Intramural gas in stomach along with acute calculus cholecystitis: an unusual association
Naqvi, Zohaib Gulzar; Shahzad, Noman; Alvi, Abdul Rehman; Effendi, Shahrukh
2013-01-01
Intramural gas in stomach is a rare finding, but differential diagnosis of this condition into gastric emphysema and emphysematous gastritis is clinically important because of vastly different aetiologies and prognosis. Emphysematous gastritis is caused by gas producing micro-organisms inside the stomach wall and is a potentially fatal condition, while, on the other hand, gas enters stomach wall through mucosal breach in the case of gastric emphysema and prognosis is usually good with complete resolution. To date, no case has been reported in the literature showing gas in the stomach wall in a patient with acute calculus cholecystitis. We present a case of a young man with upper abdominal pain, and who, upon diagnostic work up was diagnosed with acute calculus cholecystitis with associated intramural gas in the stomach with no known aetiological factors to be positive. Conservative management with close observation resulted in complete symptomatic resolution. PMID:23645637
Acute acalculous cholecystitis
Fox, M.S.; Wilk, P.J.; Weissmann, H.S.; Freeman, L.M.; Gliedman, M.L.
1984-07-01
Sixty-eight patients with acute acalculous cholecystitis were reviewed. The results of history and physical examinations were usually nondiagnostic. IDA cholescintigraphy (93 per cent accuracy rate) was the only reliable diagnostic modality. The results of oral cholecystography, intravenous cholangiography and ultrasonography were considerably less reliable. One-half of the patients had gangrenous cholecystitis. Cholecystectomy was the preferred operation with an over-all mortality of 9 per cent. IDA cholescintigraphy is an important new modality for the diagnosis of acute acalculous cholecystitis which, in the past, has often been difficult to diagnose.
Acute acalculous cholecystitis.
Barie, Philip S; Eachempati, Soumitra R
2003-08-01
Acute cholecystitis can develop without gallstones in critically ill or injured patients. However, the development of acute acalculous cholecystitis is not limited to surgical or injured patients, or even to the intensive care unit. Diabetes, malignant disease, abdominal vasculitis, congestive heart failure, cholesterol embolization, and shock or cardiac arrest have been associated with acute acalculous cholecystitis. Children may also be affected, especially after a viral illness. The pathogenesis of acute acalculous cholecystitis is a paradigm of complexity. Ischemia and reperfusion injury, or the effects of eicosanoid proinflammatory mediators, appear to be the central mechanisms, but bile stasis, opioid therapy, positive-pressure ventilation, and total parenteral nutrition have all been implicated. Ultrasound of the gallbladder is the most accurate diagnostic modality in the critically ill patient, with gallbladder wall thickness of 3.5 mm or greater and pericholecystic fluid being the two most reliable criteria. The historical treatment of choice for acute acalculous cholecystitis has been cholecystectomy, but percutaneous cholecystostomy is now the mainstay of therapy, controlling the disease in about 85% of patients. Rapid improvement can be expected when the procedure is performed properly. The mortality rates (historically about 30%) for percutaneous and open cholecystostomy appear to be similar, reflecting the severity of illness, but improved resuscitation and critical care may portend a decreased risk of death. Interval cholecystectomy is usually not indicated after acute acalculous cholecystitis in survivors; if the absence of gallstones is confirmed and the precipitating disorder has been controlled, the cholecystostomy tube can be pulled out after the patient has recovered. PMID:12864960
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.
Cholescintigraphy in acute acalculous cholecystitis
Ramanna, L.; Brachman, M.B.; Tanasescu, D.E.; Berman, D.S.; Waxman, A.D.
1984-08-01
Acute acalculous cholecystitis is a relatively rare but potentially lethal condition if not treated promptly. Since stones are not present, diagnostic procedures such as ultrasound or other radiological procedures are frequently not helpful. Tc-99m iminodiacetic acid scan results were analyzed in 11 proven cases of acute acalculous cholecystitis. All had positive tests with nonvisualization of the gallbladder giving a sensitivity of 100%. Tc-99m iminodiacetic acid cholescintigraphy is a highly reliable test and is easily performed even in acutely ill patients and should be the test of choice in all patients predisposed to and suspected of acute acalculous cholecystitis.
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.
[Improvement of treatment results of acute cholecystitis].
Sovtsov, S A; Prilepina, E V
2015-01-01
The aim of this study was investigation of treatment results of acute cholecystitis according to suggested forms of cholecystitis by international experts in the research (Tokyo-2007). It was analyzed the immediate treatment results of 1399 patients with acute cholecystitis for the last 4 years in the Chelyabinsk Regional Hospital No3. 912 patients had acute cholecystitis I degree (easy cholecystitis), 270 patients--II (moderate) degree and 217 patients--III degree (severe cholecystitis). It was operated 1281 patients. Operating activity was 91.5%. Postoperative mortality in whole patients group was 0.78%. The authors suggested the main principles such as early, differentiated by the volume operative interventions according to graduations of investigation "Tokyo-2007". Controlled trial of treatment results of patients randomized on three degrees of acute cholecystitis observed appropriateness of allocation of these groups. It is necessary for differentiated treatment and improvement of treatment results of patients with acute cholecystitis. PMID:26031820
Acute Cholecystitis in Patients with Scrub Typhus.
Lee, Hyun; Ji, Misuk; Hwang, Jeong-Hwan; Lee, Ja-Yeon; Lee, Ju-Hyung; Chung, Kyung Min; Lee, Chang-Seop
2015-11-01
Acute cholecystitis is a rare complication of scrub typhus. Although a few such cases have been reported in patients with scrub typhus, the clinical course is not well described. Of 12 patients, acute cholecystitis developed in 66.7% (8/12) of patients older than 60 yr. The scrub typhus group with acute cholecystitis had marginal significant longer hospital stay and higher cost than the group without cholecystitis according to propensity score matching. Scrub typhus should be kept in mind as a rare etiology of acute cholecystitis in endemic areas because the typical signs of scrub typhus such as skin rash and eschar can present after the abdominal pain. PMID:26539017
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.
Cholescintigraphy in acute and chronic cholecystitis
Freitas, J.E.
1982-01-01
Since the introduction of /sup 99m/Tc-labeled cholescintigraphic agents in the mid-1970s, there has been extensive investigation of their role in the evaluation of biliary tract disorders. These agents accurately assess the patency of the cystic and common bile ducts, and to date, their greatest impact has been on the diagnostic evaluation of suspected acute cholecystitis. This article reviews the use of /sup 99m/Tc-iminodiacetic acid (IDA) derivatives in acute and chronic cholecystitis. Since acute cholecystitis is characterized by cystic duct obstruction, failure of the gallbladder to visualize following /sup 99m/Tc-IDA administration is indicative of cystic duct obstruction and acute cholecystitis. Using this approach, cholescintigraphy has been shown to be highly sensitive, specific, and efficacious in the diagnosis of acute cholecystitis. Cholescintigraphy is now the procedure of choice for the detection of acute cholecystitis. Unlike its successful applications in acute cholecystitis, cholescintigraphy appears of limited value in chronic cholecystitis. Certain circumstances where cholescintigraphy is of value in chronic cholecystitis are discussed. Whether or not cholescintigraphy may play a greater role in the future in elucidating the pathogenesis of chronic cholecystitis by assessment of biliary kinetics remains unanswered.
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
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...
Congenital bilobed gallbladder with phrygian cap presenting as calculus cholecystitis.
Kannan, N S; Kannan, Usha; Babu, C P Ganesh
2014-08-01
The incidence of congenital bilobed gall bladder is 1 in 3000 to 4000. A Phrygian cap is a congenital abnormality of the gallbladder with an incidence of 4%. Preferred mode of diagnosis for Phrygian cap is cholescintigraphy and multi phase MRI, as Ultrasonography and CT are not always conclusive. The estimated prevalence of gallstone disease in India has been reported as 2% to 29%. A case of bilobed gall bladder with Phrygian cap in both the lobes and pigment gallstone in one of the lobes presenting as calculus cholecystitis is reported for its rarity and difficulty in arriving at correct preoperaive diagnosis. PMID:25302235
Congenital Bilobed Gallbladder with Phrygian Cap Presenting as Calculus Cholecystitis
Kannan, Usha; Babu, C.P. Ganesh
2014-01-01
The incidence of congenital bilobed gall bladder is 1 in 3000 to 4000. A Phrygian cap is a congenital abnormality of the gallbladder with an incidence of 4%. Preferred mode of diagnosis for Phrygian cap is cholescintigraphy and multi phase MRI, as Ultrasonography and CT are not always conclusive. The estimated prevalence of gallstone disease in India has been reported as 2% to 29%. A case of bilobed gall bladder with Phrygian cap in both the lobes and pigment gallstone in one of the lobes presenting as calculus cholecystitis is reported for its rarity and difficulty in arriving at correct preoperaive diagnosis PMID:25302235
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.
Calculated Antibiosis of Acute Cholangitis and Cholecystitis
Bornscheuer, Till; Schmiedel, Stefan
2014-01-01
Background The aim of this article is to present the most recent suggestions for the therapy of acute cholangitis and cholecystitis based on a review of the current literature. Methods We performed a systematic literature search in the Medline, PubMed, and Google Scholar databases using the keywords mentioned above. This article is strongly influenced by the publication of the Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07, TG13) in 2007 and 2013. These were the first practical guidelines targeting diagnosis and treatment of acute cholangitis and cholecystitis. These guidelines are based on the best published evidence and a consensus conference of international experts in the field. Results and Conclusion Acute cholangitis and acute cholecystitis are common conditions that may result in progressively severe infection and death when not treated appropriately. Beside supportive therapy and antiobstructive measures, therapy with antimicrobial agents is an important component in the management of affected patients. Here, we discuss the use of antimicrobial agents that are suitable for the first-line management of these infections. Empirical therapy depends upon the knowledge of local microbial epidemiology and patient-specific factors affecting the selection of appropriate agents. PMID:26535043
Hatanaka, Takeshi; Itoi, Takao; Ijima, Masashi; Matsui, Ayako; Kurihara, Eishin; Okuno, Nozomi; Kobatake, Tsutomu; Kakizaki, Satoru; Yamada, Masanobu
2016-01-01
Objective Endoscopic gallbladder stenting (EGBS) is an alternative treatment option for high-risk surgical patients with acute cholecystitis. However, there are no reports focusing on EGBS in patients with concomitant unresectable cancer. The aim of this study was thus to evaluate EGBS in such patients. Methods Twenty-two consecutive patients with acute cholecystitis and unresectable cancer were enrolled between September 2010 and December 2014. Their median age was 74.5 years (range: 51-95). Thirteen patients were men and nine were women. The primary cancers of the patients were biliary tract cancer (9), pancreas cancer (9), lung cancer (2), gastric cancer (1), and colon cancer (1). The causes of cholecystitis were calculus cholecystitis (7), obstruction by malignant tumor (13), and obstruction by fully covered stent (2). Results EGBS was successfully performed in 17 patients (77.2%). The technical success rates for calculus cholecystitis, obstruction by malignant tumor, and obstruction by fully covered stent were 85.7% (6/7), 69.2% (9/13), and 100% (2/2), respectively. No complications were observed. Percutaneous transhepatic gallbladder drainage was conducted on two patients in whom EGBS had failed and then we performed EGBS by a rendezvous approach. Of the 19 patients in whom we finally deployed EGBS, the median follow-up period was 229 days (range: 14-880 days). A recurrence of acute cholecystitis occurred in three (15.7%) patients 14, 130, and 440 days after EGBS placement. The rates of recurrence of cholecystitis at one and two years were 10.5% and 18.7%, respectively. Conclusion Our study demonstrated that EGBS is a safe and effective method for acute cholecystitis in patients with concomitant unresectable cancer. PMID:27250045
Kocuria kristinae infection associated with acute cholecystitis
Ma, Edmond SK; Wong, Chris LP; Lai, Kristi TW; Chan, Edmond CH; Yam, WC; Chan, Angus CW
2005-01-01
Background Kocuria, previously classified into the genus of Micrococcus, is commonly found on human skin. Two species, K. rosea and K. kristinae, are etiologically associated with catheter-related bacteremia. Case presentation We describe the first case of K. kristinae infection associated with acute cholecystitis. The microorganism was isolated from the bile of a 56-year old Chinese man who underwent laparoscopic cholecystectomy. He developed post-operative fever that resolved readily after levofloxacin treatment. Conclusion Our report of K. kristinae infection associated with acute cholecystitis expands the clinical spectrum of infections caused by this group of bacteria. With increasing number of recent reports describing the association between Kocuria spp. and infectious diseases, the significance of their isolation from clinical specimens cannot be underestimated. A complete picture of infections related to Kocuria spp. will have to await the documentation of more clinical cases. PMID:16029488
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.
Gallbladder melanoma mimicking acute acalculous cholecystitis.
De Simone, P; Mainente, P; Bedin, N
2000-06-01
Gallbladder (GB) melanoma is a rare entity with a dismal prognosis. Its primary or secondary status is difficult to establish in the absence of an overt cutaneous localization. We report herein the case of a misdiagnosed GB melanoma mimicking acute acalculous cholecystitis that was treated by means of laparoscopic cholecystectomy (LC). A 54-year-old man was referred to our institution for acute cholecystitis. Apart from the ablation of some nevocytic nevi 7 years before admission, the patient's medical history was unremarkable. The ultrasound (US) examination showed a slightly enlarged acalculous gallbladder with thickened walls and a well-circumscribed polypoid mass in the fundus. The patient was treated medically and referred to LC. At surgery, some satellite nodules were visualized in the GB hepatic bed. The GB was removed, and two hepatic nodules were excised. Histology showed a pT3 melanoma. The patient underwent an open hepatic wedge resection 3 weeks after laparoscopy. No recurrence was observed at 6-month follow-up. To date, only one case of melanoma of the gallbladder treated with LC has been reported. GB melanoma is a diagnostic challenge when there is no evidence of a primary lesion. However, the occurrence of acalculous cholecystitis and a GB polyp in patients with a positive history of mole ablation should alert surgeons to the possibility of a melanoma. PMID:11265063
[A case of acute cholecystitis after colonoscopy].
Yun, Jung Ho; Jeong, Woo Jin; Chang, Woo Sung; Jo, Min Hyeong; Park, Jong Kyu; Lee, Sang Jin; Kim, Young Don; Cheon, Gab Jin
2013-01-25
A 43-year-old man, who received total gastrectomy five years ago for advanced gastric cancer, underwent a screening colonoscopy and abdominal CT scan. Abdominal CT scan revealed no abnormal findings. Colonoscopy revealed polyps at the rectum, which were removed by polypectomy. The patient did not complain of abdominal pain or discomfort throughout the procedure. But, he developed right upper quadrant abdominal pain on the next day after colonoscopy. Abdominal CT scan revealed the distended gallbladder with mild wall thickening and suspicious sandy stones or sludge in the gallbladder. The patient underwent an open cholecystectomy. Pathology was compatible with acute cholecystitis. We should be aware of and consider cholecystitis in the differential diagnosis for patients with abdominal pain after colonoscopy. PMID:23354349
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. PMID:24862426
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.
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.
A Case of Scrub Typhus Complicated by Acute Calculous Cholecystitis
Lee, Su Jin; Lee, Sang Yeoup; Jeong, Dong Wook; Choi, Eun Jung; Kim, Yun Jin; Lee, Jeong Gyu; Lee, Yu Hyun
2012-01-01
We report a case of acute calculous cholecystitis through scrub typhus. A 69-year-old woman presented with a history of general myalgia, fever, and right abdominal pain. She referred to our hospital for surgical treatment of clinically suspected acute cholecystitis. Physicians concluded the cause of cholecystitis as gall bladder (GB) stone and proper antibiotics treatment of scrub typhus was started later. The patient developed acute respiratory distress syndrome and multi organ failure through scrub typhus. Five days after admission, the patient was treated with proper antibiotics and discharged on the 13th day after starting doxycycline treatment without any sequelae. In areas endemic for tsutsugamushi disease, even though a patient with GB stone presents with symptoms of acute cholecystitis, careful history and physical examination are required to reveal the existence of eschars or skin eruptions. PMID:22916327
Cholecystitis - chronic ... Most of the time, chronic cholecystitis is caused by repeated attacks of acute (sudden) cholecystitis. Most of these attacks are caused by gallstones in the gallbladder. These ...
Evaluation of Early versus Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis.
Agrawal, Rati; Sood, K C; Agarwal, Bhupender
2015-01-01
Background. The role of early laparoscopic cholecystectomy for acute cholecystitis with cholelithiasis is not yet established. The aim of our prospective randomized study was to evaluate the safety and feasibility of early LC for acute cholecystitis and to compare the results with delayed LC. Methods. Between March 2007 to December 2008, 50 patients with diagnosis of acute cholecystitis were assigned randomly to early group, n = 25 (LC within 24 hrs of admission), and delayed group, n = 25 (initial conservative treatment followed by delayed LC, 6-8 weeks later). Results. We found in our study that the conversion rate in early LC and delayed LC was 16% and 8%, respectively, Operation time for early LC was 69.4 min versus 66.4 min for delayed LC, postoperative complications for early LC were 24% versus 8% for delayed LC, and blood loss was 159.6 mL early group versus 146.8 mL for delayed group. However early LC had significantly shorter hospital stay (4.1 days versus 8.6 days). Conclusions. Early LC for acute cholecystitis with cholelithiasis is safe and feasible, offering the additional benefit of shorter hospital stay. It should be offered to the patients with acute cholecystitis, provided that the surgery is performed within 96 hrs of acute symptoms by an experienced surgeon. PMID:25729775
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.
Feasibility of single-incision laparoscopic cholecystectomy for acute cholecystitis
Ikumoto, Taro; Yamagishi, Hidetsugu; Iwatate, Mineo; Sano, Yasushi; Kotaka, Masahito; Imai, Yasuo
2015-01-01
AIM: To assess the safety of single-incision laparoscopic cholecystectomy (SILC) for acute cholecystitis. METHODS: All patients who underwent SILC at Sano Hospital (Kobe, Japan) between January 2010 and December 2014 were included in this retrospective study. Clinical data related to patient characteristics and surgical outcomes were collected from medical records. The parameters for assessing the safety of the procedure included operative time, volume of blood loss, achievement of the critical view of safety, use of additional trocars, conversion to laparotomy, intraoperative and postoperative complications, and duration of postoperative hospital stay. Patient backgrounds were statistically compared between those with and without conversion to laparotomy. RESULTS: A total of 100 patients underwent SILC for acute cholecystitis during the period. Preoperative endoscopic treatment was performed for suspected choledocholithiasis in 41 patients (41%). The mean time from onset of acute cholecystitis was 7.7 d. According to the Updated Tokyo Guidelines (TG13) for the severity of cholecystitis, 86 and 14 patients had grade I and grade II acute cholecystitis, respectively. The mean operative time was 87.4 min. The mean estimated blood loss was 80.6 mL. The critical view of safety was obtained in 89 patients (89%). Conversion laparotomy was performed in 12 patients (12%). Postoperative complications of Clavien-Dindo grade III or greater were observed in 4 patients (4%). The mean duration of postoperative hospital stay was 5.7 d. Patients converted from SILC to laparotomy tended to have higher days after onset. CONCLUSION: SILC is feasible for acute cholecystitis; in addition, early surgical intervention may reduce the risk of laparotomy conversion. PMID:26722614
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.
Matolo, N.M.; Stadalnik, R.C.; McGahan, J.P.
1982-12-01
Seventy-five patients with abdominal pain in the right upper quadrant who were subsequently confirmed operatively and histologically to have acute or chronic cholecystitis underwent radionuclide imaging of the biliary tree, ultrasonography, and/or computerized tomography before operation. fifty-eight of the patients had acute cholecystitis and 17 had chronic cholecystitis and cholelithiasis. Analysis of our data indicates that ultrasonography is an accurate and better screening test than cholescintigraphy in the diagnosis of chronic cholecystitis and cholelithiasis, but it is less accurate in the detection of acute cholecystitis. On the other hand, radionuclide imaging is highly sensitive and specific in the early diagnosis of acute cholecystitis, but it is poor in the diagnosis of chronic cholecystitis and cholelithiasis unless the cystic duct is obstructed. CT scanning is more expensive than ultrasonography but may be extremely helpful in problematic cases such as the diagnosis of the cause in biliary obstruction or in imaging of the pancreas.
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.
Poddighe, Dimitri; Tresoldi, Matteo; Licari, Amelia; Marseglia, Gian Luigi
2015-01-01
Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder, which does not appear to be associated with the presence of gallstones. AAC is estimated to represent more than 50% of cases of acute cholecystitis in the pediatric population. Although this pathology was initially described in critically ill patients, actually most pediatric cases have been observed during several infectious diseases. Particularly, here we reviewed pediatric infectious acute acalculous cholecystitis and analyzed the pathophysiological and clinical aspects of bacterial and viral forms. PMID:26640715
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
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
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: a rare complication of snake bite.
