Two-year pilot study of newborn screening for congenital adrenal hyperplasia in New South Wales compared with nationwide case surveillance in Australia.

PubMed

Gleeson, Helena K; Wiley, Veronica; Wilcken, Bridget; Elliott, Elizabeth; Cowell, Christopher; Thonsett, Michael; Byrne, Geoffrey; Ambler, Geoffrey

2008-10-01

To assess the benefits and practicalities of setting up a newborn screening (NBS) program in Australia for congenital adrenal hyperplasia (CAH) through a 2 year pilot screening in ACT/NSW and comparing with case surveillance in other states. The pilot newborn screening occurred between 1/10/95 and 30/9/97 in NSW/ACT. Concurrently, case reporting for all new CAH cases occurred through the Australian Paediatric Surveillance Unit (APSU) across Australia. Details of clinical presentation, re-sampling and laboratory performance were assessed. 185,854 newborn infants were screened for CAH in NSW/ACT. Concurrently, 30 cases of CAH were reported to APSU, twelve of which were from NSW/ACT. CAH incidence was 1 in 15 488 (screened population) vs 1 in 18,034 births (unscreened) (difference not significant). Median age of initial notification was day 8 with confirmed diagnosis at 13(5-23) days in the screened population vs 16(7-37) days in the unscreened population (not significant). Of the 5 clinically unsuspected males in the screened population, one had mild salt-wasting by the time of notification, compared with salt-wasting crisis in all 6 males from the unscreened population. 96% of results were reported by day 10. Resampling was requested in 637 (0.4%) and median re-sampling delay was 11(0-28) days with higher resample rates in males (p < 0.0001). The within-laboratory cost per case of clinically unsuspected cases was A$42 717. There seems good justification for NBS for CAH based on clear prevention of salt-wasting crises and their potential long-term consequences. Also, prospects exist for enhancing screening performance.

Review of systems, physical examination, and routine tests for case-finding in ambulatory patients.

PubMed

Boland, B J; Wollan, P C; Silverstein, M D

1995-04-01

The screening value of the comprehensive review of systems and the complete physical examination in detecting unsuspected diseases for which therapeutic interventions are initiated has not been formally studied in ambulatory patients. The medical records of 100 randomly selected adult patients who had an ambulatory general medical evaluation at the Mayo Clinic in 1990-1991 were surveyed to compare review of systems and physical examination with routine laboratory tests, chest radiography, and electrocardiography as case-finding maneuvers. The main outcome measure was the therapeutic yield of each case-finding maneuver, defined as the proportion of maneuvers leading to a new therapy for a new clinically important diagnosis. The utilization rate of routine tests in the 100 patients (mean age: 59 +/- 16 years; 58% women) was high, ranging from 77 to 98%. Overall, the case-finding maneuvers led to 36 unsuspected clinically important diagnoses and resulted in 25 new therapeutic interventions. Higher therapeutic yield was observed for review of systems (7%), physical examination (5%), and lipid screening (9.2%) than for chemistry group (2.2%), complete blood count (1.8%), thyroid tests (1.5%), urinalysis (1.1%), electrocardiography (0%), or chest radiography (0%). The number of therapeutic interventions was not associated with patient's age (P = 0.55), sex (P = 0.88), comorbidity (P = 0.30) or with the time interval since the last general medical evaluation (P = 0.12). Based on therapeutic yield, these data suggest that review of systems and physical examination are valuable case-finding maneuvers in the periodic medical evaluation of ambulatory patients.

Degenerated uterine fibroid mimicking hydrometra: fallacy in CT

PubMed Central

Tok, CH; Bux, SI; Mohamed, SI; Lim, BK

2006-01-01

Fibroids are the commonest uterine neoplasms, occurring in 20% - 30% of women of reproductive age. In women who have pelvic masses of unknown cause, unusual manifestations of fibroids such as necrosis or degeneration may simulate a carcinoma or hydrometra resulting in problems with image interpretation. We report a case of an unsuspected large degenerated uterine fibroid in a lady mistakenly diagnosed as hydrometra on computed tomography scanning. PMID:21614328

Gonococcal salpingitis in gynaecology--myth or missed?

PubMed Central

Sparks, R A; Davies, A J

1976-01-01

A series of 25 cases of gonococcal salpingitis were seen in a teaching hospital between October, 1972, and March, 1975. These cases formed 29 per cent of all cases of salpingitis excluding post-abortal cases. The majority were investigated at the bedside by taking films and cultures from the cervix and urethra. The films were stained by Gram's method and specimens for culture were streaked on to prewarmed Gonococcal Selective Medium (Oxoid) and the plates were incubated at once in a CO2-enriched atmosphere at 37 degrees C. A group of cases was identified with minimal symptoms and minimal, or absent, signs; in such cases the diagnosis may be unsuspected. Reasons are advanced for the failure of other gynaecological units to recognize gonococcal salpingitis. PMID:819091

Neuropsychological Function in a Case of Dandy-Walker Variant in a 68-Year-Old Veteran.

PubMed

Gross, Patricia L; Kays, Jill L; Shura, Robert D

2016-01-01

Dandy-Walker syndrome (DWS) is a congenital brain malformation that is characterized by partial or complete agenesis of the cerebellar vermis and cystic dilatation of the 4th ventricle that shifts ventrolaterally to displace the cerebellar hemispheres. This case is a 68-year-old male veteran with complaints of new-onset cognitive disorder who was found to have previously unsuspected DWS on head computed tomography. This is one of the first case studies to present complete neuropsychological test results in a veteran with DWS. Despite the level of abnormality on imaging, the veteran functioned well until onset of mild cognitive impairments in late adulthood.

Low sensitivity of implant sonication when screening for infection in revision surgery

PubMed Central

Van Diek, Floor M; Albers, Christiaan G M; Van Hooff, Miranda L; Meis, Jacques F; Goosen, Jon H M

2017-01-01

Background and purpose Prosthetic-joint infection (PJI) is the most serious complication of arthroplasty, and accurate identification of a potentially responsible microorganism is essential for successful antibiotic treatment. We therefore determined the diagnostic accuracy of sonication and compared it with tissue culture as a screening tool in detecting prosthetic joint infection in revision arthroplasty. Patients and methods 252 consecutive revision arthroplasty cases were enrolled. These cases were determined as being suspected or unsuspected of having infection according to standard criteria. Perioperatively, 6 periprosthetic interface tissue biopsies were obtained from each patient and the implants removed were sonicated. The sensitivity and specificity of periprosthetic tissue culture and sonication fluid cultures were determined. Results Preoperatively, 75 revision cases were classified as having PJI (33 early and 42 late) and 177 were unsuspected of having infection. Compared with tissue culture, the sensitivity of the sonication fluid analysis was low: 0.47 (95% CI: 0.35–0.59) for sonication as compared to 0.68 (95% CI: 0.56–0.78) for tissue culture. The specificity of the sonication fluid analysis was higher than that for tissue culture: 0.99 (95% CI: 0.96–1.0) as compared to 0.80 (95% CI: 0.74–0.86). Interpretation Sonication is a highly specific test for diagnosis of PJI. However, due to the low sensitivity, a negative sonication result does not rule out the presence of PJI. Thus, sonication is not of value for screening of microorganisms during revision surgery. PMID:28287012

Detection of deep venous thrombophlebitis by gallium 67 scintigraphy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, J.H.

1981-07-01

Deep venous thrombophlebitis may escape clinical detection. Three cases are reported in which whole-body gallium 67 scintigraphy was used to detect unsuspected deep venous thrombophlebitis related to indwelling catheters in three children who were being evaluated for fevers of unknown origin. Two of these children had septicemia from Candida organisms secondary to these venous lines. Gallium 67 scintigraphy may be useful in the detection of complications of indwelling venous catheters.

Detection of deep venous thrombophlebitis by Gallium 67 scintigraphy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, J.H.

1981-07-01

Deep venous thrombophlebitis may escape clinical detection. Three cases are reported in which whole-body gallium 67 scintigraphy was used to detect unsuspected deep venous thrombophlebitis related to indwelling catheters in three children who were being evaluated for fevers of unknown origin. Two of these children had septicemia from Candida organisms secondary to these venous lines. Gallium 67 scintigraphy may be useful in the detection of complications of indwelling venous catheters.

Unsuspected Clenbuterol Toxicity in a Patient Using Intramuscular Testosterone

PubMed Central

Griswold, Matthew K.; Blohm, Eike; Cross, Roderick; Boyer, Edward W.; Carey, Jennifer L.

2017-01-01

Clenbuterol is a beta-agonist that has been abused by fitness-oriented individuals for muscle growth and weight loss. We report a case of a 46-year-old man who presented tachycardic, hypokalemic, and hyperglycemic after injecting testosterone obtained from Brazil. He developed refractory hypotension and was started on an esmolol infusion for suspected beta-agonist toxicity. Laboratory analysis showed a detectable clenbuterol serum concentration. Analysis of an unopened ampule contained boldenone undecylenate, clenbuterol, and vitamin E. This case illustrates a novel exposure that caused beta-agonist toxicity and was treated successfully with rapid-onset beta blocker. PMID:29849287

Role of fine needle aspiration cytology in diagnosing filarial arm cysts.

PubMed

Tandon, Nishi; Bansal, Cherry; Sharma, Richa; Irfan, Sumaiya

2013-05-17

Filariasis is prevalent in tropical and subtropical areas and is endemic in regions of India. Lymphatic filariasis in India is caused mainly by two species of nematodes: Wuchereria bancrofti and Brugia malayi, which invade the human lymphatic system. We report two cases of superficial cystic lesions of the upper limb revealed on fine needle aspiration (FNA) to be clinically unsuspected filariasis. Despite similar aetiologies, both cases revealed variations in aspirate nature, smear morphology and peripheral blood findings. FNA provides definitive diagnosis and is an important tool for diagnosing soft tissue swellings owing to filariasis.

Recent US Case of Variant Creutzfeldt-Jakob Disease—Global Implications

PubMed Central

Fischer, Michael; Gambetti, Pierluigi; Parker, Alicia; Ram, Aarthi; Soto, Claudio; Concha-Marambio, Luis; Cohen, Yvonne; Belay, Ermias D.; Maddox, Ryan A.; Mead, Simon; Goodman, Clay; Kass, Joseph S.; Schonberger, Lawrence B.; Hussein, Haitham M.

2015-01-01

Variant Creutzfeldt-Jakob disease (vCJD) is a rare, fatal prion disease resulting from transmission to humans of the infectious agent of bovine spongiform encephalopathy. We describe the clinical presentation of a recent case of vCJD in the United States and provide an update on diagnostic testing. The location of this patient’s exposure is less clear than those in the 3 previously reported US cases, but strong evidence indicates that exposure to contaminated beef occurred outside the United States more than a decade before illness onset. This case exemplifies the persistent risk for vCJD acquired in unsuspected geographic locations and highlights the need for continued global surveillance and awareness to prevent further dissemination of vCJD. PMID:25897712

Recent US Case of Variant Creutzfeldt-Jakob Disease-Global Implications.

PubMed

Maheshwari, Atul; Fischer, Michael; Gambetti, Pierluigi; Parker, Alicia; Ram, Aarthi; Soto, Claudio; Concha-Marambio, Luis; Cohen, Yvonne; Belay, Ermias D; Maddox, Ryan A; Mead, Simon; Goodman, Clay; Kass, Joseph S; Schonberger, Lawrence B; Hussein, Haitham M

2015-05-01

Variant Creutzfeldt-Jakob disease (vCJD) is a rare, fatal prion disease resulting from transmission to humans of the infectious agent of bovine spongiform encephalopathy. We describe the clinical presentation of a recent case of vCJD in the United States and provide an update on diagnostic testing. The location of this patient's exposure is less clear than those in the 3 previously reported US cases, but strong evidence indicates that exposure to contaminated beef occurred outside the United States more than a decade before illness onset. This case exemplifies the persistent risk for vCJD acquired in unsuspected geographic locations and highlights the need for continued global surveillance and awareness to prevent further dissemination of vCJD.

Filarial abscess: Aspiration of adult gravid female worm from submandibular region, an unusual presentation.

PubMed

Afrose, Ruquiya; Alam, Mohammad Feroz; Ahmad, Syed Shamshad; Naim, Mohammed

2017-01-01

Microfilaria is a major public health problem in tropical and subtropical countries and is an endemic problem in India. Wuchereria bancrofti is the most common filarial infection. In some cases, microfilariae and adult filarial worm have been incidentally detected in fine-needle aspirates of various lesions; detection of microfilaria from subcutaneous site or from abscess site is even rarer. We here report an unusual case of Bancroftian microfilariasis in a 68-year-old female coming from endemic area presenting with right submandibular abscess. Our aim is to highlight the chances of finding microfilaria and adult worm in cytology of an unsuspected case at an unusual site.

Filarial abscess: Aspiration of adult gravid female worm from submandibular region, an unusual presentation

PubMed Central

Afrose, Ruquiya; Alam, Mohammad Feroz; Ahmad, Syed Shamshad; Naim, Mohammed

2017-01-01

Microfilaria is a major public health problem in tropical and subtropical countries and is an endemic problem in India. Wuchereria bancrofti is the most common filarial infection. In some cases, microfilariae and adult filarial worm have been incidentally detected in fine-needle aspirates of various lesions; detection of microfilaria from subcutaneous site or from abscess site is even rarer. We here report an unusual case of Bancroftian microfilariasis in a 68-year-old female coming from endemic area presenting with right submandibular abscess. Our aim is to highlight the chances of finding microfilaria and adult worm in cytology of an unsuspected case at an unusual site. PMID:28182103

High prevalence of clinically unsuspected dengue disease among children in Ribeirao Preto city, Brazil.

PubMed

Poloni, Telma Regina; Dornas, Fabio Pio; Dos Santos, Nilton Nascimento; Soares, Adriana Moreira; Amarilla, Alberto Anastacio; Alfonso, Helda Liz; Trigueiro, Sabrina; Lavrador, Marco Aurélio Sicchiroli; Yamamoto, Aparecida Yulie; Aquino, Victor Hugo

2016-10-01

The aim of this study was to analyze the characteristics of Dengue virus (DENV)-infected children and the accuracy of dengue diagnosis based on clinical presentations. The inclusion criteria were children ≥1-year-old presenting febrile illness with 1-7 days of onset. Children (n = 110) aged 2-15 years were included in this study. DENV infection was confirmed with virological tests using serum, salvia, and/or urine samples. The attending pediatricians classified 56/110 (50.91%) of the children as suspected dengue cases. The DENV infection was confirmed by specific laboratory tests in 52/56 (92.9%) of the suspected dengue cases but also in 44/54 (81.5%) of the unsuspected dengue cases; total of 96/110 (87.27%) confirmed dengue cases. The clinical diagnosis gave an overall sensitivity of 54.2% (52/96) and a specificity of 71.4% (10/14). The positive predictive value of the clinical diagnosis was 92.8% and negative predictive value was 18.5%. After the third day of onset of symptoms, the DENV genome detection rate was similar in serum and saliva samples, suggesting that saliva samples represent an alternative to blood samples for early dengue diagnosis. Vaccination against Yellow fever virus did not influence the antibody response against DENV-1, DENV-2, and DENV-3, which circulated during the study period. Although the signs and symptoms were compatible with dengue, the attending pediatricians did not suspect the disease in several children. Therefore, the inclusion of virological tests for early diagnosis in the protocols for dengue surveillance would help in the implementation of prompt treatment of patients and epidemic containment strategies. J. Med. Virol. 88:1711-1719, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Diagnosis of unsuspected facial fractures on routine head computerized tomographic scans in the unconscious multiply injured patient.

PubMed

Rehm, C G; Ross, S E

1995-05-01

This article assessed the value of routine head computerized axial tomographic (CT) scans for diagnosis of unsuspected facial fractures and its clinical implications in the multiply injured patient who is intubated, unconscious, or sedated at the time of initial assessment and requires a head CT scan to assess for brain injury. At a level I trauma center from June 1, 1992 to June 1, 1993 all intubated blunt trauma patients who required routine CT scan evaluation at initial assessment were studied prospectively. Routine scanning started at the foramen magnum and included the maxilla. Patients who died within the first 24 hours were excluded. The study population included 116 patients (85 male, 21 female) aged 12 to 85 years (mean, 28 years) with injury severity scores ranging from 1 to 50 (mean, 23). The mechanism of injury was: motor vehicle accidents (n = 74), motorcycling (n = 5), pedestrians accidents (n = 13), falls (n = 10), bicycling (n = 5), assaults (n = 8), and boating accident (n = 1). There were 19 suspected facial fractures; 18 required surgical repair. There were 27 unsuspected facial fractures; 13 required surgical care. Three suspected fractures were ruled out. Routine head CT scans to assess for brain injury in the multiply injured patient are also very useful in the diagnosis of unsuspected facial fractures, almost half of which will require surgical intervention.

Lawn mower-related projectile injury.

PubMed

McNamara, William F; Yamout, Sani Z; Escobar, Mauricio A; Glick, Philip L

2009-07-01

Lawn mower injuries are a potentially devastating, yet preventable cause of morbidity and mortality in the pediatric population. The sequelae to these injuries can become even worse if the initial presentation goes unsuspected by medical staff, leading to a delay in treatment. The authors report the case of a lawn mower-related penetrating missile injury, where the extent of injury was not appreciated by the patient until signs and symptoms of a soft-tissue infection developed, prompting the patient to seek medical attention the next day.

New Perspectives in Amblyopia Therapy on Adults: A Critical Role for the Excitatory/Inhibitory Balance

PubMed Central

Baroncelli, Laura; Maffei, Lamberto; Sale, Alessandro

2011-01-01

Amblyopia is the most common form of impairment of visual function affecting one eye, with a prevalence of about 1–5% of the total world population. This pathology is caused by early abnormal visual experience with a functional imbalance between the two eyes owing to anisometropia, strabismus, or congenital cataract, resulting in a dramatic loss of visual acuity in an apparently healthy eye and various other perceptual abnormalities, including deficits in contrast sensitivity and in stereopsis. It is currently accepted that, due to a lack of sufficient plasticity within the brain, amblyopia is untreatable in adulthood. However, recent results obtained both in clinical trials and in animal models have challenged this traditional view, unmasking a previously unsuspected potential for promoting recovery after the end of the critical period for visual cortex plasticity. These studies point toward the intracortical inhibitory transmission as a crucial brake for therapeutic rehabilitation and recovery from amblyopia in the adult brain. PMID:22144947

Gastric adenocarcinoma concurrent with paravertebral plasmacytoma: A case report

PubMed Central

Du, Fengcai; Jiang, Lixin; Zhu, Fangqing; Gong, Zhao Hua; Chen, Jian; Zhang, Liangming

2016-01-01

Here, we report the case of a 77-year-old male patient who was revealed to have an unsuspected case of gastric adenocarcinoma with paravertebral plasmacytoma following biopsy. Plasmacytoma may be classified into two main groups: Multiple myeloma and plasmacytoma without marrow involvement. It comprises isolated plasmacytoma of the bone and extramedullary plasmacytoma. Extramedullary plasmacytoma (EMP) accounts for 3% of all plasmacytomas; however, ~80% are located in the upper respiratory tract and upper gastrointestinal tract. It occurs extremely rarely in paravertebral areas. Case reports of EMP and other types of malignant tumor occurring at the same time have not been identified in searches of the literature. In the present study, we describe the diagnosis and treatment process of a case of gastric adenocarcinoma concurrent with paravertebral plasmacytoma. It may be helpful for early clinical diagnosis and treatment of such cases. PMID:27446469

Reliance of Wolbachia on High Rates of Host Proteolysis Revealed by a Genome-Wide RNAi Screen of Drosophila Cells.

PubMed

White, Pamela M; Serbus, Laura R; Debec, Alain; Codina, Adan; Bray, Walter; Guichet, Antoine; Lokey, R Scott; Sullivan, William

2017-04-01

Wolbachia are gram-negative, obligate, intracellular bacteria carried by a majority of insect species worldwide. Here we use a Wolbachia -infected Drosophila cell line and genome-wide RNA interference (RNAi) screening to identify host factors that influence Wolbachia titer. By screening an RNAi library targeting 15,699 transcribed host genes, we identified 36 candidate genes that dramatically reduced Wolbachia titer and 41 that increased Wolbachia titer. Host gene knockdowns that reduced Wolbachia titer spanned a broad array of biological pathways including genes that influenced mitochondrial function and lipid metabolism. In addition, knockdown of seven genes in the host ubiquitin and proteolysis pathways significantly reduced Wolbachia titer. To test the in vivo relevance of these results, we found that drug and mutant inhibition of proteolysis reduced levels of Wolbachia in the Drosophila oocyte. The presence of Wolbachia in either cell lines or oocytes dramatically alters the distribution and abundance of ubiquitinated proteins. Functional studies revealed that maintenance of Wolbachia titer relies on an intact host Endoplasmic Reticulum (ER)-associated protein degradation pathway (ERAD). Accordingly, electron microscopy studies demonstrated that Wolbachia is intimately associated with the host ER and dramatically alters the morphology of this organelle. Given Wolbachia lack essential amino acid biosynthetic pathways, the reliance of Wolbachia on high rates of host proteolysis via ubiquitination and the ERAD pathways may be a key mechanism for provisioning Wolbachia with amino acids. In addition, the reliance of Wolbachia on the ERAD pathway and disruption of ER morphology suggests a previously unsuspected mechanism for Wolbachia ' s potent ability to prevent RNA virus replication. Copyright © 2017 by the Genetics Society of America.

Postmortem audit in a paediatric cardiology unit.

PubMed Central

Russell, G A; Berry, P J

1989-01-01

Postmortem examinations performed on 76 children with a clinical diagnosis of congenital heart disease were reviewed retrospectively and compared with the findings before death. Both operated and unoperated cases were studied over a three year period. Despite intensive investigation during life, there was a high rate of unsuspected abnormalities at necropsy (80%): 29 cases had undiagnosed additional cardiac anomalies or surgical flaws, which contributed to death in 13 cases. Defects in surgery were uncommon but permitted modification in surgical technique to avoid recurrence. Myocardial necrosis and pulmonary foreign body embolism were common findings, the importance of which is uncertain and requires further study for their prevention. Even in the most thoroughly investigated cases postmortem examination has a high yield of clinically important pathology which is undetected during life. Images PMID:2794078

Flash Mob Science - Increasing Seismic Hazard Awareness and Preparedness in Oregon

NASA Astrophysics Data System (ADS)

Hoffman, J. S.; Lownsbery, D. S.

2015-12-01

Living in a region of imminent threat of a magnitude-9.0 (M­­­w ≈ ­9) earthquake is a daily reality for the millions of people predicted to be directly affected by a full rupture of the Cascadia Subduction Zone (CSZ), a fault line extending for hundreds of miles off the western coast of North America. Many coastal residents and visitors will also be affected by the tsunami caused by the rupture. How can the scientific community effectively communicate with those who are unaware of the threat and unprepared to respond? We are studying the effects of a novel approach to science outreach we have called Flash Mob Science. You have probably seen examples of flash mobs staging dynamic musical and dance routines to unsuspecting audiences. Similarly, Flash Mob Science takes the challenging (and often avoided) topic of earthquake and tsunami awareness and preparedness to unsuspecting audiences. However, Flash Mob Science seeks to move beyond having an audience of observers by engaging others as participants who enact important roles in an unfolding drama. We simulate the effects of seismic and tsunami events (e.g., prolonged surface shaking, falling debris, repeated tsunami surges) and model best practices in response (e.g., "Drop, Cover, Hold On" and moving quickly to high ground). True to the general flash mob model, when the Cascadia event inevitably does occur, it will come suddenly, and everyone affected will unavoidably be involved as actors in a real-life drama of immense scale. We seek to embed the learning of basic understandings and practices for an actual Cascadia event in a very small-scale, memorable, and sometimes even humorous, dramatization. We present here the lessons we have learned in the background, planning, and implementation of Flash Mob Science. We highlight the successes, limitations, and preliminary results evaluating the effectiveness of this outreach in developing learners' understandings and preparedness in an Oregon community affected by the CSZ.

Assessment of unsuspected exposure to drugs of abuse in children from a Mediterranean city by hair testing.

PubMed

Pichini, Simona; Garcia-Algar, Oscar; Alvarez, Airam; Gottardi, Massimo; Marchei, Emilia; Svaizer, Fiorenza; Pellegrini, Manuela; Rotolo, Maria Concetta; Pacifici, Roberta

2014-02-21

Hair testing was used to investigate the prevalence of unsuspected exposure to drugs of abuse in a group of children presenting to an urban paediatric emergency department without suggestive signs or symptoms. Hair samples were obtained from 114 children between 24 months and 10 years of age attending the emergency room of Hospital del Mar in Barcelona, Spain. Hair samples from the accompanying parent were also collected. The samples were analyzed for the presence of opiates, cocaine, amphetamines, and cannabinoids by ultra-performance liquid chromatography-tandem mass spectrometry. Parental sociodemographics and possible drug of abuse history were recorded. Hair samples from twenty-three children (20.1%) were positive for cocaine (concentration range 0.15-3.81 ng/mg hair), those of thirteen children (11.4%) to cannabinoids (D9-THC concentration range 0.05-0.54 ng/mg hair), with four samples positive to codeine (0.1-0.25 ng/mg hair), one positive for 2.09 ng methadone per mg hair and one to 6-MAM (0.42 ng/mg hair) and morphine (0. 15 ng/mg hair) . In 69.5 and 69.2% of the positive cocaine and cannabinoids cases respectively, drugs was also found in the hair of accompanying parent. Parental sociodemographics were not associated with children exposure to drugs of abuse. However, the behavioural patterns with potential harmful effects for the child's health (e.g., tobacco smoking, cannabis, benzodiazepines and/or antidepressants use) were significantly higher in the parents of exposed children. In the light of the obtained results (28% overall children exposure to drugs of abuse) and in agreement with 2009 unsuspected 23% cocaine exposure in pre-school children from the same hospital, we support general hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions.

Clinician assessment for acute chest syndrome in febrile patients with sickle cell disease: is it accurate enough?

PubMed

Morris, C; Vichinsky, E; Styles, L

1999-07-01

To determine whether the use of empiric chest radiography (CXR) is of significant value in detecting clinically unsuspected acute chest syndrome (ACS) in febrile patients with sickle cell disease (SCD). Patients with SCD presenting to the emergency department and hematology clinic with temperature greater than or equal to 38 degrees C were prospectively evaluated using a physician-completed questionnaire. The questionnaire included inquiries into the patient's physical signs and symptoms and the physician's clinical impression for the presence of ACS. The questionnaire was completed before obtaining CXR results in all patients. Seventy-three patients with SCD with 96 febrile events were evaluated over a 1-year period. Twenty-four percent (23/96) of the patients had CXR evidence of ACS. On the basis of the questionnaire data, 61% (14/23) of ACS cases were not clinically suspected by the evaluating physician before obtaining CXR. Comparing the patients with and without ACS revealed that, with the exception of splinting (4/23 [17%] versus 0/73 [0%]), no symptom or physical examination finding helped to identify which patients had ACS. Fifty-seven percent of patients with ACS had completely normal findings on physical examination. The presentation of patients with clinically detected versus clinically unsuspected ACS also did not differ significantly. Length of hospitalization, oxygen use, and need for transfusion were the same in both the unsuspected and detected ACS groups. Overall physician sensitivity for predicting ACS was only 39%, and diagnostic accuracy did not improve significantly with increasing levels of pediatric training. ACS is common in patients with SCD who present with fever and was grossly underestimated by evaluating physicians. History and physical examination appear to be of little value in defining which febrile patients require CXR. In view of the mortality and morbidity associated with ACS, empiric CXR should be considered when evaluating a febrile patient with SCD.

Assessment of Unsuspected Exposure to Drugs of Abuse in Children from a Mediterranean City by Hair Testing

PubMed Central

Pichini, Simona; Garcia-Algar, Oscar; Alvarez, Airam; Gottardi, Massimo; Marchei, Emilia; Svaizer, Fiorenza; Pellegrini, Manuela; Rotolo, Maria Concetta; Pacifici, Roberta

2014-01-01

Hair testing was used to investigate the prevalence of unsuspected exposure to drugs of abuse in a group of children presenting to an urban paediatric emergency department without suggestive signs or symptoms. Hair samples were obtained from 114 children between 24 months and 10 years of age attending the emergency room of Hospital del Mar in Barcelona, Spain. Hair samples from the accompanying parent were also collected. The samples were analyzed for the presence of opiates, cocaine, amphetamines, and cannabinoids by ultra-performance liquid chromatography-tandem mass spectrometry. Parental sociodemographics and possible drug of abuse history were recorded. Hair samples from twenty-three children (20.1%) were positive for cocaine (concentration range 0.15–3.81 ng/mg hair), those of thirteen children (11.4%) to cannabinoids (Δ9-THC concentration range 0.05–0.54 ng/mg hair), with four samples positive to codeine (0.1–0.25 ng/mg hair), one positive for 2.09 ng methadone per mg hair and one to 6-MAM (0.42 ng/mg hair) and morphine (0. 15 ng/mg hair) . In 69.5 and 69.2% of the positive cocaine and cannabinoids cases respectively, drugs was also found in the hair of accompanying parent. Parental sociodemographics were not associated with children exposure to drugs of abuse. However, the behavioural patterns with potential harmful effects for the child’s health (e.g., tobacco smoking, cannabis, benzodiazepines and/or antidepressants use) were significantly higher in the parents of exposed children. In the light of the obtained results (28% overall children exposure to drugs of abuse) and in agreement with 2009 unsuspected 23% cocaine exposure in pre-school children from the same hospital, we support general hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions. PMID:24566054

Intrathoracic stomach mimicking bone metastasis from thyroid cancer in whole-body iodine-131 scan diagnosed by SPECT/CT.

PubMed

García-Gómez, Francisco Javier; la Riva-Pérez, Pablo Antonio de; Calvo-Morón, Cinta; Buján-Lloret, Cristina; Cambil-Molina, Teresa; Castro-Montaño, Juan

2017-01-01

The whole-body iodine-131 scintigraphy is an imaging technique in monitoring patients with a history of thyroid cancer. Although the rate of false positives is negligible, it is not nonexistent. We report the case of an intervened and treated patient for thyroid cancer with good clinical and biochemical response. Scintigraphic findings were consistent with unsuspected bone metastasis. Fused SPECT/CT data allowed accurate diagnosis of giant diaphragmatic hernia associated with intrathoracic stomach, a very rare pathology that can lead to false positive results.

Unususpected meningioma in a patient with pituitary gigantism. Case report with autopsy findings.

PubMed

Stock, J M; Ghatak, N R; Oppenheimer, J H

1975-06-01

A unique example of a clinically unsuspected large parasellar meningioma is described in a 36-yr-old pituitary giant who had been treated initially with conventional irradiation, subsequently by surgical excision of an acidophil adenoma, and ultimately with medroxyprogesterone acetate (MPA) prior to his demise. The patient died of increased intracranial pressure resulting from a combined mass effect of the meningioma and recurrent tumor. The relationship between radiation and the development of the meningioma is discussed, as well as the fine ultrastructure of a highly functioning acidophil adenoma.

Coincidental Optic Nerve Meningioma and Thyroid Eye Disease.

PubMed

Garg, Aakriti; Patel, Payal; Lignelli, Angela; Baron, Edward; Kazim, Michael

2015-01-01

A 57-year-old woman with diabetes mellitus, hypertension, obesity, and Graves disease presented with clinical evidence of thyroid eye disease (TED) and optic neuropathy. She was referred when a tapered dose of steroids prompted worsening of her TED. CT and MRI were consistent with TED and bilateral optic nerve meningioma. To the authors' knowledge, this is the first reported case of concurrent TED and unsuspected bilateral optic nerve meningioma. When investigating the etiology of TED-associated optic neuropathy, careful attention to orbital imaging is required because coexisting pathology may exist.

Spring clip sterilization: one-year follow-up of 1,079 cases.

PubMed

Hulka, J F; Mercer, J P; Fishburne, J I; Kumarasamy, T; Omran, K F; Phillips, J M; Lefler, H T; Lieberman, B; Lean, T H; Pai, D N; Koetsawang, S; Castro, M V

1976-08-15

This is a report of 1,079 patients who underwent laparoscopic clip sterlization as of March, 1974. A one-year follow-up was obtained on 977 patients, or 90.5 per cent. Complications due to the clip technique appear limited to postoperative cramps for 24 to 48 hours in 26 per cent of patients. No ectopic pregnancies were detected. Pregnancies, when corrected for unsuspected existing pregnancies and surgical and manufacturing errors, occurred in 2 to 6 cases, for a method failure rate of 2 to 6/1,000. This report documents that experienced laparoscopists can perform this practice with local anesthesia, in combination with first-trimester abortion, and in hospital facilities other than an operating room.

The Zagora cryptograph

NASA Astrophysics Data System (ADS)

Coucouzeli, A.

A unique lead seal from the well-known eighth century B.C. settlement of Zagora on the island of Andros dramatically confirms and expands our knowledge of the town planning identified at the site and constituting the earliest example of an orthogonal grid plan in the Greek world. The seal in question is decorated with a symbolic design that constitutes a rare representation of the Dioskouroi as part of the constellation Gemini. This design appears to have acted as a cryptograph enciphering the basic mathematical and astronomical principles behind the planning of Zagora. Besides offering us new insights into early Greek settlement planning, the cryptograph seems to reveal an advanced practical competence in mathematics and celestial observation, which was hitherto unsuspected for such an early period. The Zagora cryptograph also suggests that astronomy and mathematics played a crucial role in the strengthening of the ruling elite's power at Zagora in the framework of the rising city-state or polis. The tight interweaving of astronomical, mathematical, architectural and social considerations in the planning of Zagora is an entirely new discovery for Greece, whose implications are far-reaching.

The value of routine chest radiographs in acute asthma admissions.

PubMed

Ismail, Y; Loo, C S; Zahary, M K

1994-04-01

We reviewed 116 chest radiographs done in 70 adult asthmatic patients who were admitted to the Hospital Universiti Sains Malaysia from January to December 1989. The chest radiographs were abnormal in 23% of cases. Twelve percent showed hyperinflation and 7% had pneumonia. Eight patients diagnosed clinically to have pneumonia had normal chest radiographs. Seven patients had radiographic findings of conditions which were unsuspected clinically. These included two cases of pneumonia, one case each of fibrosing alveolitis, pneumothorax, pneumomediastinum, mitral stenosis with left ventricular failure and right pleural effusion. In conclusion, we found that significant chest radiograph abnormalities in adult patients admitted for asthma were uncommon although chest radiographs were helpful in detecting complications or coincidental conditions. Chest radiograph is therefore an important investigation in adult asthmatic patients who are admitted. However, considering the cost and the risk of radiation, it should be done only in selective cases rather than as a routine procedure.

Cutaneous gallium uptake in patients with AIDS with mycobacterium avium-intracellulare septicemia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Allwright, S.J.; Chapman, P.R.; Antico, V.F.

1988-07-01

Gallium imaging is increasingly being used for the early detection of complications in patients with AIDS. A 26-year-old homosexual man who was HIV antibody positive underwent gallium imaging for investigation of possible Pneumocystis carinii pneumonia. Widespread cutaneous focal uptake was seen, which was subsequently shown to be due to mycobacterium avium-intracellulare (MAI) septicemia. This case demonstrates the importance of whole body imaging rather than imaging target areas only, the utility of gallium imaging in aiding the early detection of clinically unsuspected disease, and shows a new pattern of gallium uptake in disseminated MAI infection.

Bone metastases as initial presentation of hepatocellular carcinoma.

PubMed

Monteserin, Luzdivina; Mesa, Alicia; Fernandez-Garcia, Maria Soledad; Gadanon-Garcia, Arantza; Rodriguez, Manuel; Varela, María

2017-10-18

Extra-hepatic spread is present in 5% to 15% of patients with hepatocellular carcinoma (HCC) at the time of diagnosis. The most frequent sites are lung and regional lymph nodes. Here, we report 3 cases of unsuspected HCC with symptoms due to bone lesions as initial presentation. Morphological characteristics and immunohistochemistry from the examined bone were the key data for diagnosis. None of the patients had an already known chronic liver disease. Differential diagnoses with HCC upon ectopic liver disease or hepatoid adenocarcinoma were shown. Therapy with the orally active multikinase inhibitor sorafenib plus symptomatic treatment was indicated.

Ovarian metastasis in a transposed ovary 10 years after primary cervical cancer: the importance of histologic examination and review of literature.

PubMed

Janse, Julienne A; Sie-Go, Daisy M D S; Schreuder, Henk W R

2011-06-17

Cases of cervical carcinoma metastasing to the transposed ovary are rarely reported in the literature. In this report, the authors present the case of a 53-year-old woman with a persisting, unsuspected cyst in the right transposed ovary, 10 years after treatment for adenosquamous carcinoma of the cervix. It is the first report describing a secondary ovarian malignancy originating from a cervical adenosquamous carcinoma in a transposed ovary. In addition, this is the first account of an ovarian metastasis 10 years after primary treatment for cervical cancer. Furthermore, pathologic examination with immunohistochemistry and human papillomavirus genotyping played a key role in the diagnostic process, as the case did not raise suspicion by ultrasound findings neither by cytological examination after cytological aspiration or by appearance during surgery.

“Unleashed on an Unsuspecting World”: The Asbestos Information Association and Its Role in Perpetuating a National Epidemic

PubMed Central

Rosner, David

2016-01-01

Examining previously underused corporate documents, we revisit the story of the Asbestos Information Association/North America, an industry trade group that sought in the early 1970s to counteract the growing public attention to, and government regulation of, asbestos as a serious threat to workers and consumers. From the mid-1960s through the early 1970s, according to its own spokesperson, asbestos was exposed as “probably the most hazardous industrial material ever unleashed on an unsuspecting world.” In retrospect, thousands of lives may have been saved if the Asbestos Information Association had publicly acknowledged this earlier. PMID:26890170

Unsuspected Dengue as a Cause of Acute Febrile Illness in Children and Adults in Western Nicaragua.

PubMed

Reller, Megan E; de Silva, Aravinda M; Miles, Jeremy J; Jadi, Ramesh S; Broadwater, Anne; Walker, Katie; Woods, Christopher; Mayorga, Orlando; Matute, Armando

2016-10-01

Dengue is an emerging infectious disease of global significance. Suspected dengue, especially in children in Nicaragua's heavily-urbanized capital of Managua, has been well documented, but unsuspected dengue among children and adults with undifferentitated fever has not. To prospectively study dengue in semi-urban and rural western Nicaragua, we obtained epidemiologic and clinical data as well as acute and convalescent sera (2 to 4 weeks after onset of illness) from a convenience sample (enrollment Monday to Saturday daytime to early evening) of consecutively enrolled patients (n = 740) aged ≥ 1 years presenting with acute febrile illness. We tested paired sera for dengue IgG and IgM and serotyped dengue virus using reverse transcriptase-PCR. Among 740 febrile patients enrolled, 90% had paired sera. We found 470 (63.5%) were seropositive for dengue at enrollment. The dengue seroprevalance increased with age and reached >90% in people over the age of 20 years. We identified acute dengue (serotypes 1 and 2) in 38 (5.1%) patients. Only 8.1% (3/37) of confirmed cases were suspected clinically. Dengue is an important and largely unrecognized cause of fever in rural western Nicaragua. Since Zika virus is transmitted by the same vector and has been associated with severe congenital infections, the population we studied is at particular risk for being devastated by the Zika epidemic that has now reached Central America.

Median mental sinus in twins.

PubMed

Ong, S T; Ngeow, W C

1999-05-01

Sinus on the chin can be the result of a chronic apical abscess due to pulp necrosis of a mandibular anterior tooth. The tooth is usually asymptomatic, and a dental cause is therefore not apparent to the patient or the unsuspecting clinician. Not infrequently, the patient may seek treatment from a dermatologist or general surgeon instead of a dentist. Excision and repair of the fistula may be carried out with subsequent breakdown because the dental pathology is not removed. This paper reports the presence of median mental sinus of dental origin in twins. One case healed following root canal therapy while the other required both root canal therapy and surgery to eliminate the infection.

Active training for amblyopia in adult rodents

PubMed Central

Sale, Alessandro; Berardi, Nicoletta

2015-01-01

Amblyopia is the most diffused form of visual function impairment affecting one eye, with a prevalence of 1–5% in the total world population. Amblyopia is usually caused by an early functional imbalance between the two eyes, deriving from anisometropia, strabismus, or congenital cataract, leading to severe deficits in visual acuity, contrast sensitivity and stereopsis. While amblyopia can be efficiently treated in children, it becomes irreversible in adults, as a result of a dramatic decline in visual cortex plasticity which occurs at the end of the critical period (CP) in the primary visual cortex. Notwithstanding this widely accepted dogma, recent evidence in animal models and in human patients have started to challenge this view, revealing a previously unsuspected possibility to enhance plasticity in the adult visual system and to achieve substantial visual function recovery. Among the new proposed intervention strategies, non invasive procedures based on environmental enrichment, physical exercise or visual perceptual learning (vPL) appear particularly promising in terms of future applicability in the clinical setting. In this survey, we will review recent literature concerning the application of these behavioral intervention strategies to the treatment of amblyopia, with a focus on possible underlying molecular and cellular mechanisms. PMID:26578911

Sox and Drugs: Baseball, Steroids and Physics

NASA Astrophysics Data System (ADS)

Tobin, Roger

2008-03-01

The sports world is in an uproar over performance-enhancing drugs. In the United States steroids in baseball have received the most attention, in part because the purported effects are much more dramatic than in any other sport. From 1995-2003 a few players hit home runs at rates 20-50% higher than the best sluggers of the preceding century. Could steroids really increase home-run performance that much? I will describe a model that combines estimates of the physiological effects of steroids, known baseball physics, and reasonable models of batting effectiveness for highly skilled hitters. A 10% increase in muscle mass, which can reasonably be expected from steroid use, increases the speed of a batted ball by 3%. Because home runs are relatively rare events on the tail of a batter's range distribution, even this modest change in ball speed can increase the proportion of batted balls that result in home runs by 30 -- 70%, enough to account for the record-shattering performances of the recent past. I will also describe some of the attention -- both welcome and not -- that comes to the unsuspecting physicist who wades into such emotionally troubled waters.

Satanism in a psychiatric adolescent population.

PubMed

Bourget, D; Gagnon, A; Bradford, J M

1988-04-01

In a university affiliated adolescent psychiatric facility, providing approximately 250 consultations per year, an unsuspectedly high prevalence of preoccupation with "satanism" was found in referred adolescents. Interested by the phenomenon, the authors have identified and documented eight cases in an attempt to isolate common characteristics among the cases. Initially a link between the marginal cult belief and general maladjustment was hypothesized, specifically delinquent behaviour. The study confirmed this trend and showed a significant impairment in the social adjustment of these adolescents. One of the most striking findings was the high prevalence of family disruption and parental abuse. Furthermore, a wide range of psychiatric symptoms were found in our subjects. This study raises concerns over the psychological development of adolescents who are subject to high levels of psychosocial stress. It will hopefully encourage further work in the area of increased susceptibility towards beliefs and indoctrination.

Unsuspected Active Ulcerative Colitis in a Patient With Dermatomyositis: A Rare Association Detected on 18F-FDG PET/CT During the Search for an Occult Malignancy.

