMID:25337176
... that forms in the wall of the gallbladder) Pancreatitis (inflamed pancreas) Persistent bile duct blockage Inflammation of ... draining the liver (may occur after gallbladder surgery) Pancreatitis Perforation Peritonitis (inflammation of the lining of the ...
Acute Acalculous Cholecystitis by Epstein-Barr Virus Infection: A Rare Association
Vieira, Maria; Couto, Cristiana; Coelho, Maria D.; Laranjeira, Carla
2015-01-01
Acute acalculous cholecystitis (AAC) is a rare complication of Epstein Barr virus (EBV) infection, with only a few cases reported among pediatric population. This clinical condition is frequently associated with a favorable outcome and, usually, a surgical intervention is not required. We report a 16-year-old girl who presented with AAC following primary EBV infection. The diagnosis of AAC was documented by clinical and ultrasonographic examination, whereas EBV infection was confirmed serologically. A conservative treatment was performed, with a careful monitoring and serial ultrasonographic examinations, which led to the clinical improvement of the patient. Pediatricians should be aware of the possible association between EBV and AAC, in order to offer the patients an appropriate management strategy. PMID:26753086
Liu, Feng-Lin; Li, He; Wang, Xue-Fei; Shen, Kun-Tang; Shen, Zhen-Bin; Sun, Yi-Hong; Qin, Xin-Yu
2014-01-01
Acute acalculous cholecystitis (AAC) is a rare complication of gastric surgery. The most commonly accepted concepts regarding its pathogenesis are bile stasis, sepsis and ischemia, but it has not been well described how to identify and manage this disease in the early stage. We report three cases of AAC in elderly patients immediately after gastric surgery, which were treated with three different strategies. One patient died 42 d after emergency cholecystectomy, and the other two finally recovered through timely cholecystostomy and percutaneous transhepatic gallbladder drainage, respectively. These cases informed us of the value of early diagnosis and proper treatment for perioperative AAC after gastric surgery. We further reviewed reported cases of AAC immediately after gastric operation, which may expand our knowledge of this disease. PMID:25132787
Choi, Jun-Ho; Lee, Sang Soo
2015-01-01
With the evolution of the linear echoendoscope and the improved ability to direct a needle within the field of interest, the therapeutic potential of endoscopic ultrasonography (EUS) has greatly expanded. Endoscopic ultrasonography-guided transmural gallbladder drainage (EUS-GBD) may be the next frontier for therapeutic EUS. Since EUS-GBD was first described in 2007, recent reports have suggested it as an alternative to external gallbladder drainage for acute cholecystitis. EUS-GBD includes EUS-guided transmural nasogallbladder drainage, EUS-guided gallbladder aspiration, and EUS-guided transmural gallbladder stenting. Indications for the EUS-GBD technique as currently practiced, including equipment, technical details, complications, and efficacy are herein reviewed.
Acute acalculous cholecystitis caused by Hepatitis C: A rare case report
Omar, Ahmed; Osman, Medhet; Bonnet, Gerard; Ghamri, Nafiz
2015-01-01
Introduction Acute acalculous cholecystitis (AAC) is rarely encountered in clinical practice and has a high morbidity and mortality. AAC caused by viral hepatitis, with hepatitis A, B and EBV infections are rare, but well documented in the literature. Hepatitis C virus has not been reported as cause of AAC. This case report documents the first case of AAC associated with Acute Hepatitis C. Presenting concerns We present a 40 years old female with abdominal pain. She has a history of previous HCV infection. Her liver function tests were markedly deranged with elevated inflammatory markers. USS scan showed rather a very unusual appearance of an inflamed gallbladder with no gallstones and associated acute hepatitis, confirmed by an abdominal CT scan. HCV RNA PCR confirms flair up of the virus. The patient was managed conservatively in the hospital with follow up USS scan and Liver function tests showed complete recovery. Follow up HCV RNA PCR also returned to an undetectable level. The patient recovered completely with no adverse outcomes. Conclusion This case report is to the first to document the association between acute HCV and AAC. Despite being uncommon in western countries, viral hepatitis should be suspected as a causative agent of AAC, particularly when there is abnormal liver function test and no biliary obstruction. PMID:26722714
Yazıcı, Pınar; Demir, Uygar; Bozdağ, Emre; Bozkurt, Emre; Işıl, Gürhan; Bostancı, Özgür; Mihmanlı, Mehmet
2015-01-01
Objective: The red blood cell distribution width (RDW) has recently been used as a marker to predict outcome in various patient groups. In this study, we aimed to examine how RDW is influenced during the treatment and follow-up of cases of acute cholecystitis which is a common inflammatory disease. Material and Methods: Seventy-two patients who were treated for acute cholecystitis, were included into the study. The demographic data, leukocyte count, RDW, C-reactive protein (CRP) values and treatment protocols of these patients were prospectively recorded. The patients who received medical treatment for acute cholecystitis (Group A, n=33) and those who underwent surgery (Group B, n=39) were examined in separate groups. Results: There were 27 male and 45 female patients with a mean age of 50.1±18 years (min-max: 21-94). In Group B, 33 patients underwent laparoscopic cholecystectomy, whereas 6 patients underwent open cholecystectomy. The RDW values on admission were not significantly different between two groups. However the post-treatment/pre-discharge RDW values were significantly lower in the surgical group (14.4±1.9 to 13.6±1.1, respectively, p<0.05). Also, no significant RDW change was identified in the medical treatment group based on an intra-group assessment, whereas a significant decrease was observed in Group B (on admission and following surgical treatment: 14.3±1.3, 13.6±1.1, respectively, p=0.015). No significant differences were observed between groups in terms of CRP and leucocyte values. Conclusion: There was a significant decrease in RDW values in patients who were treated with surgery for acute cholecystitis, while this response could not be observed with medical treatment. PMID:25931948
Patti, Jay W.; Neeman, Ziv Wood, Bradford J.
2003-08-15
Initial reports have suggested that proximity of liver tumors to the gallbladder may increase the risk for cholecystitis after radiofrequency ablation. A colon adenocarcinoma metastasis to the liver in contact with the gallbladder was successfully treated with radiofrequency ablation without subsequent cholecystitis.
Cheng, Wei-Chun; Chiu, Yen-Cheng; Chuang, Chiao-Hsiung; Chen, Chiung-Yu
2014-09-01
The management of acute cholecystitis is still based on clinical expertise. This study aims to investigate whether the outcome of acute cholecystitis can be related to the severity criteria of the Tokyo guidelines and additional clinical comorbidities. A total of 103 patients with acute cholecystitis were retrospectively enrolled and their medical records were reviewed. They were all classified according to therapeutic modality, including early cholecystectomy and antibiotic treatment with or without percutaneous cholecystostomy. The impact of the Tokyo guidelines and the presence of comorbidities on clinical outcome were assessed by univariate and multivariate regression analyses. According to Tokyo severity grading, 48 patients were Grade I, 31 patients were Grade II, and 24 patients were Grade III. The Grade III patients had a longer hospital stay than Grade II and Grade I patients (15.2 days, 9.2 days, and 7.3 days, respectively, p < 0.05). According to multivariate analysis, patients with Grade III Tokyo severity, higher Charlson's Comorbidity Score, and encountering complications had a longer hospital stay. Based on treatment modality, surgeons selected the patients with less severity and fewer comorbidities for cholecystectomy, and these patients had a shorter hospital stay. In addition to the grading of the Tokyo guidelines, comorbidities had an additional impact on clinical outcomes and should be an important consideration when making therapeutic decisions.
Aparici, Carina Mari; Win, Aung Zaw
2016-01-01
We present a case of a 69-year-old patient who underwent ascending aortic aneurysm repair with aortic valve replacement. On postsurgical day 12, he developed leukocytosis and low-grade fevers. The chest computed tomography (CT) showed a periaortic hematoma which represents a postsurgical change from aortic aneurysm repair, and a small pericardial effusion. The abdominal ultrasound showed cholelithiasis without any sign of cholecystitis. Finally, a fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT examination was ordered to find the cause of fever of unknown origin, and it showed increased FDG uptake in the gallbladder wall, with no uptake in the lumen. FDG-PET/CT can diagnose acute cholecystitis in patients with nonspecific clinical symptoms and laboratory results. PMID:27625897
Aparici, Carina Mari; Win, Aung Zaw
2016-01-01
We present a case of a 69-year-old patient who underwent ascending aortic aneurysm repair with aortic valve replacement. On postsurgical day 12, he developed leukocytosis and low-grade fevers. The chest computed tomography (CT) showed a periaortic hematoma which represents a postsurgical change from aortic aneurysm repair, and a small pericardial effusion. The abdominal ultrasound showed cholelithiasis without any sign of cholecystitis. Finally, a fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT examination was ordered to find the cause of fever of unknown origin, and it showed increased FDG uptake in the gallbladder wall, with no uptake in the lumen. FDG-PET/CT can diagnose acute cholecystitis in patients with nonspecific clinical symptoms and laboratory results. PMID:27625897
Aparici, Carina Mari; Win, Aung Zaw
2016-01-01
We present a case of a 69-year-old patient who underwent ascending aortic aneurysm repair with aortic valve replacement. On postsurgical day 12, he developed leukocytosis and low-grade fevers. The chest computed tomography (CT) showed a periaortic hematoma which represents a postsurgical change from aortic aneurysm repair, and a small pericardial effusion. The abdominal ultrasound showed cholelithiasis without any sign of cholecystitis. Finally, a fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT examination was ordered to find the cause of fever of unknown origin, and it showed increased FDG uptake in the gallbladder wall, with no uptake in the lumen. FDG-PET/CT can diagnose acute cholecystitis in patients with nonspecific clinical symptoms and laboratory results.
Gadzhiev, D N; Tagiev, É G; Guseĭnaliev, A G; Gadzhiev, N D; Talyshinskaia, L R
2013-04-01
The results of application of systemic cytokinotherapy and splenopid in patients, operated on for an acute calculous cholecystitis, are presented. While in patients of a control group the conventional basic therapy was conducted, to the patients of the main group the systemic cytokinotherapy and splenopid were conducted preoperatively and postoperatively on background of basic therapy during 3-10 days at average. In both groups preoperatively the reduction of interleukin-2 (IL-2) and gamma-interferon (IFNgamma) content were observed, as well as raising of the blood level of the tumor necrosis factor-alpha (TNF-alpha), IL-6 and IL-10. In the patients of a control group a tendency towards the studied indices normalisation was noted postoperatively, and in the patients of the main group the elimination of the organism cytokine state dysbalance was achieved. While doing comparative analysis of ratio of TNF-alpha/IL-10 and IL-2/IL-10 in the blood serum in the main group there was established, that up to the observation period end the both indices were close to the norm. PMID:23888711
The role of scintiangiography in suspected acute cholecystitis: The hyperemic gallbladder fossa
Colletti, P.; Ralls, P.W.; Siegel, M.E.; Halls, J.
1984-01-01
Gallbladder hyperemia in acute cholecystitis (AC) has been described pathologically and angiographically. The authors' purpose is to evaluate the use of scintiangiography for the detection of this hypernia as a supporting sign of AC. Ten mCi of Tc 99m disofenin were injected by bolus technique in 64 patients with suspected AC. Sequential 3 second images were obtained with a 500K blood pool image at one minute. Routine images to 60 minutes were performed followed by delayed views. The scintiangiogram was positive if there was focal increased activity in the gallbladder fossa greater than liver and separate from right kidney during the preportal arterial phase. The location of the gallbladder fossa was determined by superimposition with the early hepatocyte phase. AC was confirmed surgically and normals confirmed clinically. Increased flow to the gallbladder fossa was demonstrated in 23/32 cases of AC and in 2/33 normals (72% sensitivity, 94% specificity). Accuracy is 54/65 (83%). Positive predictive value is 23/25 (92%). All patients with both a positive scintiangiogram and cholescintigram had AC, while 3 with pericholecystic abscess and false negative cholescintigram had positive scintiangiograms. Increased perfusion to the gallbladder fossa during scintiangiography is a sign of AC. This along with gallbladder nonvisualization by cholescintigraphy was able to predict AC in 100% of cases where both findings occurred. Scintiangiography may help select our patients with a very high likelihood of AC and may potentially shorten chole-scintigraphy examinations.
Fink-Bennett, D.; Freitas, J.E.; Ripley, S.D.; Bree, R.L.
1985-08-01
To determine the sensitivity of hepatobiliary imaging (HBI) and strict- and liberal-criteria real-time ultrasonography (RTUS), the authors retrospectively analyzed 100 cases of pathologically proved acute cholecystitis (AC). A positive HBI was one in which there was nonvisualization of the gallbladder up to four hours after the administration of technetium 99m-disofenin. In the absence of hypoalbuminemia, cirrhosis, or ascites, pathognomonic RTUS findings (strict criteria) for AC were wall edema and/or pericholecystic fluid. Findings indicative of AC (liberal criteria) included the demonstration of stones, a thick gallbladder wall, nonshadowing echoes, or the ultrasonographic Murphy's sign. Of the 100 cases of AC, 91 were calculous, and nine were acalculous. Four of 100 patients had associated choledocholithiasis. The sensitivities in detecting calculous AC were as follows: HBI, 97%; liberal-criteria RTUS, 86%; and strict-criteria RTUS, 24%. The sensitivities in detecting acalculous AC were as follows: HBI, 100%; liberal-criteria RTUS, 89%; and strict-criteria RTUS, 44%.
Nomura, Yukinobu; Inui, Kazuo; Yoshino, Junji; Wakabayashi, Takao; Okushima, Kazumu; Kobayashi, Takashi; Miyoshi, Hironao; Nakamura, Yuta
2007-09-01
This study was undertaken to clarify the importance of nutritional status in patients with acute cholecystitis, and also evaluate whether they benefited from enteral nutrition supplementation, including medium-chain triglycerides (MCT), during the convalescent stage. Patients with acute cholecystitis admitted to our hospital between April 1994 and March 2002 were classified into a poor nutrition group (n=40; total serum protein<5.0 g/dl) or a fair nutrition group (n=71; >5.0 g/dl). Patients with poor nutrition were significantly more elderly than those with fair nutrition, and had significantly higher serum C-reactive protein (CRP) concentrations. The two groups did not differ significantly with respect to other laboratory data, gender distribution, or medical treatment. We supplemented ordinary meals with enteral nutrition including MCT in 16 patients during the convalescent stage (MCT group). We compared their length of hospital stay and days required to recovery to pre-admission functional status for activities of daily living (ADL) with the same intervals in 16 patients without supplementation (non-MCT group) selected to match for age, gender, and fair or poor nutritional status from among 111 patients. Hospitalizations were significantly longer in the poor nutrition group (43.0+/-2.2 days) than in the fair nutrition group (27.0+/-8.2 days). Significantly more days were required to recover ADL status in the poor nutrition group (12.0+/-7.2 days) than in the fair group (9.4+/-5.2 days). Hospitalizations were significantly shorter in the MCT group (20.1+/-15 days) than in the non-MCT group (35.4+/-12.8 days). Significantly fewer days were required to recover ADL status in the MCT group (10.9+/-7 days) than in the non-MCT group (13.1+/-6.8 days). Administration of enteral nutrition including MCT during convalescence from acute cholecystitis thus appears to promote functional recovery shorten hospital stay.
Senapati, P. S. P.; Bhattarcharya, D.; Harinath, G.; Ammori, B. J.
2003-01-01
BACKGROUND: Recent management guidelines and randomised clinical trials have provided evidence-based guidance to the management of acute biliary pancreatitis and acute cholecystitis. METHODS: A questionnaire was sent to the 1086 members of the Association of Surgeons of Great Britain and Ireland. There were 583 responders (54%). RESULTS: A policy of cholecystectomy during the index admission or within 4 weeks in fit patients recovering from mild acute biliary pancreatitis was adopted by 58% of surgeons, and was significantly associated with an upper gastrointestinal and hepato-pancreato-biliary subspecialty interest and a volume of more than 50 cholecystectomies per annum (OR, 0.43; 95% CI, 0.26-0.72; P = 0.001: and OR, 0.46; 95% CI, 0.29-0.74; P = 0.001, respectively). A policy of urgent cholecystectomy for acute cholecystitis was adopted by 20% of surgeons, and was significantly associated with an upper gastrointestinal/hepato-pancreato-biliary subspecialty interest and the 'routine' adoption of laparoscopic approach to cholecystectomy (OR, 0.34; 95% CI, 0.19-0.60; P < 0.001: and OR, 0.51; 95% CI, 0.3-0.86; P = 0.01, respectively). CONCLUSIONS: The management of cholelithiasis in patients with acute biliary pancreatitis in the UK remains suboptimal. Moreover, only a minority of surgeons offer patients presenting with acute cholecystitis the benefits of early laparoscopic cholecystectomy. The management of acute biliary disease may be improved if these cases were concentrated in the hands of surgeons with upper gastrointestinal/hepato-pancreato-biliary interest and those who perform laparoscopic cholecystectomy regularly. PMID:14594533
Gil-Sande, E.; Brun-Otero, M.; Campo-Cerecedo, F.; Esteban, E.; Aguilar, L.; García-de-Lomas, J.
2006-01-01
Gordonia terrae has been reported to be a rare cause of bacteremia. We report the first case of bacteremia associated with acute cholecystitis. Commercial biochemical testing was not able to identify the strain at the genus level, classifying it instead as Rhodococcus sp. Definitive identification was obtained by sequencing of the 16S rRNA gene. PMID:16825404
Kosmidis, Christophoros; Anthimidis, Georgios; Varsamis, Nikolaos; Makedou, Fotini; Georgakoudi, Eleni; Efthimiadis, Christophoros
2016-01-01
Patient: Female, 33 Final Diagnosis: Acute cholecystitis after Familial Mediterranean Fever-related peritonitis Symptoms: Acute abdomen • fever Medication: Colchicine Clinical Procedure: Laparoscopic cholecystectomy and adhesiolysis in the second trimester of pregnancy Specialty: Surgery Objective: Rare co-existance of disease or pathology Background: Differential diagnosis of acute abdomen in pregnant patients is one of the greatest challenges for the clinician. Occurrence of Familial Mediterranean Fever (FMF) paroxysm of peritonitis and acute cholecystitis during pregnancy is a unique clinical entity that leads to serious diagnostic and therapeutic dilemmas. Case Report: We present the case of a 33-year-old Armenian patient at 16 weeks’ gestational age with a history of FMF, who was admitted twice within 1 month with acute abdomen. The first episode was attributed to FMF and successfully treated conservatively with colchicine. The second episode was diagnosed as acute cholecystitis and led to emergent laparoscopic cholecystectomy and lysis of peritoneal adhesions from previous FMF attacks. The patient presented an uneventful postoperative clinical course and had a normal delivery of a healthy infant at the 39th week of gestation. Conclusions: Pregnant patients with acute abdomen should be evaluated with open mind. To the best of our knowledge, this is the first published report of the coexistence of 2 different causes of acute abdomen during pregnancy. Meticulous history and thorough physical, laboratory, and radiologic examination are the keys to reach a correct diagnosis. Treatment of pregnant patients with acute abdomen should be individualized. Administration of colchicine should be continued during conception, pregnancy, and lactation in patients with FMF history. Laparoscopic intervention in pregnant patients with surgical abdomen such as acute cholecystitis is the optimal method of treatment. PMID:26907752
Brain, Philip H; Barrs, Vanessa R; Martin, Patricia; Baral, Randolph; White, Joanna D; Beatty, Julia A
2006-04-01
Clinicopathological findings from six cats with confirmed cholecystitis or acute neutrophilic cholangitis are presented. Historical findings included lethargy and anorexia or inappetence of up to five days duration. On physical examination all cats were pyrexic and four out of six were jaundiced and had cranial abdominal pain. Bile samples were obtained by cholecystocentesis at exploratory coeliotomy (two cases) or by percutaneous, ultrasound-guided cholecystocentesis (four cases). Gall bladder rupture and bile peritonitis occurred subsequent to ultrasound-guided cholecystocentesis in one case. The most common bacterial isolate was Escherichia coli (four cases); E coli was isolated alone in two cases, in combination with a Streptococcus species (one case) and in combination with a Clostridium species (one case). Streptococcus species alone was isolated from one case, as was Salmonella enterica serovar Typhimurium. The latter is the first reported case of Salmonella-associated cholecystitis in a cat. Concurrent pancreatic or intestinal disease was detected histologically in three cases. All cases were treated with antimicrobials based on in vitro susceptibility results. Treatment was successful in five cases. One cat with concurrent diffuse epitheliotropic intestinal lymphoma was euthanased. Percutaneous ultrasound-guided cholecystocentesis is an effective, minimally-invasive technique enabling identification of bacterial isolates in cats with inflammatory hepatobiliary disease.
Song, Guo-Min; Bian, Wei; Zeng, Xian-Tao; Zhou, Jian-Guo; Luo, Yong-Qiang; Tian, Xu
2016-06-01
The laparoscopic cholecystectomy (LC) is an important approach of treating acute cholecystitis and the timing of performing this given treatment is associated with clinical outcomes. Although several meta-analyses have been done to investigate the optimal timing of implementing this treatment, the conflicting findings from these meta-analyses still confuse decision-making. And thus, we performed this systematic review to assess discordant meta-analyses and generate conclusive findings to facilitate informed decision-making in clinical context eventually. We electronically searched the PubMed, Cochrane Library, and EMBASE to include meta-analysis comparing early (within 7 days of the onset of symptoms) with delayed LC (at least 1 week after initial conservative treatment) for acute cholecystitis through August 2015. Two independent investigators completed all tasks including scanning and appraising eligibility, abstracting essential information using prespecified extraction form, assessing methodological quality using Oxford Levels of Evidence and Assessment of Multiple Systematic Reviews (AMSTAR) tool, and assessing the reporting quality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), as well as implementing Jadad algorithm in each step for the whole process. A heterogeneity degree of ≤50% is accepted. Seven eligible meta-analyses were included eventually. Only one was Level I of evidence and remaining studies were Level II of evidence. The AMSTAR scores varied from 8 to 11 with a median of 9. The PRISMA scores varied from 19 to 26. The most heterogeneity level fell into the desired criteria. After implementing Jadad algorithm, 2 meta-analyses with more eligible RCTs were selected based on search strategies and implication of selection. The best available evidence indicated a nonsignificant difference in mortality, bile duct injury, bile leakage, overall complications, and conversion to open surgery, but a significant reduction
Cholecystitis occurring without stones
Seal, M.L.
1986-03-01
A case of acalculous cholecystitis in a 65-year-old man with underlying diabetes mellitus, hypertension, and peripheral arteriosclerosis is presented here. His case remained diagnostically puzzling for some time until symptoms and signs became more severe and very suggestive of acute cholecystitis. The clinical impression was then supported by an abnormal radioisotope biliary scan. The scan has fairly good sensitivity in detecting this condition but may not be totally dependable. Acalculous cholecystitis is an unusual but serious variant of a common disorder in which treatable gallbladder disease may masquerade as a less treatable liver malady. A common denominator among this disorder's many etiologies may be impairment of the gallbladder microcirculation in the presence of one or more conditions that lower the gallbladder's resistance to bacterial invasion. Prompt detection and treatment are desirable to reduce morbidity and mortality. However, early diagnosis is not always possible, because the clinical picture often is unclear, clear, gallstones are absent, and laboratory test results may be normal or equivocal. As in the case reported here, the vague clinical picture may dictate following a patient until the illness reaches an intensity acute enough to permit identification. The greatest aid to earlier diagnosis for the physician faced with circumstances similar to those described here is to think of cholecystitis and then to give strong weight to that clinical suspicion. At times, a recommendation for cholecystectomy may have to be made mainly on clinical judgment.
Kim, Ji Hyung; Kang, Do-Hyung; Park, Se Chang
2015-06-04
Lactococcus garvieae, which is generally known as a marine and freshwater fish pathogen, is now considered to be an emerging zoonotic pathogen in both human and veterinary medicine. In recent years, we have reported the infection of L. garvieae LG-ilsanpaik-gs201105 in the gallbladder of an old fisherman. In this study, we present the draft genome sequence of L. garvieae LG-ilsanpaik-gs201105, with a total genome size of 1,960,261 bp in 53 contigs and a 38.1% average G+C content. Interestingly, the capsule gene cluster, which was known as one of the crucial virulence factors in L. garvieae, was not detected in our isolate. This is the first genome sequence of human-pathogenic L. garvieae, which caused acute acalculous cholecystitis.
Korotkyĭ, V M; Soliaryk, S O; Tsyganok, A M; Sysak, O M
2012-01-01
The share of elderly and senile patients with acute cholecystitis concomitant cardiovascular pathology whom the laparoscopic cholecystectomy has been provided is increased. The heightened intraabdominal pressure has negative influence at the cardiovascular system, so the alternative ways for treatment of this group of patients are used in clinic. We propose the pneumoperitoneum model using the pneumatic belt which is fixed at the abdomen in preoperative period in patients with an acute and chronic cholecystitis. This model is useful to forecast cardiovascular disorders during future laparoscopic cholecystectomy. The arterial pressure level, pulse score and ECG are monitored during the test (90 min). Myocardial ischemia appearance seems that the risk of laparoscopic cholecystectomy with pneumoperitoneum is high. The alternative method of surgery in such group of patients (no pneumoperitoneum is applied) is laparoscopic assisted cholecystectomya from miniaccess. This method allows to reducing frequency of intra- and postoperative complications connected with pneumoperitoneum negative influence at the patients with concomitant pathology of cardiovascular system.
Nichitayio, M Yu; Bazyak, A M; Klochan, V V; Grusha, P K; Goman, A V
2015-02-01
Comparative analysis of results of the laser diode (the wave length 940 nm) and elec- trocoagulation application while performing laparoscopic cholecystectomy was con- ducted. For an acute calculous cholecystitis 52 patients were operated, in whom instead of electrocoagulation the laser was applied, provide for reduction of thermal impact on tissues, the complications absence, reduction of the patients stationary treatment duration postoperatively from (5.2 ± 1.2) to (4.9 ± 0.6) days.
Grus, Tomáš; Lambert, Lukáš; Rohn, Vilém; Klika, Tomáš; Grusová, Gabriela; Michálek, Pavel
2016-01-01
We present a case of a female patient with infectious (mycotic) juxtarenal abdominal aneurysm with atypical symptoms beginning as acute exacerbation of chronic cholecystitis. Apart from common antibiotic treatment, the patient successfully underwent resection of the diseased segment and replacement by a fresh allograft in order to reduce the risk of infection of the graft, but with the need of subsequent life-long immunosuppressive therapy. Perioperative monitoring of the spinal cord by near infrared spectroscopy was used to identify possible spinal ischemia. The choice of the fresh allograft was based on our experience supported by review of the literature. PMID:26995203
Ono, Shiro; Kobayashi, Tadanao; Nishio, Kenji
2016-05-01
Infection with the Epstein-Barr virus (EBV) is a common disease and is mainly asymptomatic during childhood, whereas infectious mononucleosis with clinical signs such as fever, pharyngitis, lymphadenopathy and hepatosplenomegaly often occurs in adolescents and adults with primary infection. Acalculous cholecystitis has been reported as a rare complication. We report herein a case of acalculous cholecystitis accompanied by infectious mononucleosis by EBV, which was treated successfully by medical treatment. A 33-year-old woman who had been admitted by fever, pharyngitis and lymphadenopathy developed a right upper quadrant pain, that was diagnosed as acalculous cholecystitis based on an imaging study. Antibiotic treatment did not resolve the symptoms, and surgical intervention was considered. We diagnosed her as having infectious mononucleosis based on a typical physical presentation and seropositivity for the EBV viral capsid antigen, suggesting that the acalculous cholecystatis might have been a complication of the EBV infection. After the administration of glucocorticoid and acyclovir, the patient became afebrile and the abdominal pain disappeared. Though acalculous cholecystitis rarely accompanies infectious mononucleosis caused by EBV, clinicians should be aware of this complication to avoid unnecessary cholecystectomy. PMID:27529970
Ivantsok, V M
2015-05-01
While complicated acute cholecystitis (ACH) course the focus of infection constitutes one of the main causes of the endogenic intoxication (EI) occurrence, what leads to ischemic and hypoxic myocardial damage. There were presented the treatment results analysis in 213 patients, ageing 60 years old and older, managed for an ACH, complicated by peritonitis, paravesical abscess, with concurrent cardiac insufficiency of ischemic genesis, to whom laparoscopic cholecytectomy (LCHE) was conducted. Microflora of the abdominal cavity exudates in the patients, suffering an ACH of various severity, was studied. More rapid regression of inflammatory process, the EI severity and the ischemic-hypoxic myocardial affection reduction, positive impact on hemodynamics, reduction of myocardial ischemia severity were noted while local affection, when bacteriophages for treatment were applied.
Use of morphine in cholescintigraphy for obstructive cholecystitis
Kim, E.E.; Nguyen, M.; Pjura, G.; Pollack, M.; Gobuty, A.
1985-05-01
Non-visualization of the gallbladder (GB) during the first hour of cholescintigraphy is observed in cystic duct obstruction (e.g. in acute cholecystitis) but may also occur in chronic cholecystitis, hepatocellular disease, alcoholism and prolonged total parenteral nutrition. Low dose morphine is shown to improve the specificity of the diagnosis of acute cholecystitis (from 85% to 100%) with no loss in sensitivity (98%) at a small cost in terms of additional study time. The authors reviewed 27 selected cholescintigraphic examinations augmented by intravenous (IV) morphine (0.04 mg/Kg). Of the 16 cases with persistent nonvisualization of the GB, ultrasound revealed gallstones in 5 cases, sludge in 4, acalculous cholecystitis in 3, one distended GB, one contracted GB and 2 normal GB's. Of the 4 patients taken to surgery, one with gallstones and one with acalculous cholecystitis were confirmed to have acute cholecystitis while another with gallstones had chronic cholecystitis and the final patient, who was sonographically normal, presented a single common duct stone. The authors conclude that the use of IV morphine is an effective adjunct to cholescintigraphy in the evaluation of gallbladder disease, especially when visualization post morphine rules out acute cholecystitis.
Cholelithiasis and Cholecystitis in Childhood
Wingert, Willis A.; Mikity, Victor G.
1967-01-01
Six cases of cholecystitis and cholelithiasis confirmed by x-ray examination and surgical operation were observed in a ten-year period. Due to the wide variability in signs and symptoms in children, cholecystitis and cholelithiasis can be diagnosed only with a high degree of clinical suspicion and roentgenological examination. Gallbladder disease is uncommon in childhood but should be considered in children with vague abdominal pains or bouts of unexplained jaundice. If a normal appendix is found at laparotomy in the “acute abdomen,” the surgeon would be wise to palpate other specific organs within the abdomen, including the liver and gallbladder. The treatment of choice is cholecystectomy. The prognosis for recovery is excellent if there is no complicating systemic disease. ImagesFigure 1.Figure 2.Figure 3. PMID:6045485
Hemorrhagic acalculous cholecystitis: an unusual location of uremic bleeding.
Lai, Yi-Chun; Tarng, Der-Cherng
2009-09-01
Hemorrhagic acalculous cholecystitis is a rare but potentially fatal disease. An increased bleeding tendency is present in both acute and chronic renal failure with impaired platelet function. We herein present a case of hemorrhagic acalculous cholecystitis in a hemodialysis patient who suffered from acute abdomen and upper gastrointestinal bleeding. The pathogenesis may have been associated with ischemia and reperfusion injury, eventually leading to necrosis of the gallbladder wall. Abdominal ultrasound can aid in diagnosis. Biliary colic, jaundice, and melena are the typical symptoms of hemorrhagic cholecystitis, particularly in a patient with unexplained gastrointestinal bleeding. PMID:19762317
Bezruchko, M V; Malyk, S V; Kravchenko, S P; Osipov, O S; Sytnik, D A
2013-03-01
The results of comparison between the operation stress degree in various kinds of surgical interventions, performed for an acute cholecystitis, using determination of cortizol, prolactin and glucose content before the operation, intraoperatively and postoperatively in 50 patients, are adduced. There was established, that the largest (in 5.3 times) and the most durable (more than 24 hours) intr erative raising of the cortizol level in the blood serum was noted in patients, to whom open cholecystectomy (OCH) was done, and the minimal (in 2.2 times) and the least durable (up to 1 hour)--while performing transcutaneous transhepatic draining (TTD) of gallbladder under ultrasonographic control. While performance of laparoscopic cholecystectomy (LCH) there was noted the most pronounced intraoperative raising of prolactin level (in 3.6 times) and more rapid its lowering (during 24 hours) in comparison with such while the OCH performance (during 72 hours). In TTD there was observed the minimal intraoperative inhancing of the prolactin level (in 2.3 times) and its duration (during 1 hour) postoperatively. The above mentioned have witnessed, that while TTD of gallbladder performance stimulation of the anterior hypophysis is significantly lesser, than while LCH and OCH.
Cholescintigraphy in cholecystic cancer
Nagle, C.E.; Freitas, J.; Dworkin, H.J.
1983-05-01
Two case reports of nonvisualization of the gallbladder by hepatobiliary scintigraphy in patients with carcinoma of the gallbladder are described. A hypothesis regarding the pathogenesis of gallbladder nonvisualization in cholecystic cancer is offered. The possible clinical utility of hepatobiliary scintigraphy in these patients is discussed.
[Leptospirosis with necro-haemorrhagic cholecystitis in a Boxer puppy].
Steil, D; Quandt, A; Mayer-Scholl, A; Sie, J M; Löhr, C V; Teifke, J P
2014-01-01
A Boxer puppy from the island of Rügen, which was properly vaccinated according to its age, was presented with acute gastrointestinal symptoms. The presumptive diagnosis of leptospirosis with acute renal failure, hepatic damage, and jaundice was confirmed by seroconversion (increased titre to 1 : 800 in a non-vaccine serogroup 4 weeks after disease onset). Cholecystitis was diagnosed based on clinical symptoms and sonographic results. After an initial improvement, the puppy's condition deteriorated and cholecystectomy was performed. Histopathological diagnosis indicated a haemorrhagic necrotizing cholecystitis.
[Leptospirosis with necro-haemorrhagic cholecystitis in a Boxer puppy].
Steil, D; Quandt, A; Mayer-Scholl, A; Sie, J M; Löhr, C V; Teifke, J P
2014-01-01
A Boxer puppy from the island of Rügen, which was properly vaccinated according to its age, was presented with acute gastrointestinal symptoms. The presumptive diagnosis of leptospirosis with acute renal failure, hepatic damage, and jaundice was confirmed by seroconversion (increased titre to 1 : 800 in a non-vaccine serogroup 4 weeks after disease onset). Cholecystitis was diagnosed based on clinical symptoms and sonographic results. After an initial improvement, the puppy's condition deteriorated and cholecystectomy was performed. Histopathological diagnosis indicated a haemorrhagic necrotizing cholecystitis. PMID:25423604
[Enzymatic cholecystitis and cholecystopancreatitis].
Sobeshchanskaia, E A; Myrkin, S D; Babalich, A K
1977-02-01
Taking into consideration the role of pancreatic enzymes in the etiology of cholecystitis and cholecystopancreatits, the authors examined amylase in 92 patients, bile lipase--in 39 patients during cholecystectomy and also amylase in the choledochus bile during external drainage of the duct in 15 patients in the early postoperative period. The investigations inducated different levels of pancreatic enzymes in bile. Their level is found to depend on the occurrence of hypertension in the bile tract both pre- and postoperatively.
Granulomatous Lithiasic Cholecystitis in Sarcoidosis
Handra-Luca, Adriana
2016-01-01
Gallbladder granulomas are exceedingly rare, reported in association with tuberculosis or sarcoidosis. Here we report a case of gallbladder granulomatous cholecystitis occurring in the context of sarcoidosis. A 70-years old man presented with abdominal pain, nausea and vomiting. The medical history revealed sarcoidosis diagnosed more than 20-years previously. 2-years previously the patient showed renal lithiasis, hypercalcemia and, increased angiotensin converting enzyme. The imaging features suggested thoraco-abdominal sarcoidosis. Prednisone was given at 1.2 mg/kg/day initially, than decreased, being at 2.5 mg/day at present. The ultrasound examination showed gallbladder lithiasis. A cholecystectomy was performed. Microscopy showed subacute and chronic cholecystitis with several epithelioid and giant cell granulomas some of them perineural. In conclusion, we report a case of granulomatous cholecystitis occurring in the course of treated sarcoidosis. The perineural location of granulomas may give further insights into the pathogenesis of gallbladder dysmotility. PMID:27162601
PIPIDA scintigraphy for cholecystitis: false positives in alcoholism and total parenteral nutrition
Shuman, W.P.; Gibbs, P.; Rudd, T.G.; Mack, L.A.
1982-01-01
A review of gallbladder scintigraphy in patients with potentially compromised hepatobiliary function revealed two groups in whom cholecystitis might be mistakenly diagnosed. In 200 consecutive hospitalized patients studied with technetium-99m-PIPIDA for acute cholecystitis or cholestasis, there were 41 alcoholics and 17 patients on total parenteral nutrition. In 60% of the alcoholics and 92% of those on parenteral nutrition, absent or delayed visualization of the gallbladder occurred without physical or clinical evidence of cholecystitis. A cholecystagogue, sincalide, did not prevent the false-positive features which presumably are due to altered bile flow kinetics related to alcoholism and parenteral nutrition. Four patients on parenteral nutrition undergoing cholecystectomy for suspected cholecystitis had normal gallbladders filled with jellylike viscous thick bile. A positive (nonvisualized or delayed visualized) gallbladder PIPIDA scintigram in these two populations should not be interpreted as indicating a need for cholecystectomy.
How to image the gallbladder in suspected cholecystitis
Marton, K.I.; Doubilet, P.
1988-11-01
As a result of important advances in medical imaging, the oral cholecystogram is no longer the primary test of gallbladder function and anatomy. Real-time ultrasonography and cholescintigraphy, both highly sensitive and specific tests, are the two major methods for assessing gallbladder pathology. Oral cholecystography, endoscopic retrograde pancreatography, and percutaneous gallbladder puncture serve as supplementary tests. Decisions about which test to use depend on the kind of gallbladder disease that is suspected as well as the estimated likelihood of the disease before the information is obtained from the procedure. Thus, ultrasonography is the test of choice for chronic cholecystitis, with oral cholecystography reserved for situations in which the diagnosis is uncertain after ultrasonography. When acute cholecystitis is suspected, ultrasonography is also the test of choice in most patients, and cholescintigraphy is used to resolve uncertainty. 103 references.
Szmyt, Mirosław; Kasprzak, Aldona; Malkowski, Wojciech; Surdyk-Zasada, Joanna; Przybyszewska, Wiesława; Siodła, Elżbieta; Seraszek-Jaros, Agnieszka; Jagielska, Joanna
2013-01-01
Proteins of S100 group, produced by phagocytes represent endogenous activators of innate immune responses. Role of these proteins in the etiopathogenesis of cholelithiasis remains unknown. The studies aimed at the morphometric evaluation of S100A8 and S100A9 protein expression in gallbladder mucosa in patients with acute and chronic calculous cholecystitis (n = 71). The presence of proteins was detected by immunohistochemistry while quantitative analysis employed the spatial visualization technique. We found the immunopositive expression of the two studied S100 proteins in neutrophils and monocytes/macrophages of the gallbladder's wall and a higher expression in acute cholecystitis. Quantitative study revealed higher immunoexpression of S100A9 over S100A8 in both studied groups of patients. Moreover, a reciprocal linear relationship between the expression of the studied proteins and a positive correlation between expression of either S100A8 or S100A9 and inflammatory activity (grading) in the gallbladder wall were found. The expression of S100A8 protein in the chronic cholecystitis group and in older patients correlated with leukocytosis, which suggests the role of S100A8 particularly at the chronic stage of cholecystitis. The obtained results indicated close relationship between S100A8 and S100A9 proteins in their proinflammatory functions. The increased expression of only one of them can be recognized as a useful index of local inflammatory activity in calculous cholecystitis. PMID:23907944
ERIC Educational Resources Information Center
Amdahl, Kenn; Loats, Jim
This book, written for students of calculus, is designed to augment the explanations of concepts covered in a calculus class. It consists of an overview of calculus divided into basic ideas and vocabulary, the process of differential calculus, and integral calculus. The book is intended as a resource to explain the concepts of calculus in everyday…
Xanthogranulomatous cholecystitis in laparoscopic surgery.