Senthilkumaran, Subramanian; Menezes, Ritesh G; Pant, Sadip; Thirumalaikolundusubramanian, Ponniah
2013-09-01
Snake bite is an environmental and occupational hazard in many tropical and subtropical countries. It demands a high level of knowledge and skill in managing the envenomation syndrome. Herein, we describe a rare case of acute acalculous cholecystitis (AAC) that developed in a 36-year-old man after an Indian cobra (Naja naja) bite in the absence of any other predisposing factors for AAC. The probable mechanisms for the occurrence of AAC have been highlighted. Recognizing the possibility of such a complication after envenomation will definitely aid in early diagnosis and, subsequently, a better outcome. PMID:23473791
[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
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
Epstein-Barr Virus Infection with Acute Acalculous Cholecystitis
Kim, Ahlee; Moon, Jin Soo; Chang, Ju Young; Ko, Jae Sung
2014-01-01
Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder in the absence of demonstrated stones. AAC is frequently associated with severe systemic inflammation. However, the exact etiology and pathogenesis of AAC still remain unclear. Acute infection with Epstein Barr virus (EBV) in childhood is usually aymptomatic, whereas it often presents as typical infectious mononucleosis symptoms such as fever, cervical lymphadenopathy, and hepatosplenomegaly. AAC may occur during the course of acute EBV infection, which is rarely encountered in the pediatric population. AAC complicating the course of a primary EBV infection is usually associated with a favorable outcome. Most of the patients recover without any surgical treatment. Therefore, the detection of EBV in AAC would be important for prediction of better prognosis. We describe the case of a 10-year-old child who presented with AAC during the course of primary EBV infection, the first in Korea, and review the relevant literature. PMID:24749090
Epstein-barr virus infection with acute acalculous cholecystitis.
Kim, Ahlee; Yang, Hye Ran; Moon, Jin Soo; Chang, Ju Young; Ko, Jae Sung
2014-03-01
Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder in the absence of demonstrated stones. AAC is frequently associated with severe systemic inflammation. However, the exact etiology and pathogenesis of AAC still remain unclear. Acute infection with Epstein Barr virus (EBV) in childhood is usually aymptomatic, whereas it often presents as typical infectious mononucleosis symptoms such as fever, cervical lymphadenopathy, and hepatosplenomegaly. AAC may occur during the course of acute EBV infection, which is rarely encountered in the pediatric population. AAC complicating the course of a primary EBV infection is usually associated with a favorable outcome. Most of the patients recover without any surgical treatment. Therefore, the detection of EBV in AAC would be important for prediction of better prognosis. We describe the case of a 10-year-old child who presented with AAC during the course of primary EBV infection, the first in Korea, and review the relevant literature. PMID:24749090
Laparoscopic cholecystectomy for acute cholecystitis: early or delayed?
Song, Guo-Min; Bian, Wei; Zeng, Xian-Tao; Zhou, Jian-Guo; Luo, Yong-Qiang; Tian, Xu
2016-01-01
Abstract 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
Diagnosis of acute cholecystitis using hepatobiliary scan with technetium-99m PIPIDA
Bennett, M.T.; Sheldon, M.I.; dos Remedios, L.V.; Weber, P.M.
1981-09-01
Sixty patients were evaluated for acute abdominal pain using technetium-99m PIPIDA hepatobiliary imaging. The sensitivity of the test was 90.6 percent in all patients and the accuracy was 93.3 percent. In the evaluation of acutely ill patients with right upper quadrant pain, fever, nausea and vomiting, hepatobiliary imaging with PIPIDA is the preferred test for diagnosing acute cholecystitis. If the test is positive, disease of the gallbladder and probably acute cholecystitis are present. Early operation can proceed if desirable. If the test is negative and the bilirubin level is less than 5.0 mg/dl, acute cholecystitis is not present. In such cases conservative treatment is appropriate, and follow-up tests should be performed to evaluate the possibility of chronic cholecystitis. When the bilirubin level exceeds 5.0 mg/dl, the test is often indeterminate.
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.
HIDA scanning and ultrasonography in the expeditious diagnosis of acute cholecystitis
Massie, J.D.; Austin, H.M.; Kuvula, M.; Tarcan, Y.
1982-02-01
Radionuclide hepatobiliary imaging (HIDA scanning), a pathophysiologic modality, has become the diagnostic method of choice for suspected acute cholecystitis. The diagnosis is made quickly with this technic, which is simple, safe, and accurate. It is in widespread use and will soon be available for small community hospitals as well as large metropolitan and university centers. Ultrasound, though an excellent anatomic modality for diagnosing cholelithiasis, does not demonstrate the status of the cystic duct, information essential to the diagnosis of acute cholecystitis.
Hwang, Hamish; Marsh, Ian; Doyle, Jason
2014-01-01
Background Acute cholecystitis is one of the most common diseases requiring emergency surgery. Ultrasonography is an accurate test for cholelithiasis but has a high false-negative rate for acute cholecystitis. The Murphy sign and laboratory tests performed independently are also not particularly accurate. This study was designed to review the accuracy of ultrasonography for diagnosing acute cholecystitis in a regional hospital. Methods We studied all emergency cholecystectomies performed over a 1-year period. All imaging studies were reviewed by a single radiologist, and all pathology was reviewed by a single pathologist. The reviewers were blinded to each other’s results. Results A total of 107 patients required an emergency cholecystectomy in the study period; 83 of them underwent ultrasonography. Interradiologist agreement was 92% for ultrasonography. For cholelithiasis, ultrasonography had 100% sensitivity, 18% specificity, 81% positive predictive value (PPV) and 100% negative predictive value (NPV). For acute cholecystitis, it had 54% sensitivity, 81% specificity, 85% PPV and 47% NPV. All patients had chronic cholecystitis and 67% had acute cholecystitis on histology. When combined with positive Murphy sign and elevated neutrophil count, an ultrasound showing cholelithiasis or acute cholecystitis yielded a sensitivity of 74%, specificity of 62%, PPV of 80% and NPV of 53% for the diagnosis of acute cholecystitis. Conclusion Ultrasonography alone has a high rate of false-negative studies for acute cholecystitis. However, a higher rate of accurate diagnosis can be achieved using a triad of positive Murphy sign, elevated neutrophil count and an ultrasound showing cholelithiasis or cholecystitis. PMID:24869607
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.
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.
Iukhtin, V I; Khripun, A I; Raksha, A P; Zhukotskiĭ, A V; Sergeeva, N A; Dorofeeva, I M; Belous, G G
1996-01-01
Specific morphological and functional changes in the liver in acute obturative cholecystitis have been experimentally studied in 30 dogs and clinically examined in 21 patients. No morphological substrate of liver insufficiency were found in early period of acute obturative cholecystitis. Early changes in the liver are of reactive nature and have the features of active nonspecific hepatitis. The reactions of compensation and decompensation are changing each other periodically. The intensive reactions of compensation take place in the first 2 or 3 days of disease. The reactions of compensation weaken gradually. There is no correlation between changes in the liver and in blood serum. The early surgery and laparoscopic procedures in acute obturative cholecystitis are advocated. PMID:8965448
Acute cholecystitis associated with infection of Enterobacteriaceae from gut microbiota.
Liu, J; Yan, Q; Luo, F; Shang, D; Wu, D; Zhang, H; Shang, X; Kang, X; Abdo, M; Liu, B; Ma, Y; Xin, Y
2015-09-01
Acute cholecystitis (AC) is one of the most common surgical diseases. Bacterial infection accounts for 50% to 85% of the disease's onset. Since there is a close relationship between the biliary system and the gut, the aims of this study were to characterize and determine the influence of gut microbiota on AC, to detect the pathogenic microorganism in the biliary system, and to explore the relationship between the gut and bile microbiota of patients with AC. A total of 185 713 high-quality sequence reads were generated from the faecal samples of 15 patients and 13 healthy controls by 16S rRNA gene pyrosequencing. Patients' samples were significantly enriched in Akkermansia, Enterobacter and Escherichia/Shigella group. The healthy controls, however, showed significant enrichment of Clostridiales, Coprococcus, Coprobacillaceae, Paraprevotella, Turicibacter and TM7-3 in their faecal samples. Escherichia coli was the main biliary pathogenic microorganism, among others such as Klebsiella spp., Clostridium perfringens, Citrobacter freundii and Enterobacter cloacae in the bile of the patients. Additionally, the amount of bile endotoxin significantly correlated with the number of Enterobacteriaceae, especially E. coli. Our data indicate that Enterobacteriaceae might play essential role in the pathogenesis and/or progress of AC. This was verified in an in vivo model using a pathogenic E. coli isolated from one of the patients in guinea pigs and observed marked gallbladder inflammation and morphologic changes. This study thus provides insight which could be useful for the prevention, diagnosis and treatment of AC and related diseases by controlling the growth of Enterobacteriaceae to alleviate the infection. PMID:26025761
Epstein–Barr virus-associated acute cholecystitis in a teenager
De Alwis, Y; Saleem, M
2013-01-01
A 14-year-old girl was admitted to hospital with fever, headache, sore throat and abdominal pain. Her blood lymphocyte count and inflammatory markers were raised. Acute Epstein–Barr virus (EBV) infection was suspected and confirmed serologically and by measuring the viral load. On day 7, she developed jaundice with abnormal liver function tests. An abdominal ultrasound scan revealed thickening of the gallbladder and bile duct walls without calculi suggesting acute acalculous cholecystitis. The patient improved slowly with symptomatic treatment, and a repeat ultrasound scan six months later was normal. Acalculous cholecystitis is a rare complication of EBV infection and usually has a good prognosis.
Management of acute cholecystitis in UK hospitals: time for a change.
Cameron, I C; Chadwick, C; Phillips, J; Johnson, A G
2004-05-01
Early cholecystectomy for patients with acute cholecystitis is safe, cost effective, and leads to less time off work compared with delayed surgery. This study was designed to assess current practice in the management of acute cholecystitis in the UK. A postal questionnaire was sent to 440 consultant general surgeons to ascertain their current management of patients with acute cholecystitis. Replies were received from 308 consultants who were involved in treating patients with acute cholecystitis of whom 18 transferred these patients on to another team for further management the day after admission. Thirty two consultants (11%) routinely treated patients by early cholecystectomy, with limiting factors stated to be the availability of surgical staff, theatre space, and radiological investigations. The remaining consultants (n = 258) routinely manage their patients conservatively with intravenous antibiotics and allow the inflammation to resolve before undertaking cholecystectomy at a later date. Indications for undertaking early cholecystectomy during the first admission by this latter group included the presence of spreading peritonitis due to bile leak, empyema, and unexpected space on theatre list. The commonest method for both elective and early cholecystectomy is laparoscopic, but the percentage of consultants using an open method rises from 8% in the elective situation to 47% for urgent early cholecystectomy. Despite evidence which strongly advocates early cholecystectomy, this practice is routinely carried out by only 11% of consultants in the UK at present. PMID:15138321
Prediction of the Grade of Acute Cholecystitis by Plasma Level of C-Reactive Protein
Kabul Gurbulak, Esin; Gurbulak, Bunyamin; Akgun, Ismail Ethem; Duzkoylu, Yigit; Battal, Muharrem; Fevzi Celayir, Mustafa; Demir, Uygar
2015-01-01
Background: Acute cholecystitis is the most common complication of gallbladder stones. Today, Tokyo guidelines criteria are recommended for diagnosis, grading, and management of acute cholecystitis. Objectives: We aimed to evaluate the levels of C-reactive protein (CRP) at different cut-off values to predict the severity of the disease and its possible role in grading the disease with regard to the guideline. Patients and Methods: This is a retrospective study, analyzing 682 cases out of consecutive 892 patients with acute cholecystitis admitted to two different general surgery clinics in Istanbul, Turkey. Records of patients diagnosed with acute cholecystitis were screened retrospectively from the hospital computer database between January 2011 and July 2014. A total of 210 patients with concomitant diseases causing high CRP levels were excluded from the study. The criteria of Tokyo guidelines were used in grading the severity of acute cholecystitis, and patients were divided into 3 groups. CRP values at the time of admission were analyzed and compared among the groups. Results: Mean CRP levels of groups were found to be significantly different, 18.96 mg/L in Group I, 133.51 mg/L in Group II, and 237.23 mg/L in Group III (P < 0.001). Having examined CRP values among the groups, they were found to be highly and significantly correlated with the disease grade (P < 0.0001). After evaluating CRP levels according to the grade of the disease, group 2 was distinguished from group 1 with a cut-off CRP level of 70.65 mg/L, and from group 3 with a value of 198.95 mg/L. Those results were found to be statistically significant (P < 0.001). Conclusions: CRP, a well-known acute phase reactant that increases rapidly in various inflammatory processes, can be accepted as a strong predictor in classifying different grades of the disease, and treatment can be reliably planned according to this classification. PMID:26023353
Dong, Chengwei; Wang, Yuxu; Hu, Sanyuan; Du, Futian; Ding, Wei
2015-01-01
Acute acalculous cholecystitis has a high mortality rate due to the difficulties in early diagnosis and high rate of complications like empyema, gangrene and perforation. We report a case of 20-year-old male with acute severe pancreatitis, acute renal failure and acute peripancreatic fluid collection who was transferred to our department after blood filtration treatment in ICU. After percutaneous catheter drainage for 20 hours, the patient got a high fever. Computed tomography revealed retroperitoneal colon injury. In this case, percutaneous catheter drainage was performed again and the pus cavity was flushed regularly, after which the patient’s state gradually improved. Unpredictably, septic shock appeared on the 51st day. Repeated computed tomography revealed acute acalculous cholecystitis and abscess formation. After percutaneous transhepatic gallbladder catheterization and drainage, the patient got better gradually. Three months later the retroperitoneal catheter was removed. Four months later, ultrasound examination showed normal gallbladder and the catheter was removed. PMID:26131252
Swayne, L.C.
1986-07-01
Forty-one proved cases of acute acalculous cholecystitis imaged with technetium-99m iminodiacetic acid (IDA) cholescintigraphy were retrospectively analyzed. After the exclusion of one indeterminate scan (showing poor initial hepatic uptake and excretion), the study yielded a 92.5% (37 of 40) sensitivity for the detection of cystic or common bile duct obstruction. Each of the three patients with false-negative scintigrams had other abnormal scintigraphic findings suggestive of biliary tract disease. Of the 20 patients (48.8%) with focal or diffuse gangrenous cholecystitis or perforation, seven (35%) exhibited either free peritoneal spill or increased pericholecystic activity to indicate the presence of advanced disease.
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
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
Weissmann, H.S.; Berkowitz, D.; Fox, M.S.; Gliedman, M.L.; Rosenblatt, R.; Sugarman, L.A.; Freeman, L.M.
1983-01-01
Technetium-99m iminodiacetic acid (IDA) cholescintigraphy was performed in 15 patients with acute acalculous cholecystitis. Fourteen of the 15 patients with acute disease had positive findings, indicating the presence of cystic duct or common duct obstruction. One case in which the gallbladder was visualized failed to respond to sincalide stimulation; this was classified as a suggestive finding of disease. The diagnostic accuracy of /sup 99m/Tc-IDA cholescintigraphy was far superior to the other imaging studies used (8 sonograms, 1 intravenous cholangiogram, 3 oral cholecystograms, 1 percutaneous transhepatic cholangiogram). The /sup 99m/Tc-IDA study is recommended as the imaging procedure of choice for examining patients with suspected acute acalculous cholecystitis.
Weissmann, H.S.; Berkowitz, D.; Fox, M.S.; Gliedman, M.L.; Rosenblatt, R.; Sugarman, L.A.; Freeman, F.M.
1983-01-01
Technetium-99m iminodiacetic acid (IDA) cholescintigraphy was performed in 15 patients with acute acalculous cholecystitis. Fourteen of the 15 patients with acute disease had positive findings, indicating the presence of cystic duct or common duct obstruction. One case in which the gallbladder was visualized failed to respond to sincalide stimulation; this was classified as a suggestive finding of disease. The diagnostic accuracy of /sup 99//sup m/Tc-IDA cholescintigraphy was far superior to the other imaging studies used (8 sonograms, 1 intravenous cholangiogram, 3 oral cholecystograms, 1 percutaneous transhepatic cholangiogram). The /sup 99//sup m/Tc-IDA study is recommended as the imaging procedure of choice for examining patients with suspected acute acalculous cholecystitis.
Samuels, B.I.; Freitas, J.E.; Bree, R.L.; Schwab, R.E.; Heller, S.T.
1983-04-01
The relative value of hepatobiliary scintigraphy vs. real-time ultrasound for the identification of acute cholecystitis was evaluated. No significant difference in sensitivity (97% vs. 97%) existed between the two modalities. Scintigraphy demonstrated better specificity (93% vs. 64%) and predictive value (77% vs. 40%). Although real-time ultrasound provided improved sensitivity over static gray-scale imaging for identification of gallbadder disease, hepatobiliary scintigraphy remains the procedure of choice for acute cholecystitis detection.
Percutaneous cystic duct stent placement in the treatment of acute cholecystitis.
Comin, Jules M; Cade, Richard J; Little, Andrew F
2010-10-01
Percutaneous cholecystostomy is well established as a temporising treatment option in selected patients presenting with acute cholecystitis. However, some patients who undergo cholecystostomy will have persistent discharge, which precludes catheter removal, or may not be medically suitable for future cholecystectomy. In these circumstances, percutaneous cystic duct stenting isa novel treatment option. It may delay or avoid the need for cholecystectomy, and thereby provide definitive treatment in a subset of patients who have acute cholecystitis and a high anaesthetic risk or limited life expectancy. Current application has been limited largely to patients with pre-existing malignant common bile duct strictures, but there is potential for the application to be broadened to include other subsets of patients. In this paper, we describe the technique used for percutaneous cystic duct stenting in a patient and report on its effectiveness. We also explore the technical considerations and consider the application of the procedure on other groups of patients. PMID:20976992
Diagnosis of acute acalculous cholecystitis: a comparison of sonography, scintigraphy, and CT
Mirvis, S.E.; Vainright, J.R.; Nelson, A.W.; Johnston, G.S.; Shorr, R.; Rodriguez, A.; Whitley, N.O.
1986-12-01
The clinical and laboratory diagnosis of acute acalculous cholecystitis is difficult, and the reliability of various diagnostic imaging techniques has not been established. The results of several imaging procedures performed over a 6-year period on 56 patients with clinically suspected acute acalculous cholecystitis were evaluated retrospectively. Sonography and CT were both highly sensitive (92% and 100%, respectively) and specific (96% and 100%, respectively). Hepatobiliary scintigraphy was compromised by frequent false-positives; the result was a specificity of only 38%. Percutaneous bile aspiration was insufficiently sensitive (33%) for diagnosis. Sonography was as sensitive as hepatobiliary scintigraphy and was more specific in establishing the diagnosis. Because sonography is relatively inexpensive and can be performed at the bedside, it should be regarded as a satisfactory screening procedure. However, CT is a good alternative in an easily transported patient when other intraabdominal disease is suspected.
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. PMID:24857607
Outcomes of contemporary management of gangrenous and non-gangrenous acute cholecystitis
Nikfarjam, Mehrdad; Niumsawatt, Vachara; Sethu, Arun; Fink, Michael A; Muralidharan, Vijayaragavan; Starkey, Graham; Jones, Robert M; Christophi, Christopher
2011-01-01
Background: Gangrenous cholecystitis (GC) is considered a more severe form of acute cholecystitis. The risk factors associated with this condition and its impact on morbidity and mortality compared with those of non-gangrenous acute cholecystitis (NGAC) are poorly defined and based largely on findings from older studies. Methods: Patients with histologically confirmed acute cholecystitis treated in specialized units in a tertiary hospital between 2005 and 2010 were identified from a prospectively maintained database. Data were reviewed retrospectively and patients with GC were compared with those with NGAC. Results: A total of 184 patients with NGAC and 106 with GC were identified. The risk factors associated with GC included older age (69 years vs. 57 years; P = 0.001), diabetes (19% vs. 10%; P = 0.049), temperature of >38 °C (36% vs. 16%; P < 0.001), tachycardia (31% vs. 15%; P = 0.002), detection of muscle rigidity on examination (27% vs. 12%; P = 0.01) and greater elevations in white cell count (WCC) (13.4 × 109/l vs. 10.7 × 109/l; P < 0.001), C-reactive protein (CRP) (94 mg/l vs. 17 mg/l; P = 0.001), bilirubin (19 µmol/l vs. 17 µmol/l; P = 0.029), urea (5.3 mmol/l vs. 4.7 mmol/l; P = 0.016) and creatinine (82 µmol/l vs. 74 µmol/l; P = 0.001). The time from admission to operation in days was greater in the GC group (median = 1 day, range: 0–14 days vs. median = 1 day, range: 0–10 days; P = 0.029). There was no overall difference in complication rates between the GC and NGAC groups (22% vs. 14%; P = 0.102). There was a lower incidence of common bile duct stones in the GC group (5% vs. 13%; P = 0.017). Gangrenous cholecystitis was associated with increased mortality (4% vs. 0%; P = 0.017), but this was not an independent risk factor on multivariate analysis. Conclusions: Gangrenous cholecystitis has certain clinical features and associated laboratory findings that may help to differentiate it from NGAC. It is not associated with an overall increase in
[Use of antibiotics and nitrofurans in treating acute and chronic cholecystitis].