PubMed

Rayamajhi, Sampanna Jung; Gorla, Arun Kumar Reddy; Basher, Rajender Kumar; Sood, Ashwani; Mittal, Bhagwant Rai

2017-01-01

Dermatomyositis is an inflammatory myopathy with the characteristic features of skin rash and myopathy. We here present a known case of dermatomyositis evaluated with 18 F-FDG PET/CT for the presence of any occult malignancy. The scan was negative for the presence of any malignancy. However, it revealed multiple intensely FDG avid colonic strictures that were later proven on colonoscopic biopsy to be ulcerative colitis. Also, a well-known association of bilateral sacroilitis was simultaneously demonstrated on the scan. The present case demonstrates that 18 F-FDG PET/CT imaging can serve as a one-stop shop imaging modality in dermatomyositis by facilitating detection of occult primary if any and by providing insight into other rare systemic associations.

Unsuspected Active Ulcerative Colitis in a Patient With Dermatomyositis: A Rare Association Detected on 18F-FDG PET/CT During the Search for an Occult Malignancy

PubMed Central

Rayamajhi, Sampanna Jung; Gorla, Arun Kumar Reddy; Basher, Rajender Kumar; Sood, Ashwani; Mittal, Bhagwant Rai

2017-01-01

Dermatomyositis is an inflammatory myopathy with the characteristic features of skin rash and myopathy. We here present a known case of dermatomyositis evaluated with 18F-FDG PET/CT for the presence of any occult malignancy. The scan was negative for the presence of any malignancy. However, it revealed multiple intensely FDG avid colonic strictures that were later proven on colonoscopic biopsy to be ulcerative colitis. Also, a well-known association of bilateral sacroilitis was simultaneously demonstrated on the scan. The present case demonstrates that 18F-FDG PET/CT imaging can serve as a one-stop shop imaging modality in dermatomyositis by facilitating detection of occult primary if any and by providing insight into other rare systemic associations. PMID:28533643

Infant botulism: case reports and review.

PubMed

Krishna, S; Puri, V

2001-04-01

Infant Botulism (IB) is a relatively uncommon, though potentially life-threatening neuroparalytic illness caused by the toxins elaborated by Clostridium botulinum (C botulinum). We describe two cases of Infant Botulism. Both these infants presented with a sepsis-like picture and were unsuspectingly treated with the conventional antibiotics ampicillin and gentamicin. The neuroparalytic syndrome of both infants was probably potentiated by the use of gentamicin. We suggest that cefotaxime be carefully considered instead of gentamicin in the initial management of infants presenting with a sepsis-like clinical picture and associated history of constipation, recent onset of hypotonia, poor feeding and/or drooling. Clinical trials evaluating human Botulism Immune Globulin (BIG) are under way by the California Department of Health. This article comes at a very timely moment because once FDA approved, BIG will be the only specific treatment available for this illness.

Symmetry breaking in a nutshell: the odyssey of a pseudo problem in molecular physics. The X̃(2)Σ(u)(+) BNB case revisited.

PubMed

Kalemos, Apostolos

2013-06-14

The X̃(2)Σu (+) BNB state considered to be of symmetry broken (SB) character has been studied by high level multireference variational and full configuration interaction methods. We discuss in great detail the roots of the so-called SB problem and we offer an in depth analysis of the unsuspected reasons behind the double minimum topology found in practically all previous theoretical investigations. We argue that the true reason of failure to recover a D∞h equilibrium geometry lies in the lack of the correct permutational symmetry of the wavefunctions employed and is by no means a real effect.

Mercury Poisoning from an Unsuspected Source

PubMed Central

Tamir, M.; Bornstein, B.; Behar, M.; Chwat, M.

1964-01-01

In the manufacture of zinc oxide the raw material normally used in zinc metal plates. In a factory in which old aeroplane batteries containing zinc mercury amalgam were substituted, it was not realized that mercury vapour was being produced. Of 25 workers exposed, seven developed serious chronic mercury poisoning and were admitted to hospital. The clinical findings in the affected workers are described. They were first treated with penicillamine D, but in all but one case this had to be stopped because of rashes. Little improvement followed a switch to B.A.L. It is suggested that if penicillamine D is used in the treatment of mercury poisoning, steroid cover should be given from the start. PMID:14249900

The laboratory diagnosis of syphilis.

PubMed

Ratnam, Sam

2005-01-01

Syphilis has several clinical manifestations, making laboratory testing a very important aspect of diagnosis. In North America, many unsuspected cases are discovered by laboratory testing. The etiological agent, Treponema pallidum, cannot be cultured, and there is no single optimal alternative test. Serological testing is the most frequently used approach in the laboratory diagnosis of syphilis. The present paper discusses the various serological and alternative tests currently available along with their limitations, and relates their results to the likely corresponding clinical stage of the disease. The need to use multiple tests is discussed, and the importance of quality control is noted. The complexity of syphilis serology means that the services of reference laboratories and clinical experts are often needed.

Giant mucinous cystadenocarcinoma of ovary: A case report and review of literature

PubMed Central

Katke, Rajshree Dayanand

2016-01-01

Giant cystadenocarcinomas of the ovary are rarely described. Huge ovarian masses are mostly benign, but malignancy should be ruled out by investigations and clinical assessment. Giant cysts require resection because of compressive symptoms or risk of malignancy and their management invariably requires laparotomy to prevent perforation and spillage of the cyst fluid into peritoneal cavity. Here, we present a case of a 42-year-old female with severe and rapidly growing abdominal distension operated for exploratory laparotomy for cystic mass excision. On histology, mass was found to be metastatic mucinous cystadenocarcinoma with omental metastasis. The diagnostic and management challenges posed by this unexpected and unusual presentation of an ovarian cystadenocarcinoma are discussed. The main aim of this report is to draw attention to huge ovarian epithelial cysts with unsuspected presentation contributing to a decrease in any underdiagnosis, misdiagnosis, and mismanagement that might occur. PMID:27134482

Genuine sildenafil tablets sold in Brazil disguised as MDMA.

PubMed

Coelho Neto, José; Faraco, Renata F P; Alves, Cíntia F; Castro, Stela M M; Machado, Yuri

2018-02-01

MDMA and sildenafil are two examples among many substances consumed in "raves", as well as in other types of "recreative" social events nowadays. During the first six months of 2017, five cases of supposedly MDMA tablets seized by local law enforcement forces in the state of Minas Gerais, Brazil, and brought to our forensic laboratory for examination, attracted our attention among dozens of others, as the tablets apprehended in these cases were, in fact, colorfully painted versions of genuine, pentagon-shaped, sildenafil tablets, freely available for sale in local pharmacies and drugstores. Physical profiling, together with ATR-FTIR spectral matching, multi-component/deconvolution analysis and correlation were employed to prove that these tablets were genuine sildenafil tablets from a specific manufacturer, painted in a colorful way so that they could be marketed as MDMA tablets to unsuspecting buyers. Copyright © 2017 Elsevier B.V. All rights reserved.

Parathyroid cysts: the Latin-American experience.

PubMed

Román-González, Alejandro; Aristizábal, Natalia; Aguilar, Carolina; Palacios, Karen; Pérez, Juan Camilo; Vélez-Hoyos, Alejandro; Duque, Carlos Simon; Sanabria, Alvaro

2016-12-01

Parathyroid cyst is an infrequent and unsuspected disease. There are more than 300 hundred cases reported in the world literature, a few of them are from Latin America. The experience of our centers and a review of the cases are presented. Case report of a series of patients with parathyroid cyst from our institutions according to the CARE guidelines (Case Reports). A search of Medline, Embase, BIREME ( Biblioteca Regional de Medicina ) LILACS ( Literatura Latinoamericana y del Caribe en Ciencias de la Salud ), Google Scholar and Scielo ( Scientific Electronic Library on Line ) databases and telephonic or email communications with other experts from Latin-America was performed . Six patients with parathyroid cyst were found in our centers in Colombia. Most of them were managed with aspiration of the cyst. Two of them required surgery. Only one case was functional. Twelve reports from Latin America were found for a total of 18 cases in our region adding ours. Parathyroid cysts are uncommonly reported in Latin America. Most of them are diagnosed postoperatively. Suspicion for parathyroid cyst should be raised when a crystal clear fluid is aspirated from a cyst. The confirmation of the diagnosis may be easily done if parathyroid hormone (PTH) level is measured in the cyst fluid.

Carcinoma of the gallbladder. The Roswell Park experience.

PubMed

Silk, Y N; Douglass, H O; Nava, H R; Driscoll, D L; Tartarian, G

1989-12-01

The median survival, from diagnosis, of patients with cancer of the gallbladder is 6 months. Our purpose in reviewing our experience was to identify factors, either in patient characteristics or treatment, that influence this statistic. In 22 years 71 cases of gallbladder carcinoma were referred to Roswell Park Memorial Institute in Buffalo, New York. Most had a cholecystectomy that revealed an unsuspected neoplasm, before referral. Mean age was 62 years and 75% were female. Symptoms, signs, and laboratory and imaging studies were uniformly unhelpful in determining the diagnosis. Early diagnosis at a stage amenable to surgical excision remains the sole salvation. Patients who receive chemotherapy did better than those who did not, but this is probably a reflection of patient selection. Newer treatment modalities are urgently needed.

Smelling time: a neural basis for olfactory scene analysis

PubMed Central

Ache, Barry W.; Hein, Andrew M.; Bobkov, Yuriy V.; Principe, Jose C.

2016-01-01

Behavioral evidence from phylogenetically diverse animals and humans suggests that olfaction could be much more involved in interpreting space and time than heretofore imagined by extracting temporal information inherent in the olfactory signal. If this is the case, the olfactory system must have neural mechanisms capable of encoding time at intervals relevant to the turbulent odor world in which many animals live. We review evidence that animals can use populations of rhythmically active or ‘bursting’ olfactory receptor neurons (bORNs) to extract and encode temporal information inherent in natural olfactory signals. We postulate that bORNs represent an unsuspected neural mechanism through which time can be accurately measured, and that ‘smelling time’ completes the requirements for true olfactory scene analysis. PMID:27594700

Unsuspected neurologic disease in aviation personnel : survival following seizures in flight.

DOT National Transportation Integrated Search

1963-08-01

The increasing use of private and commercial air transportation combined with the steady increase in recreational aviation have inevitably increased the likelihood of pilot failure caused by medical disability simply because there are more pilots in ...

Smallpox Control in Canada

PubMed Central

Best, E. W. R.; Davies, J. W.

1965-01-01

During the period 1961 to 1963 there were 10 separate importations of smallpox cases by aircraft into England and Wales, Germany, Sweden, Poland and Canada. A feature of the resulting outbreaks was the number of cases and deaths of physicians and other health personnel. With the increasing volume of international air traffic there is a risk of importing incubating cases of smallpox into Canada, as occurred in 1962. Millions of Canadians have been protected against smallpox. Some complications of smallpox vaccination have occurred in Canada; such complications can be minimized by proper attention to contraindications to vaccination. The Food and Drug Directorate, Department of National Health and Welfare, has circularized all physicians in Canada to request their co-operation in reporting adverse reactions to drugs. This includes serious, unusual or unsuspected reactions to immunizing agents (vaccines, toxoids and antitoxins). The latter information will be shared with the Epidemiology Division, Department of National Health and Welfare, and the provincial epidemiologist and manufacturer concerned. The importance of maintaining the smallpox immunity of physicians, nurses and other hospital and health personnel in Canada is emphasized. PMID:14296005

Carcinoma of the gallbladder. The Roswell Park experience.

PubMed Central

Silk, Y N; Douglass, H O; Nava, H R; Driscoll, D L; Tartarian, G

1989-01-01

The median survival, from diagnosis, of patients with cancer of the gallbladder is 6 months. Our purpose in reviewing our experience was to identify factors, either in patient characteristics or treatment, that influence this statistic. In 22 years 71 cases of gallbladder carcinoma were referred to Roswell Park Memorial Institute in Buffalo, New York. Most had a cholecystectomy that revealed an unsuspected neoplasm, before referral. Mean age was 62 years and 75% were female. Symptoms, signs, and laboratory and imaging studies were uniformly unhelpful in determining the diagnosis. Early diagnosis at a stage amenable to surgical excision remains the sole salvation. Patients who receive chemotherapy did better than those who did not, but this is probably a reflection of patient selection. Newer treatment modalities are urgently needed. PMID:2589888

Parathyroid cysts: the Latin-American experience

PubMed Central

Aristizábal, Natalia; Aguilar, Carolina; Palacios, Karen; Pérez, Juan Camilo; Vélez-Hoyos, Alejandro; Duque, Carlos Simon; Sanabria, Alvaro

2016-01-01

Background Parathyroid cyst is an infrequent and unsuspected disease. There are more than 300 hundred cases reported in the world literature, a few of them are from Latin America. The experience of our centers and a review of the cases are presented. Methods Case report of a series of patients with parathyroid cyst from our institutions according to the CARE guidelines (Case Reports). A search of Medline, Embase, BIREME (Biblioteca Regional de Medicina) LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud), Google Scholar and Scielo (Scientific Electronic Library on Line) databases and telephonic or email communications with other experts from Latin-America was performed . Results Six patients with parathyroid cyst were found in our centers in Colombia. Most of them were managed with aspiration of the cyst. Two of them required surgery. Only one case was functional. Twelve reports from Latin America were found for a total of 18 cases in our region adding ours. Conclusions Parathyroid cysts are uncommonly reported in Latin America. Most of them are diagnosed postoperatively. Suspicion for parathyroid cyst should be raised when a crystal clear fluid is aspirated from a cyst. The confirmation of the diagnosis may be easily done if parathyroid hormone (PTH) level is measured in the cyst fluid. PMID:28149800

Botulism from chopped garlic: delayed recognition of a major outbreak.

PubMed

St Louis, M E; Peck, S H; Bowering, D; Morgan, G B; Blatherwick, J; Banerjee, S; Kettyls, G D; Black, W A; Milling, M E; Hauschild, A H

1988-03-01

Diagnosis of botulism in two teenaged sisters in Montreal led to the identification of 36 previously unrecognized cases of type B botulism in persons who had eaten at a restaurant in Vancouver, British Columbia, during the preceding 6 weeks. A case-control study implicated a new vehicle for botulism, commercial chopped garlic in soybean oil (P less than 10(-4)). Relatively mild and slowly progressive illness, dispersion of patients over at least eight provinces and states in three countries, and a previously unsuspected vehicle had contributed to prolonged misdiagnoses, including myasthenia gravis (six patients), psychiatric disorders (four), stroke (three), and others. Ethnic background influenced severity of illness: 60% of Chinese patients but only 4% of others needed mechanical ventilation (P less than 10(-3]. Trypsinization of serum was needed to show toxemia in one patient. Electromyography results with high-frequency repetitive stimulation corroborated the diagnosis of botulism up to 2 months after onset. Although botulism is a life-threatening disease, misdiagnosis may be common and large outbreaks can escape recognition completely.

IT Expo

NASA Image and Video Library

2012-06-21

Jaci Mize of the National Oceanic and Atmospheric Administration at Stennis Space Center learns about 'phishing,' a favorite ploy used by hackers to gain sensitive information from unsuspecting computer users, during the eighth annual Information Technology Expo held June 2, 2012,1 at the rocket engine test facility.

Development of a highway incident management operational and training guide for incident responders in Illinois.

DOT National Transportation Integrated Search

2011-08-01

Each year highway traffic incidents, such as crashes, place responders on and beside roadways with : dangerous high-speed traffic. The unexpected conditions of an incident scene have the potential to surprise : unsuspecting or inattentive drivers, po...

A dramatic, objective antiandrogen withdrawal response: case report and review of the literature.

PubMed

Lau, Yiu-Keung; Chadha, Manpreet K; Litwin, Alan; Trump, Donald L

2008-11-05

Antiandrogen withdrawal response is an increasingly recognized entity in patients with metastatic prostate cancer. To our knowledge, there have been no reports describing a durable radiologic improvement along with prostate-specific antigen (PSA) with discontinuation of the antiandrogen agent bicalutamide. We report a case in which a dramatic decline of serum PSA levels associated with a dramatic improvement in radiologic disease was achieved with bicalutamide discontinuation.

Magnetic Resonance Imaging (MRI): Operative Findings Correlation in 229 Fistula-in-Ano Patients.

PubMed

Garg, Pankaj; Singh, Pratiksha; Kaur, Baljit

2017-06-01

To correlate the operative findings of patients with fistula-in-ano with preoperative MRI and quantify the information added with MRI. All consecutive fistula-in-ano patients operated between July 2013 and May 2015 were prospectively enrolled. Preoperative MRI was done in every patient. The details of tracts, internal opening and "complex parameters" (additional tract or additional internal opening, horseshoe tract, associated abscess and supralevator extension) found at surgery were compared to the findings determined by MRI. A total of 229 patients (424 tracts) with mean age-49.0 ± 11.3 years were included. M/F 198/31. James hospital classification: Type I 58, II 20, III 49, IV 86 and V 16. The sensitivity and specificity of MRI in diagnosing fistula tracts were 98.8 and 99.7%, respectively, and in identifying internal opening were 97.7 and 98.6%, respectively. MRI added significant information in 46.7% (107/229) patients which was presence of additional tracts in 71 (66.3%), horseshoe tract in 63 (58.8%), supralevator extension in 16 (14.9%), unsuspected abscess in 11 (10.3%) and multiple internal openings in one patient (1%). The proportion of simple/complex fistula (based on history and clinical examination alone) was 32.8/67.2% which changed to 21.4/78.6% after the MRI scan. MRI added significant information about unsuspecting complex parameters which were missed on history and clinical examination in more than one-third (26/75: 34.6%) of simple fistulae and more than half (81/154: 52.5%) of already known complex fistulae. MRI is highly accurate in diagnosing fistula-in-ano and added significant information about unsuspected complex parameters in over one-third (34.6%) of simple and in half (52.5%) of complex fistula-in-ano.

Studies in Intelligence. Volume 52, Number 1, 2008

DTIC Science & Technology

2008-03-01

filming of his love-making with his unsuspecting wife, and, finally, his posting on the Internet of soft porn stories in his true name. Ray acknowledged...divorced, became estranged from his children , and suffered “depression, anger, compulsive behaviors, posttraumatic syndrome, and general alienation

Single Molecule Analysis of Serotonin Transporter Regulation Using Quantum Dots

NASA Astrophysics Data System (ADS)

Chang, Jerry; Tomlinson, Ian; Warnement, Michael; Ustione, Alessandro; Carneiro, Ana; Piston, David; Blakely, Randy; Rosenthal, Sandra

2011-03-01

For the first time, we implement a novel, single molecule approach to define the localization and mobility of the brain's major target of widely prescribed antidepressant medications, the serotonin transporter (SERT). SERT labeled with single quantum dot (Qdot) revealed unsuspected features of transporter mobility with cholesterol-enriched membrane microdomains (often referred to as ``lipid rafts'') and cytoskeleton network linked to transporter activation. We document two pools of surface SERT proteins defined by their lateral mobility, one that exhibits relatively free diffusion in the plasma membrane and a second that displays significantly restricted mobility and localizes to cholesterol-enriched microdomains. Diffusion model prediction and instantaneous velocity analysis indicated that stimuli that act through p38 MAPK-dependent signaling pathways to activate SERT trigger rapid SERT movements within membrane microdomains. Cytoskeleton disruption showed that SERT lateral mobility behaves a membrane raft-constrained, cytoskeleton-associated manner. Our results identify an unsuspected aspect of neurotransmitter transporter regulation that we propose reflects the dissociation of inhibitory, SERT-associated cytoskeletal anchors.

Acute pancreatitis and severe hypertriglyceridaemia masking unsuspected underlying diabetic ketoacidosis.

PubMed

Aboulhosn, Kewan; Arnason, Terra

2013-09-04

A healthy 18-year-old girl presented to a local emergency room with 48 h of abdominal pain and vomiting. A radiological and biochemical diagnosis of moderate acute pancreatitis was made. Bloodwork demonstrated prominent hypertriglyceridaemia (HTG) of 19.5 mmol/L (severe HTG: 11.2-22.4), detectable urine ketones and a random blood glucose of 13 mmol/L dropping to 10.5 mmol/L on repeat (normal random <11). Ketone levels were deemed consistent with fasting ketosis after 48 h of vomiting. There was no known history of diabetes in the patient. Management included aggressive rehydration and pain control, yet the patient rapidly decompensated into shock requiring intensive care unit support. Blood gases revealed severe metabolic acidosis (pH 6.99) and unsuspected underlying diabetic ketoacidosis was diagnosed. The HTG gradually resolved following intravenous fluids and insulin infusion with slower correction of the metabolic acidosis. Importantly, her glycated haemoglobin was 12%, indicating the silent presence of chronic glucose elevations.

Acute pancreatitis and severe hypertriglyceridaemia masking unsuspected underlying diabetic ketoacidosis

PubMed Central

Aboulhosn, Kewan; Arnason, Terra

2013-01-01

A healthy 18-year-old girl presented to a local emergency room with 48 h of abdominal pain and vomiting. A radiological and biochemical diagnosis of moderate acute pancreatitis was made. Bloodwork demonstrated prominent hypertriglyceridaemia (HTG) of 19.5 mmol/L (severe HTG: 11.2–22.4), detectable urine ketones and a random blood glucose of 13 mmol/L dropping to 10.5 mmol/L on repeat (normal random <11). Ketone levels were deemed consistent with fasting ketosis after 48 h of vomiting. There was no known history of diabetes in the patient. Management included aggressive rehydration and pain control, yet the patient rapidly decompensated into shock requiring intensive care unit support. Blood gases revealed severe metabolic acidosis (pH 6.99) and unsuspected underlying diabetic ketoacidosis was diagnosed. The HTG gradually resolved following intravenous fluids and insulin infusion with slower correction of the metabolic acidosis. Importantly, her glycated haemoglobin was 12%, indicating the silent presence of chronic glucose elevations. PMID:24005972

A dramatic, objective antiandrogen withdrawal response: case report and review of the literature

PubMed Central

Lau, Yiu-Keung; Chadha, Manpreet K; Litwin, Alan; Trump, Donald L

2008-01-01

Antiandrogen withdrawal response is an increasingly recognized entity in patients with metastatic prostate cancer. To our knowledge, there have been no reports describing a durable radiologic improvement along with prostate-specific antigen (PSA) with discontinuation of the antiandrogen agent bicalutamide. We report a case in which a dramatic decline of serum PSA levels associated with a dramatic improvement in radiologic disease was achieved with bicalutamide discontinuation. PMID:18986533

Simultaneous transcriptome analysis of Colletotrichum gloeosporioides and tomato fruit pathosystem reveals novel fungal pathogenicity and fruit defense strategies.

PubMed

Alkan, Noam; Friedlander, Gilgi; Ment, Dana; Prusky, Dov; Fluhr, Robert

2015-01-01

The fungus Colletotrichum gloeosporioides breaches the fruit cuticle but remains quiescent until fruit ripening signals a switch to necrotrophy, culminating in devastating anthracnose disease. There is a need to understand the distinct fungal arms strategy and the simultaneous fruit response. Transcriptome analysis of fungal-fruit interactions was carried out concurrently in the appressoria, quiescent and necrotrophic stages. Conidia germinating on unripe fruit cuticle showed stage-specific transcription that was accompanied by massive fruit defense responses. The subsequent quiescent stage showed the development of dendritic-like structures and swollen hyphae within the fruit epidermis. The quiescent fungal transcriptome was characterized by activation of chromatin remodeling genes and unsuspected environmental alkalization. Fruit response was portrayed by continued highly integrated massive up-regulation of defense genes. During cuticle infection of green or ripe fruit, fungi recapitulate the same developmental stages but with differing quiescent time spans. The necrotrophic stage showed a dramatic shift in fungal metabolism and up-regulation of pathogenicity factors. Fruit response to necrotrophy showed activation of the salicylic acid pathway, climaxing in cell death. Transcriptome analysis of C. gloeosporioides infection of fruit reveals its distinct stage-specific lifestyle and the concurrent changing fruit response, deepening our perception of the unfolding fungal-fruit arms and defenses race. © 2014 The Authors. New Phytologist © 2014 New Phytologist Trust.

Muscle-specific PPARγ-deficient mice develop increased adiposity and insulin resistance but respond to thiazolidinediones

PubMed Central

Norris, Andrew W.; Chen, Lihong; Fisher, Simon J.; Szanto, Ildiko; Ristow, Michael; Jozsi, Alison C.; Hirshman, Michael F.; Rosen, Evan D.; Goodyear, Laurie J.; Gonzalez, Frank J.; Spiegelman, Bruce M.; Kahn, C. Ronald

2003-01-01

Activation of peroxisome proliferator-activated receptor γ (PPARγ) by thiazolidinediones (TZDs) improves insulin resistance by increasing insulin-stimulated glucose disposal in skeletal muscle. It remains debatable whether the effect of TZDs on muscle is direct or indirect via adipose tissue. We therefore generated mice with muscle-specific PPARγ knockout (MuPPARγKO) using Cre/loxP recombination. Interestingly, MuPPARγKO mice developed excess adiposity despite reduced dietary intake. Although insulin-stimulated glucose uptake in muscle was not impaired, MuPPARγKO mice had whole-body insulin resistance with a 36% reduction (P < 0.05) in the glucose infusion rate required to maintain euglycemia during hyperinsulinemic clamp, primarily due to dramatic impairment in hepatic insulin action. When placed on a high-fat diet, MuPPARγKO mice developed hyperinsulinemia and impaired glucose homeostasis identical to controls. Simultaneous treatment with TZD ameliorated these high fat–induced defects in MuPPARγKO mice to a degree identical to controls. There was also altered expression of several lipid metabolism genes in the muscle of MuPPARγKO mice. Thus, muscle PPARγ is not required for the antidiabetic effects of TZDs, but has a hitherto unsuspected role for maintenance of normal adiposity, whole-body insulin sensitivity, and hepatic insulin action. The tissue crosstalk mediating these effects is perhaps due to altered lipid metabolism in muscle. PMID:12925701

A robust and cost-effective approach to sequence and analyze complete genomes of small RNA viruses

USDA-ARS?s Scientific Manuscript database

Background: Next-generation sequencing (NGS) allows ultra-deep sequencing of nucleic acids. The use of sequence-independent amplification of viral nucleic acids without utilization of target-specific primers provides advantages over traditional sequencing methods and allows detection of unsuspected ...

Suggestopaedia-Canada. Information Letter, No. 3.

ERIC Educational Resources Information Center

Racle, Gabriel

This issue consists of the following: a "minilexicon" of terms directly or indirectly related to the field of suggestion and learning; the translation of an article by T. Tachev entitled "Learning Foreign Languages by Suggestion: The Unsuspected Possibilities of Human Memory"; a review of the book "An Introduction to…

Internet Fraud: Information for Teachers and Students

ERIC Educational Resources Information Center

Nkotagu, Gabriel Hudson

2011-01-01

Internet fraud takes a number of forms with the responsible individuals changing tactics rapidly to avoid detection. The perpetrators rely on telemarketing, emails, as well as presenting themselves personally to unsuspecting people. The evolution of internet marketing as well as ecommerce and the ease of connectivity create increasing…

Parietal seeding of unsuspected gallbladder carcinoma after laparoscopic cholecystectomy.

PubMed

Marmorale, C; Scibé, R; Siquini, W; Massa, M; Brunelli, A; Landi, E

1998-01-01

Laparoscopic cholecystectomy (VALC) represents the treatment of choice for the symptomatic gallstones. However the occurrence of an adenocarcinoma of the gallbladder results a controindication for this surgical technique. We present a case of a 52 years old woman who underwent a VALC; histology revealed a gallbladder adenocarcinoma. For this reason the patient underwent a second operation that is right hepatic trisegmentectomy. Six months later the patient presented with a parietal recurrence at the extraction site of the gallbladder. We discuss the possible mechanism responsible for carcinomatous dissemination during laparoscopic surgery and we raccommend the use of some procedures in order to limit the risk and eventually to treat a neoplastic parietal seeding. These complications suggest the problem about the utility and the future played by video assisted laparoscopic surgery in the diagnosis and treatment of intraabdominal malignancies.

Gallbladder carcinoma late metastases and incisional hernia at umbilical port site after laparoscopic cholecystectomy.

PubMed

Ciulla, A; Romeo, G; Genova, G; Tomasello, G; Agnello, G; Cstronovo, Gaetano

2006-05-01

A potentially serious complication of laparoscopic cholecystectomy is the inadvertent dissemination of unsuspected gallbladder carcinoma. There are increasing reports of seeding of tumor at the trocar sites following laparoscopic cholecystectomy in patients with unexpected or inapparent gallbladder carcinoma. Although the mechanism of the abdominal wall recurrence is still unclear, laparoscopic handling of the tumor, perforation of the gallbladder, and extraction of the specimen without an endobag may be risk factors for the spreading of malignant cells. The Authors report the case of late development of umbilical metastasis after laparoscopic cholecystectomy; the presence of an incisional hernia and the finding of a stone in subcutaneous tissue demonstrate the diffusion of tumor cells into subcutaneous tissue during the extraction of gallbladder. The patient underwent an excision of the metastases. She is disease free two years after surgical treatment.

Case report: MR imaging features of disseminated uterine leiomyosarcoma presenting after hysterectomy with morcellation.

PubMed

Ciszak, Tadi; Mittal, Pardeep K; Sullivan, Patrick; Cardona, Kenneth; Hanley, Krisztina Z; Khanna, Namita; Moreno, Courtney Coursey

2015-10-01

A 53-year-old woman underwent elective hysterectomy for symptomatic anemia secondary to abnormal uterine bleeding. She presented 15 months later with complaints of abdominal fullness. Abdominopelvic magnetic resonance imaging demonstrated multiple confluent enhancing solid masses centered in the pelvis and extending cranially to the level of the umbilicus. Additional separate nodules also were visible along the peritoneum. Biopsy demonstrated leiomyosarcoma. Additional clinical information was obtained, which revealed that the patient's prior hysterectomy was performed with morcellation. In November 2014, the United States Food and Drug Administration issued a warning discouraging the use of morcellation during hysterectomy and myomectomy because of the risk of seeding unsuspected malignancy. Radiologists should be aware of this potential complication of morcellation and its imaging appearance so that the correct diagnosis can be suggested in the imaging report.

[Nuclear magnetic resonance of anorectal malformations and persistent postoperative fecal incontinence].

PubMed

de Agustín, J C; Alami, H; Lassaletta, L; Gámez, M; Fernández, A; Fraile, E; Alenda, J G; Rollán, V; Utrilla, J G

1992-07-01

We review our experience with Magnetic Resonance Imaging (MRI) in the evaluation of 6 patients showing anorectal malformation, and 4 more with persistent postoperative fecal incontinence. Preoperative sagittal, axial and coronal planes were studied with special consideration to the pelvic and vertebral structures. The excellent resolution of MRI allowed accurate identification of the pelvic musculature in all patients, including those with bizarre sacral abnormalities. MRI revealed structural anomalies not detected previously, such as teathering cord, intraspinal lipoma, presacral mass and renal malformation. In our institution, MRI has replaced the CT scan in the study of patients suffering of persistent fecal incontinence. In non operated on cases of anorectal malformations, MRI determines with extraordinary accuracy the location of the rectal atretic pouch, the actual pelvic muscular quality, and the detection of previously unsuspected associated anomalies.

Pedagogical Reflections on Internalizing Geopolitical Representations in Print Media

ERIC Educational Resources Information Center

Abdul-Jabbar, Wisam Khalid

2015-01-01

This essay explores how print media conceals implicit hegemonic texts that common readers unsuspectingly tend to internalize. These geopolitically infused texts are set to appropriate the reader's worldviews by sublimating the kind of perceptions and notions they want to promote. This paper raises questions and awareness about how academia…

Laminar Differences in Associative Memory Signals in Monkey Perirhinal Cortex.

PubMed

Vogels, Rufin

2016-10-19

New research published in Neuron describes assignment of cortical layer to single neurons recorded in awake monkeys. Applying the procedure to perirhinal cortex, Koyano et al. (2016) found marked and unsuspected differences among layers in the coding of associative memory signals. Copyright © 2016. Published by Elsevier Inc.

Extra-skeletal Ewing's sarcoma resembling acute abdomen. Case report.

PubMed

Valdivia Gómez, Gilberto Guzmán; Soto Guerrero, María Teresa; Cedillo de la Cruz, María Isabel

2010-01-01

Extraosseous Ewing's sarcoma is a rare tumor of neuroectodermal origin. It presents mainly in the soft tissue of the extremities and thorax. Histologically, it is similar to Ewing's sarcoma of the bone. We present the case of a male who arrived at the emergency room with acute abdomen, leucocytosis and imaging techniques (abdominal ultrasound and computed tomography) suggestive of complicated diverticular disease. He was treated with emergency surgery. Intraoperative findings were an unsuspected tumor (20 x 15 x 15 cm). Treatment consisted of extirpation of the tumor, separating it from the adjacent viscera and followed by chemotherapy based on epirubicin, cyclophosphamide and vincristine for six cycles. Because the control abdominal CT demonstrated tumor activity in the retroperitoneum adjacent to the ascending colon and cecum, further resection was decided upon. In a review of the literature, no previous reports of extraosseous Ewing's sarcoma were found presenting as acute abdomen. Due to the rarity of this tumor, only case reports or series have been found in the literature without randomized or comparative studies. Surgery was the cornerstone of treatment, without reports of preoperative chemotherapy. If the patient's condition permits, percutaneous needle biopsy is mandatory to obtain optimum treatment as well as to improve prognosis.

[Clinicopathologic study of 817 enucleations].

PubMed

Gassler, N; Lommatzsch, P K

1995-11-01

The clinical findings, the indications for enucleation and the histopathological diagnoses from 817 eyes from the University Eye Hospital in Leipzig, enucleated between 01/01/1980 and 31/12/1989 (433 males; 384 females), were analysed retrospectively to investigate, however, the therapeutic and diagnostic importance of enucleation to ophthalmological problems. The most frequent underlying ocular diseases were: intraocular tumour (47.7%), surgical disease [primary glaucoma, retinal detachment, cataract] (18.6%), trauma [enucleation within 4 weeks after the event] (10.3%), systemic disease (6.6%), inflammation (6.1%), other diseases (10.7%). The final causes for enucleation were: intraocular tumour (46.4%), secondary glaucoma (31.6%), atrophia and phthisis bulbi (11.9%), inflammation (6.5%), trauma (0.9%), other diseases (2.7%). An increase in the enucleation rate was noted with increasing age. The ophthalmoscopic diagnoses of 8 i.o. malignant melanomas and 7 cases of retinoblastoma were histopathologically not verified. The histopathological diagnoses included: exudative-hemorrhagic lesion (7), metastasis (1) respectively M. Coats (3), retinal detachment (2), M. Norrie (1), panophthalmitis (1). In 2 cases of i.o. malignant melanoma and 2 cases of retinoblastoma the tumours were clinically unsuspected. The incorrect clinical diagnoses included: secondary glaucoma (2) respectively M. Coats (1), secondary glaucoma (1).

Computing sensitivity and selectivity in parallel factor analysis and related multiway techniques: the need for further developments in net analyte signal theory.

PubMed

Olivieri, Alejandro C

2005-08-01

Sensitivity and selectivity are important figures of merit in multiway analysis, regularly employed for comparison of the analytical performance of methods and for experimental design and planning. They are especially interesting in the second-order advantage scenario, where the latter property allows for the analysis of samples with a complex background, permitting analyte determination even in the presence of unsuspected interferences. Since no general theory exists for estimating the multiway sensitivity, Monte Carlo numerical calculations have been developed for estimating variance inflation factors, as a convenient way of assessing both sensitivity and selectivity parameters for the popular parallel factor (PARAFAC) analysis and also for related multiway techniques. When the second-order advantage is achieved, the existing expressions derived from net analyte signal theory are only able to adequately cover cases where a single analyte is calibrated using second-order instrumental data. However, they fail for certain multianalyte cases, or when third-order data are employed, calling for an extension of net analyte theory. The results have strong implications in the planning of multiway analytical experiments.

Optimization of Archeological Anomalies using GIS method for Magnetic and Resistivity Study at Sungai Batu, Lembah Bujang, Kedah (Malaysia)

NASA Astrophysics Data System (ADS)

Yusoh, R.; Saad, R.; Saidin, M.; Anda, S. T.; Muhammad, S. B.; Ashraf, M. I. M.; Hazreek, Z. A. M.

2018-04-01

Magnetic and resistivity method has become a reliable option in archeological exploration. The use of both method has become popular these day. However, both method gives different type of sensing in detecting anomalies and direct interpret from the anomalies will result large coverage area for excavation. Therefore, to overcome this issue, both anomalies can be extracted using ArcGIS software to reduce excavated coverage area. The case study located at Sungai Batu, Lembah Bujang near SB2ZZ lot expected buried clay brick monument which will be a perfect case to apply this technique. Magnetic and resistivity method was implemented at the study area where the anomalies coverage area for magnetic and resistivity is 531.5 m2 and 636 m2 respectively which total area of both anomalies was 764 m2. By applying combine technique, the anomalies area reduce to 403.7 m2 which reduce the suspected anomalies by 47.16 %. The unsuspected clay brick monument area was increase from 15.86% to 55.54% which improve the cost and labor work for excavation.

Alveolar soft part sarcoma presenting as a breast metastasis in a patient with a history of thyroid cancer: a case report

PubMed Central

Bychkov, Andrey; Sampatanukul, Pichet

2015-01-01

Metastases to the breast are uncommon, accounting for 0.5% of breast tumors, and most of them are originated from lymphoma, melanoma and carcinomas of various organs. Alveolar soft part sarcoma (ASPS) is a very rare neoplasm that is usually found in the lower extremities. Lungs are the common site of dissemination and may represent initial manifestation of disease. We report a clinically unsuspected case of ASPS presenting as a breast metastasis in a 25-year-old woman. The patient’s medical history was notable for a thyroid cancer treated by surgery and radioiodine ablation 2 years ago. Core needle biopsy of slowly growing breast mass yielded polygonal cells with abundant eosinophilic cytoplasm arranged into solid pattern. Differential diagnosis between apocrine cell carcinoma, paraganglioma, granular cell tumor, neuroendocrine carcinoma, ASPS and metastatic hepatocellular and renal cell carcinoma was rendered by immunohistochemistry. Strong nuclear TFE3 immunoreactivity confirmed a diagnosis of ASPS. Retrospectively a primary tumor was found in the thigh. Most likely, ASPS and thyroid cancer in the patient were growing synchronously and independently. PMID:26464747

Sustainability: Higher Education's New Fundamentalism

ERIC Educational Resources Information Center

Peterson, Rachelle; Wood, Peter W.

2015-01-01

"Sustainability" is a key idea on college campuses in the United States and the rest of the Western world. To the unsuspecting, sustainability is just a new name for environmentalism. This report is the first in-depth critical study of the sustainability movement in higher education. The focus of this study is on how the sustainability…

Channel One Online: Advertising Not Educating.

ERIC Educational Resources Information Center

Pasnik, Shelley

Rather than viewing Channel One's World Wide Web site as an authentic news bureau, as the organization claims, it is better understood as an advertising delivery system. The web site is an attempt to expand Channel One's reach into schools, taking advantage of unsuspecting teachers and students who might fall prey to spurious claims. This paper…

Paleogenetic analyses reveal unsuspected phylogenetic affinities between mice and the extinct Malpaisomys insularis, an endemic rodent of the Canaries.

PubMed

Pagès, Marie; Chevret, Pascale; Gros-Balthazard, Muriel; Hughes, Sandrine; Alcover, Josep Antoni; Hutterer, Rainer; Rando, Juan Carlos; Michaux, Jacques; Hänni, Catherine

2012-01-01

The lava mouse, Malpaisomys insularis, was endemic to the Eastern Canary islands and became extinct at the beginning of the 14(th) century when the Europeans reached the archipelago. Studies to determine Malpaisomys' phylogenetic affinities, based on morphological characters, remained inconclusive because morphological changes experienced by this insular rodent make phylogenetic investigations a real challenge. Over 20 years since its first description, Malpaisomys' phylogenetic position remains enigmatic. In this study, we resolved this issue using molecular characters. Mitochondrial and nuclear markers were successfully amplified from subfossils of three lava mouse samples. Molecular phylogenetic reconstructions revealed, without any ambiguity, unsuspected relationships between Malpaisomys and extant mice (genus Mus, Murinae). Moreover, through molecular dating we estimated the origin of the Malpaisomys/mouse clade at 6.9 Ma, corresponding to the maximal age at which the archipelago was colonised by the Malpaisomys ancestor via natural rafting. This study reconsiders the derived morphological characters of Malpaisomys in light of this unexpected molecular finding. To reconcile molecular and morphological data, we propose to consider Malpaisomys insularis as an insular lineage of mouse.

Is Identification of Lupus Erythematosus Cells Still Useful? A Case Report.

PubMed

Xu, Min; MacNeal, Lucinda A; Wittman, Brenda J; Rutledge, Joe C

A 13-year-old girl presented with significant weight loss, depression, anemia, and neutropenia. The preliminary diagnosis was anorexia nervosa combined with depression. Due to peripheral cytopenia, a bone marrow biopsy was performed to rule out leukemia. Lupus erythematosus (LE) cells were found in the bone marrow aspirate, which prompted autoantibody testing, although clinically it was not suspected the patient had systemic lupus erythematosus (SLE). Further testing demonstrated very high levels of antinuclear antibodies (ANA) (>12 U) and anti-double strand DNA (dsNDA) (>1000 IU/mL), which confirmed the diagnosis of SLE. The patient was treated with steroids for SLE, and symptoms improved quickly. In conclusion, although the identification of LE cells as one of the diagnostic criteria for SLE has been obsolete, careful examination of bone marrow to identify LE cells is still very important in the diagnosis of unsuspected SLE.

Microstructures define melting of molybdenum at high pressures

NASA Astrophysics Data System (ADS)

Hrubiak, Rostislav; Meng, Yue; Shen, Guoyin

2017-03-01

High-pressure melting anchors the phase diagram of a material, revealing the effect of pressure on the breakdown of the ordering of atoms in the solid. An important case is molybdenum, which has long been speculated to undergo an exceptionally steep increase in melting temperature when compressed. On the other hand, previous experiments showed nearly constant melting temperature as a function of pressure, in large discrepancy with theoretical expectations. Here we report a high-slope melting curve in molybdenum by synchrotron X-ray diffraction analysis of crystalline microstructures, generated by heating and subsequently rapidly quenching samples in a laser-heated diamond anvil cell. Distinct microstructural changes, observed at pressures up to 130 gigapascals, appear exclusively after melting, thus offering a reliable melting criterion. In addition, our study reveals a previously unsuspected transition in molybdenum at high pressure and high temperature, which yields highly textured body-centred cubic nanograins above a transition temperature.