Guzmán-Valdivia, Gilberto
2005-04-01
Xanthogranulomatous cholecystitis (XGC) is one presentation of cholecystitis and can be a cause of difficulty in cholecystectomy. We reviewed the clinical files of 12,426 patients who had undergone cholecystectomy. In this group, there were 182 cases of XGC, and 41 of these patients had undergone laparoscopic surgery. Patients with XGC represented 1.46% of the cholecystectomies that were performed. Of the 41 patients who underwent laparoscopic surgery, 27 were men (66%) and 14 were women (34%) (average age, 52 years). A total of 36 patients (88%) presented with a chronic condition. XGC was found to be associated with lithiasis in 85%, with jaundice in 22%, and with cancer in 2.4% (one patient). A total of 33 patients (80%) required conversion to open surgery, because of technical difficulties; of these patients, 64% underwent partial cholecystectomy. We conclude that XGC creates difficulty at laparoscopy and therefore any preoperative suspicion of XGC should cause the clinician to consider open cholecystectomy. PMID:15797229
Primary gallbladder lymphoma presenting with perforated cholecystitis and hyperamylasaemia.
Shah, K S V; Shelat, V G; Jogai, S; Trompetas, V
2016-02-01
Primary gallbladder lymphoma is rare. Perforated cholecystitis due to primary gallbladder lymphoma and not related to chemotherapy has been unreported. We report the case of an 80-year-old woman presenting with an acute abdomen and clinical peritonitis. Her serum amylase was raised to 878 iu/l. Urgent computed tomography revealed generalised free fluid with a normal pancreas and was non-diagnostic as to the underlying pathology. An emergency laparotomy revealed bilious peritonitis with a necrotic patch on a distended gallbladder. A cholecystectomy was carried out and histology of the gallbladder revealed a marginal zone lymphoma.
ERIC Educational Resources Information Center
Cirillo, Michelle
2007-01-01
In this article, the author explores the history and the mathematics used by Newton and Leibniz in their invention of calculus. The exploration of this topic is intended to show students that mathematics is a human invention. Suggestions are made to help teachers incorporate the mathematics and the history into their own lessons. (Contains 3…
ERIC Educational Resources Information Center
McGivney-Burelle, Jean; Xue, Fei
2013-01-01
In this paper we discuss flipping pedagogy and how it can transform the teaching and learning of calculus by applying pedagogical practices that are steeped in our understanding of how students learn most effectively. In particular, we describe the results of an exploratory study we conducted to examine the benefits and challenges of flipping a…
Dengue hemorrhagic fever patients with acute abdomen: clinical experience of 14 cases.
Khor, Boon-Siang; Liu, Jien-Wei; Lee, Ing-Kit; Yang, Kuender D
2006-05-01
Among 328 patients with dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), 14 (4 men and 10 women, median age 44 years) had acute abdomen. DHF/DSS was initially suspected in only 2 of these 14 patients. Presumptive diagnoses of acute cholecystitis (6 acalculus and 4 calculus cholecystitis) were made in 10 patients, non-specific peritonitis in three patients, and acute appendicitis in one patients. Cholecystectomy, percutaneous transhepatic gallbladder drainage, and appendectomy were performed in three patients. Transfused blood in the three patients who underwent invasive procedures and the 11 patients who received supportive treatment included packed red blood cells (24 versus 0 units; P = 0.048), fresh frozen plasma (84 versus 0 units; P = 0.048), and platelets (192 versus 180 units; P = 0.003). Patients who underwent invasive procedures also had prolonged time in the hospital (median = 11 versus 7 days; P = 0.015). To avoid unnecessary invasive procedure-related morbidity and mortality, this report underscores the importance of a careful differential diagnosis in patients with acute abdomen in a dengue-endemic setting.
Özkaya, Ahmet Kağan; Güler, Ekrem; Çetinkaya, Ahmet; Karakaya, Ali Erdal; Göksügür, Yalçın; Katı, Ömer; Güler, Ahmet Gökhan; Davutoğlu, Mehmet
2016-05-01
Henoch-Schönlein purpura (HSP) is the most common childhood systemic vasculitis. Gastro-intestinal involvement occurs in two-thirds of patients. The characteristic skin lesions generally precede abdominal symptoms or present concurrently. A 7-year-old boy presented with intussusception and acalculous cholecystitis and had a cholecystectomy. Two weeks later he was re-admitted with features typical of HSP which responded to corticosteroids. Eleven months later he presented with abdominal pain and recurrence of HSP and, at laparotomy, there was acute appendicitis. This is the first case of a child presenting with HSP complicated by acalculous cholecystitis. PMID:27077617
Emphysematous cholecystitis in a Siberian husky.
Armstrong, J A; Taylor, S M; Tryon, K A; Porter, C D
2000-01-01
A 6-year-old, intact male Siberian husky was evaluated for a 24-hour history of vomiting and lethargy. Diagnosis of emphysematous cholecystitis was achieved based on survey abdominal radiographs, a barium contrast gastrointestinal series, and abdominal ultrasound. Diagnosis and medical and surgical management of the condition are discussed.
A Rare Case of Cholecystitis Caused by Raoultella planticola.
Teo, Isabel; Wild, Jonathan; Ray, Saikat; Chadwick, David
2012-01-01
A 62-year-old female presented with right upper quadrant pain. Clinical examination and ultrasound scan were consistent with gallstones and acute cholecystitis. She received 3 days of intravenous Co-amoxiclav and was discharged with 5-days of oral antibiotics with arrangements to return for an elective cholecystectomy. This was performed 5 months later which revealed an inflamed gallbladder and a localised abscess secondary to gallbladder perforation. Fluid from the gallbladder was taken which cultured Raoultella planticola, a gram-negative, nonmotile environmental bacteria (Bagley et al. (1981)). This is the first report of biliary sepsis with a primary infection by R. planticola. This patient was treated with a 5-day course of oral Co-amoxiclav and made a full recovery.
Mechanisms of impaired gallbladder contractile response in chronic acalculous cholecystitis.
Merg, Anders R; Kalinowski, Scott E; Hinkhouse, Marilyn M; Mitros, Frank A; Ephgrave, Kimberly S; Cullen, Joseph J
2002-01-01
The mechanisms involved in the impaired gallbladder contractile response in chronic acalculous cholecystitis are unknown. To determine the mechanisms that may lead to impaired gallbladder emptying in chronic acalculous cholecystitis, gallbladder specimens removed during hepatic resection (controls) and after cholecystectomy for chronic acalculous cholecystitis were attached to force transducers and placed in tissue baths with oxygenated Krebs solution. Electrical field stimulation (EFS) (1 to 10 Hz, 0.1 msec, 70 V) or the contractile agonists, CCK-8 (10(-9) to 10(-5)) or K(+) (80 mmol/L), were placed separately in the tissue baths and changes in tension were determined. Patients with chronic acalculous cholecystitis had a mean gallbladder ejection fraction of 12% +/- 4%. Pathologic examination of all gallbladders removed for chronic acalculous cholecystitis revealed chronic cholecystitis. Spontaneous contractile activity was present in gallbladder strips in 83% of control specimens but only 29% of gallbladder strips from patients with chronic acalculous cholecystitis (P < 0.05 vs. controls). CCK-8 contractions were decreased by 54% and EFS-stimulated contractions were decreased by 50% in the presence of chronic acalculous cholecystitis (P < 0.05 vs. controls). K(+)-induced contractions were similar between control and chronic acalculous cholecystitis gallbladder strips. The impaired gallbladder emptying in chronic acalculous cholecystitis appears to be due to diminished spontaneous contractile activity and decreased contractile responsiveness to both CCK and EFS.
Tc-99m IDA cholescintigraphy in acute pancreatitis: concise communication
Ali, A.; Turner, D.A.; Fordham, E.W.
1982-10-01
Recently it has been suggested that cholescintigraphy is unreliable in the detection of acute cholecystitis when acute pancreatitis is present. During a recent 17 month interval, twenty-one patients with a firmly established diagnosis of acute pancreatitis underwent cholescintigraphy in our laboratory. The gallbladder failed to visualize in only five cases, all of whom had acute cholecystitis. These data, and those available in the literature, lead us to conclude that cholescintigraphy is useful in the diagnosis of acute cholecystitis whether or not acute pancreatitis is present.
Calculus ABCs: A Gateway for Freshman Calculus
ERIC Educational Resources Information Center
Fulton, Scott R.
2003-01-01
This paper describes a gateway testing program designed to ensure that students acquire basic skills in freshman calculus. Students must demonstrate they have mastered standards for "Absolutely Basic Competency"--the Calculus ABCs--in order to pass the course with a grade of C or better. We describe the background, standards, and testing program.…
[The effectiveness of spasmolytic therapy in chronic acalculous cholecystitis].
Shaĭkhutdinova, O V; Galiakberova, A R; Gur'ev, D A; Ionova, S I; Volevach, L V
2009-01-01
The therapeutic efficacy of duspatalin was evaluated in 69 patients with chronic cholecystitis and dyskinesia of the biliary tract (BT). Supplementation of duspatalin to the combined therapy in the patients with chronic cholecystitis shown to exert a pronounced therapeutic effect. This caused positive changes in clinical symptoms and BT function and quality of life, diminished the lithogenic properties of bile. PMID:19552029
[Chronic cholecystitis and its clinical masks: diagnosis and differential diagnosis].
Tsimmerman, Ia S
2006-01-01
The author adduces modern data on the ethiology and pathogenesis of chronic cholecystitis and the stages of the development of biliary pathology (motorotonic disturbances of the gall bladder and the sphincter apparatus of the extrahepatic biliary tract - chronic acalculous cholecystitis - chronic calculous cholecystitis). He considers in detail the methods of diagnostics of chronic cholecystitis paying special attention to clinical (non-instrumental) methods. The author offers an original classification of physical symptoms of chronic cholecystitis, distinguishing three groups of symptoms according to their pathogenesis and clinical significance: segmentary reflectory symptoms ("exacerbation symptoms"); reflectory symptoms, localized in the right half of the body outside the segments of hepatobiliary system innervation ("severity symptoms"); irritative symptoms, observed during all the periods of chronic cholecystitis. The article contains a description of various clinical "masks" of chronic cholecystitis, which make the diagnosis more difficult: cardial, duodenal (gastrointestinal), rheumatic, solaralgic, allergic, pre-menstrual tension, and other masks, as well as a description of their differential diagnostic methods. PMID:16827271
Differentiation of complicated cholecystitis from gallbladder carcinoma by computed tomography
Smathers, R.L.; Lee, J.K.T.; Heiken, J.P.
1984-08-01
Differentiation between complicated cholecystitis and advanced gallbladder carcinoma can be difficult when clinical findings are confusing. Computed tomographic (CT) scans were reviewed from 22 patients with a surgical diagnosis of complicated cholecystitis (11 cases) or advanced gallbladder carcinoma (11 cases). The presence of a curvilinear low-attenuation halo around the gallbladder wall was specific for complicated cholecystitis. Findings indicative of gallbladder carcinoma included a focal soft-invasion or metastases. Knowledge of these differential CT findings may result in a more accurate preoperative diagnosis.
Initialized Fractional Calculus
NASA Technical Reports Server (NTRS)
Lorenzo, Carl F.; Hartley, Tom T.
2000-01-01
This paper demonstrates the need for a nonconstant initialization for the fractional calculus and establishes a basic definition set for the initialized fractional differintegral. This definition set allows the formalization of an initialized fractional calculus. Two basis calculi are considered; the Riemann-Liouville and the Grunwald fractional calculi. Two forms of initialization, terminal and side are developed.
ERIC Educational Resources Information Center
Sutherland, Melissa
2006-01-01
In this paper we discuss manipulatives and hands-on investigations for Calculus involving volume, arc length, and surface area to motivate and develop formulae which can then be verified using techniques of integration. Pre-service teachers in calculus courses using these activities experience a classroom in which active learning is encouraged and…
Calculus Demonstrations Using MATLAB
ERIC Educational Resources Information Center
Dunn, Peter K.; Harman, Chris
2002-01-01
The note discusses ways in which technology can be used in the calculus learning process. In particular, five MATLAB programs are detailed for use by instructors or students that demonstrate important concepts in introductory calculus: Newton's method, differentiation and integration. Two of the programs are animated. The programs and the…
ERIC Educational Resources Information Center
Sauerheber, Richard D.
2012-01-01
Methods of teaching the Calculus are presented in honour of Sir Isaac Newton, by discussing an extension of his original proofs and discoveries. The methods, requested by Newton to be used that reflect the historical sequence of the discovered Fundamental Theorems, allow first-time students to grasp quickly the basics of the Calculus from its…
Fatty meal ultrasonography in chronic acalculous cholecystitis.
Donen, Anna; Kantor, Robin
2014-01-01
Chronic acalculous cholecystits typically presents with biliary symptoms, normal blood tests and unremarkable ultrasound, computerized tomography and magnetic resonance cholangiopancreatography. However, cholescintigraphy may show reduced gallbladder ejection fraction (GBEF). There are no reports on using ultrasound to measure GBEF in adults. Twenty-eight patients with the above presentation underwent ultrasound before and after ingestion of a standardized fatty meal. Consequently, GBEF was calculated. Seven patients had reduced GBEFs (<38%). Two of these patients underwent cholecystectomy and both were found to have chronic gallbladder inflammation. Three patients with normal GBEFs underwent cholecystectomy and were also found to have chronic gallbladder inflammation. There may be a role for fatty meal ultrasonography in the diagnosis of chronic acalculous cholecystitis, but it should be used more widely in this patient cohort for its role to be established. It ideally needs to performed alongside cholescintigraphy for the comparison of accuracy. PMID:25409675
Hermeneutic operative calculus
NASA Astrophysics Data System (ADS)
Ramakrishnan, Sivakumar; Isawasan, Pradeep; Mohanan, Vasuky
2014-07-01
The predicate calculus used currently by mathematical logic in computer science, philosophy and linguistic was found to be too restrictive and inadequate for describing the grammar of natural and artificial language. Therefore many higher order logics have been developed to overcome the limitation of predicate calculus. In this paper a new representation of logic using mathematical principles has been developed for the natural language called Hermeneutic Operative Calculus. This Hermeneutic Operative Calculus is a new language interpretive calculus developed to account for the syntactic, semantic and pragmatic features of natural language and allows removing the restrictions of any particular natural language in the semantic field its map out. The logic of Hermeneutic Operative Calculus capable of represent the syntactic and semantic of factual information of a natural language precisely in any language. The logic of this Hermeneutic Operative Calculus has two different forms of operations called object and meta-operations. The object operation allow for listing the various objects, picturing the various propositions and so forth. The meta-operation would specify what cannot be specified by the object operation like semantical stances of a proposition. The basic operative processes of linguistics and cognitive logic will be mathematically conceptualized and elaborated in this paper.
NASA Technical Reports Server (NTRS)
Cleaveland, Rance; Luettgen, Gerald; Bushnell, Dennis M. (Technical Monitor)
2002-01-01
This paper presents the Logical Process Calculus (LPC), a formalism that supports heterogeneous system specifications containing both operational and declarative subspecifications. Syntactically, LPC extends Milner's Calculus of Communicating Systems with operators from the alternation-free linear-time mu-calculus (LT(mu)). Semantically, LPC is equipped with a behavioral preorder that generalizes Hennessy's and DeNicola's must-testing preorder as well as LT(mu's) satisfaction relation, while being compositional for all LPC operators. From a technical point of view, the new calculus is distinguished by the inclusion of: (1) both minimal and maximal fixed-point operators and (2) an unimple-mentability predicate on process terms, which tags inconsistent specifications. The utility of LPC is demonstrated by means of an example highlighting the benefits of heterogeneous system specification.
An 86-year-old man with acute abdominal pain.
van Dam, Paul M E L; Posthouwer, Dirk
2016-01-01
An 86-year-old man presented with severe pain in the upper abdomen along with fever. On physical examination, we found an arterial blood pressure of 84/43 mm Hg, a heart rate of 80 bpm and a temperature of 38.3°C. The abdomen was painful and peristalsis was absent. Empiric antibiotic therapy for sepsis was started with amoxicillin/clavulanate and gentamicin. CT scan of the abdomen revealed an emphysematous cholecystitis. Percutaneous ultrasound-guided cholecystostomy was applied. Bile cultures revealed Clostridium perfringens. Emphysematous cholecystitis is a life-threatening form of acute cholecystitis that occurs as a consequence of ischaemic injury to the gallbladder, followed by translocation of gas-forming bacteria (ie, C. perfringens, Escherichia coli, Klebsiella and Streptococci). The mortality associated with emphysematous cholecystitis is higher than in non-emphysematous cholecystitis (15% vs 4%). Therefore, early diagnosis with radiological imaging is of vital importance. PMID:26869625
Non-Functional Adrenal Gland Ganglioneuroma Masquerading as Chronic Calculus Cholecystitis.
Patel, Rashmi D; Vanikar, Aruna V; Trivedi, H L
2015-09-01
Adrenal ganglioneuromas in young adults are rare and ill-understood. We report an incidentally detected adrenal gland tumor diagnosed as ganglioneuroma (mature type) in 33 years old man who presented with vomiting and epigastric pain for 2 months. Histopathology examination revealed a well-encapsulated benign tumor of mature ganglion cells and Schwann-like cells arranged in fascicles, staining strongly with NSE and s-100 proteins, with adjacent unremarkable adrenal cortex and medulla. PMID:27608876
Chronic cholecystitis with Cystoisospora belli in an immunocompetent patient.
Takahashi, Hideo; Falk, Gavin A; Cruise, Michael; Morris-Stiff, Gareth
2015-01-01
A 47-year-old woman presented with a history of vague abdominal pain for several years, which worsened over the past 2 months, with pain more prominent in the right upper quadrant. She also had a history of peptic ulcer disease. The ultrasound scan of right upper quadrant revealed normal gallbladder and oesophagogastroduodenoscopy was unremarkable. A (99m)technetium labelled hepato iminodiacetic acid (HIDA) scan with cholecystokinin provocation demonstrated a decreased gallbladder ejection fraction (EF) of 32%. On this basis, the patient was diagnosed with biliary dyskinesia and underwent an elective laparoscopic cholecystectomy. Histopathological analysis revealed chronic cholecystitis with Cystoisospora belli identified in the gallbladder wall. Cystoisospora has been identified to cause an opportunistic acalculous cholecystitis among immunocompromised hosts, especially those with AIDS. This is the first case report of chronic cholecystitis due to C. belli in an immunocompetent patient. PMID:26065551
Putting Differentials Back into Calculus
ERIC Educational Resources Information Center
Dray, Tevian; Manogue, Corrine A.
2010-01-01
We argue that the use of differentials in introductory calculus courses is useful and provides a unifying theme, leading to a coherent view of the calculus. Along the way, we meet several interpretations of differentials, some better than others.
[Laser therapy in complex treatment of chronic acalculous cholecystitis].
Burduli, N M; Raniuk, L G
2006-01-01
The effectiveness of various laser techniques in patients with exacerbation of chronic acalculous cholecystitis was studied. The subjects were 62 patients, in whom the diagnosis was made using clinical and instrumental tests. The patients were divided into three groups. Group I received conventional pharmacotherapy; group II received a course of intravenous laser therapy in addition to it; group III received a course of laseropuncture and low-intensive laser irradiation of the hepatic area in addition to pharmacotherapy. The best results according to clinical and instrumental data were achieved in group III. Thus, the study demonstrates advantages provided by laser therapy in complex treatment of exacerbation of chronic acalculous cholecystitis PMID:16924800
ERIC Educational Resources Information Center
Harding, Simon; Scott, Paul
2004-01-01
Calculus is a mathematical concept that is fundamental to how we understand the world around us. Whether it is in the world of technology, finance, astronomy, sociology, medicine, calculus in one form or another can be found. This brief article describes the origins of calculus in Greece, further developments by Newton and Leibniz, and the…
Multiplicative Calculus and Student Projects.
ERIC Educational Resources Information Center
Campbell, Duff
1999-01-01
Multiplicative calculus is based on a multiplicative rate of change whereas the usual calculus is based on an additive rate of change. Describes some student investigations into multiplicative calculus, including an original student idea about multiplicative Euler's Method. (Author/ASK)
Tangent Lines without Calculus
ERIC Educational Resources Information Center
Rabin, Jeffrey M.
2008-01-01
This article presents a problem that can help high school students develop the concept of instantaneous velocity and connect it with the slope of a tangent line to the graph of position versus time. It also gives a method for determining the tangent line to the graph of a polynomial function at any point without using calculus. (Contains 1 figure.)
Software Review: "Interactive Calculus."
ERIC Educational Resources Information Center
Connors, Edward A.
1995-01-01
An interactive, multimedia text for calculus instruction that contains the entire contents of a corresponding textbook is evaluated and found to have features that enhance concepts with dynamic examples of graphs and problems that make good use of animation, audio, and video. Its design accommodates diverse student abilities and educational…
ERIC Educational Resources Information Center
Steckroth, Jeffrey J.
2010-01-01
For nearly three decades, during which the author taught everything from basic algebra to advanced placement calculus, the author thought of himself as a secondary school mathematics teacher. The notion of teaching elementary school math never appealed to him because of its simplicity. The author stresses that anyone could teach children to count,…
ERIC Educational Resources Information Center
Fletcher, T. J.
1971-01-01
Non-traditional methods of presenting and solving calculus problems in high school mathematics classes are presented. All problems deal with the principle that the maximum product of two numbers whose sum is constant is obtained if the numbers are equal (i.e., the arithmetic mean of n numbers is greater than or equal to the geometric mean). (JG)
Effect of pancreatic biliary reflux as a cofactor in cholecystitis.
Amr, Abdel Raouf; Hamdy, Hussam Mohamed; Nasr, Magid Mahmoud; Hedaya, Mohammed Saied; Hassan, Ahmed Mohamed Abdelaziz
2012-04-01
This study assessed the effect of pancreatico-biliary reflux (PBR) as co-factor in the process of chronic cholecystitis by measurement of the levels of active pancreatic enzyme amylase in gallbladder bile and serum of patients undergoing cholecystectomy. Pancreatic Amylase levels in bile from the gallbladder and serum were measured during surgery in 68 patients with chronic calcular cholecystitis subjected to elective open or laparoscopic cholecystectomy in the National Hepatology and Tropical Medicine Research Institution and Theodore Bilharz Research Institute. Bile amylase was detected in 64 patients (94.1%) indicating pancreatico-biliary reflux. Biliary amylase level ranged from 20-50 IU/L in 42 patients (61.76%), below 20 IU/l in 14 patients (20.59%), over 50 IU/L in 8 patients (11.76%) and undetectable in two patients. According to gallbladder bile amylase, the incidence of Occult PBR in patients operated upon for chronic calcular cholecystitis was 94.1%. The reason should be clarified by further research and wider scale study. Routinely investigating biliary amylase in every patient having cholecystitis can be a method for early detection of precancerous lesions.
Tissue concentrations of cefepime in acute cholecystitis patients.
Okamoto, M P; Gill, M A; Nakahiro, R K; Chin, A; Yellin, A E; Berne, T V; Sclar, D A; Knupp, C A; Heseltine, P N; Appleman, M D
1992-06-01
Cefepime is a new broad-spectrum cephalosporin with activity against Staphylococcus, Streptococcus, Pseudomonas, and the Enterobacteriaceae. The purpose of this study was to measure cefepime concentrations in plasma, peritoneal fluid, bile fluid and appendix tissue in patients undergoing elective cholecystectomy. Patients were randomly assigned to receive either cefepime, 2 g intravenously in phosphate buffer (IVPB) q 12 h or gentamicin 1.5 mg/kg IVPB q 8 h plus mezlocillin 4 g IVPB q 6 h. During surgery, gall bladder tissue, plasma, peritoneal fluid, and bile fluid samples were obtained at approximately the same time. Thirty-three patients had data acceptable for analysis. Values are given as mean +/- standard deviation. The mean delta time (defined as the time between the administration of cefepime and the time the samples were obtained) was 8.58 +/- 3.53 h. The values for plasma, peritoneal fluid, bile fluid, and gall bladder tissue concentrations were 7.63 +/- 14.17 micrograms/ml, 5.66 +/- 6.80 micrograms/ml, 15.51 +/- 16.94 micrograms/ml, and 5.36 +/- 6.57 micrograms/gm, respectively. The peritoneal fluid/plasma ratio was 2.10 +/- 2.33, the bile fluid/plasma ratio was 14.44 +/- 31.99, and the gall bladder tissue/plasma ratio was 1.44 +/- 1.82. There was a significant correlation between peritoneal fluid and plasma concentration (r = 0.91, p less than 0.0005), and gall bladder tissue and plasma concentration (r = 0.90, p less than 0.0005). There was no correlation between bile fluid and plasma cefepime concentrations. The minimum inhibitory concentration (MIC) data from previous in vitro studies indicate that cefepime concentrations achieved in this patient population would be adequate against typical biliary tract pathogens.(ABSTRACT TRUNCATED AT 250 WORDS)
NASA Astrophysics Data System (ADS)
Sauerheber, Richard D.
2012-01-01
Methods of teaching the Calculus are presented in honour of Sir Isaac Newton, by discussing an extension of his original proofs and discoveries. The methods, requested by Newton to be used that reflect the historical sequence of the discovered Fundamental Theorems, allow first-time students to grasp quickly the basics of the Calculus from its original foundation. It is necessary to present the information along with other methods one might employ now in common use; avoiding these principles of the Calculus can cloud its simplicity. The nature and significance of integration and differentiation are clarified, including the power and chain rules, logarithmic differentiation, and the fundamental relationships between integrals and derivatives. By considering in detail the graphical areas covered by a thin thread under a continuous smooth function along its course, the Fundamental Theorems of the Calculus may be proven. Any function f(x) is both the derivative of and the integrand of its integral F(x). The area traced out by any f(x) has ordinal values that are the slopes of F(x) because the function is the derivative of the integral. Differences in ordinal values of an integral, F(b) - F(a), calculate the total of all dy variations along the integral and equal the exact net area of thin vertical f(x)dx threads between the derivative function and the horizon from a to b. Unique features of the sine function, including its line integral arc length and its area, demonstrate the power of the Fundamental Theorems of the Calculus.
Fractional calculus in bioengineering.
Magin, Richard L
2004-01-01
Fractional calculus (integral and differential operations of noninteger order) is not often used to model biological systems. Although the basic mathematical ideas were developed long ago by the mathematicians Leibniz (1695), Liouville (1834), Riemann (1892), and others and brought to the attention of the engineering world by Oliver Heaviside in the 1890s, it was not until 1974 that the first book on the topic was published by Oldham and Spanier. Recent monographs and symposia proceedings have highlighted the application of fractional calculus in physics, continuum mechanics, signal processing, and electromagnetics, but with few examples of applications in bioengineering. This is surprising because the methods of fractional calculus, when defined as a Laplace or Fourier convolution product, are suitable for solving many problems in biomedical research. For example, early studies by Cole (1933) and Hodgkin (1946) of the electrical properties of nerve cell membranes and the propagation of electrical signals are well characterized by differential equations of fractional order. The solution involves a generalization of the exponential function to the Mittag-Leffler function, which provides a better fit to the observed cell membrane data. A parallel application of fractional derivatives to viscoelastic materials establishes, in a natural way, hereditary integrals and the power law (Nutting/Scott Blair) stress-strain relationship for modeling biomaterials. In this review, I will introduce the idea of fractional operations by following the original approach of Heaviside, demonstrate the basic operations of fractional calculus on well-behaved functions (step, ramp, pulse, sinusoid) of engineering interest, and give specific examples from electrochemistry, physics, bioengineering, and biophysics. The fractional derivative accurately describes natural phenomena that occur in such common engineering problems as heat transfer, electrode/electrolyte behavior, and sub
Fractional calculus in bioengineering.
Magin, Richard L
2004-01-01
Fractional calculus (integral and differential operations of noninteger order) is not often used to model biological systems. Although the basic mathematical ideas were developed long ago by the mathematicians Leibniz (1695), Liouville (1834), Riemann (1892), and others and brought to the attention of the engineering world by Oliver Heaviside in the 1890s, it was not until 1974 that the first book on the topic was published by Oldham and Spanier. Recent monographs and symposia proceedings have highlighted the application of fractional calculus in physics, continuum mechanics, signal processing, and electromagnetics, but with few examples of applications in bioengineering. This is surprising because the methods of fractional calculus, when defined as a Laplace or Fourier convolution product, are suitable for solving many problems in biomedical research. For example, early studies by Cole (1933) and Hodgkin (1946) of the electrical properties of nerve cell membranes and the propagation of electrical signals are well characterized by differential equations of fractional order. The solution involves a generalization of the exponential function to the Mittag-Leffler function, which provides a better fit to the observed cell membrane data. A parallel application of fractional derivatives to viscoelastic materials establishes, in a natural way, hereditary integrals and the power law (Nutting/Scott Blair) stress-strain relationship for modeling biomaterials. In this review, I will introduce the idea of fractional operations by following the original approach of Heaviside, demonstrate the basic operations of fractional calculus on well-behaved functions (step, ramp, pulse, sinusoid) of engineering interest, and give specific examples from electrochemistry, physics, bioengineering, and biophysics. The fractional derivative accurately describes natural phenomena that occur in such common engineering problems as heat transfer, electrode/electrolyte behavior, and sub
NASA Technical Reports Server (NTRS)
Tucker, Jerry H.; Tapia, Moiez A.; Bennett, A. Wayne
1988-01-01
The concept of Boolean integration is developed, and different Boolean integral operators are introduced. Given the changes in a desired function in terms of the changes in its arguments, the ways of 'integrating' (i.e. realizing) such a function, if it exists, are presented. The necessary and sufficient conditions for integrating, in different senses, the expression specifying the changes are obtained. Boolean calculus has applications in the design of logic circuits and in fault analysis.
[Asymptomatic celiac disease in patient with chronic acalculous cholecystitis].
Parfenov, A I; Dolgasheva, G M; Krums, L M; Bystrovskaia, E V; Sabel'nikova, E A; Gudkova, R B; Vorob'eva, N N; Lishchinskaia, A A
2011-01-01
We described a patient 40 years old, admitted to the clinic with periodic attacks of pain in the right upper quadrant. With ultrasound it was confirmed chronic acalculous cholecystitis, and at endoscopy and multiple biopsies revealed atrophy of the mucosa of the duodenum (DM), corresponding to celiac disease (stage III in the Marsh classification). Titer of antibodies to gliadin (AGA) and tissue transglutaminase (AtTG) were higher: 60 and 110 units/ml, respectively, at a rate of 10 units/ml. The patient was assigned a lifetime adherence to a gluten-free diet, serologic test and a control endoscopy with biopsy at 6 months. The important role of the doctor-endoscopist in the diagnosis of latent forms of celiac disease. The significance of DM atrophy in the pathogenesis of patients with chronic cholecystitis. PMID:21695960
Polynomial Calculus: Rethinking the Role of Calculus in High Schools
ERIC Educational Resources Information Center
Grant, Melva R.; Crombie, William; Enderson, Mary; Cobb, Nell
2016-01-01
Access to advanced study in mathematics, in general, and to calculus, in particular, depends in part on the conceptual architecture of these knowledge domains. In this paper, we outline an alternative conceptual architecture for elementary calculus. Our general strategy is to separate basic concepts from the particular advanced techniques used in…
Early Vector Calculus: A Path through Multivariable Calculus
ERIC Educational Resources Information Center
Robertson, Robert L.
2013-01-01
The divergence theorem, Stokes' theorem, and Green's theorem appear near the end of calculus texts. These are important results, but many instructors struggle to reach them. We describe a pathway through a standard calculus text that allows instructors to emphasize these theorems. (Contains 2 figures.)
Polynomial calculus: rethinking the role of calculus in high schools
NASA Astrophysics Data System (ADS)
Grant, Melva R.; Crombie, William; Enderson, Mary; Cobb, Nell
2016-08-01
Access to advanced study in mathematics, in general, and to calculus, in particular, depends in part on the conceptual architecture of these knowledge domains. In this paper, we outline an alternative conceptual architecture for elementary calculus. Our general strategy is to separate basic concepts from the particular advanced techniques used in their definition and exposition. We develop the beginning concepts of differential and integral calculus using only concepts and skills found in secondary algebra and geometry. It is our underlining objective to strengthen students' knowledge of these topics in an effort to prepare them for advanced mathematics study. The purpose of this reconstruction is not to alter the teaching of limit-based calculus but rather to affect students' learning and understanding of mathematics in general by introducing key concepts during secondary mathematics courses. This approach holds the promise of strengthening more students' understanding of limit-based calculus and enhancing their potential for success in post-secondary mathematics.
ERIC Educational Resources Information Center
Scherger, Nicole
2012-01-01
Of the most universal applications in integral calculus are those involved with finding volumes of solids of revolution. These profound problems are typically taught with traditional approaches of the disk and shell methods, after which most calculus curriculums will additionally cover arc length and surfaces of revolution. Even in these visibly…
Calculus in the Middle School?
ERIC Educational Resources Information Center
Barger, Rita H.; McCoy, Ann C.
2010-01-01
This article presents an example of how middle school teachers can lay a foundation for calculus. Although many middle school activities connect directly to calculus concepts, the authors have decided to look in depth at only one: the concept of change. They will show how teachers can lead their students to see and appreciate the calculus…
The Basic Principle of Calculus?
ERIC Educational Resources Information Center
Hardy, Michael
2011-01-01
A simple partial version of the Fundamental Theorem of Calculus can be presented on the first day of the first-year calculus course, and then relied upon repeatedly in assigned problems throughout the course. With that experience behind them, students can use the partial version to understand the full-fledged Fundamental Theorem, with further…
Ultrasonography in acute gallbladder perforation.
Soiva, M; Pamilo, M; Päivänsalo, M; Taavitsainen, M; Suramo, I
1988-01-01
The files of patients with acute cholecystitis from two large university hospitals from the years 1978-1985 were employed to find the cases with acute gallbladder perforation for this study. Only those patients (n = 9) were selected for the analysis of sonographic signs of acute gallbladder perforation who had less than 48 hours of symptoms before sonography, and were operated upon within 24 hours of the sonography. Patients (n = 10) with non-complicated acute cholecystitis and identical in regard to the duration of the symptoms and the timing of the sonography and the operation formed a control group. The sonographic findings in patients with gallbladder perforation were pericholecystic fluid collections, free peritoneal fluid, disappearance of the gallbladder wall echoes, focal highly echogenic areas with acoustic shadows in the gallbladder, and an inhomogeneous, generally echo-poor gallbladder wall. PMID:2964842
Open Calculus: A Free Online Learning Environment
ERIC Educational Resources Information Center
Korey, Jane; Rheinlander, Kim; Wallace, Dorothy
2007-01-01
Dartmouth College mathematicians have developed a free online calculus course called "Open Calculus." Open Calculus is an exportable distance-learning/self-study environment for learning calculus including written text, nearly 4000 online homework problems and instructional videos. The paper recounts the evaluation of course elements since 2000 in…
A Simple Acronym for Doing Calculus: CAL
ERIC Educational Resources Information Center
Hathaway, Richard J.
2008-01-01
An acronym is presented that provides students a potentially useful, unifying view of the major topics covered in an elementary calculus sequence. The acronym (CAL) is based on viewing the calculus procedure for solving a calculus problem P* in three steps: (1) recognizing that the problem cannot be solved using simple (non-calculus) techniques;…
A generalized nonlocal vector calculus
NASA Astrophysics Data System (ADS)
Alali, Bacim; Liu, Kuo; Gunzburger, Max
2015-10-01
A nonlocal vector calculus was introduced in Du et al. (Math Model Meth Appl Sci 23:493-540, 2013) that has proved useful for the analysis of the peridynamics model of nonlocal mechanics and nonlocal diffusion models. A formulation is developed that provides a more general setting for the nonlocal vector calculus that is independent of particular nonlocal models. It is shown that general nonlocal calculus operators are integral operators with specific integral kernels. General nonlocal calculus properties are developed, including nonlocal integration by parts formula and Green's identities. The nonlocal vector calculus introduced in Du et al. (Math Model Meth Appl Sci 23:493-540, 2013) is shown to be recoverable from the general formulation as a special example. This special nonlocal vector calculus is used to reformulate the peridynamics equation of motion in terms of the nonlocal gradient operator and its adjoint. A new example of nonlocal vector calculus operators is introduced, which shows the potential use of the general formulation for general nonlocal models.
Fluorescence detection of dental calculus
NASA Astrophysics Data System (ADS)
Gonchukov, S.; Biryukova, T.; Sukhinina, A.; Vdovin, Yu
2010-11-01
This work is devoted to the optimization of fluorescence dental calculus diagnostics in optical spectrum. The optimal wavelengths for fluorescence excitation and registration are determined. Two spectral ranges 620 - 645 nm and 340 - 370 nm are the most convenient for supra- and subgingival calculus determination. The simple implementation of differential method free from the necessity of spectrometer using was investigated. Calculus detection reliability in the case of simple implementation is higher than in the case of spectra analysis at optimal wavelengths. The use of modulated excitation light and narrowband detection of informative signal allows us to decrease essentially its diagnostic intensity even in comparison with intensity of the low level laser dental therapy.
Classroom Integral Calculus: Some Useful Digressions When Teaching Integral Calculus.
ERIC Educational Resources Information Center
Acosta, Daniel J.; Wills, Randall
2002-01-01
Outlines ideas and exercises for two topics that accompany the standard treatment of integral calculus. Emphasizes intuition to help facilitate student comprehension of the definite integral as a limit of Riemann Sums. (Author/MM)
Dynamic Visualizations of Calculus Ideas.
ERIC Educational Resources Information Center
Embse, Charles Vonder
2001-01-01
Presents three fundamental ideas of calculus and explains using the coordinate plane geometrically. Uses Cabri Geometry II to show how computer geometry systems can facilitate student understanding of general conic objects and its dynamic algebraic equations. (KHR)
Cartooning in Algebra and Calculus
ERIC Educational Resources Information Center
Moseley, L. Jeneva
2014-01-01
This article discusses how teachers can create cartoons for undergraduate math classes, such as college algebra and basic calculus. The practice of cartooning for teaching can be helpful for communication with students and for students' conceptual understanding.
Catwalk: First-Semester Calculus.
ERIC Educational Resources Information Center
Speiser, Bob; Walter, Chuck
1994-01-01
Describes the use of time-lapse photographs of a running cat as a model to investigate the concepts of function and derivative in a college calculus course. Discusses student difficulties and implications for teachers. (MKR)
Davis, G.B.; Berk, R.N.; Sheible, F.W.; Witztum, K.F.; Gilmore, I.T.; Strong, R.M.; Hofmann, A.F.
1982-12-01
Because the efficacy of cholecystokinin cholecystography in the detection of chronic acalculous cholecystitis remains in doubt, the procedure is rarely used in clinical practice. However, the ability to observe gallbladder contraction with sonography and /sup 99m/Tc-para-isopropylacetanilido-iminodiacetic acid cholescintigraphy (PIPIDA) offers a possibility to improve the sensitivity of the test. To determine if the degree of gallbladder contraction after cholecystokinin is the same as measured by the three techniques and if it differs in symptomatic patients compared to the normal population, cholecystokinin cholecystography, cholecystokinin sonography, and cholecystokinin PIPIDA were performed in 10 symptomatic patients and 10 normal volunteers. The mean maximum contraction of the gallbladder during the three studies was 63%, 61%, and 68%, respectively, for the volunteers, and 72%, 63%, and 73%, respectively, for the patients. The mean maximum gallbladder contraction during all three procedues was 64% +/- 26% SD in the volunteers and 74% +/- 17% SD in the patients. The differences were not statistically significant. Although there was good correlation in the degree of maximum gallbladder contraction among cholecystokinin PIPIDA, marked variation in both the volunteers and the patients makes it unlikely that the degree of contraction as observed by any of these techniques can be used to indicate the presence of chronic acalculous cholecystitis.
Davis, G.B.; Berk, R.N.; Scheible, F.W.; Witztum, K.F.; Gilmore, I.T.; Strong, R.M.; Hofmann, A.F.