Venger, I K
1984-02-01
Sixty-two patients with acute cholecystitis and 108 patients with chronic calculous cholecystitis were examined. High levels of contamination of the bile, gallbladder mucosa and gallstones were shown. E. coli, Staphylococcus and Streptococcus were most frequent among 20 species of aerobic and anaerobic bacteria. Preoperative sanation of the hepatoduodenal area with antibiotics did not result in complete elimination of the bacteria in the bile, gallbladder mucosa and gallstones. The use of nitrofurans and especially furazolidone and furagin in the preoperative period prevented the microbial growth in the specimens collected during the operations. The data of the study allow recommending the use of furazolidone and furagin for preoperative sanation of the biliferous tract. PMID:6703666
[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
Spectrum of 99m-Tc-IDA cholescintigraphic patterns in acute cholecystitis
Weissmann, H.S.; Badia, J.; Sugarman, L.A.; Kluger, L.; Rosenblatt, R.; Freeman, L.M.
1981-01-01
Cholescintigraphy with 99m-Tc labeled iminodiacetic acid (IDA) derivatives has proved to be extremely reliable in the evaluation of suspected acute cholecystitis. The major diagnostic feature of the study is the presence (cystic dust patency) or absence (cystic duct obstruction) of gallbladder visualization. Secondary findings include degree and rate of liver uptake, visualization and caliber of the intrahepatic and common bile ducts, and the presence of intestinal activity as well as rapidity of biliary tract-to-bowel transit of the radiotracer. Various combinations of these secondary parameters result in a spectrum of cholescintigraphic patterns which can assist in determining the cause of the patient's acute clinical problem.
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.
Chilaiditi Sign on 99mTc-Mebrofenin Hepatobiliary Scan Mimicking Bile Leak in Acute Cholecystitis.
Pascarella, Suzanne; Dadparvar, Simin
2016-06-01
Chilaiditi sign is the incidental radiologic finding of intestinal interposition between the liver and diaphragm, whereas Chilaiditi syndrome describes the presence of accompanying clinical symptoms including abdominal pain, constipation, vomiting, and respiratory distress. We describe a case of radiotracer accumulation over the liver dome on Tc-mebrofenin hepatobiliary scan performed on a 72-year-old man with acute cholecystitis mimicking a bile leak. However, chest radiograph and CT revealed intestinal hepatodiaphragmatic interposition. This case illustrates the importance of being familiar with the scintigraphic appearance of the Chilaiditi sign and correlating abnormal nuclear medicine scan findings with other available radiologic modalities. PMID:26859214
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
Yıldız, İhsan; Koca, Yavuz Savas; Barut, İbrahim
2015-01-01
Introduction. The incidence of gallbladder cancer presenting with acute cholecystitis is 2.3%, squamous cell carcinoma is rarely seen, and overlap of acute cholecystitis and squamous cell carcinoma is a very rare condition in the literature. Presentation of Case. A 75-year-old woman was admitted to emergency service with a pain in the right upper quadrant, nausea, and vomiting. The patient was considered as having acute cholecystitis. During the exploration because Hartman's pouch was not dissected, it was adhered to the cystic duct and had fibrotic adhesion. It could not be understood whether this adhesion was a tumor or a fibrotic tumor and thus we performed cholecystectomy with a 1 cm resection of the choledochus. Pathological examination revealed the presence of (R0), T1 N0 M0 squamous cell carcinoma with clean resection borders and there was no in tumor five dissected lymph nodes. The patient has been followed up for about two years and no clinical problem has been observed throughout the follow-up. Discussion. Acute cholecystitis with gallstones may overlap with gallbladder cancer and generally presents nonspecific symptoms. No additional imaging techniques were performed since no clinical sign except for the wall thickening was detected and no suspected malignancy such as mass was detected on USG. Squamous cell carcinoma of the gallbladder shows poor diagnosis, but since its overlap with cholecystitis presents early symptoms and thus leads to early diagnosis and effective treatment, the localization of the carcinoma is of prime importance. Conclusion. Gallbladder cancer should be kept in mind in elderly patients with acute cholecystitis. PMID:26356191
Laurila, Jouko J; Karttunen, Tuomo; Koivukangas, Vesa; Laurila, Päivi A; Syrjälä, Hannu; Saarnio, Juha; Soini, Ylermi; Ala-Kokko, Tero I
2007-06-01
There is a paucity of information of tight junction (TJ) proteins in gallbladder epithelium, and disturbances in the structure of these proteins may play a role in the pathogenesis of acute acalculous cholecystitis (AAC) and acute calculous cholecystitis (ACC). Using immunohistochemistry, we investigated the expression of TJ proteins claudin-1, -2, -3, and -4, occludin, zonula occludens (ZO-1), and E-cadherin in 9 normal gallbladders, 30 gallbladders with AAC, and 21 gallbladders with ACC. The number of positive epithelial and endothelial cells and the intensity of the immunoreaction were determined. Membrane-bound and cytoplasmic immunoreactivities were separately assessed. We found that TJ proteins were uniformly expressed in normal gallbladder epithelium, with the exception of claudin-2, which was present in less than half of the cells. In AAC, expression of cytoplasmic occludin and claudin-1 were decreased, as compared with normal gallbladder. In ACC, expression of claudin-2 was increased, and expression of claudin-1, -3, and -4, occludin, and ZO-1 were decreased, as compared with normal gallbladder or AAC. We conclude that there are significant differences in expression of TJ proteins in AAC and ACC, supporting the idea that AAC represents a manifestation of systemic inflammatory disease, whereas ACC is a local inflammatory and often infectious disease. PMID:17283368
Teratodermoid mimicking cholecystitis.
Iftikhar, Hina; Idu, Shareen; Omer, Abdel
2016-05-01
An acute abdomen assessment in pregnancy is complicated. Pain can have obstetric and nonobstetric causes. Cholecystitis is a common cause of pain in pregnancy with significant morbidity if not managed promptly. We report a case of a ruptured, torted, right ovarian teratodermoid erroneously diagnosed as cholecystitis in pregnancy. PMID:27190615
Kim, Yong Joo; Shin, Tae Beom
2011-01-01
Objective To evaluate the technical feasibility and clinical efficacy of percutaneous transhepatic cholecystolithotomy under fluoroscopic guidance in high-risk surgical patients with acute cholecystitis. Materials and Methods Sixty-three consecutive patients of high surgical risk with acute calculous cholecystitis underwent percutaneous transhepatic gallstone removal under conscious sedation. The stones were extracted through the 12-Fr sheath using a Wittich nitinol stone basket under fluoroscopic guidance on three days after performing a percutaneous cholecystostomy. Large or hard stones were fragmented using either the snare guide wire technique or the metallic cannula technique. Results Gallstones were successfully removed from 59 of the 63 patients (94%). Reasons for stone removal failure included the inability to grasp a large stone in two patients, and the loss of tract during the procedure in two patients with a contracted gallbladder. The mean hospitalization duration was 7.3 days for acute cholecystitis patients and 9.4 days for gallbladder empyema patients. Bile peritonitis requiring percutaneous drainage developed in two patients. No symptomatic recurrence occurred during follow-up (mean, 608.3 days). Conclusion Fluoroscopy-guided percutaneous gallstone removal using a 12-Fr sheath is technically feasible and clinically effective in high-risk surgical patients with acute cholecystitis. PMID:21430938
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
... foods may relieve symptoms in people. However, the benefit of a low-fat diet has not been proven. Alternative Names Cholecystitis - chronic Images Cholecystitis, CT scan Cholecystitis, cholangiogram Cholecystolithiasis Gallstones, cholangiogram Cholecystogram References Wang ...
Kaminski, D L; Andrus, C H; German, D; Deshpande, Y G
1990-01-01
Gallbladder tissue from patients with acute acalculous cholecystitis contains increased amounts of prostanoids when compared to normal gallbladder tissue. Platelet-activating factor (PAF) is a potent stimulus of eicosanoid formation. It has been implicated as a mediator of acute inflammatory processes and systemic responses to shock. In this study the role of PAF in acute acalculous cholecystitis was evaluated. Anesthetized cats underwent gallbladder perfusion with a physiologic buffer solution containing [14C]polyethylene glycol as a nonabsorbable tracer to quantitate mucosal water absorption. Platelet-activating factor was infused into the hepatic artery for 2 hours. Control experiments were performed when vehicle alone was infused. Experiments also were performed when indomethacin was administered intravenously and when indomethacin and PAF were administered. Gallbladder mucosal absorption/secretion and perfusate and tissue prostaglandin E (PGE) and 6 keto prostaglandin F1 alpha (6-keto PGF1 alpha) levels were evaluated. Gallbladder inflammation was evaluated by beta-glucuronidase and myeloperoxidase tissue concentrations and by a histologic scoring system. Platelet-activating factor eliminated gallbladder absorption and produced net fluid secretion associated with dose-related increases in perfusate PGE concentrations and gallbladder tissue PGE and 6 keto PGF1 alpha levels when compared to control values. Platelet-activating factor produced significant inflammation in the gallbladder with increases in the histologic score of inflammation and tissue lysosomal enzyme activities. Indomethacin significantly decreased the fluid secretion, prostanoid levels, and inflammation produced by PAF. The results suggest that PAF may induce acute gallbladder inflammation associated with systemic stress through a prostanoid-mediated mechanism. Images Fig. 2. PMID:2171443
Acute acalculous cholecystitis in a Lebanese girl with primary Epstein-Barr viral infection.
Majdalani, Marianne; Milad, Nadine; Sahli, Zeyad; Rizk, Sarah
2016-01-01
Acute acalculous cholecystitis (AAC) constitutes 5-10% of all cases of cholecystitis in adults, and is even less common in children. The recent literature has described an association between primary Epstein-Barr virus (EBV) infection and AAC, however, it still remains an uncommon presentation of the infection. Most authors advise that the management of AAC in patients with primary EBV infection should be supportive, since the use of antibiotics does not seem to alter the severity or prognosis of the illness. Furthermore, surgical intervention has not been described as necessary or indicated in the management of uncomplicated AAC associated with EBV infection. We report a case of a 16-year-old Lebanese girl with AAC associated with primary EBV infection. She presented to the emergency department, with high-grade fever, fatigue, vomiting and abdominal pain. Liver enzymes were elevated with a cholestatic pattern, and imaging confirmed the diagnosis of AAC. She was admitted to the regular floor, and initial management was conservative. Owing to persistence of fever, antibiotics were initiated on day 3 of admission. She had a smooth clinical course and was discharged home after a total of 9 days, with no complications. PMID:27090538
... 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
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
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.
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
Acute ischemic cholecystitis after transarterial chemoembolization with drug-eluting beads.
Karaman, Bülent; Battal, Bilal; Ören, Nisa Cem; Üstünsöz, Bahri; Yağci, Gökhan
2012-01-01
Transarterial chemoembolization (TACE) is a widely used treatment choice for hepatocellular cancer. DC Bead microspheres are a new embolic material for TACE that doxorubicin can be loaded to. The tumor response rate of this well-tolerated treatment was changed between 60% and 81.8%. We report a case of ischemic cholecystitis after TACE with drug-eluting beads (DEB) that required cholecystectomy. The possibility of cholecystitis is always remembered during TACE-DEB for tumors in segment IV and/or V. Although selective catheterization is related with a lower risk for ischemic cholecystitis, the anatomic and vascular variability in patients with malignancy may lead to some unexpected conditions. PMID:23154025
Acute Alithiasic Cholecystitis and Human Herpes Virus Type-6 Infection: First Case.
Gomes, Maria Miguel; Antunes, Henedina; Lobo, Ana Luísa; Branca, Fernando; Correia-Pinto, Jorge; Moreira-Pinto, João
2016-01-01
A three-year-old male child presented with erythematous maculopapular nonpruritic generalized rash, poor feeding, vomiting, and cramping generalized abdominal pain. He was previously healthy and there was no family history of immunologic or other diseases. On examination he was afebrile, hemodynamically stable, with painful palpation of the right upper quadrant and positive Murphy's sign. Laboratory tests revealed elevated inflammatory markers, elevated aminotransferase activity, and features of cholestasis. Abdominal ultrasound showed gallbladder wall thickening of 8 mm with a positive sonographic Murphy's sign, without gallstones or pericholecystic fluid. Acute Alithiasic Cholecystitis (AAC) was diagnosed. Tests for underlying infectious causes were negative except positive blood specimen for Human Herpes Virus Type-6 (HHV-6) by polymerase chain reaction. With supportive therapy the child became progressively less symptomatic with gradual improvement. The child was discharged on the sixth day, asymptomatic and with improved analytic values. Two months later he had IgM negative and IgG positive antibodies (1/160) for HHV-6, which confirmed the diagnosis of previous infection. In a six-month follow-up period he remains asymptomatic. To the best of our knowledge, this represents the first case of AAC associated with HHV-6 infection. PMID:27200203
Acute Alithiasic Cholecystitis and Human Herpes Virus Type-6 Infection: First Case
Lobo, Ana Luísa; Branca, Fernando
2016-01-01
A three-year-old male child presented with erythematous maculopapular nonpruritic generalized rash, poor feeding, vomiting, and cramping generalized abdominal pain. He was previously healthy and there was no family history of immunologic or other diseases. On examination he was afebrile, hemodynamically stable, with painful palpation of the right upper quadrant and positive Murphy's sign. Laboratory tests revealed elevated inflammatory markers, elevated aminotransferase activity, and features of cholestasis. Abdominal ultrasound showed gallbladder wall thickening of 8 mm with a positive sonographic Murphy's sign, without gallstones or pericholecystic fluid. Acute Alithiasic Cholecystitis (AAC) was diagnosed. Tests for underlying infectious causes were negative except positive blood specimen for Human Herpes Virus Type-6 (HHV-6) by polymerase chain reaction. With supportive therapy the child became progressively less symptomatic with gradual improvement. The child was discharged on the sixth day, asymptomatic and with improved analytic values. Two months later he had IgM negative and IgG positive antibodies (1/160) for HHV-6, which confirmed the diagnosis of previous infection. In a six-month follow-up period he remains asymptomatic. To the best of our knowledge, this represents the first case of AAC associated with HHV-6 infection. PMID:27200203
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%.
Ralls, P.W.; Colletti, P.M.; Halls, J.M.; Siemsen, J.K.
1982-07-01
Prospective analysis of the efficacy of /sup 99m/Tc-IDA cholescintigraphy and cholecystosonography showed that both are excellent techniques for assessing patients with suspected acute cholecystitis (accuracy 84.7% and 88.1% respectively). Consequently, the choice of tests selected to evaluate patients with suspected acute cholecystitis depends on several factors including; (a.) quality of equipment available; (b.) capability of the technologist performing the examination; (c.) relative experience of the physician supervising the examination; and (d.) willingness of the surgical consultant to accept a positive examination as sufficient evidence to perform emergency surgery. The authors feel that cholecystosonography should be used to assess the presence of acute cholecystitis in jaundiced patients because of its capability in the assessment of bile duct dilatation, and because of the lower reliability of cholescintigraphy when bile duct obstruction is possible (i.e., in jaundice). Ancillary findings in cholecystosonography and cholescintigraphy can aid in the differential diagnosis of acute right upper quandrant pain syndromes.
Luhmann, Andreas; Buter, Anton; Abela, Jo-Etienne
2013-01-01
INTRODUCTION Haemobilia is a rare cause of upper gastro-intestinal haemorrhage which can be difficult to diagnose. PRESENTATION OF CASE We present the case of a patient who suffered from acute acalculous cholecystitis while on dual anti-platelet therapy with aspirin and clopidogrel. We describe the diagnostic and treatment challenges arising from the patient's complicated past history and the steps leading to the diagnosis of haemobilia causing biliary obstruction and cholangitis. Our patient did not, at any point, manifest anaemia or evidence of haemorrhage. DISCUSSION Haemobilia has a varied aetiology. To our knowledge there is no association with dual anti-platelet treatment in the literature to date. Diagnosis is difficult and relies on multiple modalities. In our patient the final diagnosis was only made in the course of open bile duct exploration. CONCLUSION In acute biliary obstruction we recommend the consideration of haemobilia in the differential diagnosis, especially in patients with a bleeding tendency. PMID:23466686
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
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.
Does positive hepatobiliary scan in cholecystitis stay positive, and for how long
Liu, J.; Mena, I.; McCartney, S.
1986-10-01
A prospective study of 11 patients who had undergone two sequential hepatobiliary scans prior to surgery demonstrated that initially positive scans could be due to acute cholecystitis, or chronic cholecystitis with exacerbation. A second hepatobiliary scan performed four to five days later differentiated acute from chronic cholecystitis. All five patients with surgery-proven acute cholecystitis remained hepatobiliary-positive, while patients with surgery-proven chronic cholecystitis reverted back to negative hepatobiliary scans if the second hepatobiliary scan was done properly.
Ralls, P.W.; Colletti, P.M.; Halls, J.M.; Siemsen, J.K.
1982-07-01
Prospective analysis of the efficacy of /sup 99//sup m/Tc-IDA cholescintigraphy and cholecystosonography showed that both are excellent techniques for assessing patients with suspected acute cholecystitis (accuracy 84.7% and 88.1% respectively). Consequently, the choice of tests selected to evaluate patients with suspected acute cholecystitis depends on several factors, including; (a.) quality of equipment available; (b.) capability of the technologist performing the examination; (c.) relative experience of the physician supervising the examination; and (d.) willingness of the surgical consultant to accept a positive examination as sufficient evidence to perform emergency surgery. The authors feel that cholecystosonography should be used to asses the presence of acute cholecystitis in jaundiced patients because of its capability in the assessment of bile duct dilation, and because of the lower reliability of cholescintigraphy when bile duct obstruction is possible (i.e., in jaundice). Ancillary findings in cholecystosonography and cholescintigraphy can aid in the differential diagnosis of acute right upper quadrant pain syndromes.