Microstructures define melting of molybdenum at high pressures

PubMed Central

Hrubiak, Rostislav; Meng, Yue; Shen, Guoyin

2017-01-01

High-pressure melting anchors the phase diagram of a material, revealing the effect of pressure on the breakdown of the ordering of atoms in the solid. An important case is molybdenum, which has long been speculated to undergo an exceptionally steep increase in melting temperature when compressed. On the other hand, previous experiments showed nearly constant melting temperature as a function of pressure, in large discrepancy with theoretical expectations. Here we report a high-slope melting curve in molybdenum by synchrotron X-ray diffraction analysis of crystalline microstructures, generated by heating and subsequently rapidly quenching samples in a laser-heated diamond anvil cell. Distinct microstructural changes, observed at pressures up to 130 gigapascals, appear exclusively after melting, thus offering a reliable melting criterion. In addition, our study reveals a previously unsuspected transition in molybdenum at high pressure and high temperature, which yields highly textured body-centred cubic nanograins above a transition temperature. PMID:28248309

Evidence that chytrids dominate fungal communities in high-elevation soils

PubMed Central

Freeman, K. R.; Martin, A. P.; Karki, D.; Lynch, R. C.; Mitter, M. S.; Meyer, A. F.; Longcore, J. E.; Simmons, D. R.; Schmidt, S. K.

2009-01-01

Periglacial soils are one of the least studied ecosystems on Earth, yet they are widespread and are increasing in area due to retreat of glaciers worldwide. Soils in these environments are cold and during the brief summer are exposed to high levels of UV radiation and dramatic fluctuations in moisture and temperature. Recent research suggests that these environments harbor immense microbial diversity. Here we use sequencing of environmental DNA, culturing of isolates, and analysis of environmental variables to show that members of the Chytridiomycota (chytrids) dominate fungal biodiversity and perhaps decomposition processes in plant-free, high-elevation soils from the highest mountain ranges on Earth. The zoosporic reproduction of chytrids requires free water, yet we found that chytrids constituted over 70% of the ribosomal gene sequences of clone libraries from barren soils of the Himalayas and Rockies; by contrast, they are rare in other soil environments. Very few chytrids have been cultured, although we were successful at culturing chytrids from high-elevation sites throughout the world. In a more focused study of our sites in Colorado, we show that carbon sources that support chytrid growth (eolian deposited pollen and microbial phototrophs) are abundant and that soils are saturated with water for several months under the snow, thus creating ideal conditions for the development of a chytrid-dominated ecosystem. Our work broadens the known biodiversity of the Chytridomycota, and describes previously unsuspected links between aquatic and terrestrial ecosystems in alpine regions. PMID:19826082

The Legacy of the Texas Tower Sniper

ERIC Educational Resources Information Center

Lavergne, Gary

2007-01-01

In this article, the author relates the incident that happened at the University of Texas to the tragedy that took place at Virginia Tech. On August 1, 1966, Charles Joseph Whitman ascended the University of Texas Tower, in Austin, and in 96 minutes fired 150 high-powered rounds of ammunition down upon an unsuspecting university family. The…

Crib sheets or security blankets?

PubMed

Drake, V K; Freed, P; Hunter, J M

1998-01-01

This article describes the sanctioned use of crib sheets as a nursing intervention to decrease test anxiety when the classroom is the practice setting for psychiatric/mental health nursing faculty. The products that the students created offered additional unsuspected benefits. The faculty were convinced that the use of crib sheets can be a sound intervention to reduce students' test-taking anxiety.

A Rural School/Community: A Case Study of a Dramatic Turnaround & Its Implications for School Improvement.

ERIC Educational Resources Information Center

Carlson, Robert V.

This paper presents a case study of a rural community exhibiting a dramatic turnaround in community support for a new school bond issue. Demographic change was partly responsible for the change in community attitudes, with two waves of immigration altering the long-term conservative orientation of this community. After a series of failed…

Cordylobia rodhaini infestation of the breast: Report of a case mimicking a breast abscess.

PubMed

Grassi, Veronica; Butterworth, James William; Latiffi, Layloma

2016-01-01

Myiasis, parasitic infestation of the body by fly larvae, caused by the Cordylobia rodhaini is very rare with only fourteen cases published since 1970. We present a rare case of myiasis mimicking a breast abscess. A 17-year-old female presented with a nodular ulcerative lesion in her left breast 14days following a trip to Ghana. She had been initially unsuccessfully treated with the antibiotic flucloxacillin following a misdiagnosis of a breast abscess. Following application of Vaseline to the breast wound, covering the wound for 2h and gentle manipulation the larvae was removed successfully and the patient made a good recovery. Presenting as an inflammatory papule with central opening oozing serosanguinous fluid myiasis secondary to C. rodhaini can easily be mistaken for a breast abscess, often avoiding detection by unsuspecting surgeons on initial assessment. In turn ineffective antibiotic treatment is often prescribed leading to further disease progression and associated morbidity. Myiasis secondary to C. rodhaini is a rare but important differential surgeons should consider in women presenting with an inflammatory breast lesion with a recent history of foreign travel to ensure timely diagnosis and treatment. Ultrasound imaging can be useful in confirming diagnosis and avoiding treatment delays. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules.

PubMed

Schwarz, Carsten; Schönfeld, Nicolas; Bittner, Roland C; Mairinger, Thomas; Rüssmann, Holger; Bauer, Torsten T; Kaiser, Dirk; Loddenkemper, Robert

2013-01-01

The diagnostic value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules (SPN) is still under debate among pneumologists, radiologists and thoracic surgeons. In a prospective observational manner, flexible bronchoscopy was routinely performed in 225 patients with SPN of unknown origin. Of the 225 patients, 80.5% had lung cancer, 7.6% had metastasis of an extrapulmonary primary tumour and 12% had benign aetiology. Unsuspected endobronchial involvement was found in 4.4% of all 225 patients (or in 5.5% of patients with lung cancer). In addition, flexible bronchoscopy clarified the underlying aetiology in 41% of the cases. The bronchoscopic biopsy results from the SPN were positive in 84 (46.5%) patients with lung cancer. Surgery was cancelled due to the results of flexible bronchoscopy in four cases (involvement of the right main bronchus (impaired pulmonary function did not allow pneumonectomy) n=1, small cell lung cancer n=1, bacterial pneumonia n=2), and the surgical strategy had to be modified to bilobectomy in one patient. Flexible bronchoscopy changed the planned surgical approach in five cases substantially. These results suggest that routine flexible bronchoscopy should be included in the regular pre-operative work-up of patients with SPN.

Cryptococcal meningitis with secondary cutaneous involvement in an immunocompetent host.

PubMed

Tabassum, Saadia; Rahman, Atiya; Herekar, Fivzia; Masood, Sadia

2013-09-16

Cryptococcosis is a potentially fatal fungal disease caused by variants of Cryptococcus neoformans species.  The respiratory tract is the usual portal of entry, with a peculiar predilection to invade the central nervous system.  The skin can be secondarily involved in disseminated infection or be exceptionally involved as primary cutaneous infection by inoculation.  The disease is mostly seen in immunodeficiency states.  The diagnosis is frequently unsuspected in immunocompetent patients. We report a case of disseminated cryptococcal meningitis in an immunocompetent young adult. The cutaneous eruption prompted the accurate diagnosis.  The patient, a 20-year-old female, had fever, cough, headache and intractable vomiting for the past two months and was being managed as a case of tuberculous meningitis. Two weeks after starting antituberculous treatment she developed umbilicated papules on the head and neck region. Necessary laboratory workup identified C. neoformans in cerebrospinal fluid (CSF) and skin specimens.  The titers of cryptococcal antigen were measured in CSF and serum for diagnostic and prognostic purposes.  Anti-fungal treatment resulted in regression of the cutaneous lesions and resolution of systemic complaints. The case highlights the need for high degree of suspicion, especially in healthy young adults, in the diagnosis of cryptococcosis. The cutaneous eruptions can be the first manifestation or a diagnostic clue of enormous significance.

Revealing the Mind of the Sage: The Narrative Rhetoric of the "Chuang Tzu."

ERIC Educational Resources Information Center

Kirkwood, William G.

1992-01-01

Argues that one of the formative texts of Taoism, the "Chuang Tzu," is worthy of study by rhetoric scholars because it reveals a unique approach to rhetoric in its attempt to disclose the mind of the sage not through logic but through intuition, and it shows how storytelling can acquaint people with previously unsuspected possibilities of thought…

Unsuspected reason for sciatica in Bertolotti's syndrome.

PubMed

Shibayama, M; Ito, F; Miura, Y; Nakamura, S; Ikeda, S; Fujiwara, K

2011-05-01

Patients with Bertolotti's syndrome have characteristic lumbosacral anomalies and often have severe sciatica. We describe a patient with this syndrome in whom standard decompression of the affected nerve root failed, but endoscopic lumbosacral extraforaminal decompression relieved the symptoms. We suggest that the intractable sciatica in this syndrome could arise from impingement of the nerve root extraforaminally by compression caused by the enlarged transverse process.

Female Representation in Gikuyu Popular Music: A Catalyst for Domestic Violence.

ERIC Educational Resources Information Center

Maina, Faith

The females portrayed in the Gikuyu popular music of Kenya are almost always evil. Women are often viewed as prostitutes who see their sexuality as a commodity to be exchanged for material goods. After the unsuspecting males have delivered the goods, the women are more often than not betrayed. These portraits create a hostile and toxic environment…

[GMOs in food: risk assessment, scientific management and regulatory aspects].

PubMed

Casse, F; Hervieu, F

2003-03-01

Genetic transformation constitutes a new tool for improvement of microorganisms, animals and plants used in food. We present foreseeable risks, as well as management measures to avoid unsuspected risks of GMOs. Few risks are specific to GMOs. Present elements of French and European regulations concerning placing on the market and follow up GMOs and other novel foods are described.

Paleogenetic Analyses Reveal Unsuspected Phylogenetic Affinities between Mice and the Extinct Malpaisomys insularis, an Endemic Rodent of the Canaries

PubMed Central

Gros-Balthazard, Muriel; Hughes, Sandrine; Alcover, Josep Antoni; Hutterer, Rainer; Rando, Juan Carlos; Michaux, Jacques; Hänni, Catherine

2012-01-01

Background The lava mouse, Malpaisomys insularis, was endemic to the Eastern Canary islands and became extinct at the beginning of the 14th century when the Europeans reached the archipelago. Studies to determine Malpaisomys' phylogenetic affinities, based on morphological characters, remained inconclusive because morphological changes experienced by this insular rodent make phylogenetic investigations a real challenge. Over 20 years since its first description, Malpaisomys' phylogenetic position remains enigmatic. Methodology/Principal Findings In this study, we resolved this issue using molecular characters. Mitochondrial and nuclear markers were successfully amplified from subfossils of three lava mouse samples. Molecular phylogenetic reconstructions revealed, without any ambiguity, unsuspected relationships between Malpaisomys and extant mice (genus Mus, Murinae). Moreover, through molecular dating we estimated the origin of the Malpaisomys/mouse clade at 6.9 Ma, corresponding to the maximal age at which the archipelago was colonised by the Malpaisomys ancestor via natural rafting. Conclusion/Significance This study reconsiders the derived morphological characters of Malpaisomys in light of this unexpected molecular finding. To reconcile molecular and morphological data, we propose to consider Malpaisomys insularis as an insular lineage of mouse. PMID:22363563

Cost-benefit value of microscopic examination of intervertebral discs.

PubMed

Grzybicki, D M; Callaghan, E J; Raab, S S

1998-09-01

Given the virtual absence of histologically detected, clinically unsuspected disease in intervertebral disc specimens, some authors have advocated that histological examination be discontinued. However, the examination of intervertebral disc specimens remains common practice in most pathology laboratories. No cost-benefit analysis of this practice has been made; therefore, the authors' goal in this study was perform such an analysis. Using the University of Iowa surgical pathology database, 1109 patients who had undergone a laminectomy were identified retrospectively. These cases were classified into four categories based on the patients' preoperative clinical diagnosis and final histopathological diagnosis: insignificant clinical diagnosis/insignificant pathological diagnosis (ICIP), significant clinical diagnosis/insignificant pathological diagnosis (SCIP), significant clinical diagnosis/significant pathological diagnosis (SCSP), and insignificant clinical diagnosis/significant pathological diagnosis (ICSP). A significant clinical diagnosis was defined as one other than a benign, noninfectious indication for laminectomy. A significant pathological diagnosis was a diagnosis other than degenerative changes. The cost-benefit value of performing a histological examination in cases with significant or insignificant clinical diagnoses was examined. The cases were classified as: 1068 ICIP, 17 SCIP, 21 SCSP, and three ICSP. On chart review, in all three cases of ICSP an epidural abscess was identified perioperatively and the subsequent histological diagnosis did not affect patient care. The costs per case of identifying a significant pathological diagnosis with a significant and an insignificant clinical diagnosis were $44.79 and $8811, respectively. Histological examination of intervertebral disc specimens is cost beneficial only if there is a significant preoperative clinical diagnosis.

Tuberculous Otitis with Proteus mirabilis Co-Infection: An Unsuspected Presentation Encountered in Clinical Practice.

PubMed

Rajesh Gandham, Nageswari; Sardar, Moumita; Jadhav, Savita Vivek; Vyawahare, Chanda; Misra, Rabindranath

2014-05-01

Tuberculosis, a contagious bacterial disease which is caused by Mycobacterium tuberculosis, primarily involves the lungs.Though Pulmonary tuberculosis (PTB) is the commonest clinical presentation, there is a need for alertness towards uncommon presentations which involve other organs. Tuberculous otitis media (TOM) is one such rare presentation seen in paediatric practice. It is characterized by painless otorrhoea which fails to respond to the routine antibacterial treatment. TOM usually occurs secondary to PTB. Here is a case of tuberculous otitis media with Proteus mirabilis co-infection, with no evidence of PTB. In the sample of ear discharge obtained from the patient, acid fast bacilli were demonstrated on direct microscopy after Ziehl-Neelsen staining. Culture done on Lowenstein-Jensen medium demonstrated slow-growing Mycobacterium. Bacteriological culture and identification helped in isolating Proteus mirabilis. PCR, followed by Line- Probe Assay for early identification and susceptibility testing to primary drugs, was done. Further, patient tested negative for the Mantoux test. Patient was enrolled in National Tuberculosis programme- RNTCP. This case emphasizes on one of the less common presentations of a common disease. A high clinical suspicion and laboratory confirmation are required for appropriate patient management.

Tuberculous Otitis with Proteus mirabilis Co-Infection: An Unsuspected Presentation Encountered in Clinical Practice

PubMed Central

Sardar, Moumita; Jadhav, Savita Vivek; Vyawahare, Chanda; Misra, Rabindranath

2014-01-01

Tuberculosis, a contagious bacterial disease which is caused by Mycobacterium tuberculosis, primarily involves the lungs.Though Pulmonary tuberculosis (PTB) is the commonest clinical presentation, there is a need for alertness towards uncommon presentations which involve other organs. Tuberculous otitis media (TOM) is one such rare presentation seen in paediatric practice. It is characterized by painless otorrhoea which fails to respond to the routine antibacterial treatment. TOM usually occurs secondary to PTB. Here is a case of tuberculous otitis media with Proteus mirabilis co-infection, with no evidence of PTB. In the sample of ear discharge obtained from the patient, acid fast bacilli were demonstrated on direct microscopy after Ziehl-Neelsen staining. Culture done on Lowenstein-Jensen medium demonstrated slow-growing Mycobacterium. Bacteriological culture and identification helped in isolating Proteus mirabilis. PCR, followed by Line- Probe Assay for early identification and susceptibility testing to primary drugs, was done. Further, patient tested negative for the Mantoux test. Patient was enrolled in National Tuberculosis programme- RNTCP. This case emphasizes on one of the less common presentations of a common disease. A high clinical suspicion and laboratory confirmation are required for appropriate patient management. PMID:24995225

Forensic toxicology.

PubMed

Davis, Gregory G

2012-01-01

Toxicologic analysis is an integral part of death investigation, and the use or abuse of an unsuspected substance belongs in the differential diagnosis of patients who have a sudden, unexpected change in their condition. History and physical findings may alter suspicion that intoxication played a role in a patient's decline or death, but suspicions cannot be confirmed and is performed, analysis unless toxicologic no toxicologic analysis is possible unless someone collects the proper specimens necessary for analysis. In a hospital autopsy the only specimens that can rightfully be collected are those within the restrictions stated in the autopsy permit. Autopsies performed by the medical examiner do not have these restrictions. Sometimes the importance of toxicologic testing in a case is not evident until days or weeks after the change in the patient's status, thus retaining the appropriate specimens until investigation of that case has ended is important. Proper interpretation of toxicologic findings requires integrating the clinical setting and findings with the toxicologic results in a way that makes medical sense. If called upon to testify concerning findings, answer the questions truthfully, politely, and in a way that is understandable to someone who has no special training in toxicology.

Cyberskepticism: The Mind’s Firewall

DTIC Science & Technology

2008-01-01

phonebook; BitTorrent; iTunes ; YouTube; forums; chat rooms; dating; Craig’s List; donate; blog/vlog; video games; e-invitations; e- cards ; weather...computer. Real-world romance techniques on the Internet have produced some very innovative cyber deception techniques. Valentine cards sent...electronically are one technique designed to enhance romance. In 2006 electronic Valentine cards were sent to unsuspecting people who opened them for various

Technology assessment: What should it be?

NASA Technical Reports Server (NTRS)

Black, G.

1975-01-01

The necessity of uncovering unsuspected relationships in proposed actions is discussed along with the feasibility of using decision theoretical models to cope with problems of uncertainty in the future-oriented analyses characteristic of assessments. It is shown that it is necessary to integrate the results of technology assessment with other program analyses and that results of technology assessment be supplied in a form that permits integration with other information.

Clinical and mycological study of occult tinea pedis and tinea unguium in dermatological patients from Tokyo.

PubMed

Ogasawara, Y; Hiruma, M; Muto, M; Ogawa, H

2003-04-01

An epidemiological investigation was conducted to determine the prevalence and circumstances of untreated, unsuspected tinea pedis and tinea unguium, morbid conditions that could be termed occult athlete's foot, in patients visiting a dermatology clinic in Tokyo, Japan, for the first time, for other complaints. All subjects completed a questionnaire covering comprehensive anamnestic details, and were examined for disposition of toes, presence of signs suggestive of tinea pedis, other diseases of the foot, score of clinical signs and symptoms, potassium hydroxide (KOH) test, severity score, and mycological culture. The results showed that the prevalence of occult athlete's foot was 25%, and that 59% of those cases were complicated by tinea unguium. The characteristics of patients with occult athlete's foot included a higher proportion of men and a tendency toward a low clinical score together with a high severity score. In the patient background, a strong correlation was observed between a positive KOH test result and characteristics such as age, disposition of toes, and predisposing disease.

Bilateral ethmoid sinusitis with unilateral proptosis as an initial manifestation of metastatic prostate carcinoma.

PubMed Central

Fortson, J. K.; Bezmalinovic, Z. L.; Moseley, D. L.

1994-01-01

This article presents a case of bilateral ethmoid sinusitis with unilateral proptosis as a presenting sign of an unsuspected prostate carcinoma. A 59-year-old Hispanic male presented to his primary care physician with nasal congestion and rhinitis. He was treated with antibiotics and antihistamine decongestants for 3 weeks without improvement. A trial of steroids resulted in brief improvement followed by a rapid onset of nasal obstruction with proptosis. A computed tomography scan revealed opacification of the ethmoid sinus with right proptosis. The presumptive diagnosis was orbital cellulitis secondary to chronic ethmoid sinusitis. Endoscopic sinusotomy and bilateral ethmoidectomies were performed. Biopsy results returned as metastatic adenocarcinoma, probably of prostate origin. Urological work-up and evaluation with biopsy confirmed the diagnosis of prostatic carcinoma. The patient was treated with chemotherapy and radiation therapy. He died 7 months later with disseminated disease. Images Figure 1 Figure 2 Figure 3 Figure 4A Figure 4B PMID:7861473

Endogenous rhythmic growth in oak trees is regulated by internal clocks rather than resource availability

PubMed Central

Herrmann, S.; Recht, S.; Boenn, M.; Feldhahn, L.; Angay, O.; Fleischmann, F.; Tarkka, M T.; Grams, T.E.E.; Buscot, F.

2015-01-01

Common oak trees display endogenous rhythmic growth with alternating shoot and root flushes. To explore the mechanisms involved, microcuttings of the Quercus robur L. clone DF159 were used for 13C/15N labelling in combination with RNA sequencing (RNASeq) transcript profiling of shoots and roots. The effect of plant internal resource availability on the rhythmic growth of the cuttings was tested through inoculation with the ectomycorrhizal fungus Piloderma croceum. Shoot and root flushes were related to parallel shifts in above- and below-ground C and, to a lesser extent, N allocation. Increased plant internal resource availability by P. croceum inoculation with enhanced plant growth affected neither the rhythmic growth nor the associated resource allocation patterns. Two shifts in transcript abundance were identified during root and shoot growth cessation, and most concerned genes were down-regulated. Inoculation with P. croceum suppressed these transcript shifts in roots, but not in shoots. To identify core processes governing the rhythmic growth, functions [Gene Ontology (GO) terms] of the genes differentially expressed during the growth cessation in both leaves and roots of non-inoculated plants and leaves of P. croceum-inoculated plants were examined. Besides genes related to resource acquisition and cell development, which might reflect rather than trigger rhythmic growth, genes involved in signalling and/or regulated by the circadian clock were identified. The results indicate that rhythmic growth involves dramatic oscillations in plant metabolism and gene regulation between below- and above-ground parts. Ectomycorrhizal symbiosis may play a previously unsuspected role in smoothing these oscillations without modifying the rhythmic growth pattern. PMID:26320242

Dual targeting of ANGPT1 and TGFBR2 genes by miR-204 controls angiogenesis in breast cancer

PubMed Central

Flores-Pérez, Ali; Marchat, Laurence A.; Rodríguez-Cuevas, Sergio; Bautista-Piña, Verónica; Hidalgo-Miranda, Alfredo; Ocampo, Elena Aréchaga; Martínez, Mónica Sierra; Palma-Flores, Carlos; Fonseca-Sánchez, Miguel A.; Astudillo-de la Vega, Horacio; Ruíz-García, Erika; González-Barrios, Juan Antonio; Pérez-Plasencia, Carlos; Streber, María L.; López-Camarillo, César

2016-01-01

Deregulated expression of microRNAs has been associated with angiogenesis. Studying the miRNome of locally advanced breast tumors we unsuspectedly found a dramatically repression of miR-204, a small non-coding RNA with no previous involvement in tumor angiogenesis. Downregulation of miR-204 was confirmed in an independent cohort of patients and breast cancer cell lines. Gain-of-function analysis indicates that ectopic expression of miR-204 impairs cell proliferation, anchorage-independent growth, migration, invasion, and the formation of 3D capillary networks in vitro. Likewise, in vivo vascularization and angiogenesis were suppressed by miR-204 in a nu/nu mice model. Genome-wide profiling of MDA-MB-231 cells expressing miR-204 revealed changes in the expression of hundred cancer-related genes. Of these, we focused on the study of pro-angiogenic ANGPT1 and TGFβR2. Functional analysis using luciferase reporter and rescue assays confirmed that ANGPT1 and TGFβR2 are novel effectors downstream of miR-204. Accordingly, an inverse correlation between miR-204 and ANGPT1/TGFβR2 expression was found in breast tumors. Knockdown of TGFβR2, but not ANGPT1, impairs cell proliferation and migration whereas inhibition of both genes inhibits angiogenesis. Taken altogether, our findings reveal a novel role for miR-204/ANGPT1/TGFβR2 axis in tumor angiogenesis. We propose that therapeutic manipulation of miR-204 levels may represent a promising approach in breast cancer. PMID:27703260

Critical review of norovirus surrogates in food safety research: rationale for considering volunteer studies.

PubMed

Richards, Gary P

2012-03-01

The inability to propagate human norovirus (NoV) or to clearly differentiate infectious from noninfectious virus particles has led to the use of surrogate viruses, like feline calicivirus (FCV) and murine norovirus-1 (MNV), which are propagatable in cell culture. The use of surrogates is predicated on the assumption that they generally mimic the viruses they represent; however, studies are proving this concept invalid. In direct comparisons between FCV and MNV, their susceptibility to temperatures, environmental and food processing conditions, and disinfectants are dramatically different. Differences have also been noted between the inactivation of NoV and its surrogates, thus questioning the validity of surrogates. Considerable research funding is provided globally each year to conduct surrogate studies on NoVs; however, there is little demonstrated benefit derived from these studies in regard to the development of virus inactivation techniques or food processing strategies. Human challenge studies are needed to determine which processing techniques are effective in reducing NoVs in foods. A major obstacle to clinical trials on NoVs is the perception that such trials are too costly and risky, but in reality, there is far more cost and risk in allowing millions of unsuspecting consumers to contract NoV illness each year, when practical interventions are only a few volunteer studies away. A number of clinical trials have been conducted, providing important insights into NoV inactivation. A shift in research priorities from surrogate research to volunteer studies is essential if we are to identify realistic, practical, and scientifically valid processing approaches to improve food safety.

Root nodule symbiosis in Lotus japonicus drives the establishment of distinctive rhizosphere, root, and nodule bacterial communities.

PubMed

Zgadzaj, Rafal; Garrido-Oter, Ruben; Jensen, Dorthe Bodker; Koprivova, Anna; Schulze-Lefert, Paul; Radutoiu, Simona

2016-12-06

Lotus japonicus has been used for decades as a model legume to study the establishment of binary symbiotic relationships with nitrogen-fixing rhizobia that trigger root nodule organogenesis for bacterial accommodation. Using community profiling of 16S rRNA gene amplicons, we reveal that in Lotus, distinctive nodule- and root-inhabiting communities are established by parallel, rather than consecutive, selection of bacteria from the rhizosphere and root compartments. Comparative analyses of wild-type (WT) and symbiotic mutants in Nod factor receptor5 (nfr5), Nodule inception (nin) and Lotus histidine kinase1 (lhk1) genes identified a previously unsuspected role of the nodulation pathway in the establishment of different bacterial assemblages in the root and rhizosphere. We found that the loss of nitrogen-fixing symbiosis dramatically alters community structure in the latter two compartments, affecting at least 14 bacterial orders. The differential plant growth phenotypes seen between WT and the symbiotic mutants in nonsupplemented soil were retained under nitrogen-supplemented conditions that blocked the formation of functional nodules in WT, whereas the symbiosis-impaired mutants maintain an altered community structure in the nitrogen-supplemented soil. This finding provides strong evidence that the root-associated community shift in the symbiotic mutants is a direct consequence of the disabled symbiosis pathway rather than an indirect effect resulting from abolished symbiotic nitrogen fixation. Our findings imply a role of the legume host in selecting a broad taxonomic range of root-associated bacteria that, in addition to rhizobia, likely contribute to plant growth and ecological performance.

Root nodule symbiosis in Lotus japonicus drives the establishment of distinctive rhizosphere, root, and nodule bacterial communities

PubMed Central

Zgadzaj, Rafal; Garrido-Oter, Ruben; Jensen, Dorthe Bodker; Koprivova, Anna; Schulze-Lefert, Paul; Radutoiu, Simona

2016-01-01

Lotus japonicus has been used for decades as a model legume to study the establishment of binary symbiotic relationships with nitrogen-fixing rhizobia that trigger root nodule organogenesis for bacterial accommodation. Using community profiling of 16S rRNA gene amplicons, we reveal that in Lotus, distinctive nodule- and root-inhabiting communities are established by parallel, rather than consecutive, selection of bacteria from the rhizosphere and root compartments. Comparative analyses of wild-type (WT) and symbiotic mutants in Nod factor receptor5 (nfr5), Nodule inception (nin) and Lotus histidine kinase1 (lhk1) genes identified a previously unsuspected role of the nodulation pathway in the establishment of different bacterial assemblages in the root and rhizosphere. We found that the loss of nitrogen-fixing symbiosis dramatically alters community structure in the latter two compartments, affecting at least 14 bacterial orders. The differential plant growth phenotypes seen between WT and the symbiotic mutants in nonsupplemented soil were retained under nitrogen-supplemented conditions that blocked the formation of functional nodules in WT, whereas the symbiosis-impaired mutants maintain an altered community structure in the nitrogen-supplemented soil. This finding provides strong evidence that the root-associated community shift in the symbiotic mutants is a direct consequence of the disabled symbiosis pathway rather than an indirect effect resulting from abolished symbiotic nitrogen fixation. Our findings imply a role of the legume host in selecting a broad taxonomic range of root-associated bacteria that, in addition to rhizobia, likely contribute to plant growth and ecological performance. PMID:27864511

Turning off the spigot: reducing drug-resistant tuberculosis transmission in resource-limited settings.

PubMed

Nardell, E; Dharmadhikari, A

2010-10-01

Ongoing transmission and re-infection, primarily in congregate settings, is a key factor fueling the global multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) epidemic, especially in association with the human immunodeficiency virus. Even as efforts to broadly implement conventional TB transmission control measures begin, current strategies may be incompletely effective under the overcrowded conditions extant in high-burden, resource-limited settings. Longstanding evidence suggesting that TB patients on effective therapy rapidly become non-infectious and that unsuspected, untreated TB cases account for the most transmission makes a strong case for the implementation of rapid point-of-care diagnostics coupled with fully supervised effective treatment. Among the most important decisions affecting transmission, the choice of an MDR-TB treatment model that includes community-based treatment may offer important advantages over hospital or clinic-based care, not only in cost and effectiveness, but also in transmission control. In the community, too, rapid identification of infectious cases, especially drug-resistant cases, followed by effective, fully supervised treatment, is critical to stopping transmission. Among the conventional interventions available, we present a simple triage and separation strategy, point out that separation is intimately linked to the design and engineering of clinical space and call attention to the pros and cons of natural ventilation, simple mechanical ventilation systems, germicidal ultraviolet air disinfection, fit-tested respirators on health care workers and short-term use of masks on patients before treatment is initiated.

Turning off the spigot: reducing drug-resistant tuberculosis transmission in resource-limited settings

PubMed Central

Nardell, E.; Dharmadhikari, A.

2013-01-01

SUMMARY Ongoing transmission and re-infection, primarily in congregate settings, is a key factor fueling the global multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) epidemic, especially in association with the human immunodeficiency virus. Even as efforts to broadly implement conventional TB transmission control measures begin, current strategies may be incompletely effective under the overcrowded conditions extant in high-burden, resource-limited settings. Longstanding evidence suggesting that TB patients on effective therapy rapidly become non-infectious and that unsuspected, untreated TB cases account for the most transmission makes a strong case for the implementation of rapid point-of-care diagnostics coupled with fully supervised effective treatment. Among the most important decisions affecting transmission, the choice of an MDR-TB treatment model that includes community-based treatment may offer important advantages over hospital or clinic-based care, not only in cost and effectiveness, but also in transmission control. In the community, too, rapid identification of infectious cases, especially drug-resistant cases, followed by effective, fully supervised treatment, is critical to stopping transmission. Among the conventional interventions available, we present a simple triage and separation strategy, point out that separation is intimately linked to the design and engineering of clinical space and call attention to the pros and cons of natural ventilation, simple mechanical ventilation systems, germicidal ultraviolet air disinfection, fit-tested respirators on health care workers and short-term use of masks on patients before treatment is initiated. PMID:20843413

Viral Communities Associated with Human Pericardial Fluids in Idiopathic Pericarditis

PubMed Central

Fancello, Laura; Monteil, Sonia; Popgeorgiev, Nikolay; Rivet, Romain; Gouriet, Frédérique; Fournier, Pierre-Edouard; Raoult, Didier; Desnues, Christelle

2014-01-01

Pericarditis is a common human disease defined by inflammation of the pericardium. Currently, 40% to 85% of pericarditis cases have no identified etiology. Most of these cases are thought to be caused by an infection of undetected, unsuspected or unknown viruses. In this work, we used a culture- and sequence-independent approach to investigate the viral DNA communities present in human pericardial fluids. Seven viral metagenomes were generated from the pericardial fluid of patients affected by pericarditis of unknown etiology and one metagenome was generated from the pericardial fluid of a sudden infant death case. As a positive control we generated one metagenome from the pericardial fluid of a patient affected by pericarditis caused by herpesvirus type 3. Furthermore, we used as negative controls a total of 6 pericardial fluids from 6 different individuals affected by pericarditis of non-infectious origin: 5 of them were sequenced as a unique pool and the remaining one was sequenced separately. The results showed a significant presence of torque teno viruses especially in one patient, while herpesviruses and papillomaviruses were present in the positive control. Co-infections by different genotypes of the same viral type (torque teno viruses) or different viruses (herpesviruses and papillomaviruses) were observed. Sequences related to bacteriophages infecting Staphylococcus, Enterobacteria, Streptococcus, Burkholderia and Pseudomonas were also detected in three patients. This study detected torque teno viruses and papillomaviruses, for the first time, in human pericardial fluids. PMID:24690743

Running a postmortem service--a business case and clinical experience.

PubMed

Cohen, Marta C; Whitby, Elspeth; Fink, Michelle A; Collett, Jacquelene M; Offiah, Amaka C

2015-04-01

The purpose of the postmortem examination is to offer answers to explain the cause and manner of death. In the case of perinatal, infant and paediatric postmortem examinations, the goal is to identify unsuspected associated features, to describe pathogenic mechanisms and new conditions, and to evaluate the clinical management and diagnosis. Additionally, the postmortem examination is useful to counsel families regarding the probability of recurrence in future pregnancies and to inform family planning. Worldwide the rate of paediatric autopsy examinations has significantly declined during the last few decades. Religious objections to postmortem dissection and organ retention scandals in the United Kingdom provided some of the impetus for a search for non-invasive alternatives to the traditional autopsy; however, until recently, imaging studies remained an adjunct to, rather than a replacement for, the traditional autopsy. In 2012, Sheffield Children's Hospital National Health Service Foundation Trust set up the service provision of minimally invasive fetal, perinatal and neonatal autopsy, while a postmortem imaging service has been running in Melbourne, Australia, since 2008. Here we summarise the essentials of a business case and practical British and Australian experiences in terms of the pathological and radiologic aspects of setting up a minimally invasive clinical service in the United Kingdom and of developing a clinical postmortem imaging service as a complementary tool to the traditional autopsy in Australia.

Negative Suppressors of Oncogenic Activation of the Met Receptor Tyrosine Kinase

DTIC Science & Technology

2008-09-01

However, using anti-ubiquitin antibodies , we observe no increase in Met ubiquitination in Gab1 over-expressing cells when compared to vector controls...highlights an unsuspected role for Gab1 in RTK homeostasis. 11 Materials and Methods Reagents, Antibodies , Cell culture and Transfections A...its oncogenic activation through deregulate endocytosis. My recent work has uncovered a novel role for the Gab1 scaffold in regulating Met signaling

Effects of Long-Term Low-Level Radiofrequency Radiation Exposure on Rats. Volume 6. Hematological, Serum Chemistry, Thyroxine, and Protein Electrophoresis Evaluations.

DTIC Science & Technology

1984-03-01

many ad- vantages. The profile is an aid in evaluating the animals for unsuspected organ-system malfunction. In animals with subclinical or...stress the animal. This frequency of biochemical evaluation also increases the opportunity to detect subclinical abnormalities and follow their...1975) is used. Cholesterol Serum cholesterol levels are increased in hypothyroidism , diabetes mellitus, Dancreatitis, liver disease (hepatocellular

Effects of Long-Term Low-Level Radiofrequency Radiation Exposure on Rats. Volume 1. Design, Facilities, and Procedures.

DTIC Science & Technology

1983-09-01

uncovering unsuspected organ system malfunctions. In animals with subclinical or undiagnosed abnormalities, the emphasis is placed on the correct...normochromic, normocytic anemia are suggestive of hypothyroidism , although they do not occur in all hypothyroid animals. The thyroid hormones, thyroxine (T4...evaluation increased the opportunity to detect subclinical abnormalities and follow their pathophysiological course. Open-field assessment was conducted

Genomic analysis of the origins and evolution of multicentric diffuse lower-grade gliomas.

PubMed

Hayes, Josie; Yu, Yao; Jalbert, Llewellyn E; Mazor, Tali; Jones, Lindsey E; Wood, Matthew D; Walsh, Kyle M; Bengtsson, Henrik; Hong, Chibo; Oberndorfer, Stefan; Roetzer, Thomas; Smirnov, Ivan V; Clarke, Jennifer L; Aghi, Manish K; Chang, Susan M; Nelson, Sarah J; Woehrer, Adelheid; Phillips, Joanna J; Solomon, David A; Costello, Joseph F

2018-04-09

Rare multicentric lower-grade gliomas (LGGs) represent a unique opportunity to study the heterogeneity among distinct tumor foci in a single patient and to infer their origins and parallel patterns of evolution. In this study, we integrate clinical features, histology, and immunohistochemistry for 4 patients with multicentric LGG, arising both synchronously and metachronously. For 3 patients we analyze the phylogeny of the lesions using exome sequencing, including one case with a total of 8 samples from the 2 lesions. One patient was diagnosed with multicentric isocitrate dehydrogenase 1 (IDH1) mutated diffuse astrocytomas harboring distinct IDH1 mutations, R132H and R132C; the latter mutation has been associated with Li-Fraumeni syndrome, which was subsequently confirmed in the patient's germline DNA and shown in additional cases with The Cancer Genome Atlas data. In another patient, phylogenetic analysis of synchronously arising grade II and grade III diffuse astrocytomas demonstrated a single shared mutation, IDH1 R132H, and revealed convergent evolution via non-overlapping mutations in ATRX and TP53. In 2 cases, there was divergent evolution of IDH1-mutated and 1p/19q-codeleted oligodendroglioma and IDH1-mutated and 1p/19q-intact diffuse astrocytoma, occurring synchronously in one case and metachronously in a second. Each tumor in multicentric LGG cases may arise independently or may diverge very early in their development, presenting as genetically and histologically distinct tumors. Comprehensive sampling of these lesions can therefore significantly alter diagnosis and management. Additionally, somatic IDH1 R132C mutation in either multicentric or solitary LGG identifies unsuspected germline TP53 mutation, validating the limited number of published cases.

Computed tomography in pulmonary sarcoidosis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lynch, D.A.; Webb, W.R.; Gamsu, G.

1989-05-01

We studied the high resolution CT (HRCT) scans of 15 patients with biopsy-proven sarcoidosis and correlated the findings with pulmonary function tests (12 patients), 67Ga scans (10 patients), bronchoalveolar lavage (five patients), recent transbronchial biopsy (six patients), and recent open lung biopsy (three patients). The HRCT features included small nodules, thickened interlobular septa, patchy focal increase in lung density, honeycombing, and central conglomeration of vessels and bronchi. Active alveolitis was present by gallium scanning criteria in 5 of 10 cases. By bronchoalveolar lavage criteria, activity was present in three of five cases. Patchy increase in density may correlate with activemore » alveolitis as seen on /sup 67/Ga scanning. High resolution CT was better than chest X-radiography for demonstration of patchy increase in density and for distinguishing nodules from septal thickening. Both nodules and patchy density were partly reversible following therapy. Nodular densities seen on CT correlated with the presence of granulomata on histology. Resting pulmonary function tests correlated poorly with presence and extent of lung disease on HRCT. The presence on HRCT of focal fine nodules, patchy focal increase in lung density, and central crowding of bronchi and vessels should suggest the diagnosis of sarcoidosis. In some patients, HRCT can identify unsuspected parenchymal lung disease and document the reversible components of sarcoid lung disease.« less

Perforation of viscera, a dramatic complication of liposuction: a review of 19 cases evaluated by experts in France between 2000 and 2012.

PubMed

Zakine, Gilbert; Baruch, Jean; Dardour, Jean-Claude; Flageul, Gérard

2015-03-01

Perforation of one or several intraperitoneal organs during a liposuction procedure is an exceptional but underestimated complication. Knowledge of this complication is essential because of frequent delay in diagnosis and possible dramatic consequences. Nineteen cases were evaluated by experts and are presented in a retrospective analysis. Sixteen women and three men, aged 24 to 72 years, were operated on in France between July of 2001 and January of 2012. Abdominal liposuction (200 to 2400 ml) was performed in combination or not with an abdominoplasty. Uncommon pain and an intestinal obstruction were present in all of the patients. The peritonitis was never frank, replaced frequently by infraclinic peritonitis with septic and/or hypovolemic shock. Diagnosis, performed by abdominal scan between days 1 and 7, revealed intraperitoneal gas or liquid. Perforation, unique or multiple, because of the intraperitoneal passage of the cannula, often in the umbilical region and promoted by the presence of a hernia, involved the following organs: ileum (14 cases), jejunum (two cases), spleen (two cases), transverse colon (one case), cecum (one case), and sigmoid (one case). Death occurred in three cases, between days 2 and 11. Eleven patients had temporary ileostomy or colostomy. Associated complications were abdominal wall cellulitis, necrotizing fasciitis, thrombophlebitis, lung collection, and late subobstructive syndrome. Visceral perforation during liposuction, a severe and sometimes fatal complication with late and difficult diagnosis, is not often reported. Careful technique, particularly if an umbilical approach is used, should avoid this dramatic complication. Therapeutic, IV.

Endogenous rhythmic growth in oak trees is regulated by internal clocks rather than resource availability.

PubMed

Herrmann, S; Recht, S; Boenn, M; Feldhahn, L; Angay, O; Fleischmann, F; Tarkka, M T; Grams, T E E; Buscot, F

2015-12-01

Common oak trees display endogenous rhythmic growth with alternating shoot and root flushes. To explore the mechanisms involved, microcuttings of the Quercus robur L. clone DF159 were used for (13)C/(15)N labelling in combination with RNA sequencing (RNASeq) transcript profiling of shoots and roots. The effect of plant internal resource availability on the rhythmic growth of the cuttings was tested through inoculation with the ectomycorrhizal fungus Piloderma croceum. Shoot and root flushes were related to parallel shifts in above- and below-ground C and, to a lesser extent, N allocation. Increased plant internal resource availability by P. croceum inoculation with enhanced plant growth affected neither the rhythmic growth nor the associated resource allocation patterns. Two shifts in transcript abundance were identified during root and shoot growth cessation, and most concerned genes were down-regulated. Inoculation with P. croceum suppressed these transcript shifts in roots, but not in shoots. To identify core processes governing the rhythmic growth, functions [Gene Ontology (GO) terms] of the genes differentially expressed during the growth cessation in both leaves and roots of non-inoculated plants and leaves of P. croceum-inoculated plants were examined. Besides genes related to resource acquisition and cell development, which might reflect rather than trigger rhythmic growth, genes involved in signalling and/or regulated by the circadian clock were identified. The results indicate that rhythmic growth involves dramatic oscillations in plant metabolism and gene regulation between below- and above-ground parts. Ectomycorrhizal symbiosis may play a previously unsuspected role in smoothing these oscillations without modifying the rhythmic growth pattern. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology.

Observations on streamwise vortices in laminar and turbulent boundary layers

NASA Technical Reports Server (NTRS)

Morkovin, M. V.

1979-01-01

The frequent but often unsuspected presence of streamwise vortices in nominally two dimensional laminar and turbulent boundary layers and some of their consequences are described. Since there is no body of systematic information on streamwise vortices imbedded in boundary layers, a number of issues concerning their occurrence and behavior are discussed in the form of a set of succinct observations. Desirable experimental and numerical research to remedy the current lack of knowledge is recommended.