1982-12-01
Because the efficacy of cholecystokinin cholecystography in the detection of chronic acalculous cholecystitis remains in doubt, the procedure is rarely used in clinical practice. However, the ability to observe gallbladder contraction with sonography and /sup 99m/Tc-para-isopropylacetanilido-iminodiacetic acid cholescintigraphy (PIPIDA) offers a possibility to improve the sensitivity of the test. To determine if the degree of gallbladder contraction after cholecystokinin is the same as measured by the three techniques and if it differs in symptomatic patients compared to the normal population, cholecystokinin cholecystography, cholecystokinin sonography, and cholecystokinin PIPIDA were performed in 10 symptomatic patients and 10 normal volunteers. The mean maximum contraction of the gallbladder during the three studies was 63%, 61%, and 68%, respectively, for the volunteers, and 72%, 63%, and 73%, respectively, for the patients. The mean maximum gallbladder contraction during all three procedures was 64% +/- 26% SD in the volunteers and 74% +/- 17% SD in the patients. The differences were not statistically significant. Although there was good correlation in the degree of maximum gallbladder contraction among cholecystokinin cholecystography, cholecystokinin sonography, and cholecystokinin PIPIDA, marked variation in both the volunteers and the patients makes it unlikely that the degree of contraction as observed by any of these techniques can be used to indicate the presence of chronic acalculous cholecystitis.
``Riemann equations'' in bidifferential calculus
NASA Astrophysics Data System (ADS)
Chvartatskyi, O.; Müller-Hoissen, F.; Stoilov, N.
2015-10-01
We consider equations that formally resemble a matrix Riemann (or Hopf) equation in the framework of bidifferential calculus. With different choices of a first-order bidifferential calculus, we obtain a variety of equations, including a semi-discrete and a fully discrete version of the matrix Riemann equation. A corresponding universal solution-generating method then either yields a (continuous or discrete) Cole-Hopf transformation, or leaves us with the problem of solving Riemann equations (hence an application of the hodograph method). If the bidifferential calculus extends to second order, solutions of a system of "Riemann equations" are also solutions of an equation that arises, on the universal level of bidifferential calculus, as an integrability condition. Depending on the choice of bidifferential calculus, the latter can represent a number of prominent integrable equations, like self-dual Yang-Mills, as well as matrix versions of the two-dimensional Toda lattice, Hirota's bilinear difference equation, (2+1)-dimensional Nonlinear Schrödinger (NLS), Kadomtsev-Petviashvili (KP) equation, and Davey-Stewartson equations. For all of them, a recent (non-isospectral) binary Darboux transformation result in bidifferential calculus applies, which can be specialized to generate solutions of the associated "Riemann equations." For the latter, we clarify the relation between these specialized binary Darboux transformations and the aforementioned solution-generating method. From (arbitrary size) matrix versions of the "Riemann equations" associated with an integrable equation, possessing a bidifferential calculus formulation, multi-soliton-type solutions of the latter can be generated. This includes "breaking" multi-soliton-type solutions of the self-dual Yang-Mills and the (2+1)-dimensional NLS equation, which are parametrized by solutions of Riemann equations.
Agholi, Mahmoud; Heidarian, Hamid Reza; Moghadami, Mohsen; Hatam, Gholam Reza
2014-06-01
Acalculous cholecystitis and cholangitis are increasingly being recognized as complications of AIDS. The opportunistic parasites that have been most commonly associated with these disorders are Cryptosporidium species, Isospora belli, Cyclospora cayetanensis and Enterocytozoon bieneusi. The authors performed a parasitological survey on the gallbladder tissue sections of patients underwent cholecystectomy due to chronic acalculous cholecystitis at the Shiraz University of Medical Sciences, Iran. Light microscopic investigation in more than three hundred archived histopathological slides revealed the presence of sexual stages (i.e., mature sporocysts) of a coccidial protozoan in a patient with AIDS who developed acalculous cholecystitis as confirmed by histological, parasitological and molecular tests in which Sarcocystis species was the only identifiable pathogen in gallbladder sections. In the best of our knowledge it's the first documented case of chronic non-calculous cholecystitis due to Sarcocystis parasite in an Iranian AIDS patient from worldwide. PMID:24827104
Kaur, Navjot; Chander, Bal; Kaur, Harjit; Kaul, Rashmi
2016-01-01
Heterotopic pancreatic tissue in the gall bladder is an uncommon incidental finding in most cases. We hereby describe the case of a 45-year-old woman who presented with symptoms of acalculous cholecystitis. Pathological examination detected heterotopic pancreatic tissue, pseudopyloric metaplasia, and adenomyomatous hyperplasia in the gall bladder. This is a rare combination of three entities which is being reported for the first time. This case emphasizes that heterotopic pancreas might be the causative factor for cholecystitis. PMID:27365925
Investigating the Fundamental Theorem of Calculus
ERIC Educational Resources Information Center
Johnson, Heather L.
2010-01-01
The fundamental theorem of calculus, in its simplified complexity, connects differential and integral calculus. The power of the theorem comes not merely from recognizing it as a mathematical fact but from using it as a systematic tool. As a high school calculus teacher, the author developed and taught lessons on this fundamental theorem that were…
The Power of Investigative Calculus Projects
ERIC Educational Resources Information Center
Perrin, John Robert; Quinn, Robert J.
2008-01-01
This article describes investigative calculus projects in which students explore a question or problem of their own construction. Three exemplary pieces of student work are showcased. Investigative calculus projects are an excellent way to foster student understanding and interest in calculus. (Contains 4 figures.)
An AP Calculus Classroom Amusement Park
ERIC Educational Resources Information Center
Ferguson, Sarah
2016-01-01
Throughout the school year, AP Calculus teachers strive to teach course content comprehensively and swiftly in an effort to finish all required material before the AP Calculus exam. As early May approaches and the AP Calculus test looms, students and teachers nervously complete lessons, assignments, and assessments to ensure student preparation.…
Ascaris cholecystitis and cholangitis: an experience in Myanmar.
Lwin, M; Tint, K S
1994-08-01
Twenty-seven cases of ascaris cholecystitis and cholangitis were managed in a surgical unit of a general hospital in Yangon, Myanmar, from January 1989 to March 1990. Nineteen women and eight men with a mean age of 42 years were studied. Main clinical manifestations were right hypochondrial pain, fever, chills, rigors, nausea, vomiting and jaundice. Diagnosis was established by abdominal ultrasonograms in all cases. Laparotomy was performed in all cases because of failure to respond to initial conservative treatment. Live and dead ascarids were found in the gall bladder and biliary ductal system. Cholecystectomy, bile duct exploration, worm extraction and T-tube drainage were done in all cases. There were no deaths. Two patients developed minor wound sepsis. During the follow-up period ranging from 3 to 12 months, there was no recurrence of symptoms in all patients. All patients were given antihelminthics before discharge and three weeks later.
Calculus with a quaternionic variable
NASA Astrophysics Data System (ADS)
Schwartz, Charles
2009-01-01
Most of theoretical physics is based on the mathematics of functions of a real or a complex variable; yet we frequently are drawn in trying to extend our reach to include quaternions. The noncommutativity of the quaternion algebra poses obstacles for the usual manipulations of calculus, but we show in this paper how many of those obstacles can be overcome. The surprising result is that the first order term in the expansion of F(x +δ) is a compact formula involving both F'(x) and [F(x )-F(x∗)]/(x -x∗). This advance in the differential calculus for quaternionic variables also leads us to some progress in studying integration.
Individualized additional instruction for calculus
NASA Astrophysics Data System (ADS)
Takata, Ken
2010-10-01
College students enrolling in the calculus sequence have a wide variance in their preparation and abilities, yet they are usually taught from the same lecture. We describe another pedagogical model of Individualized Additional Instruction (IAI) that assesses each student frequently and prescribes further instruction and homework based on the student's performance. Our study compares two calculus classes, one taught with mandatory remedial IAI and the other without. The class with mandatory remedial IAI did significantly better on comprehensive multiple-choice exams, participated more frequently in classroom discussion and showed greater interest in theorem-proving and other advanced topics.
Calculus of twisted vertex operators
Lepowsky, J.
1985-01-01
Starting from an arbitrary isometry of an arbitrary even lattice, twisted and shifted vertex operators are introduced. Under commutators, these operators provide realizations of twisted affine Lie algebras. This construction, generalizing a number of known ones, is based on a self-contained “calculus.” PMID:16593635
Reading the World with Calculus
ERIC Educational Resources Information Center
Verzosa, Debbie
2015-01-01
It is now increasingly recognized that mathematics is not a neutral value-free subject. Rather, mathematics can challenge students' taken-for-granted realities and promote action. This article describes two issues, namely deforestation and income inequality. These were specifically chosen because they can be related to a range of calculus concepts…
Individualized Additional Instruction for Calculus
ERIC Educational Resources Information Center
Takata, Ken
2010-01-01
College students enrolling in the calculus sequence have a wide variance in their preparation and abilities, yet they are usually taught from the same lecture. We describe another pedagogical model of Individualized Additional Instruction (IAI) that assesses each student frequently and prescribes further instruction and homework based on the…
Mathematical Features of the Calculus
ERIC Educational Resources Information Center
Sauerheber, Richard D.
2010-01-01
The fundamental theorems of the calculus describe the relationships between derivatives and integrals of functions. The value of any function at a particular location is the definite derivative of its integral and the definite integral of its derivative. Thus, any value is the magnitude of the slope of the tangent of its integral at that position,…
Constructivized Calculus in College Mathematics
ERIC Educational Resources Information Center
Lawrence, Barbara Ann
2012-01-01
The purpose of this study is to present some of the classical concepts, definitions, and theorems of calculus from the constructivists' point of view in the spirit of the philosophies of L.E.J. Brouwer and Errett Bishop. This presentation will compare the classical statements to the constructivized statements. The method focuses on giving…
Differential Calculus: Concepts and Notation.
ERIC Educational Resources Information Center
Hobbs, David; Relf, Simon
1997-01-01
Suggests that many students with A-level mathematics, and even with a degree in mathematics or a related subject, do not have an understanding of the basic principles of calculus. Describes the approach used in three textbooks currently in use. Contains 14 references. (Author/ASK)
Calculus Student Understanding of Continuity
ERIC Educational Resources Information Center
Wangle, Jayleen Lillian
2013-01-01
Continuity is a central concept in calculus. Yet very few students seem to understand the nature of continuity. The research described was conducted in two stages. Students were asked questions in multiple choice and true/false format regarding function, limit and continuity. These results were used to identify participants as strong, weak or…
Portfolio Analysis for Vector Calculus
ERIC Educational Resources Information Center
Kaplan, Samuel R.
2015-01-01
Classic stock portfolio analysis provides an applied context for Lagrange multipliers that undergraduate students appreciate. Although modern methods of portfolio analysis are beyond the scope of vector calculus, classic methods reinforce the utility of this material. This paper discusses how to introduce classic stock portfolio analysis in a…
Calculus Students' Understanding of Volume
ERIC Educational Resources Information Center
Dorko, Allison; Speer, Natasha M.
2013-01-01
Researchers have documented difficulties that elementary school students have in understanding volume. Despite its importance in higher mathematics, we know little about college students' understanding of volume. This study investigated calculus students' understanding of volume. Clinical interview transcripts and written responses to volume…
Calculus: The Dynamics of Change. MAA Notes Number 39.
ERIC Educational Resources Information Center
Roberts, A. Wayne, Ed.
This book discusses the calculus reform effort. The first essay captures the basic themes that should characterize a calculus course that is modern in its vision as well as its pedagogy and content. The next section contains essays on the vision of calculus reform: "Visions of Calculus" (Sharon Cutler Ross); "Nonalgebraic Approaches to Calculus"…
Factors Associated with Success in College Calculus II
ERIC Educational Resources Information Center
Rosasco, Margaret E.
2013-01-01
Students are entering college having earned credit for college Calculus 1 based on their scores on the College Board's Advanced Placement (AP) Calculus AB exam. Despite being granted credit for college Calculus 1, it is unclear whether these students are adequately prepared for college Calculus 2. College calculus classes are often taught…
Fractal calculus involving gauge function
NASA Astrophysics Data System (ADS)
Golmankhaneh, Alireza K.; Baleanu, Dumitru
2016-08-01
Henstock-Kurzweil integral or gauge integral is the generalization of the Riemann integral. The functions which are not integrable because of singularity in the senses of Lebesgue or Riemann are gauge integrable. In this manuscript, we have generalized Fα-calculus using the gauge integral method for the integrating of the functions on fractal set subset of real-line where they have singularities. The suggested new method leads to the wider class of functions on the fractal subset of real-line that are *Fα-integrable. Using gauge function we define *Fα-derivative of functions their Fα-derivative is not exist. The reported results can be used for generalizing the fundamental theorem of Fα-calculus.
Bartosh, L F; Balakina, I V; Gridneva, L M
2004-01-01
Ninety patients aged 21 to 56 years who had chronic non-calculous cholecystitis (CNCC) concurrent with hyperkinetic dyskinesia (HKD) detectable by a stepwise duodenal probing and sonography, by using a choleretic breakfast and by determining the relaxation coefficient (RC) that was equal to the ratio of the volume of the gallbladder (GB) after the use of a spasmolytic to the baseline GB volume. The patients were divided into 3 groups. The authors used as a spasmolytic agent pinaverium bromide (dicetel) in a dose of 50 mg (1 tablet) in Group 1), octylonium bromide (spasmomen) in a dose of 40 mg (1 dragee) in Group 2, and drotaverine (no-spa) in a dose of 40 mg (1 tablet). There was a more significant sonographic increase in the size of GB in Groups 1 and 2 as compared with Group 3. In the acute drug test and during long-term treatment as well, the highest spasmolytic effect was noted in patients receiving dicetel (Group 1) and spasmomen (Group 2) as compared with that in Group 3 patients taking drotaverine. With this, RC was 1.25 +/- 0.2, 1.6 +/- 0.15, and 1.08 +/- 0.1, respectively. No adverse reactions occurred in the patients having selective calcium blockers (SCBs) whereas the patients receiving no-spa were found to have the following side effects: dry mouth (n = 3), transient constipation (n = 1), and numb tongue (n = 1). Thus, the study has provided evidence for the fact that SCBs have some advantage over myotropic spasmolytic agents in the treatment of CNCC with the signs of HKD. PMID:15540426
Evidence for a pyloro-cholecystic reflex for gallbladder contraction.
Debas, H T; Yamagishi, T
1979-01-01
We studied the effect of graded antral distension on gallbladder contraction both when gastrin release was promoted (alkaline distension) and when gastrin release was blocked (acid distension) in five dogs provided with innervated antral pouch, chronic bile fistula and gastric fistula. Graded distension of the antrum caused graded gallbladder contraction as evidenced by bilirubin output even when gastrin release was completely suppressed. This nongastrin mechanism of gallbladder contraction is abolished by parenteral atropine and by transthoracic truncal vagotomy. These observations provide evidence for a cholinergic, pyloro-cholecystic reflex for gallbladder contraction that is dependent on intact long vagal pathways. Similar reflex mechanisms have been shown to be initiated by antral distension and to cause pancreatic enzyme secretion (pyloro-pancreatic reflex) or acid secretion from the oxyntic gland area of the stomach (pyloro-oxyntic reflex). It would appear, therefore, that the antrum plays a central role in the integration of upper gastrointestinal function not only through the hormone gastrin but also through neural reflex mechanisms. PMID:464689
Osadchuk, M A; Kon'kov, A V; Lipatov, T E
2004-01-01
The article provides information on 145 patients with chronic acalculous cholecystitis and 62 patients with chronic calculous cholecystitis subjected to a study of the quantitative characteristic of gastric antral epithelial cells immunopositive for NO synthase. The increased number of NO synthase immunopositive gastric epithelial cells at chronic cholecystitis was discovered. Most of them were discovered at the calculous process. The study discovered the relation between the gallbladder inflammatory activity, bile lithogenicity and the number of NO synthase immunopositive gastric epithelial cells. The clinical, biochemical and morphologic analyses showed that the application of Hepabene for treating patients with chronic acalculous cholecystitis produces a clinical and biochemical remission in a shorter term. Bile lithogenicity decreases; the quantitative characteristic of NO synthase immunopositive gastric epithelial cells normalizes. The study results make it possible to recommend Hepabene as a highly efficient drug for treating patients with chronic acalculous cholecystitis. PMID:15770857
An Introduction to Lagrangian Differential Calculus.
ERIC Educational Resources Information Center
Schremmer, Francesca; Schremmer, Alain
1990-01-01
Illustrates how Lagrange's approach applies to the differential calculus of polynomial functions when approximations are obtained. Discusses how to obtain polynomial approximations in other cases. (YP)
Generalized vector calculus on convex domain
NASA Astrophysics Data System (ADS)
Agrawal, Om P.; Xu, Yufeng
2015-06-01
In this paper, we apply recently proposed generalized integral and differential operators to develop generalized vector calculus and generalized variational calculus for problems defined over a convex domain. In particular, we present some generalization of Green's and Gauss divergence theorems involving some new operators, and apply these theorems to generalized variational calculus. For fractional power kernels, the formulation leads to fractional vector calculus and fractional variational calculus for problems defined over a convex domain. In special cases, when certain parameters take integer values, we obtain formulations for integer order problems. Two examples are presented to demonstrate applications of the generalized variational calculus which utilize the generalized vector calculus developed in the paper. The first example leads to a generalized partial differential equation and the second example leads to a generalized eigenvalue problem, both in two dimensional convex domains. We solve the generalized partial differential equation by using polynomial approximation. A special case of the second example is a generalized isoperimetric problem. We find an approximate solution to this problem. Many physical problems containing integer order integrals and derivatives are defined over arbitrary domains. We speculate that future problems containing fractional and generalized integrals and derivatives in fractional mechanics will be defined over arbitrary domains, and therefore, a general variational calculus incorporating a general vector calculus will be needed for these problems. This research is our first attempt in that direction.
Dental Calculus Arrest of Dental Caries
Keyes, Paul H.; Rams, Thomas E.
2016-01-01
Background An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. Materials and methods A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Results Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. Conclusions These observations further document the potential protective effects of dental calculus mineralization against dental caries. PMID:27446993
Study on bioactive compounds of in vitro cultured Calculus Suis and natural Calculus Bovis.
Wan, Tien-Chun; Cheng, Fu-Yuan; Liu, Yu-Tse; Lin, Liang-Chuan; Sakata, Ryoichi
2009-12-01
The purpose of the study was to investigate bioactive compounds of in vitro cultured Calculus Suis and natural Calculus Bovis obtained as valuable by-products from animals used for meat production. The results showed that the components of natural Calculus Bovis were rich in bilirubin and biliverdin and had higher content of essential amino acids. The major amino acids of in vitro cultured Calculus Suis were identified as glycine, alanine, glutamic acid and aspartic acid, and those for natural Calculus Bovis were found to be glutamic acid, aspartic acid, proline, and arginine. The methionine and cysteine contents of precursors for glutathione in natural Calculus Bovis were significantly higher than those of in vitro cultured Calculus Suis. The mineral contents of zinc, iron and manganese of natural Calculus Bovis were significantly higher than those of in vitro cultured Calculus Suis. The major bile acids in both products were cholic acid and dehydrocholic acid, respectively. The chenodeoxycholic and ursodeoxycholic acid content of in vitro cultured Calculus Suis was significantly higher than that of natural Calculus Bovis.
Imagine Yourself in This Calculus Classroom
ERIC Educational Resources Information Center
Bryan, Luajean
2007-01-01
The efforts to attract students to precalculus, trigonometry, and calculus classes became more successful at the author's school when projects-based classes were offered. Data collection from an untethered hot air balloon flight for calculus students was planned to maximize enrollment. The data were analyzed numerically, graphically, and…
Calculus and Success in a Business School
ERIC Educational Resources Information Center
Kim, Dong-gook; Garcia, Fernando; Dey, Ishita
2012-01-01
Many business schools or colleges require calculus as a prerequisite for certain classes or for continuing to upper division courses. While there are many studies investigating the relationship between performance in calculus and performance in a single course, such as economics, statistics, and finance, there are very few studies investigating…
Raise Test Scores: Integrate Biology and Calculus.
ERIC Educational Resources Information Center
Lukens, Jeffrey D.; Feinstein, Sheryl
This paper presents the results of research that compared the academic achievement of high school students enrolled in an integrated Advanced Placement Biology/Advanced Placement Calculus course with students enrolled in traditional Advanced Placement Biology and Advanced Placement Calculus courses. Study subjects included high school students…
Improving student learning in calculus through applications
NASA Astrophysics Data System (ADS)
Young, C. Y.; Georgiopoulos, M.; Hagen, S. C.; Geiger, C. L.; Dagley-Falls, M. A.; Islas, A. L.; Ramsey, P. J.; Lancey, P. M.; Straney, R. A.; Forde, D. S.; Bradbury, E. E.
2011-07-01
Nationally only 40% of the incoming freshmen Science, Technology, Engineering and Mathematics (STEM) majors are successful in earning a STEM degree. The University of Central Florida (UCF) EXCEL programme is a National Science Foundation funded STEM Talent Expansion Programme whose goal is to increase the number of UCF STEM graduates. One of the key requirements for STEM majors is a strong foundation in Calculus. To improve student learning in calculus, the EXCEL programme developed two special courses at the freshman level called Applications of Calculus I (Apps I) and Applications of Calculus II (Apps II). Apps I and II are one-credit classes that are co-requisites for Calculus I and II. These classes are teams taught by science and engineering professors whose goal is to demonstrate to students where the calculus topics they are learning appear in upper level science and engineering classes as well as how faculty use calculus in their STEM research programmes. This article outlines the process used in producing the educational materials for the Apps I and II courses, and it also discusses the assessment results pertaining to this specific EXCEL activity. Pre- and post-tests conducted with experimental and control groups indicate significant improvement in student learning in Calculus II as a direct result of the application courses.
Plotting Pots: Archaeological Exercises in Introductory Calculus.
ERIC Educational Resources Information Center
Meier, John; Thorme, Trisha
1997-01-01
Outlines a pair of projects used in introductory calculus that are inspired by techniques archaeologists use in the analysis of pottery. These real-world application problems appeal to students who are not necessarily interested in the standard application of calculus. (Author/DDR)
Areas and Volumes in Pre-Calculus
ERIC Educational Resources Information Center
Jarrett, Joscelyn A.
2008-01-01
This article suggests the introduction of the concepts of areas bounded by plane curves and the volumes of solids of revolution in Pre-calculus. It builds on the basic knowledge that students bring to a pre-calculus class, derives a few more formulas, and gives examples of some problems on plane areas and the volumes of solids of revolution that…
A Cross-National Study of Calculus
ERIC Educational Resources Information Center
Chai, Jun; Friedler, Louis M.; Wolff, Edward F.; Li, Jun; Rhea, Karen
2015-01-01
The results from a cross-national study comparing calculus performance of students at East China Normal University (ECNU) in Shanghai and students at the University of Michigan before and after their first university calculus course are presented. Overall, ECNU significantly outperformed Michigan on both the pre- and post-tests, but the Michigan…
Top-Down Calculus: A Concise Course.
ERIC Educational Resources Information Center
Williamson, S. Gill
This textbook was designed for a first course in differential and integral calculus, and is directed toward students in engineering, the sciences, mathematics, and computer science. Its major goal is to bring students to a level of technical competence and intuitive understanding of calculus that is adequate for applying the subject to real world…
Aspects of Calculus for Preservice Teachers
ERIC Educational Resources Information Center
Fothergill, Lee
2011-01-01
The purpose of this study was to compare the perspectives of faculty members who had experience teaching undergraduate calculus and preservice teachers who had recently completed student teaching in regards to a first semester undergraduate calculus course. An online survey was created and sent to recent student teachers and college mathematics…
Calculus: An Active Approach with Projects.
ERIC Educational Resources Information Center
Hilbert, Steve; And Others
Ithaca College, in New York, has developed and tested a projects-based first-year calculus course over the last 3 years which uses the graphs of functions and physical phenomena to illustrate and motivate the major concepts of calculus and to introduce students to mathematical modeling. The course curriculum is designed to: (1) emphasize on the…
Calculus: An Active Approach with Projects.
ERIC Educational Resources Information Center
Hilbert, Stephen; And Others
1993-01-01
Discusses a pedagogical approach to calculus based on the question: What kinds of problems should students be able to solve? Includes a discussion of types of problems and curriculum threads for such a course. Describes a projects-based calculus with examples of projects and classroom activities. (Author/MDH)
Educating about Sustainability while Enhancing Calculus
ERIC Educational Resources Information Center
Pfaff, Thomas J.
2011-01-01
We give an overview of why it is important to include sustainability in mathematics classes and provide specific examples of how to do this for a calculus class. We illustrate that when students use "Excel" to fit curves to real data, fundamentally important questions about sustainability become calculus questions about those curves. (Contains 5…
[The use of natural hitamine-based natural substance at chronic cholecystitis].
Antoniuk, M V; Saĭno, O V; Knyshova, V V
2005-01-01
The results of application of hitamine, enterosorbent of marine origin, by the patients with chronic noncalculous cholecystitis in the remission phase are cited. It has been established that dietotheraphy in complex with hitamine renders the antiinflammatory and lipidcorrected action, favours the increase of remission terms. PMID:16044844
[Pathogenesis of chronic acalculous cholecystitis in inhabitants of the Republic of Chuvashia].
Tarasova, L V; Khokhlova, E A; Arkhipova, A V
2009-01-01
The study of Serum content of Selenium, Zinc, Manganese in inhabitants of the Republic of Chuvashia and also in chronic acalculous cholecystitis patients. Possibility of correction motor dysfunction of gallbladder with the use of natural mineral water "Syvlah-Zdorovie". PMID:19938285
Computer-Oriented Calculus Courses Using Finite Differences.
ERIC Educational Resources Information Center
Gordon, Sheldon P.
The so-called discrete approach in calculus instruction involves introducing topics from the calculus of finite differences and finite sums, both for motivation and as useful tools for applications of the calculus. In particular, it provides an ideal setting in which to incorporate computers into calculus courses. This approach has been…
Using Dynamic Software to Address Common College Calculus Stumbling Blocks
ERIC Educational Resources Information Center
Seneres, Alice W.; Kerrigan, John A.
2014-01-01
There are specific topics in college calculus that can be major stumbling blocks for students. Having taught college calculus for four years to over a thousand students, we observed that even the students who have already taken pre-calculus or calculus during their high school careers had common misunderstandings. Students may remember a technique…
ERIC Educational Resources Information Center
Gibson, Megan
2013-01-01
Due in part to the growing popularity of the Advanced Placement program, an increasingly large percentage of entering college students are enrolling in calculus courses having already taken calculus in high school. Many students do not score high enough on the AP calculus examination to place out of Calculus I, and many do not take the…
The Impact of Taking a College Pre-Calculus Course on Students' College Calculus Performance
ERIC Educational Resources Information Center
Sonnert, Gerhard; Sadler, Philip M.
2014-01-01
Poor performance on placement exams keeps many US students who pursue a STEM (science, technology, engineering, mathematics) career from enrolling directly in college calculus. Instead, they must take a pre-calculus course that aims to better prepare them for later calculus coursework. In the USA, enrollment in pre-calculus courses in two- and…
Teaching calculus with Wolfram|Alpha
NASA Astrophysics Data System (ADS)
Dimiceli, Vincent E.; Lang, Andrew S. I. D.; Locke, LeighAnne
2010-12-01
This article describes the benefits and drawbacks of using Wolfram|Alpha as the platform for teaching calculus concepts in the lab setting. It is a result of our experiences designing and creating an entirely new set of labs using Wolfram|Alpha. We present the reasoning behind our transition from using a standard computer algebra system (CAS) to Wolfram|Alpha in our differential and integral calculus labs, together with the positive results from our experience. We also discuss the current limitations of Wolfram|Alpha, including a discussion on why we still use a CAS for our multivariate calculus labs.
Recursive sequences in first-year calculus
NASA Astrophysics Data System (ADS)
Krainer, Thomas
2016-02-01
This article provides ready-to-use supplementary material on recursive sequences for a second-semester calculus class. It equips first-year calculus students with a basic methodical procedure based on which they can conduct a rigorous convergence or divergence analysis of many simple recursive sequences on their own without the need to invoke inductive arguments as is typically required in calculus textbooks. The sequences that are accessible to this kind of analysis are predominantly (eventually) monotonic, but also certain recursive sequences that alternate around their limit point as they converge can be considered.
Astrophysical Applications of Fractional Calculus
NASA Astrophysics Data System (ADS)
Stanislavsky, Aleksander A.
The paradigm of fractional calculus occupies an important place for the macroscopic description of subdiffusion. Its advance in theoretical astrophysics is expected to be very attractive too. In this report we discuss a recent development of the idea to some astrophysical problems. One of them is connected with a random migration of bright points associated with magnetic fields at the solar photosphere. The transport of the bright points has subdiffusive features that require the fractional generalization of the Leighton's model. Another problem is related to the angular distribution of radio beams, being propagated through a medium with random inhomogeneities. The peculiarity of this medium is that radio beams are trapped because of random wave localization. This idea can be useful for the diagnostics of interplanetary and interstellar turbulent media.
Calculus fragmentation in laser lithotripsy.
Welch, A J; Kang, H W; Lee, H; Teichman, J M H
2004-03-01
The intracorporeal treatment of urinary calculi with lasers is presented, which describes laser-calculus interactions associated with lithotripsy. Reliable fragmentation of calculi with diverse compositions and minimal collateral tissue damage are primarily contingent upon laser parameters (wavelength, pulse duration, and pulse energy) and physical properties of calculi (optical, mechanical, and chemical). The pulse duration governs the dominant mechanism in calculi fragmentation, which is either photothermal or photoacoustical/photomechanical. Lasers with long pulse durations (i.e. > tens of micros) induce a temperature rise in the laser-affected zone with minimal acoustic waves; material is removed by means of vaporization, melting, mechanical stress, and/or chemical decomposition. Short-pulsed laser ablation (i.e. < 10 micros), on the other hand, produces shock waves, and the resultant mechanical energy fragments calculi. Work continues throughout the world to evaluate the feasibility of advanced lasers in lithotripsy and to optimize laser parameters and light delivery systems pertinent to efficient fragmentation of calculi.
Fractional-calculus diffusion equation
2010-01-01
Background Sequel to the work on the quantization of nonconservative systems using fractional calculus and quantization of a system with Brownian motion, which aims to consider the dissipation effects in quantum-mechanical description of microscale systems. Results The canonical quantization of a system represented classically by one-dimensional Fick's law, and the diffusion equation is carried out according to the Dirac method. A suitable Lagrangian, and Hamiltonian, describing the diffusive system, are constructed and the Hamiltonian is transformed to Schrodinger's equation which is solved. An application regarding implementation of the developed mathematical method to the analysis of diffusion, osmosis, which is a biological application of the diffusion process, is carried out. Schrödinger's equation is solved. Conclusions The plot of the probability function represents clearly the dissipative and drift forces and hence the osmosis, which agrees totally with the macro-scale view, or the classical-version osmosis. PMID:20492677
Kochergin, Iu V
2007-01-01
Studies covered chronologic algorithm of physiologic parameters in healthy children and those with hepato-biliary diseases. 71.3% of children suffering from hepato-biliary diseases appeared to have significant desynchronization. The authors conducted time-wise optimization of mud care in children with cholecystitis. Findings are that mud care has considerable sanogenous effect and could be recommended as a treatment for children with ecologically mediated cholecystitis.
Generalized Laplace Transforms and Extended Heaviside Calculus
ERIC Educational Resources Information Center
Deakin, Michael A. B.
2008-01-01
An extended Heaviside calculus proposed by Peraire in a recent paper is similar to a generalization of the Laplace transform proposed by the present author. This similarity will be illustrated by analysis of an example supplied by Peraire.
Applying Change of Variable to Calculus Problems
ERIC Educational Resources Information Center
Kachapova, Farida; Kachapov, Ilias
2011-01-01
This article describes the technique of introducing a new variable in some calculus problems to help students master the skills of integration and evaluation of limits. This technique is algorithmic and easy to apply.
Generalized Cartan Calculus in general dimension
NASA Astrophysics Data System (ADS)
Wang, Yi-Nan
2015-07-01
We develop the generalized Cartan Calculus for the groups and SO(5 , 5). They are the underlying algebraic structures of d = 9 , 7 , 6 exceptional field theory, respectively. These algebraic identities are needed for the "tensor hierarchy" structure in exceptional field theory. The validity of Poincaré lemmas in this new differential geometry is also discussed. Finally we explore some possible extension of the generalized Cartan calculus beyond the exceptional series.
Generalized Cartan Calculus in general dimension
Wang, Yi -Nan
2015-07-22
We develop the generalized Cartan Calculus for the groups G = SL(2,R) × R+, SL(5,R) and SO(5,5). They are the underlying algebraic structures of d=9,7,6 exceptional field theory, respectively. These algebraic identities are needed for the "tensor hierarchy" structure in exceptional field theory. The validity of Poincar\\'e lemmas in this new differential geometry is also discussed. Lastly, we explore some possible extension of the generalized Cartan calculus beyond the exceptional series.
Non-commutative functional calculus: Unbounded operators
NASA Astrophysics Data System (ADS)
Colombo, Fabrizio; Gentili, Graziano; Sabadini, Irene; Struppa, Daniele C.
2010-02-01
In a recent work, Colombo (in press) [1], we developed a functional calculus for bounded operators defined on quaternionic Banach spaces. In this paper we show how the results from the above-mentioned work can be extended to the unbounded case, and we highlight the crucial differences between the two cases. In particular, we deduce a new eigenvalue equation, suitable for the construction of a functional calculus for operators whose spectrum is not necessarily real.
A prospective study of radionuclide biliary scanning in acute pancreatitis.
Neoptolemos, J. P.; Fossard, D. P.; Berry, J. M.
1983-01-01
Early surgery for biliary pancreatitis has resulted in a need for an accurate method of gallstone detection in acute pancreatitis. Fifty patients with acute pancreatitis were studied prospectively to assess the diagnostic value of Radionuclide Biliary Scanning (RBS) performed within 72 hours of an attack. To assess the general accuracy of RBS a further 154 patients with suspected acute cholecystitis or biliary colic were similarly studied. There were 34 patients with biliary pancreatitis and 18 (53%) had a positive scan (no gallbladder seen). There were 16 patients with non-biliary pancreatitis and 5 (31%) had a positive scan. All 51 patients with acute cholecystitis had a positive scan, as did 82% of the 51 patients with biliary colic. There were 52 patients with no biliary or pancreatic disease and none of these had a positive scan. RBS is highly accurate in confirming a diagnosis of acute cholecystitis or biliary colic. However, it cannot be relied on to differentiate between biliary and non-biliary pancreatitis and should certainly not be used as the basis for biliary surgery in these patients. PMID:6859781
NASA Astrophysics Data System (ADS)
Schoenly, Joshua E.; Seka, Wolf; Romanos, Georgios; Rechmann, Peter
A desired outcome of scaling and root planing is the complete removal of calculus and infected root tissue and preservation of healthy cementum for rapid healing of periodontal tissues. Conventional periodontal treatments for calculus removal, such as hand instrument scaling and ultrasonic scaling, often deeply scrape the surface of the underlying hard tissue and may leave behind a smear layer. Pulsed lasers emitting at violet wavelengths (specifically, 380 to 400 nm) are a potential alternative treatment since they can selectively ablate dental calculus without ablating pristine hard tissue (i.e., enamel, cementum, and dentin). In this study, light and scanning electron microscopy are used to compare and contrast the efficacy of in vitro calculus removal for several conventional periodontal treatments (hand instruments, ultrasonic scaler, and Er:YAG laser) to calculus removal with a frequency-doubled Ti:sapphire (λ = 400 nm). After calculus removal, enamel and cementum surfaces are investigated for calculus debris and damage to the underlying hard tissue surface. Compared to the smear layer, grooves, and unintentional hard tissue removal typically found using these conventional treatments, calculus removal using the 400-nm laser is complete and selective without any removal of pristine dental hard tissue. Based on these results, selective ablation from the 400-nm laser appears to produce a root surface that would be more suitable for successful healing of periodontal tissues.
[A case of chronic acalculous cholecystitis diagnosed by delayed contrast emptying in gallbladder].
Kim, Chang Won; Lee, Jong Min; Coh, Jane; Jung, In Sung; Kang, Ki Man; Jung, Shin Hong; Lee, Gye Sung; Kim, Anna; Kwak, Seung Soo; Lee, Mi Sun
2004-05-01
Chronic acalculous cholecystitis is a diagnosis of exclusion in patients complaining acalculous biliary pain. The possible causes of acalculous biliary pain are chronic gallbladder (GB) inflammation, GB dysfunction, cholesterolosis, cystic duct stenosis or microlithiasis. Recently, laparoscopic cholecystectomy is the choice of treatment for acalculous biliary pain. We experienced a 32-year-old woman whose initial symptoms were right upper quadrant pain and nausea only. The abdominal computed tomography, DISIDA scan, and upper and lower endoscopic examinations were nonspecific. Up to 48 hours after endoscopic retrograde cholangiopancreatography, contrast emptying of GB was delayed, implying dysfunctional GB. As the patient's right upper quadrant pain and tenderness became aggravated, the laparoscopic cholecystectomy was done and the final diagnosis of chronic acalculous cholecystitis was confirmed. PMID:15156120
Mechanistic explanation of integral calculus
NASA Astrophysics Data System (ADS)
Sauerheber, Richard D.
2015-04-01
The anatomic features of filaments, drawn through graphs of an integral F(x) and its derivative f(x), clarify why integrals automatically calculate area swept out by derivatives. Each miniscule elevation change dF on an integral, as a linear measure, equals the magnitude of square area of a corresponding vertical filament through its derivative. The sum of all dF increments combine to produce a range ΔF on the integral that equals the exact summed area swept out by the derivative over that domain. The sum of filament areas is symbolized ∫f(x)dx, where dx is the width of any filament and f(x) is the ordinal value of the derivative and thus, the intrinsic slope of the integral point dF/dx. dx displacement widths, and corresponding dF displacement heights, along the integral are not uniform and are determined by the intrinsic slope of the function at each point. Among many methods that demonstrate why integrals calculate area traced out by derivatives, this presents the physical meaning of differentials dx and dF, and how the variation in each along an integral curve explicitly computes area at any point traced by the derivative. This area is the filament width dx times its height, the ordinal value of the derivative function f(x), which is the tangent slope dF/dx on the integral. This explains thoroughly but succinctly the precise mechanism of integral calculus.
Gallbladder torsion-induced emphysematous cholecystitis in a 16-year-old boy.
Tanaka, Shogo; Kubota, Daisuke; Oba, Kazuki; Lee, Sang Hun; Yamamoto, Takatsugu; Uenishi, Takahiro; Tanaka, Hiromu; Kubo, Shoji; Matsuyama, Mitsuharu
2007-01-01
The patient was a 16-year-old boy who had turned to the right rapidly as he fielded a baseball that had come to him quickly. Two days after this event, which occurred in July 2004, he was admitted to hospital with repeated vomiting and increasing right hypochondralgia. Laboratory examination on admission showed elevation of the white blood count and of serum C-reactive protein and total bilirubin. Computed tomography on admission demonstrated an enlarged gallbladder and a thickened wall without gallstones, and magnetic resonance imaging performed 1 day later showed air within the gallbladder wall. His symptoms worsened, with a positive Murphy's sign, and emergency laparotomy was performed, with a diagnosis of emphysematous cholecystitis. Intraoperatively, the gallbladder was dark red, necrotic, distended, and enlarged. The cystic duct was attached only to the mesentery, and the gallbladder was floating freely, with the neck of the gallbladder having rotated 180 degrees counterclockwise, leading to a definitive diagnosis of gallbladder torsion with emphysematous cholecystitis. Cholecystectomy was performed, and analysis of bile showed Escherichia coli to be the causative organism. Histopathologic examination revealed necrotized cholecystitis. The patient is doing well 25 months after surgery, with an uneventful postoperative course.
Anti-calculus and whitening toothpastes.
van Loveren, Cor; Duckworth, Ralph M
2013-01-01
In terms of novel formulations, there seems to have been a shift in emphasis from anti-caries/anti-gingivitis to anti-calculus/whitening toothpastes in recent years. The anti-calculus and whitening effects of toothpastes are to some extent based on the same active ingredients: compounds of high affinity for tooth mineral. Due to this affinity, crystal growth may be hindered (anti-calculus) and chromophores be displaced (whitening). Besides these common ingredients, both types of toothpaste may contain agents specifically aimed at each condition. Clinical studies have shown that these active ingredients can be successfully formulated in fluoride toothpastes to give significant reductions in supragingival calculus and stain formation and facilitate their removal. Some of the ingredients are formulated in toothpastes that additionally contain anti-plaque and anti-gingivitis ingredients, making these toothpastes (together with the fluoride) truly multi-functional. The development of these products is not straightforward because of interaction between formulation components and because the active ingredients must maintain their beneficial characteristics during the shelf life of the paste. Neither a therapeutic benefit (in terms of less gingivitis or less caries) nor a societal benefit (in terms of less treatment demand) has been demonstrated as a result of the anti-calculus and whitening effects of toothpastes. PMID:23817060
Ancient DNA analysis of dental calculus.