Bekele, Zenebe; Tegegn, Kassahun
2002-07-01
This is a prospective study conducted from September 1991 to September 2000. Seven-hundred and twelve patients operated for acute and chronic cholecystitis were studied. The male to female ratios for elective and emergency admissions were 1:5 and 1:2.4, respectively. The mean age was 42.7 years. Acute cholecystitis accounted for 10.6% of the 712 cases. There were a total of 666 (93.5%) calculus and 46 (6.5%) acalculus cases. Empyema was seen in 77 (10.8%) patients and hydrops of the gallbladder in 35 (4.9%). Iatrogenic Common Bile Duct (CBD) injury was found to be more of a problem of the contracted gallbladder. In this study severe complications like gangrenous gallbladder, perforated gallbladder, suppurative cholangitis and subhepatic abscess were found more in males than in females. Calculus cholecystitis was found to be a common disease in Ethiopia, and that its features and prevalence as well as sex predilection compare well with reports from other areas. However the findings in this report were found to be different from the reports of the rest of the African Continent. PMID:12602244
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
Takagi, Wataru; Ogura, Takeshi; Sano, Tatsushi; Onda, Saori; Okuda, Atsushi; Masuda, Daisuke; Imoto, Akira; Takeuchi, Toshihisa; Fukunishi, Shinya; Higuchi, Kazuhide
2016-01-01
Background: Recently, endoscopic ultrasound-guided gall bladder drainage (EUS-GBD) has been reported using a self-expandable metallic stent. To prevent stent migration and food flowing into the common bile duct through the cystic duct, we perform a novel EUS-guided cholecystoduodenostomy. The aim of our study was to evaluate the safety and feasibility of EUS-guided cholecystoduodenostomy with an anti-stent migration and anti-food impaction system. Methods: A total of 16 consecutive patients who underwent EUS-guided cholecystoduodenostomy for acute cholecystitis were included in this study. Results: Technical and clinical success was obtained in all patients. The median procedure time was 26.9 min (range 19–42 min). Median follow-up time was 181.5 days (range 18–604 days), and in this time, recurrence of acute cholecystitis was not seen in all patients. Adverse events such as stent migration and cholangitis were not seen in any patients, although pneumoperitoneum was seen in one patient. Conclusion: Our technique may be favorable and effective for the prevention of adverse events on EUS-GBD. PMID:26770264
Wang, Chih-Hung; Wu, Cheng-Yi; Yang, Justin Cheng-Ta; Lien, Wan-Ching; Wang, Hsiu-Po; Liu, Kao-Lang; Wu, Yao-Ming; Chen, Shyr-Chyr
2016-01-01
Background Percutaneous cholecystostomy tube (PCT) has been effectively used for the treatment of acute cholecystitis (AC) for patients unsuitable for early cholecystectomy. This retrospective study investigated the recurrence rate after successful PCT treatment and factors associated with recurrence. Methods We reviewed patients treated with PCT for AC from October 2004 through December 2013. Patients with successful PCT treatment were those who were free from persistent PCT drainage. We used multivariable logistic regression analysis sequentially to identify factors associated with each outcome. Results The study included 184 patients (mean age: 70.1 years). The average duration for parenteral antibiotics was 14.4 days and 20.0 days for PCT drainage. The one-year recurrence rate was 9.2% (17/184) with most recurrences occurring within two months (6.5%, 12/184) of the procedure. Complicated cholecystitis (odds ratio [OR]: 4.67; 95% confidence interval [CI]: 1.44–15.70; P = 0.01) and PCT drainage duration >32 days (OR: 4.92; 95% CI: 1.03–23.53; P = 0.05) positively correlated with one-year recurrence; parenteral antibiotics duration >10 days (OR: 0.21; 95% CI: 0.05–0.68; P = 0.01) was inversely associated with one-year recurrence. Conclusions The recurrence rate was low for patients after successful PCT treatment. Predictors for recurrence included the severity of initial AC and subsequently provided treatments. PMID:26821150
Ni, Qingqiang; Chen, Dongbo; Xu, Rui; Shang, Dong
2015-01-01
Abstract To evaluate the efficacy of percutaneous transhepatic gallbladder drainage (PTGD) for high-risk elderly patients with acute cholecystitis. Retrospective analysis of 159 acute cholecystitis patients who were admitted to General Surgery Division III of the First Affiliated Hospital of Dalian Medical University between January 2005 and November 2012. A total of 123 patients underwent laparoscopic cholecystectomy (LC), and 36 received only PTGD treatment. The LC patients were divided into 3 groups based on their preoperative treatment: group A, emergency patients (33 patients); group B (26 patients), patients who were treated with PTGD prior to LC; and group C (64 patients), patients who received nonsurgical treatment prior to LC. General conditions, LC surgery duration, intraoperative blood loss, rate of conversion to open surgery, incidence of postoperative complications, total fasting time, and total hospitalization time were analyzed and compared among the 3 groups. The remission rates of patients in the PTGD treatment groups (including group B and PTGD treatment only group) were significantly higher within 24 and 48 hours than those of patients who received nonsurgical treatment prior to LC (P < 0.05). Among the patients in the 3 surgery groups, the operation conversion rate (19.2%) of group B was significantly higher than that of group A (3.0%) and group C (1.6%) (P < 0.05). The total hospitalization time of the patients in group B (18.5 ± 4.5 days) was longer than that of the patients in group A (8.2 ± 3.9 days) and group C (10.5 ± 6.4 days). The total fasting time of the patients in group A (2.4 ± 1.2 days) was significantly shorter than that of those in group B (4.1 ± 1.7 days) and group C (3.4 ± 2.7 days) (P < 0.05). For high-risk elderly patients, if there is any emergency surgery contraindication, PTGD therapy may be safe and effective and can relieve the symptoms within a short time. For acute
Ni, Qingqiang; Chen, Dongbo; Xu, Rui; Shang, Dong
2015-08-01
To evaluate the efficacy of percutaneous transhepatic gallbladder drainage (PTGD) for high-risk elderly patients with acute cholecystitis.Retrospective analysis of 159 acute cholecystitis patients who were admitted to General Surgery Division III of the First Affiliated Hospital of Dalian Medical University between January 2005 and November 2012. A total of 123 patients underwent laparoscopic cholecystectomy (LC), and 36 received only PTGD treatment. The LC patients were divided into 3 groups based on their preoperative treatment: group A, emergency patients (33 patients); group B (26 patients), patients who were treated with PTGD prior to LC; and group C (64 patients), patients who received nonsurgical treatment prior to LC. General conditions, LC surgery duration, intraoperative blood loss, rate of conversion to open surgery, incidence of postoperative complications, total fasting time, and total hospitalization time were analyzed and compared among the 3 groups.The remission rates of patients in the PTGD treatment groups (including group B and PTGD treatment only group) were significantly higher within 24 and 48 hours than those of patients who received nonsurgical treatment prior to LC (P < 0.05). Among the patients in the 3 surgery groups, the operation conversion rate (19.2%) of group B was significantly higher than that of group A (3.0%) and group C (1.6%) (P < 0.05). The total hospitalization time of the patients in group B (18.5 ± 4.5 days) was longer than that of the patients in group A (8.2 ± 3.9 days) and group C (10.5 ± 6.4 days). The total fasting time of the patients in group A (2.4 ± 1.2 days) was significantly shorter than that of those in group B (4.1 ± 1.7 days) and group C (3.4 ± 2.7 days) (P < 0.05).For high-risk elderly patients, if there is any emergency surgery contraindication, PTGD therapy may be safe and effective and can relieve the symptoms within a short time. For acute cholecystitis patients
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
Cholecystitis: prospective evaluation of sonography and /sup 99m/ Tc-HIDA cholescintigraphy
Worthen, N.J.; Uszler, J.M.; Funamura, J.L.
1981-11-01
Major and minor criteria are determined for sonographic diagnosis of acute and chronic cholecystitis. A prospective study of 113 cases was performed on patients with suspected acute cholecystitis who were evaluated by cholesonography and /sup 99m/Tc-HIDA cholescintigraphy. Data support the use of sonography as the intial imaging procedure for the patient with suspected acute cholecystitis. /sup 99m/Tc-HIDA is useful in those cases without stones which exhibit minor criteria for gallbladder abnormality.
Yoo, J.H.K.; Beal, W.H.; Ware, R.W.; Straw, J.D.; Chaudhuri, T.K.
1985-05-01
Despite the wide acceptance of the hepatobiliary scintigraphy as a popular diagnostic imaging modality for gallbladder and hepatobiliary disease, correlation between radionuclide diagnoses and the final clinical and/or pathologic findings have not been thoroughly evaluated. The lack of correlative studies frequently generates difficulties in making appropriate diagnostic interpretation of the objective findings. A retrospective clinical pathological and surgical correlative study was undertaken by the authors in 138 male veteran patients, who underwent computer assisted minute by minute Tc-99m DISIDA cholescintigraphy. A very high percentage (75%) revealed abnormalities; non-visualization of gallbladder (GB) with normal choledochus system (46%), choledochal obstruction with no GB visualization (13%), choledochal obstruction with normal GB visualization (6%), severe hepatocellular disease with non-diagnostic GB (4%), and delayed GB visualization (longer than 60 minutes) (3%). Non-visualization of GB but normal choledochus demonstrated diverse pathologic etiologies, acute and chronic cholecystitis (64%), S/P cholecystectomy (8%), functional obstruction secondary to sepsis or pancreatitis (6%), and various other pathologies including porcelain GB and cholangitis (22%). The most important cause of choledochal obstruction was mass lesions or local infiltration with metastases (33%) rather than acute cholecystitis (27%). Although the sensitivity (98%) and specificity (92%) for cystic duct obstruction were very high, the specificity decreases significantly for cholecystitis.
Hayasaki, Aoi; Takahashi, Koji; Fujii, Takehiro; Kumamoto, Koji; Fujii, Koji; Matsumoto, Eiichi; Miyahara, Shigeki; Kusuta, Tsukasa; Azumi, Yoshinori; Isaji, Shuji
2016-01-01
Purpose. To identify significant independent preoperative factors influencing postoperative hospital stay (PHS) and medical costs (MC) in 171 patients who underwent cholecystectomy for benign gallbladder diseases and had definite, suspected, or unmatched acute cholecystitis (AC) diagnosis according to the Tokyo Guidelines 2013 (TG13). Methods. The 171 patients were classified according to the combination of diagnostic criteria including local signs of inflammation (A), systemic signs of inflammation (B), and imaging findings (C): A+ B+ C (definite diagnosis, n = 84), A+ B (suspected diagnosis, n = 25), (A or B) + C (n = 10), A (n = 41), and B (n = 11). Results. The A+ B + C and (A or B) + C groups had equivalent PHS and MC, suggesting that imaging findings were essential for AC diagnosis. PHS and MC were significantly increased in the order of severity grades based on TG13. Performance status (PS), white blood cell count, and severity grade were identified as preoperative factors influencing PHS by multivariate analysis, and significant independent preoperative factors influencing MC were age, PS, preoperative biliary drainage, hospital stay before surgery, albumin, and severity grade. Conclusion. PS and severity grade significantly influenced prolonged PHS and increased MC. PMID:27239193
Eosinophilic cholecystitis with common bile duct stricture: a rare disease.
Mehanna, Daniel; Naseem, Zainab; Mustaev, Muslim
2016-01-01
Although the most common cause of cholecystitis is gallstones, other conditions may present as acute cholecystitis. We describe a case of eosinophilic cholecystitis with common bile duct stricture. A 36-year-old woman initially had generalised abdominal pain and peripheral eosinophilia. Diagnostic laparoscopy showed eosinophilic ascites and necrotic nodules on the posterior abdominal wall. She was treated with anthelminthics on presumption of toxacara infection based on borderline positivity of serological tests. She later presented with acute cholecystitis and had a cholecystectomy and choledocotomy. Day 9 T-tube cholangiogram showed irregular narrowing of the distal common bile duct. The patient's symptoms were improved with steroids and the T-tube was subsequently removed. PMID:27222280
Al-Waili, N S
1986-03-01
The effect of indomethacin suppositories on both acute urinary colic and urinary calculus, resistant or refractory to conventional therapy with analgesics and spasmolytics was investigated. Fifty-five patients with acute urinary colic refractory to treatment with repeated injections of antispasmodics and analgesics had dramatic or complete pain relief after receiving indomethacin suppositories (100 mg) (P less than 0.01). Fifteen of the 55 patients passed urinary stones within 30 days of treatment with indomethacin. Three out of 30 other patients with renal or ureteric stones were treated with indomethacin suppositories (100 mg) twice daily. Twenty-one of the 30 patients passed their stones within 30 days of treatment. It is concluded that indomethacin suppositories can relieve acute urinary colic resistant to treatment with analgesic/antispasmodic drugs, and facilitate expulsion of urinary calculi. The mechanism of action of indomethacin is discussed in terms of its analgesic and anti-inflammatory effects and its prostaglandin synthesis inhibition. PMID:3720020
[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
Xanthogranulomatous cholecystitis mimicking gallbladder cancer.
Ewelukwa, Ofor; Ali, Omair; Akram, Salma
2014-01-01
Xanthogranulomatous cholecystitis (XGC) is a benign, uncommon variant of chronic cholecystitis characterised by focal or diffuse destructive inflammatory process of the gallbladder (GB). Macroscopically, it appears like yellowish tumour-like masses in the wall of the GB. This article reports on a 74-year-old woman with XGC mimicking GB cancer. PMID:24811556
Xanthogranulomatous cholecystitis mimicking gallbladder cancer
Ewelukwa, Ofor; Ali, Omair; Akram, Salma
2014-01-01
Xanthogranulomatous cholecystitis (XGC) is a benign, uncommon variant of chronic cholecystitis characterised by focal or diffuse destructive inflammatory process of the gallbladder (GB). Macroscopically, it appears like yellowish tumour-like masses in the wall of the GB. This article reports on a 74-year-old woman with XGC mimicking GB cancer. PMID:24811556
Xanthogranulomatous cholecystitis: What every radiologist should know
Singh, Vaibhav P; Rajesh, S; Bihari, Chhagan; Desai, Saloni N; Pargewar, Sudheer S; Arora, Ankur
2016-01-01
Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis characterized by xanthogranulomatous inflammation of the gallbladder. Intramural accumulation of lipid-laden macrophages and acute and chronic inflammatory cells is the hallmark of the disease. The xanthogranulomatous inflammation of the gallbladder can be very severe and can spill over to the neighbouring structures like liver, bowel and stomach resulting in dense adhesions, perforation, abscess formation, fistulous communication with adjacent bowel. Striking gallbladder wall thickening and dense local adhesions can be easily mistaken for carcinoma of the gallbladder, both intraoperatively as well as on preoperative imaging. Besides, cases of concomitant gallbladder carcinoma complicating XGC have also been reported in literature. So, we have done a review of the imaging features of XGC in order to better understand the entity as well as to increase the diagnostic yield of the disease summarizing the characteristic imaging findings and associations of XGC. Among other findings, presence of intramural hypodense nodules is considered diagnostic of this entity. However, in some cases, an imaging diagnosis of XGC is virtually impossible. Fine needle aspiration cytology might be handy in such patients. A preoperative counselling should include possibility of differential diagnosis of gallbladder cancer in not so characteristic cases. PMID:26981227
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.
Mylarappa, Prasad; Javali, Tarun; Prathvi; Ramesh, D.
2014-01-01
Extracorporeal shock wave lithotripsy (SWL) is considered the standard of care for the treatment of small upper ureteric and renal calculi. A few centers have extended its use to the treatment of bile duct calculi and pancreatic calculi. The complication rates with SWL are low, resulting in its wide spread acceptance and usage. However, some of the serious complications reported in 1% of patients include acute pancreatitis, perirenal hematoma, urosepsis, venous thrombosis, biliary obstruction, bowel perforation, lung injury, rupture of aortic aneurysm and intracranial hemorrhage. To our knowledge, only six cases of acute pancreatitis or necrotizing pancreatitis following SWL have been documented in the literature. Herein, we report a rare case of acute pancreatitis and formation of a pseudo cyst following SWL for left renal pelvic calculus. PMID:24497695
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.
Old man gallbladder syndrome: Gangrenous cholecystitis in the unsuspected patient population
Dhir, Teena; Schiowitz, Robert
2015-01-01
Introduction Acute cholecystitis is a common surgical condition, but not many are aware of the serious complication of gangrenous cholecystitis (GC). Presence of GC increases patients’ postoperative complications, morbidity and mortality. Predictive factors for GC include age >45, male gender, white blood cell count >13,000/mm3 and ultrasound findings of a negative Murphy’s sign. Case presentation (1) GW, 83 male with dull right upper quadrant pain and a negative Murphy’s sign with further imaging showing a thickened septated gallbladder suggestive of GC. Patient’s surgery was difficult and he received a cholecystostomy tube for drainage. (2) PH, 75 male with minimal right upper quadrant pain, equivocal ultrasound with a negative Murphy’s sign and computer tomography (CT) showing acute cholecystitis. Patient was taken to the operating room for cholecystectomy, with pathology consistent with gangrenous cholecystitis. Discussion Multiple laboratory findings and imaging patterns have been found to be highly predictive of GC. Along with age and WBC, thickened gallbladder wall and lack of mucosal enhancement have been predictive of GC. On physical examination, lack of Murphy’s sign secondary to denervation from gangrenous changes also increases the index of suspicion for GC. Conclusion GC is a serious complication of acute cholecystitis with increased morbidity and mortality. There should be a high index of suspicion for GC if the above unique physical and laboratory findings are present. PMID:25917175
Hemorrhagic cholecystitis as a complication of anticoagulant therapy: role of CT in its diagnosis.
Pandya, Rajul; O'Malley, Charles
2008-01-01
Hemorrhage within the gallbladder lumen is a rare but potentially fatal complication of acute cholecystitis. Concomitant anticoagulant therapy increases the chances of hemorrhage. In this case report we describe one such case which showed active extravasation of the contrast into the lumen of the gallbladder. Early diagnosis of this potentially fatal condition is important to facilitate urgent surgical treatment. PMID:18629579
[DISSEMINATION BY H. PYLORI IN PATIENTS, SUFFERING VARIOUS FORMS OF CHOLECYSTITIS].
Kyazimov, I L; Takhmazova, Ch T
2015-05-01
Comparative analysis of dissemination by H. pylori of the bile portions in patients of a control group, suffering an acute calculous cholecystitis (ACCH), was performed. Dissemination of H. pylori in a control group was significantly less, than in a bile portions of patients, suffering ACCH. While analyzing the rate and degree of dissemination by H. pylori of the gastic and gallbladder mucosa biopsies of patients, suffering chronic non-calculous cholecystitis, associated with duodenogastric reflux and gastroduodenitis, bacteria were revealed trustworthy more often and in more number, than in a gallbladder mucosa in patients, suffering ACCH. PMID:26419024
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…
Low sensitivity of sonography and cholescintigraphy in acalculous cholecystitis
Shuman, W.P.; Rogers, J.V.; Rudd, T.G.; Mack, L.A.; Plumley, T.; Larson, E.B.
1984-03-01
Acalculous cholecystitis is difficult to diagnose by clinical means or contrast radiography. Because sonography and cholescintigraphy have both been shown to do well in the diagnosis of calculous cholecystitis, the sensitivity of these newer imaging methods was assessed retrospectively in 33 proven cases of acalculous cholecystitis. The sensitivities to acalculous cholecystitis for sonography (67%) and for cholescintigraphy (68%) were not as high as has been reported for these tests in calculous cholecystitis. Reasons for the lower sensitivity with each test and the pathogenesis of acalculous cholecystitis are discussed.
A complication of xanthogranulomatous cholecystitis with Mirizzi syndrome.
Zhang, H-Y; Cao, X-D; Chen, J-J; Luo, Y-Q; Wang, X-C
2015-05-01
A patient had right upper quadrant pain with sclera was transferred from emergency room to the hospital, she was proposed to have acute cholecystitis, gallstones, obstructive jaundice, and a four-year history of gallbladder stones. The NMR results showed that the gallbladder was significantly enlarged and the gallbladder wall was thickening irregularly. The liver morphology was not abnormal except with extensive intrahepatic bile duct dilatation. The MRCP results demonstrated that the intrahepatic bile ducts were significant expanded. The ERCP results showed that duodenal stenosis and extra-hepatic bile duct stenosis. We placed a plastic stent of 8.5Fr and 12 cm in length in the hepatic duct, and after biliary plastic stent placement, jaundice was rapidly reduced and liver function was improved significantly. A surgery was performed and the final pathologic diagnosis is a complication of Xanthogranulomatous cholecystitis with Mirizzi syndrome. After the surgery of cholecystectomy and a bile duct repair were performed, the patient was recovered well. Conclusively, if a patient was diagnosed as biliary stricture, a biliary metal stent should not be placed until pathological diagnosis of malignancy. PMID:26044215
Ubeeva, I P; Sambueva, Z G; Azhunova, T A; Nikolaev, S M
1990-01-01
The effect of polyphytochol representing a combination of vegetable agents was studied on models of acute toxic hepatitis caused by CCl4 and cholecystitis. The efficiency of the drug in pathology of the hepatobiliary system was shown: it decreases cholestasis acting as a choleretic and bile-secreting drug, acts on the main pathogenetic links in hepatitis, exerts a marked membrane-stabilizing effect, influences favourably the processes of synthesis in the liver. PMID:2369954
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
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.
Acalculous cholecystitis: a case with variable cholescintigram
Schneider, P.B.
1984-01-01
A 62-yr-old man with acalculous cholecystitis is presented. At different stages of his disease his cholescintigram was abnormal and then normal. The case demonstrates the variations of the cholescintigram that may occur during the disease and illstrates the difficulties that may be encountered in making the diagnosis.
Kotkar, Kunal; Thakkar, Ravi; Songra, MC
2011-01-01
Primary urethral calculus is rarely seen and is usually encountered in men with urethral stricture or diverticulum. We present a case of giant urethral calculus secondary to a urethral stricture in a man. The patient was treated with calculus extraction with end to end urethroplasty. PMID:24950400
Xanthogranulomatous cholecystitis: a rare cause of digestive hemorrhage.