X-linked ocular albinism in Blacks. Ocular albinism cum pigmento.

PubMed

O'Donnell, F E; Green, W R; Fleischman, J A; Hambrick, G W

1978-07-01

X-linked ocular albinism can be an unsuspected cause of congenital nystagmus in blacks. In this study, eight of ten black ocular albinos from two kindreds had nonalbinotic, moderately pigmented fundi and no transillumination of the iris. We refer to this paradoxical condition as "ocular albinism cum pigmento." The only constant ophthalmoscopic feature was a foveal hypoplasia. Biopsy of clinically normal skin to demonstrate giant pigment granules is the most accurate means of diagnosis.

Knowledge Based Systems (KBS) Verification, Validation, Evaluation, and Testing (VVE&T) Bibliography: Topical Categorization

DTIC Science & Technology

2003-03-01

Different?," Jour. of Experimental & Theoretical Artificial Intelligence, Special Issue on Al for Systems Validation and Verification, 12(4), 2000, pp...Hamilton, D., " Experiences in Improving the State of Practice in Verification and Validation of Knowledge-Based Systems," Workshop Notes of the AAAI...Unsuspected Power of the Standard Turing Test," Jour. of Experimental & Theoretical Artificial Intelligence., 12, 2000, pp3 3 1-3 4 0 . [30] Gaschnig

Beam Attenuators and the Risk of Unrecognized Large-Fraction Irradiation of Critical Tissues

DOE Office of Scientific and Technical Information (OSTI.GOV)

Luka, S.; Marks, J.E.

2015-01-15

The use of radiation beam attenuators led to radiation injury of the spinal cord in one patient and of the peripheral nerve in another due to unsuspected large-fraction irradiation. The anatomic distribution of radiation dose was reconstructed in the sagittal plane for the patient who developed radiation myelopathy and in the axial plane for the patient who developed peripheral neuropathy. The actual dose delivered to the injured structure in each patient was taken from the dose distribution and recorded along with the time, number of fractions, and dose per fraction. The patient who developed radiation myelopathy received a total ofmore » 46.5 Gy in twenty-three 2.1 Gy fractions in 31 days to the upper cervical spinal cord where the thickness of the neck was less than the central axis thickness due to cervical lordosis and absence of a posterior compensating filter. The patient who developed peripheral neuropathy received 55 Gy in twenty-five 2.2 Gy fractions in 50 days to the femoral nerve using bolus over the groins and an anterior one-half value layer Cerrobend pelvic block to bias the dose anteriorly. Compensating filters and other beam attenuators should be used with caution because they may result in unsuspected large-fraction irradiation and total doses of radiation that exceed the tolerance of critical structures.« less

Unsuspected functional disparity in Devonian fishes revealed by tooth morphometrics?

NASA Astrophysics Data System (ADS)

Gauchey, Samuel; Girard, Catherine; Adnet, Sylvain; Renaud, Sabrina

2014-09-01

The shape of features involved in key biological functions, such as teeth in nutrition, can provide insights into ecological processes even in ancient time, by linking the occupation of the morphological space (disparity) to the occupation of the ecological space. Investigating disparity in radiating groups may provide insights into the ecological diversification underlying evolution of morphological diversity. Actinopterygian fishes initiated their radiation in the Devonian, a period characterized by the diversification of marine ecosystem. Although a former morpho-functional analysis of jaw shape concluded to conservative and poorly diversified morphologies in this early part of their history, fish tooth disparity evidenced here an unsuspected diversity of possible functional significance in the pivotal period of the Late Devonian (Famennian). All teeth being caniniforms, some were stocky and robust, in agreement with expectations for active generalist predators. More surprisingly, elongated teeth also occurred at the beginning of Famennian. Their needle-like shape challenges morpho-functional interpretations by making them fragile in response to bending or torsion. The occurrence of both types of fish teeth during the beginning of the Famennian points to a discrete but real increase in disparity, thus testifying a first burst of feeding specialization despite overall conservative jaw morphology. The disappearance of these needle-like teeth in the Late Famennian might have been related to a relay in dental diversity with abundant co-occurring groups, namely conodonts and chondrichthyans (sharks).

Clinical utility of transthoracic two-dimensional and Doppler echocardiography.

PubMed

Krumholz, H M; Douglas, P S; Goldman, L; Waksmonski, C

1994-07-01

The purpose of this study was to determine the value of contemporary echocardiography for patient diagnosis and management in clinical practice. Although the use of echocardiography is growing rapidly, there is little information about its clinical utility. A prospective observational study was performed at a community-based, tertiary care teaching hospital. Physicians were interviewed before and after learning the result of their patients' echocardiographic examination. Chart reviews were performed to confirm reports of new diagnoses and treatments that resulted from echocardiography. Physician interviews were successfully completed for 244 (49%) of 497 inpatients and 101 (30%) of 336 outpatients. Among patients with moderate or greater mitral regurgitation, the diagnosis of "clinically significant" mitral regurgitation was unsuspected in 5 (31%) of 16 outpatients and 28 (60%) of 47 inpatients. Among the patients with left ventricular wall motion abnormalities, the result was unsuspected in 7 (50%) of 14 outpatients and 18 (22%) of 81 inpatients. As assessed by chart review, echocardiography produced a definite new diagnosis in 25 inpatients (10%) and 5 outpatients (5%) and was responsible for changes in pharmacologic treatment in at least 16 inpatients (7%) and 2 outpatients (2%). The echocardiogram commonly provided information that was unexpected. This information provided a definite new diagnosis or treatment in a smaller proportion of the patients. Further research is necessary to define the appropriate yield that would warrant echocardiography on the basis of both clinical and cost-effectiveness criteria.

A phosphodiesterase 4B-dependent interplay between tumor cells and the microenvironment regulates angiogenesis in B-cell lymphoma

PubMed Central

Suhasini, Avvaru N.; Lin, An-Ping; Bhatnagar, Harshita; Kim, Sang-Woo; Moritz, August W.; Aguiar, Ricardo C. T.

2015-01-01

Angiogenesis associates with poor outcome in diffuse large B-cell lymphoma (DLBCL), but the contribution of the lymphoma cells to this process remains unclear. Addressing this knowledge gap may uncover unsuspecting proangiogenic signaling nodes and highlight alternative antiangiogenic therapies. Here we identify the second messenger cyclic-AMP (cAMP) and the enzyme that terminates its activity, phosphodiesterase 4B (PDE4B), as regulators of B-cell lymphoma angiogenesis. We first show that cAMP, in a PDE4B-dependent manner, suppresses PI3K/AKT signals to down-modulate VEGF secretion and vessel formation in vitro. Next, we create a novel mouse model that combines the lymphomagenic Myc transgene with germline deletion of Pde4b. We show that lymphomas developing in a Pde4b-null background display significantly lower microvessel density in association with lower VEGF levels and PI3K/AKT activity. We recapitulate these observations by treating lymphoma-bearing mice with the FDA-approved PDE4 inhibitor Roflumilast. Lastly, we show that primary human DLBCLs with high PDE4B expression display significantly higher microvessel density. Here, we defined an unsuspected signaling circuitry in which the cAMP generated in lymphoma cells downmodulates PI3K/AKT and VEGF secretion to negatively influence vessel development in the microenvironment. These data identify PDE4 as an actionable antiangiogenic target in DLBCL. PMID:26503641

The use of organic and inorganic impurities found in MDMA police seizures in a drug intelligence perspective.

PubMed

Morelato, Marie; Beavis, Alison; Tahtouh, Mark; Ribaux, Olivier; Kirkbride, Paul; Roux, Claude

2014-01-01

Traditional forensic drug profiling involves numerous analytical techniques, and the whole process is typically costly and may be time consuming. The aim of this study was to investigate the possibility of prioritising techniques utilised at the Australian Federal Police (AFP) for the chemical profiling of 3,4-methylenedioxymethylamphetamine (MDMA). The outcome would provide the AFP with the ability to obtain more timely and valuable results that could be used in an intelligence perspective. Correlation coefficients were used to obtain a similarity degree between a population of linked samples (within seizures) and a population of unlinked samples (between different seizures) and discrimination between the two populations was ultimately achieved. The results showed that gas chromatography-mass spectrometry (GC-MS) was well suited as a single technique to detect links between seizures and could be used in priority for operational intelligence purposes. Furthermore, the method was applied to seizures known or suspected (through their case information) to be linked to each other to assess the chemical similarity between samples. It was found that half of the seizures previously linked by the case number were also linked by the chemical profile. This procedure was also able to highlight links between cases that were previously unsuspected and retrospectively confirmed by circumstantial information. The findings are finally discussed in the broader forensic intelligence context, with a focus on how they could be successfully incorporated into investigations and in an intelligence-led policing perspective in order to understand trafficking markets. © 2014.

Pseudomonas oryzihabitans sepsis in a 1-year-old child with multiple skin rashes: a case report.

PubMed

Owusu, Michael; Owusu-Dabo, Ellis; Acheampong, Godfred; Osei, Isaac; Amuasi, John; Sarpong, Nimako; Annan, Augustina; Chiang, Hsin-Ying; Kuo, Chih-Horng; Park, Se Eun; Marks, Florian; Adu-Sarkodie, Yaw

2017-03-23

Pseudomonas oryzihabitans is a Pseudomonas bacterial organism rarely implicated in human infections. The bacterium has been isolated in a few reported cases of neurosurgical infections and patients with end-stage cirrhosis, sickle cell disease, and community-acquired urinary tract infections. Limited information exists in developing countries, however, because of the lack of advanced microbiological tools for identification and characterization of this bacterium. This case report describes the isolation of a rare Pseudomonas bacterium in a patient presenting with sepsis and skin infection. A 1-year-old girl was presented to a hospital in the northeastern part of Ghana with a 1-week history of pustular rashes on her scalp and neck, which occasionally ruptured, along with discharge of yellowish purulent fluid. The child is of Mole-Dagbon ethnicity and hails from the northern part of Ghana. Pseudomonas oryzihabitans was identified in the patient's blood culture using the 16S ribosomal deoxyribonucleic acid sequencing technique. The rash on the patient's scalp and skin resolved after continuous treatment with gentamicin while her condition improved clinically. This finding suggests the potential of this bacterium to cause disease in unsuspected situations and emphasizes the need to have evidence for the use of the appropriate antibiotic in clinical settings, particularly in rural settings in Africa. It also brings to the fore the unreliability of conventional methods for identification of Pseudomonas bacteria in clinical samples and thus supports the use of 16S ribosomal deoxyribonucleic acid in making the diagnosis.

Laparoscopic managment of common bile duct stones: our initial experience.

PubMed Central

Aroori, S.; Bell, J. C.

2002-01-01

The management of choledocholithiasis has changed radically since the introduction of laparoscopic cholecystectomy. However, perceived technical difficulties have deterred many surgeons from treating common bile duct stones laparoscopically at the time of cholecystectomy. This has lead to reliance on endoscopic retrograde cholangiopancreatography followed by endoscopic sphincterotomy to deal with common bile duct stones. We retrospectively reviewed the charts of patients who had laparoscopic common bile duct exploration at Downe Hospital between December 1999 and August 2001. Among 149 laparoscopic cholecystectomies done by our group in this period, 10 patients (6.7%) underwent laparoscopic CBD exploration, three by the transcystic technique and seven by choledochotomy. Three patients (2%) had unsuspected stones found on routine per- operative cholangiogram. The mean operative time was 2.34hrs (range 1.50-3.30hrs). The mean hospital post- operative stay was 3 days (range 1-6 days). Post-operative morbidity was zero. Stone clearance was achieved in all cases. We conclude, laparoscopic exploration of the common bile duct is relatively safe and straightforward method. The key skill required is the ability to perform laparoscopic suturing with confidence. PMID:12137159

Laparoscopic managment of common bile duct stones: our initial experience.

PubMed

Aroori, S; Bell, J C

2002-05-01

The management of choledocholithiasis has changed radically since the introduction of laparoscopic cholecystectomy. However, perceived technical difficulties have deterred many surgeons from treating common bile duct stones laparoscopically at the time of cholecystectomy. This has lead to reliance on endoscopic retrograde cholangiopancreatography followed by endoscopic sphincterotomy to deal with common bile duct stones. We retrospectively reviewed the charts of patients who had laparoscopic common bile duct exploration at Downe Hospital between December 1999 and August 2001. Among 149 laparoscopic cholecystectomies done by our group in this period, 10 patients (6.7%) underwent laparoscopic CBD exploration, three by the transcystic technique and seven by choledochotomy. Three patients (2%) had unsuspected stones found on routine per- operative cholangiogram. The mean operative time was 2.34hrs (range 1.50-3.30hrs). The mean hospital post- operative stay was 3 days (range 1-6 days). Post-operative morbidity was zero. Stone clearance was achieved in all cases. We conclude, laparoscopic exploration of the common bile duct is relatively safe and straightforward method. The key skill required is the ability to perform laparoscopic suturing with confidence.

Automatic classification of spectra from the Infrared Astronomical Satellite (IRAS)

NASA Technical Reports Server (NTRS)

Cheeseman, Peter; Stutz, John; Self, Matthew; Taylor, William; Goebel, John; Volk, Kevin; Walker, Helen

1989-01-01

A new classification of Infrared spectra collected by the Infrared Astronomical Satellite (IRAS) is presented. The spectral classes were discovered automatically by a program called Auto Class 2. This program is a method for discovering (inducing) classes from a data base, utilizing a Bayesian probability approach. These classes can be used to give insight into the patterns that occur in the particular domain, in this case, infrared astronomical spectroscopy. The classified spectra are the entire Low Resolution Spectra (LRS) Atlas of 5,425 sources. There are seventy-seven classes in this classification and these in turn were meta-classified to produce nine meta-classes. The classification is presented as spectral plots, IRAS color-color plots, galactic distribution plots and class commentaries. Cross-reference tables, listing the sources by IRAS name and by Auto Class class, are also given. These classes show some of the well known classes, such as the black-body class, and silicate emission classes, but many other classes were unsuspected, while others show important subtle differences within the well known classes.

Vancomycin-Associated Cast Nephropathy

PubMed Central

Luque, Yosu; Louis, Kevin; Jouanneau, Chantal; Placier, Sandrine; Esteve, Emmanuel; Bazin, Dominique; Rondeau, Eric; Letavernier, Emmanuel; Wolfromm, Alice; Gosset, Clément; Boueilh, Anna; Burbach, Maren; Frère, Perrine; Verpont, Marie-Christine; Vandermeersch, Sophie; Langui, Dominique; Daudon, Michel; Frochot, Vincent

2017-01-01

Vancomycin is a widely prescribed antibiotic, but the exact nature of vancomycin-associated nephrotoxicity is unclear, in particular when considering the frequent coadministration of aminoglycosides. We describe here the initial case of a 56-year-old woman with normal renal function developing unexplained ARF without hypovolemia after administration of vancomycin without coadministration of aminoglycosides. Studying the patient’s renal biopsy specimen, we ascertained that obstructive tubular casts composed of noncrystal nanospheric vancomycin aggregates entangled with uromodulin explained the vancomycin-associated ARF. We developed in parallel a new immunohistologic staining technique to detect vancomycin in renal tissue and confirmed retrospectively that deleterious vancomycin-associated casts existed in eight additional patients with acute tubular necrosis in the absence of hypovolemia. Concomitant high vancomycin trough plasma levels had been observed in each patient. We also reproduced experimentally the toxic and obstructive nature of vancomycin-associated cast nephropathy in mice, which we detected using different in vivo imaging techniques. In conclusion, the interaction of uromodulin with nanospheric vancomycin aggregates represents a new mode of tubular cast formation, revealing the hitherto unsuspected mechanism of vancomycin-associated renal injury. PMID:28082518

Vancomycin-Associated Cast Nephropathy.

PubMed

Luque, Yosu; Louis, Kevin; Jouanneau, Chantal; Placier, Sandrine; Esteve, Emmanuel; Bazin, Dominique; Rondeau, Eric; Letavernier, Emmanuel; Wolfromm, Alice; Gosset, Clément; Boueilh, Anna; Burbach, Maren; Frère, Perrine; Verpont, Marie-Christine; Vandermeersch, Sophie; Langui, Dominique; Daudon, Michel; Frochot, Vincent; Mesnard, Laurent

2017-06-01

Vancomycin is a widely prescribed antibiotic, but the exact nature of vancomycin-associated nephrotoxicity is unclear, in particular when considering the frequent coadministration of aminoglycosides. We describe here the initial case of a 56-year-old woman with normal renal function developing unexplained ARF without hypovolemia after administration of vancomycin without coadministration of aminoglycosides. Studying the patient's renal biopsy specimen, we ascertained that obstructive tubular casts composed of noncrystal nanospheric vancomycin aggregates entangled with uromodulin explained the vancomycin-associated ARF. We developed in parallel a new immunohistologic staining technique to detect vancomycin in renal tissue and confirmed retrospectively that deleterious vancomycin-associated casts existed in eight additional patients with acute tubular necrosis in the absence of hypovolemia. Concomitant high vancomycin trough plasma levels had been observed in each patient. We also reproduced experimentally the toxic and obstructive nature of vancomycin-associated cast nephropathy in mice, which we detected using different in vivo imaging techniques. In conclusion, the interaction of uromodulin with nanospheric vancomycin aggregates represents a new mode of tubular cast formation, revealing the hitherto unsuspected mechanism of vancomycin-associated renal injury. Copyright © 2017 by the American Society of Nephrology.

Multiplex qPCR for reliable detection and differentiation of Burkholderia mallei and Burkholderia pseudomallei.

PubMed

Janse, Ingmar; Hamidjaja, Raditijo A; Hendriks, Amber C A; van Rotterdam, Bart J

2013-02-14

Burkholderia mallei and B. pseudomallei are two closely related species of highly virulent bacteria that can be difficult to detect. Pathogenic Burkholderia are endemic in many regions worldwide and cases of infection, sometimes brought by travelers from unsuspected regions, also occur elsewhere. Rapid, sensitive methods for identification of B. mallei and B. pseudomallei are urgently needed in the interests of patient treatment and epidemiological surveillance. Signature sequences for sensitive, specific detection of pathogenic Burkholderia based on published genomes were identified and a qPCR assay was designed and validated. A single-reaction quadruplex qPCR assay for the detection of pathogenic Burkholderia, which includes a marker for internal control of DNA extraction and amplification, was developed. The assay permits differentiation of B. mallei and B. pseudomallei strains, and probit analysis showed a very low detection limit. Use of a multicopy signature sequence permits detection of less than 1 genome equivalent per reaction. The new assay permits rapid detection of pathogenic Burkholderia and combines enhanced sensitivity, species differentiation, and inclusion of an internal control for both DNA extraction and PCR amplification.

Activation of RNA polymerase III transcription of human Alu repetitive elements by adenovirus type 5: requirement for the E1b 58-kilodalton protein and the products of E4 open reading frames 3 and 6.

PubMed Central

Panning, B; Smiley, J R

1993-01-01

We found that transcription of endogenous human Alu elements by RNA polymerase III was strongly stimulated following infection of HeLa cells with adenovirus type 5, leading to the accumulation of high levels of Alu transcripts initiated from Alu polymerase III promoters. In contrast to previously reported cases of adenovirus-induced activation of polymerase III transcription, induction required the E1b 58-kDa protein and the products of E4 open reading frames 3 and 6 in addition to the 289-residue E1a protein. In addition, E1a function was not required at high multiplicities of infection, suggesting that E1a plays an indirect role in Alu activation. These results suggest previously unsuspected regulatory properties of the adenovirus E1b and E4 gene products and provide a novel approach to the study of the biology of the most abundant class of dispersed repetitive DNA in the human genome. Images PMID:7684492

Is ursodeoxycholic acid detrimental in obstructive cholestasis? A propos of a case of malignant biliary obstruction.

PubMed

Bessone, Fernando; Roma, Marcelo Gabriel

2016-01-01

Ursodeoxycholic acid (UDCA) is the first choice medication for most cholestatic hepatopathies, due to its capability to counteract inflammation and bile-acid-induced liver damage, two common features in cholestasis. However, UDCA is usually contraindicated in obstructive cholestasis, due to the alleged risk of biliary integrity disruption due to its choleretic effect. We report on an 83-year-old man with an unsuspected malignant biliary obstruction who received moderate doses of UDCA (8-12 mg/kg/day) for 5 weeks, because the preliminary evidence suggested he had chemotherapy-induced cholestasis. Liver integrity was extensively protected by UDCA, as indicated by a marked decrease in serum liver enzymes, despite a steady increase in the levels of bilirubin and serum bile acids due to the obstructive process. In conclusion, this report shows, for the first time in humans, that moderate UDCA doses can reduce liver injury associated with complete biliary obstruction. This may contribute to a better understanding of the risk-benefit ratio of the use of UDCA in obstructive cholangiopathies.

Current strategies to avoid misdiagnosis of malaria.

PubMed

Hänscheid, T

2003-06-01

Malaria remains the most important parasitic disease, and tens of thousands of cases are imported into non-endemic countries annually. However, any single institution may see only a very few cases-this is probably the reason why laboratory and clinical misdiagnosis may not be uncommon. In the laboratory, unfamiliarity with microscopic diagnosis may be the main reason, considering the large number of laboratory staff who provide on-call services, often without expert help at hand, as well as the difficulty in detecting cases with low-level parasitemia. Staff should therefore be provided with continuing microscopic training to maintain proficiency. The complementary use of immunochromatographic rapid detection tests (RDTs) may be useful, especially during on-call hours, although, in order to ensure correct interpretation, their inherent limitations have to be well known. Diagnosis based on the polymerase chain reaction is still unsuitable for routine use, due to its long turnaround time, its cost, and its unavailability outside regular hours, although it may be helpful in selected cases. Once the alert clinician has considered the possibility of malaria, and suspicion continues to be high, malaria can be excluded by repeat smears or RDTs. However, the absence of clinical suspicion may not be infrequent, and may have more serious consequences. Depending on the local number of malaria cases seen, laboratory staff should have a low threshold for the decision to perform unsolicited malaria diagnostic tests on suspicious samples, especially if other laboratory tests are abnormal (e.g. thrombocytopenia, presence of atypical lymphocytes, or raised lactate dehydrogenase). The detection of intraleukocytic hemozoin during automated full blood counts is a promising new way to avoid misdiagnosis of clinically unsuspected malaria.

Sonographic features of incidentally detected, small, nonpalpable ovarian dermoids.

PubMed

Serafini, G; Quadri, P G; Gandolfo, N G; Gandolfo, N; Martinoli, C; Derchi, L E

1999-09-01

We describe the transvaginal sonographic features of incidentally detected, small, nonpalpable ovarian dermoid cysts. A total of 38 small (less than 3 cm in diameter), nonpalpable, incidentally discovered ovarian dermoids in 35 women were retrospectively reviewed; 3 patients had small bilateral lesions, and 7 had a small ovarian dermoid detected during preoperative evaluation of a symptomatic, large, contralateral lesion. Transvaginal sonography permitted identification of all 38 dermoids, whereas abdominal sonography detected only 22 of the lesions. Three main structural patterns were observed with transvaginal sonography: (1) 20 of 38 lesions had a solid, hyperechoic appearance, either homogeneous (11) or heterogeneous (9); (2) a fluid-filled area with a hyperechoic focus in its wall was seen in 10 cases; and (3) a mixed pattern, with solid and liquid areas, was seen in 8 cases. Calcifications were appreciated in 7 lesions. Acoustic shadowing was noted in 30 cases, either as a shadow posterior to the hyperechoic portion of the mass or as an edge shadow lateral to the lesion. Doppler studies were obtained for 20 lesions but proved inconclusive: 4 mixed-pattern dermoids had a few internal signals with a low resistance pattern; in the remaining cases, there were signals at the periphery of the cysts, but it could not be determined whether these were from vessels within the lesions or from vessels in the surrounding ovarian parenchyma. Surgery confirmed benign cystic dermoids in all 38 cases. Sonographically, small ovarian dermoids have a variety of textural patterns quite similar to those encountered in large, symptomatic lesions. The increased resolution capabilities provided by transvaginal sonography allow incidental detection of previously unsuspected dermoids and permit identification of their nature. Copyright 1999 John Wiley & Sons, Inc.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Finestone, H.; Goldfarb, C.R.; Ongseng, F.

Spontaneous pneumothorax is a serious though infrequently reported pulmonary complication of AIDS. An unsuspected lung collapse was discovered via gallium scintigraphy for the study of Pneumocystis carinii pneumonia. Neither the pneumonia nor the pneumothorax were apparent on the most recent chest roentgenogram. In evaluating gallium images during the work-up of AIDS patients with associated pulmonary pathology, the possible complication of lung collapse should be considered. If pneumothorax is suspected on gallium imaging, a chest roentgenogram in expiration must be obtained for prompt delineation of this serious, yet correctable, condition.

Disseminated strongyloidiasis in a immunocompromised host.

PubMed

Mundkur, Suneel C; Aroor, Shrikiran; Jayashree, K

2011-12-01

Strongyloidiasis in an immunocompromised patient has the potential to be life threatening. We describe a boy who was on steroids for acute demyelinating myelitis and receiving antibiotics for E. coli UTI and meningitis. He developed anasarca, malabsorption, malnutrition and left ventricular failure. Duodenal biopsy revealed abundant rhabditiform larvae of Strongyloides stercoralis. The diagnosis went unsuspected and proved fatal. This emphasizes the need to have a high index of suspicion and early intervention for S. stercoralis in immunosuppressed persons who present with refractory gastrointestinal symptoms.

TAR (Theatre as Representation) as a Provocative Teaching Tool in School Administration: A Dramatized Inclusive Classroom Scenario

ERIC Educational Resources Information Center

Meyer, Matthew J.; Young, David C.

2013-01-01

The following dramatized classroom scenario depicts a teacher struggling with the nature of an inclusive learning environment, with instructional leadership and supervision of instruction as the theoretical and practical backdrop. The purpose of this article is to demonstrate how the use of a TAR (theatre as representation) case study can be used…

Producing Multimodal Picture Books and Dramatic Performances in a Core French Classroom: An Exploratory Case Study

ERIC Educational Resources Information Center

Early, Margaret; Yeung, Cindy

2009-01-01

In a Grade 9 core French class, the teacher designed a multi-stage project in which students composed original children's stories in French; illustrated their stories to produce picture books; then, in groups, adapted one group member's story into a play script; and, finally, dramatized the scripts for children from the local French immersion…

Becoming Warriors: Dramatic Inquiry with 11- to 12-Year-Olds in an EBD Classroom

ERIC Educational Resources Information Center

Edmiston, Brian; Sobjack, Laura

2017-01-01

Using a dialogue format, a college professor and a teacher of 11- to 12-year-old children with emotional and behavioural difficulties (EBD) report on a case study of four children (three boys and a girl) when over a three-week period dramatic inquiry pedagogy (focused on the meaning for students of fictional violent events depicted in extracts…

Heterogeneity of Environments Associated with Transmission of Visceral Leishmaniasis in South-Eastern France and Implication for Control Strategies

PubMed Central

Faucher, Benoit; Gaudart, Jean; Faraut, Francoise; Pomares, Christelle; Mary, Charles; Marty, Pierre; Piarroux, Renaud

2012-01-01

Background Visceral leishmaniasis due to Leishmania infantum is currently spreading into new foci across Europe. Leishmania infantum transmission in the Old World was reported to be strongly associated with a few specific environments. Environmental changes due to global warming or human activity were therefore incriminated in the spread of the disease. However, comprehensive studies were lacking to reliably identify all the environments at risk and thereby optimize monitoring and control strategy. Methodology/Findings We exhaustively collected 328 cases of autochthonous visceral leishmaniasis from 1993 to 2009 in South-Eastern France. Leishmaniasis incidence decreased from 31 yearly cases between 1993 and 1997 to 12 yearly cases between 2005 and 2009 mostly because Leishmania/HIV coinfection were less frequent. No spread of human visceral leishmaniasis was observed in the studied region. Two major foci were identified, associated with opposite environments: whereas one involved semi-rural hillside environments partly made of mixed forests, the other involved urban and peri-urban areas in and around the region main town, Marseille. The two neighboring foci were related to differing environments despite similar vectors (P. perniciosus), canine reservoir, parasite (L. infantum zymodeme MON-1), and human host. Conclusions/Significance This unprecedented collection of cases highlighted the occurrence of protracted urban transmission of L. infantum in France, a worrisome finding as the disease is currently spreading in other areas around the Mediterranean. These results complete previous studies about more widespread canine leishmaniasis or human asymptomatic carriage. This first application of systematic geostatistical methods to European human visceral leishmaniasis demonstrated an unsuspected heterogeneity of environments associated with the transmission of the disease. These findings modify the current view of leishmaniasis epidemiology. They notably stress the need for locally defined control strategies and extensive monitoring including in urban environments. PMID:22880142

Heterogeneity of environments associated with transmission of visceral leishmaniasis in South-Eastern France and implication for control strategies.

PubMed

Faucher, Benoit; Gaudart, Jean; Faraut, Francoise; Pomares, Christelle; Mary, Charles; Marty, Pierre; Piarroux, Renaud

2012-01-01

Visceral leishmaniasis due to Leishmania infantum is currently spreading into new foci across Europe. Leishmania infantum transmission in the Old World was reported to be strongly associated with a few specific environments. Environmental changes due to global warming or human activity were therefore incriminated in the spread of the disease. However, comprehensive studies were lacking to reliably identify all the environments at risk and thereby optimize monitoring and control strategy. We exhaustively collected 328 cases of autochthonous visceral leishmaniasis from 1993 to 2009 in South-Eastern France. Leishmaniasis incidence decreased from 31 yearly cases between 1993 and 1997 to 12 yearly cases between 2005 and 2009 mostly because Leishmania/HIV coinfection were less frequent. No spread of human visceral leishmaniasis was observed in the studied region. Two major foci were identified, associated with opposite environments: whereas one involved semi-rural hillside environments partly made of mixed forests, the other involved urban and peri-urban areas in and around the region main town, Marseille. The two neighboring foci were related to differing environments despite similar vectors (P. perniciosus), canine reservoir, parasite (L. infantum zymodeme MON-1), and human host. This unprecedented collection of cases highlighted the occurrence of protracted urban transmission of L. infantum in France, a worrisome finding as the disease is currently spreading in other areas around the Mediterranean. These results complete previous studies about more widespread canine leishmaniasis or human asymptomatic carriage. This first application of systematic geostatistical methods to European human visceral leishmaniasis demonstrated an unsuspected heterogeneity of environments associated with the transmission of the disease. These findings modify the current view of leishmaniasis epidemiology. They notably stress the need for locally defined control strategies and extensive monitoring including in urban environments.

The risk of retention of the capsule endoscope in patients with known or suspected Crohn's disease.

PubMed

Cheifetz, Adam S; Kornbluth, Asher A; Legnani, Peter; Schmelkin, Ira; Brown, Alphonso; Lichtiger, Simon; Lewis, Blair S

2006-10-01

Capsule endoscopy (CE) allows visualization of the mucosa of the entire small bowel and is therefore a potentially important tool in the evaluation of patients with known or suspected Crohn's disease (CD). However, small bowel strictures, which are not uncommon in Crohn's, are considered to be a contraindication to CE for fear of capsule retention. Our goal was to determine the risk of capsule retention in patients with suspected or known CD. We retrospectively reviewed the records of 983 CE cases performed at three private gastroenterology practices between December 2000 and December 2003, and selected those with suspected or proven Crohn's. A total of 102 cases were identified in which CE was used in patients with suspected (N = 64) or known (N = 38) CD. Only one of 64 patients (1.6%) with suspected CD had a retained capsule. However, in five of 38 (13%) patients with known Crohn's, the capsule was retained proximal to a stricture. Of the five cases of retained capsules, three strictures were previously unknown. In four cases, the obstructing lesions were resected without complications, leading to complete resolution of the patient's underlying symptoms. One patient chose not to undergo surgery and has remained without an episode of small bowel obstruction for over 38 months. Capsule retention occurred in 13% (95% CI 5.6%-28%) of patients with known CD, but only in 1.6% (95% CI 0.2%-10%) with suspected Crohn's. A retained capsule may indicate unsuspected strictures in Crohn's that may require an unexpected, but therapeutic, surgical intervention. Patients and physicians should be aware of these potential risks when using CE in CD.

Eagle's Syndrome

PubMed Central

Pinheiro, Thaís Gonçalves; Soares, Vítor Yamashiro Rocha; Ferreira, Denise Bastos Lage; Raymundo, Igor Teixeira; Nascimento, Luiz Augusto; Oliveira, Carlos Augusto Costa Pires de

2013-01-01

Summary Introduction: Eagle's syndrome is characterized by cervicopharyngeal signs and symptoms associated with elongation of the styloid apophysis. This elongation may occur through ossification of the stylohyoid ligament, or through growth of the apophysis due to osteogenesis triggered by a factor such as trauma. Elongation of the styloid apophysis may give rise to intense facial pain, headache, dysphagia, otalgia, buzzing sensations, and trismus. Precise diagnosis of the syndrome is difficult, and it is generally confounded by other manifestations of cervicopharyngeal pain. Objective: To describe a case of Eagle's syndrome. Case Report: A 53-year-old man reported lateral pain in his neck that had been present for 30 years. Computed tomography (CT) of the neck showed elongation and ossification of the styloid processes of the temporal bone, which was compatible with Eagle's syndrome. Surgery was performed for bilateral resection of the stylohyoid ligament by using a transoral and endoscopic access route. The patient continued to present pain laterally in the neck, predominantly on his left side. CT was performed again, which showed elongation of the styloid processes. The patient then underwent lateral cervicotomy with resection of the stylohyoid process, which partially resolved his painful condition. Final Comments: Patients with Eagle's syndrome generally have a history of chronic pain. Appropriate knowledge of this disease is necessary for adequate treatment to be provided. The importance of diagnosing this uncommon and often unsuspected disease should be emphasized, given that correct clinical-surgical treatment is frequently delayed. The diagnosis of Eagle's syndrome is clinical and radiographic, and the definitive treatment in cases of difficult-to-control pain is surgical. PMID:25992033

A case of organic brain syndrome following head injury successfully treated with carbamazepine.

PubMed

Bouvy, P F; van de Wetering, B J; Meerwaldt, J D; Bruijn, J B

1988-03-01

A case of organic brain syndrome occurring in relation to psychological stress 2 years after a severe head injury is described. Treatment with haloperidol resulted only in slight improvement. A dramatic improvement was achieved with carbamazepine.

Chronic cutaneous lupus erythematosus presenting as periorbital edema and erythema.

PubMed

Cyran, S; Douglass, M C; Silverstein, J L

1992-02-01

We report two unusual cases of cutaneous lupus erythematosus presenting as dramatic eyelid edema and erythema. Neither patient had evidence of systemic or other significant cutaneous involvement. The eyelid edema and erythema were unilateral in one case and bilateral in the other. Both cases responded to therapy with antimalarial drugs.

Etiological and therapeutical observations in a case of belly dancer's dyskinesia.

PubMed

Linazasoro, Girutz; Van Blercom, Nadège; Lasa, Asier; Fernández, José Manuel; Aranzábal, Inés

2005-02-01

We report on the case of a woman with belly dancer's syndrome. This case presented two peculiarities: (1) the condition was induced by the chronic use of clebopride, and (2) abdominal dyskinesias showed a dramatic response to the application of transcutaneous electrical nerve stimulation. Copyright 2004 Movement Disorder Society.

Impact of poor-quality medicines in the 'developing' world.

PubMed

Newton, Paul N; Green, Michael D; Fernández, Facundo M

2010-03-01

Since our ancestors began trading several millennia ago, counterfeit and substandard medicines have been a recurring problem, with history punctuated by crises in the supply of anti-microbials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Unfortunately this problem persists, in particular afflicting unsuspecting patients in 'developing' countries. Poor-quality drugs are a vital (but neglected) public health problem. They contribute to a 'crevasse' between the enormous effort in therapeutic research and policy decisions and implementation of good-quality medicines. 2009 Elsevier Ltd. All rights reserved.

Chloroquine, quinine, procaine, quinidine, tricyclic antidepressants, and methylxanthines as prostaglandin agonists and antagonists.

PubMed

Manku, M S; Horrobin, D F

1976-11-20

Chloroquine, quanine, procaine, quinidine, clomipramine, theophylline, and caffeine have been shown to be strong prostaglandin antagonists and weak agonists. The antagonist effect is clearly demonstrable at concentrations reached in human plasma when the drugs are used therapeutically. This suggests that prostaglandins are important in several situations in which their role has hitherto been unsuspected. New approaches to the development of prostaglandin antagonists and new uses for established drugs are indicated. In a preliminary study chloroquine has been successfully used to close patent ductus arteriosus in three infants.

Cytological detection of a peripheral lung carcinoma in a coke oven worker

DOE Office of Scientific and Technical Information (OSTI.GOV)

Teplitz, R.L.; Belman, M.J.; Nathwani, B.

1980-06-01

OSHA mandated programs of pulmonary cytology among coke oven workers have resulted in detection of a number of unsuspected tumors. While it is too early to determine the eventual impact of these programs, this report describes the detection of a 0.3 cm peripheral lesion, believed to be the smallest identified by cytology. In addition to being diminutive, the tumor proved to be of the epidermoid type, unusual for the location. Further investigation is required to determine whether peripheral epidermoid neoplasms are associated with exposure to coke vapors.

Impact of poor-quality medicines in the ‘developing’ world

PubMed Central

Newton, Paul N.; Green, Michael D.; Fernández, Facundo M.

2010-01-01

Since our ancestors began trading several millennia ago, counterfeit and substandard medicines have been a recurring problem, with history punctuated by crises in the supply of anti-microbials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Unfortunately this problem persists, in particular afflicting unsuspecting patients in ‘developing’ countries. Poor-quality drugs are a vital (but neglected) public health problem. They contribute to a ‘crevasse’ between the enormous effort in therapeutic research and policy decisions and implementation of good-quality medicines. PMID:20117849

Tumors masquerading in patients with thyroid eye disease.

PubMed

Griepentrog, Gregory J; Burkat, Cat N; Kikkawa, Don O; Lucarelli, Mark J

2013-08-01

Thyroid eye disease (TED) is the most common cause of proptosis in adults. The external manifestations of TED are characteristic and the diagnosis is typically made without imaging. Although there are multiple descriptions of primary and secondary orbital tumors initially mistaken for TED in the literature, there are limited reports detailing the findings of patients with long-standing TED whom developed an orbital tumor at a later date. Herein, we present a 6-year retrospective multi-center report of three patients with long-standing TED who developed an initially unsuspected orbital or cavernous sinus tumor.

The DREAM complex: Master coordinator of cell cycle dependent gene expression

PubMed Central

Sadasivam, Subhashini; DeCaprio, James A.

2014-01-01

Preface The dimerization partner (DP), retinoblastoma (RB)-like, E2F and MuvB (DREAM) complex provides a previously unsuspected unifying role in the cell cycle by directly linking p130, p107, E2F, BMYB and FOXM1. DREAM mediates gene repression during G0 and coordinates periodic gene expression with peaks during G1/S and G2/M. Perturbations in DREAM regulation shift the balance from quiescence towards proliferation and contribute to increased mitotic gene expression levels frequently observed in cancers with poor prognosis. PMID:23842645

The Effectiveness of a Case Study-Based First-Year Biology Class at a Black Women's College

ERIC Educational Resources Information Center

Pai, Aditi; Benning, Tracy; Woods, Natasha; McGinnis, Gene; Chu, Joanne; Netherton, Josh; Bauerle, Cynthia

2010-01-01

The authors used a case study-based approach in the introductory biology course at Spelman College. The course taught to entering freshmen was divided into three modules--ecology, evolution, and biodiversity, each designed around a case study. They noted that (1) case study teaching was dramatically more effective than the traditional lecture…

Dramatic reduction of culture time of Mycobacterium tuberculosis

NASA Astrophysics Data System (ADS)

Ghodbane, Ramzi; Raoult, Didier; Drancourt, Michel

2014-02-01

Mycobacterium tuberculosis culture, a critical technique for routine diagnosis of tuberculosis, takes more than two weeks. Here, step-by-step improvements in the protocol including a new medium, microaerophlic atmosphere or ascorbic-acid supplement and autofluorescence detection dramatically shortened this delay. In the best case, primary culture and rifampicin susceptibility testing were achieved in 72 hours when specimens were inoculated directly on the medium supplemented by antibiotic at the beginning of the culture.

URBAN DRINKING WATER DISTRIBUTION SYSTEMS: A U.S. PERSPECTIVE

EPA Science Inventory

This paper will examine several case studies that illustrate the critical role drinking water treatment and distribution systems play in protecting public health. It will also present a case study that documents the dramatic impact that the regulations promulgated under the Safe...

Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease

PubMed Central

Jostins, Luke; Ripke, Stephan; Weersma, Rinse K; Duerr, Richard H; McGovern, Dermot P; Hui, Ken Y; Lee, James C; Schumm, L Philip; Sharma, Yashoda; Anderson, Carl A; Essers, Jonah; Mitrovic, Mitja; Ning, Kaida; Cleynen, Isabelle; Theatre, Emilie; Spain, Sarah L; Raychaudhuri, Soumya; Goyette, Philippe; Wei, Zhi; Abraham, Clara; Achkar, Jean-Paul; Ahmad, Tariq; Amininejad, Leila; Ananthakrishnan, Ashwin N; Andersen, Vibeke; Andrews, Jane M; Baidoo, Leonard; Balschun, Tobias; Bampton, Peter A; Bitton, Alain; Boucher, Gabrielle; Brand, Stephan; Büning, Carsten; Cohain, Ariella; Cichon, Sven; D’Amato, Mauro; De Jong, Dirk; Devaney, Kathy L; Dubinsky, Marla; Edwards, Cathryn; Ellinghaus, David; Ferguson, Lynnette R; Franchimont, Denis; Fransen, Karin; Gearry, Richard; Georges, Michel; Gieger, Christian; Glas, Jürgen; Haritunians, Talin; Hart, Ailsa; Hawkey, Chris; Hedl, Matija; Hu, Xinli; Karlsen, Tom H; Kupcinskas, Limas; Kugathasan, Subra; Latiano, Anna; Laukens, Debby; Lawrance, Ian C; Lees, Charlie W; Louis, Edouard; Mahy, Gillian; Mansfield, John; Morgan, Angharad R; Mowat, Craig; Newman, William; Palmieri, Orazio; Ponsioen, Cyriel Y; Potocnik, Uros; Prescott, Natalie J; Regueiro, Miguel; Rotter, Jerome I; Russell, Richard K; Sanderson, Jeremy D; Sans, Miquel; Satsangi, Jack; Schreiber, Stefan; Simms, Lisa A; Sventoraityte, Jurgita; Targan, Stephan R; Taylor, Kent D; Tremelling, Mark; Verspaget, Hein W; De Vos, Martine; Wijmenga, Cisca; Wilson, David C; Winkelmann, Juliane; Xavier, Ramnik J; Zeissig, Sebastian; Zhang, Bin; Zhang, Clarence K; Zhao, Hongyu; Silverberg, Mark S; Annese, Vito; Hakonarson, Hakon; Brant, Steven R; Radford-Smith, Graham; Mathew, Christopher G; Rioux, John D; Schadt, Eric E; Daly, Mark J; Franke, Andre; Parkes, Miles; Vermeire, Severine; Barrett, Jeffrey C; Cho, Judy H

2012-01-01

Crohn’s disease (CD) and ulcerative colitis (UC), the two common forms of inflammatory bowel disease (IBD), affect over 2.5 million people of European ancestry with rising prevalence in other populations1. Genome-wide association studies (GWAS) and subsequent meta-analyses of CD and UC2,3 as separate phenotypes implicated previously unsuspected mechanisms, such as autophagy4, in pathogenesis and showed that some IBD loci are shared with other inflammatory diseases5. Here we expand knowledge of relevant pathways by undertaking a meta-analysis of CD and UC genome-wide association scans, with validation of significant findings in more than 75,000 cases and controls. We identify 71 new associations, for a total of 163 IBD loci that meet genome-wide significance thresholds. Most loci contribute to both phenotypes, and both directional and balancing selection effects are evident. Many IBD loci are also implicated in other immune-mediated disorders, most notably with ankylosing spondylitis and psoriasis. We also observe striking overlap between susceptibility loci for IBD and mycobacterial infection. Gene co-expression network analysis emphasizes this relationship, with pathways shared between host responses to mycobacteria and those predisposing to IBD. PMID:23128233

A structural variant in the 5’-flanking region of the TWIST2 gene affects melanocyte development in belted cattle

PubMed Central

Drögemüller, Cord; Jagannathan, Vidhya; Keller, Irene; Wüthrich, Daniel; Bruggmann, Rémy; Schütz, Ekkehard; Demmel, Steffi; Moser, Simon; Signer-Hasler, Heidi; Pieńkowska-Schelling, Aldona; Schelling, Claude; Sande, Marcos; Rongen, Ronald

2017-01-01

Belted cattle have a circular belt of unpigmented hair and skin around their midsection. The belt is inherited as a monogenic autosomal dominant trait. We mapped the causative variant to a 37 kb segment on bovine chromosome 3. Whole genome sequence data of 2 belted and 130 control cattle yielded only one private genetic variant in the critical interval in the two belted animals. The belt-associated variant was a copy number variant (CNV) involving the quadruplication of a 6 kb non-coding sequence located approximately 16 kb upstream of the TWIST2 gene. Increased copy numbers at this CNV were strongly associated with the belt phenotype in a cohort of 333 cases and 1322 controls. We hypothesized that the CNV causes aberrant expression of TWIST2 during neural crest development, which might negatively affect melanoblasts. Functional studies showed that ectopic expression of bovine TWIST2 in neural crest in transgenic zebrafish led to a decrease in melanocyte numbers. Our results thus implicate an unsuspected involvement of TWIST2 in regulating pigmentation and reveal a non-coding CNV underlying a captivating Mendelian character. PMID:28658273

Changes in pulmonary circulation in severe bronchopulmonary dysplasia.

PubMed Central

Bush, A; Busst, C M; Knight, W B; Hislop, A A; Haworth, S G; Shinebourne, E A

1990-01-01

Eight patients with severe bronchopulmonary dysplasia underwent cardiac catheterisation. Seven had a pulmonary vascular resistance greater than 3 mm Hg.l-1 min.m2 (mean 8.9, range 2.2-13.8). All had raised intrapulmonary shunts (mean 25.6%, range 5.4-50%, normal less than 5%). Two had a high alveolar dead space, and two had unsuspected congenital heart disease. Epoprostenol (prostacyclin), but not 100% oxygen, caused a significant fall in pulmonary vascular resistance. Death was associated with a high pulmonary vascular resistance and a high shunt. Morphometric studies in three cases showed normal numbers of airways, but increased thickness of bronchial muscle. The numbers of alveoli were reduced and the walls thickened. There was increased medial thickness in small pulmonary arteries with distal extension of muscle. In the oldest child some vessels were obliterated by fibrosis. We speculate that measurements of pulmonary vascular resistance and shunt may have prognostic value; that a trial of pulmonary vasodilators other than oxygen might be worthwhile in patients with poor prognosis; and that abnormalities of the pulmonary circulation contribute to the difficulties of managing patients with bronchopulmonary dysplasia. Images Figure 7 PMID:2117421

Emerging diseases and implications for Millennium Development Goals in Africa by 2015 - an overview.

PubMed

Aluwong, Tagang; Bello, Mohammed

2010-01-01

Emerging zoonotic diseases have assumed increasing fundamental importance in both public and animal health, as the last few years have seen a steady increase of new cases, each emerging from an unsuspected geographic area and causing serious problems, often leading to mortalities among animals and humans. The reasons for disease emergence or re-emergence are multiple and include certain major factors, such as expansion of the human population, climate change and globalisation of trade. Further contributing issues, such as the increased movement of animal species, microbial evolution, ecological disruption, changes in human behaviour, all imply that emerging diseases will not only continue to occur, but the rate of their emergence will also increase. These will constitute constraints for the attainment of the Millennium Development Goals by African Governments by 2015. There is no doubt that the current trend calls for more and stronger partnerships between national and international organisations, veterinary and medical communities, environmentalists, academics and policy-makers of various governments on the continent within the context of the global 'One Health' movement. This article attempts to analyse the impact of emerging diseases and the implications for the achievement of the Millennium Development Goals in Africa by the year 2015.

Bacterial symbionts and natural products

PubMed Central

Crawford, Jason M.; Clardy, Jon

2011-01-01

The study of bacterial symbionts of eukaryotic hosts has become a powerful discovery engine for chemistry. This highlight looks at four case studies that exemplify the range of chemistry and biology involved in these symbioses: a bacterial symbiont of a fungus and a marine invertebrate that produce compounds with significant anticancer activity, and bacterial symbionts of insects and nematodes that produce compounds that regulate multilateral symbioses. In the last ten years, a series of shocking revelations – the molecular equivalents of a reality TV show’s uncovering the true parents of a well known individual or a deeply hidden family secret – altered the study of genetically encoded small molecules, natural products for short. These revelations all involved natural products produced by bacterial symbionts, and while details differed, two main plot lines emerged: parentage, in which the real producers of well known natural products with medical potential were not the organisms from which they were originally discovered, and hidden relationships, in which bacterially produced small molecules turned out to be the unsuspected regulators of complex interactions. For chemists, these studies led to new molecules, new biosynthetic pathways, and an understanding of the biological functions these molecules fulfill. PMID:21594283

Kathy: A Case of Innovative Mathematics Teaching in a Multicultural Classroom. Teaching Cases in Cross-Cultural Education Series, No. 9.

ERIC Educational Resources Information Center

McDiarmid, G. Williamson; Kleinfeld, Judith, Ed.

Teaching cases have been utilized in professional training and can offer dramatic accounts of problems teachers may confront in the classroom. This case study examines a fact-based story of a third-grade teacher's confrontation with the mother of an African-American child who disagrees with the innovative approach utilized in her child's…

The Unheralded History of the Lemon Grove Desegregation Case

ERIC Educational Resources Information Center

Madrid, E. Michael

2008-01-01

In 1931, the Southern California community of Lemon Grove served as the unlikely stage for a dramatic and significant civil rights court case. A group of Mexican and Mexican-American parents and their children won a major victory in the battle against school segregation and the notion of separate but equal facilities. The case, now commonly…

Epigenetic age analysis of children who seem to evade aging.

PubMed

Walker, Richard F; Liu, Jia Sophie; Peters, Brock A; Ritz, Beate R; Wu, Timothy; Ophoff, Roel A; Horvath, Steve

2015-05-01

We previously reported the unusual case of a teenage girl stricken with multifocal developmental dysfunctions whose physical development was dramatically delayed resulting in her appearing to be a toddler or at best a preschooler, even unto the occasion of her death at the age of 20 years. Her life-long physician felt that the disorder was unique in the world and that future treatments for age-related diseases might emerge from its study. The objectives of our research were to determine if other such cases exist, and if so, whether aging is actually slowed. Of seven children characterized by dramatically slow developmental rates, five also had associated disorders displayed by the first case. All of the identified subjects were female. To objectively measure the age of blood tissue from these subjects, we used a highly accurate biomarker of aging known as "epigenetic clock" based on DNA methylation levels. No statistically significant differences in chronological and epigenetic ages were detected in any of the newly discovered cases.

Advances in malaria elimination in Botswana: a dramatic shift to parasitological diagnosis, 2008–2014

PubMed Central

Edwards, J. K.; Motlaleng, M.; Namboze, J.; Butt, W.; Obopile, M.; Mosweunyane, T.; Manzi, M.; Takarinda, K. C.; Owiti, P.

2018-01-01

Background: Malaria elimination requires infection detection using quality assured diagnostics and appropriate treatment regimens. Although Botswana is moving towards malaria elimination, reports of unconfirmed cases may jeopardise this effort. This study aimed to determine the proportion of cases treated for malaria that were confirmed by rapid diagnostic testing (RDT) and/or microscopy. Methods: This was a retrospective descriptive study using routine national data from the integrated disease surveillance and case-based surveillance systems from 2008 to 2014. The data were categorised into clinical and confirmed cases each year. An analysis of the data on cases registered in three districts that reported approximately 70% of all malaria cases was performed, stratified by year, type of reporting health facilities and diagnostic method. Results: During 2008–2014, 50 487 cases of malaria were reported in Botswana, and the proportion of RDT and/or blood microscopy confirmed cases improved from 6% in 2008 to 89% in 2013. The total number of malaria cases decreased by 97% in the same period, then increased by 41% in 2013. Conclusion: This study shows that malaria diagnostic tests dramatically improved malaria diagnosis and consequently reduced the malaria burden in Botswana. The study identified a need to build capacity on microscopy for species identification, parasite quantification and guiding treatment choices. PMID:29713592

Advances in malaria elimination in Botswana: a dramatic shift to parasitological diagnosis, 2008-2014.

PubMed

Moakofhi, K; Edwards, J K; Motlaleng, M; Namboze, J; Butt, W; Obopile, M; Mosweunyane, T; Manzi, M; Takarinda, K C; Owiti, P

2018-04-25

Background: Malaria elimination requires infection detection using quality assured diagnostics and appropriate treatment regimens. Although Botswana is moving towards malaria elimination, reports of unconfirmed cases may jeopardise this effort. This study aimed to determine the proportion of cases treated for malaria that were confirmed by rapid diagnostic testing (RDT) and/or microscopy. Methods: This was a retrospective descriptive study using routine national data from the integrated disease surveillance and case-based surveillance systems from 2008 to 2014. The data were categorised into clinical and confirmed cases each year. An analysis of the data on cases registered in three districts that reported approximately 70% of all malaria cases was performed, stratified by year, type of reporting health facilities and diagnostic method. Results: During 2008-2014, 50 487 cases of malaria were reported in Botswana, and the proportion of RDT and/or blood microscopy confirmed cases improved from 6% in 2008 to 89% in 2013. The total number of malaria cases decreased by 97% in the same period, then increased by 41% in 2013. Conclusion: This study shows that malaria diagnostic tests dramatically improved malaria diagnosis and consequently reduced the malaria burden in Botswana. The study identified a need to build capacity on microscopy for species identification, parasite quantification and guiding treatment choices.

Genome-wide gene expression profiling reveals unsuspected molecular alterations in pemphigus foliaceus

PubMed Central

Malheiros, Danielle; Panepucci, Rodrigo A; Roselino, Ana M; Araújo, Amélia G; Zago, Marco A; Petzl-Erler, Maria Luiza

2014-01-01

Pemphigus foliaceus (PF) is a complex autoimmune disease characterized by bullous skin lesions and the presence of antibodies against desmoglein 1. In this study we sought to contribute to a better understanding of the molecular processes in endemic PF, as the identification of factors that participate in the pathogenesis is a prerequisite for understanding its biological basis and may lead to novel therapeutic interventions. CD4+ T lymphocytes are central to the development of the disease. Therefore, we compared genome-wide gene expression profiles of peripheral CD4+ T cells of various PF patient subgroups with each other and with that of healthy individuals. The patient sample was subdivided into three groups: untreated patients with the generalized form of the disease, patients submitted to immunosuppressive treatment, and patients with the localized form of the disease. Comparisons between different subgroups resulted in 135, 54 and 64 genes differentially expressed. These genes are mainly related to lymphocyte adhesion and migration, apoptosis, cellular proliferation, cytotoxicity and antigen presentation. Several of these genes were differentially expressed when comparing lesional and uninvolved skin from the same patient. The chromosomal regions 19q13 and 12p13 concentrate differentially expressed genes and are candidate regions for PF susceptibility genes and disease markers. Our results reveal genes involved in disease severity, potential therapeutic targets and previously unsuspected processes involved in the pathogenesis. Besides, this study adds original information that will contribute to the understanding of PF's pathogenesis and of the still poorly defined in vivo functions of most of these genes. PMID:24813052

Screening for cognitive impairment in older individuals. Validation study of a computer-based test.

PubMed

Green, R C; Green, J; Harrison, J M; Kutner, M H

1994-08-01

This study examined the validity of a computer-based cognitive test that was recently designed to screen the elderly for cognitive impairment. Criterion-related validity was examined by comparing test scores of impaired patients and normal control subjects. Construct-related validity was computed through correlations between computer-based subtests and related conventional neuropsychological subtests. University center for memory disorders. Fifty-two patients with mild cognitive impairment by strict clinical criteria and 50 unimpaired, age- and education-matched control subjects. Control subjects were rigorously screened by neurological, neuropsychological, imaging, and electrophysiological criteria to identify and exclude individuals with occult abnormalities. Using a cut-off total score of 126, this computer-based instrument had a sensitivity of 0.83 and a specificity of 0.96. Using a prevalence estimate of 10%, predictive values, positive and negative, were 0.70 and 0.96, respectively. Computer-based subtests correlated significantly with conventional neuropsychological tests measuring similar cognitive domains. Thirteen (17.8%) of 73 volunteers with normal medical histories were excluded from the control group, with unsuspected abnormalities on standard neuropsychological tests, electroencephalograms, or magnetic resonance imaging scans. Computer-based testing is a valid screening methodology for the detection of mild cognitive impairment in the elderly, although this particular test has important limitations. Broader applications of computer-based testing will require extensive population-based validation. Future studies should recognize that normal control subjects without a history of disease who are typically used in validation studies may have a high incidence of unsuspected abnormalities on neurodiagnostic studies.

Why Henry III of Navarre’s Hair Probably did not Turn White Overnight

PubMed Central

Navarini, Alexander A; Trüeb, Ralph M

2010-01-01

Although a rare event, sudden whitening of hair (canities subita) has reportedly affected a number of well-known historical figures, usually in relation to dramatic events in their lives. Although early accounts are substantiated by more recent case reports in scientific literature, we suspect that the phenomenon is not only used as a literary means in fiction, with the aim of dramatizing, but probably also in historical accounts. For this purpose, we examine the case history of Henry III of Navarre who allegedly turned white on the evening of the Saint Bartholomew’s day massacre, and challenge this claim, due to inconsistencies in his biography, with the current pathophysiological understanding of canities subita. PMID:21188015

[Massive haemoperitoneum due to traumatic rupture of multifocal hepatocarcinoma in the right hepatic lobe. Case report].

PubMed

Spaziani, E; Briganti, M; Saltarelli, A; Iozzino, M; Notarianni, E; Cianni, R; Di Filippo, A; Picchio, M; Ceci, F; Gammardella, P; De Angelis, F; Nardecchia, G; Cipriani, B; Nicodemi, S; Stagnitti, F

2009-01-01

Abdominal blunt trauma is the main cause of death in people younger than 40 years old. The liver injury still represents a challenging problem. Isolated hepatic injury is rare and it occurs more frequentely in polytraumatizated patients and causes massive haemoperitoneum. The Authors report a case of a 83 years-old woman admitted to Emergency Department for syncope due to an active bleeding arising from a rupture of a right hepatic lobe unsuspected tumor. The computer tomography (CT) scans showed a clear pattern of liver laceration of the VI segment with contrast enhancement spreading in the surrounding tissues, and detected a multifocal hepatocarcinoma located in the VI, VII and VIII segments. Patient's haemodinamically unstable conditions suggested an urgent laparotomy. An accurate perihepatic packing with sterile-drape were successfully employed to control liver hemorrage. Temporary abdominal closure, followed by hepatic arteriography and the right hepatic artery embolization, completed the damage control. Re-exploration laparotomy after 72 hours confirmed the definitive haemostasis and the pack removal was performed without complications. CT plays a leading role in the diagnosis of liver damage. The patient's haemodynamic status is the principal criterion determining conservative or operative therapy in blunt liver injury. The early perihepatic packing followed by artheriographic embolization to stop liver hemorrhage showed efficacy and safety for the patient. The packing performed with sterile-drape is able to avoid removal complications and 72 hours timing for the pack removal is effective to avoid re-bleeding.

Spontaneous adverse event signaling methods: classification and use with health care treatment products.

PubMed

Clark, J A; Klincewicz, S L; Stang, P E

2001-01-01

AE signal detection and its techniques are part of the continuum of public health surveillance, borrowing from both its theory and application (171). Like public health surveillance networks, whose major goals are to identify early signs of new outbreaks, pinpoint new organisms, and monitor designated illnesses, AE signaling and surveillance systems attempt to provide early warnings of previously unsuspected product-AE pairs, hypothesize potential drug-event relations, identify populations "at risk," and facilitate case ascertainment and definition. In both examples, definitive research is often subsequently undertaken to quantify the strength of relations that may be proposed. As with any public health surveillance effort, AE surveillance provides an infrastructure for the ongoing collection of health data and its direct integration into the health regulatory policy (172), including its keystone role in risk assessment and management. However, unlike many surveillance systems, postmarketing AE systems collect case information that is often relatively incomplete and imperfect, estimate exposure based on surrogate values (e.g., sales data), and are used by both governmental and the private sector for preventive planning. These factors make AE signaling and surveillance more ambiguous, regulatory oriented, and complex than its disease counterparts (173). Despite such issues, AE signaling methods continue to evolve in extent, complexity, and acceptance (4, 131, 174). Undoubtedly, this is largely due to the widespread practical experience that has been gained with spontaneous reporting systems over the past 4 decades and the cumulative usefulness that has been demonstrated.

Child Abuse and Neglect. Data Snapshot

ERIC Educational Resources Information Center

DC Action for Children, 2011

2011-01-01

The number of substantiated cases of child abuse and neglect in the District rose by 27 percent in FY 2009. This dramatic spike came after two consecutive years of decline in the number of substantiated cases reported the D.C. Child and Family Services Agency (CFSA). In FY 2010, the number of closed, substantiated cases dropped back down to 1,691,…

Behavioral treatment of the traumatically brain-injured: a case study.

PubMed

Horton, A M; Howe, N R

1981-10-01

The present case illustrates the application of behavioral modification methodology with a traumatically brain-injured adult. Such a treatment regime utilizing a report-card system and a response-cost procedure was implemented to decrease behaviors of using foul language and biting staff members. Dramatic improvement was demonstrated.

Monophyly and extensive extinction of advanced eusocial bees: insights from an unexpected Eocene diversity.

PubMed

Engel, M S

2001-02-13

Advanced eusociality sometimes is given credit for the ecological success of termites, ants, some wasps, and some bees. Comprehensive study of bees fossilized in Baltic amber has revealed an unsuspected middle Eocene (ca. 45 million years ago) diversity of eusocial bee lineages. Advanced eusociality arose once in the bees with significant post-Eocene losses in diversity, leaving today only two advanced eusocial tribes comprising less than 2% of the total bee diversity, a trend analogous to that of hominid evolution. This pattern of changing diversity contradicts notions concerning the role of eusociality for evolutionary success in insects.

Sea-floor methane blow-out and global firestorm at the K-T boundary

USGS Publications Warehouse

Max, M.D.; Dillon, William P.; Nishimura, C.; Hurdle, B.G.

1999-01-01

A previously unsuspected source of fuel for the global firestorm recorded by soot in the Cretaceous-Tertiary impact layer may have resided in methane gas associated with gas hydrate in the end-Cretaceous seafloor. End-Cretaceous impact-generated shock and megawaves would have had the potential to initiate worldwide oceanic methane gas blow-outs from these deposits. The methane would likely have ignited and incompletely combusted. This large burst of methane would have been followed by longer-term methane release as a part of a positive thermal feedback in the disturbed ocean-atmosphere system.

[Childhood scabies: a different entity].

PubMed

Níguez Carbonell, J C; García-Marcos Alvarez, L; Sebastián Raz, J M; García Marcos, V; Guillén Pérez, J J

1988-01-01

Epidemiological, clinical, diagnostic and therapeutic aspects that make scabies a clinical entity with a special personality in the pediatric field, are reviewed. On the epidemiological aspects, a special mention of its unsuspected frequency in this age is made. Scabies is an endemic disease in our country among the more deprived people. On the clinical aspects, the great importance of clinical history and distribution of skin lesions for the early diagnosis is pointed out. Some "alert pointers" are described for this early diagnosis. On the therapeutic field, the importance of the primary care prevention is discussed, and the drug approach for its relieve is commented.

Concise calculation of the scaling function, exponents, and probability functional of the Edwards-Wilkinson equation with correlated noise

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, Y.; Pang, N.; Halpin-Healy, T.

1994-12-01

The linear Langevin equation proposed by Edwards and Wilkinson [Proc. R. Soc. London A 381, 17 (1982)] is solved in closed form for noise of arbitrary space and time correlation. Furthermore, the temporal development of the full probability functional describing the height fluctuations is derived exactly, exhibiting an interesting evolution between two distinct Gaussian forms. We determine explicitly the dynamic scaling function for the interfacial width for any given initial condition, isolate the early-time behavior, and discover an invariance that was unsuspected in this problem of arbitrary spatiotemporal noise.

Pinch current limitation effect in plasma focus

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, S.; Saw, S. H.; INTI International University College, 71800 Nilai

The Lee model couples the electrical circuit with plasma focus dynamics, thermodynamics, and radiation. It is used to design and simulate experiments. A beam-target mechanism is incorporated, resulting in realistic neutron yield scaling with pinch current and increasing its versatility for investigating all Mather-type machines. Recent runs indicate a previously unsuspected 'pinch current limitation' effect. The pinch current does not increase beyond a certain value however low the static inductance is reduced to. The results indicate that decreasing the present static inductance of the PF1000 machine will neither increase the pinch current nor the neutron yield, contrary to expectations.

Use of computed tomography abdomen and pelvis for investigation of febrile neutropenia in adult haematology patients.

PubMed

Lim, H Y; Ashby, M; Williams, B; Grigg, A

2016-11-01

We retrospectively evaluated the use of computed tomography abdomen and pelvis (CTAP) in febrile neutropenic autologous stem cell transplant (ASCT) and acute myeloid leukaemia (AML) patients. CTAP was more common in ASCT patients (59%) compared with AML (31%; P  < 0.001). Although abnormal findings were reported in 51%, only 10% resulted in therapy change (addition of anaerobic antibiotic/bowel rest), which would have otherwise been instituted based on clinical grounds. CTAP in these patients rarely provide useful information unsuspected clinically. © 2016 Royal Australasian College of Physicians.

Modulated Expression of Genes Encoding Estrogen Metabolizing Enzymes by G1-Phase Cyclin-Dependent Kinases 6 and 4 in Human Breast Cancer Cells

PubMed Central

Jia, Yi; Domenico, Joanne; Swasey, Christina; Wang, Meiqin; Gelfand, Erwin W.; Lucas, Joseph J.

2014-01-01

G1-phase cell cycle defects, such as alterations in cyclin D1 or cyclin-dependent kinase (cdk) levels, are seen in most tumors. For example, increased cyclin D1 and decreased cdk6 levels are seen in many human breast tumors. Overexpression of cdk6 in breast tumor cells in culture has been shown to suppress proliferation, unlike the growth stimulating effects of its close homolog, cdk4. In addition to directly affecting proliferation, alterations in cdk6 or cdk4 levels in breast tumor cells also differentially influence levels of numerous steroid metabolic enzymes (SMEs), including those involved in estrogen metabolism. Overexpression of cdk6 in tumor cell lines having low cdk6 resulted in decreased levels of mRNAs encoding aldo-keto reductase (AKR)1C1, AKR1C2 and AKR1C3, which are hydroxysteroid dehydrogenases (HSDs) involved in steroid hormone metabolism. In contrast, increasing cdk4 dramatically increased these transcript levels, especially those encoding AKR1C3, an enzyme that converts estrone to 17β-estradiol, a change that could result in a pro-estrogenic state favoring tumor growth. Effects on other estrogen metabolizing enzymes, including cytochrome P450 (CYP) 19 aromatase, 17β-HSD2, and CYP1B1 transcripts, were also observed. Interactions of cdk6 and cdk4, but not cyclin D1, with the promoter region of a cdk-regulated gene, 17β-HSD2, were detected. The results uncover a previously unsuspected link between the cell cycle and hormone metabolism and differential roles for cdk6 and cdk4 in a novel mechanism for pre-receptor control of steroid hormone action, with important implications for the origin and treatment of steroid hormone-dependent cancers. PMID:24848372

The formation of giant clastic extrusions at the end of the Messinian Salinity Crisis

NASA Astrophysics Data System (ADS)

Kirkham, Christopher; Cartwright, Joe; Hermanrud, Christian; Jebsen, Christopher

2018-01-01

This paper documents the discovery of five multi-km scale lensoid bodies that directly overlie the upper surface of the thick (>1 km) Messinian Evaporite sequence. They were identified through the analysis of 3D seismic data from the western Nile Cone. The convergence of the upper and lower bounding reflections of these lensoid bodies, their external and internal reflection configuration, the positive 'depositional' relief at their upper surface, and the stratal relationship with underlying and overlying deposits supports the interpretation that these are giant clastic extrusions. The interpretations combined with the stratal position of these clastic extrusions demonstrate a prior unsuspected link between periods of major environment change and basin hydrodynamics on a plate scale. All five lensoid bodies were extruded onto a single, seismically resolvable marker horizon correlatable with the end of the Messinian Salinity Crisis (Horizon M). It is argued that the source of these clastic extrusions is pre-Messinian in origin, which implies massive sediment remobilisation at depth in the pre-evaporitic succession and intrusion through the thick evaporite layer. We propose that the scale and timing of this dramatic event was primed and triggered by near-lithostatic overpressure in the pre-evaporitic sediments generated through (1) their rapid burial and loading during the Messinian Salinity Crisis and (2) catastrophic re-flooding during its immediate aftermath. The largest of these clastic extrusions has a volume of over c. 116 km3, making it amongst the largest extruded sedimentary bodies described on Earth. The findings extend the understanding of the upper scale of other analogous clastic extrusions such as mud volcanoes and sediment-hosted hydrothermal systems. Following the 2006 eruption of the Lusi sediment-hosted hydrothermal system in Indonesia, an understanding of the upper scale limit of clastic extrusions has even greater societal relevance, in order to increase awareness of the risk posed by the potential size and longevity of future giant clastic extrusions.

From Bearing Witness to Art Exhibitions to Inspiring the Understanding of Climate Change

NASA Astrophysics Data System (ADS)

Burko, D.

2016-12-01

I intend to demonstrate how artists such as myself can influence the public discourse on climate change. I believe aesthetically compelling visualizations can transcend data and language. I will speak specifically to how I communicate scientific research to diverse populations. I have much to share since first speaking in 2012 on the Panel "Communication of Science through Art: Raison d'Etre for Interdisciplinary Communication". I then illustrated how I utilized visual cues such as archival evidence in the form of repeats, geological charts of recessional lines, graphs, symbols and Landsat maps in my large scale paintings and photographs and inspired learning. I continue to develop visual strategies delivering information on an emotional/non-verbal level. Now 4 years later, I've added the most dramatic layer to my creative process: bearing witness. I've been to the three largest ice fields in the world: Greenland, Antarctica and Argentina's Patagonia, observing the unprecedented pace of glacial melt. Those expeditions feed my practice, leading to exhibitions that begin a dialog with an audience not initially interested in science. In the past 5 years my work has appeared in 6 solo and 19 group exhibits all devoted to the environment. I make myself present in universities, museums and galleries to explain what the images are about. I require universities to include a public component: an all-college lecture or panel where the geography/environmental/sociology/geology departments participate with broad student involvement. I believe that such endeavors are worthwhile and can be models for further efforts to educate an unsuspecting audience. Artists can bridge the gap communicating to a public of art appreciators, nonscientists - how easy it is to understand geology and global warming. I believe we can even inspire attitudinal change. Aside from personal examples I will include other artists and exhibition venues contributing to this phenomenon.

Symbols of a cosmic order

NASA Astrophysics Data System (ADS)

Madjid, F. Hadi; Myers, John M.

2016-10-01

The world runs on networks over which signals communicate sequences of symbols, e.g. numerals. Examining both engineered and natural communications networks reveals an unsuspected order that depends on contact with an unpredictable entity. This order has three roots. The first is a proof within quantum theory that no evidence can ever determine its explanation, so that an agent choosing an explanation must do so unpredictably. The second root is the showing that clocks that step computers do not "tell time" but serve as self-adjusting symbol-handling agents that regulate "logically synchronized" motion in response to unpredictable disturbances. Such a clock-agent has a certain independence as well as the capacity to communicate via unpredictable symbols with other clock-agents and to adjust its own tick rate in response to that communication. The third root is the noticing of unpredictable symbol exchange in natural systems, including the transmission of symbols found in molecular biology. We introduce a symbol-handling agent as a role played in some cases by a person, for example a physicist who chooses an explanation of given experimental outcomes, and in other cases by some other biological entity, and in still other cases by an inanimate device, such as a computer-based detector used in physical measurements. While we forbear to try to explain the propensity of agents at all levels from cells to civilizations to form and operate networks of logically synchronized symbol-handling agents, we point to this propensity as an overlooked cosmic order, an order structured by the unpredictability ensuing from the proof. Appreciating the cosmic order leads to a conception of agency that replaces volition by unpredictability and reconceives the notion of objectivity in a way that makes a place for agency in the world as described by physics. Some specific implications for physics are outlined.

Exposure of unsuspecting workers to deadly atmospheres in below-ground confined spaces and investigation of related whole-air sample composition using adsorption gas chromatography.

PubMed

Smith, Philip A; Lockhart, Bonnie; Besser, Brett W; Michalski, Michael A R

2014-01-01

Hazardous atmospheres in confined spaces may be obvious when a source of air contamination or oxygen (O2) deficiency is recognized. Such is often the case in general industry settings, especially with work processes which create hazardous atmospheres that may be anticipated. Hazards present in active sewers are also well recognized; but the possibility that O2 deficiency or high airborne contaminant concentrations may exist in new construction sewers or storm drains has been repeatedly ignored with deadly results. Low O2 and high carbon dioxide (CO2) concentrations may exist in new construction manholes that have not yet been connected to an active sewer or drain system, and these concentrations have been shown to vary over time. A recent incident is described where workers repeatedly entered such a confined space without incident, but subsequent entry resulted in a fatality and a near-miss for a co-worker rescuer. Additional cases are discussed, with an emphasis placed on elevated CO2 concentrations as a causative factor. A description is provided for the adsorptive gas chromatography whole-air analysis methodology used to quantitatively determine atmospheric conditions present at this type of fatality site or others after an incident, and for the gas chromatography-mass spectrometry method used to provide confirmation of analyte identity with high certainty. Many types of confined spaces may be encountered in addition to the underground varieties discussed, and many possible atmospheric hazards are possible. The definitive whole-air analysis approach described here may be of use and should be considered to investigate many confined space fatality and near-miss cases, and to better understand the causes of dangerous atmosphere conditions that may arise in confined spaces.

Changing Epidemiology of Hepatitis A and Hepatitis E Viruses in China, 1990-2014.

PubMed

Ren, Xiang; Wu, Peng; Wang, Liping; Geng, Mengjie; Zeng, Lingjia; Zhang, Jun; Xia, Ningshao; Lai, Shengjie; Dalton, Harry R; Cowling, Benjamin J; Yu, Hongjie

2017-02-01

We compared the epidemiology of hepatitis A and hepatitis E cases in China from 1990-2014 to better inform policy and prevention efforts. The incidence of hepatitis A cases declined dramatically, while hepatitis E incidence increased. During 2004-2014, hepatitis E mortality rates surpassed those of hepatitis A.

Teachers Unions at Risk of Losing "Agency Fees"

ERIC Educational Resources Information Center

Antonucci, Mike

2016-01-01

For 50 years, American education policy has often danced to the tune of labor realities. "Friedrichs v. California Teachers Association" is a case that awaits hearing by the U.S. Supreme Court that could dramatically change this picture. The case, if decided for the plaintiffs, could end the practice of "agency" fees--money…

Privatising the Public University: The Case of Law

ERIC Educational Resources Information Center

Thornton, Margaret

2011-01-01

"Privatising the Public University: The Case of Law" is the first full-length critical study examining the impact of the dramatic reforms that have swept through universities over the last two decades. Drawing on extensive research and interviews in Australia, New Zealand, the UK and Canada, Margaret Thornton considers the impact of the…

Moral Rudders and Superintendent Values

ERIC Educational Resources Information Center

Kidder, Rushworth M.

2008-01-01

The core challenge is this--a difficult ethical decision, where values are in play and both sides have powerful moral arguments in their favor. One case presented in this article outlines a dilemma faced by one teacher who became a superintendent herself. The case exploded dramatically in a midsize metropolitan school district, where a principal…

Association of Human Q Fever with Animal Husbandry, Taiwan, 2004-2012.

PubMed

Lai, Chung-Hsu; Chang, Lin-Li; Lin, Jiun-Nong; Liao, Ming-Huei; Liu, Shyh-Shyan; Lee, Hsu-Hsun; Lin, Hsi-Hsun; Chen, Yen-Hsu

2015-12-01

In Taiwan, Q fever cases in humans began increasing in 2004 and peaked in 2007 but dramatically declined in 2008 and 2011. Cases were significantly correlated with the number of goats. The decline might be associated with the collateral effects of measures to control goat pox in 2008 and 2010.

The Borders of Historical Empathy: Students Encounter the Holocaust through Film

ERIC Educational Resources Information Center

Metzger, Scott Alan

2012-01-01

This case study explores potential educational tensions in historical empathy for learning about emotionally difficult topics through lessons that use dramatic feature films (movies). It investigates one case of historical empathy in the classroom by analyzing what a high-school teacher and her students do and talk about in class. The observed…

An Approach to Meeting the Needs of Medical Students with Learning Disabilities.

ERIC Educational Resources Information Center

Walters, Janice A.; Croen, Lila G.

1993-01-01

A study at the Albert Einstein College of Medicine (Yeshiva University, New York) has identified students from each medical class with previously unidentified learning disabilities. In three case studies, the importance of early identification and support is illustrated. In each case, dramatic improvement occurred with student awareness and…

IQ Scores Should Not Be Adjusted for the Flynn Effect in Capital Punishment Cases

ERIC Educational Resources Information Center

Hagan, Leigh D.; Drogin, Eric Y.; Guilmette, Thomas J.

2010-01-01

"Atkins v. Virginia" (2002) dramatically raised the stakes for mental retardation in capital punishment cases, but neither defined this condition nor imposed uniform standards for its assessment. The basic premise that mean IQ scores shift over time enjoys wide recognition, but its application--including the appropriateness of…

Results From the New Jersey Statewide Critical Congenital Heart Defects Screening Program

PubMed Central

Garg, Lorraine F.; Van Naarden Braun, Kim; Knapp, Mary M.; Anderson, Terry M.; Koppel, Robert I.; Hirsch, Daniel; Beres, Leslie M.; Hyg, MS; Sweatlock, Joseph; Olney, Richard S.; Glidewell, Jill; Hinton, Cynthia F.; Kemper, Alex R.

2015-01-01

BACKGROUND AND OBJECTIVE New Jersey was the first state to implement legislatively mandated newborn pulse oximetry screening (POxS) in all licensed birthing facilities to detect critical congenital heart defects (CCHDs). The objective of this report was to evaluate implementation of New Jersey’s statewide POxS mandate. METHODS A 2-pronged approach was used to collect data on infants screened in all New Jersey birthing facilities from August 31, 2011, through May 31, 2012. Aggregate screening results were submitted by each birthing facility. Data on failed screens and clinical characteristics of those newborns were reported to the New Jersey Birth Defects Registry (NJBDR). Three indicators were used to distinguish the added value of mandated POxS from standard clinical care: prenatal congenital heart defect diagnosis, cardiology consultation or echocardiogram indicated or performed before PoxS, or clinical findings at the time of POxS warranting a pulse oximetry measurement. RESULTS Of 75 324 live births in licensed New Jersey birthing facilities, 73 320 were eligible for screening, of which 99% were screened. Forty-nine infants with failed POxS were reported to the NJBDR, 30 of whom had diagnostic evaluations solely attributable to the mandated screening. Three of the 30 infants had previously unsuspected CCHDs and 17 had other diagnoses or non-CCHD echocardiogram findings. CONCLUSIONS In the first 9 months after implementation, New Jersey achieved a high statewide screening rate and established surveillance mechanisms to evaluate the unique contribution of POxS. The screening mandate identified 3 infants with previously unsuspected CCHDs that otherwise might have resulted in significant morbidity and mortality and also identified other significant secondary targets such as sepsis and pneumonia. PMID:23858425

[Positron tomography with 18F-fluorodeoxyglucose in the preoperative evaluation of gall bladder lesions suspicious of malignancy. Diagnostic utility and clinical impact].

PubMed

Ramos-Font, C; Gómez Río, M; Rodríguez-Fernández, A; Sánchez Sánchez, R; Llamas Elvira, J M

2011-01-01

Gallbladder carcinoma is a neoplasm having a poor prognosis in which the role of the positron emission tomography with (18)F-fluordeoxyglucose as a diagnostic tool, although of possible usefulness, has not been well-defined. It is a prospective cohort of patients with radiologically malignant suspicious gallbladder lesions. A staging diagnostic presurgical FDG-PET study was carried out in each patient using both dedicated PET and multimodality PET-CT scanners. Diagnostic accuracy parameters were calculated from the results of PET imaging and were correlated with the condition and/or the clinical course of the patients. The clinical impact of its implementation in the diagnosis of gallbladder carcinoma was also analyzed. A total of 42 patients were recruited (22 malignant lesions, 20 benign). Overall diagnostic accuracy was 83.33% for the diagnosis of the primary lesion, 88.89% for the evaluation of lymph node involvement and 85.1% for the evaluation of metastatic disease. Mean SUVmax in malignant gallbladder lesions was 6.14±2.89. ROC curve showed a cut-off value of 3.65 in the SUVmax for malignancy. Accuracy of PET studies alone (n=21) was slightly lower than that of the PET/CT (n=21). FDG-PET changed the management of 14.8% of the population due to the identification of unsuspected metastatic disease. FDG-PET accurately diagnoses malignancy or benignity of suspicious gallbladder lesions, with the addition of its capacity to identify unsuspected metastatic disease. PET-CT improves the diagnostic accuracy of the procedure, due to the metabolic-structural complementarity of their information. The SUVmax has a complementary value added to the visual analysis. Copyright © 2010 Elsevier España, S.L. y SEMNIM. All rights reserved.

Unsuspected Critical Illness Among Emergency Department Patients Presenting for Acute Alcohol Intoxication.

PubMed

Klein, Lauren R; Cole, Jon B; Driver, Brian E; Battista, Christopher; Jelinek, Ryan; Martel, Marc L

2018-03-01

Emergency department (ED) visits for acute alcohol intoxication are common, but this population is at risk for decompensation and occult critical illness. The purpose of this study is to describe the incidence and predictors of unsuspected critical illness among patients with acute alcohol intoxication. This was a retrospective observational study of ED patients from 2011 to 2016 with acute alcohol intoxication. The study cohort included patients presenting for alcohol intoxication, whose initial assessment was uncomplicated alcohol intoxication without any other active acute medical or traumatic complaints. The primary outcome was defined as the unanticipated subsequent use of critical care resources during the encounter or admission to an ICU. We investigated potential predictors for this outcome with generalized estimating equations. We identified 31,364 eligible patient encounters (median age 38 years; 71% men; median breath alcohol concentration 234 mg/dL); 325 encounters (1%) used critical care resources. The most common diagnoses per 1,000 ED encounters were acute hypoxic respiratory failure (3.1), alcohol withdrawal (1.7), sepsis or infection (1.1), and intracranial hemorrhage (1.0). Three patients sustained a cardiac arrest. Presence of the following had an increased adjusted odds ratio (aOR) of developing critical illness: hypoglycemia (aOR 9.2), hypotension (aOR 3.8), tachycardia (aOR 1.8), fever (aOR 7.6), hypoxia (aOR 3.8), hypothermia (aOR 4.2), and parenteral sedation (aOR 2.4). The initial blood alcohol concentration aOR was 1.0. Critical care resources were used for 1% of ED patients with alcohol intoxication who were initially assessed by physicians to have low risk. Abnormal vital signs, hypoglycemia, and chemical sedation were associated with increased odds of critical illness. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Inadequate management of pregnancy-associated listeriosis: lessons from four case reports.

PubMed

Charlier, C; Goffinet, F; Azria, E; Leclercq, A; Lecuit, M

2014-03-01

Listeria monocytogenes infection during pregnancy can lead to dramatic fetal or neonatal outcomes. No clinical trial has evaluated treatment options, and retrospective studies of cases are therefore important to define optimal regimens. We report four cases of materno-neonatal listeriosis illustrating inadequate antimicrobial therapy management and discuss recommended treatment options. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications.

PubMed

Schmidt, Arthur; Beyna, Torsten; Schumacher, Brigitte; Meining, Alexander; Richter-Schrag, Hans-Juergen; Messmann, Helmut; Neuhaus, Horst; Albers, David; Birk, Michael; Thimme, Robert; Probst, Andreas; Faehndrich, Martin; Frieling, Thomas; Goetz, Martin; Riecken, Bettina; Caca, Karel

2017-08-10

Endoscopic full-thickness resection (EFTR) is a novel treatment of colorectal lesions not amenable to conventional endoscopic resection. The aim of this prospective multicentre study was to assess the efficacy and safety of the full-thickness resection device. 181 patients were recruited in 9 centres with the indication of difficult adenomas (non-lifting and/or at difficult locations), early cancers and subepithelial tumours (SET). Primary endpoint was complete en bloc and R0 resection. EFTR was technically successful in 89.5%, R0 resection rate was 76.9%. In 127 patients with difficult adenomas and benign histology, R0 resection rate was 77.7%. In 14 cases, lesions harboured unsuspected cancer, another 15 lesions were primarily known as cancers. Of these 29 cases, R0 resection was achieved in 72.4%; 8 further cases had deep submucosal infiltration >1000 µm. Therefore, curative resection could only be achieved in 13/29 (44.8%). In the subgroup with SET (n=23), R0 resection rate was 87.0%. In general, R0 resection rate was higher with lesions ≤2 cm vs >2 cm (81.2% vs 58.1%, p=0.0038). Adverse event rate was 9.9% with a 2.2% rate of emergency surgery. Three-month follow-up was available from 154 cases and recurrent/residual tumour was evident in 15.3%. EFTR has a reasonable technical efficacy especially in lesions ≤2 cm with acceptable complication rates. Curative resection rate for early cancers was too low to recommend its primary use in this indication. Further comparative studies have to show the clinical value and long-term outcome of EFTR in benign colorectal lesions. NCT02362126; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Outbreak of vancomycin-resistant enterococcus colonization among pediatric oncology patients.