Weyrich, Laura S; Dobney, Keith; Cooper, Alan
2015-02-01
Dental calculus (calcified tartar or plaque) is today widespread on modern human teeth around the world. A combination of soft starchy foods, changing acidity of the oral environment, genetic pre-disposition, and the absence of dental hygiene all lead to the build-up of microorganisms and food debris on the tooth crown, which eventually calcifies through a complex process of mineralisation. Millions of oral microbes are trapped and preserved within this mineralised matrix, including pathogens associated with the oral cavity and airways, masticated food debris, and other types of extraneous particles that enter the mouth. As a result, archaeologists and anthropologists are increasingly using ancient human dental calculus to explore broad aspects of past human diet and health. Most recently, high-throughput DNA sequencing of ancient dental calculus has provided valuable insights into the evolution of the oral microbiome and shed new light on the impacts of some of the major biocultural transitions on human health throughout history and prehistory. Here, we provide a brief historical overview of archaeological dental calculus research, and discuss the current approaches to ancient DNA sampling and sequencing. Novel applications of ancient DNA from dental calculus are discussed, highlighting the considerable scope of this new research field for evolutionary biology and modern medicine.
A cross-national study of calculus
NASA Astrophysics Data System (ADS)
Chai, Jun; Friedler, Louis M.; Wolff, Edward F.; Li, Jun; Rhea, Karen
2015-05-01
The results from a cross-national study comparing calculus performance of students at East China Normal University (ECNU) in Shanghai and students at the University of Michigan before and after their first university calculus course are presented. Overall, ECNU significantly outperformed Michigan on both the pre- and post-tests, but the Michigan students showed a larger gain and normalized gain, and hence narrowed the gap. ECNU's superior performance was especially striking on the subset of problems requiring only a pre-calculus background. On those, Michigan's post-test scores were below ECNU's pre-test scores and, indeed, ECNU's higher performance on both the overall pre-test and overall post-test is attributable to its success on these problems.
Hepatobiliary scan with delayed gallbladder visualization in a case of acute appendicitis
Smathers, R.L.; Harman, P.K.; Wanebo, H.J.; Read, M.E.
1982-05-01
A 40-year-old woman presented with acute epigastric pain with vomiting. Within 24 hours, the pain spread to the right periumbilical region. /sup 99m/Tc disofenin hepatobiliary scan failed to demonstrate the gallbladder on a 60-minute view. The presumative diagnosis of acute cholecystitis was thought to be confirmed on this basis by the patient's physicians. However, a 75-minute view demonstrated filling of the gallbladder. In hepatobiliary scanning for acute abdominal pain, delayed views (2 to 24 hours) are recommended when the gallbladder is not visualized on the 60-minute view. If the gallbladder is visualized, cystic duct obstruction can be excluded and diagnoses such as pancreatitis, acalculous cholecystitis, and acute appendicitis should be investigated.
A Transition Course from Advanced Placement to College Calculus
ERIC Educational Resources Information Center
Lucas, Timothy A.; Spivey, Joseph
2011-01-01
In the Spring of 2007, a group of highly motivated mathematics graduate students conducted a review of Duke's Calculus curriculum. They focused on two main problems. The first problem is the result of a very positive trend: a growing number of students are earning AP credit for Calculus I in high school. However, this results in Calculus II…
Improving Calculus II and III through the Redistribution of Topics
ERIC Educational Resources Information Center
George, C. Yousuf; Koetz, Matt; Lewis, Heather A.
2016-01-01
Three years ago our mathematics department rearranged the topics in second and third semester calculus, moving multivariable calculus to the second semester and series to the third semester. This paper describes the new arrangement of topics, and how it could be adapted to calculus curricula at different schools. It also explains the benefits we…
A Historical Perspective on Teaching and Learning Calculus
ERIC Educational Resources Information Center
Doorman, Michiel; van Maanen, Jan
2008-01-01
Calculus is one of those topics in mathematics where the algorithmic manipulation of symbols is easier than understanding the underlying concepts. Around 1680 Leibniz invented a symbol system for calculus that codifies and simplifies the essential elements of reasoning. The calculus of Leibniz brings within the reach of an ordinary student…
Science 101: How Do We Use Calculus in Science?
ERIC Educational Resources Information Center
Robertson, Bill
2014-01-01
How is calculus used in science? That might seem like an odd question to answer in a magazine intended primarily for elementary school teachers. After all, how much calculus gets used in elementary science? Here the author guesses that quite a few readers of this column do not know a whole lot about calculus and have not taken a course in…
Partial nephrectomy: an option in calculus disease?
Timoney, A G; Payne, S R; Walmsley, B H; Vinnicombe, J; Abercrombie, G F
1988-12-01
Thirty-seven patients treated by partial nephrectomy for calculus disease between 1971 and 1986 were reviewed retrospectively. Of the 25 patients available for analysis, 20% developed immediate surgical complications, 20% had residual post-operative stone and 33% developed true ipsilateral stone recurrence during the period of follow-up. Our results from partial nephrectomy for calculus disease are compared with the results of treatment by percutaneous nephrolithotomy and extracorporeal shockwave lithotripsy. It was concluded that partial nephrectomy should be reserved for situations where stone disease is associated with anatomical abnormalities which cannot be treated by the newer modalities of stone management.
Generalized Cartan Calculus in general dimension
Wang, Yi -Nan
2015-07-22
We develop the generalized Cartan Calculus for the groups G = SL(2,R) × R^{+}, SL(5,R) and SO(5,5). They are the underlying algebraic structures of d=9,7,6 exceptional field theory, respectively. These algebraic identities are needed for the "tensor hierarchy" structure in exceptional field theory. The validity of Poincar\\'e lemmas in this new differential geometry is also discussed. Lastly, we explore some possible extension of the generalized Cartan calculus beyond the exceptional series.
Dynamical Regge calculus as lattice gravity
NASA Astrophysics Data System (ADS)
Hagura, Hiroyuki
2001-03-01
We propose a hybrid approach to lattice quantum gravity by combining simultaneously the dynamical triangulation with the Regge calculus, called the dynamical Regge calculus (DRC). In this approach lattice diffeomorphism is realized as an exact symmetry by some hybrid ( k, l) moves on the simplicial lattice. Numerical study of 3D pure gravity shows that an entropy of the DRC is not exponetially bounded if we adopt the uniform measure Π idli. On the other hand, using the scale-invariant measure Π idli/ li, we can calculate observables and observe a large hysteresis between two phases that indicates the first-order nature of the phase transition.
Brazzelli, Miriam; Cruickshank, Moira; Kilonzo, Mary; Ahmed, Irfan; Stewart, Fiona; McNamee, Paul; Elders, Andrew; Fraser, Cynthia; Avenell, Alison; Ramsay, Craig
2014-01-01
BACKGROUND Approximately 10-15% of the adult population suffer from gallstone disease, cholelithiasis, with more women than men being affected. Cholecystectomy is the treatment of choice for people who present with biliary pain or acute cholecystitis and evidence of gallstones. However, some people do not experience a recurrence after an initial episode of biliary pain or cholecystitis. As most of the current research focuses on the surgical management of the disease, less attention has been dedicated to the consequences of conservative management. OBJECTIVES To determine the clinical effectiveness and cost-effectiveness of cholecystectomy compared with observation/conservative management in people presenting with uncomplicated symptomatic gallstones (biliary pain) or cholecystitis. DATA SOURCES We searched all major electronic databases (e.g. MEDLINE, EMBASE, Science Citation Index, Bioscience Information Service, Cochrane Central Register of Controlled Trials) from 1980 to September 2012 and we contacted experts in the field. REVIEW METHODS Evidence was considered from randomised controlled trials (RCTs) and non-randomised comparative studies that enrolled people with symptomatic gallstone disease (pain attacks only and/or acute cholecystitis). Two reviewers independently extracted data and assessed the risk of bias of included studies. Standard meta-analysis techniques were used to combine results from included studies. A de novo Markov model was developed to assess the cost-effectiveness of the interventions. RESULTS Two Norwegian RCTs involving 201 participants were included. Eighty-eight per cent of people randomised to surgery and 45% of people randomised to observation underwent cholecystectomy during the 14-year follow-up period. Participants randomised to observation were significantly more likely to experience gallstone-related complications [risk ratio = 6.69; 95% confidence interval (CI) 1.57 to 28.51; p = 0.01], in particular acute
Is Calculus Really That Different from Algebra? A More Logical Way To Understand and Teach Calculus.
ERIC Educational Resources Information Center
Elk, Seymour B.
1998-01-01
Discards the blinders that have hampered the traditional teaching of calculus and reexamines some of the intuitive ideas that underlie this subject matter. Analyzes the various indeterminate forms that arise through the blind application of algebraic operations. (Author/ASK)
Supragingival calculus formation in a group of young adults.
Galgut, P N
1996-12-01
The presence of calculus was assessed on the lingual surfaces of the mandibular anterior teeth in a randomly selected group of 63 young adults. The rate of regrowth of calculus after professional prophylaxis was also observed. Twenty-two individuals had supragingival calculus on the mandibular lingual surfaces of their teeth at baseline. Eleven of these individuals demonstrated regrowth of calculus by the end of the study, in spite of repeated professional prophylaxis. Thus, 17.5% of subjects exhibited rapid regrowth of calculus on the mandibular lingual surfaces of their teeth within 2 weeks of professional prophylaxis.
The Development of Newtonian Calculus in Britain, 1700-1800
NASA Astrophysics Data System (ADS)
Guicciardini, Niccoló
2003-11-01
Introduction; Overture: Newton's published work on the calculus of fluxions; Part I. The Early Period: 1. The diffusion of the calculus (1700-1730); 2. Developments in the calculus of fluxions (1714-1733); 3. The controversy on the foundations of the calculus (1734-1742); Part II. The Middle Period: 4. The textbooks on fluxions (1736-1758); 5. Some applications of the calculus (1740-1743); 6. The analytic art (1755-1785); Part III. The Reform: 7. Scotland (1785-1809); 8. The Military Schools (1773-1819); 9. Cambridge and Dublin (1790-1820); 10. Tables; Endnotes; Bibliography; Index.
Hassan, Ehsan H; Gerges, Shawkat S; Ahmed, Rehab; Mostafa, Zeinab M; Al-Hamid, Hager Abd; Abd El-Galil, Heba; Thabet, Suzan
2015-12-01
Evidences supporting the association between H. pylori infection and chronic cholecystitis could be found by using direct culture or staining of H. pylori in gallbladder tissues as well as indirect techniques. Stool antigen test has been widely used due to its noninvasive nature. Various stool antigen tests were developed to detect H. pylori using an enzyme immunoassay (EIA) based on monoclonal or polyclonal antibodies This study evaluated the frequency of H. pylori antigen in stool samples of patients with chronic calcular cholecystitis as regard gall bladder histopathological changes. Fifty patients were included presented with symptomatic qholecystolithiasis recruited from the outpatient clinic of National Hepatology and Tropical Medicine Research Institute during 2014-2015. Full history and clinical examination and abdominal ultrasonography were performed. Stool samples were collected, prepared and examined for detection of H. pylori antigen. Cholecystectomy was done for all patients; 45 patients (90%) by laparoscopic Cholecystectomy and 5 patients (10%) by open surgery and removed gallbladders were submitted to pathology department for detection of H. pylori in tissue under microscope using Giemsa stain. The results showed that (82%) were females with mean age (42.6 +/- 1 years). The mean BMI was (29 + 7.2) H. pylori-specific antigen in stool samples was detected in 40% of patients and 38% were detected in patients; tissue, with significant correlation between H. pylori-specific antigen in stool and in tissue. Histopathological pictures infection in tissue were 68.4% mucosal erosions, 63.2% mucosal atrophy, 57.9% mucosal hyperplasia, 26.3% metaplasia, 42.1% musculosa hypertrophy, 26.3% fibrosis, but lymphoid aggregates were in 42.1% of cases. PMID:26939235
I Teach Economics, Not Algebra and Calculus
ERIC Educational Resources Information Center
Hey, John D.
2005-01-01
Most people learn to drive without knowing how the engine works. In a similar vein, the author believes that students can learn economics without knowing the algebra and calculus underlying the results. If instructors follow the philosophy of other economics courses in using graphs to illustrate the results, and draw the graphs accurately, then…
On Online Assignments in a Calculus Class
ERIC Educational Resources Information Center
Jungic, Veselin; Kent, Deborah; Menz, Petra
2012-01-01
In this paper, we describe our experience with the creation and utilization of online assignments for several calculus classes at Simon Fraser University (SFU). We present our findings regarding available software by considering the needs and perspectives of the instructors, students, and administrators. We provide a list of questions that guide…
Using Matlab in a Multivariable Calculus Course.
ERIC Educational Resources Information Center
Schlatter, Mark D.
The benefits of high-level mathematics packages such as Matlab include both a computer algebra system and the ability to provide students with concrete visual examples. This paper discusses how both capabilities of Matlab were used in a multivariate calculus class. Graphical user interfaces which display three-dimensional surfaces, contour plots,…
Calculus: The Importance of Precise Notation
ERIC Educational Resources Information Center
Mahavier, William S.; Mahavier, W. Ted
2008-01-01
The careful use of notation and language in the statement of both the definitions and problems of calculus can begin the process of making students mathematically literate while allowing them to enjoy working on challenging problems and applications without the aid of numerous examples. Engaging the students to participate in the precise use of…
Instructional Guide for Calculus, Secondary Mathematics.
ERIC Educational Resources Information Center
Montgomery County Public Schools, Rockville, MD.
The purpose of this instructional guide is to assist teachers of calculus in the organization and presentation of the course content to best meet the needs of the student. The behaviors expected of the student have been organized into eleven units. These units include the topics recommended for those students preparing for the CEEB advanced…
A Planar Calculus for Infinite Index Subfactors
NASA Astrophysics Data System (ADS)
Penneys, David
2013-05-01
We develop an analog of Jones' planar calculus for II 1-factor bimodules with arbitrary left and right von Neumann dimension. We generalize to bimodules Burns' results on rotations and extremality for infinite index subfactors. These results are obtained without Jones' basic construction and the resulting Jones projections.
Some Factors Effected Student's Calculus Learning Outcome
ERIC Educational Resources Information Center
Rajagukguk, Wamington
2016-01-01
The purpose of this study is to determine the factors effected calculus learning outcome of the student. This study was conducted with 176 respondents, which were selected randomly. The data were obtained by questionnaire, and then analyzed by using multiple regressions, and correlation, at level of a = 0.05. The findings showed there is the…
Are Homeschoolers Prepared for College Calculus?
ERIC Educational Resources Information Center
Wilkens, Christian P.; Wade, Carol H.; Sonnert, Gerhard; Sadler, Philip M.
2015-01-01
Homeschooling in the United States has grown considerably over the past several decades. This article presents findings from the Factors Influencing College Success in Mathematics (FICSMath) survey, a national study of 10,492 students enrolled in tertiary calculus, including 190 students who reported homeschooling for a majority of their high…
Exposing Calculus Students to Advanced Mathematics
ERIC Educational Resources Information Center
Griffiths, Barry J.; Haciomeroglu, Erhan Selcuk
2014-01-01
To ensure the competitiveness of the USA in the global economy, and its role as a leader in science and engineering, it is important to cultivate the next generation of home grown mathematicians. However, while universities across the USA offer calculus classes to thousands of undergraduate students each year, very few of them go on to major in…
Sharks, Minnows, and Wheelbarrows: Calculus Modeling Projects
ERIC Educational Resources Information Center
Smith, Michael D.
2011-01-01
The purpose of this article is to present two very active applied modeling projects that were successfully implemented in a first semester calculus course at Hollins University. The first project uses a logistic equation to model the spread of a new disease such as swine flu. The second project is a human take on the popular article "Do Dogs Know…
Enabling quaternion derivatives: the generalized HR calculus
Xu, Dongpo; Jahanchahi, Cyrus; Took, Clive C.; Mandic, Danilo P.
2015-01-01
Quaternion derivatives exist only for a very restricted class of analytic (regular) functions; however, in many applications, functions of interest are real-valued and hence not analytic, a typical case being the standard real mean square error objective function. The recent HR calculus is a step forward and provides a way to calculate derivatives and gradients of both analytic and non-analytic functions of quaternion variables; however, the HR calculus can become cumbersome in complex optimization problems due to the lack of rigorous product and chain rules, a consequence of the non-commutativity of quaternion algebra. To address this issue, we introduce the generalized HR (GHR) derivatives which employ quaternion rotations in a general orthogonal system and provide the left- and right-hand versions of the quaternion derivative of general functions. The GHR calculus also solves the long-standing problems of product and chain rules, mean-value theorem and Taylor's theorem in the quaternion field. At the core of the proposed GHR calculus is quaternion rotation, which makes it possible to extend the principle to other functional calculi in non-commutative settings. Examples in statistical learning theory and adaptive signal processing support the analysis. PMID:26361555
A TENTATIVE GUIDE, DIFFERENTIAL AND INTEGRAL CALCULUS.
ERIC Educational Resources Information Center
BRANT, VINCENT; GERARDI, WILLIAM
THE COURSE IS INTENDED TO GO BEYOND THE REQUIREMENTS OF THE ADVANCED PLACEMENT PROGRAM IN MATHEMATICS AS DESIGNED BY THE COLLEGE ENTRANCE EXAMINATION BOARD. THE ADVANCED PLACEMENT PROGRAM CONSISTS OF A 1-YEAR COURSE COMBINING ANALYTIC GEOMETRY AND CALCULUS. PRESUPPOSED HERE ARE--A SEMESTER COURSE IN ANALYTIC GEOMETRY AND A THOROUGH KNOWLEDGE OF…
Enabling quaternion derivatives: the generalized HR calculus.
Xu, Dongpo; Jahanchahi, Cyrus; Took, Clive C; Mandic, Danilo P
2015-08-01
Quaternion derivatives exist only for a very restricted class of analytic (regular) functions; however, in many applications, functions of interest are real-valued and hence not analytic, a typical case being the standard real mean square error objective function. The recent HR calculus is a step forward and provides a way to calculate derivatives and gradients of both analytic and non-analytic functions of quaternion variables; however, the HR calculus can become cumbersome in complex optimization problems due to the lack of rigorous product and chain rules, a consequence of the non-commutativity of quaternion algebra. To address this issue, we introduce the generalized HR (GHR) derivatives which employ quaternion rotations in a general orthogonal system and provide the left- and right-hand versions of the quaternion derivative of general functions. The GHR calculus also solves the long-standing problems of product and chain rules, mean-value theorem and Taylor's theorem in the quaternion field. At the core of the proposed GHR calculus is quaternion rotation, which makes it possible to extend the principle to other functional calculi in non-commutative settings. Examples in statistical learning theory and adaptive signal processing support the analysis. PMID:26361555
Flipping a Calculus Class: One Instructor's Experience
ERIC Educational Resources Information Center
Palmer, Katrina
2015-01-01
This paper describes one instructor's experiences during a year of flipping four calculus classes. The first exploration attempts to understand student expectations of a math class and their preference towards a flipped classroom. The second examines success of students from a flipped classroom, and the last investigates relationships with student…
Enabling quaternion derivatives: the generalized HR calculus.
Xu, Dongpo; Jahanchahi, Cyrus; Took, Clive C; Mandic, Danilo P
2015-08-01
Quaternion derivatives exist only for a very restricted class of analytic (regular) functions; however, in many applications, functions of interest are real-valued and hence not analytic, a typical case being the standard real mean square error objective function. The recent HR calculus is a step forward and provides a way to calculate derivatives and gradients of both analytic and non-analytic functions of quaternion variables; however, the HR calculus can become cumbersome in complex optimization problems due to the lack of rigorous product and chain rules, a consequence of the non-commutativity of quaternion algebra. To address this issue, we introduce the generalized HR (GHR) derivatives which employ quaternion rotations in a general orthogonal system and provide the left- and right-hand versions of the quaternion derivative of general functions. The GHR calculus also solves the long-standing problems of product and chain rules, mean-value theorem and Taylor's theorem in the quaternion field. At the core of the proposed GHR calculus is quaternion rotation, which makes it possible to extend the principle to other functional calculi in non-commutative settings. Examples in statistical learning theory and adaptive signal processing support the analysis.
Teaching Calculus with Wolfram|Alpha
ERIC Educational Resources Information Center
Dimiceli, Vincent E.; Lang, Andrew S. I. D.; Locke, LeighAnne
2010-01-01
This article describes the benefits and drawbacks of using Wolfram|Alpha as the platform for teaching calculus concepts in the lab setting. It is a result of our experiences designing and creating an entirely new set of labs using Wolfram|Alpha. We present the reasoning behind our transition from using a standard computer algebra system (CAS) to…
ERIC Educational Resources Information Center
Bolt, Mike
2010-01-01
Many optimization problems can be solved without resorting to calculus. This article develops a new variational method for optimization that relies on inequalities. The method is illustrated by four examples, the last of which provides a completely algebraic solution to the problem of minimizing the time it takes a dog to retrieve a thrown ball,…
Students' Difficulties with Vector Calculus in Electrodynamics
ERIC Educational Resources Information Center
Bollen, Laurens; van Kampen, Paul; De Cock, Mieke
2015-01-01
Understanding Maxwell's equations in differential form is of great importance when studying the electrodynamic phenomena discussed in advanced electromagnetism courses. It is therefore necessary that students master the use of vector calculus in physical situations. In this light we investigated the difficulties second year students at KU Leuven…
Maple Graphing Tools for Calculus III
ERIC Educational Resources Information Center
Cook, Darwyn
2006-01-01
For those instructors lacking artistic skills, teaching 3-dimensional calculus can be a challenge. Although some instructors spend a great deal of time working on their illustrations, trying to get them just right, students nevertheless often have a difficult time understanding some of them. To address this problem, the author has written a series…
Boolean integral calculus for digital systems
NASA Technical Reports Server (NTRS)
Tucker, J. H.; Tapia, M. A.; Bennett, A. W.
1985-01-01
The concept of Boolean integration is introduced and developed. When the changes in a desired function are specified in terms of changes in its arguments, then ways of 'integrating' (i.e., realizing) the function, if it exists, are presented. Boolean integral calculus has applications in design of logic circuits.
Fractional calculus in bioengineering, part 3.
Magin, Richard L
2004-01-01
Fractional calculus (integral and differential operations of noninteger order) is not often used to model biological systems. Although the basic mathematical ideas were developed long ago by the mathematicians Leibniz (1695), Liouville (1834), Riemann (1892), and others and brought to the attention of the engineering world by Oliver Heaviside in the 1890s, it was not until 1974 that the first book on the topic was published by Oldham and Spanier. Recent monographs and symposia proceedings have highlighted the application of fractional calculus in physics, continuum mechanics, signal processing, and electromagnetics, but with few examples of applications in bioengineering. This is surprising because the methods of fractional calculus, when defined as a Laplace or Fourier convolution product, are suitable for solving many problems in biomedical research. For example, early studies by Cole (1933) and Hodgkin (1946) of the electrical properties of nerve cell membranes and the propagation of electrical signals are well characterized by differential equations of fractional order. The solution involves a generalization of the exponential function to the Mittag-Leffler function, which provides a better fit to the observed cell membrane data. A parallel application of fractional derivatives to viscoelastic materials establishes, in a natural way, hereditary integrals and the power law (Nutting/Scott Blair) stress-strain relationship for modeling biomaterials. In this review, I will introduce the idea of fractional operations by following the original approach of Heaviside, demonstrate the basic operations of fractional calculus on well-behaved functions (step, ramp, pulse, sinusoid) of engineering interest, and give specific examples from electrochemistry, physics, bioengineering, and biophysics. The fractional derivative accurately describes natural phenomena that occur in such common engineering problems as heat transfer, electrode/electrolyte behavior, and sub
Fractional calculus in bioengineering, part 3.
Magin, Richard L
2004-01-01
Fractional calculus (integral and differential operations of noninteger order) is not often used to model biological systems. Although the basic mathematical ideas were developed long ago by the mathematicians Leibniz (1695), Liouville (1834), Riemann (1892), and others and brought to the attention of the engineering world by Oliver Heaviside in the 1890s, it was not until 1974 that the first book on the topic was published by Oldham and Spanier. Recent monographs and symposia proceedings have highlighted the application of fractional calculus in physics, continuum mechanics, signal processing, and electromagnetics, but with few examples of applications in bioengineering. This is surprising because the methods of fractional calculus, when defined as a Laplace or Fourier convolution product, are suitable for solving many problems in biomedical research. For example, early studies by Cole (1933) and Hodgkin (1946) of the electrical properties of nerve cell membranes and the propagation of electrical signals are well characterized by differential equations of fractional order. The solution involves a generalization of the exponential function to the Mittag-Leffler function, which provides a better fit to the observed cell membrane data. A parallel application of fractional derivatives to viscoelastic materials establishes, in a natural way, hereditary integrals and the power law (Nutting/Scott Blair) stress-strain relationship for modeling biomaterials. In this review, I will introduce the idea of fractional operations by following the original approach of Heaviside, demonstrate the basic operations of fractional calculus on well-behaved functions (step, ramp, pulse, sinusoid) of engineering interest, and give specific examples from electrochemistry, physics, bioengineering, and biophysics. The fractional derivative accurately describes natural phenomena that occur in such common engineering problems as heat transfer, electrode/electrolyte behavior, and sub
Characteristics of subgingival calculus detection by multiphoton fluorescence microscopy
NASA Astrophysics Data System (ADS)
Tung, Oi-Hong; Lee, Shyh-Yuan; Lai, Yu-Lin; Chen, How-Foo
2011-06-01
Subgingival calculus has been recognized as a major cause of periodontitis, which is one of the main chronic infectious diseases of oral cavities and a principal cause of tooth loss in humans. Bacteria deposited in subgingival calculus or plaque cause gingival inflammation, function deterioration, and then periodontitis. However, subgingival calculus within the periodontal pocket is a complicated and potentially delicate structure to be detected with current dental armamentaria, namely dental x-rays and dental probes. Consequently, complete removal of subgingival calculus remains a challenge to periodontal therapies. In this study, the detection of subgingival calculus employing a multiphoton autofluorescence imaging method was characterized in comparison with a one-photon confocal fluorescence imaging technique. Feasibility of such a system was studied based on fluorescence response of gingiva, healthy teeth, and calculus with and without gingiva covered. The multiphoton fluorescence technology perceived the tissue-covered subgingival calculus that cannot be observed by the one-photon confocal fluorescence method.
Vakhrushev, Ia M; Petrova, L I
2004-01-01
The therapeutic efficacy of tykveol was evaluated in 22 patients with chronic non-calculous cholecystitis and/or dyskinesia of the biliary tract (BT) concurrent with gallbladder deformity (GD). Supplementation of tykveol to the combined therapy in the patients with chronic non-calculous cholecystitis concurrent with GD was shown to exert a pronounced therapeutic effect. This caused positive changes in clinical symptoms and BT function, diminished the lithogenic propertes of bile. With the use of tykveol, recovery of neurohumoral regulation is an important factor that improves biliary tract function, as evidenced by decreased gastrin secretion. PMID:15584601
HOSPITALIZATIONS FOR CHOLECYSTITIS AND CHOLELITHIASIS IN THE STATE OF RIO GRANDE DO SUL, BRAZIL
NUNES, Emeline Caldana; ROSA, Roger dos Santos; BORDIN, Ronaldo
2016-01-01
ABSTRACT Background: The cholelithiasis is disease of surgical resolution with about 60,000 hospitalizations per year in the Sistema Único de Saúde (SUS - Brazilian National Health System) of the Rio Grande do Sul state. Aim: To describe the profile of hospitalizations for cholecystitis and cholelithiasis performed by the SUS of Rio Grande do Sul state, 2011-2013. Methods: Hospital Information System data from the National Health System through morbidity list for cholelithiasis and cholecystitis (ICD-10 K80-K81). Variables studied were sex, age, number of hospitalizations and approved Hospitalization Authorizations (AIH), total amount and value of hospital services generated, days and average length of stay, mortality, mortality and case fatality ratio, from health regions of the Rio Grande do Sul. Results: During 2011-2013 there were 60,517 hospitalizations for cholecystitis and cholelithiasis, representing 18.86 hospitalizations per 10,000 inhabitants/year, most often in the age group from 60 to 69 years (41.34 admissions per 10,000 inhabitants/year) and female (27.72 hospitalizations per 10,000 inhabitants/year). The fatality rate presented an inverse characteristic: 13.52 deaths per 1,000 admissions/year for males, compared with 7.12 deaths per 1,000 admissions/year in females. The state had an average total amount spent and value of hospital services of R$ 16,244,050.60 and R$ 10,890,461.31, respectively. The health region "Capital/Gravataí Valley" exhibit the highest total expenditure and hospital services, and the largest number of deaths, and average length of stay. Conclusion: The hospitalization and lethality coefficients, the deaths, the length of stay and spending related to admissions increased from 50 years old. Females had a higher frequency and higher values spent on hospitalization, while the male higher coefficient of mortality and mean hospital stay. PMID:27438030
[Gas in the abdominal cavity--due to cholecystitis caused by gas-producing bacteria].
Miettinen, Simo; Hakkarainen, Timo; Reinikainen, Matti; Hakala, Tapio
2010-01-01
In most cases, gas in the abdominal cavity indicates perforation of the gastrointestinal wall. We describe a patient, in whom the cause of abdominal gas detected in computed tomography turned out to be emphysematous cholecystitis caused by gas-producing bacteria. It is a rare disease characterized by accumulation of gas into the gall bladder or its wall. The gas can be easily observed in computed tomography. The disease easily becomes complicated and is associated with high mortality. Prompt cholecystectomy and antibiotic therapy are the cornerstones of the treatment.
Poddubnaia, O A; Levitskiĭ, E F; Zamoshchina, T A
2014-01-01
Study of biological cycles in chronic cholecystitis with dysfunction of gallbladder has a great practical importance. The results of chronoanalysis testify a dominance of 24-hours cycle in structure of cycles of functional activity of organs of hepatobiliary system. The comparative analysis of trust intervals reveals the intensification of internal connections, expressed intensification of synchronization of cycles of functional activity of system and a breach of synchronism of central regulation and self-regulation, testifying overstrain of proper adaptive possibilities and unconcordance in system of regulation. This manifestations of desynchronization provokes development and progress of dysfunction of gallbladder and dysbalance of vegetative nervous system, that make worse the present disturbances. PMID:25911916
[Extravasation into a renal sinus cyst due to ureteral calculus: a case report].
Taue, R; Naroda, T; Tamura, M; Kanayama, H; Kagawa, S
1999-07-01
A 71-year-old man who had been treated conservatively for advanced prostate cancer with hormonal therapy presented with complaint of left flank pain. Intravenous urography demonstrated obstruction caused by a left upper ureteral calculus and leakage of contrast medium outside the renal pelvis and calyces. Left percutaneous nephrostomy was performed, and subsequent nephrostography showed extravasation into a parapelvic renal sinus cyst previously recognized on follow-up computed tomography (CT). The left ureteral calculus was treated with extracorporeal shock wave lithotripsy (ESWL), after which obstruction and extravasation disappeared. One month later, abdominal CT demonstrated no left renal nor ureteral calculi, as well as a reduction in the left renal sinus cyst. Urinary extravasation sometimes occurs as a complication of acute urinary obstruction. However, extravasation into a cyst is very rare. We have found only one case reported in the literature, so far.
[Computer tomography in acute pyelonephritis].
Triller, J; Scheidegger, J; Terrier, F
1983-07-01
Computer tomography of the kidneys was performed on 30 patients with acute renal infections (acute suppurative pyelonephritis, acute renal abscess, infected cyst, pyelonephrosis, calculus perforation, retroperitoneal abscess). Computer tomography provided more accurate information concerning the extent of the renal and extra-renal inflammatory process than did the urogram or sonogram. This may significantly affect the choice of treatment, particularly concerning the use of drugs or of surgery. Angiography and retrograde pyelography may be used in selected cases, especially where there is a suspicion of acute bacterial nephritis, renal vein thrombosis or ureteric obstruction.
A sign of symptomatic chronic cholecystitis on biliary scintigraphy
Al-Sheikh, W.; Hourani, M.; Barkin, J.S.; Clarke, L.P.; Ashkar, F.S.; Serafini, A.N.
1983-02-01
Five hundred patients with acute right-upper-quadrant pain underwent biliary scintigraphy with /sup 99m/Tc paraisopropyliminodiacetic acid. One hundred and thirty-four studies were reported normal (both gallbladder and activity in bowel are noted in 1 hr). Of the 134 studies reported as normal, 32 showed intestinal activity before gallbladder visualization during the first hour of the study. Sonography and/or oral cholecystography revealed that 24 patients had gallstones, and eight patients had no demonstrable pathology in the biliary system. Of the 134 studies, 102 showed visualization of the gallbladder before intestinal activity during the first hour of the study. Sonography and/or oral cholecystography showed that 73 patients had normal biliary system. The remaining 29 patients had gallstones. The overall sensitivity of this finding is 45%, the specificity is 90%, and the accuracy is 73%. In this group of symptomatic patients, the appearance of intestinal activity before gallbladder activity on biliary scintigraphy warrants further evaluation of these patients by sonography and/or oral cholecystography.
Fractional calculus in bioengineering, part 2.
Magin, Richard L
2004-01-01
Fractional calculus (integral and differential operations of noninteger order) is not often used to model biological systems. Although the basic mathematical ideas were developed long ago by the mathematicians Leibniz (1695), Liouville (1834), Riemann (1892), and others and brought to the attention of the engineering world by Oliver Heaviside in the 1890s, it was not until 1974 that the first book on the topic was published by Oldham and Spanier. Recent monographs and symposia proceedings have highlighted the application of fractional calculus in physics, continuum mechanics, signal processing, and electromagnetics, but with few examples of applications in bioengineering. This is surprising because the methods of fractional calculus, when defined as a Laplace or Fourier convolution product, are suitable for solving many problems in biomedical research. For example, early studies by Cole (1933) and Hodgkin (1946) of the electrical properties of nerve cell membranes and the propagation of electrical signals are well characterized by differential equations of fractional order. The solution involves a generalization of the exponential function to the Mittag-Leffler function, which provides a better fit to the observed cell membrane data. A parallel application of fractional derivatives to viscoelastic materials establishes, in a natural way, hereditary integrals and the power law (Nutting/Scott Blair) stress-strain relationship for modeling biomaterials. In this review, I will introduce the idea of fractional operations by following the original approach of Heaviside, demonstrate the basic operations of fractional calculus on well-behaved functions (step, ramp, pulse, sinusoid) of engineering interest, and give specific examples from electrochemistry, physics, bioengineering, and biophysics. The fractional derivative accurately describes natural phenomena that occur in such common engineering problems as heat transfer, electrode/electrolyte behavior, and sub
Fractional calculus in bioengineering, part 2.
Magin, Richard L
2004-01-01
Fractional calculus (integral and differential operations of noninteger order) is not often used to model biological systems. Although the basic mathematical ideas were developed long ago by the mathematicians Leibniz (1695), Liouville (1834), Riemann (1892), and others and brought to the attention of the engineering world by Oliver Heaviside in the 1890s, it was not until 1974 that the first book on the topic was published by Oldham and Spanier. Recent monographs and symposia proceedings have highlighted the application of fractional calculus in physics, continuum mechanics, signal processing, and electromagnetics, but with few examples of applications in bioengineering. This is surprising because the methods of fractional calculus, when defined as a Laplace or Fourier convolution product, are suitable for solving many problems in biomedical research. For example, early studies by Cole (1933) and Hodgkin (1946) of the electrical properties of nerve cell membranes and the propagation of electrical signals are well characterized by differential equations of fractional order. The solution involves a generalization of the exponential function to the Mittag-Leffler function, which provides a better fit to the observed cell membrane data. A parallel application of fractional derivatives to viscoelastic materials establishes, in a natural way, hereditary integrals and the power law (Nutting/Scott Blair) stress-strain relationship for modeling biomaterials. In this review, I will introduce the idea of fractional operations by following the original approach of Heaviside, demonstrate the basic operations of fractional calculus on well-behaved functions (step, ramp, pulse, sinusoid) of engineering interest, and give specific examples from electrochemistry, physics, bioengineering, and biophysics. The fractional derivative accurately describes natural phenomena that occur in such common engineering problems as heat transfer, electrode/electrolyte behavior, and sub
[Acute pancreatitis and pregnancy].
Scollo, P; Licitra, G
1993-12-01
Aetiologic factors (gallstones, hyperlipidemia I-IV, hypertriglyceridaemia) make their occurrence, mainly, in the third trimester of gestation. Two cases of acute pancreatitis in pregnancy are described; in both cases patients referred healthy diet, no habit to smoke and no previous episode of pancreatitis. An obstructive pathology of biliary tract was the aetiologic factor. Vomiting, upper abdominal pain are aspecific symptoms that impose a differential diagnosis with acute appendicitis, cholecystitis and obstructive intestinal pathology. Laboratory data (elevated serum amylase and lipase levels) and ultrasonography carry out an accurate diagnosis. The management of acute pancreatitis is based on the use of symptomatic drugs, a low fat diet alternated to the parenteral nutrition when triglycerides levels are more than 28 mmol/L. Surgical therapy, used only in case of obstructive pathology of biliary tract, is optimally collected in the third trimester or immediately after postpartum. Our patients, treated only medically, delivered respectively at 38th and 40th week of gestation. Tempestivity of diagnosis and appropriate therapy permit to improve prognosis of a pathology that, although really associated with pregnancy, presents high maternal mortality (37%) cause of complications (shock, coagulopathy, acute respiratory insufficiency) and fetal (37.9%) by occurrence of preterm delivery.
Aberrant activation of Sonic hedgehog signaling in chronic cholecystitis and gallbladder carcinoma.
Xie, Fang; Xu, Xiaoping; Xu, Angao; Liu, Cuiping; Liang, Fenfen; Xue, Minmin; Bai, Lan
2014-03-01
Sonic hedgehog (Shh) signaling has been extensively studied and is implicated in various inflammatory diseases and malignant tumors. We summarized the clinicopathological features and performed immunohistochemistry assays to examine expression of Shh signaling proteins in 10 normal mucosa, 32 gallbladder carcinoma (GBC), and 95 chronic cholecystitis (CC) specimens. The CC specimens were classified into three groups according to degree of inflammation. Compared with normal mucosa, CC, and GBC specimens exhibited increased expression of Shh. The immunoreactive score of Shh in the GBC group was higher than that in the mild to moderate CC groups but lower than that in the severe CC group (P < .05). Expression of Patched (Ptch) and Gli1 gradually increased from non-malignant cholecystitis to malignant tumors. Compared with CC specimens, GBC specimens showed higher cytoplasmic and membranous expression for Ptch (P < .05). Gli1 staining showed cytoplasmic expression of Gli1 in both CC (60% for mild, 77% for moderate, and 84% for severe) and GBC specimens (97%). Nuclear expression of Gli1 was detected in 16% of severe CC specimens with moderate to poor atypical hyperplasia, and in 62.5% of GBC specimens. Shh expression strongly correlated with expression of Ptch and Gli1. Furthermore, patients with strongly positive Gli1 staining had significantly lower survival rates than those with weakly positive staining. Our data indicate that the Shh signaling pathway is aberrantly activated in CC and GBC, and altered Shh signaling may be involved in the course of development from CC to gallbladder carcinogenesis.