Scheiwe, C; Muller, A; Rocas, D; Cotte, E
2014-02-01
Xanthogranulomatous cholecystitis is a rare affection with non-specific symptoms. It is essential to differentiate it from gall bladder adenocarcinoma. Presentation signs include hemorrhage or fistula. This report concerns a patient with pseudotumoral xanthogranulomatous cholecystitis who presented with gastrointestinal hemorrhage. PMID:24411821
Rathod, Rajiv; Bansal, Prashant; Gutta, Srinivas
2013-01-01
Ureteric stones are usually small and symptomatic. We present a case of a 35-year old female who presented with minimally symptomatic right distal ureteric calculus with proximal hydroureteronephrosis. Laparoscopic right ureterolithotomy was performed and a giant ureteric calculus measuring 11 cm Χ 1.5 cm, weighing 40 g was retrieved. PMID:24082453
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…
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.
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…
Rathod, Rajiv; Bansal, Prashant; Gutta, Srinivas
2013-07-01
Ureteric stones are usually small and symptomatic. We present a case of a 35-year old female who presented with minimally symptomatic right distal ureteric calculus with proximal hydroureteronephrosis. Laparoscopic right ureterolithotomy was performed and a giant ureteric calculus measuring 11 cm Χ 1.5 cm, weighing 40 g was retrieved. PMID:24082453
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.
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.
Stochastic calculus in physics
Fox, R.F.
1987-03-01
The relationship of Ito-Stratonovich stochastic calculus to studies of weakly colored noise is explained. A functional calculus approach is used to obtain an effective Fokker-Planck equation for the weakly colored noise regime. In a smooth limit, this representation produces the Stratonovich version of the Ito-Stratonovich calculus for white noise. It also provides an approach to steady state behavior for strongly colored noise. Numerical simulation algorithms are explored, and a novel suggestion is made for efficient and accurate simulation of white noise equations.
Gallstone spillage caused by spontaneously perforated hemorrhagic cholecystitis
Kim, Young Chul; Park, Mi-Suk; Chung, Yong Eun; Lim, Joon Suk; Kim, Myeong-Jin; Kim, Ki Whang
2007-01-01
There are occasional incidences of gallstone spillage during laparoscopic cholecystectomy, and there have been frequent reports on such a topic in the literature. To the best of our knowledge, however, there have been no reports about spilled stones caused by spontaneously perforated hemorrhagic cholecystitis. Here, we report the radiologic findings of spilled stones caused by spontaneously perforated hemorrhagic cholecystitis in a 55-year-old man. PMID:17907301
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.
Cui, Helen; Thomas, Johanna; Kumar, Sunil
2013-01-01
We present a case of a renal calculus treated solely with antibiotics which has not been previously reported in the literature. A man with a 17 mm lower pole renal calculus and concurrent Escherichia coli urine infection was being worked up to undergo percutaneous nephrolithotomy. However, after a course of preoperative antibiotics the stone was no longer seen on retrograde pyelography or CT imaging. PMID:23580676
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.
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
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…
NASA Astrophysics Data System (ADS)
Gionti, S. J. Gabriele
2013-01-01
Recent results in Local Regge Calculus are confronted with Spin Foam Formalism. Introducing Barrett-Crane Quantization in Local Regge Calculus makes it possible to associate a unique Spin jh with an hinge h, fulfilling one of the requirements of Spin Foam definition. It is shown that inter-twiner terms of Spin Foam can follow from the closure constraint in Local Regge Calculus.
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
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.)
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)
ERIC Educational Resources Information Center
Palmaccio, Richard J.
1982-01-01
A method of using vector analysis is presented that is an application of calculus that helps to find the best angle for tacking a boat into the wind. While the discussion is theoretical, it is seen as a good illustration of mathematical investigation of a given situation. (MP)
Evaluation of acute right upper quadrant pain: sonography and /sup 99m/Tc-PIPIDA cholescintigraphy
Shuman, W.P.; Mack, L.A.; Rudd, T.G.; Rogers, J.V.; Gibbs, P.
1982-07-01
A group of 75 patients with acute right upper quadrant pain was evaluated with both sonography and cholescintigraphy. Accuracy in screening for gallbladder disease was significantly greater with sonography (96%) than with cholescintigraphy (74%). For selecting patients with acute cholecystitis from this population that included acute and chronic cholecystitis as well as nonbiliary pathology, PIPIDA was less accurate (77%) than might be expected based on previous reports primarily due to false positive nonvisualization caused by chronic cholecystitis. Of patients with nonbiliary pathology, sonography was able to detect the cause of the right upper quadrant pain in 21%. Patients with acute right upper quadrant pain should first be screened with sonography. If cholescintigraphy is subsequently used for suspected acute cholecystitis, positive results should be interpreted with caution before surgery is planned.
Acalculous cholecystitis associated with hemorrhagic fever with renal syndrome.
Nicolas, J B
2015-10-01
Hantaviruses are responsible for various types of hemorrhagic fevers depending on the involved subtype. In Europe, Puumala virus is responsible for an epidemic nephropathy. This infection can be complicated by severe abdominal pain. A rarely reported cause of this presenting symptom is acalculous cholecystitis, which must be integrated in the clinicobiological spectrum and should not lead to a surgical sanction. Its presence seems to be correlated with the severity of the disease, whose main pathophysiological phenomenon is plasma leakage induced by a microvascular endothelial dysfunction. We report the case of a young male patient who presented with severe hantavirus infection complicated by acalculous cholecystitis. PMID:25982259
Rewriting Calculus: Foundations and Applications
NASA Astrophysics Data System (ADS)
Cirstea, Horatiu
2000-11-01
This thesis is devoted to the study of a calculus that describes the application of conditional rewriting rules and the obtained results at the same level of representation. We introduce the rewriting calculus, also called the rho-calculus, which generalizes the first order term rewriting and lambda-calculus, and makes possible the representation of the non-determinism. In our approach the abstraction operator as well as the application operator are objects of calculus. The result of a reduction in the rewriting calculus is either an empty set representing the application failure, or a singleton representing a deterministic result, or a set having several elements representing a not-deterministic choice of results. In this thesis we concentrate on the properties of the rewriting calculus where a syntactic matching is used in order to bind the variables to their current values. We define evaluation strategies ensuring the confluence of the calculus and we show that these strategies become trivial for restrictions of the general rewriting calculus to simpler calculi like the lambda-calculus. The rewriting calculus is not terminating in the untyped case but the strong normalization is obtained for the simply typed calculus. In the rewriting calculus extended with an operator allowing to test the application failure we define terms representing innermost and outermost normalizations with respect to a set of rewriting rules. By using these terms, we obtain a natural and concise description of the conditional rewriting. Finally, starting from the representation of the conditional rewriting rules, we show how the rewriting calculus can be used to give a semantics to ELAN, a language based on the application of rewriting rules controlled by strategies.
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
Sclerosing cholecystitis associated with autoimmune pancreatitis
Kamisawa, Terumi; Tu, Yuyang; Nakajima, Hitoshi; Egawa, Naoto; Tsuruta, Kouji; Okamoto, Atsutake; Horiguchi, Shinichirou
2006-01-01
AIM: To evaluate the histopathological and radiological findings of the gallbladder in patients with autoimmune pancreatitis (AIP). METHODS: The radiological findings of the gallbladder of 19 AIP patients were retrospectively reviewed. Resected gallbladders of 8 AIP patients were examined histologically and were immunostained with anti-IgG4 antibody. Controls consisted of gallbladders resected for symptomatic gallstones (n = 10) and those removed during pancreatoduodenectomy for pancreatic carcinoma (n = 10), as well as extrahepatic bile ducts and pancreases removed by pancreatoduodenectomy for pancreatic carcinoma (n = 10). RESULTS: Thickening of the gallbladder wall was detected by ultrasound and/or computed tomography in 10 patients with AIP (3 severe and 7 moderate); in these patients severe stenosis of the extrahepatic bile duct was also noted. Histologically, thickening of the gallbladder was detected in 6 of 8 (75%) patients with AIP; 4 cases had transmural lymphoplasmacytic infiltration with fibrosis, and 2 cases had mucosal-based lymphoplasmacytic infiltration. Considerable transmural thickening of the extrahepatic bile duct wall with dense fibrosis and diffuse lymphoplasmacytic infiltration was detected in 7 patients. Immunohistochemically, severe or moderate infiltration of IgG4-positive plasma cells was detected in the gallbladder, bile duct, and pancreas of all 8 patients, but was not detected in controls. CONCLUSION: Gallbladder wall thickening with fibrosis and abundant infiltration of IgG4-positive plasma cells is frequently detected in patients with AIP. We propose the use of a new term, sclerosing cholecystitis, for these cases that are induced by the same mechanism as sclerosing pancreatitis or sclerosing cholangitis in AIP. PMID:16773691
Eosinophilic Cystitis with Eosinophilic Cholecystitis: A Rare Association
Mallat, F.; Hmida, W.; Mestiri, S.; Ziadi, S.; Sriha, B.; Mokni, M.; Mosbah, F.
2013-01-01
We describe a rare case of eosinophilic cystitis associated with eosinophilic cholecystitis in a 30-year-old patient who underwent bladder biopsy for irritative voiding symptoms and routine elective cholecystectomy for gallstones. Diagnosis was confirmed by histopathological examination. The rarity of this condition prompted us to report this entity in which no specific cause could be found. PMID:24195001
NASA Astrophysics Data System (ADS)
Feinsilver, Philip; Schott, René
2009-09-01
We discuss topics related to finite-dimensional calculus in the context of finite-dimensional quantum mechanics. The truncated Heisenberg-Weyl algebra is called a TAA algebra after Tekin, Aydin and Arik who formulated it in terms of orthofermions. It is shown how to use a matrix approach to implement analytic representations of the Heisenberg-Weyl algebra in univariate and multivariate settings. We provide examples for the univariate case. Krawtchouk polynomials are presented in detail, including a review of Krawtchouk polynomials that illustrates some curious properties of the Heisenberg-Weyl algebra, as well as presenting an approach to computing Krawtchouk expansions. From a mathematical perspective, we are providing indications as to how to implement infinite terms Rota's 'finite operator calculus'.
Rahman, M; Uddin, A; Das, G C; Akanda, N I
2007-07-01
Massive or giant vesical calculus is a rare entity in the recent urological practice. Males are affected more than the females. Vesical calculi are usually secondary to bladder outlet obstruction. These patients present with recurrent urinary tract infection, haematuria or with retention of urine. We report a young male patient who presented with defaecatory problems along with other urinary symptoms. The patient having an average built, non diabetic but hypertensive. The stone could be palpated by physical examination. His urea levels were within normal limits but urine examination shows infection. USG reveals bilateral hydronephrosis with multiple stones in both kidneys along with a giant vesical calculus. After controlling urinary infection and hypertention he underwent an open cystolithotomy. During operation digital rectal help was needed to remove the stone as it was adherent with bladder mucosa. Post operative period was uneventful. His urinary output was quite normal and had no defaecatory problems. Patient left the hospital 10 days after operation. PMID:17917633
Gall bladder rupture associated with cholecystitis in a domestic ferret (Mustela putorius).
Huynh, M; Guillaumot, P; Hernandez, J; Ragetly, G
2014-09-01
A six-year-old neutered female albino ferret was presented with an acute episode of lethargy and anorexia. Clinical examination revealed marked cranial abdominal pain. A severe neutrophilic leukocytosis was present. Abdominal ultrasound was consistent with a diffuse peritonitis and severe bile duct inflammation. Cytology of the abdominal effusion revealed bile peritonitis. An exploratory laparotomy was performed and the gall bladder appeared inflamed with multiple perforations. A cholecystectomy was performed. The ferret recovered without complication. Bacteriological culture of the bile and gall bladder yielded a pure growth of Pseudomonas aeruginosa. Histopathological analysis of the gall bladder and liver was consistent with a marked cholecystitis and cholangiohepatitis. On the basis of sensitivity testing, the ferret was treated with marbofloxacin for one month. No complications or reoccurrence were seen up to 1 year after the diagnosis. To the author's knowledge, this is the first report of bile peritonitis secondary to gall bladder rupture in a ferret. PMID:25168742
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.
Inquiry Calculus and Information Theory
NASA Astrophysics Data System (ADS)
Center, Julian L.
2009-12-01
We consider the relationship between information theory and a calculus of inquiries. We show how an inquiry calculus can be constructed using lattice theory, and how the inquiry calculus relates to information theory. The key idea is to identify both inquiries and variables with partitions of the state space. We also show an approach to extending information theory that deals with the problem of negative entropies on questions that do not correspond to partitions.
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.)
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…
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…
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…
Cholecystitis of a duplicated gallbladder complicated by a cholecystoenteric fistula.
Huang, Brady K; Chess, Mitchell A
2009-04-01
Gallbladder duplications are uncommon anatomic variants that are sometimes mistaken for other entities on imaging. We present a surgically confirmed case of cholecystitis in a ductular-type duplicated gallbladder complicated by the formation of an inflammatory fistula to the adjacent duodenum. Both US and magnetic resonance cholangiopancreatography were performed preoperatively, in addition to intraoperative cholangiography, which confirmed the presence of a duplicated gallbladder. PMID:19205686
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.
Testicular calculus: A rare case
Sen, Volkan; Bozkurt, Ozan; Demir, Omer; Tuna, Burcin; Yorukoglu, Kutsal; Esen, Adil
2015-01-01
ABSTRACT Background: Testicular calculus is an extremely rare case with unknown etiology and pathogenesis. To our knowledge, here we report the third case of testicular calculus. A 31-year-old man was admitted to our clinic with painful solid mass in left testis. After diagnostic work-up for a possible testicular tumour, he underwent inguinal orchiectomy and histopathologic examination showed a testicular calculus. Case hypothesis: Solid testicular lesions in young adults generally correspond to testicular cancer. Differential diagnosis should be done carefully. Future implications: In young adults with painful and solid testicular mass with hyperechogenic appearance on scrotal ultrasonography, testicular calculus must be kept in mind in differential diagnosis. Further reports on this topic may let us do more clear recommendations about the etiology and treatment of this rare disease. PMID:26200556
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.
Unusual Giant Prostatic Urethral Calculus
Bello, A.; Maitama, H. Y.; Mbibu, N. H.; Kalayi, G. D.; Ahmed, A.
2010-01-01
Giant vesico-prostatic urethral calculus is uncommon. Urethral stones rarely form primarily in the urethra, and they are usually associated with urethral strictures, posterior urethral valve or diverticula. We report a case of a 32-year-old man with giant vesico-prostatic (collar-stud) urethral stone presenting with sepsis and bladder outlet obstruction. The clinical presentation, management, and outcome of the giant prostatic urethral calculus are reviewed. PMID:22091328
``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.
A Discrete Approach to the Calculus.
ERIC Educational Resources Information Center
Gordon, Sheldon P.
1979-01-01
The calculus of finite differences and finite sums is used to create a context in which the computer can be incorporated into calculus courses. Analyses of the experimental implementations are included. (MP)
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.
Xanthogranulomatous cholecystitis: differentiation from associated gall bladder carcinoma.
Rao, R V Raghavendra; Kumar, Ashok; Sikora, Sadiq S; Saxena, Rajan; Kapoor, Vinay K
2005-01-01
Xanthogranulomatous cholecystitis (XGC) is a destructive form of chronic cholecystitis. In some patients it coexists with gall bladder carcinoma (GBC) and is often difficult to differentiate between the two. Present study was performed with an aim to identify differentiating features of XGC and those of XGC with associated Gall bladder carcinoma (XGC ass. GBC). A retrospective analysis of prospectively maintained data of 4800 cholecystectomies performed from January 1988 to December 2003 was carried out. On histopathology 453 cholecystectomy specimens revealed XGC. These patients were divided into two groups, those with associated GBC (n=26) and those without GBC (n=427). Clinical, radiological and operative findings were compared in these two groups. P value of < 0.05 was considered statistically significant. The incidence of associated GBC in present series was 6%. XGC patients with associated GBC, at presentation were older than those with XGC alone and there was male preponderance. XGC patients with associated GBC were more likely to present with anorexia, weight loss, palpable lump and jaundice. Gall stones were present in majority of patients in both the groups. GB wall thickening, GB mass, enlarged abdominal lymph nodes may be found on imaging in both the groups but more so in patients with associated GBC. Both preoperative FNAC and peroperative FNAC/imprint cytology failed to reveal the associated GBC with XGC in some patients. PMID:15974235
Polite, Nathan M; Brown, Roy; Braveman, Joshua
2013-12-01
Acute cholecystitis in patients unfit for general anesthesia often initially requires cholecystectomy tube placement without cholecystectomy. The best way to definitively manage those patients with irreversible medical conditions, leaving them unable to undergo cholecystectomy, has yet to be defined. Laser lithotripsy is currently used in the management of stones of the genitourinary system. Extracorporeal shock wave cholelithotripsy has been extensively evaluated in Munich, Germany and since then, has been abandoned as an alternative treatment of cholelithiasis. This report discusses a novel approach using established cholecystocutaneous fistula tracts and laser lithotripsy to definitively treat this group of patients. PMID:24300938
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.…
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.)
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 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.
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
Lee, Tae Hoon; Park, Sang-Heum; Kim, Sang Pil; Park, Ji-Young; Lee, Chang Kyun; Chung, Il-Kwun; Kim, Hong Soo; Kim, Sun-Joo
2009-01-01
Chemical ablation of the gallbladder is effective in patients at high risk of complications after surgery. Percutaneous gallbladder drainage is an effective treatment for cholecystitis; however, when the drain tube cannot be removed because of recurrent symptoms, retaining it can cause problems. An 82-year-old woman presented with cholecystitis and cholangitis caused by biliary stent occlusion and suspected tumor invasion of the cystic duct. We present successful chemical ablation of the gallbladder using pure alcohol, through a percutaneous gallbladder drainage tube, in a patient who developed intractable cholecystitis with obstruction of the cystic duct after receiving a biliary stent. Our results suggest that chemical ablation therapy is an effective alternative to surgical therapy for intractable cholecystitis. PMID:19399941
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…
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 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…
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…
The Pendulum and the Calculus.
ERIC Educational Resources Information Center
Sworder, Steven C.
A pair of experiments, appropriate for the lower division fourth semester calculus or differential equations course, are presented. The second order differential equation representing the equation of motion of a simple pendulum is derived. The period of oscillation for a particular pendulum can be predicted from the solution to this equation. As 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…
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…
A "Model" Multivariable Calculus Course.
ERIC Educational Resources Information Center
Beckmann, Charlene E.; Schlicker, Steven J.
1999-01-01
Describes a rich, investigative approach to multivariable calculus. Introduces a project in which students construct physical models of surfaces that represent real-life applications of their choice. The models, along with student-selected datasets, serve as vehicles to study most of the concepts of the course from both continuous and discrete…
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,…
The impact of taking a college pre-calculus course on students' college calculus performance
NASA Astrophysics Data System (ADS)
Sonnert, Gerhard; Sadler, Philip M.
2014-11-01
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 four-year colleges continues to grow, and these courses are well-populated with students who already took pre-calculus in high school. We examine student performance in college calculus, using regression discontinuity to estimate the effects of taking college pre-calculus or not, in a national US sample of 5507 students at 132 institutions. We find that students who take college pre-calculus do not earn higher calculus grades.
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
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…
Toward lattice fractional vector calculus
NASA Astrophysics Data System (ADS)
Tarasov, Vasily E.
2014-09-01
An analog of fractional vector calculus for physical lattice models is suggested. We use an approach based on the models of three-dimensional lattices with long-range inter-particle interactions. The lattice analogs of fractional partial derivatives are represented by kernels of lattice long-range interactions, where the Fourier series transformations of these kernels have a power-law form with respect to wave vector components. In the continuum limit, these lattice partial derivatives give derivatives of non-integer order with respect to coordinates. In the three-dimensional description of the non-local continuum, the fractional differential operators have the form of fractional partial derivatives of the Riesz type. As examples of the applications of the suggested lattice fractional vector calculus, we give lattice models with long-range interactions for the fractional Maxwell equations of non-local continuous media and for the fractional generalization of the Mindlin and Aifantis continuum models of gradient elasticity.
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.
Variational calculus on Banach spaces
Uglanov, A V
2000-10-31
The problem of variational calculus is considered in a (variable) subdomain of a Banach space. Analogues of the basic principles of the finite-dimensional theory are derived: the main formula for variations of a functional, necessary conditions of an extremum, Noether's theorem. All the results obtained are dimension-invariant and become the classical ones in the finite-dimensional setting. The main tool of the analysis is the theory of surface integration in Banach spaces.