PubMed

Nolan, Sheila M; Gerber, Jeffrey S; Zaoutis, Theoklis; Prasad, Priya; Rettig, Susan; Gross, Kimberly; McGowan, Karin L; Reilly, Anne F; Coffin, Susan E

2009-04-01

To detect the burden of vancomycin-resistant Enterococcus (VRE) colonization among pediatric oncology patients and to determine risk factors for VRE acquisition. Retrospective case-control study. The Children's Hospital of Philadelphia. Pediatric oncology patients hospitalized from June 2006 through December 2007. Prevalence surveys revealed an increased VRE burden among pediatric oncology patients. For the case-control study, the 16 case patients were pediatric oncology patients who had 1 stool sample negative for VRE at screening before having a stool sample positive for VRE at screening; the 62 control patients had 2 consecutive screenings in which stool samples were negative for VRE. Case and control patients were matched on the duration of the interval between screens. Analyses were performed to determine the association between multiple exposures and VRE acquisition. The prevalence survey revealed that 5 (9.6%) of 52 patients had unsuspected VRE colonization at the time of hospitalization. Multivariate analysis identified a lack of empirical contact precautions (odds ratio [OR], 17.16 [95% confidence interval {CI}, 1.49-198.21]; P= .02) and the presence of a gastrointestinal device (OR, 4.03 [95% CI, 1.04-15.56]; P= .04) as significant risk factors for acquisition of VRE. Observations in the interventional radiology department revealed that staff could not access the portions of the electronic medical record in which isolation precautions were documented. Simple interventions that granted access and that trained interventional radiology staff to review the need for precautions, coupled with enhanced infection control practices, interrupted ongoing transmission and reduced the proportion of VRE screens that were positive to 15 (1.2%) of 1,270. Inadequate communication with regard to infection control precautions can increase the risk of transmission of epidemiologically important organisms, particularly when patients receive care at multiple clinic locations. Adherence to infection control practices across the spectrum of care may limit the spread of resistant organisms.

Outbreak of Vancomycin-Resistant Enterococcus Colonization Among Pediatric Oncology Patients

PubMed Central

Nolan, Sheila M.; Gerber, Jeffrey S.; Zaoutis, Theoklis; Prasad, Priya; Rettig, Susan; Gross, Kimberly; McGowan, Karin L.; Reilly, Anne F.; Coffin, Susan E.

2010-01-01

OBJECTIVE To detect the burden of vancomycin-resistant Enterococcus (VRE) colonization among pediatric oncology patients and to determine risk factors for VRE acquisition. DESIGN Retrospective case-control study. SETTING The Children’s Hospital of Philadelphia. PATIENTS Pediatric oncology patients hospitalized from June 2006 through December 2007. METHODS Prevalence surveys revealed an increased VRE burden among pediatric oncology patients. For the case-control study, the 16 case patients were pediatric oncology patients who had 1 stool sample negative for VRE at screening before having a stool sample positive for VRE at screening; the 62 control patients had 2 consecutive screenings in which stool samples were negative for VRE. Case and control patients were matched on the duration of the interval between screens. Analyses were performed to determine the association between multiple exposures and VRE acquisition. RESULTS The prevalence survey revealed that 5 (9.6%) of 52 patients had unsuspected VRE colonization at the time of hospitalization. Multivariate analysis identified a lack of empirical contact precautions (odds ratio [OR], 17.16 [95% confidence interval {CI}, 1.49–198.21]; P = .02) and the presence of a gastrointestinal device (OR, 4.03 [95% CI, 1.04–15.56]; P = .04) as significant risk factors for acquisition of VRE. Observations in the interventional radiology department revealed that staff could not access the portions of the electronic medical record in which isolation precautions were documented. Simple interventions that granted access and that trained interventional radiology staff to review the need for precautions, coupled with enhanced infection control practices, interrupted ongoing transmission and reduced the proportion of VRE screens that were positive to 15 (1.2%) of 1,270. CONCLUSIONS Inadequate communication with regard to infection control precautions can increase the risk of transmission of epidemiologically important organisms, particularly when patients receive care at multiple clinic locations. Adherence to infection control practices across the spectrum of care may limit the spread of resistant organisms. PMID:19239375

Soil Lead Testing at a High Spatial Resolution in an Urban Community Garden: A Case Study in Relic Lead in Terre Haute, Indiana.

PubMed

Latimer, Jennifer C; Van Halen, David; Speer, James; Krull, Stephanie; Weaver, Patricia; Pettit, Joseph; Foxx, Heather

2016-10-01

Industrial emissions, deteriorating or improperly removed lead paint, and the use of lead additives in fuel have left a substantial burden of heavy metals, such as lead, in urban soils. Much of this lead remains near the surface where it has the potential to impact human health. Exposure to lead, especially in children, can have lasting impacts on neurological development and academic achievement. Urban gardening, in particular, is an activity that could result in increased exposure to soil lead for many unsuspecting gardeners. During the summer of 2012, more than 1,061 surface soil samples were collected from an approximately 1.25 acre urban community garden in Terre Haute, Indiana. Samples were collected to evaluate the spatial distribution of lead across the community garden on the plot level. The results highlight the variability that can be seen within small areas of a former residential property, for example lead concentrations that are low (<200 parts per million [ppm]) within the same 10 x 10 foot garden plot as concentrations that are considered high (>600 ppm). Based on the results of this work, several areas of concern were identified and the community garden was reconfigured to reduce potential lead exposure to gardeners and the local community.

Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease.

PubMed

Jostins, Luke; Ripke, Stephan; Weersma, Rinse K; Duerr, Richard H; McGovern, Dermot P; Hui, Ken Y; Lee, James C; Schumm, L Philip; Sharma, Yashoda; Anderson, Carl A; Essers, Jonah; Mitrovic, Mitja; Ning, Kaida; Cleynen, Isabelle; Theatre, Emilie; Spain, Sarah L; Raychaudhuri, Soumya; Goyette, Philippe; Wei, Zhi; Abraham, Clara; Achkar, Jean-Paul; Ahmad, Tariq; Amininejad, Leila; Ananthakrishnan, Ashwin N; Andersen, Vibeke; Andrews, Jane M; Baidoo, Leonard; Balschun, Tobias; Bampton, Peter A; Bitton, Alain; Boucher, Gabrielle; Brand, Stephan; Büning, Carsten; Cohain, Ariella; Cichon, Sven; D'Amato, Mauro; De Jong, Dirk; Devaney, Kathy L; Dubinsky, Marla; Edwards, Cathryn; Ellinghaus, David; Ferguson, Lynnette R; Franchimont, Denis; Fransen, Karin; Gearry, Richard; Georges, Michel; Gieger, Christian; Glas, Jürgen; Haritunians, Talin; Hart, Ailsa; Hawkey, Chris; Hedl, Matija; Hu, Xinli; Karlsen, Tom H; Kupcinskas, Limas; Kugathasan, Subra; Latiano, Anna; Laukens, Debby; Lawrance, Ian C; Lees, Charlie W; Louis, Edouard; Mahy, Gillian; Mansfield, John; Morgan, Angharad R; Mowat, Craig; Newman, William; Palmieri, Orazio; Ponsioen, Cyriel Y; Potocnik, Uros; Prescott, Natalie J; Regueiro, Miguel; Rotter, Jerome I; Russell, Richard K; Sanderson, Jeremy D; Sans, Miquel; Satsangi, Jack; Schreiber, Stefan; Simms, Lisa A; Sventoraityte, Jurgita; Targan, Stephan R; Taylor, Kent D; Tremelling, Mark; Verspaget, Hein W; De Vos, Martine; Wijmenga, Cisca; Wilson, David C; Winkelmann, Juliane; Xavier, Ramnik J; Zeissig, Sebastian; Zhang, Bin; Zhang, Clarence K; Zhao, Hongyu; Silverberg, Mark S; Annese, Vito; Hakonarson, Hakon; Brant, Steven R; Radford-Smith, Graham; Mathew, Christopher G; Rioux, John D; Schadt, Eric E; Daly, Mark J; Franke, Andre; Parkes, Miles; Vermeire, Severine; Barrett, Jeffrey C; Cho, Judy H

2012-11-01

Crohn's disease and ulcerative colitis, the two common forms of inflammatory bowel disease (IBD), affect over 2.5 million people of European ancestry, with rising prevalence in other populations. Genome-wide association studies and subsequent meta-analyses of these two diseases as separate phenotypes have implicated previously unsuspected mechanisms, such as autophagy, in their pathogenesis and showed that some IBD loci are shared with other inflammatory diseases. Here we expand on the knowledge of relevant pathways by undertaking a meta-analysis of Crohn's disease and ulcerative colitis genome-wide association scans, followed by extensive validation of significant findings, with a combined total of more than 75,000 cases and controls. We identify 71 new associations, for a total of 163 IBD loci, that meet genome-wide significance thresholds. Most loci contribute to both phenotypes, and both directional (consistently favouring one allele over the course of human history) and balancing (favouring the retention of both alleles within populations) selection effects are evident. Many IBD loci are also implicated in other immune-mediated disorders, most notably with ankylosing spondylitis and psoriasis. We also observe considerable overlap between susceptibility loci for IBD and mycobacterial infection. Gene co-expression network analysis emphasizes this relationship, with pathways shared between host responses to mycobacteria and those predisposing to IBD.

Ultrasound findings in dual kidney transplantation.

PubMed

Damasio, M B; Cittadini, G; Rolla, D; Massarino, F; Stagnaro, N; Gherzi, M; Paoletti, E; Derchi, L E

2013-02-01

This study was done to analyse colour Doppler ultrasound (CDUS) findings in patients with dual kidney transplantation (DKT) and to compare renal volume and resistive index (RI) values between DKT and single kidney transplantation (SKT). We reviewed the clinical and imaging findings [30 CDUS, five magnetic resonance (MR) and one computed tomography (CT) examination] in 30 patients with DKT (23 men and seven women; median age 65 years; range 55-82). Three patients had clinical signs of graft malfunction. Renal volumes and RI were compared with those of 14 SKT patients and comparable levels of renal function. Three patients had graft dysfunction: one had chronic rejection and two had pathologies involving one kidney only (one encrusted pyeloureteritis of a left graft and one occluded main artery of a left graft). Asymptomatic unilateral pathologies were seen in six cases. In asymptomatic DKT patients, no significant differences in length, volume, cortical echogenicity and RI between the two kidneys were observed; DKTs were smaller (median volume 116.7 vs. 171.6 cc) and had higher RIs (0.76 vs. 0.68) (p<0.01) than SKTs. CDUS provides useful information in patients with DKT, allowing detection of clinically unsuspected unilateral diseases. At comparable levels of renal function, DKT patients had higher RI and lower volumes than SKT patients.

Risperidone prolongs cardiac repolarization by blocking the rapid component of the delayed rectifier potassium current.

PubMed

Drolet, Benoit; Yang, Tao; Daleau, Pascal; Roden, Dan M; Turgeon, Jacques

2003-06-01

Cases of QT prolongation and sudden death have been reported with risperidone, a neuroleptic agent increasingly prescribed worldwide. Although hypokalemia was present in some of these events, we hypothesized that risperidone may have unsuspected electrophysiologic effects predisposing patients to proarrhythmia. In six isolated guinea pig hearts, risperidone elicited prolongation of cardiac repolarization: action potential duration increased from a baseline value of 128 ms +/- 5 to 147 ms +/- 5 (15%) with risperidone 1 microM during pacing at 250-ms cycle length, whereas the increase was only 10%, from 101 ms +/- 2 to 111 ms +/- 4, with pacing at a cycle length of 150 ms. In human ether-a-go-go (HERG)-transfected Chinese hamster ovary cells (n = 16), risperidone caused concentration-dependent block of the rapid component (I(Kr)) of the delayed rectifier potassium current with an IC(50) for tail block of 261 nM. Risperidone did not block I(Ks). Risperidone exerts cardiac electrophysiologic effects similar to those of Class III antiarrhythmic drugs. These effects are observed at clinically relevant concentrations. Because risperidone is metabolized primarily by CYP2D6, these actions likely enhance risk for risperidone-related QT prolongation and proarrhythmia in specific patient subsets (e.g., poor metabolizers and those taking interacting drugs).

A family with Wagner syndrome with uveitis and a new versican mutation

PubMed Central

Rothschild, Pierre-Raphaël; Brézin, Antoine P.; Nedelec, Brigitte; des Roziers, Cyril Burin; Ghiotti, Tiffany; Orhant, Lucie; Boimard, Mathieu

2013-01-01

Purpose To report the clinical and molecular findings of a kindred with Wagner syndrome (WS) revealed by intraocular inflammatory features. Methods Eight available family members underwent complete ophthalmologic examination, including laser flare cell meter measurements. Collagen, type II, alpha 1, versican (VCAN), frizzled family receptor 4, low density lipoprotein receptor-related protein 5, tetraspanin 12, and Norrie disease (pseudoglioma) genes were screened with direct sequencing. Results The index case was initially referred for unexplained severe and chronic postoperative bilateral uveitis following a standard cataract surgery procedure. Clinical examination of the proband revealed an optically empty vitreous with avascular vitreous strands and veils, features highly suggestive of WS. The systematic familial ophthalmologic examination identified three additional unsuspected affected family members who also presented with the WS phenotype, including uveitis for one of them. We identified a novel c.4004–6T>A nucleotide substitution at the acceptor splice site of intron 7 of the VCAN gene that segregated with the disease phenotype. Conclusions We present a family with WS with typical WS features and intraocular inflammatory manifestations associated with a novel splice site VCAN mutation. Beyond the structural role in the retinal-vitreous architecture, versican is also emerging as a pivotal mediator of the inflammatory response, supporting uveitis predisposition as a clinical manifestation of WS. PMID:24174867

A family with Wagner syndrome with uveitis and a new versican mutation.

PubMed

Rothschild, Pierre-Raphaël; Brézin, Antoine P; Nedelec, Brigitte; Burin des Roziers, Cyril; Ghiotti, Tiffany; Orhant, Lucie; Boimard, Mathieu; Valleix, Sophie

2013-01-01

To report the clinical and molecular findings of a kindred with Wagner syndrome (WS) revealed by intraocular inflammatory features. Eight available family members underwent complete ophthalmologic examination, including laser flare cell meter measurements. Collagen, type II, alpha 1, versican (VCAN), frizzled family receptor 4, low density lipoprotein receptor-related protein 5, tetraspanin 12, and Norrie disease (pseudoglioma) genes were screened with direct sequencing. The index case was initially referred for unexplained severe and chronic postoperative bilateral uveitis following a standard cataract surgery procedure. Clinical examination of the proband revealed an optically empty vitreous with avascular vitreous strands and veils, features highly suggestive of WS. The systematic familial ophthalmologic examination identified three additional unsuspected affected family members who also presented with the WS phenotype, including uveitis for one of them. We identified a novel c.4004-6T>A nucleotide substitution at the acceptor splice site of intron 7 of the VCAN gene that segregated with the disease phenotype. We present a family with WS with typical WS features and intraocular inflammatory manifestations associated with a novel splice site VCAN mutation. Beyond the structural role in the retinal-vitreous architecture, versican is also emerging as a pivotal mediator of the inflammatory response, supporting uveitis predisposition as a clinical manifestation of WS.

The Use of Dexamethasone in Support of High-Altitude Ground Operations and Physical Performance: Review of the Literature

DTIC Science & Technology

2014-12-01

rates vary dramatically, the physiological effect of hypobaric high-altitude hypoxia ( HHH ) is ubiquitous.1,2 Symptoms of less severe cases of HHH ...nausea, headache, and peripheral edema.3-6 More severe cases of HHH may result in acute mountain sickness (AMS), high-altitude pulmonary edema

Yellow Fever in an Unvaccinated Traveler to Peru.

PubMed

Winnicka, Lydia; Abdullah, Amirahwaty; Yang, Tsujung; Norville, Kim; Irizarry-Acosta, Melina

2017-01-01

We present a case of an unvaccinated traveler who traveled from New York to Peru and contracted yellow fever. He likely acquired the infection while visiting the Amazon River, with a point of exit of Lima, Peru. Our case illustrates the dramatic course that yellow fever may take, as well as the importance of pretravel vaccination.

Effect of dynamic temperature storage in retail display case on the quality and microbiota of packaged fresh-cut leafy greens

USDA-ARS?s Scientific Manuscript database

Commercial refrigeration equipment is projected to rise 5.2% annually to meet the consumer demand for fresh-cut produce items. The highly variable temperature conditions associated with storage of fresh-cuts in commercial open-refrigerated display cases dramatically affects the shelf-life and qualit...

Case study comparison of two pellet heating facilities in southeastern Alaska

Treesearch

David Nicholls; Allen Brackley; Robert Deering; Daniel Parrent; Brian Kleinhenz; Craig. Moore

2016-01-01

Over the past decade, wood-energy use in Alaska has grown dramatically. Since 2000, several dozen new wood-energy installations have been established, with numerous others in the design or construction phase. This case study report compares two wood-pellet heating systems in Juneau, Alaska. The Tlingit-Haida Regional Housing Authority, a native housing authority that...

Models of Shelter Management Training and Delivery Systems.

DTIC Science & Technology

1980-05-31

case study can be pre- sented orally, in writing, through a dramatization, or on film. Advantages: the case can be designed to focus on a problem or...develop a good, complex case study ; it may not be possible to use a case with more than one group (Ax & Kohls, 1977; Bauman, 1977; U.S. Civil Service...Although public information on self-protection continued to be distributed, the shelter program remained incomplete (e.g., an AIR study in 1966 noted that

Witchcraft or mycotoxin? The Salem witch trials.

PubMed

Woolf, A

2000-01-01

The Salem witchcraft trials of 1692 have been studied by many historians looking for the complex social, political, and psychological determinants behind the community-wide hysteria that led to a travesty of justice and the deaths of 20 innocent Puritans. Recently, ergot poisoning has been put forth by some as a previously unsuspected cause of the bizarre behaviors of the young adolescent girls who accused the townsfolk of witchcraft. In this essay the circumstances behind the ergot poisoning theory for this historical event are described. When the evidence is weighed carefully both pro and con, it seems unlikely that ergotism explains much of what went on in colonial Salem.

Poor quality drugs: grand challenges in high throughput detection, countrywide sampling, and forensics in developing countries†

PubMed Central

Fernandez, Facundo M.; Hostetler, Dana; Powell, Kristen; Kaur, Harparkash; Green, Michael D.; Mildenhall, Dallas C.; Newton, Paul N.

2012-01-01

Throughout history, poor quality medicines have been a persistent problem, with periodical crises in the supply of antimicrobials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Regrettably, this problem seems to have grown in the last decade, especially afflicting unsuspecting patients and those seeking medicines via on-line pharmacies. Here we discuss some of the challenges related to the fight against poor quality drugs, and counterfeits in particular, with an emphasis on the analytical tools available, their relative performance, and the necessary workflows needed for distinguishing between genuine, substandard, degraded and counterfeit medicines. PMID:21107455

Genetic Modifiers of Sickle Cell Disease

PubMed Central

Steinberg, Martin H.; Sebastiani, Paola

2015-01-01

Sickle cell anemia is associated with unusual clinical heterogeneity for a Mendelian disorder. Fetal hemoglobin concentration and coincident ∝ thalassemia, both which directly affect the sickle erythrocyte, are the major modulators of the phenotype of disease. Understanding the genetics underlying the heritable subphenotypes of sickle cell anemia would be prognostically useful, could inform personalized therapeutics, and might help the discovery of new “druggable” pathophysiologic targets. Genotype-phenotype association studies have been used to identify novel genetic modifiers. In the future, whole genome sequencing with its promise of discovering hitherto unsuspected variants could add to our understanding of the genetic modifiers of this disease. PMID:22641398

How the study of Listeria monocytogenes has led to new concepts in biology.

PubMed

Rolhion, Nathalie; Cossart, Pascale

2017-06-01

The opportunistic intracellular bacterial pathogen Listeria monocytogenes has in 30 years emerged as an exceptional bacterial model system in infection biology. Research on this bacterium has provided considerable insight into how pathogenic bacteria adapt to mammalian hosts, invade eukaryotic cells, move intracellularly, interfere with host cell functions and disseminate within tissues. It also contributed to unveil features of normal host cell pathways and unsuspected functions of previously known cellular proteins. This review provides an updated overview of our knowledge on this pathogen. In many examples, findings on L. monocytogenes provided the basis for new concepts in bacterial regulation, cell biology and infection processes.

New Mesoscale Fluvial Landscapes - Seismic Geomorphology and Exploration

NASA Technical Reports Server (NTRS)

Wilkinson, M. J.

2013-01-01

Megafans (100-600 km radius) are very large alluvial fans that cover significant areas on most continents, the surprising finding of recent global surveys. The number of such fans and patterns of sedimentation on them provides new mesoscale architectures that can now be applied on continental fluvial depositional systems, and therefore on. Megafan-scale reconstructions underground as yet have not been attempted. Seismic surveys offer new possibilities in identifying the following prospective situations at potentially unsuspected locations: (i) sand concentrations points, (ii) sand-mud continuums at the mesoscale, (iii) paleo-valley forms in these generally unvalleyed landscapes, (iv) stratigraphic traps, and (v) structural traps.

Unsuspected glucose-6-phosphate dehydrogenase deficiency presenting as symptomatic methemoglobinemia with severe hemolysis after fava bean ingestion in a 6-year-old boy.

PubMed

Odièvre, Marie-Hélène; Danékova, Névéna; Mesples, Bettina; Chemouny, Myriam; Couque, Nathalie; Parez, Nathalie; Ducrocq, Rolande; Elion, Jacques

2011-05-01

We report the occurrence of symptomatic methemoglobinemia in a previously healthy boy, who presented with severe acute hemolysis after fava bean ingestion. The methemoglobinemia revealed a previously unrecognized glucose-6-phosphate dehydrogenase (G6PD) deficiency. We discuss the pathophysiology of severe methemoglobinemia when associated with acute hemolysis, favism, and the common African G6PD A-variant [G6PD, VAL68MET, ASN126ASP]. In conclusion, screening for G6PD deficiency must be considered in symptomatic methemoglobinemia, especially in young boys, when associated with intravascular hemolysis.

Novel recurrently mutated genes in African American colon cancers.

PubMed

Guda, Kishore; Veigl, Martina L; Varadan, Vinay; Nosrati, Arman; Ravi, Lakshmeswari; Lutterbaugh, James; Beard, Lydia; Willson, James K V; Sedwick, W David; Wang, Zhenghe John; Molyneaux, Neil; Miron, Alexander; Adams, Mark D; Elston, Robert C; Markowitz, Sanford D; Willis, Joseph E

2015-01-27

We used whole-exome and targeted sequencing to characterize somatic mutations in 103 colorectal cancers (CRC) from African Americans, identifying 20 new genes as significantly mutated in CRC. Resequencing 129 Caucasian derived CRCs confirmed a 15-gene set as a preferential target for mutations in African American CRCs. Two predominant genes, ephrin type A receptor 6 (EPHA6) and folliculin (FLCN), with mutations exclusive to African American CRCs, are by genetic and biological criteria highly likely African American CRC driver genes. These previously unsuspected differences in the mutational landscapes of CRCs arising among individuals of different ethnicities have potential to impact on broader disparities in cancer behaviors.

Unsuspected Diversity of Arsenite-Oxidizing Bacteria as Revealed by Widespread Distribution of the aoxB Gene in Prokaryotes ▿ †

PubMed Central

Heinrich-Salmeron, Audrey; Cordi, Audrey; Brochier-Armanet, Céline; Halter, David; Pagnout, Christophe; Abbaszadeh-fard, Elham; Montaut, Didier; Seby, Fabienne; Bertin, Philippe N.; Bauda, Pascale; Arsène-Ploetze, Florence

2011-01-01

In this study, new strains were isolated from an environment with elevated arsenic levels, Sainte-Marie-aux-Mines (France), and the diversity of aoxB genes encoding the arsenite oxidase large subunit was investigated. The distribution of bacterial aoxB genes is wider than what was previously thought. AoxB subfamilies characterized by specific signatures were identified. An exhaustive analysis of AoxB sequences from this study and from public databases shows that horizontal gene transfer has likely played a role in the spreading of aoxB in prokaryotic communities. PMID:21571879

REOSC approach to ELTs and segmented optics

NASA Astrophysics Data System (ADS)

Geyl, Roland; Cayrel, Marc

2000-07-01

On the basis of its experience gained on the VLT and GEMINI primary mirrors polishing REOSC will present his first comments on the preliminary technical specifications of some concepts (OWL, MAXAT) discussed with their instigators (ESO, AURA). Similarities with other projects presently running (CEA LIL) at REOSC that lead to consider such type of giant telescope with some unsuspected serenity. In addition the discussion will be illustrated with the REOSC experience in medium and large size off axis aspheric optics fabrication, the most recent being the Gran Telescopio Canaries project for which REOSC has just been awarded by GRANTECAN S.A. for polishing the 36 segments of this 11-m instrument.

Incidental cervical metastases from thyroid carcinoma during neck dissection.

PubMed

Périé, S; Torti, F; Lefevre, M; Chabbert-Buffet, N; Jafari, A; Lacau St Guily, J

2016-12-01

To quantify and discuss the prevalence of unsuspected thyroid lymph node metastases discovered in specimens from neck dissection for head and neck squamous cell carcinoma (HNSCC) and discuss the impact on patient management. Retrospective study between May 2004 and January 2007. University hospital. Pathological analysis of cervical lymph node dissection performed during surgery for HNSCC in a total of 349 neck dissections in 266 consecutive patients. Twenty-one patients showed metastatic lymph nodes from thyroid cancer (prevalence 7.9%): 13 cases were metastatic from a papillary thyroid carcinoma and 8 cases from a follicular carcinoma. In 5 of the 21 patients, classical dissection was associated to recurrent nerve dissection and unilateral lobectomy; no thyroid carcinoma was found. Thirteen patients received radiotherapy for HNSCC. Follow-up comprised annual ultrasonographic examination of the neck and thyroid in these 21 patients. Total thyroidectomy was decided on in 5, with discovery of 3 micro-papillary thyroid carcinomas, in a single patient (complementary 131 I treatment). No thyroid carcinomas were found for the other 4 patients. No patients died from thyroid carcinoma during follow-up (mean: 41 months). The prevalence of lymph node metastasis from thyroid carcinoma in cervical lymph node dissection during treatment of HNSCC seems higher (7.9%) than rates reported in the literature (0.3 to 1.6%). This may be due to the histopathological methods employed. Management of patients should be discussed in the light of thyroid ultrasonography and prognosis of HNSCC. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Advantages and limitations of computed tomography scans for treatment planning of lung cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mira, J.G.; Potter, J.L.; Fullerton, G.D.

1982-09-01

Forty-five Chest computed tomography (CT) scans performed on patients with lung carcinoma (LC) were evaluated in an attempt to understand the pattern of intrathoracic tumor spread and the advantages and limitations this technique offers for treatment planning when compared to planning done by conventional X rays. The following findings can help treatment planning. (1) When regular X rays do not show location (i.e., hemithorax opacification), CT scan will show it in 68% of patients. If regular X rays show a well localized mass, unsuspected tumor extensions were disclosed in 78% of these patients. Hence, CT scans should be done inmore » all LC patients prior to treatment planning; (2) Mediastinal masses frequently spread anteriorly toward the sternum and posteriorly around the vertebral bodies toward the cord and costal pleura. This should be considered for radiotherapy boost techniques; (3) Lung masses spread in one third of cases toward the lateral costal pleura. Thus, the usual 1-2cm of safety margin around the LC are not sufficient in some cases; (4) Tumor size can appear much smaller in regular X rays than in CT scans. Hence, CT scans are necessary for accurate staging and evaluation of tumor response. Some CT scan limitations are: (1) Atelectasis blends with tumor in approximately half of the patients, thus obscuring tumor boundaries; (2) CT numbers and contrast enhancement did not help to differentiate between these two structures; and (3) Limited definition of CT scan prevents investigation of suspected microscopic spread around tumor masses.« less

A Population Accounting Approach to Assess Tourism Contributions to Conservation of IUCN-Redlisted Mammal Species

PubMed Central

Buckley, Ralf C.; Castley, J. Guy; Pegas, Fernanda de Vasconcellos; Mossaz, Alexa C.; Steven, Rochelle

2012-01-01

Over 1,000 mammal species are red-listed by IUCN, as Critically Endangered, Endangered or Vulnerable. Conservation of many threatened mammal species, even inside protected areas, depends on costly active day-to-day defence against poaching, bushmeat hunting, invasive species and habitat encroachment. Many parks agencies worldwide now rely heavily on tourism for routine operational funding: >50% in some cases. This puts rare mammals at a new risk, from downturns in tourism driven by external socioeconomic factors. Using the survival of individual animals as a metric or currency of successful conservation, we calculate here what proportions of remaining populations of IUCN-redlisted mammal species are currently supported by funds from tourism. This proportion is ≥5% for over half of the species where relevant data exist, ≥15% for one fifth, and up to 66% in a few cases. Many of these species, especially the most endangered, survive only in one single remaining subpopulation. These proportions are not correlated either with global population sizes or recognition as wildlife tourism icons. Most of the more heavily tourism-dependent species, however, are medium sized (>7.5 kg) or larger. Historically, biological concern over the growth of tourism in protected areas has centered on direct disturbance to wildlife. These results show that conservation of threatened mammal species has become reliant on revenue from tourism to a previously unsuspected degree. On the one hand, this provides new opportunities for conservation funding; but on the other, dependence on such an uncertain source of funding is a new, large and growing threat to red-listed species. PMID:22984467

A population accounting approach to assess tourism contributions to conservation of IUCN-redlisted mammal species.

PubMed

Buckley, Ralf C; Castley, J Guy; Pegas, Fernanda de Vasconcellos; Mossaz, Alexa C; Steven, Rochelle

2012-01-01

Over 1,000 mammal species are red-listed by IUCN, as Critically Endangered, Endangered or Vulnerable. Conservation of many threatened mammal species, even inside protected areas, depends on costly active day-to-day defence against poaching, bushmeat hunting, invasive species and habitat encroachment. Many parks agencies worldwide now rely heavily on tourism for routine operational funding: >50% in some cases. This puts rare mammals at a new risk, from downturns in tourism driven by external socioeconomic factors. Using the survival of individual animals as a metric or currency of successful conservation, we calculate here what proportions of remaining populations of IUCN-redlisted mammal species are currently supported by funds from tourism. This proportion is ≥ 5% for over half of the species where relevant data exist, ≥ 15% for one fifth, and up to 66% in a few cases. Many of these species, especially the most endangered, survive only in one single remaining subpopulation. These proportions are not correlated either with global population sizes or recognition as wildlife tourism icons. Most of the more heavily tourism-dependent species, however, are medium sized (>7.5 kg) or larger. Historically, biological concern over the growth of tourism in protected areas has centered on direct disturbance to wildlife. These results show that conservation of threatened mammal species has become reliant on revenue from tourism to a previously unsuspected degree. On the one hand, this provides new opportunities for conservation funding; but on the other, dependence on such an uncertain source of funding is a new, large and growing threat to red-listed species.

Cessation of Long-Term Naltrexone Therapy and Self-Injury: A Case Study.

ERIC Educational Resources Information Center

Crews, W. David, Jr.; And Others

1993-01-01

This case study of a woman with profound mental retardation and a history of severe self-injurious behavior (SIB) found that the dramatic decrease in SIB following Naltrexone administration was maintained through placebo and no drug phases and at six-month follow-up. Findings are discussed in terms of endogenous opioid system theories of SIB. (DB)

Explorations of Psyche and Callisto Enabled by Ion Propulsion

NASA Technical Reports Server (NTRS)

Wenkert, Daniel D.; Landau, Damon F.; Bills, Bruce G.; Elkins-Tanton, Linda T.

2013-01-01

Recent developments in ion propulsion (specifically solar electric propulsion - SEP) have the potential for dramatically reducing the transportation cost of planetary missions. We examine two representative cases, where these new developments enable missions which, until recently, would have required resouces well beyond those allocated to the Discovery program. The two cases of interest address differentiation of asteroids and large icy satellites

Macrodystrophia lipomatosa. A case report.

PubMed

Loro, A; Francechi, F; Dal Lago, A

1995-07-01

Macrodystrophia lipomatosa, a rare form of localized gigantism of unknown cause, is characterized by a dramatic overgrowth of all the mesenchymal elements, particularly the fibroadipose tissue, of one or more digits of the foot or hand. Of the known forms, static and progressive (1), we report the case of an African patient, of Bantu origin, who had a progressive deformity of his left hand.

Dramatic weight loss associated with commencing clozapine.

PubMed

Lally, John; McDonald, Colm

2011-11-08

The authors report the case of a 44-year-old man with a long history of chronic enduring schizophrenia who experienced dramatic weight loss after commencing treatment with clozapine, an antipsychotic medication characteristically associated with the greatest degree of weight gain among medical treatments for schizophrenia. He was obese with a body mass index (BMI) of 41.5 kg/m(2), but after commencing clozapine therapy he experienced an improvement in psychotic symptoms and 40% loss of his body weight attained through an altered diet and exercise regime, which resulted in him attaining a normal BMI of 24.8 kg/m(2).

The Exceptional Responders Initiative: Welcoming More Cases

Cancer.gov

The initiative is studying tissue, clinical, and genomic data from patients with cancer who have had dramatic and long-lasting responses to standard and experimental treatments that were not seen in similar patients who received the same treatment.

Prolonged exclusive breast-feeding from vegan mother causing an acute onset of isolated methylmalonic aciduria due to a mild mutase deficiency.

PubMed

Ciani, F; Poggi, G M; Pasquini, E; Donati, M A; Zammarchi, E

2000-04-01

We describe a case of methylmalonic aciduria (MMA) occurred in a 22-month-old boy whose diet was exclusively based upon breast-feeding from a mother following a long-lasting strict vegetarian diet. Clinical picture showed a dramatic onset, with a profound drowsiness associated with a severe metabolic acidosis, hyperammonemia, macrocytic anemia, ketonuria, and massive methylmalonic aciduria without homocystinuria. Both symptoms and biochemical findings quickly improved thanks to prompt vitamin B(12)parenteral therapy. Biochemical and enzymatic findings allowed a diagnosis of mild mutase deficiency, which only and inadequate dietary B(12)contribution might have revealed. Our case highlights the risk of a prolonged strictly vegetarian diet of lactating mother for providing inadequate amounts of some nutrients to the breast-fed baby. Moreover, such a dietary behaviour could dramatically unmask otherwise clinically unapparent metabolic defects in the baby. Copyright 2000 Harcourt Publishers Ltd.

Elimination of Plasmodium vivax Malaria in Azerbaijan

PubMed Central

Mammadov, Suleyman; Gasimov, Elkhan; Kurdova-Mintcheva, Rossitza; Wongsrichanalai, Chansuda

2016-01-01

Azerbaijan in the south caucasus region of far southeastern Europe has a long history of malaria endemicity but just successfully eliminated local transmission. After a period of relatively stable malaria situation (1960–1970), the country witnessed an epidemic followed by a series of outbreaks of various magnitudes in the following two decades, all caused by Plasmodium vivax. Compared with 1993, the number of malaria cases in the country jumped 29 times in 1994, 123 times in 1995, and 571 times in 1996 at the peak of the epidemic, when 13,135 cases were officially registered. Incidence rate increased dramatically from 0.2/100,000 population in 1991 to over 17/100,000 population in 1996. Scaled-up malaria control led to the containment of the epidemic and to a dramatic decrease of malaria burden nationwide. Azerbaijan has applied contemporary, complex control and surveillance strategies and approaches and is currently in the prevention of reintroduction phase. This article describes Azerbaijan's public health experience in conducting malaria control and elimination interventions over several decades until 2013 when the country reached an important milestone—no indigenous malaria cases were recorded. PMID:27708184

The Show Must Go On.

ERIC Educational Resources Information Center

Faust, Debra Dion

1995-01-01

Discusses the challenges of sponsoring extracurricular drama activities from the planning of a theatre season to the supervision of acting. Suggests changes to make the job more manageable. Makes a case for why dramatic productions are especially effective vehicles of education. (TB)

A Sacrificial Lam: A Divided School Board, a Beleaguered Superintendent, and an Urgent Need to Improve Student Achievement

ERIC Educational Resources Information Center

Fossey, Richard

2011-01-01

This case describes the confrontational relationship between four trustees on the San Antonio School Board and the San Antonio School District's superintendent Diana Lam, a nationally recognized school reformer, who came to San Antonio in 1994. The case includes a dramatic board meeting where a closely divided board meets to buy out Lam's…

Lexis, My Little Fairy Princess: Literature Review and Case Report on Non-Organic Failure To Thrive (NOFTT).

ERIC Educational Resources Information Center

Racicot, Lina C.

This paper explores the issues and possible etiologies associated with Non-Organic Failure To Thrive (NOFTT), a syndrome in which a child's weight gain deviates from an established pattern to become dramatically less than norms for age and sex. The case study of a 4-year-old named Lexis complements the literature review. Lexis remained small and…

Bulgaria, Romania, and Poland: Case Studies of a Changing Region. Fulbright-Hays Summer Seminar Abroad 1996 (Bulgaria and Romania).

ERIC Educational Resources Information Center

Mallory-Boyle, Nancy

This paper presents a unit for government and economics and one for world history on the dramatic regional changes which have occurred in Central and Eastern Europe since the late 1980s. The units can be taught cohesively covering 2-3 weeks or as modules integrated into relevant themes in the curriculum. The "case studies" approach…

Nuthatches eavesdrop on variations in heterospecific chickadee mobbing alarm calls

PubMed Central

Templeton, Christopher N.; Greene, Erick

2007-01-01

Many animals recognize the alarm calls produced by other species, but the amount of information they glean from these eavesdropped signals is unknown. We previously showed that black-capped chickadees (Poecile atricapillus) have a sophisticated alarm call system in which they encode complex information about the size and risk of potential predators in variations of a single type of mobbing alarm call. Here we show experimentally that red-breasted nuthatches (Sitta canadensis) respond appropriately to subtle variations of these heterospecific “chick-a-dee” alarm calls, thereby evidencing that they have gained important information about potential predators in their environment. This study demonstrates a previously unsuspected level of discrimination in intertaxon eavesdropping. PMID:17372225

Nuthatches eavesdrop on variations in heterospecific chickadee mobbing alarm calls.

PubMed

Templeton, Christopher N; Greene, Erick

2007-03-27

Many animals recognize the alarm calls produced by other species, but the amount of information they glean from these eavesdropped signals is unknown. We previously showed that black-capped chickadees (Poecile atricapillus) have a sophisticated alarm call system in which they encode complex information about the size and risk of potential predators in variations of a single type of mobbing alarm call. Here we show experimentally that red-breasted nuthatches (Sitta canadensis) respond appropriately to subtle variations of these heterospecific "chick-a-dee" alarm calls, thereby evidencing that they have gained important information about potential predators in their environment. This study demonstrates a previously unsuspected level of discrimination in intertaxon eavesdropping.

The activation of plasminogen by Hageman factor (Factor XII) and Hageman factor fragments.

PubMed Central

Goldsmith, G H; Saito, H; Ratnoff, O S

1978-01-01

Activation of plasminogen through surface-mediated reactions is well recognized. In the presence of kaolin, purified Hageman factor (Factor XII) changed plasminogen to plasmin, as assayed upon a synthetic amide substrate and by fibrinolysis. Kinetic studies suggested an enzymatic action of Hageman factor upon its substrate, plasminogen. Hageman factor fragments, at a protein concentration equivalent to whole Hageman factor, activated plasminogen to a lesser extent. These protein preparations were not contaminated with other agents implicated in surface-mediated fibrinolysis. Diisopropyl fluorophosphate treatment of plasminogen did not inhibit its activation by Hageman factor. These studies indicate that Hageman factor has a hitherto unsuspected function, the direct activation of plasminogen. PMID:659637

Learning and cognition in insects.

PubMed

Giurfa, Martin

2015-01-01

Insects possess small brains but exhibit sophisticated behavioral performances. Recent works have reported the existence of unsuspected cognitive capabilities in various insect species, which go beyond the traditional studied framework of simple associative learning. In this study, I focus on capabilities such as attention, social learning, individual recognition, concept learning, and metacognition, and discuss their presence and mechanistic bases in insects. I analyze whether these behaviors can be explained on the basis of elemental associative learning or, on the contrary, require higher-order explanations. In doing this, I highlight experimental challenges and suggest future directions for investigating the neurobiology of higher-order learning in insects, with the goal of uncovering l architectures underlying cognitive processing. © 2015 John Wiley & Sons, Ltd.

Computed tomographic detection of sinusitis responsible for intracranial and extracranial infections

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carter, B.L.; Bankoff, M.S.; Fisk, J.D.

1983-06-01

Computed tomography (CT) is now used extensively for the evaluation of orbital, facial, and intracranial infections. Nine patients are presented to illustrate the importance of detecting underlying and unsuspected sinusitis. Prompt treatment of the sinusitis is essential to minimize the morbidity and mortality associated with complications such as brain abscess, meningitis, orbital cellulitis, and osteomyelitis. A review of the literature documents the persistence of these complications despite the widespread use of antibiotic therapy. Recognition of the underlying sinusitis is now possible with CT if the region of the sinuses is included and bone-window settings are used during the examination ofmore » patients with orbital and intracranial infection.« less

Genome engineering for microbial natural product discovery.

PubMed

Choi, Si-Sun; Katsuyama, Yohei; Bai, Linquan; Deng, Zixin; Ohnishi, Yasuo; Kim, Eung-Soo

2018-03-03

The discovery and development of microbial natural products (MNPs) have played pivotal roles in the fields of human medicine and its related biotechnology sectors over the past several decades. The post-genomic era has witnessed the development of microbial genome mining approaches to isolate previously unsuspected MNP biosynthetic gene clusters (BGCs) hidden in the genome, followed by various BGC awakening techniques to visualize compound production. Additional microbial genome engineering techniques have allowed higher MNP production titers, which could complement a traditional culture-based MNP chasing approach. Here, we describe recent developments in the MNP research paradigm, including microbial genome mining, NP BGC activation, and NP overproducing cell factory design. Copyright © 2018 Elsevier Ltd. All rights reserved.

An extensive review of commercial product labels the good, bad and ugly.

PubMed

Mrvos, R; Dean, B S; Krenzelok, E P

1986-02-01

Cautions and warnings on consumer products play an important role in the prevention and treatment of poison exposures. Frequently those exposed will follow the directions before calling the poison center, physician or emergency room. An extensive label review of 200 commercial products was conducted to determine if medical treatment advice was correct, if the general public was able to comprehend warning statements, and if warnings were adequate. We conclude there are products available that provide precise, correct information. However, there are many that contain incorrect, misleading, and often dangerous information to an unsuspecting public. Various examples of both types are given to make the poison information specialist aware of what information is presented.