Intra-cholecystic approach for laparoscopic management of Mirizzi's syndrome: A case series
Nag, Hirdaya H.; Gangadhara, Vageesh Bettageri; Dangi, Amit
2016-01-01
INTRODUCTION: Laparoscopic management of patients with Mirizzi's syndrome (MS) is not routinely recommended due to the high risk of iatrogenic complications. PATIENTS AND METHODS: Intra-cholecystic (IC) or inside-gall bladder (GB) approach was used for laparoscopic management of 16 patients with MS at a tertiary care referral centre in North India from May 2010 to August 2014; a retrospective analysis of prospectively collected data was performed. RESULTS: Mean age was 40.1 ± 14.7 years, the male-to-female ratio was 1:3, and 9 (56.25%) patients had type 1 MS (MS1) and 7 (43.75%) had type 2 MS (MS2) (McSherry's classification). The laparoscopic intra-cholecystic approach (LICA) was successful in 11 (68.75%) patients, whereas 5 patients (31.25%) required conversion to open method. Median blood loss was 100 mL (range: 50-400 mL), and median duration of surgery was 3.25 h (range: 2-7.5 h). No major complications were encountered except 1 patient (6.5%) who required re-operation for retained bile duct stones. The final histopathology report was benign in all the patients. No remote complications were noted during a mean follow-up of 20.18 months. CONCLUSION: LICA is a feasible and safe approach for selected patients with Mirizzi's syndrome; however, a low threshold for conversion is necessary to avoid iatrogenic complications. PMID:27251843
Shakya, Poonam; Sharma, A. K.; Kumar, Naveen; Vellachi, Remya; Mathew, Dayamon D.; Dubey, Prasoon; Singh, Kiranjeet; Shrivastava, Sonal; Shrivastava, Sameer; Maiti, S. K.; Hasan, Anwarul; Singh, K. P.
2016-01-01
An acellular cholecyst derived extracellular matrix (b-CEM) of bubaline origin was prepared using anionic biological detergent. Healing potential of b-CEM was compared with commercially available collagen sheet (b-CS) and open wound (C) in full thickness skin wounds in rats. Thirty-six clinically healthy adult Sprague Dawley rats of either sex were randomly divided into three equal groups. Under general anesthesia, a full thickness skin wound (20 × 20 mm2) was created on the dorsum of each rat. The defect in group I was kept as open wound and was taken as control. In group II, the defect was repaired with commercially available collagen sheet (b-CS). In group III, the defect was repaired with cholecyst derived extracellular matrix of bovine origin (b-CEM). Planimetry, wound contracture, and immunological and histological observations were carried out to evaluate healing process. Significantly (P < 0.05) increased wound contraction was observed in b-CEM (III) as compared to control (I) and b-CS (II) on day 21. Histologically, improved epithelization, neovascularization, fibroplasia, and best arranged collagen fibers were observed in b-CEM (III) as early as on postimplantation day 21. These findings indicate that b-CEM have potential for biomedical applications for full thickness skin wound repair in rats. PMID:27127678
Students' difficulties with vector calculus in electrodynamics
NASA Astrophysics Data System (ADS)
Bollen, Laurens; van Kampen, Paul; De Cock, Mieke
2015-12-01
Understanding Maxwell's equations in differential form is of great importance when studying the electrodynamic phenomena discussed in advanced electromagnetism courses. It is therefore necessary that students master the use of vector calculus in physical situations. In this light we investigated the difficulties second year students at KU Leuven encounter with the divergence and curl of a vector field in mathematical and physical contexts. We have found that they are quite skilled at doing calculations, but struggle with interpreting graphical representations of vector fields and applying vector calculus to physical situations. We have found strong indications that traditional instruction is not sufficient for our students to fully understand the meaning and power of Maxwell's equations in electrodynamics.
Exposing calculus students to advanced mathematics
NASA Astrophysics Data System (ADS)
Griffiths, Barry J.; Selcuk Haciomeroglu, Erhan
2014-07-01
To ensure the competitiveness of the USA in the global economy, and its role as a leader in science and engineering, it is important to cultivate the next generation of home grown mathematicians. However, while universities across the USA offer calculus classes to thousands of undergraduate students each year, very few of them go on to major in mathematics. This paper posits that one of the main reasons is that the mathematical community does not expose calculus students to the beauty and complexity of upper-level mathematics, and that by doing so before they fully commit to their programme of study, the number of students with a qualification in mathematics can be increased. The results show a significant increase in the number of students planning to add a minor in mathematics, and an increased likelihood among freshmen and sophomores to change their major.
On the interpretation of Stratonovich calculus
NASA Astrophysics Data System (ADS)
Moon, W.; Wettlaufer, J. S.
2014-05-01
The Itô-Stratonovich dilemma is revisited from the perspective of the interpretation of Stratonovich calculus using shot noise. Over the long time scales of the displacement of an observable, the principal issue is how to deal with finite/zero autocorrelation of the stochastic noise. The former (non-zero) noise autocorrelation structure preserves the normal chain rule using a mid-point selection scheme, which is the basis Stratonovich calculus, whereas the instantaneous autocorrelation structure of Itô's approach does not. By considering the finite decay of the noise correlations on time scales very short relative to the overall displacement times of the observable, we suggest a generalization of the integral Taylor expansion criterion of Wong and Zakai (1965 Ann. Math. Stat. 36 1560-4) for the validity of the Stratonovich approach.
The Malliavin calculus and hypoelliptic differential operators
NASA Astrophysics Data System (ADS)
Bell, Denis
2015-03-01
This article is intended as an introduction to Malliavin's stochastic calculus of variations and his probabilistic approach to hypoellipticity. Topics covered include an elementary derivation of the basic integration by parts formulae, a proof of the probabilistic version of Hörmander's theorem as envisioned by Malliavin and completed by Kusuoka and Stroock, and an extension of Hörmander's theorem valid for operators with degeneracy of exponential type due to the author and S. Mohammed.
Dental calculus image based on optical coherence tomography
NASA Astrophysics Data System (ADS)
Hsieh, Yao-Sheng; Ho, Yi-Ching; Lee, Shyh-Yuan; Chuang, Ching-Cheng; Wang, Chun-Yang; Sun, Chia-Wei
2011-03-01
In this study, the dental calculus was characterized and imaged by means of swept-source optical coherence tomography (SSOCT). The refractive indices of enamel, dentin, cementum and calculus were measured as 1.625+/-0.024, 1.534+/-0.029, 1.570+/-0.021 and 1.896+/-0.085, respectively. The dental calculus lead strong scattering property and thus the region can be identified under enamel with SSOCT imaging. An extracted human tooth with calculus was covered by gingiva tissue as in vitro sample for SSOCT imaging.
Improved radiographic visualization of calculus in distal ureter.
Amar, A D
1979-10-01
Roentgenographic visualization of a calculus in the distal ureter is often made difficult by gas or bowel contents in the region of the pelvis. Filling the bladder with sterile water raises the bladder dome and displaces the bowel upward. Any calculus in the lower 4 to 5 cm. of the distal ureter is then clearly demonstrated on roentgenograms taken against the water-filled bladder instead of against the bowel filled with gas and feces. This maneuver also aids in differentiation of a calculus in the distal ureter from a phlebolith in the bladder wall, and has improved visualization of distal ureteral calculus in 50 patients during the last six years. PMID:494477
A new proof of the generalized Hamiltonian–Real calculus
Gao, Hua; Mandic, Danilo P.
2016-01-01
The recently introduced generalized Hamiltonian–Real (GHR) calculus comprises, for the first time, the product and chain rules that makes it a powerful tool for quaternion-based optimization and adaptive signal processing. In this paper, we introduce novel dual relationships between the GHR calculus and multivariate real calculus, in order to provide a new, simpler proof of the GHR derivative rules. This further reinforces the theoretical foundation of the GHR calculus and provides a convenient methodology for generic extensions of real- and complex-valued learning algorithms to the quaternion domain.
Vaginal calculus following severe form of female genital mutilation: a case report.
Yusuf, Lukman; Negash, Sheferaw
2008-04-01
We present a case of vaginal calculus formation following an initial insult of female genital mutilation (FGM) and crocodile bite to the external genital. A literature review made with regards to acute and late complication of female genital mutilation. Female genital cutting existed as early as the 5th century B.C. This ritualistic practice has affected the physical, mental, and social well being of women and undermined the basic reproductive and sexual health rights of the female population. Worldwide, 85-114 million girls and young women are subjected to this dreadful practice. It is mostly practiced in Africa and Middle East. Various authors classify female genital cutting differently. The World Health Organization classifies FGM in to FOUR types. Female genital mutilation is associated with immediate, intermediate and long-term complications (1-4). The complications are strongly related to the variant of the mutilation, especially of the third and the fourth types where introcision or vaginal scraping is performed. Vaginal calculus formation is a rare phenomenon. Our patient had a total obliteration of the introitus, vaginal calculus formation and urethra-vaginal fistula, which were surgically managed and corrected PMID:21309209
A clinical comparison of two calculus-inhibiting dentifrices.
Conforti, N; Berta, R; Petrone, M E; DeVizio, W; Volpe, A R; Proskin, H M
2000-01-01
The objective of this double-blind clinical study, conducted in harmony with the Volpe-Manhold design for studies of dental calculus, was to compare the effect on supragingival calculus formation of a dentifrice containing pyrophosphate, tripolyphosphate and a copolymer in a 0.243% sodium fluoride/silica base (Test Dentifrice), to that of a commercially available calculus-inhibiting dentifrice containing tetrapotassium pyrophosphate, disodium pyrophosphate and tetrasodium pyrophosphate in a 0.243% sodium fluoride/silica base (Positive Control Dentifrice). Adult male and female subjects from the Buffalo, New York area were entered into the study, provided a full oral prophylaxis, and assigned the use of a placebo (non-calculus-inhibiting) dentifrice for fourteen weeks. At the completion of this initial period, subjects were assessed for baseline Volpe-Manhold Calculus Index scores, provided another full prophylaxis, and stratified into two treatment groups which were balanced for age, sex and baseline calculus. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice, using a soft-bristled toothbrush. Examinations for dental calculus were again performed after twelve weeks' use of the study dentifrices. Ninety-one (91) subjects complied with the protocol and completed the entire study. At the three-month examination, the Test Dentifrice group exhibited a statistically significant 27.3% reduction in mean Volpe-Manhold Calculus Index score as compared to the Positive Control Dentifrice group. The results of this clinical study support the conclusion that a new calculus-inhibiting dentifrice, containing pyrophosphate, tripolyphosphate and a copolymer in a 0.243% sodium fluoride/silica base, is efficacious for the control of the development of supragingival calculus, and provides a level of benefit greater than that provided by a commercially available calculus-inhibiting dentifrice containing
Emphysematous Cholecystitis in 24-Year-old Male Without Predisposing Factors.
Sayit, Asli Tanrivermis; Gunbey, Hediye Pinar
2015-07-01
Emphysematous cholecystitis (EC) is a life threatening condition characterized by gangrene of the gallbladder due to an infection with gas-forming organisms. It is more common in elderly men and has been associated with systemic disease, especially diabetes and vascular disease. Computed tomography is the most important and accurate imaging modality for the diagnosis of EC. EC should be thought of when the radiographic presence of gas is detected within the gallbladder wall or lumen. Emergency surgical intervention and antibiotic treatment for the gas-forming organism should be initiated after the diagnosis of the EC. Here, we present the imaging and pathologic findings of a 24-year-old male with EC without any predisposing factors, successfully treated with laparoscopic cholecystectomy. PMID:26393182
True left-sided gallbladder with variations of bile duct and cholecystic vein.
Ishii, Hiromichi; Noguchi, Akinori; Onishi, Mie; Takao, Koji; Maruyama, Takahiro; Taiyoh, Hiroaki; Araki, Yasunobu; Shimizu, Takeshi; Izumi, Hiroyuki; Tani, Naoki; Yamaguchi, Masahide; Yamane, Tetsuro
2015-06-01
A left-sided gallbladder without a right-sided round ligament, which is called a true left-sided gallbladder, is extremely rare. A 71-year-old woman was referred to our hospital due to a gallbladder polyp. Computed tomography (CT) revealed not only a gallbladder polyp but also the gallbladder located to the left of the round ligament connected to the left umbilical portion. CT portography revealed that the main portal vein diverged into the right posterior portal vein and the common trunk of the left portal vein and right anterior portal vein. CT cholangiography revealed that the infraportal bile duct of segment 2 joined the common bile duct. Laparoscopic cholecystectomy was performed for a gallbladder polyp, and the intraoperative finding showed that the cholecystic veins joined the round ligament. A true left-sided gallbladder is closely associated with several anomalies; therefore, surgeons encountering a true left-sided gallbladder should be aware of the potential for these anomalies.
ERIC Educational Resources Information Center
National Science Foundation, Arlington, VA. Div. of Undergraduate Education.
The Undergraduate Course and Curriculum Development Program of the National Science Foundation supports the development of courses in all disciplines to improve the quality of undergraduate courses and curricula in science, mathematics, engineering, and technology. The purpose of the program in Curriculum Development in Mathematics: Calculus and…
ERIC Educational Resources Information Center
Pilgrim, Mary E.
2010-01-01
Data indicate that about 40 percent of students initially enrolled in MATH 160: Calculus for Physical Scientists I finish the course with a grade of D or F, dropped, or withdrew from the course (Reinholz, 2009). The high failure rate let to an intervention course (MATH 180) for students at risk of failing MATH 160. At-risk students were…
Improving Student Success in Calculus I Using a Co-Requisite Calculus I Lab
ERIC Educational Resources Information Center
Vestal, Sharon Schaffer; Brandenburger, Thomas; Furth, Alfred
2015-01-01
This paper describes how one university mathematics department was able to improve student success in Calculus I by requiring a co-requisite lab for certain groups of students. The groups of students required to take the co-requisite lab were identified by analyzing student data, including Math ACT scores, ACT Compass Trigonometry scores, and…
An Evaluative Calculus Project: Applying Bloom's Taxonomy to the Calculus Classroom
ERIC Educational Resources Information Center
Karaali, Gizem
2011-01-01
In education theory, Bloom's taxonomy is a well-known paradigm to describe domains of learning and levels of competency. In this article I propose a calculus capstone project that is meant to utilize the sixth and arguably the highest level in the cognitive domain, according to Bloom et al.: evaluation. Although one may assume that mathematics is…
Restricted diversity of dental calculus methanogens over five centuries, France
Huynh, Hong T. T.; Nkamga, Vanessa D.; Signoli, Michel; Tzortzis, Stéfan; Pinguet, Romuald; Audoly, Gilles; Aboudharam, Gérard; Drancourt, Michel
2016-01-01
Methanogens are acknowledged archaeal members of modern dental calculus microbiota and dental pathogen complexes. Their repertoire in ancient dental calculus is poorly known. We therefore investigated archaea in one hundred dental calculus specimens collected from individuals recovered from six archaeological sites in France dated from the 14th to 19th centuries AD. Dental calculus was demonstrated by macroscopic and cone-beam observations. In 56 calculus specimens free of PCR inhibition, PCR sequencing identified Candidatus Methanobrevibacter sp. N13 in 44.6%, Methanobrevibacter oralis in 19.6%, a new Methanomassiliicoccus luminyensis-like methanogen in 12.5%, a Candidatus Nitrososphaera evergladensis-like in one and Methanoculleus bourgensis in one specimen, respectively. One Candidatus Methanobrevibacter sp. N13 dental calculus was further documented by fluorescent in situ hybridization. The prevalence of dental calculus M. oralis was significantly lower in past populations than in modern populations (P = 0.03, Chi-square test). This investigation revealed a previously unknown repertoire of archaea found in the oral cavity of past French populations as reflected in preserved dental calculus. PMID:27166431
Experimental Design: Utilizing Microsoft Mathematics in Teaching and Learning Calculus
ERIC Educational Resources Information Center
Oktaviyanthi, Rina; Supriani, Yani
2015-01-01
The experimental design was conducted to investigate the use of Microsoft Mathematics, free software made by Microsoft Corporation, in teaching and learning Calculus. This paper reports results from experimental study details on implementation of Microsoft Mathematics in Calculus, students' achievement and the effects of the use of Microsoft…
Use of Technology to Develop Student Intuition in Multivariable Calculus
ERIC Educational Resources Information Center
Kaur, Manmohan
2006-01-01
In order to get undergraduates interested in mathematics, it is essential to involve them in its "discovery". In this paper, we will explain how technology and the knowledge of lower dimensional calculus can be used to help them develop intuition leading to their discovering the first derivative rule in multivariable calculus. (Contains 7 figures.)
Modelling the Landing of a Plane in a Calculus Lab
ERIC Educational Resources Information Center
Morante, Antonio; Vallejo, Jose A.
2012-01-01
We exhibit a simple model of a plane landing that involves only basic concepts of differential calculus, so it is suitable for a first-year calculus lab. We use the computer algebra system Maxima and the interactive geometry software GeoGebra to do the computations and graphics. (Contains 5 figures and 1 note.)
An Exploration of Definition and Procedural Fluency in Integral Calculus
ERIC Educational Resources Information Center
Grundmeier, Todd A.; Hansen, Jennifer; Sousa, Emily
2006-01-01
A survey was administered to calculus students who had previously been exposed to a course on integral calculus. The purpose of the survey was to explore students' understanding of the definition of a definite integral, their abilities to evaluate definite integrals, and their graphical interpretations of definite integrals. The analysis of…
Student Created Calculus Movies Using Computers and the TI-92.
ERIC Educational Resources Information Center
Sher, Lawrence; Wilkinson, Patricia
The Mathematics Department at Borough of Manhattan Community College (BMCC) (New York) has been actively involved since 1988 in a serious and successful program to improve instruction, understanding, and retention for women and minority students in calculus courses. One result of this work has been students creating calculus animations using…
On Flipping the Classroom in Large First Year Calculus Courses
ERIC Educational Resources Information Center
Jungic, Veselin; Kaur, Harpreet; Mulholland, Jamie; Xin, Cindy
2015-01-01
Over the course of two years, 2012-2014, we have implemented a "flipping" the classroom approach in three of our large enrolment first year calculus courses: differential and integral calculus for scientists and engineers. In this article we describe the details of our particular approach and share with the reader some experiences of…
Calculus Students' Early Concept Images of Tangent Lines
ERIC Educational Resources Information Center
Vincent, Brittany; LaRue, Renee; Sealey, Vicki; Engelke, Nicole
2015-01-01
This study explored first-semester calculus students' understanding of tangent lines as well as how students used tangent lines within the context of Newton's method. Task-based interviews were conducted with twelve first-semester calculus students who were asked to verbally describe a tangent line, sketch tangent lines for multiple curves, and…
Calculus Reform and Graphing Calculators: A University View.
ERIC Educational Resources Information Center
Stick, Marvin E.
1997-01-01
Describes the results of a teacher's exploration of the effects of using graphing calculators in calculus instruction in sections other than those that are experimental. Two experimental and two traditional sections of Calculus I and II participated in the study. (DDR)
Descartes' Calculus of Subnormals: What Might Have Been
ERIC Educational Resources Information Center
Boudreaux, Gregory Mark; Walls, Jess E.
2013-01-01
Rene Descartes' method for finding tangents (equivalently, subnormals) depends on geometric and algebraic properties of a family of circles intersecting a given curve. It can be generalized to establish a calculus of subnormals, an alternative to the calculus of Newton and Leibniz. Here we prove subnormal counterparts of the well-known…
Advanced Algebra and Calculus. High School Mathematics Curricula. Instructor's Guide.
ERIC Educational Resources Information Center
Natour, Denise M.
This manual is an instructor's guide for the utilization of the "CCA High School Mathematics Curricula: Advanced Algebra and Calculus" courseware developed by the Computer-based Education Research Laboratory (CERL). The curriculum comprises 34 algebra lessons within 12 units and 15 calculus lessons that are computer-based and require mastery for…
Coordinating Multiple Representations in a Reform Calculus Textbook
ERIC Educational Resources Information Center
Chang, Briana L.; Cromley, Jennifer G.; Tran, Nhi
2015-01-01
Coordination of multiple representations (CMR) is widely recognized as a critical skill in mathematics and is frequently demanded in reform calculus textbooks. However, little is known about the prevalence of coordination tasks in such textbooks. We coded 707 instances of CMR in a widely used reform calculus textbook and analyzed the distributions…
Effects of Clicker Use on Calculus Students' Mathematics Anxiety
ERIC Educational Resources Information Center
Batchelor, John
2015-01-01
This paper reports the results of a survey study of clicker use and mathematics anxiety among students enrolled in an undergraduate calculus course during the Fall 2013 semester. Students in two large lecture sections of calculus completed surveys at the beginning and end of the course. One class used clickers, whereas the other class was taught…
Visual Thinking and Gender Differences in High School Calculus
ERIC Educational Resources Information Center
Haciomeroglu, Erhan Selcuk; Chicken, Eric
2012-01-01
This study sought to examine calculus students' mathematical performances and preferences for visual or analytic thinking regarding derivative and antiderivative tasks presented graphically. It extends previous studies by investigating factors mediating calculus students' mathematical performances and their preferred modes of thinking. Data were…
Improving Student Success in Calculus at Seattle University
ERIC Educational Resources Information Center
Carter, J. D.; Helliwell, D.; Henrich, Allison; Principe, M.; Sloughter, J. M.
2016-01-01
Finding ways to improve student success in calculus is a critically important step on the path to supporting students who are pursuing degrees in STEM fields. Far too many students fail calculus 1 and are pushed to drop their majors in technical fields. One way of addressing this issue is by following a program that was pioneered at University of…
Calculus: A Computer Oriented Presentation, Part 1 [and] Part 2.
ERIC Educational Resources Information Center
Stenberg, Warren; Walker, Robert J.
Parts one and two of a one-year computer-oriented calculus course (without analytic geometry) are presented. The ideas of calculus are introduced and motivated through computer (i.e., algorithmic) concepts. An introduction to computing via algorithms and a simple flow chart language allows the book to be self-contained, except that material on…
DIFFERENTIAL AND INTEGRAL CALCULUS. A TENTATIVE CURRICULUM GUIDE.
ERIC Educational Resources Information Center
BRANT, VINCENT; GERARDI, WILLIAM
A GUIDE FOR A 1-YEAR COURSE IN DIFFERENTIAL AND INTEGRAL CALCULUS PREREQUISITED KNOWLEDGE IN ALGEBRA, ANALYTIC TRIGONOMETRY, AND ELEMENTARY ANALYSIS. EACH ASSIGNMENT CONTAINED BOTH NEW AND REVIEW WORK TO REINFORCE THE NEW WORK. THERE WERE ELEVEN UNITS OF STUDY USING THE FOLLOWING FOUR BOOKS--"CALCULUS AND ANALYTIC GEOMETRY, THIRD EDITIONS," BY…
Advanced Placement Mathematics Calculus, Grade 12 Curriculum Guide.
ERIC Educational Resources Information Center
Scharf, John; And Others
This document is a guide to the advanced placement program in calculus for grade 12 in the city schools in Warren, Ohio. The program covers analytic geometry, differential and integral calculus of algebraic functions, elementary transcendental functions, and applications of differentiation and integration. The philosophy and aims of the program…
How to Enjoy Calculus: With Computer Applications. Revised Edition.
ERIC Educational Resources Information Center
Pine, Eli S.
The author states that this book was written for anyone who wants to know what calculus is all about, and that those with knowledge of some algebra and geometry should be able to understand it. That calculus should be called "slope finding" is discussed, and this term is used extensively. The book is divided into three chapters: (1) the…
On flipping the classroom in large first year calculus courses
NASA Astrophysics Data System (ADS)
Jungić, Veselin; Kaur, Harpreet; Mulholland, Jamie; Xin, Cindy
2015-05-01
Over the course of two years, 2012--2014, we have implemented a 'flipping' the classroom approach in three of our large enrolment first year calculus courses: differential and integral calculus for scientists and engineers. In this article we describe the details of our particular approach and share with the reader some experiences of both instructors and students.
Partial Fractions in Calculus, Number Theory, and Algebra
ERIC Educational Resources Information Center
Yackel, C. A.; Denny, J. K.
2007-01-01
This paper explores the development of the method of partial fraction decomposition from elementary number theory through calculus to its abstraction in modern algebra. This unusual perspective makes the topic accessible and relevant to readers from high school through seasoned calculus instructors.
The Use of Technology and Visualization in Calculus Instruction
ERIC Educational Resources Information Center
Samuels, Jason
2010-01-01
This study was inspired by a history of student difficulties in calculus, and innovation in response to those difficulties. The goals of the study were fourfold. First, to design a mathlet for students to explore local linearity. Second, to redesign the curriculum of first semester calculus around the use of technology, an emphasis on…
Reflections on Our First Calculus Undergraduate Teaching Assistant
ERIC Educational Resources Information Center
Deshler, Jessica M.
2016-01-01
This article describes some reflections from the first Calculus I undergraduate teaching assistant in our department as she explored the various ways in which she was able to support both novice and experienced Calculus teachers and the effect of her experience on her academic and career plans.
Promoting Students' Ability to Think Conceptually in Calculus
ERIC Educational Resources Information Center
Zerr, Ryan J.
2010-01-01
An overview is given of three conceptual lessons that can be incorporated into any first-semester calculus class. These lessons were developed to help promote calculus students' ability to think conceptually, in particular with regard to the role that infinity plays in the subject. A theoretical basis for the value of these lessons is provided,…
Restricted diversity of dental calculus methanogens over five centuries, France.
Huynh, Hong T T; Nkamga, Vanessa D; Signoli, Michel; Tzortzis, Stéfan; Pinguet, Romuald; Audoly, Gilles; Aboudharam, Gérard; Drancourt, Michel
2016-01-01
Methanogens are acknowledged archaeal members of modern dental calculus microbiota and dental pathogen complexes. Their repertoire in ancient dental calculus is poorly known. We therefore investigated archaea in one hundred dental calculus specimens collected from individuals recovered from six archaeological sites in France dated from the 14(th) to 19(th) centuries AD. Dental calculus was demonstrated by macroscopic and cone-beam observations. In 56 calculus specimens free of PCR inhibition, PCR sequencing identified Candidatus Methanobrevibacter sp. N13 in 44.6%, Methanobrevibacter oralis in 19.6%, a new Methanomassiliicoccus luminyensis-like methanogen in 12.5%, a Candidatus Nitrososphaera evergladensis-like in one and Methanoculleus bourgensis in one specimen, respectively. One Candidatus Methanobrevibacter sp. N13 dental calculus was further documented by fluorescent in situ hybridization. The prevalence of dental calculus M. oralis was significantly lower in past populations than in modern populations (P = 0.03, Chi-square test). This investigation revealed a previously unknown repertoire of archaea found in the oral cavity of past French populations as reflected in preserved dental calculus. PMID:27166431
Interrater Agreement on Subgingival Calculus Detection Following Scaling.
ERIC Educational Resources Information Center
Pippin, David J.; Feil, Philip
1992-01-01
Two studies investigated interrater agreement among 10 clinical dental examiners who scored residual subgingival calculus after student scaling on 4,160 real and 92 manikin tooth surfaces. Interrater reliability was low. Results suggest a need in periodontics for effective examiner calibration methods and objective subgingival calculus detection…
Transitioning from Introductory Calculus to Formal Limit Conceptions
ERIC Educational Resources Information Center
Nagle, Courtney
2013-01-01
The limit concept is a fundamental mathematical notion both for its practical applications and its importance as a prerequisite for later calculus topics. Past research suggests that limit conceptualizations promoted in introductory calculus are far removed from the formal epsilon-delta definition of limit. In this article, I provide an overview…
Calculus, Part 3, Student's Text, Unit No. 70. Revised Edition.
ERIC Educational Resources Information Center
Beck, A.; And Others
This is part three of a three-part SMSG calculus text for high school students. One of the goals of the text is to present calculus as a mathematical discipline as well as presenting its practical uses. The authors emphasize the importance of being able to interpret the concepts and theory in terms of models to which they apply. The text…
Calculus Instructors' and Students' Discourses on the Derivative
ERIC Educational Resources Information Center
Park, Jungeun
2011-01-01
Recently, there has been an increasing interest in collegiate mathematics education, especially teaching and learning calculus (e.g., Oehrtman, Carlson, & Thompson, 2008; Speer, Smith, & Horvath, 2010). Of many calculus concepts, the derivative is known as a difficult concept for students to understand because it involves various concepts such as…
Our Experiences with Using Visualization Tools in Teaching Calculus.
ERIC Educational Resources Information Center
Kowalczyk, Robert E.; Hausknecht, Adam O.
This paper describes two uses of the software package TEMATH (Tools for Exploring Mathematics) with calculus students: (1) as a demonstration tool in the classroom to visually explore with students the many mathematical models introduced in a first year calculus course; and (2) as a part of a lab where students use a set of laboratory explorations…
Utilizing Microsoft Mathematics in Teaching and Learning Calculus
ERIC Educational Resources Information Center
Oktaviyanthi, Rina; Supriani, Yani
2015-01-01
The experimental design was conducted to investigate the use of Microsoft Mathematics, free software made by Microsoft Corporation, in teaching and learning Calculus. This paper reports results from experimental study details on implementation of Microsoft Mathematics in Calculus, students' achievement and the effects of the use of Microsoft…
Evaluating the Use of Learning Objects for Improving Calculus Readiness
ERIC Educational Resources Information Center
Kay, Robin; Kletskin, Ilona
2010-01-01
Pre-calculus concepts such as working with functions and solving equations are essential for students to explore limits, rates of change, and integrals. Yet many students have a weak understanding of these key concepts which impedes performance in their first year university Calculus course. A series of online learning objects was developed to…
The Qualitative Trajectory Calculus on Networks
NASA Astrophysics Data System (ADS)
Bogaert, Peter; van de Weghe, Nico; Cohn, Anthony G.; Witlox, Frank; de Maeyer, Philippe
Moving objects are commonly handled using quantitative methods and information. However, in many cases, qualitative information can be more efficient and more meaningful than quantitative information. A lot of research has been done in generating, indexing, modelling and querying network-based moving objects, but little work has been done in building a calculus of relations between these objects in a qualitative way. In this paper, we introduce a formal definition of how to represent and reason about the relative trajectories of pairs of objects moving along a network.
The Calculus of Responsibility and Commitment
NASA Astrophysics Data System (ADS)
Pollard, Carl
Ever since Montague (1974 [1970]) laid the foundations for formally precise analysis of natural language (hereafter NL) semantics in the late 1960's, the typed lambda calculus (hereafter TLC) and certain of its extensions have been the linguists' tool of choice for representing the meanings of NL expressions. But starting around the turn of the millenium, motivated by a range of linguistic phenomena collectively known as covert movement phenomena, logical grammarians of various persuasions have proposed the use of other semantic term calculi that embody, directly or indirectly, some notion or other of continuation.
Algorithmic Differentiation for Calculus-based Optimization
NASA Astrophysics Data System (ADS)
Walther, Andrea
2010-10-01
For numerous applications, the computation and provision of exact derivative information plays an important role for optimizing the considered system but quite often also for its simulation. This presentation introduces the technique of Algorithmic Differentiation (AD), a method to compute derivatives of arbitrary order within working precision. Quite often an additional structure exploitation is indispensable for a successful coupling of these derivatives with state-of-the-art optimization algorithms. The talk will discuss two important situations where the problem-inherent structure allows a calculus-based optimization. Examples from aerodynamics and nano optics illustrate these advanced optimization approaches.
Regge calculus and observations. II. Further applications.
NASA Astrophysics Data System (ADS)
Williams, Ruth M.; Ellis, G. F. R.
1984-11-01
The method, developed in an earlier paper, for tracing geodesies of particles and light rays through Regge calculus space-times, is applied to a number of problems in the Schwarzschild geometry. It is possible to obtain accurate predictions of light bending by taking sufficiently small Regge blocks. Calculations of perihelion precession, Thomas precession, and the distortion of a ball of fluid moving on a geodesic can also show good agreement with the analytic solution. However difficulties arise in obtaining accurate predictions for general orbits in these space-times. Applications to other problems in general relativity are discussed briefly.
On the origins of generalized fractional calculus
NASA Astrophysics Data System (ADS)
Kiryakova, Virginia
2015-11-01
In Fractional Calculus (FC), as in the (classical) Calculus, the notions of derivatives and integrals (of first, second, etc. or arbitrary, incl. non-integer order) are basic and co-related. One of the most frequent approach in FC is to define first the Riemann-Liouville (R-L) integral of fractional order, and then by means of suitable integer-order differentiation operation applied over it (or under its sign) a fractional derivative is defined - in the R-L sense (or in Caputo sense). The first mentioned (R-L type) is closer to the theoretical studies in analysis, but has some shortages - from the point of view of interpretation of the initial conditions for Cauchy problems for fractional differential equations (stated also by means of fractional order derivatives/ integrals), and also for the analysts' confusion that such a derivative of a constant is not zero in general. The Caputo (C-) derivative, arising first in geophysical studies, helps to overcome these problems and to describe models of applied problems with physically consistent initial conditions. The operators of the Generalized Fractional Calculus - GFC (integrals and derivatives) are based on commuting m-tuple (m = 1, 2, 3, …) compositions of operators of the classical FC with power weights (the so-called Erdélyi-Kober operators), but represented in compact and explicit form by means of integral, integro-differential (R-L type) or differential-integral (C-type) operators, where the kernels are special functions of most general hypergeometric kind. The foundations of this theory are given in Kiryakova 18. In this survey we present the genesis of the definitions of the GFC - the generalized fractional integrals and derivatives (of fractional multi-order) of R-L type and Caputo type, analyze their properties and applications. Their special cases are all the known operators of classical FC, their generalizations introduced by other authors, the hyper-Bessel differential operators of higher integer
Intitialization, Conceptualization, and Application in the Generalized Fractional Calculus
NASA Technical Reports Server (NTRS)
Lorenzo, Carl F.; Hartley, Tom T.
1998-01-01
This paper provides a formalized basis for initialization in the fractional calculus. The intent is to make the fractional calculus readily accessible to engineering and the sciences. A modified set of definitions for the fractional calculus is provided which formally include the effects of initialization. Conceptualizations of fractional derivatives and integrals are shown. Physical examples of the basic elements from electronics are presented along with examples from dynamics, material science, viscoelasticity, filtering, instrumentation, and electrochemistry to indicate the broad application of the theory and to demonstrate the use of the mathematics. The fundamental criteria for a generalized calculus established by Ross (1974) are shown to hold for the generalized fractional calculus under appropriate conditions. A new generalized form for the Laplace transform of the generalized differintegral is derived. The concept of a variable structure (order) differintegral is presented along with initial efforts toward meaningful definitions.
ERIC Educational Resources Information Center
Ferguson, Leann J.
2012-01-01
Calculus is an important tool for building mathematical models of the world around us and is thus used in a variety of disciplines, such as physics and engineering. These disciplines rely on calculus courses to provide the mathematical foundation needed for success in their courses. Unfortunately, due to the basal conceptions of what it means to…
Graphical calculus for Gaussian pure states
Menicucci, Nicolas C.; Flammia, Steven T.; Loock, Peter van
2011-04-15
We provide a unified graphical calculus for all Gaussian pure states, including graph transformation rules for all local and semilocal Gaussian unitary operations, as well as local quadrature measurements. We then use this graphical calculus to analyze continuous-variable (CV) cluster states, the essential resource for one-way quantum computing with CV systems. Current graphical approaches to CV cluster states are only valid in the unphysical limit of infinite squeezing, and the associated graph transformation rules only apply when the initial and final states are of this form. Our formalism applies to all Gaussian pure states and subsumes these rules in a natural way. In addition, the term 'CV graph state' currently has several inequivalent definitions in use. Using this formalism we provide a single unifying definition that encompasses all of them. We provide many examples of how the formalism may be used in the context of CV cluster states: defining the 'closest' CV cluster state to a given Gaussian pure state and quantifying the error in the approximation due to finite squeezing; analyzing the optimality of certain methods of generating CV cluster states; drawing connections between this graphical formalism and bosonic Hamiltonians with Gaussian ground states, including those useful for CV one-way quantum computing; and deriving a graphical measure of bipartite entanglement for certain classes of CV cluster states. We mention other possible applications of this formalism and conclude with a brief note on fault tolerance in CV one-way quantum computing.
How Students Use Their Knowledge of Calculus in an Engineering Mechanics Course.
ERIC Educational Resources Information Center
Roddick, Cheryl Stitt
This study investigated students' conceptual and procedural understanding of calculus within the context of an engineering mechanics course. Four traditional calculus students were compared with three students from one of the calculus reform projects, Calculus & Mathematica. Task-based interviews were conducted with each participant throughout the…
Miniature endoscopic optical coherence tomography for calculus detection.
Kao, Meng-Chun; Lin, Chun-Li; Kung, Che-Yen; Huang, Yi-Fung; Kuo, Wen-Chuan
2015-08-20
The effective treatment of periodontitis involves the detection and removal of subgingival dental calculus. However, subgingival calculus is more difficult to detect than supragingival calculus because it is firmly attached to root surfaces within periodontal pockets. To achieve a smooth root surface, clinicians often remove excessive amounts of root structure because of decreased visibility. In addition, enamel pearl, a rare type of ectopic enamel formation on the root surface, can easily be confused with dental calculus in the subgingival environment. In this study, we developed a fiber-probe swept-source optical coherence tomography (SSOCT) technique and combined it with the quantitative measurement of an optical parameter [standard deviation (SD) of the optical coherence tomography (OCT) intensity] to differentiate subgingival calculus from sound enamel, including enamel pearl. Two-dimensional circumferential images were constructed by rotating the miniprobe (0.9 mm diameter) while acquiring image lines, and the adjacent lines in each rotation were stacked to generate a three-dimensional volume. In OCT images, compared to sound enamel and enamel pearls, dental calculus showed significant differences (P<0.001) in SD values. Finally, the receiver operating characteristic curve had a high capacity (area under the curve=0.934) for discriminating between healthy regions (including enamel pearl) and dental calculus. PMID:26368780
Visual thinking and gender differences in high school calculus
NASA Astrophysics Data System (ADS)
Selcuk Haciomeroglu, Erhan; Chicken, Eric
2012-04-01
This study sought to examine calculus students' mathematical performances and preferences for visual or analytic thinking regarding derivative and antiderivative tasks presented graphically. It extends previous studies by investigating factors mediating calculus students' mathematical performances and their preferred modes of thinking. Data were collected from 183 Advanced Placement calculus students in five high schools. Students' visual preferences were not influenced by gender. Statistically significant differences in visual preference scores were found among high- and low-performing students. Thus, the results suggest that stronger preference for visual thinking was associated with higher mathematical performances.
LC Graphs for the Lambek Calculus with Product
NASA Astrophysics Data System (ADS)
Fowler, Timothy A. D.
This paper introduces a novel graph representation of proof nets for the Lambek calculus that extends the LC graph representation of [13] to include the product connective. This graph representation more clearly specifies the difference between the Lambek calculus with and without product than other proof net representations, which is important to the search for polynomial time among Lambek calculus fragments. We use LC graphs to further the efforts to characterize the boundary between polynomial time and NP-complete sequent derivability by analyzing the NP-completeness proof of [14] and discussing a sequent derivability algorithm.
Representing and reasoning about program in situation calculus
NASA Astrophysics Data System (ADS)
Yang, Bo; Zhang, Ming-yi; Wu, Mao-nian; Xie, Gang
2011-12-01
Situation calculus is an expressive tool for modeling dynamical system in artificial intelligence, changes in a dynamical world is represented naturally by the notions of action, situation and fluent in situation calculus. Program can be viewed as a discrete dynamical system, so it is possible to model program with situation calculus. To model program written in a smaller core programming language CL, notion of fluent is expanded for representing value of expression. Together with some functions returning concerned objects from expressions, a basic action theory of CL programming is constructed. Under such a theory, some properties of program, such as correctness and termination can be reasoned about.
VEST: Abstract Vector Calculus Simplification in Mathematica
J. Squire, J. Burby and H. Qin
2013-03-12
We present a new package, VEST (Vector Einstein Summation Tools), that performs abstract vector calculus computations in Mathematica. Through the use of index notation, VEST is able to reduce scalar and vector expressions of a very general type using a systematic canonicalization procedure. In addition, utilizing properties of the Levi-Civita symbol, the program can derive types of multi-term vector identities that are not recognized by canonicalization, subsequently applying these to simplify large expressions. In a companion paper [1], we employ VEST in the automation of the calculation of Lagrangians for the single particle guiding center system in plasma physics, a computation which illustrates its ability to handle very large expressions. VEST has been designed to be simple and intuitive to use, both for basic checking of work and more involved computations. __________________________________________________
Regge calculus models of closed lattice universes
NASA Astrophysics Data System (ADS)
Liu, Rex G.; Williams, Ruth M.
2016-01-01
This paper examines the behavior of closed "lattice universes" wherein masses are distributed in a regular lattice on the Cauchy surfaces of closed vacuum universes. Such universes are approximated using a form of Regge calculus originally developed by Collins and Williams to model closed Friedmann-Lemaître-Robertson-Walker universes. We consider two types of lattice universes, one where all masses are identical to each other and another where one mass gets perturbed in magnitude. In the unperturbed universe, we consider the possible arrangements of the masses in the Regge Cauchy surfaces and demonstrate that the model will only be stable if each mass lies within some spherical region of convergence. We also briefly discuss the existence of Regge models that are dual to the ones we have considered. We then model a perturbed lattice universe and demonstrate that the model's evolution is well behaved, with the expansion increasing in magnitude as the perturbation is increased.