Schubert calculus and singularity theory
NASA Astrophysics Data System (ADS)
Gorbounov, Vassily; Petrov, Victor
2012-02-01
Schubert calculus has been in the intersection of several fast developing areas of mathematics for a long time. Originally invented as the description of the cohomology of homogeneous spaces, it has to be redesigned when applied to other generalized cohomology theories such as the equivariant, the quantum cohomology, K-theory, and cobordism. All this cohomology theories are different deformations of the ordinary cohomology. In this note, we show that there is, in some sense, the universal deformation of Schubert calculus which produces the above mentioned by specialization of the appropriate parameters. We build on the work of Lerche Vafa and Warner. The main conjecture these authors made was that the classical cohomology of a Hermitian symmetric homogeneous manifold is a Jacobi ring of an appropriate potential. We extend this conjecture and provide a simple proof. Namely, we show that the cohomology of the Hermitian symmetric space is a Jacobi ring of a certain potential and the equivariant and the quantum cohomology and the K-theory is a Jacobi ring of a particular deformation of this potential. This suggests to study the most general deformations of the Frobenius algebra of cohomology of these manifolds by considering the versal deformation of the appropriate potential. The structure of the Jacobi ring of such potential is a subject of well developed singularity theory. This gives a potentially new way to look at the classical, the equivariant, the quantum and other flavors of Schubert calculus.
Jet-calculus approach including coherence effects
Jones, L.M.; Migneron, R.; Narayanan, K.S.S.
1987-01-01
We show how integrodifferential equations typical of jet calculus can be combined with an averaging procedure to obtain jet-calculus-based results including the Mueller interference graphs. Results in longitudinal-momentum fraction x for physical quantities are higher at intermediate x and lower at large x than with the conventional ''incoherent'' jet calculus. These results resemble those of Marchesini and Webber, who used a Monte Carlo approach based on the same dynamics.
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.
Immunoglobulin G4-related sclerosing cholecystitis presenting as gallbladder cancer: a case report.
Takahashi, Kodai; Ito, Hideto; Katsube, Toshio; Tsuboi, Ayaka; Hashimoto, Masatoshi; Ota, Emi; Mita, Kazuhito; Asakawa, Hideki; Hayashi, Takashi; Fujino, Keiichi; Okamoto, Sigeru
2015-12-01
Immunoglobulin G4 (IgG4)-related sclerosing disease is a systemic inflammatory syndrome, and an understanding of its characteristics is currently evolving. IgG4-related cholecystitis is a manifestation of IgG4-related sclerosing disease in the gallbladder. This case report describes the clinical, radiographic, and histopathological findings in a young male patient who presented with a synchronous mass in the gallbladder. Serum levels of IgG4 and the IgG4/IgG ratio were normal, and there was no associated autoimmune pancreatitis. Therefore, establishing a preoperative diagnosis of IgG4-related cholecystitis was very difficult, and a differential diagnosis of gallbladder cancer infiltrating the liver was suggested. Postoperative histopathological examination established a diagnosis of IgG4-related cholecystitis definitively. A preoperative diagnosis of IgG4-related cholecystitis, although possible, would have been highly challenging in this case. It is difficult to establish whether surgical intervention is necessary in IgG4-related cholecystitis. Because malignant tumors are frequently suspected with this clinical presentation, surgical intervention should be undertaken only after due deliberation. PMID:26943444
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
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.
A rare gallbladder ciliated foregut cyst in chronic cholecystitis
Lee, Mee-Jin; Salinas, James; Varikatthas, Winny; Alsnih, Ghiyath
2016-01-01
Introduction Ciliated foregut cysts (CFC) are rare anomalies due to aberrant embryological development. It is thought to arise from a remnant of the embryologic foregut. The solitary cysts are characterised by ciliated pseudostratified columnar epithelium. They are usually located above the diaphragm but they can also arise in relation to the liver, gallbladder and pancreas. Presentation of case We present the first ciliated foregut cyst of the gallbladder case reported in Australia, and the ninth known case to be reported worldwide. A 61-year-old male with chronic cholecystitis and cholelithiasis underwent an elective laparoscopic cholecystectomy and intraoperative cholangiogram. Intraoperatively, ‘out-pouching’ was noted on the lateral border of the gallbladder. Microscopically the histopathology showed that the cyst was lined by ciliated columnar epithelium the characteristic feature of a ciliated foregut cyst. Discussion To date only 8 cases of these ciliated foregut cysts in the gallbladder have been reported in literature. Our case is the first reported in Australia. It is unique in that the patient was an older male as opposed to most other previous cases, which were younger females. These cysts can be difficult to distinguish from neoplasms clinically and radiographically. Reports have shown that these cysts may become dysplastic and is best excised when discovered. Conclusion Despite the rarity of CFCs and their potential to mimic malignancy, we propose awareness and understanding of the management for them—being excision and hopefully not cause any confusion or devastatingly allow it to become malignant. PMID:26890682
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. PMID:20163661
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 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…
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…
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…
[Pharmacological action of cultured calculus bovis].
Yuan, H
1991-02-01
By means of comparative pharmacological study, the main pharmacodynamics and toxicity of cultured calculus bovis and natural calculus bovis were compared under the same conditions. The results show that both drugs possess sedative, antispasmodic, antipyretic, antiinflammatory, cardiotonic and hypotensive effects, the strength of effect and toxicity being similar. PMID:1872960
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 Snapshot of the Calculus Classroom
ERIC Educational Resources Information Center
Weathers, Tony D.; Latterell, Carmen M.
2003-01-01
Essentially a focus group to discuss textbook related issues, a meeting of calculus instructors from a wide variety of environments was convened and sponsored by McGraw Hill to provide feedback on the current state of the calculus classroom. This paper provides a description of the group's discussions.
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…
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…
Can We Learn Calculus from a Jerk?
ERIC Educational Resources Information Center
Kenyon, Paula L.; Bardzell, Michael J.
2001-01-01
Summarizes an interdisciplinary undergraduate research project involving experimental physics and calculus and illustrates how mathematics was used to finesse incomplete experimental information and maximize physical quantity known as jerk. Describes how calculus can be applied in the "real world" where functions are not always given by nice…
Some Calculus Affordances of a Graphics Calculator
ERIC Educational Resources Information Center
Kissane, Barry; Kemp, Marian
2008-01-01
Calculus at the secondary school level has traditionally represented the peak of school mathematics in Australia, and has been available only to the most capable students. Until recently, many calculus curricula have focused on developing standard techniques, such as those concerned with differentiation and integration, with an emphasis on…
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…
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.
Attendance and Attainment in a Calculus Course
ERIC Educational Resources Information Center
Meulenbroek, Bernard; van den Bogaard, Maartje
2013-01-01
In this paper the relationship between attendance and attainment in a standard calculus course is investigated. Calculus could in principle be studied without attending lectures due to the wealth of material available (in hardcopy and online). However, in this study we will show that the pass rate of students attending classes regularly (>75%…
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…
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)
Characterization, treatment, and outcome of bacterial cholecystitis and bactibilia in dogs.
Lawrence, Yuri A; Ruaux, Craig G; Nemanic, Sarah; Milovancev, Milan
2015-05-01
Objective-To characterize historical, clinicopathologic, ultrasonographic, microbiological, surgical, and histopathologic features of bacterial cholecystitis and bactibilia in dogs and evaluate response to treatment and outcomes in these patients. Design-Retrospective case-control study. Animals-40 client-owned dogs (10 with bacterial cholecystitis on histologic analysis or bactibilia on cytologic examination [case dogs] and 30 without bactibilia [controls]) evaluated at a veterinary teaching hospital between 2010 and 2014. Procedures-Signalment, history, clinicopathologic findings, ultrasonographic features, microbiological results, surgical findings, histopathologic changes, treatments, and outcomes of case dogs were derived from medical records and summarized. Demographic and clinicopathologic data and ultrasonographic findings were compared between case and control dogs. Relationships among prior antimicrobial treatment, sediment formation in the gallbladder, presence of immobile biliary sludge, and presence of bactibilia or bacterial cholecystitis were assessed. Results-No finding was pathognomonic for bactibilia or bacterial cholecystitis in dogs. Case dogs were significantly more likely to have immobile biliary sludge and had a greater degree of biliary sediment formation than did control dogs. All case dogs for which gallbladders were examined histologically (6/6) had bacterial cholecystitis. Five of 10 case dogs were Dachshunds. Medical or surgical treatment resulted in good outcomes. Conclusions and Clinical Relevance-Bactibilia and bacterial cholecystitis were important differential diagnoses in dogs with signs referable to biliary tract disease. Dachshunds were overrepresented, which may suggest a breed predisposition. Cytologic evaluation of bile should be considered in the routine assessment of dogs with hepatobiliary disease if immobile biliary sludge is present. (J Am Vet Med Assoc 2015;246:982-989). PMID:25875669
Geometric calculus: a new computational tool for Riemannian geometry
Moussiaux, A.; Tombal, P.
1988-05-01
We compare geometric calculus applied to Riemannian geometry with Cartan's exterior calculus method. The correspondence between the two methods is clearly established. The results obtained by a package written in an algebraic language and doing general manipulations on multivectors are compared. We see that the geometric calculus is as powerful as exterior calculus.
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…
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…
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…
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.
Antipenko, P V; Ponomarenko, G N
1997-01-01
It is shown in 22 patients with chronic noncalculous cholecystitis that hepatic exposure of such patients to constant current changes chemical composition of bile components in such a way that bile lithogenic characteristics make formation of choleliths less probable. PMID:9190749
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.
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
Extending Stochastic Network Calculus to Loss Analysis
Yu, Li; Zheng, Jun
2013-01-01
Loss is an important parameter of Quality of Service (QoS). Though stochastic network calculus is a very useful tool for performance evaluation of computer networks, existing studies on stochastic service guarantees mainly focused on the delay and backlog. Some efforts have been made to analyse loss by deterministic network calculus, but there are few results to extend stochastic network calculus for loss analysis. In this paper, we introduce a new parameter named loss factor into stochastic network calculus and then derive the loss bound through the existing arrival curve and service curve via this parameter. We then prove that our result is suitable for the networks with multiple input flows. Simulations show the impact of buffer size, arrival traffic, and service on the loss factor. PMID:24228019
Null-strut calculus. II. Dynamics
Kheyfets, A.; LaFave, N.J.; Miller, W.A. )
1990-06-15
In this paper, we continue from the preceding paper to develop a fully functional Regge calculus geometrodynamic algorithm from the null-strut-calculus construction. The developments discussed include (a) the identification of the Regge calculus analogue of the constraint and evolution equations on the null-strut lattice, (b) a description of the Minkowski solid geometry for the simplicial blocks of the null-strut lattice, (c) a description of the evolution algorithm for the geometrodynamic scheme and an analysis of its consistency, and (d) a presentation of the dynamical degrees of freedom for a simplicial hypersurface and the description of an initial-value prescription. To demonstrate qualitatively this new approach to geometrodynamics, we present the most simple application of null-strut calculus that we know of---the Friedmann cosmology using the three-boundary of a 600-cell simplicial polytope to model the simplicial hypersurface.
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 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.
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.
A phenomenological calculus of Wiener description space.
Richardson, I W; Louie, A H
2007-10-01
The phenomenological calculus is a categorical example of Robert Rosen's modeling relation. This paper is an alligation of the phenomenological calculus and generalized harmonic analysis, another categorical example. Our epistemological exploration continues into the realm of Wiener description space, in which constitutive parameters are extended from vectors to vector-valued functions of a real variable. Inherent in the phenomenology are fundamental representations of time and nearness to equilibrium. PMID:17955459
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.
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.
[New model of acute pancreatitis].
Cherkezova-Kinova, E; Lateva, E
1981-01-01
The authors propose a new model of acute pancreatitis by infusing duodenal content, obtained both from animals with experimental pancreatitis and from patients with pancreatitis, hepatitis and cholecystitis, into the duodenum of experimental animals without pressure for a period of several days. Pancreatitis was established functionally and histomorphologically. The control group of animals did not reveal deviations from the norm after infusion of duodenal content. The authors suggested the presence of pathogenic substances in the duodenal content of animals and sick persons, and these components damaged the pancreas, liver and kidneys by means of blood and lymph ways. PMID:7227280
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.
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. PMID:25476244
A Case of Amyloidosis Presenting as Chronic Cholecystitis, Misdiagnosed as Polymyalgia Rheumatica.
Um, Yoo Jin; Kim, Hyoun Ah; Jung, Jin Hee; Cho, Hundo; Kang, Joon Koo
2016-07-25
Amyloidosis is a rare disease defined by extracellular deposits of amorphous fibrillar proteins, derived from aggregations of misfolded proteins. Localization of amyloidosis in the gallbladder is uncommon; only eight cases have been reported. We describe a case of amyloidosis diagnosed by cholecystectomy, which possibly also affected the liver and kidney. The patient was misdiagnosed with polymyalgia rheumatica, but after a cholecystectomy to treat chronic cholecystitis, we ultimately diagnosed him with amyloidosis. We review amyloidosis with gallbladder involvement in the literature. PMID:27443625
Horesh, N; Gutman, M; Rosin, D
2016-05-01
Laparoscopic cholecystectomy can be a challenging procedure in gallbladders with chronic disease. We describe a patient with chronic cholecystitis and difficult visualisation of the gallbladder at surgery who underwent laparoscopic hepatotomy along the drainage tube of the cholecystostomy. In this way, the gallbladder was identified to avoid non-visualisation of ductal anatomy. This exceptional solution should be added to the surgical options if anatomical recognition is difficult and complete removal of the gallbladder is too risky. PMID:26985702
Fractional vector calculus and fractional Maxwell's equations
Tarasov, Vasily E.
2008-11-15
The theory of derivatives and integrals of non-integer order goes back to Leibniz, Liouville, Grunwald, Letnikov and Riemann. The history of fractional vector calculus (FVC) has only 10 years. The main approaches to formulate a FVC, which are used in the physics during the past few years, will be briefly described in this paper. We solve some problems of consistent formulations of FVC by using a fractional generalization of the Fundamental Theorem of Calculus. We define the differential and integral vector operations. The fractional Green's, Stokes' and Gauss's theorems are formulated. The proofs of these theorems are realized for simplest regions. A fractional generalization of exterior differential calculus of differential forms is discussed. Fractional nonlocal Maxwell's equations and the corresponding fractional wave equations are considered.
The giant calculus within the prostatic urethra.
Demir, Omer; Kefi, Aykut; Cahangirov, Asif; Cihan, Ahmet; Obuz, Funda; Esen, Adil Ahmet; Celebi, Ilhan
2011-08-01
The giant calculus within the prostatic urethra is a rare clinical entity in the young population. Most of the calculi within the urethra migrate from the urinary bladder and obliterate the urethra. These stones are often composed of calcium phosphate or calcium oxalate. The decision of treatment strategy is affected by the size, shape and position of the calculus and by the status of the urethra. If the stone is large and immovable, it may be extracted via the perineal or the suprapubic approach. In most cases, the giant calculi were extracted via the transvesical approach and external urethrotomy. Our case is the biggest prostatic calculus, known in the literature so far, which was treated endoscopically by the combination of laser and the pneumatic lithotriptor. PMID:21188583
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.
Early Diagnosis of a Large Vesical Calculus Complicating Pregnancy
Pricilla, Ruby Angeline; David, Kirubah Vasandhi; Venkatesan, Sankarapandian; Benjamin, Santosh Joseph
2013-01-01
Vesical calculus-complicating pregnancy is rare. This is a case report of a large vesical calculus-complicating pregnancy. The early diagnosis and appropriate surgical management of the large vesical calculus prevented complications like recurrent urinary tract infections and obstructed labor. It enabled the mother to have an uneventful vaginal delivery. PMID:24479053
Laparoscopic Ureterolithotomy for Giant Ureteric Calculus: A Case Report.
Magdum, Prasad V; Nerli, Rajendra B; Devaraju, Shishir; Hiremath, Murigendra B
2015-09-01
We present a case of a 21 year old male who presented with symptomatic right upper ureteric calculus measuring 5 cm × 1.5 cm fulfilling the criteria to be named as giant ureteric calculus. Laparoscopic right ureterolithotomy was performed and the giant ureteric calculus was retrieved. PMID:26793529
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…
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…
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…
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.
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.
Connes' calculus for the quantum double suspension
NASA Astrophysics Data System (ADS)
Chakraborty, Partha Sarathi; Guin, Satyajit
2015-02-01
Given a spectral triple (A, H, D) Connes associated a canonical differential graded algebra ΩD• (A) . However, so far this has been computed for very few special cases. We identify suitable hypotheses on a spectral triple that helps one to compute the associated Connes' calculus for its quantum double suspension. This allows one to compute ΩD• for spectral triples obtained by iterated quantum double suspension of the spectral triple associated with a first order differential operator on a compact smooth manifold. This gives the first systematic computation of Connes' calculus for a large family of spectral triples.
Null-strut calculus. I. Kinematics
Kheyfets, A.; LaFave, N.J.; Miller, W.A. )
1990-06-15
This paper describes the kinematics of null-strut calculus---a 3+1 Regge calculus approach to general relativity. We show how to model the geometry of spacetime with simplicial spacelike three-geometries (TET's) linked to earlier'' and later'' momentumlike lattice surfaces (TET{sup *}) entirely by light rays or null struts.'' These three-layered lattice spacetime geometries are defined and analyzed using combinatorial formulas for the structure of polytopes. The following paper in this series describes how these three-layered spacetime lattices are used to model spacetimes in full conformity with Einstein's theory of gravity.
Detection, removal and prevention of calculus: Literature Review
Kamath, Deepa G.; Umesh Nayak, Sangeeta
2013-01-01
Dental plaque is considered to be a major etiological factor in the development of periodontal disease. Accordingly, the elimination of supra- and sub-gingival plaque and calculus is the cornerstone of periodontal therapy. Dental calculus is mineralized plaque; because it is porous, it can absorb various toxic products that can damage the periodontal tissues. Hence, calculus should be accurately detected and thoroughly removed for adequate periodontal therapy. Many techniques have been used to identify and remove calculus deposits present on the root surface. The purpose of this review was to compile the various methods and their advantages for the detection and removal of calculus. PMID:24526823
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.
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…
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…
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,…
Discovering a Geometric Volume Relationship in Calculus.
ERIC Educational Resources Information Center
Morriss, Patrick
1998-01-01
Outlines the discovery of an advanced calculus class based on the generalization of the relationship between the volume of a right circular cone and the volume of a right cylinder with same height and base radius while studying solids of revolution. Relates the course of discovery and concludes with plans to use it to try to generate the same…
Cartan calculus on quantum Lie algebras
Schupp, P.; Watts, P.; Zumino, B.
1993-12-09
A generalization of the differential geometry of forms and vector fields to the case of quantum Lie algebras is given. In an abstract formulation that incorporates many existing examples of differential geometry on quantum spaces we combine an exterior derivative, inner derivations, Lie derivatives, forms and functions au into one big algebra, the ``Cartan Calculus.``
Discrete quantum gravity; The Regge calculus approach
Williams, J.W. )
1992-06-01
After a brief introduction to Regge calculus, some examples of its application is quantum gravity are described in this paper. In particular, the earliest such application, by Ponzano and Regge, is discussed in some detail and it is shown how this leads naturally to current work on invariants of three-manifolds.
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
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
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…
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…
Using the Microcomputer to Enhance Calculus Teaching.
ERIC Educational Resources Information Center
Clayton, Debbie; And Others
1990-01-01
Discusses differences between computer-enhanced learning (CEL) and computer-aided learning (CAL), and describes a microcomputer-based graph-plotting program called Capgraph that was developed for use in a college calculus course. Results of a course evaluation are presented; student attitudes are described; and future considerations are discussed.…
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…
Areas and the Fundamental Theorem of Calculus
ERIC Educational Resources Information Center
Vajiac, A.; Vajiac, B.
2008-01-01
We present a concise, yet self-contained module for teaching the notion of area and the Fundamental Theorem of Calculus for different groups of students. This module contains two different levels of rigour, depending on the class it used for. It also incorporates a technological component. (Contains 6 figures.)
Using Discovery in the Calculus Class
ERIC Educational Resources Information Center
Shilgalis, Thomas W.
1975-01-01
This article shows how two discoverable theorems from elementary calculus can be presented to students in a manner that assists them in making the generalizations themselves. The theorems are the mean value theorems for derivatives and for integrals. A conjecture is suggested by pictures and then refined. (Author/KM)
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…
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…
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…
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…
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,…
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.
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…
Beliefs about Proof in Collegiate Calculus.
ERIC Educational Resources Information Center
Raman, Manya
The broad aim of this research is to characterize the views of proof held by college calculus students and their two types of teachers mathematics graduate students and professors. The analysis is based on an examination of the ways in which people in all three groups produce and evaluate different types of solutions to a proof-based problem from…
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…
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.
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…
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.