Treatment of Morbidity with Atypical Chest Pain

PubMed Central

Cott, Arthur

1987-01-01

The appropriate management of atypical chest pain requires an integration of medical and behavioural treatments. Unnecessary medicalization can increase morbidity. A sensitivity to the behavioural factors contributing to symptoms and disability may reduce both. The purpose of this paper is to provide physicians with a cognitive-behavioural perspective of the nature of morbidity and disability associated with chronic chest discomfort; some strategies for detecting heretofore unsuspected disability associated with chronic chest pain and related discomfort in patients with organic findings (both cardiac and non-cardiac), as well those with no identifiable disease process or organic cause; and some simple behavioural and cognitive-behavioural therapeutic techniques for treating and preventing such problems. PMID:21263912

Cutaneous metastases of internal tumors.

PubMed

Fernández-Antón Martínez, M C; Parra-Blanco, V; Avilés Izquierdo, J A; Suárez Fernández, R M

2013-12-01

Cutaneous metastases are relatively rare in clinical practice and their diagnosis requires a high index of suspicion because clinical findings can be subtle. These metastases reveal the presence of disseminated malignant disease and can lead to the diagnosis of unsuspected internal tumors or the spread or recurrence of an already diagnosed tumor. Early recognition of cutaneous metastases can facilitate prompt and accurate diagnosis resulting in early treatment; however, they are generally indicative of a poor prognosis. Some tumors have a predilection to metastasize to specific areas. Recognition of these patterns provides essential information that can guide the search for the underlying tumor. Copyright © 2011 Elsevier España, S.L. y AEDV. All rights reserved.

Dramatic response to temozolomide, irinotecan, and bevacizumab for recurrent medulloblastoma with widespread osseous metastases.

PubMed

Bonney, Phillip A; Santucci, Joshua A; Maurer, Adrian J; Sughrue, Michael E; McNall-Knapp, Rene Y; Battiste, James D

2016-04-01

There is little evidence to guide the choice of chemotherapeutic agents for osseous metastases in medulloblastoma. Recently, triple therapy with temozolomide, irinotecan, and bevacizumab has been reported to have efficacy in recurrent medulloblastoma, and this regimen alone and in combination with other agents has been tested in several early-phase clinical trials. Here we report a 20-year-old woman with multiply-relapsed medulloblastoma with numerous osseous metastases 8 years after original diagnosis who responded dramatically to temozolomide, irinotecan, and bevacizumab therapy. This case highlights the potential for this regimen in treating osseous metastases in medulloblastoma. Copyright © 2016. Published by Elsevier Ltd.

A young-onset frontal dementia with dramatic calcifications due to a novel CSF1R mutation.

PubMed

Gore, Ethan; Manley, Andrew; Dees, Daniel; Appleby, Brian S; Lerner, Alan J

2016-06-01

Neuroimaging and genomic analysis greatly aid in the identification of young-onset dementia antemortem. We present the case of a 33-year-old female with a 2-year rapid decline to dementia and immobility marked by personality change, executive deficits including compulsions, attention deficit, apraxia, Parkinsonism, and pyramidal signs. She had unique and dramatic calcifications and confluent white matter changes on imaging and was found to have a novel mutation in the colony stimulating factor 1 receptor gene causing adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP). Here, we review ALSP and briefly discuss differential diagnoses.

Risk assessment of malaria in land border regions of China in the context of malaria elimination.

PubMed

Zhang, Qian; Sun, Junling; Zhang, Zike; Geng, Qibin; Lai, Shengjie; Hu, Wenbiao; Clements, Archie C A; Li, Zhongjie

2016-11-08

Cross-border malaria transmission poses a challenge for countries to achieve and maintain malaria elimination. Because of a dramatic increase of cross-border population movement between China and 14 neighbouring countries, the malaria epidemic risk in China's land border regions needs to be understood. In this study, individual case-based epidemiological data on malaria in the 136 counties of China with international land borders, from 2011 to 2014, were extracted from the National Infectious Disease Information System. The Plasmodium species, seasonality, spatiotemporal distribution and changing features of imported and indigenous cases were analysed using descriptive spatial and temporal methods. A total of 1948 malaria cases were reported, with 1406 (72.2%) imported cases and 542 (27.8%) indigenous cases. Plasmodium vivax is the predominant species, with 1536 malaria cases occurrence (78.9%), following by Plasmodium falciparum (361 cases, 18.5%), and the others (51 cases, 2.6%). The magnitude and geographic distribution of malaria in land border counties shrunk sharply during the elimination period. Imported malaria cases were with a peak of 546 cases in 2011, decreasing yearly in the following years. The number of counties with imported cases decreased from 28 counties in 2011 to 26 counties in 2014. Indigenous malaria cases presented a markedly decreasing trend, with 319 indigenous cases in 2011 reducing to only 33 indigenous cases in 2014. The number of counties with indigenous cases reduced from 26 counties in 2011 to 10 counties in 2014. However, several bordering counties of Yunnan province adjacent to Myanmar reported indigenous malaria cases in the four consecutive years from 2011 to 2014. The scale and extent of malaria occurrence in the international land border counties of China decreased dramatically during the elimination period. However, several high-risk counties, especially along the China-Myanmar border, still face a persistent risk of malaria introduction and transmission. The study emphasizes the importance and urgency of cross-border cooperation between neighbouring countries to jointly face malaria threats to elimination goals.

Familial dopa-responsive cervical dystonia.

PubMed

Schneider, S A; Mohire, M D; Trender-Gerhard, I; Asmus, F; Sweeney, M; Davis, M; Gasser, T; Wood, N W; Bhatia, K P

2006-02-28

The authors present four cases from two unrelated families with young-onset predominant cervical dystonia with a dramatic sustained response to levodopa. Onset age was 12 years (range 9 to 15). Additional symptoms included postural hand tremor and laryngeal dystonia. Genetic testing for GTP cyclohydrolase I, tyrosine hydroxylase, and sepiapterin reductase was negative. These cases may represent new forms of dopa-responsive dystonia. Levodopa is advisable in all patients with young-onset cervical dystonia.

Decline in the U.S. furniture industry: a case study of the impacts to the hardwood lumber supply chain

Treesearch

Shawn T. Grushecky; Urs Buehlmann; Al Schuler; William Luppold; Ed Cesa

2006-01-01

Traditionally, the wood household furniture industry has accounted for a sizeable portion of total hardwood lumber use in the United States. However, for more than a decade, imports have gained an increasing share of the hardwood furniture market, and lumber consumption by this industry has declined dramatically in the last 5 years. We used a case study methodology to...

Rapid Identification of Laboratory Contamination with Mycobacterium tuberculosis Using Variable Number Tandem Repeat Analysis

PubMed Central

Gascoyne-Binzi, Deborah M.; Barlow, Rachael E. L.; Frothingham, Richard; Robinson, Grant; Collyns, Timothy A.; Gelletlie, Ruth; Hawkey, Peter M.

2001-01-01

Compared with solid media, broth-based mycobacterial culture systems have increased sensitivity but also have higher false-positive rates due to cross-contamination. Systematic strain typing is rarely undertaken because the techniques are technically demanding and the data are difficult to organize. Variable number tandem repeat (VNTR) analysis by PCR is rapid and reproducible. The digital profile is easily manipulated in a database. We undertook a retrospective study of Mycobacterium tuberculosis isolates collected over an 18-month period following the introduction of the BACTEC MGIT 960 system. VNTR allele profiles were determined with early positive broth cultures and entered into a database with the specimen processing date and other specimen data. We found 36 distinct VNTR profiles in cultures from 144 patients. Three common VNTR profiles accounted for 45% of true-positive cases. By combining VNTR results with specimen data, we identified nine cross-contamination incidents, six of which were previously unsuspected. These nine incidents resulted in 34 false-positive cultures for 29 patients. False-positive cultures were identified for three patients who had previously been culture positive for tuberculosis and were receiving treatment. Identification of cross-contamination incidents requires careful documentation of specimen data and good communication between clinical and laboratory staff. Automated broth culture systems should be supplemented with molecular analysis to identify cross-contamination events. VNTR analysis is reproducible and provides timely results when applied to early positive broth cultures. This method should ensure that patients are not placed on unnecessary tuberculosis therapy or that cases are not falsely identified as treatment failures. In addition, areas where existing procedures may be improved can be identified. PMID:11136751

Importation, Mitigation, and Genomic Epidemiology of Candida auris at a Large Teaching Hospital.

PubMed

Lesho, Emil P; Bronstein, Melissa Z; McGann, Patrick; Stam, Jason; Kwak, Yoon; Maybank, Rosslyn; McNamara, Jodi; Callahan, Megan; Campbell, Jean; Hinkle, Mary K; Walsh, Edward E

2018-01-01

OBJECTIVE Candida auris (CA) is an emerging multidrug-resistant pathogen associated with increased mortality. The environment may play a role, but transmission dynamics remain poorly understood. We sought to limit environmental and patient CA contamination following a sustained unsuspected exposure. DESIGN Quasi-experimental observation. SETTING A 528-bed teaching hospital. PATIENTS The index case patient and 17 collocated ward mates. INTERVENTION Immediately after confirmation of CA in the bloodstream and urine of a patient admitted 6 days previously, active surveillance, enhanced transmission-based precautions, environmental cleaning with peracetic acid-hydrogen peroxide and ultraviolet light, and patient relocation were undertaken. Pre-existing agreements and foundational relationships among internal multidisciplinary teams and external partners were leveraged to bolster detection and mitigation efforts and to provide genomic epidemiology. RESULTS Candida auris was isolated from 3 of 132 surface samples on days 8, 9, and 15 of ward occupancy, and from no patient samples (0 of 48). Environmental and patient isolates were genetically identical (4-8 single-nucleotide polymorphisms [SNPs]) and most closely related to the 2013 India CA-6684 strain (~200 SNPs), supporting the epidemiological hypothesis that the source of environmental contamination was the index case patient, who probably acquired the South Asian strain from another New York hospital. All isolates contained a mutation associated with azole resistance (K163R) found in the India 2105 VPCI strain but not in CA-6684. The index patient remained colonized until death. No surfaces were CA-positive 1 month later. CONCLUSION Compared to previous descriptions, CA dissemination was minimal. Immediate access to rapid CA diagnostics facilitates early containment strategies and outbreak investigations. Infect Control Hosp Epidemiol 2018;39:53-57.

The evolutionary logic of sepsis.

PubMed

Rózsa, Lajos; Apari, Péter; Sulyok, Mihály; Tappe, Dennis; Bodó, Imre; Hardi, Richárd; Müller, Viktor

2017-11-01

The recently proposed Microbiome Mutiny Hypothesis posits that members of the human microbiome obtain information about the host individuals' health status and, when host survival is compromised, switch to an intensive exploitation strategy to maximize residual transmission. In animals and humans, sepsis is an acute systemic reaction to microbes invading the normally sterile body compartments. When induced by formerly mutualistic or neutral microbes, possibly in response to declining host health, sepsis appears to fit the 'microbiome mutiny' scenario except for its apparent failure to enhance transmission of the causative organisms. We propose that the ability of certain species of the microbiome to induce sepsis is not a fortuitous side effect of within-host replication, but rather it might, in some cases, be the result of their adaptive evolution. Whenever host health declines, inducing sepsis can be adaptive for those members of the healthy human microbiome that are capable of colonizing the future cadaver and spread by cadaver-borne transmission. We hypothesize that such microbes might exhibit switches along the 'mutualist - lethal pathogen - decomposer - mutualist again' scenario, implicating a previously unsuspected, surprising level of phenotypic plasticity. This hypothesis predicts that those species of the healthy microbiome that are recurring causative agents of sepsis can participate in the decomposition of cadavers, and can be transmitted as soil-borne or water-borne infections. Furthermore, in individual sepsis cases, the same microbial clones that dominate the systemic infection that precipitates sepsis, should also be present in high concentration during decomposition following death: this prediction is testable by molecular fingerprinting in experimentally induced animal models. Sepsis is a leading cause of human death worldwide. If further research confirms that some cases of sepsis indeed involve the 'mutiny' (facultative phenotypic switching) of normal members of the microbiome, then new strategies could be devised to prevent or treat sepsis by interfering with this process. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Identification of unsuspected Wolfram syndrome cases through clinical assessment and WFS1 gene screening in type 1 diabetes mellitus patients.

PubMed

Blanco-Aguirre, Maria E; la Parra, David Rivera-De; Tapia-Garcia, Hugo; Gonzalez-Rodriguez, Johanna; Welschen, Daniela; Welskin, Daniela; Arroyo-Yllanes, Maria Estela; Escudero, Irineo; Nuñez-Hernandez, Jorge A; Medina-Bravo, Patricia; Zenteno, Juan C

2015-07-15

Wolfram syndrome (WS) is a severe autosomal recessive pleiotropic disease primarily characterized by the association of juvenile-onset diabetes mellitus and optic atrophy. Earlier reports have shown that a proportion of WS cases may remain unrecognized due to misdiagnosis as type 1 diabetes mellitus (T1DM). The objectives of this work were to estimate the prevalence of patients fulfilling clinical criteria for WS in a cohort of subjects diagnosed as T1DM and to identify causal WFS1 gene mutations in those individuals meeting clinical criteria for the disease. A cohort of 131 unrelated Mexican T1DM patients was collected, including 77 females and 54 males. Additional clinical anomalies suggesting WS were identified through review of medical files, detailed physical examination and/or specialized tests. WFS1 gene analysis was performed using exon-by-exon PCR amplification and direct Sanger sequencing on genomic DNA from patients reaching WS clinical criteria. Clinical criteria for a WS diagnosis were reached in 6 probands, corresponding to a 4.58% frequency of the disease. WFS1 mutations were identified in 4 out of 5 (80%) individuals fulfilling WS clinical criteria, including two homozygous, one compound heterozygous, and one patient with a single allele mutation. No WFS1 mutations were identified in the remaining subject. In our cohort, approximately 6% of cases diagnosed as T1DM were in fact patients with Wolfram syndrome. WFS1 mutations were identified in 4 out of 5 individuals (80%) fulfilling clinical criteria for WS. Clinical and genetic analyses of large cohorts of T1DM patients from different ethnic origins would help to better estimate the occurrence of WS and will lead to a better management of such patients. Copyright © 2015 Elsevier B.V. All rights reserved.

Where Hospital Boards Often Fail: Auditing Leadership Performance.

PubMed

Friedman, Susan Y; Rabkin, Mitchell T

2018-03-06

Hospital boards address quality of care and patient safety as well as financial performance through long-accepted practices. By contrast, a hospital's administrative operations and institutional culture are not usually subject to such detailed scrutiny. Yet, despite a healthy bottom line and patient commendations, hospital personnel can be underperforming, burdened with poor morale, and suffering from less than optimal leadership, unwarranted inefficiency, and ethically questionable management practices. The resulting employee dissatisfaction or disengagement can affect productivity, quality, turnover, innovation, patient and donor attraction and retention, public image, etc., and can be missed by an unsuspecting board. While boards do not scrutinize most administrative operations, they do examine financial performance, through review of the independent auditor's Management Letter. Designed to help the chief financial officer (CFO) improve the efficiency and integrity of the hospital's financial systems and to recommend improvements to the board for implementation (rather than to assess the CFO's performance), the Management Letter has no equal with respect to a comparable evaluation of the hospital's administrative performance and workplace culture. When, as is often the case, there is only superficial review of the chief executive officer, the board has no source of analysis or recommendations to improve the hospital's institutional environment. In this Invited Commentary, the authors suggest a methodology to provide such a review, leading to a Leadership Letter, and discuss its utility for both non-profit and for-profit organizations.

The Older Worker: A Travelers Insurance Companies' Case Study.

ERIC Educational Resources Information Center

Hagstrom, Paul F.

1981-01-01

Some companies are making dramatic changes in their personnel practices. Research findings at Travelers Insurance Company led to the creation of a retiree job bank that lists retired persons available for temporary and part-time work at the company. (Author/MLF)

Conservation tillage

USDA-ARS?s Scientific Manuscript database

Conservation tillage, especially the no-tillage type of it, represents the most dramatic change in soil management for crop production in the history of agriculture. Historically, farmers prepared their entire field as a seedbed, but seeds in most cases were placed only in small areas in the field. ...

Small Town in Mass Society Revisited.

ERIC Educational Resources Information Center

Young, Frank W.

1996-01-01

A 1958 New York community study dramatized the thesis that macro forces (urbanization, industrialization, bureaucratization) have undermined all small communities' autonomy. Such "oppositional case studies" succeed when they render the dominant view immediately obsolete, have plausible origins, are testable, and generate new research.…

Preablation 131-I scans with SPECT/CT in postoperative thyroid cancer patients: what is the impact on staging?

PubMed

Avram, Anca M; Fig, Lorraine M; Frey, Kirk A; Gross, Milton D; Wong, Ka Kit

2013-03-01

The utility of preablation radioiodine scans for the management of differentiated thyroid cancer remains controversial. To determine the contribution of preablation Iodine 131 (131-I) planar with single-photon emission computed tomography/computed tomography (SPECT/CT; diagnostic [Dx] scans) to differentiated thyroid cancer staging. Prospective sequential series at university clinic. Using American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) staging, seventh edition 320 patients post-total thyroidectomy were initially staged based on clinical and pathology data (pTN) and then restaged after imaging (TNM). The impact of Dx scans with SPECT/CT on N and M scores, and TNM stage, was assessed in younger, age <45 years, n = 138 (43%), and older, age ≥ 45 years, n = 182 (57%) patients, with subgroup analysis for T1a and T1b tumors. In younger patients Dx scans detected distant metastases in 5 of 138 patients (4%), and nodal metastases in 61 of 138 patients (44%), including unsuspected nodal metastases in 24 of 63 (38%) patients initially assigned pathologic (p) N0 or pNx. In older patients distant metastases were detected in 18 of 182 patients (10%), and nodal metastases in 51 of 182 patients (28%), including unsuspected nodal metastases in 26 of 108 (24%) patients initially assigned pN0 or pNx. Dx scans detected distant metastases in 2 of 49 (4%) T1a, and 3 of 67 (4.5%) T1b patients. Dx scans detected regional metastases in 35% of patients, and distant metastases in 8% of patients. Information acquired with Dx scans changed staging in 4% of younger, and 25% of older patients. Preablation scans with SPECT/CT contribute to staging of thyroid cancer. Identification of regional and distant metastases prior to radioiodine therapy has significant potential to alter patient management.

High taxonomic diversity of cultivation-recalcitrant endophytic bacteria in grapevine field shoots, their in vitro introduction, and unsuspected persistence.

PubMed

Thomas, Pious; Sekhar, Aparna C; Shaik, Sadiq Pasha

2017-11-01

Molecular and microscopic analyses reveal enormous non-cultivable endophytic bacteria in grapevine field shoots with functional significance. Diverse bacteria enter tissue cultures through surface-sterilized tissues and survive surreptitiously with varying taxonomic realignments. The study was envisaged to assess the extent of endophytic bacterial association with field shoot tissues of grapevine and the likelihood of introduction of such internally colonizing bacteria in vitro adopting molecular techniques targeting the non-cultivable bacterial community. PowerFood ® -kit derived DNA from surface-sterilized field shoot tips of grapevine Flame Seedless was employed in a preliminary bacterial class-specific PCR screening proving positive for major prokaryotic taxa including Archaea. Taxonomic and functional diversity were analyzed through whole metagenome profiling (WMG) which revealed predominantly phylum Actinobacteria, Proteobacteria, and minor shares of Firmicutes, Bacteroidetes, and Deinococcus-Thermus with varying functional roles ascribable to the whole bacterial community. Field shoot tip tissues and callus derived from stem segments were further employed in 16S rRNA V3-V4 amplicon taxonomic profiling. This revealed elevated taxonomic diversity in field shoots over WMG, predominantly Proteobacteria succeeded by Actinobacteria, Firmicutes, Bacteroidetes, and 15 other phyla including several candidate phyla (135 families, 179 genera). Callus stocks also displayed broad bacterial diversity (16 phyla; 96 families; 141 genera) bearing resemblance to field tissues with Proteobacterial dominance but a reduction in its share, enrichment of Actinobacteria and Firmicutes, disappearance of some field-associated phyla and detection of a few additional taxonomic groups over field community. Similar results were documented during 16S V3-V4 amplicon taxonomic profiling on Thompson Seedless field shoot tip and callus tissues. Video microscopy on tissue homogenates corroborated enormous endophytic bacteria. This study elucidates a vast diversity of cultivation-recalcitrant endophytic bacteria prevailing in grapevine field shoots, their in vitro introduction, and unsuspecting sustenance with possible silent participation in tissue culture processes.

Case management of persons with acquired immunodeficiency syndrome in San Francisco

PubMed Central

Benjamin, A. E.; Lee, Philip R.; Solkowitz, Sharon N.

1988-01-01

The acquired immunodeficiency syndrome (AIDS) epidemic represents a growing challenge for the health care system and for case management models applied to persons with AIDS. The experience of San Francisco highlights some of the issues involved in developing a case management system appropriate to the needs of persons with AIDS, as well as providers, and payers. Dramatic growth in the size and complexity of the AIDS caseload and the involvement of public, health maintenance organization, and community providers has required the increasing formalization and centralization of case management roles. Persistent questions about the definition and goals of case management complicate development of these services. PMID:10312974

Engagement In Climate Change Awareness Through Art Exhibitions

NASA Astrophysics Data System (ADS)

Burko, D.

2016-12-01

Artists such as myself can influence the public discourse on climate change through compelling imagery transcending data and language. I will speak specifically to how I communicate scientific research to diverse populations by making those issues personal, visceral, and actionable.I began integrating scientific visual data into my aesthetic practice ten years ago by first utilizing archival evidence in the form of repeats, geological charts of recessional lines, graphs, symbols and Landsat maps. I continue to develop visual strategies delivering information on an emotional/non-verbal level. In the past 4 years, I have added the most dramatic layer to my creative process: bearing witness. I've been to the three largest ice fields in the world: Greenland, Antarctica and Argentina's Patagonia, observing the unprecedented pace of glacial melt. The emotional significance of actually being there as an artist is immense. Those expeditions impact my practice, leading to exhibitions that open a dialog with an audience not initially interested in science. In the past 5 years my work has appeared in 6 solo and 19 group exhibits all devoted to the environment. I make myself present in universities, museums and galleries to explain what the images are about. I require universities to include a public component: an all-college lecture or panel where the geography/environmental/sociology/geology departments participate with broad student involvement. I believe that such endeavors are worthwhile and can be models for further efforts to educate an unsuspecting audience. Artists can bridge the gap communicating to a public of art appreciators, nonscientists - how easy it is to understand geology and global warming. This social engagement can even inspire and result in attitudinal changes. A viewer's initial emotional response to my large paintings and photographs evolves into comprehension as a dialog about their content is revealed. By sharing my personal story about my expeditions, interactions and collaborations with glaciologists I have been able to educate and inspire. Of particular value is being able to engage with the next generation who truly may be our last hope to save our planet. Aside from personal examples I will include other artists and exhibition venues contributing to this kind of action.

Genes and plays: bringing ELSI issues to life.

PubMed

Rothenberg, Karen H; Bush, Lynn W

2012-02-01

Ethical complexities surround the promise of genomic technology and the power of genetic information as they alter conceptions of identity and dynamics within personal and professional relationships. Creative approaches such as dramatic vignettes offer a unique analytical stage for imagining the bioethical past and future. Dramatic narratives can bring to life images of differing perspectives and values when experiencing innovations in medicine. Although the scientific landscape shifts, concerns expressed in theatre from 50 years ago parallel many contemporary ELSI (ethical, legal, and social implications) issues, highlighting the ongoing struggle to appreciate the impact of emerging genetic technologies on relationships. To illuminate these enduring concerns, we explore how perceptions and relationships have influenced-and been influenced by-genetics as portrayed through dramatic vignettes. We build on the legacy of using case vignettes as a clinical teaching modality, and believe similar value exists within the research ethics domain. The selection of dialogue discussed encompasses abbreviated excerpts from two existing and one original vignette that we staged at the ELSI 2011 Congress and various academic and health institutions.

Increase in Middle East Respiratory Syndrome-Coronavirus Cases in Saudi Arabia Linked to Hospital Outbreak With Continued Circulation of Recombinant Virus, July 1–August 31, 2015

PubMed Central

Assiri, Abdullah M.; Biggs, Holly M.; Abedi, Glen R.; Lu, Xiaoyan; Bin Saeed, Abdulaziz; Abdalla, Osman; Mohammed, Mutaz; Al-Abdely, Hail M.; Algarni, Homoud S.; Alhakeem, Raafat F.; Almasri, Malak M.; Alsharef, Ali A.; Nooh, Randa; Erdman, Dean D.; Gerber, Susan I.; Watson, John T.

2016-01-01

During July–August 2015, the number of cases of Middle East respiratory syndrome (MERS) reported from Saudi Arabia increased dramatically. We reviewed the 143 confirmed cases from this period and classified each based upon likely transmission source. We found that the surge in cases resulted predominantly (90%) from secondary transmission largely attributable to an outbreak at a single healthcare facility in Riyadh. Genome sequencing of MERS coronavirus from 6 cases demonstrated continued circulation of the recently described recombinant virus. A single unique frameshift deletion in open reading frame 5 was detected in the viral sequence from 1 case. PMID:27704019

Persistent periorbital edema as a sole manifestation of cutaneous lupus erythematosus: report of two cases.

PubMed

Ghaninejad, H; Kavusi, S; Safar, F; Asgari, M; Naraghi, Z S

2006-02-28

In lupus erythematosus, dramatic periorbital edema and erythema without any evidence of other significant cutaneous or systemic involvement is unusual. We describe two patients with severe periorbital edema and erythema as the sole manifestation of cutaneous lupus erythematosus.

Implementing Teacher Evaluation: Lattice of Leadership

ERIC Educational Resources Information Center

Derrington, Mary Lynne

2016-01-01

This case study describes how all leaders in one elementary school focused their collective work implementing a dramatically changed, state-mandated teacher-evaluation system. The article describes how multiple leaders created new professional development structures based on staff feedback and adapted exiting professional development structures to…

Drama: The Play's the Thing.

ERIC Educational Resources Information Center

Irwin, Eleanor C.

1987-01-01

Discusses the history and theory of drama therapy and illustrates it through case studies. Makes suggestions for counselors who wish to use drama to promote psychological development. Notes that using dramatic activities allows counselors to view the inner world of their clients through symbolization, characterization, and interaction. (ABB)

Does thalidomide have an analgesic effect? Current status and future directions.

PubMed

Goli, Veeraindar

2007-04-01

Dramatic relief of pain and life-altering changes in quality of life in some patients treated with immunomodulators such as thalidomide compel us to look more closely at unconventional mechanisms that may be involved in propagation of persistent pain. Tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, IL-6, and IL-10 are the cytokines with the most evidence in pain modulation. TNF-alpha and IL-1beta seem to initiate neuropathic pain, IL-6 maintains such pain, and IL-10 inhibits this persistent pain. Thalidomide was found to be effective in animal models by inhibiting TNF-alpha production. Several case reports and case series in humans have demonstrated mixed results, with some patients having dramatic responses, especially in chronic intractable conditions such as complex regional pain syndrome. Thalidomide may be an alternative for some patients with intractable pain. However, use of thalidomide is limited by its neurotoxic and teratogenic effects. Newer analogues may significantly improve the risk/benefit of using such immunomodulators.

Causes of gas gangrene seen at the University of Nigeria Teaching Hospital, Enugu, Nigeria.

PubMed

Nwankwo, Okechukwu Emmanuel

2008-04-01

Gas gangrene (clostridial myonecrosis) is rarely seen and this rarity, coupled with its dramatic presentation and often devastating outcome, makes each case of gas gangrene a spectacular and memorable experience. This study analyses the cases managed, the causes and outcome. Gunshot wounds, compounded by late presentation with its accompanying florid infections, were seen as the causes in 14 cases of gas gangrene seen at the University of Nigeria Teaching Hospital, Enugu during the four-year study period from July 2000 to June 2004.

Is the Drugstore Safe? Counterfeit Diabetes Products on the Shelves

PubMed Central

Cheng, May M.

2009-01-01

It is no longer possible to identify counterfeit medical products, including medications and devices, by simply checking packaging and labeling. Improvements in technology have made it cheaper and easier to produce fake packaging and labels, making it nearly impossible for consumers and authorities to detect counterfeits without conducting tests on the products themselves, as illustrated by the sale of over one million counterfeit blood glucose test strips sold to unsuspecting U.S. consumers at drugstores in more than 35 states and in other countries around the world in the fall of 2006. The pricier the drugs, the more counterfeiters seek to mimic them to maximize returns, victimizing those patients at highest risk who rely on life-saving medications. PMID:20144408

Narrative of an R/V Meiring Naudé Cruise

NASA Astrophysics Data System (ADS)

Gründlingh, Marten Luther

Sailing at night, not a star is in sight, the vessel is rocked without grace. Thick tomes in our hands nor computer commands quell the sea which is white as the cruise leader's face. We find sigmas and t's, giant eddies, and big seas—Watch the XVI Please, SONAR, don't bug me! Thermohaline inversions, unsuspected divergence and at six every day there's beer and TV.We are up before dawn, 'ere night turns to morn/ There is no place here for the lazy. Where's the Mozambique Ridge? SSB on the bridge play our song. Man, we're all going crazy! For 10 days or more, we manage the chore tapping samples and combing the sea. Just work yourself silly—it's not willy nilly

[Adrenal incidentaloma: a clinical problem related to imaging].

PubMed

de Bruijne, E L E; Burgmans, J P J; Krestin, G P; Pols, H A P; van den Meiracker, A H; de Herder, W W

2005-08-13

Two female patients, 68 and 67 years of age, were referred for right abdominal pain and pyelonephritis, respectively. During the diagnostic work-up, an unsuspected adrenal mass was found in both patients. Hormonal evaluation and imaging showed a benign non-hyperactive functioning adenoma in one patient and a pheochromocytoma in the other. Both patients were successfully treated with endoscopic adrenalectomy. Wider application and improvement of abdominal imaging procedures have caused an increase of incidentally detected adrenal masses, posing a common clinical problem. Typically, a diagnosis can be made on the basis of the characteristic radiological image. The exact nature of the defect is often unclear and further evaluation is required to determine functionality and possible malignancy. An algorithm is presented for the management of adrenal incidentalomas.

Subsurface microbial habitats on Mars

NASA Technical Reports Server (NTRS)

Boston, P. J.; Mckay, C. P.

1991-01-01

We developed scenarios for shallow and deep subsurface cryptic niches for microbial life on Mars. Such habitats could have considerably prolonged the persistence of life on Mars as surface conditions became increasingly inhospitable. The scenarios rely on geothermal hot spots existing below the near or deep subsurface of Mars. Recent advances in the comparatively new field of deep subsurface microbiology have revealed previously unsuspected rich aerobic and anaerobic microbal communities far below the surface of the Earth. Such habitats, protected from the grim surface conditions on Mars, could receive warmth from below and maintain water in its liquid state. In addition, geothermally or volcanically reduced gases percolating from below through a microbiologically active zone could provide the reducing power needed for a closed or semi-closed microbial ecosystem to thrive.

When microbial conversations get physical

PubMed Central

Reguera, Gemma

2011-01-01

It is widely accepted that microorganisms are social beings. Whereas communication via chemical signals (e.g. quorum sensing) has been the focus of most investigations, the use of physical signals for microbial cell-cell communication has received only limited attention. Here, I argue that physical modes of microbial communication could be widespread in nature. This is based on experimental evidence on the microbial emission and response to three physical signals: sound waves, electromagnetic radiation, and electric currents. These signals propagate rapidly and, even at very low intensities, they provide useful mechanisms when a rapid response is required. I also make some suggestions for promising future research avenues that could bring novel and unsuspected insights into the physical nature of microbial signaling networks. PMID:21239171

Measurements of Humidity in the Atmosphere: Validation Experiments (MOHAVE I and MOHAVE II). Results Overview and Implication for the Long-Term Lidar Monitoring of Water Vapor in the UT/LS

NASA Technical Reports Server (NTRS)

Leblanc, Thierry; McDermid, I. S.; Vomel, H.; Whiteman, D.; Twigg, Larry; McGee, T. G.

2008-01-01

1. MOHAVE+MOHAVE II = very successful. 2. MOHAVE -> Fluorescence was found to be inherent to all three participating lidars. 3. MOHAVE II -> Fluorescence was removed and agreement with CFH was extremely good up to 16-18 km altitude. 4. MOHAVE II -> Calibration tests revealed unsuspected shortfalls of widely used techniques, with important implications for their applicability to longterm measurements. 5. A factor of 5 in future lidar signal-to-noise ratio is reasonably achievable. When this level is achieved water vapor Raman lidar will become a key instrument for the long-term monitoring of water vapor in the UT/LS

Diversity and evolution of marine phytoplankton.

PubMed

Simon, Nathalie; Cras, Anne-Lise; Foulon, Elodie; Lemée, Rodolphe

2009-01-01

Marine phytoplankton organisms account for more than 45% of the photosynthetic net primary production on Earth. They are distributed across many of the major clades of the tree of life and include prokaryotes, and eukaryotes that acquired photosynthesis through the process of endosymbiosis. If the number of extant described species is relatively low compared to the diversity of the terrestrial plants, recent insights into the genetic diversity of natural assemblages have revealed a large unsuspected diversity at different taxonomic levels. Wide infra-specific diversity is also being discovered in many widespread and well known morphological species. This review summarizes data obtained in the fields of ecology, evolutionary biology, physiology and genomics that have improved our understanding of the biodiversity and evolution of marine phytoplankton.

WNP-2, securities fraud investigation are fired up

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1984-03-01

Washington's WNP-2 nuclear plant faces a securities fraud investigation just as it is ready to start operating on schedule. The investigation's outcome and WNP-2's performance will determine whether WNP-1 and WNP-3 will be financed. Angry bondholders who did not receive interest on their investments in January prompted Congressional hearings, at which it was learned that institutional buyers had pulled out of the Washington Public Power Supply System project and unloaded the bonds on thousands of unsuspecting individuals for whom tax-free municipal bonds are inappropriate. Securities Exchange Commission investigators will focus on the initial offering and disclosure by the issuer tomore » determine if the Wall Street unloading was legal. (DCK)« less

Stem-cell-derived products: an FDA update.

PubMed

Moos, Malcolm

2008-12-01

The therapeutic potential of products derived from stem cells of various types has prompted increasing research and development and public attention. Initiation of human clinical trials in the not-too-distant future is now a realistic possibility. It is, therefore, important to weigh the potential benefits against known, theoretical and totally unsuspected risks in light of current knowledge to ensure that subjects participating in these trials are afforded the most reasonable balance possible between potential risks and potential benefits. There are no apparent differences in fundamental, qualitative biological characteristics between stem-cell-derived products and other cellular therapies regulated by the United States Food and Drug Administration (FDA). Existing authorities can, therefore, be applied. Nevertheless, these products do have properties that require careful evaluation.

The correlation structure of several popular pseudorandom number generators

NASA Technical Reports Server (NTRS)

Neuman, F.; Merrick, R.; Martin, C. F.

1973-01-01

One of the desirable properties of a pseudorandom number generator is that the sequence of numbers it generates should have very low autocorrelation for all shifts except for zero shift and those that are multiples of its cycle length. Due to the simple methods of constructing random numbers, the ideal is often not quite fulfilled. A simple method of examining any random generator for previously unsuspected regularities is discussed. Once they are discovered it is often easy to derive the mathematical relationships, which describe the mathematical relationships, which describe the regular behavior. As examples, it is shown that high correlation exists in mixed and multiplicative congruential random number generators and prime moduli Lehmer generators for shifts a fraction of their cycle lengths.

Dramatic response to nivolumab in xeroderma pigmentosum skin tumor.

PubMed

Chambon, Fanny; Osdoit, Sophie; Bagny, Kelly; Moro, Anne; Nguyen, Jacqueline; Réguerre, Yves

2018-02-01

We report the case of a 6-year-old female with xeroderma pigmentosum (XP) who developed a nonoperable scalp tumor, treated with anti-programmed cell death protein 1 (anti-PD-1) therapy (nivolumab). She presented with a sarcomatoid carcinoma of the scalp with bone lysis as well as vascular and meningeal contact. Nivolumab was initiated because it has emerged as a promising immunotherapy. We observed a dramatic tumor response with excellent tolerance. However, while on nivolumab therapy she developed two large skin melanomas and several squamous cell carcinomas, which have been resected. These results demonstrate that cancer immunotherapy in patients with XP can be impressive but complex and warrants further investigation. © 2017 Wiley Periodicals, Inc.

Intravenous immunoglobulin therapy leading to dramatic improvement in a patient with systemic juvenile idiopathic arthritis and severe pericarditis resistant to steroid pulse therapy.

PubMed

Aizawa-Yashiro, Tomomi; Oki, Eishin; Tsuruga, Kazushi; Nakahata, Tohru; Ito, Etsuro; Tanaka, Hiroshi

2012-05-01

A 7-year-old Japanese boy with a 4-month history of systemic juvenile idiopathic arthritis (s-JIA) experienced disease flare with spiking fever, exanthema and arthralgia. He then developed progressive dyspnea due to severe pericarditis, and proinflammatory hypercytokinemia was suspected. Methylprednisolone pulse therapy was ineffective and echocardiography showed massive pericardial effusion had persisted. Alternatively, subsequent intravenous immunoglobulin (IVIG) therapy resulted in dramatic resolution of the pericardial effusion, and his general condition significantly improved within a few days. This case report may lend further support the use of IVIG for selected patients with s-JIA and severe pericarditis.

Precocious puberty and large multicystic ovaries in young girls with primary hypothyroidism.

PubMed

Sanjeevaiah, Aravind Raj; Sanjay, Subbarayappa; Deepak, Tejesweni; Sharada, Ardanareshwaran; Srikanta, Sri S

2007-10-01

To describe 2 cases of primary hypothyroidism, precocious puberty, large multicystic ovaries, possible diagnostic dilemma, unilateral oophorectomies, and subsequent response to levothyroxine replacement therapy. We present the clinical, biochemical, radiologic, and histopathologic findings in 2 patients with rare cases of Van Wyk-Grumbach syndrome and megaovaries, who underwent unilateral oophorectomy. Two patients, an 8-year-old girl and a 3-year-old girl (cases 1 and 2, respectively), were referred to our center. Both patients presented with precocious puberty and vaginal bleeding and had undergone unilateral oophorectomy before referral. In the first patient (case 1), the surgical intervention was a consequence of torsion of the left megaovary, necessitating emergency oophorectomy. Oophorectomy in the second patient (case 2) was a result of initial diagnostic confusion, inasmuch as a sexcord stromal tumor was suspected. A detailed history, physical examination, and laboratory results pointed toward primary hypothyroidism due to Hashimoto's thyroiditis and thyroid dysgenesis, respectively. Serial ultrasound studies of the abdomen and pelvis revealed large multicystic ovaries, with progressive enlargement (including regrowth from an apparent ovarian "postsurgical remnant"). Both patients responded dramatically after initiation of levothyroxine replacement therapy, with no further vaginal bleeding and reversal of megaovary to normal size (in case 1). In a highly selected minority of children with untreated primary hypothyroidism, there is development of precocious puberty and progressively enlarging multicystic ovaries. The precise endocrine, neuroanatomic, and neurophysiologic bases for this phenomenon are unclear. Nevertheless, the entire clinicopathologic picture, including giant ovaries, dramatically reverts to normal status with the restoration of a euthyroid state by means of simple levothyroxine replacement therapy.

Getting patients to say yes: effective case presentations.

PubMed

Manji, I

1992-08-01

Getting patients to say yes to recommended treatment requires the dedication of each team member. It demands a commitment to educating patients and motivating them to turn their dental needs into dental wants, as well as providing financial options to make treatment affordable. When the dental team takes the time to nurture the case presentation process, the results can be dramatic. Patients embrace treatment and the practice provides it. It is nothing short of a win-win scenario.

The Image of the 1967 War in Israeli History Textbooks as Test Case: Studying an Active Past in a Protracted Regional Conflict

ERIC Educational Resources Information Center

Yogev, Esther

2012-01-01

This article seeks to shed light on the dilemma facing history education in regions beset by a protracted, and as yet unresolved ethno-political conflict. The article will examine this issue by means of a unique test case that observes a dramatic war event in Israeli textbooks. The event in question is the Six-Day War of 1967 and the study of its…

A life-threatening case of TAFRO syndrome with dramatic response to tocilizumab, rituximab, and pulse steroids: The first case report in Latin America.

PubMed

José, Fabio Freire; Kerbauy, Lucila Nassif; Perini, Guilherme Fleury; Blumenschein, Danielle Isadora; Pasqualin, Denise da Cunha; Malheiros, Denise Maria Avancini Costa; Campos Neto, Guilherme de Carvalho; de Souza Santos, Fabio Pires; Piovesan, Ronaldo; Hamerschlak, Nelson

2017-03-01

This is the report of the first case of TAFRO syndrome (Thrombocytopenia, Anasarca, myelofibrosis, Renal dysfunction, Organomegaly) in Latin America. The patient was a 61-year-old white woman of Ashkenazi Jewish descent, who presented with a history of 8 days of nausea, vomiting, and fever; severe pitting edema in both legs, ascites, splenomegaly, and palpable axillary lymph nodes. Abdominal computed tomography (CT) showed bilateral pleural effusion and retroperitoneal lymph node enlargement. Anasarca and worsening of renal function led to admission to the intensive care unit (ICU) with multiple organ failure, requiring mechanical ventilation, vasopressor medications, and continuous renal replacement therapy (CRRT). Diagnosis of TAFRO syndrome was made on day 18 after admission, based on clinical findings and results of bone marrow and lymph node biopsies. She was treated with methylprednisolone, tocilizumab, and rituximab. One week after the first tocilizumab dose, she had dramatic improvements in respiratory and hemodynamic status, and was weaned from ventilator support and vasopressor medications. After 2 weeks of therapy, CRRT was switched to intermittent hemodialysis. On day 46, the patient was discharged from the ICU to the general ward, and 3 months after admission, she went home. Provided the interleukin-6 measurement is available, this approach is suggested in cases of TAFRO syndrome, in order to customize the treatment.

Institutional Potential for Online Learning: A Hong Kong Case Study

ERIC Educational Resources Information Center

Donoghue, Sue L.

2006-01-01

Hong Kong's tertiary education environment has changed dramatically in recent years with universities now facing specific educational challenges in the areas of critical thinking, "life-long learning" and English language. The question exists as to what pedagogic developments will best allow the universities to address these challenges.…

Treating Pediatric Obesity Using an Empirically Supported Treatment: A Case Report

ERIC Educational Resources Information Center

Cunningham, Phillippe B.; Ellis, Deborah A.; Naar-King, Sylvie

2010-01-01

Overweight and obesity are increasing dramatically in the United States of America, especially among children. Effective treatment of the multiple risk factors that promote youth obesity requires treatment approaches that are flexible and comprehensive enough to address each of these factors. One such treatment approach is Multisystemic Therapy…

Africa and Discovery: Human Rights, Environment, and Development.

ERIC Educational Resources Information Center

Hitchcock, Robert K.

1993-01-01

Contends that, in the past 30 years, a dramatic upsurge has taken place in activities designed to promote human rights for indigenous peoples around the world. Asserts that, in the case of Africa, attention generally has been concentrated on socioeconomic rights, such as health care, sufficient water, food, and shelter. (CFR)

Composing across Modes: A Comparative Analysis of Adolescents' Multimodal Composing Processes

ERIC Educational Resources Information Center

Smith, Blaine E.