VEST: Abstract vector calculus simplification in Mathematica
NASA Astrophysics Data System (ADS)
Squire, J.; Burby, J.; Qin, H.
2014-01-01
We present a new package, VEST (Vector Einstein Summation Tools), that performs abstract vector calculus computations in Mathematica. Through the use of index notation, VEST is able to reduce three-dimensional scalar and vector expressions of a very general type to a well defined standard form. In addition, utilizing properties of the Levi-Civita symbol, the program can derive types of multi-term vector identities that are not recognized by reduction, subsequently applying these to simplify large expressions. In a companion paper Burby et al. (2013) [12], we employ VEST in the automation of the calculation of high-order Lagrangians for the single particle guiding center system in plasma physics, a computation which illustrates its ability to handle very large expressions. VEST has been designed to be simple and intuitive to use, both for basic checking of work and more involved computations.
Improving Student Success in Calculus: A Comparison of Four College Calculus Classes
NASA Astrophysics Data System (ADS)
Bagley, Spencer Franklin
The quality of education in science, technology, engineering, and mathematics (STEM) fields is an issue of particular educational and economic importance, and Calculus I is a linchpin course in STEM major tracks. A national study is currently being conducted examining the characteristics of successful programs in college calculus (CSPCC, 2012). In work related to the CSPCC program, this study examines the effects on student outcomes of four different teaching strategies used at a single institution. The four classes were a traditional lecture, a lecture with discussion, a lecture incorporating both discussion and technology, and an inverted model. This dissertation was guided by three questions: (1) What impact do these four instructional approaches have on students' persistence, beliefs about mathematics, and conceptual and procedural achievement in calculus? (2) How do students at the local institution compare to students in the national database? And (3) How do the similarities and differences in opportunities for learning presented in the four classes contribute to the similarities and differences in student outcomes? Quantitative analysis of surveys and exams revealed few statistically significant differences in outcomes, and students in the inverted classroom often had poorer outcomes than those in other classes. Students in the technology-enhanced class scored higher on conceptual items on the final exam than those in other classes. Comparing to the national database, local students had similar switching rates but less expert-like attitudes and beliefs about mathematics than the national average. Qualitative analysis of focus group interviews, classroom observations, and student course evaluations showed that several implementation issues, some the result of pragmatic constraints, others the result of design choice, weakened affordances provided by innovative features and shrunk the differences between classes. There were substantial differences between the
Forest Carbon Uptake and the Fundamental Theorem of Calculus
ERIC Educational Resources Information Center
Zobitz, John
2013-01-01
Using the fundamental theorem of calculus and numerical integration, we investigate carbon absorption of ecosystems with measurements from a global database. The results illustrate the dynamic nature of ecosystems and their ability to absorb atmospheric carbon.
Ants, Tunnels, and Calculus: An Exercise in Mathematical Modeling.
ERIC Educational Resources Information Center
Winkel, Brian J.
1994-01-01
Discusses an activity which models the building of a tunnel by ants using the definitions of derivative and indefinite integral from calculus. Includes a discussion of reasonableness and interpretation of the problem. (MKR)
Relational Semantics for the Lambek-Grishin Calculus
NASA Astrophysics Data System (ADS)
Kurtonina, Natasha; Moortgat, Michael
We study ternary relational semantics for LG: a symmetric version of the Lambek calculus with interaction principles due to Grishin [10]. We obtain completeness on the basis of a Henkin-style weak filter construction.
Student understanding of calculus within physics and mathematics classrooms
NASA Astrophysics Data System (ADS)
Christensen, Warren; Thompson, John
2010-03-01
The earliest results in Physics Education Research demonstrated the challenges facing students in understanding the graphical interpretations of slope, derivative, and area under curves in the context of kinematics. As part of ongoing research on mathematical challenges that may underlie documented physics difficulties, we developed and administered a brief survey on single- and multivariable calculus concepts to students within physics and mathematics classrooms at both the introductory and advanced levels. Initial findings among students in multivariable calculus show that as many as one in five students encounter some type of difficulty when asked to rank the slopes at five different points along a single path. We will present further data on the extent to which students in a first semester calculus course and an introductory calculus-based physics course encounter similar challenges.
A Closer Look at an Advanced Placement Calculus Problem.
ERIC Educational Resources Information Center
Rudd, David
1985-01-01
Answers and justifications for an interesting problem on the Advanced Placement Calculus AB Examination are discussed. The problem provides diverse ways in which students can gain appreciation and understanding for the subject. (MNS)
A transition calculus for Boolean functions. [logic circuit analysis
NASA Technical Reports Server (NTRS)
Tucker, J. H.; Bennett, A. W.
1974-01-01
A transition calculus is presented for analyzing the effect of input changes on the output of logic circuits. The method is closely related to the Boolean difference, but it is more powerful. Both differentiation and integration are considered.
True left-sided gallbladder with variations of bile duct and cholecystic vein
Ishii, Hiromichi; Noguchi, Akinori; Onishi, Mie; Takao, Koji; Maruyama, Takahiro; Taiyoh, Hiroaki; Araki, Yasunobu; Shimizu, Takeshi; Izumi, Hiroyuki; Tani, Naoki; Yamaguchi, Masahide; Yamane, Tetsuro
2015-01-01
A left-sided gallbladder without a right-sided round ligament, which is called a true left-sided gallbladder, is extremely rare. A 71-year-old woman was referred to our hospital due to a gallbladder polyp. Computed tomography (CT) revealed not only a gallbladder polyp but also the gallbladder located to the left of the round ligament connected to the left umbilical portion. CT portography revealed that the main portal vein diverged into the right posterior portal vein and the common trunk of the left portal vein and right anterior portal vein. CT cholangiography revealed that the infraportal bile duct of segment 2 joined the common bile duct. Laparoscopic cholecystectomy was performed for a gallbladder polyp, and the intraoperative finding showed that the cholecystic veins joined the round ligament. A true left-sided gallbladder is closely associated with several anomalies; therefore, surgeons encountering a true left-sided gallbladder should be aware of the potential for these anomalies. PMID:26074714
Geometric constrained variational calculus. II: The second variation (Part I)
NASA Astrophysics Data System (ADS)
Massa, Enrico; Bruno, Danilo; Luria, Gianvittorio; Pagani, Enrico
2016-10-01
Within the geometrical framework developed in [Geometric constrained variational calculus. I: Piecewise smooth extremals, Int. J. Geom. Methods Mod. Phys. 12 (2015) 1550061], the problem of minimality for constrained calculus of variations is analyzed among the class of differentiable curves. A fully covariant representation of the second variation of the action functional, based on a suitable gauge transformation of the Lagrangian, is explicitly worked out. Both necessary and sufficient conditions for minimality are proved, and reinterpreted in terms of Jacobi fields.
Fisher information, Borges operators, and q-calculus
NASA Astrophysics Data System (ADS)
Pennini, F.; Plastino, A.; Ferri, G. L.
2008-10-01
We discuss applying the increasingly popular q-calculus, or deformed calculus, so as to suitably generalize Fisher’s information measure and the Cramer-Rao inequality. A q-deformation can be attained in multiple ways, and we show that most of them do not constitute legitimate procedures. Within such a context, the only completely acceptable q-deformation is that ensuing from using the so-called Borges derivative [E.P. Borges, Physica A 340 (2004) 95].
Dynamic Compartments in the Imperative π-Calculus
NASA Astrophysics Data System (ADS)
John, Mathias; Lhoussaine, Cédric; Niehren, Joachim
Dynamic compartments with mutable configurations and variable volumes are of basic interest for the stochastic modeling of biochemistry in cells. We propose a new language to express dynamic compartments that we call the imperative π -calculus. It is obtained from the attributed π -calculus by adding imperative assignment operations to a global store. Previous approaches to dynamic compartments are improved in flexibility or efficiency. This is illustrated by an appropriate model of osmosis and a correct encoding of bioambBioAmbients.
Using `min' and `max' functions in calculus teaching
NASA Astrophysics Data System (ADS)
Satianov, Pavel; Dagan, Miriam; Amram, Meirav
2015-08-01
In this paper, we discuss the use of the min and max functions in teaching calculus to engineering students. Our experience illustrates that such functions have great possibilities in the development of a student's analytical thinking. The types of problems we present here are not common in most instructional texts, which lead us to suggest that the paper will be interesting and useful to calculus lecturers.
Dental Calculus and the Evolution of the Human Oral Microbiome.
Warinner, Christina
2016-07-01
Characterizing the evolution of the oral microbiome is a challenging, but increasingly feasible, task. Recently, dental calculus has been shown to preserve ancient biomolecules from the oral microbiota, host tissues and diet for tens of thousands of years. As such, it provides a unique window into the ancestral oral microbiome. This article reviews recent advancements in ancient dental calculus research and emerging insights into the evolution and ecology of the human oral microbiome. PMID:27514153
Dental Calculus and the Evolution of the Human Oral Microbiome.
Warinner, Christina
2016-07-01
Characterizing the evolution of the oral microbiome is a challenging, but increasingly feasible, task. Recently, dental calculus has been shown to preserve ancient biomolecules from the oral microbiota, host tissues and diet for tens of thousands of years. As such, it provides a unique window into the ancestral oral microbiome. This article reviews recent advancements in ancient dental calculus research and emerging insights into the evolution and ecology of the human oral microbiome.
ERIC Educational Resources Information Center
Hall, Angela Renee
2011-01-01
This investigative research focuses on the level of readiness of Science, Technology, Engineering, and Mathematics (STEM) students entering Historically Black Colleges and Universities (HBCU) in the college Calculus sequence. Calculus is a fundamental course for STEM courses. The level of readiness of the students for Calculus can very well play a…
Schmitt, Todd L; Sur, Roger L
2012-03-01
An adult female bottlenose dolphin (Tursiops truncatus) presented with acute anorexia secondary to progressive azotemia (blood urea nitrogen = 213 mg/dl, creatinine [Cr] = 9.5 mg/dl) and electrolyte abnormalities (K = 7.4 mEq/L). It was later diagnosed with postrenal obstruction secondary to bilaterally obstructing ureteral calculi seen on ultrasound. Treatment of the obstruction required two endoscopic procedures, cystoscopy for ureteral stent placement and ureteroscopy to perform intracorporeal lithotripsy on the obstructing calculi. Before the first procedure, the dolphin's azotemia was stabilized with aggressive fluid therapy, peritoneal dialysis, and treatment for acidosis. Diuresis subsequent to the fluid therapy enabled passage of the right obstructing urolith. For both endoscopic procedures, the dolphin was placed in left lateral recumbency due to the peritoneal dialysis catheter in the right retroperitoneal region. For the first procedure, a 12-French (Fr) flexible cystoscope was inserted retrograde into the bladder via the urethra, whereupon a calculus was seen obstructing the left ureteral orifice. A 4.8-Fr, 26-cm double-pigtail ureteral stent was placed up the left ureter to relieve the postrenal obstruction. Inadvertent proximal migration of the left ureteral stent occurred during the procedure. However, renal parameters (serum Cr = 5.8, K = 5.4) improved significantly by the next day. For the second procedure, 28 hr later, ureteroscopy was performed to treat the calculus and replace the existing stent with a longer stent. The left ureteral calculus was pulverized into tiny fragments by using a holmium:yttrium-aluminum-garnet laser inserted through a 6.9-Fr semirigid ureteroscope. The migrated stent was visualized in the distal left ureter and replaced with a 90-cm single-pigtail ureteral stent that was sutured exterior to the urogenital slit and removed 3 days later. Renal function normalized over the next several days, and the dolphin recovered over
Schmitt, Todd L; Sur, Roger L
2012-03-01
An adult female bottlenose dolphin (Tursiops truncatus) presented with acute anorexia secondary to progressive azotemia (blood urea nitrogen = 213 mg/dl, creatinine [Cr] = 9.5 mg/dl) and electrolyte abnormalities (K = 7.4 mEq/L). It was later diagnosed with postrenal obstruction secondary to bilaterally obstructing ureteral calculi seen on ultrasound. Treatment of the obstruction required two endoscopic procedures, cystoscopy for ureteral stent placement and ureteroscopy to perform intracorporeal lithotripsy on the obstructing calculi. Before the first procedure, the dolphin's azotemia was stabilized with aggressive fluid therapy, peritoneal dialysis, and treatment for acidosis. Diuresis subsequent to the fluid therapy enabled passage of the right obstructing urolith. For both endoscopic procedures, the dolphin was placed in left lateral recumbency due to the peritoneal dialysis catheter in the right retroperitoneal region. For the first procedure, a 12-French (Fr) flexible cystoscope was inserted retrograde into the bladder via the urethra, whereupon a calculus was seen obstructing the left ureteral orifice. A 4.8-Fr, 26-cm double-pigtail ureteral stent was placed up the left ureter to relieve the postrenal obstruction. Inadvertent proximal migration of the left ureteral stent occurred during the procedure. However, renal parameters (serum Cr = 5.8, K = 5.4) improved significantly by the next day. For the second procedure, 28 hr later, ureteroscopy was performed to treat the calculus and replace the existing stent with a longer stent. The left ureteral calculus was pulverized into tiny fragments by using a holmium:yttrium-aluminum-garnet laser inserted through a 6.9-Fr semirigid ureteroscope. The migrated stent was visualized in the distal left ureter and replaced with a 90-cm single-pigtail ureteral stent that was sutured exterior to the urogenital slit and removed 3 days later. Renal function normalized over the next several days, and the dolphin recovered over
Water content contribution in calculus phantom ablation during Q-switched Tm:YAG laser lithotripsy
NASA Astrophysics Data System (ADS)
Zhang, Jian J.; Rajabhandharaks, Danop; Xuan, Jason Rongwei; Wang, Hui; Chia, Ray W. J.; Hasenberg, Tom; Kang, Hyun Wook
2015-12-01
Q-switched (QS) Tm:YAG laser ablation mechanisms on urinary calculi are still unclear to researchers. Here, dependence of water content in calculus phantom on calculus ablation performance was investigated. White gypsum cement was used as a calculus phantom model. The calculus phantoms were ablated by a total 3-J laser pulse exposure (20 mJ, 100 Hz, 1.5 s) and contact mode with N=15 sample size. Ablation volume was obtained on average 0.079, 0.122, and 0.391 mm3 in dry calculus in air, wet calculus in air, and wet calculus in-water groups, respectively. There were three proposed ablation mechanisms that could explain the effect of water content in calculus phantom on calculus ablation performance, including shock wave due to laser pulse injection and bubble collapse, spallation, and microexplosion. Increased absorption coefficient of wet calculus can cause stronger spallation process compared with that caused by dry calculus; as a result, higher calculus ablation was observed in both wet calculus in air and wet calculus in water. The test result also indicates that the shock waves generated by short laser pulse under the in-water condition have great impact on the ablation volume by Tm:YAG QS laser.
Revi, Deepa; Geetha, C; Thekkuveettil, Anoopkumar; Anilkumar, Thapasimuthu V
2016-02-01
Graft-assisted healing is often proposed for clinical management of large-sized third-degree cutaneous burn wounds. Skin-graft substitutes prepared by loading appropriate cell types on suitable scaffolds have been found successful. We have previously shown that cholecyst-derived scaffold prepared by a non-detergent/enzymatic method can be used as skin-graft substitute for promoting healing of full thickness excision wounds in rabbit. This article examines the use of this scaffold for preparing bio-artificial grafts by loading homologous fibroblasts. The healing potential was evaluated in a rabbit model of full thickness skin-burn wound. The healing process was evaluated by gross morphology evaluation and histomorphology evaluation at 7, 14 and 28 days of healing. Ex vivo imaging of the wounded tissue was performed and it was found that the loaded fibroblasts remained viable at least for 14 days in the healing wound. By the first week, re-epithelialisation was evident in all animals treated with the cell-loaded graft. Histomorphological wound healing parameters such as the quickness of re-epithelialisation, the nature of collagen deposition and the extent of neo-vascularisation indicated that cell-loaded grafts promoted faster healing of the wounds. Results of immunohistochemistry indicated a parallel change in the number of proliferating cells and myofibroblast in the healing tissue. Although the pathophysiology of the healing reaction was not established, the observations suggested that homologus fibroblast-loaded cholecyst-derived scaffold promoted faster healing of third-degree wounds in rabbit model by modulating myofibroblast response. It was concluded that cholecyst-derived scaffold prepared by the non-detergent/enzymatic method is a potential scaffold for fabricating bioartificial skin grafts. PMID:26589297
Noninvasive control of dental calculus removal: qualification of two fluorescence methods
NASA Astrophysics Data System (ADS)
Gonchukov, S.; Sukhinina, A.; Bakhmutov, D.; Biryukova, T.
2013-02-01
The main condition of periodontitis prevention is the full calculus removal from the teeth surface. This procedure should be fulfilled without harming adjacent unaffected tooth tissues. Nevertheless the problem of sensitive and precise estimating of tooth-calculus interface exists and potential risk of hard tissue damage remains. In this work it was shown that fluorescence diagnostics during calculus removal can be successfully used for precise noninvasive detection of calculus-tooth interface. In so doing the simple implementation of this method free from the necessity of spectrometer using can be employed. Such a simple implementation of calculus detection set-up can be aggregated with the devices of calculus removing.
Lin, Wu-Chou; Chen, Yung-Hsiang; Xu, Jian-Ming; Chen, Der-Cherng; Chen, Wen-Chi; Lee, Chao-Te
2011-01-01
Renal colic is a common condition seen in the emergency department (ED). Our recent study showed that measures of electrical conductance may be used as supplementary diagnostic methods for patients with acute renal colic. Here, we describe the case of a 30-year-old male subject with a left ureteral calculus who presented with frequency and normal-looking urine. He had already visited the outpatient department, but in vain. Normal urinalysis and nonobstructive urogram were reported at that time. Two days later, he was admitted to the ED because of abdominal pain in the left lower quadrant. The urinalysis did not detect red blood cells. Ultrasonography did not indicate hydronephrosis. The meridian electrical conductance and index of sympathovagal balance were found to be abnormal. High level of electrical conductance on the left bladder meridian was found. An unenhanced helical computed tomography was scheduled to reveal a left ureterovesical stone. Ureteroscopic intervention was later uneventfully performed, and the patient's pain was relieved. The follow-up measurements showed that the meridian parameters had returned to normal one month after treatment. This case suggests that bladder meridian electrical conductance might be used as a supplemental method for ureteral calculus diagnosis. PMID:24533191
Generalized Functions for the Fractional Calculus
NASA Technical Reports Server (NTRS)
Lorenzo, Carl F.; Hartley, Tom T.
1999-01-01
Previous papers have used two important functions for the solution of fractional order differential equations, the Mittag-Leffler functionE(sub q)[at(exp q)](1903a, 1903b, 1905), and the F-function F(sub q)[a,t] of Hartley & Lorenzo (1998). These functions provided direct solution and important understanding for the fundamental linear fractional order differential equation and for the related initial value problem (Hartley and Lorenzo, 1999). This paper examines related functions and their Laplace transforms. Presented for consideration are two generalized functions, the R-function and the G-function, useful in analysis and as a basis for computation in the fractional calculus. The R-function is unique in that it contains all of the derivatives and integrals of the F-function. The R-function also returns itself on qth order differ-integration. An example application of the R-function is provided. A further generalization of the R-function, called the G-function brings in the effects of repeated and partially repeated fractional poles.
Potential of shock waves to remove calculus and biofilm.
Müller, Philipp; Guggenheim, Bernhard; Attin, Thomas; Marlinghaus, Ernst; Schmidlin, Patrick R
2011-12-01
Effective calculus and biofilm removal is essential to treat periodontitis. Sonic and ultrasonic technologies are used in several scaler applications. This was the first feasibility study to assess the potential of a shock wave device to remove calculus and biofilms and to kill bacteria. Ten extracted teeth with visible subgingival calculus were treated with either shock waves for 1 min at an energy output of 0.4 mJ/mm(2) at 3 Hz or a magnetostrictive ultrasonic scaler at medium power setting for 1 min, which served as a control. Calculus was determined before and after treatment planimetrically using a custom-made software using a grey scale threshold. In a second experiment, multispecies biofilms were formed on saliva-preconditioned bovine enamel discs during 64.5 h. They were subsequently treated with shock waves or the ultrasonic scaler (N = 6/group) using identical settings. Biofilm detachment and bactericidal effects were then assessed. Limited efficiency of the shock wave therapy in terms of calculus removal was observed: only 5% of the calculus was removed as compared to 100% when ultrasound was used (P ≤ 0.0001). However, shock waves were able to significantly reduce adherent bacteria by three orders of magnitude (P ≤ 0.0001). The extent of biofilm removal by the ultrasonic device was statistically similar. Only limited bactericidal effects were observed using both methods. Within the limitations of this preliminary study, the shock wave device was not able to reliably remove calculus but had the potential to remove biofilms by three log steps. To increase the efficacy, technical improvements are still required. This novel noninvasive intervention, however, merits further investigation.
Greene, T R; Kuba, C L; Irish, J D
2005-01-01
This paper describes a quantitative approach to the assessment of dental calculus in human archaeological skeletal samples. The approach combines the ranked calculus scoring method described by Buikstra and Ubelaker [1994. Arkansas Archeological Survey Research Series, Arkansas Archeological Survey, Fayetteville, Arkansas] and a modified Simplified Calculus Index, utilized by dental clinicians. We recorded amounts of calculus on the buccal, lingual, and interproximal surface of all extant teeth, and generated an index for the maxillary posterior dentition, maxillary anterior dentition, mandibular posterior dentition, and mandibular anterior dentition for three skeletal samples. They include 145 Egyptian Predynastic individuals from the site of Hierakonpolis, 104 Predynastic individuals from Naqada, Egypt, and 101 Meroitic Nubians from Semna South, present-day Sudan. Mann-Whitney U tests were used to analyze differences between the sexes and among age groups at each site. The results demonstrate that the calculus indices more effectively reveal trends and differences in calculus severity than frequency data can alone. For example, at Hierakonpolis, males (18-35 years) had significantly more calculus in the maxillary posterior dentition than females, while females (50+ years) had significantly more calculus in the maxillary posterior teeth. Frequency data merely showed that 94% of both males and females had calculus. The use of calculus indices can reveal how quickly calculus accumulates with age within the dental arcade and within a sample. Moreover, better understanding of the severity and location of calculus can improve a researcher's knowledge regarding the effect of calculus on dental pathologies, such as carious lesions and periodontal disease.
The F-functional calculus for unbounded operators
NASA Astrophysics Data System (ADS)
Colombo, Fabrizio; Sabadini, Irene
2014-12-01
In the recent years the theory of slice hyperholomorphic functions has become an important tool to study two functional calculi for n-tuples of operators and also for its applications to Schur analysis. In particular, using the Cauchy formula for slice hyperholomorphic functions, it is possible to give the Fueter-Sce mapping theorem an integral representation. With this integral representation it has been defined a monogenic functional calculus for n-tuples of bounded commuting operators, the so called F-functional calculus. In this paper we show that it is possible to define this calculus also for n-tuples containing unbounded operators and we obtain an integral representation formula analogous to the one of the Riesz-Dunford functional calculus for unbounded operators acting on a complex Banach space. As we will see, it is not an easy task to provide the correct definition of the F-functional calculus in the unbounded case. This paper is addressed to a double audience, precisely to people with interests in hypercomplex analysis and also to people working in operator theory.
Colloquium: Fractional calculus view of complexity: A tutorial
NASA Astrophysics Data System (ADS)
West, Bruce J.
2014-10-01
The fractional calculus has been part of the mathematics and science literature for 310 years. However, it is only in the past decade or so that it has drawn the attention of mainstream science as a way to describe the dynamics of complex phenomena with long-term memory, spatial heterogeneity, along with nonstationary and nonergodic statistics. The most recent application encompasses complex networks, which require new ways of thinking about the world. Part of the new cognition is provided by the fractional calculus description of temporal and topological complexity. Consequently, this Colloquium is not so much a tutorial on the mathematics of the fractional calculus as it is an exploration of how complex phenomena in the physical, social, and life sciences that have eluded traditional mathematical modeling become less mysterious when certain historical assumptions such as differentiability are discarded and the ordinary calculus is replaced with the fractional calculus. Exemplars considered include the fractional differential equations describing the dynamics of viscoelastic materials, turbulence, foraging, and phase transitions in complex social networks.
On the formulations of the quaternionic functional calculus
NASA Astrophysics Data System (ADS)
Colombo, Fabrizio; Sabadini, Irene
2010-10-01
In the paper [F. Colombo, I. Sabadini, On some properties of the quaternionic functional calculus, J. Geom. Anal. 19 (2009) 601-627] the authors treat the quaternionic functional calculus for right linear quaternionic operators whose components do not necessarily commute. This functional calculus is the quaternionic version of the classical Riesz-Dunford functional calculus. When considering quaternionic operators it is natural to also consider the case of left linear operators. Furthermore, one can use left or right slice regular functions to construct a functional calculus for right (or left) linear operators. In this paper we discuss these possibilities, showing that, in all the cases, we can associate to an operator two so-called S-resolvent operators but their interpretation depends on whether we are considering a left or a right linear operator. Also the S-resolvent equations for right or left closed operators do not have the same interpretation. Moreover, we study the bounded perturbations of both the S-resolvent operators.
On flipping first-semester calculus: a case study
NASA Astrophysics Data System (ADS)
Petrillo, Joseph
2016-05-01
High failure rates in calculus have plagued students, teachers, and administrators for decades, while science, technology, engineering, and mathematics programmes continue to suffer from low enrollments and high attrition. In an effort to affect this reality, some educators are 'flipping' (or inverting) their classrooms. By flipping, we mean administering course content outside of the classroom and replacing the traditional in-class lectures with discussion, practice, group work, and other elements of active learning. This paper presents the major results from a three-year study of a flipped, first-semester calculus course at a small, comprehensive, American university with a well-known engineering programme. The data we have collected help quantify the positive and substantial effects of our flipped calculus course on failure rates, scores on the common final exam, student opinion of calculus, teacher impact on measurable outcomes, and success in second-semester calculus. While flipping may not be suitable for every teacher, every student, and in every situation, this report provides some evidence that it may be a viable option for those seeking an alternative to the traditional lecture model.
E, Er-Deng-sang; Hang, Gai-ba-te-re; Ba, Tu; Duan, Yi-wen
2009-04-01
Trace elements in Mongolian medicine Susi-12 for cholecystitis and gallstones were analyzed in order to discuss the relation between Susi-12's drug action and the trace elements. The analysis was carried out using the pressure seal microwave digestion and inductive coupled plasma atomic emission spectrometry (ICP-AES). It was found that the medicine contained great amount of trace elements, especially human-body-needed trace elements, such as Ca, Al, Mg, Fe, Sr, Mn, Zn, Cu etc., whereas heavy metals are very little, e.g. the contents of Pb, Cb, As etc are below the country's limit. The recoveries of standard addition are in the range of 94.63%-106.40%. The relative standard deviation RSD< or =3.35%, and detection limit is < or =0.009 mg x L(-1). It is concluded that Mongolian medicine Susi-12 can effectively control and cure cholecystitis and gallstones, and the effective rate reaches 91.2% to 100%. So the trace elements in Susi-12 must have a close connection with the drug action. PMID:19626913
E, Er-Deng-sang; Hang, Gai-ba-te-re; Ba, Tu; Duan, Yi-wen
2009-04-01
Trace elements in Mongolian medicine Susi-12 for cholecystitis and gallstones were analyzed in order to discuss the relation between Susi-12's drug action and the trace elements. The analysis was carried out using the pressure seal microwave digestion and inductive coupled plasma atomic emission spectrometry (ICP-AES). It was found that the medicine contained great amount of trace elements, especially human-body-needed trace elements, such as Ca, Al, Mg, Fe, Sr, Mn, Zn, Cu etc., whereas heavy metals are very little, e.g. the contents of Pb, Cb, As etc are below the country's limit. The recoveries of standard addition are in the range of 94.63%-106.40%. The relative standard deviation RSD< or =3.35%, and detection limit is < or =0.009 mg x L(-1). It is concluded that Mongolian medicine Susi-12 can effectively control and cure cholecystitis and gallstones, and the effective rate reaches 91.2% to 100%. So the trace elements in Susi-12 must have a close connection with the drug action.
A Tutorial Review on Fractal Spacetime and Fractional Calculus
NASA Astrophysics Data System (ADS)
He, Ji-Huan
2014-11-01
This tutorial review of fractal-Cantorian spacetime and fractional calculus begins with Leibniz's notation for derivative without limits which can be generalized to discontinuous media like fractal derivative and q-derivative of quantum calculus. Fractal spacetime is used to elucidate some basic properties of fractal which is the foundation of fractional calculus, and El Naschie's mass-energy equation for the dark energy. The variational iteration method is used to introduce the definition of fractional derivatives. Fractal derivative is explained geometrically and q-derivative is motivated by quantum mechanics. Some effective analytical approaches to fractional differential equations, e.g., the variational iteration method, the homotopy perturbation method, the exp-function method, the fractional complex transform, and Yang-Laplace transform, are outlined and the main solution processes are given.
Integral calculus problem solving: an fMRI investigation.
Krueger, Frank; Spampinato, Maria Vittoria; Pardini, Matteo; Pajevic, Sinisa; Wood, Jacqueline N; Weiss, George H; Landgraf, Steffen; Grafman, Jordan
2008-07-16
Only a subset of adults acquires specific advanced mathematical skills, such as integral calculus. The representation of more sophisticated mathematical concepts probably evolved from basic number systems; however its neuroanatomical basis is still unknown. Using fMRI, we investigated the neural basis of integral calculus while healthy participants were engaged in an integration verification task. Solving integrals activated a left-lateralized cortical network including the horizontal intraparietal sulcus, posterior superior parietal lobe, posterior cingulate gyrus, and dorsolateral prefrontal cortex. Our results indicate that solving of more abstract and sophisticated mathematical facts, such as calculus integrals, elicits a pattern of brain activation similar to the cortical network engaged in basic numeric comparison, quantity manipulation, and arithmetic problem solving. PMID:18596607
Integral calculus problem solving: an fMRI investigation.
Krueger, Frank; Spampinato, Maria Vittoria; Pardini, Matteo; Pajevic, Sinisa; Wood, Jacqueline N; Weiss, George H; Landgraf, Steffen; Grafman, Jordan
2008-07-16
Only a subset of adults acquires specific advanced mathematical skills, such as integral calculus. The representation of more sophisticated mathematical concepts probably evolved from basic number systems; however its neuroanatomical basis is still unknown. Using fMRI, we investigated the neural basis of integral calculus while healthy participants were engaged in an integration verification task. Solving integrals activated a left-lateralized cortical network including the horizontal intraparietal sulcus, posterior superior parietal lobe, posterior cingulate gyrus, and dorsolateral prefrontal cortex. Our results indicate that solving of more abstract and sophisticated mathematical facts, such as calculus integrals, elicits a pattern of brain activation similar to the cortical network engaged in basic numeric comparison, quantity manipulation, and arithmetic problem solving.
Bacteria and archaea paleomicrobiology of the dental calculus: a review.
Huynh, H T T; Verneau, J; Levasseur, A; Drancourt, M; Aboudharam, G
2016-06-01
Dental calculus, a material observed in the majority of adults worldwide, emerged as a source for correlating paleomicrobiology with human health and diet. This mini review of 48 articles on the paleomicrobiology of dental calculus over 7550 years discloses a secular core microbiota comprising nine bacterial phyla - Firmicutes, Actinobacteria, Proteobacteria, Bacteroidetes, TM7, Synergistetes, Chloroflexi, Fusobacteria, Spirochetes - and one archaeal phylum Euryarchaeota; and some accessory microbiota that appear and disappear according to time frame. The diet residues and oral microbes, including bacteria, archaea, viruses and fungi, consisting of harmless organisms and pathogens associated with local and systemic infections have been found trapped in ancient dental calculus by morphological approaches, immunolabeling techniques, isotope analyses, fluorescent in situ hybridization, DNA-based approaches, and protein-based approaches. These observations led to correlation of paleomicrobiology, particularly Streptococcus mutans and archaea, with past human health and diet. PMID:26194817
Golden quantum oscillator and Binet-Fibonacci calculus
NASA Astrophysics Data System (ADS)
Pashaev, Oktay K.; Nalci, Sengul
2012-01-01
The Binet formula for Fibonacci numbers is treated as a q-number and a q-operator with Golden ratio bases q = φ and Q = -1/φ, and the corresponding Fibonacci or Golden calculus is developed. A quantum harmonic oscillator for this Golden calculus is derived so that its spectrum is given only by Fibonacci numbers. The ratio of successive energy levels is found to be the Golden sequence, and for asymptotic states in the limit n → ∞ it appears as the Golden ratio. We call this oscillator the Golden oscillator. Using double Golden bosons, the Golden angular momentum and its representation in terms of Fibonacci numbers and the Golden ratio are derived. Relations of Fibonacci calculus with a q-deformed fermion oscillator and entangled N-qubit states are indicated.
Numerical Method for Darcy Flow Derived Using Discrete Exterior Calculus
NASA Astrophysics Data System (ADS)
Hirani, A. N.; Nakshatrala, K. B.; Chaudhry, J. H.
2015-05-01
We derive a numerical method for Darcy flow, and also for Poisson's equation in mixed (first order) form, based on discrete exterior calculus (DEC). Exterior calculus is a generalization of vector calculus to smooth manifolds and DEC is one of its discretizations on simplicial complexes such as triangle and tetrahedral meshes. DEC is a coordinate invariant discretization, in that it does not depend on the embedding of the simplices or the whole mesh. We start by rewriting the governing equations of Darcy flow using the language of exterior calculus. This yields a formulation in terms of flux differential form and pressure. The numerical method is then derived by using the framework provided by DEC for discretizing differential forms and operators that act on forms. We also develop a discretization for a spatially dependent Hodge star that varies with the permeability of the medium. This also allows us to address discontinuous permeability. The matrix representation for our discrete non-homogeneous Hodge star is diagonal, with positive diagonal entries. The resulting linear system of equations for flux and pressure are saddle type, with a diagonal matrix as the top left block. The performance of the proposed numerical method is illustrated on many standard test problems. These include patch tests in two and three dimensions, comparison with analytically known solutions in two dimensions, layered medium with alternating permeability values, and a test with a change in permeability along the flow direction. We also show numerical evidence of convergence of the flux and the pressure. A convergence experiment is included for Darcy flow on a surface. A short introduction to the relevant parts of smooth and discrete exterior calculus is included in this article. We also include a discussion of the boundary condition in terms of exterior calculus.
Itô versus Stratonovich calculus in random population growth.
Braumann, Carlos A
2007-03-01
The context is the general stochastic differential equation (SDE) model dN/dt=N(g(N)+sigmaepsilon(t)) for population growth in a randomly fluctuating environment. Here, N=N(t) is the population size at time t, g(N) is the 'average' per capita growth rate (we work with a general almost arbitrary function g), and sigmaepsilon(t) is the effect of environmental fluctuations (sigma>0, epsilon(t) standard white noise). There are two main stochastic calculus used to interpret the SDE, Itô calculus and Stratonovich calculus. They yield different solutions and even qualitatively different predictions (on extinction, for example). So, there is a controversy on which calculus one should use. We will resolve the controversy and show that the real issue is merely semantic. It is due to the informal interpretation of g(x) as being an (unspecified) 'average' per capita growth rate (when population size is x). The implicit assumption usually made in the literature is that the 'average' growth rate is the same for both calculi, when indeed this rate should be defined in terms of the observed process. We prove that, when using Itô calculus, g(N) is indeed the arithmetic average growth rate R(a)(x) and, when using Stratonovich calculus, g(N) is indeed the geometric average growth rate R(g)(x). Writing the solutions of the SDE in terms of a well-defined average, R(a)(x) or R(g)(x), instead of an undefined 'average' g(x), we prove that the two calculi yield exactly the same solution. The apparent difference was due to the semantic confusion of taking the informal term 'average growth rate' as meaning the same average.
ERIC Educational Resources Information Center
Laurent, Theresa A.
2009-01-01
The purpose of this study was to investigate higher education mathematics departments' credit granting policies for students with high school calculus experience. The number of students taking calculus in high school has more than doubled since 1982 (NCES, 2007) and it is estimated that approximately 530,000 students took a calculus course in high…
ERIC Educational Resources Information Center
Subotnik, Rena F.; Strauss, Shiela M.
1995-01-01
Despite scoring lower on the mathematics Scholastic Assessment Test (SAT-M) prior to taking an advanced placement calculus course, female students (n=85) scored as well as males (n=51) on the Advanced Placement BC level calculus test. Predictors of AP scores were: first, scores on the Calculus Readiness Test; second, scores on the SAT-M; and…
The Development and Nature of Problem-Solving among First-Semester Calculus Students
ERIC Educational Resources Information Center
Dawkins, Paul Christian; Epperson, James A. Mendoza
2014-01-01
This study investigates interactions between calculus learning and problem-solving in the context of two first-semester undergraduate calculus courses in the USA. We assessed students' problem-solving abilities in a common US calculus course design that included traditional lecture and assessment with problem-solving-oriented labs. We…
ERIC Educational Resources Information Center
Patel, Rita Manubhai; McCombs, Paul; Zollman, Alan
2014-01-01
Novice students have difficulty with the topic of limits in calculus. We believe this is in part because of the multiple perspectives and shifting metaphors available to solve items correctly. We investigated college calculus instructors' personal concepts of limits. Based upon previous research investigating introductory calculus student…
Recalling Prerequisite Material in a Calculus II Course to Improve Student Success
ERIC Educational Resources Information Center
Mokry, Jeanette
2016-01-01
This article discusses preparation assignments used in a Calculus II course that cover material from prerequisite courses. Prior to learning new material, students work on problems outside of class involving concepts from algebra, trigonometry, and Calculus I. These problems are directly built upon in order to answer Calculus II questions,…
Stochastic Calculus and Differential Equations for Physics and Finance
NASA Astrophysics Data System (ADS)
McCauley, Joseph L.
2013-02-01
1. Random variables and probability distributions; 2. Martingales, Markov, and nonstationarity; 3. Stochastic calculus; 4. Ito processes and Fokker-Planck equations; 5. Selfsimilar Ito processes; 6. Fractional Brownian motion; 7. Kolmogorov's PDEs and Chapman-Kolmogorov; 8. Non Markov Ito processes; 9. Black-Scholes, martingales, and Feynman-Katz; 10. Stochastic calculus with martingales; 11. Statistical physics and finance, a brief history of both; 12. Introduction to new financial economics; 13. Statistical ensembles and time series analysis; 14. Econometrics; 15. Semimartingales; References; Index.
Computational physics in the introductory calculus-based course
NASA Astrophysics Data System (ADS)
Chabay, Ruth; Sherwood, Bruce
2008-04-01
The integration of computation into the introductory calculus-based physics course can potentially provide significant support for the development of conceptual understanding. Computation can support three-dimensional visualizations of abstract quantities, offer opportunities to construct symbolic rather than numeric solutions to problems, and provide experience with the use of vectors as coordinate-free entities. Computation can also allow students to explore models in a way not possible using the analytical tools available to first-year students. We describe how we have incorporated computer programming into an introductory calculus-based course taken by science and engineering students.
An operator calculus for surface and volume modeling
NASA Technical Reports Server (NTRS)
Gordon, W. J.
1984-01-01
The mathematical techniques which form the foundation for most of the surface and volume modeling techniques used in practice are briefly described. An outline of what may be termed an operator calculus for the approximation and interpolation of functions of more than one independent variable is presented. By considering the linear operators associated with bivariate and multivariate interpolation/approximation schemes, it is shown how they can be compounded by operator multiplication and Boolean addition to obtain a distributive lattice of approximation operators. It is then demonstrated via specific examples how this operator calculus leads to practical techniques for sculptured surface and volume modeling.
[Multidetector computed tomography in acute abdomen].