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
[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. PMID:8139793
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
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
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
Shetty, Gurucharan S; Abbey, Pooja; Prabhu, Shailesh M; Narula, Mahender K; Anand, Rama
2012-07-01
The imaging features of xanthogranulomatous cholecystitis closely resemble those of gallbladder carcinoma, especially those of the wall-thickening variety. There is an overlap between these two conditions with respect to the clinical features and certain imaging findings. However, certain finer details like the presence of intramural hypoattenuating nodules and the type of mucosal enhancement may help to differentiate these two conditions. In this article, we have highlighted some of these imaging features. The importance of making an accurate diagnosis lies in the significant difference between the prognosis and the surgical management of the two disease entities. PMID:22488612
Prince, Jip F; van den Hoven, Andor F; van den Bosch, Maurice A A J; Elschot, Mattijs; de Jong, Hugo W A M; Lam, Marnix G E H
2014-11-01
Controversy exists over the need to take precautionary measures during hepatic radioembolization to minimize the risk of radiation-induced cholecystitis. Strategies for a variety of clinical scenarios are discussed on the basis of a literature review. Precautionary measures are unnecessary in the majority of patients and should be taken only when single photon-emission computed tomography (CT; SPECT)/CT shows a significant concentration of technetium-99m macroaggregated albumin in the gallbladder wall. In this case report with quantitative SPECT analysis, it is illustrated how an adjustment of the catheter position can effectively reduce the absorbed dose of radiation delivered to the gallbladder wall by more than 90%. PMID:25442134
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.
Attendance and attainment in a Calculus course
NASA Astrophysics Data System (ADS)
Meulenbroek, Bernard; van den Bogaard, Maartje
2013-10-01
In this paper the relationship between attendance and attainment in a standard calculus course is investigated. Calculus could in principle be studied without attending lectures due to the wealth of material available (in hardcopy and online). However, in this study we will show that the pass rate of students attending classes regularly (>75% of the classes) is much higher than the pass rate of students attending fewer classes. We use a logistic model to investigate whether this correlation is significant. We will argue why we believe that this correlation between attendance and attainment is causal, i.e. why it is necessary for most students to attend classes in order to (improve their chances to) pass the exam.
Two cosmological solutions of Regge calculus
Lewis, S.M.
1982-01-15
Two cosmological solutions of Regge calculus are presented which correspond to the flat Friedmann-Robertson-Walker and the Kasner solutions of general relativity. By taking advantage of the symmetries that are present, I am able to show explicitly that a limit of Regge calculus does yield Einstein's equations for these cases. The method of averaging these equations when taking limits is important, especially for the Kasner model. I display the leading error term that arises from keeping the Regge equations in discrete form rather than using their continuum limit. In particular, this work shows that for the ''Reggeized'' Friedmann model the minimum volume is a velocity-dominated singularity as in the continuum Friedmann model. However, unlike the latter, the Regge version has a nonzero minimum volume.
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.
Getzler symbol calculus and deformation quantization
NASA Astrophysics Data System (ADS)
Mesa, Camilo
2013-11-01
In this paper we give a construction of Fedosov quantization incorporating the odd variables and an analogous formula to Getzler's pseudodifferential calculus composition formula is obtained. A Fedosov type connection is constructed on the bundle of Weyl tensor Clifford algebras over the cotangent bundle of a Riemannian manifold. The quantum algebra associated with this connection is used to define a deformation of the exterior algebra of Riemannian manifolds.
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.
A new boson calculus for SU(3)
Prakash, J.S.; Sharatchandra, H.S.
1997-09-01
It is shown that the Gelfand-Weyl pattern for SU(3) can be uniquely expressed in terms of four non-negative and one positive or negative free integers. This provides an optimal, albeit non-linear, boson calculus for SU(3) in terms of four harmonic oscillators and one planar rotor. (By optimal it is meant that every irreducible representation is obtained once and once only.) Our techniques can be generalized to other groups. {copyright} {ital 1997 American Institute of Physics.}
Nonnumeric Computer Applications to Algebra, Trigonometry and Calculus.
ERIC Educational Resources Information Center
Stoutemyer, David R.
1983-01-01
Described are computer program packages requiring little or no knowledge of computer programing for college algebra, calculus, and abstract algebra. Widely available computer algebra systems are listed. (MNS)
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
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.
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
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
Poddubnaya, O A
2015-01-01
The development of new technologies of medical rehabilitation of patients with chronic cholecystitis in combination with a chronic opisthorchiasis, remains an actual problem of clinical gastroenterology. The use of a group chronobiological approach to the complex treatment of these patients including EHF-therapy allows to increase efficiency of the conducted measures. The analysis of results testified to beneficial effect of such approach on indicators of a functional condition of hepatobiliarity system and an organism in general. The positive dynamics of all studied indicators provided high thera- peutic effect (to 84.8%), and the revealed contingency of these results to features of carrying out treatment, allowed to establish their interrelation (χ² = 104.13; p = 0.0001; Kramer's V-coefficient = 0.35). It guarantees (is a predictor) receiving of high therapeutic effect (Percent Concordant of = 86.4%; the standardized coefficient = 2.54; r = 0.001) of the complex treatment including EHF-therapy with use of chronobiological approach to treatment of patients with chronic cholecystitis in combination with a chronic opisthorchiasis. The established dependences have a great practical importance and can be used in a choice of tactics of treatment of this category of patients. PMID:27214989
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…
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…
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…
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.)
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…
Modelling the landing of a plane in a calculus lab
NASA Astrophysics Data System (ADS)
Morante, Antonio; Vallejo, José A.
2012-10-01
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.
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…
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
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…
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…
Visualization and Students' Performance in Technology-Based Calculus.
ERIC Educational Resources Information Center
Galindo, Enrique
The relationship between college students' preferred mode of processing mathematical information--visual or nonvisual--and their performance in calculus classes with and without technology was investigated. Students elected one of three different versions of an introductory differential calculus course: using graphing calculators, using the…
Discovering and Experiencing the Fundamental Theorem of Calculus.
ERIC Educational Resources Information Center
Rosenthal, Bill
1992-01-01
Offers calculus students and teachers the opportunity to motivate and discover the first Fundamental Theorem of Calculus (FTC) in an experimental, experiential, inductive, intuitive, vernacular-based manner. Starting from the observation that a distance traveled at a constant speed corresponds to the area inside a rectangle, the FTC is discovered,…
Calculus, Part 2, Student's Text, Unit No. 67. Revised Edition.
ERIC Educational Resources Information Center
Beck, A.; And Others
This is part two 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…
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.
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…
How Students Use Physics to Reason about Calculus Tasks
ERIC Educational Resources Information Center
Marrongelle, Karen A.
2004-01-01
The present research study investigates how undergraduate students in an integrated calculus and physics class use physics to help them solve calculus problems. Using Zandieh's (2000) framework for analyzing student understanding of derivative as a starting point, this study adds detail to her "paradigmatic physical" context and begins to address…
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…
Using the Finite Difference Calculus to Sum Powers of Integers.
ERIC Educational Resources Information Center
Zia, Lee
1991-01-01
Summing powers of integers is presented as an example of finite differences and antidifferences in discrete mathematics. The interrelation between these concepts and their analogues in differential calculus, the derivative and integral, is illustrated and can form the groundwork for students' understanding of differential and integral calculus.…
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…
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
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…
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…
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…
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…
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…
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.
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)
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…
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…
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…
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.
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…
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…
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…
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…
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…
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.
Heavy quarks in the jet calculus
Jones, L.M.
1983-07-01
In this paper we explore a method for treating heavy quarks such as c and b quarks within the jet calculus. These quarks are differentiated from the more common u, d, and s quarks by the requirement that the gluons never branch into heavy-quark pairs during the jet development. We compute and discuss the charmed-quark ''propagators''; the x distribution of colorless clusters containing a charmed quark, a noncharmed antiquark, and gluons; and the mass distribution of the parent partons giving rise to these colorless clusters.
Equation of motion using fractional calculus
Kihong, Kwon.
1991-01-01
One-dimensional motion of a particle was studied using fractional calculus, which is the differentiation and the integration of arbitrary order. By fractional differentiation, equation of motion could be written in compact form. Fractional parameters were numerically calculated by using the known solutions of general relativistic free fall motion. Also, from the approximate forms for fractional parameters, the physical meanings were found. The fractional parameters depended on the proper time, the mass of gravitating body, and the initial radial coordinate of the particle.
Heisenberg algebra, umbral calculus and orthogonal polynomials
Dattoli, G.; Levi, D.; Winternitz, P.
2008-05-15
Umbral calculus can be viewed as an abstract theory of the Heisenberg commutation relation [P,M]=1. In ordinary quantum mechanics, P is the derivative and M the coordinate operator. Here, we shall realize P as a second order differential operator and M as a first order integral one. We show that this makes it possible to solve large classes of differential and integrodifferential equations and to introduce new classes of orthogonal polynomials, related to Laguerre polynomials. These polynomials are particularly well suited for describing the so-called flatenned beams in laser theory.
An elementary calculus method for evaluating ?
NASA Astrophysics Data System (ADS)
Lee, Tuo Yeong; Xiong, Yuxuan
2014-08-01
We use freshman calculus to prove that
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.
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
Denoising Medical Images using Calculus of Variations
Kohan, Mahdi Nakhaie; Behnam, Hamid
2011-01-01
We propose a method for medical image denoising using calculus of variations and local variance estimation by shaped windows. This method reduces any additive noise and preserves small patterns and edges of images. A pyramid structure-texture decomposition of images is used to separate noise and texture components based on local variance measures. The experimental results show that the proposed method has visual improvement as well as a better SNR, RMSE and PSNR than common medical image denoising methods. Experimental results in denoising a sample Magnetic Resonance image show that SNR, PSNR and RMSE have been improved by 19, 9 and 21 percents respectively. PMID:22606674
Calculus detection technologies: where do we stand now?
Archana, V
2014-01-01
Epidemiological studies have implicated dental calculus as an ideal substrate for subgingival microbial colonization. Therefore, the main objective of periodontal therapy is to eliminate the microbial biofilm along with the calculus deposits from the root surface by root surface debridement. Over the past years, a large number of clinical and laboratory studies have been conducted to evaluate the efficacy of calculus removal by various methods. None of these conventional methods or devices was effective in completely eliminating all the calculus from the diseased root surfaces. In this context, a number of newer technologies have been developed to identify and selectively remove the dental calculus. Regarding this fact, the present article highlights a critical review of these devices based on published clinical and experimental data. PMID:25870667
Initialization, conceptualization, and application in the generalized (fractional) calculus.
Lorenzo, Carl F; Hartley, Tom T
2007-01-01
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. PMID:19583533
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…
Cochrane, Justin; Bland, Lacie; Noble, Mary
2015-01-01
Context. Clostridium perfringens septicemia is often associated with translocation from the gastrointestinal or gastrourinary tract and occurs in patients who have malignancy or are immunocompromised. Clostridium perfringens septicemia is usually fatal without early identification, source control, and antibiotics. Case. We present a case of a 65-year-old female with Clostridium perfringens septicemia secondary to emphysematous cholecystitis, with progression to hepatic abscesses. Conclusion. Septicemia secondary to Clostridium perfringens is generally fatal if not detected early. Source control with surgery or percutaneous drainage and early antibiotic therapy is imperative. Hyperbaric oxygen therapy may reduce mortality. Clinicians caring for patients with sepsis and intravascular hemolysis must have Clostridium perfringens septicemia on their differential diagnosis with a low threshold for starting antibiotics and pursuing source of infection. PMID:26229537
Kagohara, Luciane Tsukamoto; Schussel, Juliana L; Subbannayya, Tejaswini; Sahasrabuddhe, Nandini; Lebron, Cynthia; Brait, Mariana; Maldonado, Leonel; Valle, Blanca L; Pirini, Francesca; Jahuira, Martha; Lopez, Jaime; Letelier, Pablo; Brebi-Mieville, Priscilla; Ili, Carmen; Pandey, Akhilesh; Chatterjee, Aditi; Sidransky, David; Guerrero-Preston, Rafael
2015-01-01
Aim The aim of the study was to evaluate the use of global and gene-specific DNA methylation changes as potential biomarkers for gallbladder cancer (GBC) in a cohort from Chile. Material & methods DNA methylation was analyzed through an ELISA-based technique and quantitative methylation-specific PCR. Results Global DNA Methylation Index (p = 0.02) and promoter methylation of SSBP2 (p = 0.01) and ESR1 (p = 0.05) were significantly different in GBC when compared with cholecystitis. Receiver curve operator analysis revealed promoter methylation of APC, CDKN2A, ESR1, PGP9.5 and SSBP2, together with the Global DNA Methylation Index, had 71% sensitivity, 95% specificity, a 0.97 area under the curve and a positive predictive value of 90%. Conclusion Global and gene-specific DNA methylation may be useful biomarkers for GBC clinical assessment. PMID:25066711
Calculus and analytic geometry. Second edition
Mizrahi, A.; Sullivan, M.
1986-01-01
This book presents the details of calculus and analytic geometry. The topics covered are: Introduction. Real Numbers. Graphing. The Straight Line. Functions and Their Graphs. Operations on Functions; Types of Functions. Composite Functions. Inverse Functions. Limits from an Intuitive Point of View. Algebraic Techniques for Finding Limits. One-Sided Limits. Continuous Functions. Limit Theorems (If Time Permits). Historical Perspectives. The Derivative. Average Rate of Change. Instantaneous Rate of Change; the Derivative. Two Interpretations of the Derivative Formulas for Finding Derivatives. Formulas for Finding Derivatives (Continued). Higher-Order Derivatives. Derivatives of Trigonometric Functions. The Chain Rule. Implicit Differentiation. Derivative of an Inverse Function; Rational Exponents. Newton's Method of Solving Equations. Functions that are not Differentiable at c., Applications of the Derivative. Related Rates. Differentials. Maxima and Minima. Rolle's Theorem; Mean Value Theorem. Increasing and Decreasing Functions; First Derivative Test. Concavity; Second Derivative Test. Limits at Infinity; Infinite Limits; Asymptotes. Applied Extrema Problems. Antiderivatives. Application to Economics (If Time Permits), The Definite Integral. Area. Evaluation of Area. The Definite Integral. The Fundamental Theorem of Calculus. Properties of the Definite Integral. The Indefinite Integral; Method of Substitution. Historical Perspectives. Applications of the Integral. Area. Volume of a Solid of Revolution: Disk Method. Volume of a Solid of Revolution: Shell Method. Volume by Slicing. Arc Length. Work. Liquid Pressure and Force. Average Value of a Function.
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
Discrete Quantum Gravity in the Regge Calculus Formalism
Khatsymovsky, V.M.
2005-09-01
We discuss an approach to the discrete quantum gravity in the Regge calculus formalism that was developed in a number of our papers. The Regge calculus is general relativity for a subclass of general Riemannian manifolds called piecewise flat manifolds. The Regge calculus deals with a discrete set of variables, triangulation lengths, and contains continuous general relativity as a special limiting case where the lengths tend to zero. In our approach, the quantum length expectations are nonzero and of the order of the Plank scale, 10{sup -33} cm, implying a discrete spacetime structure on these scales.
Constraints from jet calculus on quark recombination
Jones, L.M.; Lassila, K.E.; Sukhatme, U.; Willen, D.
1981-02-01
Within the quantum-chromodynamic jet-calculus formalism, we deduce an equation describing recombination of quarks and antiquarks into mesons within a quark or gluon jet. This equation relates the recombination function R(x/sub 1/,x/sub 2/,x) used in current literature to the fragmentation function for producing that same meson out of the parton initiating the jet. We submit currently used recombination functions to our consistency test, taking as input mainly the u-quark fragmentation ''data'' into ..pi../sup +/ mesons. The qq-bar..--> pi.. recombination functions popular in the literature are consistent with measured fragmentation functions, but they must be supplemented by other contributions to provide the full D..pi../sup +//sub u/. We also discuss the Q/sup 2/ dependence of the resulting fragmentation functions.
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. __________________________________________________
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.
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.
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
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)
Modified jet calculus of Bassetto, Ciafaloni and Marchesini
Jones, L.M.; Lassila, K.E.
1982-06-01
We reexamine some of the equations derived by Bassetto, Ciafaloni, and Marchesini for the various functions in their extended jet calculus, and derive an alternative set of equations based on the same concepts.
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.
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.
A Discrete Approach to Computer-Oriented Calculus.
ERIC Educational Resources Information Center
Gordon, Sheldon P.
1979-01-01
Some of the implications and advantages of an instructional approach using results from the calculus of finite differences and finite sums, both for motivation and as tools leading to applications, are discussed. (MP)
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.
Candida dubliniensis encrustation of an obstructing upper renal tract calculus
O'Kane, Dermot; Kiosoglous, Anthony; Jones, Kay
2013-01-01
We present the case of a 53-year-old man, with a history of alcohol abuse, requiring intensive care unit admission, with an obstructing right upper renal calculus and Klebsiella pneumoniae urosepsis. Ureteroscopic treatment of this obstruction displayed a small calculus within the renal pelvis completely encapsulated within a fungal bezoar. Laboratory analysis of the fungal mass found it to be Candida dubliniensis. PMID:23975908
Three-plus-one formulation of Regge calculus
Piran, T.; Williams, R.M.
1986-03-15
Following the work of Lund and Regge for homogeneous spaces, we construct the action for Regge calculus in its three-plus-one form for general space-times. This is achieved in two ways: a first-order formalism and a second-order formalism. We describe the Regge-calculus analogue of solving the initial-value equations using conformal transformations. The second-order formalism is used to study the time development of two simple model universes.
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
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.
Hermeneutics of differential calculus in eighteenth-century northern Germany.
Blanco, Mónica
2008-01-01
This paper applies comparative textbook analysis to studying the mathematical development of differential calculus in northern German states during the eighteenth century. It begins with describing how the four textbooks analyzed presented the foundations of calculus and continues with assessing the influence each of these foundational approaches exerted on the resolution of problems, such as the determination of tangents and extreme values, and even on the choice of coordinates for both algebraic and transcendental curves. PMID:19244874
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.
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
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.
Water content contribution in calculus phantom ablation during Q-switched Tm:YAG laser lithotripsy.
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. PMID:26662067
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
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.
Tsimmerman, Ia S; Shchekotov, V V; Tret'iakova, Iu I; Solov'eva, I V; Tsimmerman, I Ia
2008-01-01
The results of prospective study of the stage of vascular endothelium and neutrophil phagocytic activity (NPA) in patients with chronic calculous cholecystitis (CCC) in perioperative period, who had anxious depressive disturbances (ADD), were represented. 61 patients were examined 3 weeks before cholecystectomy (CE). Intensity of anxiety and depression, vegetative tonus, desquamated endotheliocytes (DE) in blood and phagocytosis degree were assessed. The patients were randomized into 2 groups. The patients of 1st group (n = 30) received antidepressant coaxil during perioperative period (6 weeks); 2nd group (the control) was composed of 31 patients and was treated without coaxil. In 1st group significant decrease in AAD and symptoms of vegetative dystonia (VD) in 3 weeks after CE was detected; number of DE in blood was considerable reduces, and NPA was significantly increased vs. control group. Correlation analysis made possible to show that the higher AAD and VD intensity, the more frequently epithelium desquamation was detected, and percentage of phagocytes was reduced at increase in DE in blood. Use of balanced antidepressant coaxil in perioperative period in CCC patients makes possible to reduce occurrence and intensity of AAD and VD after operation, improve vascular endothelium state, increase NPA and adaptive reserves of organism. PMID:18720713
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. PMID:20821262
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.
Durmaz, Tahir; Keles, Telat; Aslan, Abdullah Nabi; Erdogan, Kemal Esref; Sari, Cenk; Bilen, Emine; Akcay, Murat; Bozkurt, Engin
2014-01-01
Transcatheter aortic valve replacement can be an effective, reliable treatment for severe aortic stenosis in surgically high-risk or ineligible patients. However, various sequelae like coronary artery obstruction can occur, not only in the long term, but also immediately after the procedure. We present the case of a 78-year-old woman whose left main coronary artery became obstructed with calculus 2 hours after the transfemoral implantation of an Edwards Sapien XT aortic valve. Despite percutaneous coronary intervention in that artery, the patient died. This case reminds us that early recognition of acute coronary obstruction and prompt intervention are crucial in patients with aortic stenosis who have undergone transcatheter aortic valve replacement. PMID:25120396
Two-parameter asymptotics in magnetic Weyl calculus
NASA Astrophysics Data System (ADS)
Lein, Max
2010-12-01
This paper is concerned with small parameter asymptotics of magnetic quantum systems. In addition to a semiclassical parameter ɛ, the case of small coupling λ to the magnetic vector potential naturally occurs in this context. Magnetic Weyl calculus is adapted to incorporate both parameters, at least one of which needs to be small. Of particular interest is the expansion of the Weyl product which can be used to expand the product of operators in a small parameter, a technique which is prominent to obtain perturbation expansions. Three asymptotic expansions for the magnetic Weyl product of two Hörmander class symbols are proven as (i) ɛ ≪ 1 and λ ≪ 1, (ii) ɛ ≪ 1 and λ = 1, as well as (iii) ɛ = 1 and λ ≪ 1. Expansions (i) and (iii) are impossible to obtain with ordinary Weyl calculus. Furthermore, I relate the results derived by ordinary Weyl calculus with those obtained with magnetic Weyl calculus by one- and two-parameter expansions. To show the power and versatility of magnetic Weyl calculus, I derive the semirelativistic Pauli equation as a scaling limit from the Dirac equation up to errors of fourth order in 1/c.
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.
Backpropagation and ordered derivatives in the time scales calculus.
Seiffertt, John; Wunsch, Donald C
2010-08-01
Backpropagation is the most widely used neural network learning technique. It is based on the mathematical notion of an ordered derivative. In this paper, we present a formulation of ordered derivatives and the backpropagation training algorithm using the important emerging area of mathematics known as the time scales calculus. This calculus, with its potential for application to a wide variety of inter-disciplinary problems, is becoming a key area of mathematics. It is capable of unifying continuous and discrete analysis within one coherent theoretical framework. Using this calculus, we present here a generalization of backpropagation which is appropriate for cases beyond the specifically continuous or discrete. We develop a new multivariate chain rule of this calculus, define ordered derivatives on time scales, prove a key theorem about them, and derive the backpropagation weight update equations for a feedforward multilayer neural network architecture. By drawing together the time scales calculus and the area of neural network learning, we present the first connection of two major fields of research. PMID:20615808
Two-parameter asymptotics in magnetic Weyl calculus
Lein, Max
2010-12-15
This paper is concerned with small parameter asymptotics of magnetic quantum systems. In addition to a semiclassical parameter {epsilon}, the case of small coupling {lambda} to the magnetic vector potential naturally occurs in this context. Magnetic Weyl calculus is adapted to incorporate both parameters, at least one of which needs to be small. Of particular interest is the expansion of the Weyl product which can be used to expand the product of operators in a small parameter, a technique which is prominent to obtain perturbation expansions. Three asymptotic expansions for the magnetic Weyl product of two Hoermander class symbols are proven as (i) {epsilon}<< 1 and {lambda}<< 1, (ii) {epsilon}<< 1 and {lambda}= 1, as well as (iii) {epsilon}= 1 and {lambda}<< 1. Expansions (i) and (iii) are impossible to obtain with ordinary Weyl calculus. Furthermore, I relate the results derived by ordinary Weyl calculus with those obtained with magnetic Weyl calculus by one- and two-parameter expansions. To show the power and versatility of magnetic Weyl calculus, I derive the semirelativistic Pauli equation as a scaling limit from the Dirac equation up to errors of fourth order in 1/c.
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.
Verbeeck, N; Hartmann, K M; Weber, J; Martin, M
2011-01-01
Usually considered as a life-threatening disease, emphysematous pancreatitis requires early diagnosis and aggressive multidisciplinary treatment including the Departments of Gastroenterology, Intensive Care Medicine, Interventional Radiology and even Surgery. The prognosis for emphysematous cholecystitis is also quite poor. It requires surgery even if a percutaneous cholecystostomy can contribute to a temporary stabilization of the patient. Computed tomography is the imaging modality of choice to detect emphysematous pancreatitis and gas-forming cholecystitis. It enables their grading and helps identify their complications. Moreover, it proves essential in the follow-up of the lesions. PMID:21699038
Enterococcus hirae Bacteremia Associated with Acute Pancreatitis and Septic Shock
Dicpinigaitis, Peter V.; De Aguirre, Manuel; Divito, Joseph
2015-01-01
Infection with Enterococcus hirae has rarely been reported in humans but is not uncommon in mammals and birds. We describe a case of Enterococcus hirae bacteremia associated with acute pancreatitis, acute cholecystitis, and septic shock responsive to antibiotic therapy and supportive critical care management. Unique aspects of this case of Enterococcus hirae bacteremia are its association with acute pancreatitis and its geographical origin. To our knowledge, this is the first report of Enterococcus hirae bacteremia occurring in a patient in the United States. Although human infection with this organism appears to be rare, all cases reported to date describe bacteremia associated with severe and life-threatening illness. Thus, physicians need to be cognizant of the clinical significance of this heretofore little recognized pathogen. PMID:26417465
Pattern classification using fuzzy relational calculus.
Ray, K S; Dinda, T K
2003-01-01
Our aim is to design a pattern classifier using fuzzy relational calculus (FRC) which was initially proposed by Pedrycz (1990). In the course of doing so, we first consider a particular interpretation of the multidimensional fuzzy implication (MFI) to represent our knowledge about the training data set. Subsequently, we introduce the notion of a fuzzy pattern vector to represent a population of training patterns in the pattern space and to denote the antecedent part of the said particular interpretation of the MFI. We introduce a new approach to the computation of the derivative of the fuzzy max-function and min-function using the concept of a generalized function. During the construction of the classifier based on FRC, we use fuzzy linguistic statements (or fuzzy membership function to represent the linguistic statement) to represent the values of features (e.g., feature F/sub 1/ is small and F/sub 2/ is big) for a population of patterns. Note that the construction of the classifier essentially depends on the estimate of a fuzzy relation /spl Rfr/ between the input (fuzzy set) and output (fuzzy set) of the classifier. Once the classifier is constructed, the nonfuzzy features of a pattern can be classified. At the time of classification of the nonfuzzy features of the testpatterns, we use the concept of fuzzy masking to fuzzify the nonfuzzy feature values of the testpatterns. The performance of the proposed scheme is tested on synthetic data. Finally, we use the proposed scheme for the vowel classification problem of an Indian language. PMID:18238152
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.
Quantum Stratonovich calculus and the quantum Wong-Zakai theorem
Gough, John
2006-11-15
We extend the Ito(bar sign)-to-Stratonovich analysis or quantum stochastic differential equations, introduced by Gardiner and Collett for emission (creation), absorption (annihilation) processes, to include scattering (conservation) processes. Working within the framework of quantum stochastic calculus, we define Stratonovich calculus as an algebraic modification of the Ito(bar sign) one and give conditions for the existence of Stratonovich time-ordered exponentials. We show that conversion formula for the coefficients has a striking resemblance to Green's function formulas from standard perturbation theory. We show that the calculus conveniently describes the Markov limit of regular open quantum dynamical systems in much the same way as in the Wong-Zakai approximation theorems of classical stochastic analysis. We extend previous limit results to multiple-dimensions with a proof that makes use of diagrammatic conventions.
Analysis-based arguments for abstract data type calculus.
Rouson, Damian W. I.
2008-10-01
Increasing demands on the complexity of scientific models coupled with increasing demands for their scalability are placing programming models on equal footing with the numerical methods they implement in terms of significance. A recurring theme across several major scientific software development projects involves defining abstract data types (ADTs) that closely mimic mathematical abstractions such as scalar, vector, and tensor fields. In languages that support user-defined operators and/or overloading of intrinsic operators, coupling ADTs with a set of algebraic and/or integro-differential operators results in an ADT calculus. This talk will analyze ADT calculus using three tool sets: object-oriented design metrics, computational complexity theory, and information theory. It will be demonstrated that ADT calculus leads to highly cohesive, loosely coupled abstractions with code-size-invariant data dependencies and minimal information entropy. The talk will also discuss how these results relate to software flexibility and robustness.
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
The Very Lazy λ-Calculus and the STEC Machine
NASA Astrophysics Data System (ADS)
Rochel, Jan
Current implementations of non-strict functional languages rely on call-by-name reduction to implement the λ-calculus. An interesting alternative is head occurrence reduction, a reduction strategy specifically designed for the implementation of non-strict, purely functional languages. This work introduces the very lazy λ -calculus, which allows a systematic description of this approach. It is not based on regular β-reduction but a generalised rewriting rule called γ-reduction that requires fewer reductions to obtain useful results from a term. It therefore promises more efficient program execution than conventional execution models. To demonstrate the applicability of the approach, an adaptation of the Pointer Abstract Machine (PAM) is specified that implements the very lazy λ-calculus and constitutes a foundation for a new class of efficient functional language implementations.
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…
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…
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…
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…
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,…
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.
Acute abdominal complications following hip surgery.
Deleanu, B; Prejbeanu, R; Vermesan, D; Haragus, H; Icma, I; Predescu, V
2014-01-01
Hip surgeries are some of the most common and successful orthopedic procedures. Although rarely, abdominal complications do occur and are associated with unfavorable outcomes.We aimed to identify and describe the severe abdominal complications that appear in patients under-going elective or traumatic hip surgery. A four year retrospective electronic database research identified 408 elective primary hip replacements,51 hip revisions and 1040 intra and extracapsular proximal femur fractures. Out of these, three males and 4 females between 64 - 84 years old were identified to have developed acute abdominal complications: perforated acute ulcer (3),acute cholecystitis (2), volvulus (1), toxic megacolon with peritonitis (1) and acute colonic pseudo-obstruction (1).Complications debuted 3 - 10 days after index orthopedic surgery. Acute perioperative abdominal complications are rarely encountered during orthopedic surgery. When these do occur, they do so almost exclusively in patients with hippathology, comorbidities and most often lead to life threatening situations. We thus emphasize the need for early identification and appropriate management by both orthopedic and general surgery doctors in order to improve patient safety. PMID:24742414
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.
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.
NASA Astrophysics Data System (ADS)
Steele, Diana F.; Levin, Amy K.; Blecksmith, Richard; Shahverdian, Jill
2005-10-01
The purpose of this study was to investigate the ways in which a multi-layered women's calculus course influenced the participants' learning of mathematics. This study, conducted in a state university in the Midwestern region of the United States, revealed not only that women in this particular section of calculus were likely to select careers that involved mathematics, but that the focus on peer support, psychosocial issues such as self-confidence, and pedagogy helped the young women overcome gender barriers, as well as barriers of class, poverty, and race. In this article we provide some of the relevant quantitative statistics and relate the stories of two particular women through excerpts from interviews, student artefacts, and participant observation data. We selected these young women because they faced multiple barriers to success in Calculus I and might not have completed the course or taken additional mathematics courses without the support structures that were fundamental to the course.
Mamedov, R A; Mamedov, K M; Iusubov, M O; Gasymov, É M; Dadashev, A I; Agaeva, N I
2012-12-01
Comparative analysis of the treatment results in 120 patients, suffering destructive form of biliary calculous disease (DFBCD) was performed. Depending on operative access and postoperative conservative therapy applied the patients were divided into two groups. In the main group in 58 patients, suffering DFBCD, a minilaparotomy access was applied, using "mini-assistant" apparatus named after M. I. Prudkov and postoperatively--low-intensive laser irradiation and regional lymphotropic therapy. In a comparison group in 62 patients various laparotomic accesses were used, and a standard postoperative therapy was performed. Normalization of clinical, laboratory and immune indices in the main group were observed in twice earlier than in a control one, and economical together with moral-psychological effect was measured in reduction of the medicines quantity used as well as the patients stationary stay. PMID:23610812
2012-01-01
Cystine stones, the main component of which is cystine, are very common urinary calculi, but are rare in the gall bladder. In animals, there has been only one report of cystine gallstones in tree shrews, and to our knowledge, this is the first report of cystine gallstones in humans. PMID:22472465
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.
Chen, Po-Lin; Lee, Hsin-Chun; Shan, Yan-Shen; Ko, Nai-Ying; Lee, Nan-Yao; Chang, Chia-Ming; Wu, Chi-Jung; Lee, Ching-Chi; Ko, Wen-Chien
2009-07-01
The clinical presentation of Mycobacterium tuberculosis infection varies in patients with AIDS. We report a case of disseminated tuberculosis in an AIDS patient. The initial manifestation was masked by fluoroquinolone monotherapy, and subsequently complicated by acalculous cholecystitis and immune restoration syndrome after antiretroviral therapy. PMID:19008140
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…
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)
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…
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…
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…
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.…
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…
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…
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.
Dental Calculus Is Associated with Death from Heart Infarction
Söder, Birgitta; Meurman, Jukka H.; Söder, Per-Östen
2014-01-01
Objectives. We studied whether the amount of dental calculus is associated with death from heart infarction in the dental infection—atherosclerosis paradigm. Materials. Participants were 1676 healthy young Swedes followed up from 1985 to 2011. At the beginning of the study all subjects underwent oral clinical examination including dental calculus registration scored with calculus index (CI). Outcome measure was cause of death classified according to WHO International Classification of Diseases. Unpaired t-test, Chi-square tests, and multiple logistic regressions were used. Results. Of the 1676 participants, 2.8% had died during follow-up. Women died at a mean age of 61.5 years and men at 61.7 years. The difference in the CI index score between the survivors versus deceased patients was significant by the year 2009 (P < 0.01). In multiple regression analysis of the relationship between death from heart infarction as a dependent variable and CI as independent variable with controlling for age, gender, dental visits, dental plaque, periodontal pockets, education, income, socioeconomic status, and pack-years of smoking, CI score appeared to be associated with 2.3 times the odds ratio for cardiac death. Conclusions. The results confirmed our study hypothesis by showing that dental calculus indeed associated statistically with cardiac death due to infarction. PMID:24511535
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…
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…
An Investigation of Calculus Learning Using Factorial Modeling.
ERIC Educational Resources Information Center
Dick, Thomas P.; Balomenos, Richard H.
Structural covariance models that would explain the correlations observed among mathematics achievement and participation measures and related cognitive and affective variables were developed. A sample of college calculus students (N=268; 124 females and 144 males) was administered a battery of cognitive tests (including measures of spatial-visual…
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…
Helping Mathematics Students Survive the Post-Calculus Transition
ERIC Educational Resources Information Center
Cullinane, Michael J.
2011-01-01
Many mathematics students have difficulty making the transition from procedurally oriented courses such as calculus to the more conceptually oriented courses in which they subsequently enroll. What are some of the key "stumbling blocks" for students as they attempt to make this transition? How do differences in faculty expectations for students…
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…
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…
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…
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…
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…
Factors Affecting Mathematically Talented Females' Enrollment in High School Calculus.
ERIC Educational Resources Information Center
Reynolds, Nancy G.; Conaway, Betty J.
2003-01-01
A study involving 1,244 eighth-grade females who were high achievers in algebra, investigated characteristics of those who ended up taking calculus (n=474). Results showed differences between the two groups in mother's education, socioeconomic status, and educational aspirations. However, when applying all factors together, they did not predict…
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…
The Vector Calculus Gap: Mathematics (Does Not Equal) Physics.
ERIC Educational Resources Information Center
Dray, Tevian; Manogue, Corinne A.
1999-01-01
Discusses some of the differences between the ways mathematicians and physicists view vector calculus and the gap between the way this material is traditionally taught by mathematicians and the way physicists use it. Suggests some ways to narrow the gap. (Author/ASK)
Regge calculus: applications to classical and quantum gravity
Lewis, S.M.
1983-01-01
Regge calculus is a simplicial approximation to general relativity which preserves many topological and geometrical properties of the exact theory. After discussing the foundations of this technique and deriving some basic identities, specific solutions to Regge calculus are analyzed. In particular, the flat Friedmann-Robertson-Walker (FRW) model is shown. This particular model is used in the discussion of the initial value problem for Regge calculus. An Arnowitt-Deser-Misner type of 3 + 1 decomposition is possible only under very special circumstances; solutions with a non-spatially constant lapse can not generally be decomposed. The flat FRW model is also used to compute the accuracy of this approximation method developed by Regge. A three-dimensional toy model of quantum gravity is discussed that was originally formulated by Ponzano and Regge. A more thorough calculation is performed that takes into account additional terms. The renormalization properties of this model are shown. Finally, speculations are made on the interaction of the geometry, topology and quantum effects using Regge calculus, which, because of its simplicial nature, makes these effects more amenable to calculation and intuition.
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…
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)
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.
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.
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.
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.
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…
Calculus-Based Physics Exploratory Study. Summary Report.
ERIC Educational Resources Information Center
Illinois Mathematics and Science Academy, Aurora.
Generally, the levels of participation and achievement of females in science do not match those of male learners. This report describes the formation and study of an all-female section of calculus-based physics for the purpose of providing an environment that might enhance the participation and achievement of females in the physical sciences so…
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…
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…
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…
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)
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;…
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.
Fractional calculus in hydrologic modeling: A numerical perspective
Benson, David A.; Meerschaert, Mark M.; Revielle, Jordan
2013-01-01
Fractional derivatives can be viewed either as handy extensions 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 Lévy 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 Lévy) 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. PMID:23524449
Fractional calculus in hydrologic modeling: A numerical perspective.
Benson, David A; Meerschaert, Mark M; Revielle, Jordan
2013-01-01
Fractional derivatives can be viewed either as handy extensions 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 Lévy 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 Lévy) 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. PMID:23524449
Separation of noncommutative differential calculus on quantum Minkowski space
Bachmaier, Fabian; Blohmann, Christian
2006-02-15
Noncommutative differential calculus on quantum Minkowski space is not separated with respect to the standard generators, in the sense that partial derivatives of functions of a single generator can depend on all other generators. It is shown that this problem can be overcome by a separation of variables. We study the action of the universal L-matrix, appearing in the coproduct of partial derivatives, on generators. Powers of the resulting quantum Minkowski algebra valued matrices are calculated. This leads to a nonlinear coordinate transformation which essentially separates the calculus. A compact formula for general derivatives is obtained in form of a chain rule with partial Jackson derivatives. It is applied to the massive quantum Klein-Gordon equation by reducing it to an ordinary q-difference equation. The rest state solution can be expressed in terms of a product of q-exponential functions in the separated variables.
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.
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.
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.
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.
Fractional Calculus of the Generalized Mittag-Leffler Type Function
Kumar, Sunil
2014-01-01
We introduce and study a new function called R-function, which is an extension of the generalized Mittag-Leffler function. We derive the relations that exist between the R-function and Saigo fractional calculus operators. Some results derived by Samko et al. (1993), Kilbas (2005), Kilbas and Saigo (1995), and Sharma and Jain (2009) are special cases of the main results derived in this paper.
Jet calculus beyond leading order for the gluon sector
Gunion, J.F.; Kalinowski, J.
1984-04-01
We report results for the order-C/sub A/ /sup 2/..cap alpha../sub s/ /sup 2/ jet calculus three-, two-, and one-gluon distributions of the pure gluon singlet channel. Included is an independent calculation of the C/sub A/ /sup 2/ part of the gluon..-->..gluon inclusive distribution which has been a subject of controversy for several years. We confirm the results of Furmanski and Petronzio for scheme-independent observables.
Multiple multiresolution representation of functions and calculus for fast computation
Fann, George I; Harrison, Robert J; Hill, Judith C; Jia, Jun; Galindo, Diego A
2010-01-01
We describe the mathematical representations, data structure and the implementation of the numerical calculus of functions in the software environment multiresolution analysis environment for scientific simulations, MADNESS. In MADNESS, each smooth function is represented using an adaptive pseudo-spectral expansion using the multiwavelet basis to a arbitrary but finite precision. This is an extension of the capabilities of most of the existing net, mesh and spectral based methods where the discretization is based on a single adaptive mesh, or expansions.
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.
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.
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.
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).
Barbakow, F; Imfeld, T
1989-01-01
Several brands of anticalculus dentifrices and mouthrinses claim to reduce the formation of supragingival calculus. These products contain soluble pyrophosphates (with or without Gantrez), zinc citrate trihydrate or zinc chloride which reduce the amount of supragingival but not subgingival calculus after a scaling. Most of the clinical anticalculus trials ran for 3 or 6 months and the calculus reductions were assessed using the Volpe-Manhold Index. This index assesses the coronal extension of supragingival calculus. Calculus reductions varied from 9% to 50% but no plaque scores were quantitated. However, the ADA has stipulated that dentifrices claiming anticalculus effects must clearly state that the products have not therapeutic effect on periodontal diseases. Some of the placebo dentifrices used in the clinical trials also reduced the calculus scores although they are not as yet advertised as anticalculus dentifrices. PMID:2678454
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.
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
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Uncomplicated urinary tract infection; UTI - acute; Acute bladder infection; Acute bacterial cystitis ... control. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...
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
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…
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…
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…
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.
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…
Analyzing Conceptual Gains in Introductory Calculus with Interactively-Engaged Teaching Styles
ERIC Educational Resources Information Center
Thomas, Matthew
2013-01-01
This dissertation examines the relationship between an instructional style called Interactive-Engagement (IE) and gains on a measure of conceptual knowledge called the Calculus Concept Inventory (CCI). The data comes from two semesters of introductory calculus courses (Fall 2010 and Spring 2011), consisting of a total of 482 students from the…