Carreras Aja, M; Arrieta Artieda, I; Borruel Nacenta, S
2011-10-01
MDCT has become a fundamental tool for determining the causes of acute abdomen. CT is considered the imaging technique of choice in the diagnostic workup of both localized and diffuse acute abdomen, except in patients in whom acute cholecystitis or acute gynecological disease is suspected and in children, adolescents, and pregnant patients, in whom ultrasonography is the imaging technique of choice. Plain-film X-ray examination has been relegated to the initial management of renal colic, suspected foreign bodies, and intestinal obstruction. One of the drawbacks of MDCT is its use of ionizing radiation, which makes it necessary to filter and direct the examinations as well as to ensure that the most appropriate protocols are used. For this reason, low dose protocols have been developed so that diagnostic studies can be performed with doses of radiation between 2 and 3 mSv; these are normally used in the diagnosis of renal colic and can also be used in selected patients with suspected appendicitis and acute diverticulitis. PMID:21742357
Acute Abdominal Pain in Children.
Reust, Carin E; Williams, Amy
2016-05-15
Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception. In school-aged children, constipation and infectious causes of pain, such as gastroenteritis, colitis, respiratory infections, and urinary tract infections, are more common. In female adolescents, clinicians should consider pelvic inflammatory disease, pregnancy, ruptured ovarian cysts, or ovarian torsion. Initial laboratory tests include complete blood count, erythrocyte sedimentation rate or C-reactive protein, urinalysis, and a pregnancy test. Abdominal radiography can be used to diagnose constipation or obstruction. Ultrasonography is the initial choice in children for the diagnosis of cholecystitis, pancreatitis, ovarian cyst, ovarian or testicular torsion, pelvic inflammatory disease, pregnancy-related pathology, and appendicitis. Appendicitis is the most common cause of acute abdominal pain requiring surgery, with a peak incidence during adolescence. When the appendix is not clearly visible on ultrasonography, computed tomography or magnetic resonance imaging can be used to confirm the diagnosis. PMID:27175718
Questions Revisited: A Close Examination of Calculus of Inference and Inquiry
NASA Technical Reports Server (NTRS)
Knuth, Kevin H.; Koga, Dennis (Technical Monitor)
2003-01-01
In this paper I examine more closely the way in which probability theory, the calculus of inference, is derived from the Boolean lattice structure of logical assertions ordered by implication. I demonstrate how the duality between the logical conjunction and disjunction in Boolean algebra is lost when deriving the probability calculus. In addition, I look more closely at the other lattice identities to verify that they are satisfied by the probability calculus. Last, I look towards developing the calculus of inquiry demonstrating that there is a sum and product rule for the relevance measure as well as a Bayes theorem. Current difficulties in deriving the complete inquiry calculus will also be discussed.
ERIC Educational Resources Information Center
Judson, Thomas W.; Nishimori, Toshiyuki
2005-01-01
In this study we investigated above-average high school calculus students from Japan and the United States in order to determine any differences in their conceptual understanding of calculus and their ability to use algebra to solve traditional calculus problems. We examined and interviewed 18 Calculus BC students in the United States and 26…
Contrasting Cases of Calculus Students' Understanding of Derivative Graphs
ERIC Educational Resources Information Center
Haciomeroglu, Erhan Selcuk; Aspinwall, Leslie; Presmeg, Norma C.
2010-01-01
This study adds momentum to the ongoing discussion clarifying the merits of visualization and analysis in mathematical thinking. Our goal was to gain understanding of three calculus students' mental processes and images used to create meaning for derivative graphs. We contrast the thinking processes of these three students as they attempted to…
Holmium laser lithotripsy of a complicated biliary calculus.
Monga, M; Gabal-Shehab, L L; Kamarei, M; D'Agostino, H
1999-09-01
More than 500,000 cholecystectomies are performed annually. Extracorporeal shockwave lithotripsy and endoscopic laser lithotripsy have been used for the management of common bile duct calculi, which complicate 10% of cases. We report the first successful clinical application of the Ho:YAG laser to a complex biliary calculus case.
On Flipping First-Semester Calculus: A Case Study
ERIC Educational Resources Information Center
Petrillo, Joseph
2016-01-01
High failure rates in calculus have plagued students, teachers, and administrators for decades, while science, technology, engineering, and mathematics programmes continue to suffer from low enrollments and high attrition. In an effort to affect this reality, some educators are "flipping" (or inverting) their classrooms. By flipping, we…
Calculus of Elementary Functions, Part I, Student Text. Preliminary Edition.
ERIC Educational Resources Information Center
Herriot, Sarah T.; And Others
This is part one of a three-part SMSG calculus text for high school students. The aim of the text is to develop some of the concepts and techniques which will enable the student to obtain important information about graphs of elementary functions. Chapter topics include: (1) polynomial functions; (2) the derivative of a polynomial function; and…
Calculus Students' Understanding of Area and Volume Units
ERIC Educational Resources Information Center
Dorko, Allison; Speer, Natasha
2015-01-01
Units of measure are critical in many scientific fields. While instructors often note that students struggle with units, little research has been conducted about the nature and extent of these difficulties or why they exist. We investigated calculus students' unit use in area and volume computations. Seventy-three percent of students gave…
Airfoil Design in Multivariable Calculus: Tying It All Together
ERIC Educational Resources Information Center
Laverty, Rich; Povich, Timothy; Williams, Tasha
2005-01-01
Near the conclusion of their final term in the calculus sequence at The United States Military Academy, cadets are given a week long group project. At the end of the week, the project is briefed to their instructors, classmates, and superior officers. From a teaching perspective, the goal is to encapsulate as much of the course as possible in one…
Inertial Navigation: A Bridge between Kinematics and Calculus
ERIC Educational Resources Information Center
Sadler, Philip M.; Garfield, Eliza N.; Tremblay, Alex; Sadler, Daniel J.
2012-01-01
Those who come to Cambridge soon learn that the fastest route between Harvard and MIT is by the subway. For many students, this short ride is a quick and easy way to link physics and calculus. A simple, homemade accelerometer provides all the instrumentation necessary to produce accurate graphs of acceleration, velocity, and displacement position…
Using the Pottery Wheel to Explore Topics in Calculus
ERIC Educational Resources Information Center
Farnell, Elin; Snipes, Marie A.
2015-01-01
Students sometimes struggle with visualizing the three-dimensional solids encountered in certain integral problems in a calculus class. We present a project in which students create solids of revolution with clay on a pottery wheel and estimate the volumes of these objects using Riemann sums. In addition to giving students an opportunity for…
Subsequent-Grades Assessment of Traditional and Reform Calculus.
ERIC Educational Resources Information Center
Baxter, Judith Lee; Majumdar, Dibyen; Smith, Stephen D.
1998-01-01
Studies the later course grades of students enrolled in freshman calculus taught using traditional texts through 1994-95 and the Harvard method which was fully adopted starting in 1995-96. Reports that, in some cases, the results were indistinguishable but some statistically significant patterns were found. (Author/ASK)
Development of Boolean calculus and its applications. [digital systems design
NASA Technical Reports Server (NTRS)
Tapia, M. A.
1980-01-01
The development of Boolean calculus for its application to developing digital system design methodologies that would reduce system complexity, size, cost, speed, power requirements, etc., is discussed. Synthesis procedures for logic circuits are examined particularly asynchronous circuits using clock triggered flip flops.
Non-Mathematics Students' Reasoning in Calculus Tasks
ERIC Educational Resources Information Center
Jukic Matic, Ljerka
2015-01-01
This paper investigates the reasoning of first year non-mathematics students in non-routine calculus tasks. The students in this study were accustomed to imitative reasoning from their primary and secondary education. In order to move from imitative reasoning toward more creative reasoning, non-routine tasks were implemented as an explicit part of…
Evaluating the Performance of Calculus Classes Using Operational Research Tools.
ERIC Educational Resources Information Center
Soares de Mello, Joao Carlos C. B.; Lins, Marcos P. E.; Soares de Mello, Maria Helena C.; Gomes, Eliane G.
2002-01-01
Compares the efficiency of calculus classes and evaluates two kinds of classes: traditional and others that use computational methods in teaching. Applies quantitative evaluation methods using two operational research tools, multicriteria decision aid methods (mainly using the MACBETH approach) and data development analysis. (Author/YDS)
On the Fundamental Theorem of Calculus for Fractal Sets
NASA Astrophysics Data System (ADS)
Bongiorno, Donatella; Corrao, Giuseppa
2015-04-01
The aim of this paper is to formulate the best version of the Fundamental theorem of Calculus for real functions on a fractal subset of the real line. In order to do that an integral of Henstock-Kurzweil type is introduced.
Geometric Demonstration of the Fundamental Theorems of the Calculus
ERIC Educational Resources Information Center
Sauerheber, Richard D.
2010-01-01
After the monumental discovery of the fundamental theorems of the calculus nearly 350 years ago, it became possible to answer extremely complex questions regarding the natural world. Here, a straightforward yet profound demonstration, employing geometrically symmetric functions, describes the validity of the general power rules for integration and…
Multivariate Limits and Continuity: A Survey of Calculus Textbooks.
ERIC Educational Resources Information Center
Thompson, Thomas M.; Wiggins, Kenneth L.
There has been much recent discussion concerning the content of the standard calculus course for students majoring in mathematics and the sciences. Some of this discussion has focused on the available textbooks. One weakness noted in some of these books involves the definitions of limit and continuity for functions of several variables. A…
An Application of Calculus: Optimum Parabolic Path Problem
ERIC Educational Resources Information Center
Atasever, Merve; Pakdemirli, Mehmet; Yurtsever, Hasan Ali
2009-01-01
A practical and technological application of calculus problem is posed to motivate freshman students or junior high school students. A variable coefficient of friction is used in modelling air friction. The case in which the coefficient of friction is a decreasing function of altitude is considered. The optimum parabolic path for a flying object…
a Type of Fractal Interpolation Functions and Their Fractional Calculus
NASA Astrophysics Data System (ADS)
Liang, Yong-Shun; Zhang, Qi
2016-05-01
Combine Chebyshev systems with fractal interpolation, certain continuous functions have been approximated by fractal interpolation functions unanimously. Local structure of these fractal interpolation functions (FIF) has been discussed. The relationship between order of Riemann-Liouville fractional calculus and Box dimension of FIF has been investigated.
Path Integrals, Fourier Transforms, and Feynman's Operational Calculus
Ahn, Byung Moo; Johnson, G. W.
1998-03-15
The disentangling process is the key to Feynman's operational calculus for noncommuting operators. The main result of his heuristic calculations deals with disentangling an exponential factor. We use the Wiener and Feynman integrals to make this disentangling (or time-ordering) mathematically rigorous in the case where the analytic functions from earlier work are replaced by Fourier transforms of complex-valued measures.
A Measurement Activity to Encourage Exploration of Calculus Concepts
ERIC Educational Resources Information Center
McGuffey, William
2015-01-01
This article describes an activity that incorporates measurement in order to lead students to discover and explore fundamental concepts of calculus. Students are provided with an experientially real starting point involving measurement and are encouraged to engage in mathematical discussions in a low-stakes environment. I describe the activity as…
Flipping the Calculus Classroom: A Cost-Effective Approach
ERIC Educational Resources Information Center
Young, Andrea
2015-01-01
This article discusses a cost-effective approach to flipping the calculus classroom. In particular, the emphasis is on low-cost choices, both monetarily and with regards to faculty time, that make the daunting task of flipping a course manageable for a single instructor. Student feedback and overall impressions are also presented.
Making Implicit Multivariable Calculus Representations Explicit: A Clinical Study
ERIC Educational Resources Information Center
McGee, Daniel; Moore-Russo, Deborah; Martinez-Planell, Rafael
2015-01-01
Reviewing numerous textbooks, we found that in both differential and integral calculus textbooks the authors commonly assume that: (i) students can generalize associations between representations in two dimensions to associations between representations of the same mathematical concept in three dimensions on their own; and (ii) explicit…
Calculus of One and More Variables with Maple
ERIC Educational Resources Information Center
Samkova, Libuse
2012-01-01
This is a guide to using Maple in teaching fundamental calculus of one, two and three variables (limits, derivatives, integrals, etc.), also suitable for Maple beginners. It outlines one of the ways to effective use of computers in the teaching process. It scans advantages and disadvantages of using Maple in relation to students and teacher. The…
An Experiment in "Flipped" Teaching in Freshman Calculus
ERIC Educational Resources Information Center
Anderson, Laura; Brennan, Joseph Phillip
2015-01-01
At Binghamton, Calculus 1 is taught to over 1000 students each fall in sections of about 30-40 students, with graduate student instructors teaching most sections. Despite having small classrooms instead of lecture halls, the satisfaction and performance of students has historically been poor. We had hoped to improve student success by changing how…
Students' Exploratory Thinking about a Nonroutine Calculus Task
ERIC Educational Resources Information Center
Nabb, Keith
2013-01-01
In this article on introductory calculus, intriguing questions are generated that can ignite an appreciation for the subject of mathematics. These questions open doors to advanced mathematical thinking and harness many elements of research-oriented mathematics. Such questions also offer greater incentives for students to think and reflect.…
Assessing Online Homework in First-Semester Calculus
ERIC Educational Resources Information Center
Callahan, Jason T.
2016-01-01
This paper describes and assesses the implementation of online homework in a first-semester calculus course. Comparing sections of the course before implementation to those after, we find statistically significant improvements in retention rates, measures of student engagement, and participation on homework. We do not, however, find statistically…
Sharing Teaching Ideas. Giving Meaning to Volume in Calculus.
ERIC Educational Resources Information Center
Rahn, James R.
1991-01-01
Described is an activity that uses the techniques of integral calculus to determine the volume of a bundt cake. The cake is used as an example of a solid of revolution. Included are the procedures and assumptions used by students to solve this problem. (KR)
A Team Taught Interdisciplinary Approach To Physics and Calculus Education.
ERIC Educational Resources Information Center
Johnson, David B.
The Special Intensive Program for Scientists and Engineers (SIPSE) at Diablo Valley College in California replaces the traditional engineering calculus and physics sequences with a single sequence that combines the two subjects into an integrated whole. The project report provides an overview of SIPSE, a section that traces the project from…
Using Origami Boxes to Explore Concepts of Geometry and Calculus
ERIC Educational Resources Information Center
Wares, Arsalan
2011-01-01
The purpose of this classroom note is to provide an example of how a simple origami box can be used to explore important concepts of geometry and calculus. This article describes how an origami box can be folded, then it goes on to describe how its volume and surface area can be calculated. Finally, it describes how the box could be folded to…
Designing a Telescope Mirror for Second-Semester Calculus Students
ERIC Educational Resources Information Center
Marchand, Richard J.; Rogers, Robert R.; Parker, Andrew T.
2006-01-01
The purpose of this article is to present an interdisciplinary project, developed as a collaborative effort by the authors, involving the design of a telescope mirror as it was given to second semester calculus students. The goals of the project are to provide an applied setting for the topics typically covered in this type of course including the…
Insights from the MAA National Study of College Calculus
ERIC Educational Resources Information Center
Bressoud, David
2015-01-01
Over the past five years, the Mathematical Association of America, with support from the National Science Foundation, has explored the teaching of mainstream Calculus 1 at the postsecondary level, where by "mainstream" we mean those courses that can be used as part of the prerequisite stream to more advanced postsecondary mathematics. We…
Formalization of the Integral Calculus in the PVS Theorem Prover
NASA Technical Reports Server (NTRS)
Butler, Ricky W.
2004-01-01
The PVS Theorem prover is a widely used formal verification tool used for the analysis of safety-critical systems. The PVS prover, though fully equipped to support deduction in a very general logic framework, namely higher-order logic, it must nevertheless, be augmented with the definitions and associated theorems for every branch of mathematics and Computer Science that is used in a verification. This is a formidable task, ultimately requiring the contributions of researchers and developers all over the world. This paper reports on the formalization of the integral calculus in the PVS theorem prover. All of the basic definitions and theorems covered in a first course on integral calculus have been completed.The theory and proofs were based on Rosenlicht's classic text on real analysis and follow the traditional epsilon-delta method. The goal of this work was to provide a practical set of PVS theories that could be used for verification of hybrid systems that arise in air traffic management systems and other aerospace applications. All of the basic linearity, integrability, boundedness, and continuity properties of the integral calculus were proved. The work culminated in the proof of the Fundamental Theorem Of Calculus. There is a brief discussion about why mechanically checked proofs are so much longer than standard mathematics textbook proofs.
Grigorian, E G; Malerian, D S; Seropian, N S; Sarkisian, R A; Iskandarian, V A; Khachatrian, K K; Avetisian, K G
2008-01-01
Electrophoresis using a 5% aqueous extract of mulberry leaves and a 5% aqueous extract of Tavish peat at the right hypochondrium of patients included in the study had beneficial effect on the clinical picture of chronic non-calculous cholecystitis. Specifically, the state of the hepatobiliary system improved judging by the results of staged chromatic duodenal probing, ultrasonographic examination of biliary ducts, and bioresonance diagnostics. Also, positive changes were recorded in energy metabolism. It is recommended that electrophoresis using an aqueous mulberry leaf extract be prescribed to patients with a short duration of the disease and hyperkinetic biliary ducts and intestines. In case of an inflammatory process in these organs or hypomotor dyskinesia of biliary ducts, good results can be obtained using electrophoresis with Tavish peat extracts having a wide spectrum of action. They are indicated for the rehabilitative treatment of digestive organ pathology. PMID:19069798
Tudakova, V G; Vladimirskiĭ, E V; Kunstman, T G
2013-01-01
This paper was designed to report the results of investigations into the therapeutic effectiveness of "Kluchi" sulfate magnesiumcalcium mineral water used to treat 194 patients presenting with chronic acalculous cholecystitis and different types of biliary tract dysfunction. The control group was comprised of 92 patients who took a diet. It was shown, that mineral water "Kluchi" exerted well apparent beneficial action on the motor function of the gallbladder and the sphincter apparatus. Moreover, drinking the mineral water improved colloidal stability of bile. It is concluded that the therapeutic application of "Kluchi" sulfate magnesium-calcium mineral water results in the reduction of bile lihogenicity, produces anti-inflammatory and choleretic effects, and promotes normalization of the motor and tonic condition of the biliary tract. PMID:23819416
ERIC Educational Resources Information Center
Dorko, Allison; Weber, Eric
2014-01-01
We analysed multivariable calculus students' meanings for domain and range and their generalisation of that meaning as they reasoned about the domain and range of multivariable functions. We found that students' thinking about domain and range fell into three broad categories: input/output, independence/dependence, and/or as attached to specific…
ERIC Educational Resources Information Center
Fuller, Robert G., Ed.; And Others
This is part of a series of 42 Calculus Based Physics (CBP) modules totaling about 1,000 pages. The modules include study guides, practice tests, and mastery tests for a full-year individualized course in calculus-based physics based on the Personalized System of Instruction (PSI). The units are not intended to be used without outside materials;…
Situation calculus on a dense flow of time
Fusaoka, Akira
1996-12-31
In this paper, we attempt to reconstruct the situation calculus on a dense flow of time. The proposed system: ISC, which is formulated in the framework of S2S (the monoadic second-order theory of two successor functions), allows to deal with temporal properties of time duration such as the continuity of fluents. Also it incorporates an intensional feature into the situation calculus so that the inferential process itself can be represented in ISC. On the basis of this modification, we define a nonmonotonic schema called epistemological minimization which selects the preferable model with respect to the information order in the inferential process. This method of nonmonotonic reasoning is useful for a temporal explanation problem because a sequence of events is interpreted sometimes depending on the information order in the inferential process rather than the chronological order of the actual process.
Implementation of inherence calculus in the PowerLoom environment
NASA Astrophysics Data System (ADS)
Wachulski, Marcin F.; Mulawka, Jan J.; Nieznański, Edward
The article describes an attempt to implement abstract and concrete inherence calculi in the PowerLoom technology. Issues in the field of artificial intelligence, ontology and philosophy have been addressed. The inherence calculus is a type of a formal logic system. The PowerLoom technology consists of a knowledge representation language and an inference engine. Six inherence calculi have been implemented and an appropriate testing environment has been developed. The inherence calculus has been also extended by categorical properties and a theoretical discussion of ontological Boolean algebra has been conducted. Carried out experiments showed properties of the inherence calculi and also verified capabilities of PowerLoom to construct such logic systems. It occurred that expert system operational mode of PowerLoom outperforms its abilities to work as a mathematical theorem prover.
Quantum stochastic calculus associated with quadratic quantum noises
NASA Astrophysics Data System (ADS)
Ji, Un Cig; Sinha, Kalyan B.
2016-02-01
We first study a class of fundamental quantum stochastic processes induced by the generators of a six dimensional non-solvable Lie †-algebra consisting of all linear combinations of the generalized Gross Laplacian and its adjoint, annihilation operator, creation operator, conservation, and time, and then we study the quantum stochastic integrals associated with the class of fundamental quantum stochastic processes, and the quantum Itô formula is revisited. The existence and uniqueness of solution of a quantum stochastic differential equation is proved. The unitarity conditions of solutions of quantum stochastic differential equations associated with the fundamental processes are examined. The quantum stochastic calculus extends the Hudson-Parthasarathy quantum stochastic calculus.
Calculus students' early concept images of tangent lines
NASA Astrophysics Data System (ADS)
Vincent, Brittany; LaRue, Renee; Sealey, Vicki; Engelke, Nicole
2015-07-01
This study explored first-semester calculus students' understanding of tangent lines as well as how students used tangent lines within the context of Newton's method. Task-based interviews were conducted with twelve first-semester calculus students who were asked to verbally describe a tangent line, sketch tangent lines for multiple curves, and use tangent lines within the context of Newton's method. We examined students' graphical illustrations and the language they used to describe tangent lines and identified six prominent categories that described students' concept images of tangent lines. Our data show that individual students often possessed multiple concept images of tangent lines, and often these multiple concept images were conflicting. Furthermore, students were usually willing to modify their concept images of tangent lines depending on the task presented to the students.
R-Function Relationships for Application in the Fractional Calculus
NASA Technical Reports Server (NTRS)
Lorenzo, Carl F.; Hartley, Tom T.
2000-01-01
The F-function, and its generalization the R-function, are of fundamental importance in the fractional calculus. It has been shown that the solution of the fundamental linear fractional differential equation may be expressed in terms of these functions. These functions serve as generalizations of the exponential function in the solution of fractional differential equations. Because of this central role in the fractional calculus, this paper explores various intrarelationships of the R-function, which will be useful in further analysis. Relationships of the R-function to the common exponential function, e(t), and its fractional derivatives are shown. From the relationships developed, some important approximations are observed. Further, the inverse relationships of the exponential function, el, in terms of the R-function are developed. Also, some approximations for the R-function are developed.
Fractional Calculus in Hydrologic Modeling: A Numerical Perspective
David A. Benson; Mark M. Meerschaert; Jordan Revielle
2012-01-01
Fractional derivatives can be viewed either as a handy extension of classical calculus or, more deeply, as mathematical operators defined by natural phenomena. This follows the view that the diffusion equation is defined as the governing equation of a Brownian motion. In this paper, we emphasize that fractional derivatives come from the governing equations of stable Levy motion, and that fractional integration is the corresponding inverse operator. Fractional integration, and its multi-dimensional extensions derived in this way, are intimately tied to fractional Brownian (and Levy) motions and noises. By following these general principles, we discuss the Eulerian and Lagrangian numerical solutions to fractional partial differential equations, and Eulerian methods for stochastic integrals. These numerical approximations illuminate the essential nature of the fractional calculus.
Bunny hops: using multiplicities of zeroes in calculus for graphing
NASA Astrophysics Data System (ADS)
Miller, David; Deshler, Jessica M.; Hansen, Ryan
2016-07-01
Students learn a lot of material in each mathematics course they take. However, they are not always able to make meaningful connections between content in successive mathematics courses. This paper reports on a technique to address a common topic in calculus I courses (intervals of increase/decrease and concave up/down) while also making use of students' pre-existing knowledge about the behaviour of functions around zeroes based on multiplicities.
Example Solar Electric Propulsion System asteroid tours using variational calculus
NASA Technical Reports Server (NTRS)
Burrows, R. R.
1985-01-01
Exploration of the asteroid belt with a vehicle utilizing a Solar Electric Propulsion System has been proposed in past studies. Some of those studies illustrated multiple asteroid rendezvous with trajectories obtained using approximate methods. Most of the inadequacies of those approximations are overcome in this paper, which uses the calculus of variations to calculate the trajectories and associated payloads of four asteroid tours. The modeling, equations, and solution techniques are discussed, followed by a presentation of the results.
Counterexamples on Jumarie's two basic fractional calculus formulae
NASA Astrophysics Data System (ADS)
Liu, Cheng-shi
2015-05-01
Jumarie proposed a modified Riemann-Liouville derivative definition and gave two basic fractional calculus formulae (u (t) v (t)) (α) =u (α) (t) v (t) + u (t)v (α) (t) and (f (u (t))) (α) = fu‧ u (α) (t) . We give two counterexamples to show that Jumarie's two formulae are not true. Respectively, all results obtained in references by using Jumarie's these two formulae are incorrect. In the end, we give the corresponding formulae.
A formalism for the calculus of variations with spinors
NASA Astrophysics Data System (ADS)
Bäckdahl, Thomas; Valiente Kroon, Juan A.
2016-02-01
We develop a frame and dyad gauge-independent formalism for the calculus of variations of functionals involving spinorial objects. As a part of this formalism, we define a modified variation operator which absorbs frame and spin dyad gauge terms. This formalism is applicable to both the standard spacetime (i.e., SL(2, ℂ)) 2-spinors as well as to space (i.e., SU(2, ℂ)) 2-spinors. We compute expressions for the variations of the connection and the curvature spinors.
Time Scale Calculus - a new perspectives for synthetic seismogram calculations
NASA Astrophysics Data System (ADS)
Waskiewicz, Kamil; Debski, Wojciech
2013-04-01
Synthetic, numerically generated seismograms are one of the key factors of any interpretation of recorded seismic data. At the early stage of development, calculation of full seismic waveforms was impossible due to a limited computational resource so we were forced to used only some selected characteristics of seismic waves relatively easy for numerical calculations like first arrival times, maximum amplitude, approximate source spectra, to name a few. Continues development of computational resources as well as progress in numerical techniques has opened possibilities of generation the full, 3-component seismograms incorporating many physically important elements like wave attenuation, anisotropy or randomness of the media. Although achieved results are impressive we still need new numerical methods to tackle existing problems with the synthetic seismogram generation. In this contribution we present a novel approach to discretization of the wave equation which brings together continues and discrete numerical analysis of the seismic waves. The foundations of this new technique, called Time Scale Calculus, have been formulated by Hilger in late eighties and is very dynamically developing. The Time scale calculus, due to its universality seems to have a great potential when practical applications are considered. Thus we have decided to bring the Time Scale calculus concept closer to geophysical, or more precisely to seismological applications. This presentation is intend as a basic introduction to the time scales calculus considered from seismological point of view. We shortly present and discuss the possibility of using the Time Scales (TS) technique for solving the simplest acoustic 2D wave equation keeping in mind its particular applications for mining induced seismicity.
Some basic results on the sets of sequences with geometric calculus
NASA Astrophysics Data System (ADS)
Türkmen, Cengiz; Başar, Feyzi
2012-08-01
As an alternative to the classical calculus, Grossman and Katz [Non-Newtonian Calculus, Lee Press, Pigeon Cove, Massachusetts, 1972] introduced the non-Newtonian calculus consisting of the branches of geometric, anageometric and bigeometric calculus. Following Grossman and Katz, we construct the field C(G) of geometric complex numbers and the concept of geometric metric. Also we give the triangle and Minkowski's inequalities in the sense of geometric calculus. Later we respectively define the sets w(G), ℓ∞(G), c(G), c0(G) and ℓp(G) of all, bounded, convergent, null and p-absolutely summable sequences, in the sense of geometric calculus and show that each of the set forms a complete vector space on the field C(G).
Uncomplicated urinary tract infection; UTI - acute; Acute bladder infection; Acute bacterial cystitis ... International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 ...
Subgingival calculus imaging based on swept-source optical coherence tomography
NASA Astrophysics Data System (ADS)
Hsieh, Yao-Sheng; Ho, Yi-Ching; Lee, Shyh-Yuan; Lu, Chih-Wei; Jiang, Cho-Pei; Chuang, Ching-Cheng; Wang, Chun-Yang; Sun, Chia-Wei
2011-07-01
We characterized and imaged dental calculus using swept-source optical coherence tomography (SS-OCT). The refractive indices of enamel, dentin, cementum, and calculus were measured as 1.625 +/- 0.024, 1.534 +/- 0.029, 1.570 +/- 0.021, and 2.097 +/- 0.094, respectively. Dental calculus leads strong scattering properties, and thus, the region can be identified from enamel with SS-OCT imaging. An extracted human tooth with calculus is covered with gingiva tissue as an in vitro sample for tomographic imaging.
Using dynamic tools to develop an understanding of the fundamental ideas of calculus
NASA Astrophysics Data System (ADS)
Verzosa, Debbie; Guzon, Angela Fatima; De las peñas, Ma. Louise Antonette N.
2014-02-01
Although dynamic geometry software has been extensively used for teaching calculus concepts, few studies have documented how these dynamic tools may be used for teaching the rigorous foundations of the calculus. In this paper, we describe lesson sequences utilizing dynamic tools for teaching the epsilon-delta definition of the limit and the fundamental theorem of calculus. The lessons were designed on the basis of observed student difficulties and the existing scholarly literature. We show how a combination of dynamic tools and guide questions allows students to construct their understanding of these calculus ideas.
[Tomodensitometry of severe acute pancreatitis].
Frija, J; Abanou, A; Viandier, A; Laval-Jeantet, M
1983-01-01
90 computed tomographic examinations were performed to 57 patients referred at Hospital Saint-Louis for an acute pancreatitis. 32 patients were operated or autopsied. Among these 32 patients, 19 patients had 21 examinations before surgery or autopsy; the other 13 patients had their computed tomographic examinations after one or more surgical procedures. During a severe acute pancreatitis the pancreas is always large either locally or diffusely. A pancreatic reaction is visible around and possibly at distance of the pancreas. When extraluminal gas is visible (3/5) it signifies gangrenous pancreatitis but it is necessary to eliminate a digestive fistulous tract and/or a communication between a pseudocyst and the digestive tract. Except gangrenous it is not possible to precise the nature of pancreatic reaction. The diagnosis of pseudocyst was easy 9/10, difficult 1/10; we did a false positive diagnosis of pseudocyst. Computed tomography and ultrasounds were compared in ten patients for the search of gallbladder lithiasis. Computed tomography can show large and small (2/4) biliary calculus in the gallbladder that cannot be shown by ultrasounds. A normal pancreas in a normal retroperitoneal space exclude the diagnosis of a severe acute pancreatitis. CT aspects of acute pancreatitis must be considered as a good diagnostic test of an acute pancreatitis.
A calculus clinical study comparing the efficacy of two commercially available dentifrices.
Sowinski, J; Battista, G; Petrone, D M; Petrone, M E; DeVizio, W; Volpe, A R; Proskin, H M
2000-01-01
The objective of this double-blind clinical study, conducted in harmony with the Volpe-Manhold design for studies of dental calculus, was to compare the effect on supragingival calculus formation of a dentifrice containing pyrophosphate, tripolyphosphate and a copolymer in a 0.243% sodium fluoride/silica base (Test Dentifrice), to that of a commercially available calculus-inhibiting dentifrice containing tetrapotassium pyrophosphate, disodium pyrophosphate, and tetrasodium pyrophosphate in a 0.243% sodium fluoride/silica base (Positive Control Dentifrice). Adult male and female subjects from the Northern New Jersey area were entered into the study, provided a full oral prophylaxis and assigned the use of a placebo (non-calculus-inhibiting) dentifrice for eight weeks. At the completion of this initial period, subjects were assessed for baseline Volpe-Manhold Calculus Index scores, provided another full prophylaxis and stratified into two treatment groups which were balanced for age, sex and baseline calculus. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice, using a soft-bristled toothbrush. Examinations for dental calculus were again performed after twelve weeks' use of the study dentifrices. Eighty-nine (89) subjects complied with the protocol and completed the entire study. At the three-month examination, the Test Dentifrice group exhibited a statistically significant 31.0% reduction in the mean Volpe-Manhold Calculus Index score compared to the Positive Control Dentifrice group. The results of this clinical study support the conclusion that a new calculus-inhibiting dentifrice containing pyrophosphate, tripolyphosphate, and a copolymer in a 0.243% sodium fluoride/silica base is efficacious for the control of the development of supragingival calculus, and provides a level of benefit greater than that provided by a commercially available calculus-inhibiting dentifrice containing
The development and nature of problem-solving among first-semester calculus students
NASA Astrophysics Data System (ADS)
Dawkins, Paul Christian; Mendoza Epperson, James A.
2014-08-01
This study investigates interactions between calculus learning and problem-solving in the context of two first-semester undergraduate calculus courses in the USA. We assessed students' problem-solving abilities in a common US calculus course design that included traditional lecture and assessment with problem-solving-oriented labs. We investigate this blended instruction as a local representative of the US calculus reform movements that helped foster it. These reform movements tended to emphasize problem-solving as well as multiple mathematical registers and quantitative modelling. Our statistical analysis reveals the influence of the blended traditional/reform calculus instruction on students' ability to solve calculus-related, non-routine problems through repeated measures over the semester. The calculus instruction in this study significantly improved students' performance on non-routine problems, though performance improved more regarding strategies and accuracy than it did for drawing conclusions and providing justifications. We identified problem-solving behaviours that characterized top performance or attrition in the course. Top-performing students displayed greater algebraic proficiency, calculus skills, and more general heuristics than their peers, but overused algebraic techniques even when they proved cumbersome or inappropriate. Students who subsequently withdrew from calculus often lacked algebraic fluency and understanding of the graphical register. The majority of participants, when given a choice, relied upon less sophisticated trial-and-error approaches in the numerical register and rarely used the graphical register, contrary to the goals of US calculus reform. We provide explanations for these patterns in students' problem-solving performance in view of both their preparation for university calculus and the courses' assessment structure, which preferentially rewarded algebraic reasoning. While instruction improved students' problem
Marymont, J V; Dakhil, S R; Travers, H; Housholder, D F
1985-10-01
The introduction of chemotherapeutic agents directly into the proper hepatic artery via an indwelling catheter results in perfusion of the gallbladder, because the cystic artery is usually a branch of the right hepatic artery. Five gallbladders, removed two to 16 months after insertion of permanently implanted Infusaid model 400 pumps, were examined. All of the gallbladders had significant arteritis, with narrowing or occlusion of lumina or necrosis of vessel walls. Fibrosis of the gallbladder wall was also a constant finding. Nuclear atypia of mucosal epithelium and connective tissue was common. Varying degrees of acute and chronic inflammation were present. These abnormalities may have a radiomimetic and direct irritant pathogenesis.
Regge Calculus as a Numerical Approach to General Relativity
NASA Astrophysics Data System (ADS)
Khavari, Parandis
A (3+1)-evolutionary method in the framework of Regge Calculus, known as "Parallelisable Implicit Evolutionary Scheme", is analysed and revised so that it accounts for causality. Furthermore, the ambiguities associated with the notion of time in this evolutionary scheme are addressed and a solution to resolving such ambiguities is presented. The revised algorithm is then numerically tested and shown to produce the desirable results and indeed to resolve a problem previously faced upon implementing this scheme. An important issue that has been overlooked in "Parallelisable Implicit Evolutionary Scheme" was the restrictions on the choice of edge lengths used to build the space-time lattice as it evolves in time. It is essential to know what inequalities must hold between the edges of a 4-dimensional simplex, used to construct a space-time, so that the geometry inside the simplex is Minkowskian. The only known inequality on the Minkowski plane is the "Reverse Triangle Inequality" which holds between the edges of a triangle constructed only from space-like edges. However, a triangle, on the Minkowski plane, can be built from a combination of time-like, space-like or null edges. Part of this thesis is concerned with deriving a number of inequalities that must hold between the edges of mixed triangles. Finally, the Raychaudhuri equation is considered from the point of view of Regge Calculus. The Raychaudhuri equation plays an important role in many areas of relativistic Physics and Astrophysics, most importantly in the proof of singularity theorems. An analogue to the Raychaudhuri equation in the framework of Regge Calculus is derived. Both (2+1)-dimensional and (3+1)-dimensional cases are considered and analogues for average expansion and shear scalar are found.
EARLINET Single Calculus Chain - overview on methodology and strategy
NASA Astrophysics Data System (ADS)
D'Amico, G.; Amodeo, A.; Baars, H.; Binietoglou, I.; Freudenthaler, V.; Mattis, I.; Wandinger, U.; Pappalardo, G.
2015-11-01
In this paper we describe the EARLINET Single Calculus Chain (SCC), a tool for the automatic analysis of lidar measurements. The development of this tool started in the framework of EARLINET-ASOS (European Aerosol Research Lidar Network - Advanced Sustainable Observation System); it was extended within ACTRIS (Aerosol, Clouds and Trace gases Research InfraStructure Network), and it is continuing within ACTRIS-2. The main idea was to develop a data processing chain that allows all EARLINET stations to retrieve, in a fully automatic way, the aerosol backscatter and extinction profiles starting from the raw lidar data of the lidar systems they operate. The calculus subsystem of the SCC is composed of two modules: a pre-processor module which handles the raw lidar data and corrects them for instrumental effects and an optical processing module for the retrieval of aerosol optical products from the pre-processed data. All input parameters needed to perform the lidar analysis are stored in a database to keep track of all changes which may occur for any EARLINET lidar system over the time. The two calculus modules are coordinated and synchronized by an additional module (daemon) which makes the whole analysis process fully automatic. The end user can interact with the SCC via a user-friendly web interface. All SCC modules are developed using open-source and freely available software packages. The final products retrieved by the SCC fulfill all requirements of the EARLINET quality assurance programs on both instrumental and algorithm levels. Moreover, the manpower needed to provide aerosol optical products is greatly reduced and thus the near-real-time availability of lidar data is improved. The high-quality of the SCC products is proven by the good agreement between the SCC analysis, and the corresponding independent manual retrievals. Finally, the ability of the SCC to provide high-quality aerosol optical products is demonstrated for an EARLINET intense observation
Preparatory Year Program Courses as Predictors of First Calculus Course Grade
ERIC Educational Resources Information Center
Yushau, B; Omar, M. H
2007-01-01
This study investigates the effect of the preparatory year program courses on the first calculus course (Calculus I) at King Fahd University of Petroleum and Minerals (KFUPM). The data consists of more than 2,000 bilingual Arab university students studying in the English language, tracked over seven semesters. These students represent over 70% of…
Using an Advanced Graphing Calculator in the Teaching and Learning of Calculus
ERIC Educational Resources Information Center
Leng, Ng Wee
2011-01-01
The purpose of this study was to investigate how the use of TI-Nspire[TM] could enhance the teaching and learning of calculus. A conceptual framework for the use of TI-Nspire[TM] for learning calculus in a mathematics classroom is proposed that describes the interactions among the students, TI-Nspire[TM], and the learning tasks, and how they lead…
Incorporating Inquiry-Based Learning in the Calculus Sequence: A Most Challenging Endeavour
ERIC Educational Resources Information Center
McLoughlin, M. Padraig M. M.
2009-01-01
A course in the Calculus sequence is arguably the most difficult course in which inquiry-based learning (IBL) can be achieved with any degree of success within the curriculum in part due to: (1) the plethora of majors taking Calculus to which the sequence relates to their majors in what is considered an "applied" manner; and (2) the sequence is…
ERIC Educational Resources Information Center
Hare, Angela; Phillippy, Doug
2004-01-01
A program on calculus is conducted, which helps students learn about inherent differentiation through a study of mathematical functions, while simultaneously reinforcing their understanding of functional concepts. This process develops their mathematical experience in the field of calculus and in other advanced quantitative programs.
Analysis of Errors and Misconceptions in the Learning of Calculus by Undergraduate Students
ERIC Educational Resources Information Center
Muzangwa, Jonatan; Chifamba, Peter
2012-01-01
This paper is going to analyse errors and misconceptions in an undergraduate course in Calculus. The study will be based on a group of 10 BEd. Mathematics students at Great Zimbabwe University. Data is gathered through use of two exercises on Calculus 1&2.The analysis of the results from the tests showed that a majority of the errors were due…
Students' Conceptual Knowledge of Limits in Calculus: A Two-Part Constructivist Case Study
ERIC Educational Resources Information Center
Adams, Margaret Smolinka
2013-01-01
This case study investigated students' conceptual knowledge of limits in calculus by implementing semi-structured interviews. The constructivist learning principles of Piaget and Inhelder as well as theories of understanding by Skemp guided the study. In Phase I, a pilot study was conducted with 15 students from a Calculus III class. By using…
The Impact of the Calculator on the Content Validity of Advanced Placement Calculus Problems.
ERIC Educational Resources Information Center
Gimmestad, Beverly J.
Nineteen Calculus II students were randomly sampled and divided into calculator (n=9) and noncalculator (n=10) groups. These students were asked to "think aloud" while solving 24 Advanced Placement calculus problems. Each student interview was videotaped, coded and analyzed for reasoning process as well as outcome. The results indicated that the…
Selective ablation of sub- and supragingival calculus with a frequency-doubled Alexandrite laser
NASA Astrophysics Data System (ADS)
Rechmann, Peter; Hennig, Thomas
1995-05-01
In a preceding trial the absorption characteristics of subgingival calculus were calculated using fluorescence emission spectroscopy (excitation laser: N2-laser, wavelength 337 nm, pulse duration 4 ns). Subgingival calculus seems to contain chromophores absorbing in the ultraviolet spectral region up to 420 nm. The aim of the actual study was the ablation of sub- and supragingival calculus using a frequency doubled Alexandrite-laser (wavelength 377 nm, pulse duration 100 ns, repetition rate 110 Hz). Extracted human teeth presenting sub- and supragingival calculus were irradiated perpendicular to their axis with a laser fluence of 1 Jcm-2. Using a standard application protocol calculus was irradiated at the enamel surface, at the junction between enamel and root, and at the root surface (located on dentin or on cementum). During the irradiation procedure an effective water cooling-system was engaged. For light microscopical investigations undecalcified histological sections were prepared after treatment. The histological sections revealed that a selective and total removal of calculus is possible at all locations without ablation of healthy enamel, dentin or cementum. Even low fluences provide us with a high effectiveness for the ablation of calculus. Thus, based on different absorption characteristics and ablation thresholds, engaging a frequency doubled Alexandrite-laser a fast and, even more, a selective ablation of sub- and supragingival calculus is possible without adverse side effects to the surrounding tissues. Even more, microbial dental plaque can be perfectly removed.
Student Performance with Calculus Reform at the United States Merchant Marine Academy.
ERIC Educational Resources Information Center
Ratay, Gabriella M.
1993-01-01
Reports the results of students' performance as measured by grades after the completion of the first three-quarters of calculus using the materials of the Calculus Consortium based at Harvard University. The results are presented in graphical form. The improvement is dramatic for the weaker students and moderate or none for the better students.…
Assessment of Peer-Led Team Learning in Calculus I: A Five-Year Study
ERIC Educational Resources Information Center
Merkel, John Conrad; Brania, Abdelkrim
2015-01-01
This five-year study of the peer-led team learning (PLTL) paradigm examined its implementation in a Calculus I course at an all-male HBCU institution. For this study we set up a strong control group and measured the effect of PLTL in the teaching and learning of Calculus I through two points of measure: retention and success rates and learning…
Improving Student Learning of Calculus Topics via Modified Just-in-Time Teaching Methods
ERIC Educational Resources Information Center
Natarajan, Rekha; Bennett, Andrew
2014-01-01
Although the use of traditional just-in-time teaching techniques has long been viewed positively by students and instructors in undergraduate calculus courses, past studies in this area have not addressed gains in student achievement with respect to specific calculus topics. This paper investigates the latter by administering modified just-in-time…
Retention of Concepts and Skills in Traditional and Reformed Applied Calculus.
ERIC Educational Resources Information Center
Garner, Bradley E.; Garner, Lynn E.
2001-01-01
Compares outcomes of traditional and reform calculus courses in terms of students' retention of basic concepts and skills after the passage of time. Concludes that reform students retain better conceptual knowledge and traditional students retain better procedural knowledge. Demonstrates that reform calculus students understand concepts before…
The Role of Cognitive Ability and Preferred Mode of Processing in Students' Calculus Performance
ERIC Educational Resources Information Center
Haciomeroglu, Erhan Selcuk
2015-01-01
The present study sought to design calculus tasks to determine students' preference for visual or analytic processing as well as examine the role of preferred mode of processing in calculus performance and its relationship to spatial ability and verbal-logical reasoning ability. Data were collected from 150 high school students who were enrolled…
Factors Associated with Success in a Calculus Course: An Examination of Personal Variables
ERIC Educational Resources Information Center
Ubuz, Behiye
2011-01-01
This study examined relationships between students' personal variables (gender, prior achievements, age and academic major) and their success in the first year undergraduate calculus course. The study sample consisted of 59 first year undergraduate students taking Math 154 Calculus II course. A written test about integral, sequence and series…
ERIC Educational Resources Information Center
Yaacob, Yuzita; Wester, Michael; Steinberg, Stanly
2010-01-01
This paper presents a prototype of a computer learning assistant ILMEV (Interactive Learning-Mathematica Enhanced Vector calculus) package with the purpose of helping students to understand the theory and applications of integration in vector calculus. The main problem for students using Mathematica is to convert a textbook description of a…
A Methodology in the Teaching Process of Calculus and Its Motivation.
ERIC Educational Resources Information Center
Vasquez-Martinez, Claudio-Rafael
The development of calculus and science by being permanent, didactic, demands on one part an analytical, deductive study and on another an application of methods, rhochrematics, resources, within calculus, which allows to dialectically conform knowledge in its different phases and to test the results. For the purpose of this study, the motivation…
The Introduction of Calculus in 12th Grade: The Role of Artefacts
ERIC Educational Resources Information Center
Maschietto, Michela
2004-01-01
The paper concerns the analysis of the role of artefacts and instruments in approaching calculus by graphic-symbolic calculator at high school level. We focus on an element of the introduction of calculus: the global/local game. We discus the hypothesis that the zoom-controls of calculator support the production of gestures and metaphors that…
An Excel-Aided Method for Teaching Calculus-Based Business Mathematics
ERIC Educational Resources Information Center
Liang, Jiajuan; Martin, Linda
2008-01-01
Calculus-based business mathematics is a required quantitative course for undergraduate business students in most AACSB accredited schools or colleges of business. Many business students, however, have relatively weak mathematical background or even display math-phobia when presented with calculus problems. Because of the popularity of Excel, its…
Using Dynamic Tools to Develop an Understanding of the Fundamental Ideas of Calculus
ERIC Educational Resources Information Center
Verzosa, Debbie; Guzon, Angela Fatima; De Las Peñas, Ma. Louise Antonette N.
2014-01-01
Although dynamic geometry software has been extensively used for teaching calculus concepts, few studies have documented how these dynamic tools may be used for teaching the rigorous foundations of the calculus. In this paper, we describe lesson sequences utilizing dynamic tools for teaching the epsilon-delta definition of the limit and the…
Distributed mean curvature on a discrete manifold for Regge calculus
NASA Astrophysics Data System (ADS)
Conboye, Rory; Miller, Warner A.; Ray, Shannon
2015-09-01
The integrated mean curvature of a simplicial manifold is well understood in both Regge Calculus and Discrete Differential Geometry. However, a well motivated pointwise definition of curvature requires a careful choice of the volume over which to uniformly distribute the local integrated curvature. We show that hybrid cells formed using both the simplicial lattice and its circumcentric dual emerge as a remarkably natural structure for the distribution of this local integrated curvature. These hybrid cells form a complete tessellation of the simplicial manifold, contain a geometric orthonormal basis, and are also shown to give a pointwise mean curvature with a natural interpretation as the fractional rate of change of the normal vector.
Teaching calculus using module based on cooperative learning strategy
NASA Astrophysics Data System (ADS)
Arbin, Norazman; Ghani, Sazelli Abdul; Hamzah, Firdaus Mohamad
2014-06-01
The purpose of the research is to evaluate the effectiveness of a module which utilizes the cooperative learning for teaching Calculus for limit, derivative and integral. The sample consists of 50 semester 1 students from the Science Programme (AT 16) Sultan Idris Education University. A set of questions of related topics (pre and post) has been used as an instrument to collect data. The data is analyzed using inferential statistics involving the paired sample t-test and the independent t-test. The result shows that students have positive inclination towards the modulein terms of understanding.
Advanced Jones calculus for the classification of periodic metamaterials
NASA Astrophysics Data System (ADS)
Menzel, Christoph; Rockstuhl, Carsten; Lederer, Falk
2010-11-01
By relying on an advanced Jones calculus, we analyze the polarization properties of light upon propagation through metamaterial slabs in a comprehensive manner. Based on symmetry considerations, we show that all periodic metamaterials may be divided into five different classes only. It is shown that each class differently affects the polarization of the transmitted light and sustains different eigenmodes. We show how to deduce these five classes from symmetry considerations and provide a simple algorithm that can be applied to decide to which class a given metamaterial belongs by measuring only the transmitted intensities.
Real-Time Exponential Curve Fits Using Discrete Calculus
NASA Technical Reports Server (NTRS)
Rowe, Geoffrey
2010-01-01
An improved solution for curve fitting data to an exponential equation (y = Ae(exp Bt) + C) has been developed. This improvement is in four areas -- speed, stability, determinant processing time, and the removal of limits. The solution presented avoids iterative techniques and their stability errors by using three mathematical ideas: discrete calculus, a special relationship (be tween exponential curves and the Mean Value Theorem for Derivatives), and a simple linear curve fit algorithm. This method can also be applied to fitting data to the general power law equation y = Ax(exp B) + C and the general geometric growth equation y = Ak(exp Bt) + C.
Computational approach to Thornley's problem by bivariate operational calculus
NASA Astrophysics Data System (ADS)
Bazhlekova, E.; Dimovski, I.
2012-10-01
Thornley's problem is an initial-boundary value problem with a nonlocal boundary condition for linear onedimensional reaction-diffusion equation, used as a mathematical model of spiral phyllotaxis in botany. Applying a bivariate operational calculus we find explicit representation of the solution, containing two convolution products of special solutions and the arbitrary initial and boundary functions. We use a non-classical convolution with respect to the space variable, extending in this way the classical Duhamel principle. The special solutions involved are represented in the form of fast convergent series. Numerical examples are considered to show the application of the present technique and to analyze the character of the solution.
Loop calculus in statistical physics and information science.
Chertkov, Michael; Chernyak, Vladimir Y
2006-06-01
Considering a discrete and finite statistical model of a general position we introduce an exact expression for the partition function in terms of a finite series. The leading term in the series is the Bethe-Peierls (belief propagation) (BP) contribution; the rest are expressed as loop contributions on the factor graph and calculated directly using the BP solution. The series unveils a small parameter that often makes the BP approximation so successful. Applications of the loop calculus in statistical physics and information science are discussed.
Loop calculus in statistical physics and information science
NASA Astrophysics Data System (ADS)
Chertkov, Michael; Chernyak, Vladimir Y.
2006-06-01
Considering a discrete and finite statistical model of a general position we introduce an exact expression for the partition function in terms of a finite series. The leading term in the series is the Bethe-Peierls (belief propagation) (BP) contribution; the rest are expressed as loop contributions on the factor graph and calculated directly using the BP solution. The series unveils a small parameter that often makes the BP approximation so successful. Applications of the loop calculus in statistical physics and information science are discussed.
Advanced Jones calculus for the classification of periodic metamaterials
Menzel, Christoph; Rockstuhl, Carsten; Lederer, Falk
2010-11-15
By relying on an advanced Jones calculus, we analyze the polarization properties of light upon propagation through metamaterial slabs in a comprehensive manner. Based on symmetry considerations, we show that all periodic metamaterials may be divided into five different classes only. It is shown that each class differently affects the polarization of the transmitted light and sustains different eigenmodes. We show how to deduce these five classes from symmetry considerations and provide a simple algorithm that can be applied to decide to which class a given metamaterial belongs by measuring only the transmitted intensities.
Resolution of Localized Chronic Periodontitis Associated with Longstanding Calculus Deposits
Walters, John D.
2014-01-01
This report, which is based on nonstandardized serial radiographs obtained over a period of 15 years, documents a case of localized chronic periodontitis associated with progressive deposition of calculus on the distal aspect of a mandibular second molar. The site was treated by scaling and root planing, followed by a course of adjunctive systemic azithromycin. Treatment yielded favorable reductions in probing depth and clinical inflammation, leaving only few isolated sites with pockets no deeper than 4 mm. Two years after completion of active treatment, there was radiographic evidence of increased bone density distal to the second molar. PMID:24876977
ERIC Educational Resources Information Center
Barclay, Allen C.
2012-01-01
On a national level, data indicate that about 40 percent of students in calculus courses finish with a grade of D or F, drop the course, or withdraw (Reinholz, 2009). This high failure rate has led to research studies investigating the teaching of calculus at the national level (House, 1995). Calculus courses have a history of high failure rates,…
What Does It Mean for a Student to Understand the First-Year Calculus? Perspectives of 24 Experts
ERIC Educational Resources Information Center
Sofronas, Kimberly S.; DeFranco, Thomas C.; Vinsonhaler, Charles; Gorgievski, Nicholas; Schroeder, Larissa; Hamelin, Chris
2011-01-01
This article presents the views of 24 nationally recognized authorities in the field of mathematics, and in particular the calculus, on student understanding of the first-year calculus. A framework emerged that includes four overarching end goals for understanding of the first-year calculus: (a) mastery of the fundamental concepts and-or skills of…
Factors related to the quantity of subgingival calculus in proximal root surfaces.
Martínez-Canut, P; Benlloch, D; Izquierdo, R
1999-08-01
The aim of this study was to determine the association between the quantity of subgingival calculus and the following factors: type and severity of periodontal disease, age, gender and tobacco consumption. A sample of 622 periodontal patients was studied. The radiographically detectable subgingival calculus in proximal root surfaces was recorded in periapical radiographs, considering the number of surfaces without calculus and the number of surfaces exhibiting deposits equal or greater than I mm. The association between the subgingival calculus and the factors under study was analyzed by distinct non-parametric tests. A statistically significant association was found between the absence/presence of subgingival calculus and the type and severity of periodontal disease (p<0.001), tobacco consumption (p=0.0049) and age (p<0.001). The quantity of radiographically-detectable subgingival calculus increased with increasing age and severity of the disease. However, the reverse association was found in smokers, which presented more surfaces free of calculus (p=0.0377) and less surfaces exhibiting deposits equal or greater than 1 mm. The amount of subgingival calculus decreased as the quantity of tobacco consumed increased (p=0.0129), and such differences were more significant in those smoker patients with severe periodontitis (p= 0.0065). An explanation is presented to justify these latter findings, since most literature supports that the presence of calculus is higher in smokers. According to the results of this study, more radiographically-detectable subgingival calculus in proximal root surfaces was found with increasing severity of the disease, with increasing age and with the absence of tobacco consumption.
Diagnostic peritoneal lavage in evaluating acute abdominal pain.
Barbee, C L; Gilsdorf, R B
1975-06-01
A study was performed to determine the value of peritoneal lavage in the acute abdomen not related to trauma. Lavage was performed in 33 patients in the evaluation of abdominal pain of sufficient degree to warrant consideration for surgical intervention. Peritoneal lavage was truly positive or truly negative in 64% of the cases. It showed false negative results in 28% and false positive results in 8%. The lavage was most accurate in the evaluation of appendicitis, colonic disease, and intra abdominal bleeding. It was highly inaccurate in the evaluation of cholecystitis and peptic ulcer disease. It was concluded that the peritoneal lavage can be a useful adjunct in the evaluation of patients with abdominal pain and should be considered in difficult diagnostic problems but not routinely employed.
Microscopic hematuria and calculus-related ureteral obstruction.
Stewart, D P; Kowalski, R; Wong, P; Krome, R
1990-01-01
The evaluation of patients with ureteral calculi in the emergency department has historically included urinalysis (UA) and intravenous pyelograms (IVP). This retrospective study was done to determine if a statistically significant relationship existed between the degree of calculus-related ureteral obstruction, proven by IVP, and the presence or absence of microscopic hematuria. Urine red blood cells were recorded as less than 3 rbc/hpf (negative) or greater than or equal to 3 rbc/hpf (positive). IVPs were recorded as nonsevere or severe. IVP criteria were based on the presence or absence of extravasation, greater than 2-hour ureteral filling times, and a numerical scoring system of 1 to 4 for ureteral or calyceal dilatation and nephrogenic effect. Eighty-nine men (72%) had non-severe obstructions and 34 (28%) had severe obstructions. Twenty-five women (68%) had nonsevere obstructions and 12 (32%) had severe obstructions. Of the 28 patients with normal UAs, 11 had severe ureteral obstructions and 17 had nonsevere ureteral obstructions. There were no statistically significant differences between the presence or absence of significant microscopic hematuria and the presence or absence of severe ureteral obstruction. Microscopic hematuria is neither sensitive nor specific in determining the degree of calculus-related ureteral obstruction.
Direct evidence of milk consumption from ancient human dental calculus
Warinner, C.; Hendy, J.; Speller, C.; Cappellini, E.; Fischer, R.; Trachsel, C.; Arneborg, J.; Lynnerup, N.; Craig, O. E.; Swallow, D. M.; Fotakis, A.; Christensen, R. J.; Olsen, J. V.; Liebert, A.; Montalva, N.; Fiddyment, S.; Charlton, S.; Mackie, M.; Canci, A.; Bouwman, A.; Rühli, F.; Gilbert, M. T. P.; Collins, M. J.
2014-01-01
Milk is a major food of global economic importance, and its consumption is regarded as a classic example of gene-culture evolution. Humans have exploited animal milk as a food resource for at least 8500 years, but the origins, spread, and scale of dairying remain poorly understood. Indirect lines of evidence, such as lipid isotopic ratios of pottery residues, faunal mortality profiles, and lactase persistence allele frequencies, provide a partial picture of this process; however, in order to understand how, where, and when humans consumed milk products, it is necessary to link evidence of consumption directly to individuals and their dairy livestock. Here we report the first direct evidence of milk consumption, the whey protein β-lactoglobulin (BLG), preserved in human dental calculus from the Bronze Age (ca. 3000 BCE) to the present day. Using protein tandem mass spectrometry, we demonstrate that BLG is a species-specific biomarker of dairy consumption, and we identify individuals consuming cattle, sheep, and goat milk products in the archaeological record. We then apply this method to human dental calculus from Greenland's medieval Norse colonies, and report a decline of this biomarker leading up to the abandonment of the Norse Greenland colonies in the 15th century CE. PMID:25429530
Fractional calculus model of electrical impedance applied to human skin.
Vosika, Zoran B; Lazovic, Goran M; Misevic, Gradimir N; Simic-Krstic, Jovana B
2013-01-01
Fractional calculus is a mathematical approach dealing with derivatives and integrals of arbitrary and complex orders. Therefore, it adds a new dimension to understand and describe basic nature and behavior of complex systems in an improved way. Here we use the fractional calculus for modeling electrical properties of biological systems. We derived a new class of generalized models for electrical impedance and applied them to human skin by experimental data fitting. The primary model introduces new generalizations of: 1) Weyl fractional derivative operator, 2) Cole equation, and 3) Constant Phase Element (CPE). These generalizations were described by the novel equation which presented parameter [Formula: see text] related to remnant memory and corrected four essential parameters [Formula: see text] We further generalized single generalized element by introducing specific partial sum of Maclaurin series determined by parameters [Formula: see text] We defined individual primary model elements and their serial combination models by the appropriate equations and electrical schemes. Cole equation is a special case of our generalized class of models for[Formula: see text] Previous bioimpedance data analyses of living systems using basic Cole and serial Cole models show significant imprecisions. Our new class of models considerably improves the quality of fitting, evaluated by mean square errors, for bioimpedance data obtained from human skin. Our models with new parameters presented in specific partial sum of Maclaurin series also extend representation, understanding and description of complex systems electrical properties in terms of remnant memory effects. PMID:23577065
Microscopic hematuria and calculus-related ureteral obstruction.
Stewart, D P; Kowalski, R; Wong, P; Krome, R
1990-01-01
The evaluation of patients with ureteral calculi in the emergency department has historically included urinalysis (UA) and intravenous pyelograms (IVP). This retrospective study was done to determine if a statistically significant relationship existed between the degree of calculus-related ureteral obstruction, proven by IVP, and the presence or absence of microscopic hematuria. Urine red blood cells were recorded as less than 3 rbc/hpf (negative) or greater than or equal to 3 rbc/hpf (positive). IVPs were recorded as nonsevere or severe. IVP criteria were based on the presence or absence of extravasation, greater than 2-hour ureteral filling times, and a numerical scoring system of 1 to 4 for ureteral or calyceal dilatation and nephrogenic effect. Eighty-nine men (72%) had non-severe obstructions and 34 (28%) had severe obstructions. Twenty-five women (68%) had nonsevere obstructions and 12 (32%) had severe obstructions. Of the 28 patients with normal UAs, 11 had severe ureteral obstructions and 17 had nonsevere ureteral obstructions. There were no statistically significant differences between the presence or absence of significant microscopic hematuria and the presence or absence of severe ureteral obstruction. Microscopic hematuria is neither sensitive nor specific in determining the degree of calculus-related ureteral obstruction. PMID:2096163
Direct evidence of milk consumption from ancient human dental calculus.
Warinner, C; Hendy, J; Speller, C; Cappellini, E; Fischer, R; Trachsel, C; Arneborg, J; Lynnerup, N; Craig, O E; Swallow, D M; Fotakis, A; Christensen, R J; Olsen, J V; Liebert, A; Montalva, N; Fiddyment, S; Charlton, S; Mackie, M; Canci, A; Bouwman, A; Rühli, F; Gilbert, M T P; Collins, M J
2014-01-01
Milk is a major food of global economic importance, and its consumption is regarded as a classic example of gene-culture evolution. Humans have exploited animal milk as a food resource for at least 8500 years, but the origins, spread, and scale of dairying remain poorly understood. Indirect lines of evidence, such as lipid isotopic ratios of pottery residues, faunal mortality profiles, and lactase persistence allele frequencies, provide a partial picture of this process; however, in order to understand how, where, and when humans consumed milk products, it is necessary to link evidence of consumption directly to individuals and their dairy livestock. Here we report the first direct evidence of milk consumption, the whey protein β-lactoglobulin (BLG), preserved in human dental calculus from the Bronze Age (ca. 3000 BCE) to the present day. Using protein tandem mass spectrometry, we demonstrate that BLG is a species-specific biomarker of dairy consumption, and we identify individuals consuming cattle, sheep, and goat milk products in the archaeological record. We then apply this method to human dental calculus from Greenland's medieval Norse colonies, and report a decline of this biomarker leading up to the abandonment of the Norse Greenland colonies in the 15(th) century CE.
Direct evidence of milk consumption from ancient human dental calculus.
Warinner, C; Hendy, J; Speller, C; Cappellini, E; Fischer, R; Trachsel, C; Arneborg, J; Lynnerup, N; Craig, O E; Swallow, D M; Fotakis, A; Christensen, R J; Olsen, J V; Liebert, A; Montalva, N; Fiddyment, S; Charlton, S; Mackie, M; Canci, A; Bouwman, A; Rühli, F; Gilbert, M T P; Collins, M J
2014-01-01
Milk is a major food of global economic importance, and its consumption is regarded as a classic example of gene-culture evolution. Humans have exploited animal milk as a food resource for at least 8500 years, but the origins, spread, and scale of dairying remain poorly understood. Indirect lines of evidence, such as lipid isotopic ratios of pottery residues, faunal mortality profiles, and lactase persistence allele frequencies, provide a partial picture of this process; however, in order to understand how, where, and when humans consumed milk products, it is necessary to link evidence of consumption directly to individuals and their dairy livestock. Here we report the first direct evidence of milk consumption, the whey protein β-lactoglobulin (BLG), preserved in human dental calculus from the Bronze Age (ca. 3000 BCE) to the present day. Using protein tandem mass spectrometry, we demonstrate that BLG is a species-specific biomarker of dairy consumption, and we identify individuals consuming cattle, sheep, and goat milk products in the archaeological record. We then apply this method to human dental calculus from Greenland's medieval Norse colonies, and report a decline of this biomarker leading up to the abandonment of the Norse Greenland colonies in the 15(th) century CE. PMID:25429530
Relationship between fractional calculus and fractional Fourier transform
NASA Astrophysics Data System (ADS)
Zhang, Yanshan; Zhang, Feng; Lu, Mingfeng
2015-09-01
The fractional calculus (FC) deals with integrals and derivatives of arbitrary (i.e., non-integer) order, and shares its origins with classical integral and differential calculus. The fractional Fourier transform (FRFT), which has been found having many applications in optics and other areas, is a generalization of the usual Fourier transform. The FC and the FRFT are two of the most interesting and useful fractional areas. In recent years, it appears many papers on the FC and FRFT, however, few of them discuss the connection of the two fractional areas. We study their relationship. The relational expression between them is deduced. The expectation of interdisciplinary cross fertilization is our motivation. For example, we can use the properties of the FC (non-locality, etc.) to solve the problem which is difficult to be solved by the FRFT in optical engineering; we can also through the physical meaning of the FRFT optical implementation to explain the physical meaning of the FC. The FC and FRFT approaches can be transposed each other in the two fractional areas. It makes that the success of the fractional methodology is unquestionable with a lot of applications, namely in nonlinear and complex system dynamics and image processing.
On the construction of unitary quantum group differential calculus
NASA Astrophysics Data System (ADS)
Pyatov, Pavel
2016-10-01
We develop a construction of the unitary type anti-involution for the quantized differential calculus over {{GL}}q(n) in the case | q| =1. To this end, we consider a joint associative algebra of quantized functions, differential forms and Lie derivatives over {{GL}}q(n)/{{SL}}q(n), which is bicovariant with respect to {{GL}}q(n)/{{SL}}q(n) coactions. We define a specific non-central spectral extension of this algebra by the spectral variables of three matrices of the algebra generators. In the spectrally expended algebra, we construct a three-parametric family of its inner automorphisms. These automorphisms are used for the construction of the unitary anti-involution for the (spectrally extended) calculus over {{GL}}q(n). This work has been funded by the Russian Academic Excellence Project ‘5-100’. The results of section 5 (propositions 5.2, 5.3 and theorem 5.5) have been obtained under support of the RSF grant No.16-11-10160.
... tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when ...
Poddubnaya, O A
2016-01-01
The elaboration of new technologies for the medical rehabilitation of the patients presenting with chronic cholecystitis in combination with chronic opisthorchiasis is a topical problem facing modern clinical gastroenterology. The application of up-to-date non-pharmacological therapeutic modalities, such as ultrahigh-frequency (UHF) therapy concomitantly with group chronophysiotherapy makes it possible to significantly improve the final outcome of the treatment. The results of clinical studies give evidence of the favourable influence of the combined chronorehabilitative treatment including UHF therapy on the characteristics of the functional state of the biliary-hepatic system and of the organism as a whole. The positive dynamics of these characteristics is suggestive of the high (up to 87,5%) therapeutic effectiveness of the proposed treatment. The investigations into the relationship between this effect and the peculiarities of the combined therapeutic modalities have demonstrated their correlation (χ2=104,13; p=0,0001; V-Kramer´s coefficient =0,35) and showed that the use of combined chronorehabilitation including UHF therapy based on the application of phone resonance radiation guarantees (and is a predictor of) high therapeutic effect (percent concordance =95,6%; standard coefficient=2,13; p=0,001) of the treatment of the patients with chronic cholecystitis in combination with chronic opisthorchiasis. The statistical analysis of the results of application of the modern non-pharmacological therapeutic modalities and the chronobiological approach for the purpose of the combined treatment of patients presenting with chronic cholecystitis in combination with opisthorchiasis with the use of contingency table and logit regression, allowed not only to estimate the interdependence and interrelation between the characteristics of interest but also to reveal predictors of therapeutic effectiveness. These findings are of great practical importance since they can be
Tutel'ian, V A; Vasil'ev, A V; Kochetkov, A M; Pogozheva, A V; Lysikova, S L; Akol'zina, S E; Vorob'eva, L Sh
2003-01-01
60 patients with chronic atrophic gastritis and secretory insufficiency allied with chelicobacterial infection in combination with chronic unlithic cholecystitis or diskinesia of choledoch ways were explored with a view to study the efficiency of dietary cure including biologically active food supplements--flavonoids source. Fortification of the patients food intake with flavonoids-containing biologically active food supplements benefits mucous membrane of gastroduodenal zone that is evidenced in decrease of activity of pyloric chelicobacteriosis and resolvent and reparative effect, it also contributes to normalization of hepatobiliaric system condition and antioxidant status.
Unusual case of calculus in floor of mouth: a case report.
Bahadure, Rakesh N; Thosar, Nilima; Jain, Eesha S
2012-09-01
Calculus consists of mineralized bacterial plaque that forms on the surfaces of natural teeth. It is supragingival or subgingival depending upon its relation with gingival margin. The two most common locations for supragingival calculus are the buccal surfaces of maxillary molars and lingual surfaces of mandibular anterior teeth. It is very important to rule out the predisposing factor for calculus formation. In the present case of an 11-year- old female child, 1.2 × 1.5 cm large indurated mass suggestive of calculus in the left side of floor of mouth was observed. After surgical removal, along with indurated mass, an embedded root fragment was seen. Biochemical analysis of the specimen detected the calcium and phosphate ions approximately equals to the level in calculus. Thus, we diagnosed it as a calculus. Oral hygiene instructions and regular follow-up was advised. How to cite this article: Bahadure RN, Thosar N, Jain ES. Unusual Case of Calculus in Floor of Mouth: A Case Report. Int J Clin Pediatr Dent 2012;5(3):223-225. PMID:25206174
Unusual case of calculus in floor of mouth: a case report.
Bahadure, Rakesh N; Thosar, Nilima; Jain, Eesha S
2012-09-01
Calculus consists of mineralized bacterial plaque that forms on the surfaces of natural teeth. It is supragingival or subgingival depending upon its relation with gingival margin. The two most common locations for supragingival calculus are the buccal surfaces of maxillary molars and lingual surfaces of mandibular anterior teeth. It is very important to rule out the predisposing factor for calculus formation. In the present case of an 11-year- old female child, 1.2 × 1.5 cm large indurated mass suggestive of calculus in the left side of floor of mouth was observed. After surgical removal, along with indurated mass, an embedded root fragment was seen. Biochemical analysis of the specimen detected the calcium and phosphate ions approximately equals to the level in calculus. Thus, we diagnosed it as a calculus. Oral hygiene instructions and regular follow-up was advised. How to cite this article: Bahadure RN, Thosar N, Jain ES. Unusual Case of Calculus in Floor of Mouth: A Case Report. Int J Clin Pediatr Dent 2012;5(3):223-225.
Unusual Case of Calculus in Floor of Mouth: A Case Report
Thosar, Nilima; Jain, Eesha S
2012-01-01
Abstract Calculus consists of mineralized bacterial plaque that forms on the surfaces of natural teeth. It is supragingival or subgingival depending upon its relation with gingival margin. The two most common locations for supragingival calculus are the buccal surfaces of maxillary molars and lingual surfaces of mandibular anterior teeth. It is very important to rule out the predisposing factor for calculus formation. In the present case of an 11-year- old female child, 1.2 × 1.5 cm large indurated mass suggestive of calculus in the left side of floor of mouth was observed. After surgical removal, along with indurated mass, an embedded root fragment was seen. Biochemical analysis of the specimen detected the calcium and phosphate ions approximately equals to the level in calculus. Thus, we diagnosed it as a calculus. Oral hygiene instructions and regular follow-up was advised. How to cite this article: Bahadure RN, Thosar N, Jain ES. Unusual Case of Calculus in Floor of Mouth: A Case Report. Int J Clin Pediatr Dent 2012;5(3):223-225. PMID:25206174
Real-time detection of dental calculus by blue-LED-induced fluorescence spectroscopy.
Qin, Y L; Luan, X L; Bi, L J; Lü, Z; Sheng, Y Q; Somesfalean, G; Zhou, C N; Zhang, Z G
2007-05-25
Successful periodontal therapy requires sensitive techniques to discriminate dental calculus from healthy teeth. The aim of the present study was to develop a fluorescence-based procedure to enable real-time detection and quantification of dental calculus. Thirty human teeth--15 teeth with sub- and supragingival calculus and 15 healthy teeth--covered with a layer of physiological saline solution or blood were illuminated by a focused blue LED light source of 405 nm. Autofluorescence spectra recorded along a randomly selected line stretching over the crown-neck-root area of each tooth were utilized to evaluate a so called calculus parameter R, which was selected to define a relationship between the integrated intensities specific for healthy teeth and for calculus in the 477-497 nm (S(A)) and 628-685 nm (S(B)) wavelength regions, respectively. Statistical analysis was performed and a cut-off threshold of R=0.2 was found to distinguish dental calculus from healthy teeth with 100% sensitivity and specificity under various experimental conditions. The results of the spectral evaluation were confirmed by clinical and histological findings. Automated real-time detection and diagnostics for clinical use were implemented by a corresponding software program written in Visual Basic language. The method enables cost-effective and reliable calculus detection, and can be further developed for imaging applications.
Successful enrichment and recovery of whole mitochondrial genomes from ancient human dental calculus
Ozga, Andrew T.; Nieves‐Colón, Maria A.; Honap, Tanvi P.; Sankaranarayanan, Krithivasan; Hofman, Courtney A.; Milner, George R.; Lewis, Cecil M.; Stone, Anne C.
2016-01-01
ABSTRACT Objectives Archaeological dental calculus is a rich source of host‐associated biomolecules. Importantly, however, dental calculus is more accurately described as a calcified microbial biofilm than a host tissue. As such, concerns regarding destructive analysis of human remains may not apply as strongly to dental calculus, opening the possibility of obtaining human health and ancestry information from dental calculus in cases where destructive analysis of conventional skeletal remains is not permitted. Here we investigate the preservation of human mitochondrial DNA (mtDNA) in archaeological dental calculus and its potential for full mitochondrial genome (mitogenome) reconstruction in maternal lineage ancestry analysis. Materials and Methods Extracted DNA from six individuals at the 700‐year‐old Norris Farms #36 cemetery in Illinois was enriched for mtDNA using in‐solution capture techniques, followed by Illumina high‐throughput sequencing. Results Full mitogenomes (7–34×) were successfully reconstructed from dental calculus for all six individuals, including three individuals who had previously tested negative for DNA preservation in bone using conventional PCR techniques. Mitochondrial haplogroup assignments were consistent with previously published findings, and additional comparative analysis of paired dental calculus and dentine from two individuals yielded equivalent haplotype results. All dental calculus samples exhibited damage patterns consistent with ancient DNA, and mitochondrial sequences were estimated to be 92–100% endogenous. DNA polymerase choice was found to impact error rates in downstream sequence analysis, but these effects can be mitigated by greater sequencing depth. Discussion Dental calculus is a viable alternative source of human DNA that can be used to reconstruct full mitogenomes from archaeological remains. Am J Phys Anthropol 160:220–228, 2016. © 2016 The Authors American Journal of Physical Anthropology
ERIC Educational Resources Information Center
Lindstrom, Peter A.; And Others
This document consists of four units. The first of these views calculus applications to work, area, and distance problems. It is designed to help students gain experience in: 1) computing limits of Riemann sums; 2) computing definite integrals; and 3) solving elementary area, distance, and work problems by integration. The second module views…
Fractal Physiology and the Fractional Calculus: A Perspective
West, Bruce J.
2010-01-01
This paper presents a restricted overview of Fractal Physiology focusing on the complexity of the human body and the characterization of that complexity through fractal measures and their dynamics, with fractal dynamics being described by the fractional calculus. Not only are anatomical structures (Grizzi and Chiriva-Internati, 2005), such as the convoluted surface of the brain, the lining of the bowel, neural networks and placenta, fractal, but the output of dynamical physiologic networks are fractal as well (Bassingthwaighte et al., 1994). The time series for the inter-beat intervals of the heart, inter-breath intervals and inter-stride intervals have all been shown to be fractal and/or multifractal statistical phenomena. Consequently, the fractal dimension turns out to be a significantly better indicator of organismic functions in health and disease than the traditional average measures, such as heart rate, breathing rate, and stride rate. The observation that human physiology is primarily fractal was first made in the 1980s, based on the analysis of a limited number of datasets. We review some of these phenomena herein by applying an allometric aggregation approach to the processing of physiologic time series. This straight forward method establishes the scaling behavior of complex physiologic networks and some dynamic models capable of generating such scaling are reviewed. These models include simple and fractional random walks, which describe how the scaling of correlation functions and probability densities are related to time series data. Subsequently, it is suggested that a proper methodology for describing the dynamics of fractal time series may well be the fractional calculus, either through the fractional Langevin equation or the fractional diffusion equation. A fractional operator (derivative or integral) acting on a fractal function, yields another fractal function, allowing us to construct a fractional Langevin equation to describe the evolution of a
A Two-parameter bicovariant differential calculus on the (1 + 2)-dimensional q-superspace
NASA Astrophysics Data System (ADS)
Yasar, Ergün
2016-01-01
We construct a two-parameter bicovariant differential calculus on ℛq1/2 with the help of the covariance point of view using the Hopf algebra structure of ℛq1/2. To achieve this, we first use the consistency of calculus and the approach of R-matrix which satisfies both ungraded and graded Yang-Baxter equations. In particular, based on this differential calculus, we investigate Cartan-Maurer forms for this q-superspace. Finally, we obtain the quantum Lie superalgebra corresponding the Cartan-Maurer forms.
Factors associated with success in a calculus course: an examination of personal variables
NASA Astrophysics Data System (ADS)
Ubuz, Behiye
2011-01-01
This study examined relationships between students' personal variables (gender, prior achievements, age and academic major) and their success in the first year undergraduate calculus course. The study sample consisted of 59 first year undergraduate students taking Math 154 Calculus II course. A written test about integral, sequence and series including demographic survey items was used to gather data. The test was administered prior to and upon the completion of the calculus course. Multiple regression analysis result indicated that there is relationship between students' personal variables (gender and prior achievements) and their success. Gender differences favouring males typically occurred on Riemann sum and Riemann integral.
Calculus removal on a root cement surface by ultrashort laser pulses
NASA Astrophysics Data System (ADS)
Kraft, Johan F.; Vestentoft, Kasper; Christensen, Bjarke H.; Løvschall, Henrik; Balling, Peter
2008-01-01
Ultrashort-pulse-laser ablation of dental calculus (tartar) and cement is performed on root surfaces. The investigation shows that the threshold fluence for ablation of calculus is a factor of two to three times smaller than that of a healthy root cement surface. This indicates that ultrashort laser pulses may provide an appropriate tool for selective removal of calculus with minimal damage to the underlying root cement. Future application of an in situ profiling technique allows convenient on-line monitoring of the ablation process.
Promoting Metacognition in Introductory Calculus-based Physics Labs
NASA Astrophysics Data System (ADS)
Grennell, Drew; Boudreaux, Andrew
2010-10-01
In the Western Washington University physics department, a project is underway to develop research-based laboratory curriculum for the introductory calculus-based course. Instructional goals not only include supporting students' conceptual understanding and reasoning ability, but also providing students with opportunities to engage in metacognition. For the latter, our approach has been to scaffold reflective thinking with guided questions. Specific instructional strategies include analysis of alternate reasoning presented in fictitious dialogues and comparison of students' initial ideas with their lab group's final, consensus understanding. Assessment of student metacognition includes pre- and post- course data from selected questions on the CLASS survey, analysis of written lab worksheets, and student opinion surveys. CLASS results are similar to a traditional physics course and analysis of lab sheets show that students struggle to engage in a metacognitive process. Future directions include video studies, as well as use of additional written assessments adapted from educational psychology.
A new class of problems in the calculus of variations
NASA Astrophysics Data System (ADS)
Ekeland, Ivar; Long, Yiming; Zhou, Qinglong
2013-11-01
This paper investigates an infinite-horizon problem in the one-dimensional calculus of variations, arising from the Ramsey model of endogeneous economic growth. Following Chichilnisky, we introduce an additional term, which models concern for the well-being of future generations. We show that there are no optimal solutions, but that there are equilibrium strateges, i.e. Nash equilibria of the leader-follower game between successive generations. To solve the problem, we approximate the Chichilnisky criterion by a biexponential criterion, we characterize its equilibria by a pair of coupled differential equations of HJB type, and we go to the limit. We find all the equilibrium strategies for the Chichilnisky criterion. The mathematical analysis is difficult because one has to solve an implicit differential equation in the sense of Thom. Our analysis extends earlier work by Ekeland and Lazrak.