2017-01-01

Although the shift from page to screen has dramatically redefined conceptions of writing, very little is known about how youth compose with multiple modes in digital environments. Integrating multimodality and multiliteracies theoretical frameworks, this comparative case study examined how urban twelfth-grade students collaboratively composed…

Position Description Analysis: A Method for Describing Academic Roles and Functions.

ERIC Educational Resources Information Center

Renner, K. Edward; Skibbens, Ronald J.

1990-01-01

The Position Description Analysis method for assessing the discrepancy between status quo and specializations needed by institutions to meet new demands and expectations is presented using Dalhousie University (Nova Scotia) as a case study. Dramatic realignment of fields of specialization and change strategies accommodating the aging professoriate…

After the In-Service Course Challenges of Technology Integration

ERIC Educational Resources Information Center

Frederick, Gregory R.; Schweizer, Heidi; Lowe, Robert

2006-01-01

This case study chronicles one teacher's experience in the semester after an in-service course, Using Technology for Instruction and Assessment. Results suggest that success in the course and good intentions do not necessarily translate into dramatic change in methods or media of instruction. Student mobility and special needs, unexpected…

The importance of data curation on QSAR Modeling - PHYSPROP open data as a case study. (QSAR 2016)

EPA Science Inventory

During the last few decades many QSAR models and tools have been developed at the US EPA, including the widely used EPISuite. During this period the arsenal of computational capabilities supporting cheminformatics has broadened dramatically with multiple software packages. These ...

"The City": The Rhetoric of Rhythm.

ERIC Educational Resources Information Center

Medhurst, Martin J.; Benson, Thomas W.

1981-01-01

Case study of Ralph Steiner and Willard Van Dyke's classic documentary, "The City," a work of cinematic art and a record of the problems confronting urban planners. Discusses how the film builds a rhythmic pattern through dramatic structure, image content and composition, editing, music, and narration to enhance its rhetorical appeal. (JMF)

Misdiagnosing Whipple's disease in the young.

PubMed

Papakonstantinou, Danai; Riste, Michael J; Langman, Gerald; Moran, Ed

2017-03-21

Whipple's disease is considered an infection of middle-aged white men of European ancestry. Cases are rare and disproportionately associated with occupational exposure to soil or animals. We report the case of a man aged 22 years with no risk factors, erroneously diagnosed with, and treated for, toxoplasmosis on the basis of consistent lymph node histology. The correct diagnosis was delayed by the dramatic symptomatic improvement resulting from this therapy. Whipple's disease should be considered in cases of granulomatous lymphadenopathy of unknown cause, even if the age of the patient does not fit the classic presentation of the disease. 2017 BMJ Publishing Group Ltd.

A rare case of Ibuprofen-induced eosinophilic meningitis in a 13-year-old girl.

PubMed

Bansal, Sharad; Gupta, Mukesh; Sharma, Deepak; Bansal, Shweta

2014-01-01

Eosinophilic meningoencephalitis is based on clinical manifestations and microscopic identification of eosinophils present in cerebrospinal fluid (CSF). It is caused by a variety of helminthic infections with most common being angiostrongyliasis, gnathostomiasis, toxocariasis, cysticercosis, schistosomiasis, baylisascariasis, and paragonimiasis. Many case reports are there in which parasites have been found responsible, but there are rare reports of CSF eosinophilia associated with the use of drugs. We report a case of drug-induced (ibuprofen) eosinophilic meningitis in a healthy female who presented to us with severe headache and improved dramatically after drug withdrawal.

Invasive species: Ocean ecosystem case studies for earth systems and environmental sciences

USGS Publications Warehouse

Schofield, Pam; Brown, Mary E.

2016-01-01

Marine species are increasingly transferred from areas where they are native to areas where they are not. Some nonnative species become invasive, causing undesirable impacts to environment, economy and/or human health. Nonnative marine species can be introduced through a variety of vectors, including shipping, trade, inland corridors (such as canals), and others. Effects of invasive marine species can be dramatic and irreversible. Case studies of four nonnative marine species are given (green crab, comb jelly, lionfish and Caulerpa algae).

Reiter's Syndrome.

PubMed

Savant, S S; Fernandez, J C; Dhurandhar, M W; Fernandez, R J

1979-01-01

A case of Reiter's syndrome occurring in a young mate aged 20 years having extensive skin lesions of keratoderina blenoffhagica is presented along with a review of literature. Although urethritis was absent, other clinical and histopathological features of the cutaneous lesions led us to the diagnosis. The-possible relationship of postural psoriasis to Reiter's syndrome is discussed. Failure of the patient to respond satisfactorily to steroids, antibiotics etc, prompted the use of rnethotrexate in the case. The result was dramatic, as the patient completely recovered within ten days of starting treatment.

Response to eperisone in patients of therapy-resistant dissociative convulsions: A report of two cases.

PubMed

Jha, Vijendra Nath; Singh, Pramod Kumar

2017-01-01

Dissociative convulsions or pseudoseizures are a difficult to treat common psychiatric condition. In a subset of these patients, the chief complaint is clenching of teeth with apparent nonresponsiveness alone. Neither drugs nor psychotherapeutic interventions have been found to be of much help in its management. Report of two such subsets of cases is presented, in which patients with dissociative convulsions showed sudden, dramatic, and sustained good response to the addition of a muscle relaxant eperisone.

Thyrotoxicosis presenting as acute bulbar palsy.

PubMed

Mathew, Betsy; Devasia, Anup J; Ayyar, Vaggesh; Thyagaraj, Vijayasree; Francis, Geetha Ann

2011-06-01

Myopathy chiefly affecting the proximal muscles of the limbs is frequently seen in hyperthyroidism. But isolated acute bulbar palsy without skeletal muscle involvement is rare in thyrotoxicosis. We report the case of a 52 year old man who presented with severe dysphagia, dysphonia and bouts of aspiration. Laboratory testing revealed an underlying Graves' thyrotoxicosis. His symptoms recovered dramatically within 6 weeks with treatment of hyperthyroidism. This case is reported to emphasize that thyrotoxicosis should be considered in the differential diagnosis of dysphagia of obscure etiology.

An unusual case of Miller Fisher syndrome presenting with proptosis and chemosis

PubMed Central

Waung, Maggie W.; Singer, Mike A.

2012-01-01

Miller Fisher syndrome (MFS), a rare variant of Guillan-Barré syndrome, is characterized by ophthalmoplegia, ataxia, and areflexia. In addition to this classic triad, symptoms may include bulbar palsy, weakness, and sensory loss. The anti-GQ1b IgG antibody is a sensitive and specific marker for MFS; it is found in more than 90% of affected patients. We describe an unusual case of MFS that presented with dramatic bilateral proptosis and chemosis. PMID:22499110

Acute hemorrhagic edema of infancy: report of three cases.

PubMed

Emerich, Paulo Sergio; Prebianchi, Patricia Almeida; Motta, Luciene Lage da; Lucas, Elton Almeida; Ferreira, Leonardo Mello

2011-01-01

Acute Hemorrhagic Edema of Infancy is an infrequent leukocytoclastic vasculitis which occurs almost exclusively in children between 4 months and 2 years of age. It is clinically characterized by the triad fever, purpuric lesions on the face, auricular pinna and extremities, and edema. Although the cutaneous findings are dramatic and of rapid onset, the prognosis is favorable, with spontaneous resolution within 1 to 3 weeks. Three cases are described in which clinical and histopathological findings are characteristic of acute hemorrhagic edema of infancy.

Interstitial Hardening of Stainless Steel for Enhanced Corrosion Resistance for Naval Applications

DTIC Science & Technology

2017-03-01

CASE WESTERN ]\\!:SERVE U N I V E R S I T Y EST. 1826 March 1, 2017 Defense Technical Information Center 8725 John J Kingman Road , Sute 0944...electron microscopy (TEM) ~o ·determ: t;<: the origin of the dramatic surface roughness effect just described. A cross-sectional TEM image obtained from...CASE WESTERN RESERVE UNIVERSITY REPORT NUMBER 10900 EUCLID AVE. CLEVELAND, OHIO 44106-7015 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10

Metabolic Control of Vesicular Glutamate Transport and Release

PubMed Central

Juge, Narinobu; Gray, John A.; Omote, Hiroshi; Miyaji, Takaaki; Inoue, Tsuyoshi; Hara, Chiaki; Uneyama, Hisayuki; Edwards, Robert H.; Nicoll, Roger A.; Moriyama, Yoshinori

2010-01-01

Fasting has been used to control epilepsy since antiquity, but the mechanism of coupling between metabolic state and excitatory neurotransmission remains unknown. Previous work has shown that the vesicular glutamate transporters (VGLUTs) required for exocytotic release of glutamate undergo an unusual form of regulation by Cl−. Using functional reconstitution of the purified VGLUTs into proteoliposomes, we now show that Cl− acts as an allosteric activator, and the ketone bodies that increase with fasting inhibit glutamate release by competing with Cl− at the site of allosteric regulation. Consistent with these observations, acetoacetate reduced quantal size at hippocampal synapses, and suppresses glutamate release and seizures evoked with 4-aminopyridine in the brain. The results indicate an unsuspected link between metabolic state and excitatory neurotransmission through anion-dependent regulation of VGLUT activity. PMID:20920794

Advances in quantum simulations of ATPase catalysis in the myosin motor.

PubMed

Kiani, Farooq Ahmad; Fischer, Stefan

2015-04-01

During its contraction cycle, the myosin motor catalyzes the hydrolysis of ATP. Several combined quantum/classical mechanics (QM/MM) studies of this step have been published, which substantially contributed to our thinking about the catalytic mechanism. The methodological difficulties encountered over the years in the simulation of this complex reaction are now understood: (a) Polarization of the protein peptide groups surrounding the highly charged ATP(4-) cannot be neglected. (b) Some unsuspected protein groups need to be treated QM. (c) Interactions with the γ-phosphate versus the β-phosphate favor a concurrent versus a sequential mechanism, respectively. Thus, these practical aspects strongly influence the computed mechanism, and should be considered when studying other catalyzed phosphor-ester hydrolysis reactions, such as in ATPases or GTPases. Copyright © 2015 Elsevier Ltd. All rights reserved.

Doctors in Denial: The Forgotten Women in the "Unfortunate Experiment".

PubMed

Wilkinson, Edward J

2017-10-01

The "unfortunate experiment" that took place for a period of more than 20 years at the New Zealand Woman's Hospital in Auckland, New Zealand, had tragic results for numerous unsuspecting women and ultimately caused a 20-year setback in cervical cancer screening in New Zealand. The story of Herbert Green's evolving beliefs about cervical cancer, his pursuit of proof for his unfounded theory, based on "no more that a whim and misbelief" according to author Ron Jones, as well as the history of the active as well as passive complicity of superiors and colleagues for years in the rarified realm of academic medicine, is recounted in this engrossing and well-documented book.A historical account of an unfortunate experiment in cervical neoplasia diagnosis and management is presented.

Hydrocarbons and trace metals in mussels in the Macaé coast: Preliminary assessment for a coastal zone under influence of offshore oil field exploration in southeastern Brazil.

PubMed

Santiago, Igor U; Molisani, Mauricio M; Nudi, Adriana H; Scofield, Artur L; Wagener, Angela de L R; Limaverde Filho, Aricelso M

2016-02-15

Concentrations of PAHs and metals were obtained from mussels collected in beaches, coastal island and estuary of the Macaé coast, the main operational basin for offshore oil exploration in Brazil. This survey provides reference levels for scenarios of increasing exploration, as well as for other areas of the coast undergoing urbanization to support exploration. As expected, urban areas such as the Macaé river estuary presented high concentrations of PAHs, although unsuspected sites such the island also presented signs of contamination. PAH in mussels originated from pyrolytic and petrogenic sources. Metals were typical of non-contaminated coastal environments, although Cr concentrations were above Brazilian Reference Levels. Copyright © 2015 Elsevier Ltd. All rights reserved.

George Hartley Bryan, Ludwig Boltzmann, and the Stability of Flight

NASA Astrophysics Data System (ADS)

Boyd, T. James M.

2012-03-01

A century ago, George Hartley Bryan (1864-1928) published his classic book, Stability in Aviation. I draw together some strands from events that awakened his interest in the nascent science of aviation, in particular the stability of flight. Prominent among those who influenced him was Ludwig Boltzmann (1844-1906), who held Bryan in high esteem for his contributions to thermodynamics and kinetic theory. I argue that the seeds of Bryan's interest in aviation were sown at the British Association meeting at Oxford in the summer of 1894, at which Boltzmann was guest of honor. A joint discussion between Section A (Mathematical and Physical Science) and Section G (Mechanical Science) was devoted to the problems of flight, during the course of which Boltzmann revealed a hitherto unsuspected enthusiasm for flying.

Technetium-99m labeled red blood cells in the evaluation of hemangiosarcoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Joseph, U.A.; Jhingran, S.G.

Imaging with Tc-99m labeled red blood cells (RBC) is increasingly being used in the detection of acute gastro-intestinal bleeding, especially in patients with intermittent bleeding. A patient is presented in whom the labeled RBC scan was helpful in the incidental discovery of a previously unsuspected probable angiosarcoma of the right femur and adjacent soft tissues of the right hip due to the blood pool or blush effect of the labeled cells. The labeled RBC scan also identified extravasation due to active gastrointestinal bleeding from a previously unknown angiosarcoma of the ascending colon. Thus, the Tc-99m labeled RBC scan was usefulmore » in simultaneously detecting extravasation and blood pool effect at two remote tumor sites in the same patient.« less

Domestic violence in Australia: definition, prevalence and nature of presentation in clinical practice.

PubMed

Hegarty, K; Hindmarsh, E D; Gilles, M T

2000-10-02

Domestic violence is a complex pattern of behaviours that may include, in addition to physical acts of violence, sexual abuse and emotional abuse. Women experience domestic violence at far greater rates than men do, and women and children often live in fear as a result of the abuse that is used by men to maintain control over their partners. Domestic violence is a major public health problem and is very common in women attending clinical practice. Women present most commonly with a range of chronic symptoms to unsuspecting general practitioners, emergency department doctors or medical specialists. Women who have experienced partner abuse want to be asked about it and are more likely to disclose if asked in an empathic, non-judgemental way. Doctors can make a difference.

[Rhythm disorders and cardiac crypto-malformations].

PubMed

Davy, J M; Raczka, F; Cung, T T; Combes, N; Bortone, A; Gaty, D

2005-12-01

Faced with a cardiac arrhythmia occuring in an apparently healthy heart, it is necessary to perform an anatomical investigation to detect any unsuspected anomalies. Congenital cardiopathy must certainly be excluded, as this is often responsible for rhythm disorders and/or cardiac conduction defects. Similarly, any acquired conditions, cardiomyopathy, or cardiac tumour must be sought. However, the possibility should always be considered of a minimal congenital malformation, which could be repsonsible for: any type of cardiac arrhythmia: rhythm disorder or conduction defect at the atrial, junctional or ventricular level, with a benign or serious prognosis. Unexpected therapeutic difficulties during radiofrequency ablation procedures or at implantation of pacemakers or defibrillators. Together with rhythm studies, the investigation of choice is high quality imaging, either the classic left or right angiography or the more modern cardiac CT or intracardiac mapping.

Pre-operative imaging of rectal cancer and its impact on surgical performance and treatment outcome.

PubMed

Beets-Tan, R G H; Lettinga, T; Beets, G L

2005-08-01

To discuss the ability of pre-operative MRI to have a beneficial effect on surgical performance and treatment outcome in patients with rectal cancer. A description on how MRI can be used as a tool so select patients for differentiated neoadjuvant treatment, how it can be used as an anatomical road map for the resection of locally advanced cases, and how it can serve as a tool for quality assurance of both the surgical procedure and overall patient management. As an illustration the proportion of microscopically complete resections of the period 1993-1997, when there was no routine pre-operative imaging, is compared to that of the period 1998-2002, when pre-operative MR imaging was standardized. The proportion of R0 resections increased from 92.5 to 97% (p=0.08) and the proportion of resections with a lateral tumour free margin of >1mm increased from 84.4 to 92.1% (p=0.03). The incomplete resections in the first period were mainly due to inadequate surgical management of unsuspected advanced or bulky tumours, whereas in the second period insufficient consideration was given to extensive neoadjuvant treatment when the tumour was close to or invading the mesorectal fascia on MR. There are good indications that in our setting pre-operative MR imaging, along with other improvements in rectal cancer management, had a beneficial effect on patient outcome. Audit and discussion of the incomplete resections can lead to an improved operative and perioperative management.

Treatment of liver hydatidosis: How to treat an asymptomatic carrier?

PubMed Central

Frider, Bernardo; Larrieu, Edmundo

2010-01-01

Liver hydatidosis is the most common clinical presentation of cystic echinococcosis (CE). Ultrasonographic mass surveys have demonstrated the true prevalence, including the asymptomatic characteristic of the majority of cases, providing new insight into the natural history of the disease. This raises the question of whether to treat or not to treat these patients, due to the high and unsuspected prevalence of CE. The high rate of liver/lung frequencies of cyst localization, the autopsy findings, and the involution of cysts demonstrated in long time follow-up of asymptomatic carriers contribute to this discussion. The decision to treat an asymptomatic patient by surgery, albendazole, or puncture aspiration injection and reaspiration or to wait and watch, is based on conflicting reports in the literature, the lack of complications in untreated patients over time, and the spontaneous disappearance and involution of cysts. All these points contribute to difficulties of individual clinical decisions. The patients should be informed of the reasons and the risks of watchful/waiting without treatment, the possibility of complications, and the risks of the other options. As more information on the natural history of liver hydatidosis is acquired, selection of the best treatment will be come easier. Without this knowledge it would be very difficult to establish definitive rules of treatment. At present, it is possible to manage these patients over time and to wait for the best moment for treatment. Follow-up studies must be conducted to achieve this objective. PMID:20806427

Successful management of multiple permanent pacemaker complications – infection, 13 year old silent lead perforation and exteriorisation following failed percutaneous extraction, superior vena cava obstruction, tricuspid valve endocarditis, pulmonary embolism and prosthetic tricuspid valve thrombosis

PubMed Central

Kaul, Pankaj; Adluri, Krishna; Javangula, Kalyana; Baig, Wasir

2009-01-01

A 59 year old man underwent mechanical tricuspid valve replacement and removal of pacemaker generator along with 4 pacemaker leads for pacemaker endocarditis and superior vena cava obstruction after an earlier percutaneous extraction had to be abandoned, 13 years ago, due to cardiac arrest, accompanied by silent, unsuspected right atrial perforation and exteriorisation of lead. Postoperative course was complicated by tricuspid valve thrombosis and secondary pulmonary embolism requiring TPA thrombolysis which was instantly successful. A review of literature of pacemaker endocarditis and tricuspid thrombosis along with the relevant management strategies is presented. We believe this case report is unusual on account of non operative management of right atrial lead perforation following an unsuccessful attempt at percutaneous removal of right sided infected pacemaker leads and the incidental discovery of the perforated lead 13 years later at sternotomy, presentation of pacemaker endocarditis with a massive load of vegetations along the entire pacemaker lead tract in superior vena cava, right atrial endocardium, tricuspid valve and right ventricular endocardium, leading to a functional and structural SVC obstruction, requirement of an unusually large dose of warfarin postoperatively occasioned, in all probability, by antibiotic drug interactions, presentation of tricuspid prosthetic valve thrombosis uniquely as vasovagal syncope and isolated hypoxia and near instantaneous resolution of tricuspid prosthetic valve thrombosis with Alteplase thrombolysis. PMID:19239701

Adopting a child with cleft lip and palate: a study of parents' experiences.

PubMed

Hansson, Emma; Ostman, Jenny; Becker, Magnus

2013-02-01

Adoption of Chinese children with cleft lip and palate (CLP) has become increasingly more common in Sweden. The aim of this study was to examine parents' experience when adopting a child with CLP. Since 2008, 34 adopted children with CLP have been treated in our department. A questionnaire was sent to 33 of the families and 30 of them answered (91%). The parents had queued from 1 month to 8 years before they were offered a child. Eighteen families reported that they received information on CLP from the adoption agency and 87% contacted the department of plastic surgery for additional information. In 15 cases (45%) previously unknown medical conditions or birth defects other than CLP were discovered in Sweden. Most parents (67%) had been informed before the adoption that their child could be a carrier of resistant bacteria, but not all had received enough information to grasp what it implies to be a carrier. The great majority of the families did not feel that the early hospitalisation for the first operation had a negative impact on the attachment between them and their adopted child. They thought that the aesthetic and functional results of the operations were "better than expected". Seventeen families stated that people react to the cleft and four of them think that the reactions are a problem. Presumptive adoptive parents should be informed that the child might have unsuspected medical conditions, resistant bacteria, what carriage implies, and that needed treatment and long-term results are not predictable.

Sildenafil (Viagra) prolongs cardiac repolarization by blocking the rapid component of the delayed rectifier potassium current.

PubMed

Geelen, P; Drolet, B; Rail, J; Bérubé, J; Daleau, P; Rousseau, G; Cardinal, R; O'Hara, G E; Turgeon, J

2000-07-18

BACKGROUND-Several cases of unexpected death have been reported with sildenafil in patients predisposed to ischemic cardiac events. Although acute episodes of ischemia could account for some of these deaths, we hypothesized that sildenafil may have unsuspected electrophysiological effects predisposing some patients to proarrhythmia. METHODS AND RESULTS-Studies were undertaken in 10 isolated guinea pig hearts that demonstrated prolongation of cardiac repolarization in a reverse use-dependent manner by sildenafil 30 mcmol/L. Action potential duration increased 15% from baseline 117+/-3 to 134+/-2 ms with sildenafil during pacing at 250 ms cycle length, whereas a 6% increase from 99+/-2 to 105+/-2 ms was seen with pacing at 150 ms cycle length. Experiments in human ether-a-go-go-related gene (HERG)-transfected HEK293 cells (n=30) demonstrated concentration-dependent block of the rapid component (I(Kr)) of the delayed rectifier potassium current: activating current was 50% decreased at 100 mcmol/L. This effect was confirmed using HERG-transfected Chinese hamster ovary (CHO) cells, which exhibit no endogenous I(K)-like current. CONCLUSIONS-Sildenafil possesses direct cardiac electrophysiological effects similar to class III antiarrhythmic drugs. These effects are observed at concentrations that may be found in conditions of impaired drug elimination such as renal or hepatic insufficiency, during coadministration of another CYP3A substrate/inhibitor, or after drug overdose and offer a new potential explanation for sudden death during sildenafil treatment.

Autoimmunity in 2016.

PubMed

Selmi, Carlo

2017-08-01

The number of peer-reviewed articles published during the 2016 solar year and retrieved using the "autoimmunity" key word remained stable while gaining a minimal edge among the immunology articles. Nonetheless, the quality of the publications has been rising significantly and, importantly, acquisitions have become available through scientific journals dedicated to immunology or autoimmunity. Major discoveries have been made in the fields of systemic lupus erythematosus, rheumatoid arthritis, autoimmunity of the central nervous system, vasculitis, and seronegative spondyloarthrithritides. Selected examples include the role of IL17-related genes and long noncoding RNAs in systemic lupus erythematosus or the effects of anti-pentraxin 3 (PTX3) in the treatment of this paradigmatic autoimmune condition. In the case of rheumatoid arthritis, there have been reports of the role of induced regulatory T cells (iTregs) or fibrocytes and T cell interactions with exciting implications. The large number of studies dealing with neuroimmunology pointed to Th17 cells, CD56(bright) NK cells, and low-level TLR2 ligands as involved in multiple sclerosis, along with a high salt intake or the micriobiome-derived Lipid 654. Lastly, we focused on the rare vasculitides to which numerous studies were devoted and suggested that unsuspected cell populations, including monocytes, mucosal-associated invariant T cells, and innate lymphoid cells, may be crucial to ANCA-associated manifestations. This brief and arbitrary discussion of the findings published in 2016 is representative of a promising background for developments that will enormously impact the work of laboratory scientists and physicians at an exponential rate.

Sun Protection Education for Healthy Children

ERIC Educational Resources Information Center

Fulmore, Jason S.; Geiger, Brian F.; Werner, Karen A.; Talbott, Laura L.; Jones, Dina C.

2009-01-01

The World Health Organization (WHO) estimates that between two and three million non-melanoma skin cancers and 132,000 melanoma skin cancers occur globally each year. In the event of further depletion of the ozone, these cases will increase dramatically (WHO, 2004). Within the United States, cancers of the skin are the most frequent type of…

Bed Bug Epidemic: A Challenge to Public Health

ERIC Educational Resources Information Center

Ratnapradipa, Dhitinut; Ritzel, Dale O.; Haramis, Linn D.; Bliss, Kadi R.

2011-01-01

In recent years, reported cases of bed bug infestations in the U.S. and throughout the world have escalated dramatically, posing a global public health problem. Although bed bugs are not known to transmit disease to humans, they pose both direct and indirect public health challenges in terms of health effects, treatment, cost, and resource…

International Pre-Service Teachers' Practicum Experiences in the U.S.: Ethnographic Case Studies

ERIC Educational Resources Information Center

Kang, Jihea

2017-01-01

Many colleges around the world have been undergoing demographic shifts under the influence of globalization. The population of international students continues to grow dramatically. As such increasing number of international students has been enrolling U.S colleges. Teacher education is not an exception. However, international teacher candidates'…

Long-Term Autobiographical Memory for Legal Involvement: Individual and Sociocontextual Predictors

ERIC Educational Resources Information Center

Quas, Jodi A.; Alexander, Kristen Weede; Goodman, Gail S.; Ghetti, Simona; Edelstein, Robin S.; Redlich, Allison

2010-01-01

We examined adults' long-term autobiographical memory for a dramatic life event-participating as a child victim in a criminal prosecution because of alleged sexual abuse. The study is unique in several ways, including that we had extensive documentation concerning the sexual abuse allegations, the children's involvement in their legal case, and…

A Case Study in Organizational Change: Evaluation in Cooperative Extension

ERIC Educational Resources Information Center

Rennekamp, Roger A.; Engle, Molly

2008-01-01

This chapter examines how factors both internal and external to Cooperative Extension have influenced its commitment and capability to assess the quality and impact of its programs. The authors begin by documenting how the nature of Extension programming has changed dramatically in response to societal needs over the course of the organization's…

Social Class and Workplace Harassment during the Transition to Adulthood

ERIC Educational Resources Information Center

McLaughlin, Heather; Uggen, Christopher; Blackstone, Amy

2008-01-01

Young disadvantaged workers are especially vulnerable to harassment due to their age and social class position. As young people enter the workforce, their experiences of, and reactions to, harassment may vary dramatically from those of older adult workers. Three case studies introduce theory and research on the relationship between social class…

Strategies for Reforming University/State Relationships: Australia's Experience Sets Examples.

ERIC Educational Resources Information Center

McGuire, Harriet C.

1997-01-01

The World Bank's recommendations for higher education policy in Africa offer an appropriate framework for comparison with recent educational policy changes in Australia, particularly in the area of university financing. Australia provides a case study of how national policies have had a dramatic and rapid effect on education and have quickly…

Building a Business Case for Going Green

ERIC Educational Resources Information Center

Harris, Bill; Maldeis, Neil

2011-01-01

Community college enrollments usually rise during tough economic times and the recent recession and slow recovery are no exception. According to the American Association of Community Colleges (AACC), the number of students attending community colleges has grown dramatically in the last decade to about 12.4 million last fall. The AACC says that 1.4…

Money, Choice, and Equity in Kansas City. Major Investments with Modest Returns.

ERIC Educational Resources Information Center

Morantz, Alison

This report presents a case study concerning the accomplishments of the Kansas City (Missouri) specialized magnet schools that were created to cure the low academic achievement of minority students and eliminate the racial isolation that existed. The plan sought to dramatically improve the facilities and programming of the city schools, the…

Urbanized Children: Urban-Rural Awareness and Identity Consciousness of Migrant Workers' Children

ERIC Educational Resources Information Center

Yihan, Xiong

2017-01-01

The author applies a textual analysis and case study of two dramatic events in rural migrant children's lives: following their parents to cities and returning to the countryside with volunteers. The author finds (1) early life experience holds special importance by differentiating migrant workers' children into "one-and-a-half…

Here's How You Can Carry On the Fight against Epidemics in Your Schools.

ERIC Educational Resources Information Center

Hickson, Meredith Ann; Hinman, Alan R.

1983-01-01

During the 1970's many children lacked immunization against one or more of the major childhood diseases. Recently the number of cases of childhood diseases has declined dramatically. The schools are the focal point for disease prevention. Outlined are 10 steps to continue to ensure childrens' health. (MD)

2004 Carolyn Sherif Award Address: Heart Disease and Gender Inequity

ERIC Educational Resources Information Center

Travis, Cheryl Brown

2005-01-01

Individual patient records from the National Hospital Discharge Survey for 1988 and 1998 comprising approximately 10 million cases were the basis for a binary logistic regression model to predict coronary artery bypass graft. Patterns in 1988 and in 1998 indicated a dramatic and pernicious gender discrepancy in medical decisions involving bypass…

Temporal and Spatial Patterns of Airborne Contaminants Relative to Amphibian Population in Sequoia and Kings Canyon National Parks, California

EPA Science Inventory

Airborne agricultural pesticides are being transported many tens of kilometers to remote locations in mountain areas, and they have been implicated as a cause for recent, dramatic population declines of several amphibian species in such areas. The strongest case is for the mount...

Community Mental Health Systems Generate New Chronics: The Study of a Pure Case.

ERIC Educational Resources Information Center

Lieberman, Harvey J.; And Others

1988-01-01

Study indicated that, although well-integrated comprehensive community mental health system (CMHS) dramatically reduces utilization of long-stay inpatient beds compared to traditional health care systems, it does not banish appearance of "new chronic" patients from a catchment area. CMHS new chronic patients were younger, mostly male,…

Education for Democracy: Case Study on the Partnership between Montclair State University and Kirovograd State Pedagogical University

ERIC Educational Resources Information Center

Koroleva, Irina Viktor

2013-01-01

The number of international collaborative projects between schools of higher education has grown dramatically during the past ten years (Knight, 2004). Collaboration helps teachers to grow professionally, increase personal confidence, and accordingly, improve the effectiveness of teaching and learning (Meadows & Saltzman, 2002). This finding,…

Changing Images of the Inclined Plane: A Case Study of a Revolution in American Science Education

ERIC Educational Resources Information Center

Turner, Steven C.

2012-01-01

Between 1880 and 1920 the way science was taught in American High Schools changed dramatically. The old "lecture/demonstration" method, where information was presented to essentially passive students, was replaced by the "laboratory" method, where students performed their own experiments in specially constructed student laboratories. National…

Drama and Routine in the Public Schools.

ERIC Educational Resources Information Center

Pondy, Louis R.; Huff, Anne S.

A case study of curricular change compares two leading models of organizational change. One model stresses the uncertainty and disorder of major changes and views them as dramatic events. The other model sees major organizational shifts as the result of ordinary day-to-day processes and emphasizes their routine nature. For this study, the…

Higher Education Finance: A Case Study of Minority-Serving Institutions in New Mexico

ERIC Educational Resources Information Center

Hunter, Virginia Rae

2017-01-01

This study explores the relationship between state and federal funding policies and the ability of minority-serving institutions (MSIs) to support low-income and minority students. The way US public higher education is financed has changed dramatically since the Great Recession. State appropriations to institutions have declined (SHEEO, 2017),…

Real Leaders, Real Schools: Stories of Success against Enormous Odds

ERIC Educational Resources Information Center

Leader, Gerald C.

2008-01-01

"Real Leaders, Real Schools" tells the stories of five urban public school principals who led their schools through profound and transformative changes. In each of these cases, their efforts resulted in dramatic improvements in student achievement--improvements that occurred within the current environment of high-stakes tests. The revealing and…

Small Town Renewal: Overview and Case Studies.

ERIC Educational Resources Information Center

Kenyon, Peter, Ed.; Black, Alan, Ed.

Many small, inland, and remote Australian rural communities continue to lose population and businesses, a trend that has intensified over the last 2 decades. Mean age continues to rise, while the 15-24 age group contracts dramatically. Such declining demographics are caused by the stress and uncertainty of volatile world commodity markets, as well…

Building a Foundation: How Technology-Rich Project-Based Learning Transformed Talladega County Schools. Case Study

ERIC Educational Resources Information Center

Jones, Rachel; Hall, Sara White; Thigpen, Kamila; Murray, Tom; Loschert, Kristen

2015-01-01

This report demonstrates how one predominantly low-income school district dramatically improved student engagement in the classroom and increased high school graduation rates through project-based learning (PBL) and the effective use of technology. The report, which includes short video segments with educators and students, focuses on Talladega…

Evaluating Online Bilingual Dictionaries: The Case of Popular Free English-Polish Dictionaries

ERIC Educational Resources Information Center

Lew, Robert; Szarowska, Agnieszka

2017-01-01

Language learners today exhibit a strong preference for free online resources. One problem with such resources is that their quality can vary dramatically. Building on related work on monolingual resources for English, we propose an evaluation framework for online bilingual dictionaries, designed to assess lexicographic quality in four major…

Dramatic Television and Agenda Setting: The Case of "The Day After."

ERIC Educational Resources Information Center

Miller, M. Mark; Quarles, Jan P.

A study investigated the effects of viewing the made-for-television film "The Day After" on the perceived prominence of issues surrounding nuclear war and disarmament on the public agenda. Telephone interviews were conducted with 92 adults in Knoxville, Tennessee, prior to the broadcast of the program and 232 after the broadcast…

Playing with Gladys: A case study integrating drama therapy with behavioural interventions for the treatment of selective mutism.

PubMed

Oon, Phei Phei

2010-04-01

This case study examines an integrative approach combining drama therapy and the behavioural skill "shaping", as offered to Gladys, a 5-year-old girl diagnosed with selective mutism. This study found that shaping, when implemented in the context of play, with play as the primary reinforcer, elicited from Gladys vocalization and eventually speech within a very short time. Her vocalizations allowed her to enter dramatic play, which in turn propelled spontaneous speech. This article looks at how the three elements of dramatherapy - the playspace, role-playing and dramatic projection - brought about therapeutic changes for Gladys. Aside from spontaneous speech, Gladys also developed positive self-esteem and a heightened sense of spontaneity. Subsequently, these two qualities helped her generalize her speech to new settings on her own. Gladys's newly harnessed spontaneity further helped her become more sociable and resilient.This study advances the possibility of integrating a behavioural skill with drama therapy for the therapeutic benefits of a child with an anxiety-related condition like selective mutism.

Getting stung by black scorpion Androctonus crassicauda: a case report.

PubMed

Aghabiklooei, A; Zamani, N; Hassanian-Moghaddam, H

2014-10-01

Importance of the correct diagnosis in the correct early management of a scorpion stung patient by using antivenom is not emphasized, particularly when there are little evidences. A 65-year-old female was brought to our emergency department with the chief compliant of being stung by an unknown object 3 h earlier while traveling in an intercity bus. She became agitated and simultaneously experienced tachycardia, very severe generalized sweating, cold and wet extremities, bilateral diffuse crackle in the base of lungs, tachypnea, and lethargy. With the primitive diagnosis of myocardial infarction, scorpion sting was documented as the cause of this combined cholinergic and adrenergic syndrome after the scorpion was found in the patient's bed clothes. She dramatically responded to the administration of low dose of scorpion antivenom. This case dramatically responded to the antivenom administration, especially the cholinergic and sympathetic signs, pulmonary edema, and electrocardiographic changes were fully and almost immediately recovered. Scorpion antivenom may reverse life-threatening manifestations of scorpion envenomation if used early and in appropriate patients. © The Author(s) 2013.

Increased Gut Redox and Depletion of Anaerobic and Methanogenic Prokaryotes in Severe Acute Malnutrition

PubMed Central

Million, Matthieu; Tidjani Alou, Maryam; Khelaifia, Saber; Bachar, Dipankar; Lagier, Jean-Christophe; Dione, Niokhor; Brah, Souleymane; Hugon, Perrine; Lombard, Vincent; Armougom, Fabrice; Fromonot, Julien; Robert, Catherine; Michelle, Caroline; Diallo, Aldiouma; Fabre, Alexandre; Guieu, Régis; Sokhna, Cheikh; Henrissat, Bernard; Parola, Philippe; Raoult, Didier

2016-01-01

Severe acute malnutrition (SAM) is associated with inadequate diet, low levels of plasma antioxidants and gut microbiota alterations. The link between gut redox and microbial alterations, however, remains unexplored. By sequencing the gut microbiomes of 79 children of varying nutritional status from three centers in Senegal and Niger, we found a dramatic depletion of obligate anaerobes in malnutrition. This was confirmed in an individual patient data meta-analysis including 107 cases and 77 controls from 5 different African and Asian countries. Specifically, several species of the Bacteroidaceae, Eubacteriaceae, Lachnospiraceae and Ruminococceae families were consistently depleted while Enterococcus faecalis, Escherichia coli and Staphylococcus aureus were consistently enriched. Further analyses on our samples revealed increased fecal redox potential, decreased total bacterial number and dramatic Methanobrevibacter smithii depletion. Indeed, M. smithii was detected in more than half of the controls but in none of the cases. No causality was demonstrated but, based on our results, we propose a unifying theory linking microbiota specificity, lacking anaerobes and archaea, to low antioxidant nutrients, and lower food conversion. PMID:27183876

Who gets custody now? Dramatic changes in children's living arrangements after divorce.

PubMed

Cancian, Maria; Meyer, Daniel R; Brown, Patricia R; Cook, Steven T

2014-08-01

This article reexamines the living arrangements of children following their parents' divorce, using Wisconsin Court Records, updating an analysis that showed relatively small but significant increases in shared custody in the late 1980s and early 1990s. These changes have accelerated markedly in the intervening years: between 1988 and 2008, the proportion of mothers granted sole physical custody fell substantially, the proportion of parents sharing custody increased dramatically, and father-sole custody remained relatively stable. We explore changes in the correlates of alternative custody outcomes, showing that some results from the earlier analysis still hold (for example, cases with higher total family income are more likely to have shared custody), but other differences have lessened (shared-custody cases have become less distinctive as they have become more common). Despite the considerable changes in marriage and divorce patterns over this period, we do not find strong evidence that the changes in custody are related to changes in the characteristics of families experiencing a divorce; rather, changes in custody may be the result of changes in social norms and the process by which custody is determined.

Atypical Presentations of Tularemia.

PubMed

Odegaard, Karah; Boersma, Beth; Keegan, James

2017-05-01

Francisella tularensis is a gram-negative coccobacillus that causes a condition commonly referred to as tularemia. There has been a dramatic increase in tularemia cases reported in South Dakota, many of which were challenging to diagnose due to atypical clinical manifestations. We describe an interesting case of pneumonic tularemia and summarize six similar cases, several of which presented with lung nodules suggestive of malignancy. According to the literature, this is only the third outbreak of pneumonic tularemia reported in the U.S. We believe it is important for clinicians to be aware of the increased incidence of tularemia in the area and to be vigilant in the diagnosis and management of these atypically presenting cases. Copyright© South Dakota State Medical Association.

Child sexual abuse: report of 311 cases with review of literature.

PubMed

Essabar, Laila; Khalqallah, Abdenbi; Dakhama, Badr Sououd Benjelloun

2015-01-01

Child sexual abuse (CSA) is a global problem that has significant consequences for public health; it has been a prominent topic of public concern for more than a decade, but many basic facts about the problem remain unclear or in dispute. We conducted a study of 311 cases of CSA in order to highlight the epidemiological features and negative impact on victims' well-being and to emphasize the need for a multidisciplinary approach to the primary prevention and management of CSA. We noted an increase in cases number with male predominance. Most of our patients came from lower socioeconomic classes. The perpetrators were male in 100% of cases; acquaintances in 70% of cases and family members in 22 cases. Physical examination were normal in 61% of cases, however, a range of psychological and physical effects were identified with dramatic health consequences: three cases of attempted suicide, five pregnancies and one case of HIV virus infection.

Network Penetration Testing and Research

NASA Technical Reports Server (NTRS)

Murphy, Brandon F.

2013-01-01

This paper will focus the on research and testing done on penetrating a network for security purposes. This research will provide the IT security office new methods of attacks across and against a company's network as well as introduce them to new platforms and software that can be used to better assist with protecting against such attacks. Throughout this paper testing and research has been done on two different Linux based operating systems, for attacking and compromising a Windows based host computer. Backtrack 5 and BlackBuntu (Linux based penetration testing operating systems) are two different "attacker'' computers that will attempt to plant viruses and or NASA USRP - Internship Final Report exploits on a host Windows 7 operating system, as well as try to retrieve information from the host. On each Linux OS (Backtrack 5 and BlackBuntu) there is penetration testing software which provides the necessary tools to create exploits that can compromise a windows system as well as other operating systems. This paper will focus on two main methods of deploying exploits 1 onto a host computer in order to retrieve information from a compromised system. One method of deployment for an exploit that was tested is known as a "social engineering" exploit. This type of method requires interaction from unsuspecting user. With this user interaction, a deployed exploit may allow a malicious user to gain access to the unsuspecting user's computer as well as the network that such computer is connected to. Due to more advance security setting and antivirus protection and detection, this method is easily identified and defended against. The second method of exploit deployment is the method mainly focused upon within this paper. This method required extensive research on the best way to compromise a security enabled protected network. Once a network has been compromised, then any and all devices connected to such network has the potential to be compromised as well. With a compromised network, computers and devices can be penetrated through deployed exploits. This paper will illustrate the research done to test ability to penetrate a network without user interaction, in order to retrieve personal information from a targeted host.

Human and Environmental Dangers Posed by Ongoing Global Tropospheric Aerosolized Particulates for Weather Modification.

PubMed

Herndon, J Marvin

2016-01-01

U.S. military perception of nuclear warfare led to countless unethical nuclear experiments performed on unsuspecting individuals without their informed consent. As evidenced here, subsequent perception of weather warfare has led to exposing millions of unsuspecting individuals to toxic coal fly ash with no public disclosure, no informed consent, and no health warnings. Three methods were used: (1) comparison of eight elements analyzed in rainwater samples, thought to have leached from aerosolized coal fly ash, with corresponding coal fly ash laboratory leachate; (2) comparison of 14 elements analyzed in air filter dust with corresponding elements in coal fly ash; and (3) comparison of 23 elements analyzed in fibrous mesh found after snow melted with corresponding elements in coal fly ash. The rainwater element ratios show that the aerial particulate matter has essentially the same water-leach characteristics as coal fly ash. The air filter dust element ratios occur in the same range of compositions as coal fly ash, as do element ratios in fibrous mesh found on grass after snow melted. The fibrous mesh provides an inferred direct connection with the aerosolizing jet aircraft via coal fly ash association with the jet combustion environment. Strong evidence for the correctness of the hypothesis: coal fly ash is likely the aerosolized particulate emplaced in the troposphere for geoengineering, weather modification, and/or climate alteration purposes. The documented public health associations for ≤2.5 μm particulate pollution are also applicable to aerosolized coal fly ash. The ability of coal fly ash to release aluminum in a chemically mobile form upon exposure to water or body moisture has potentially grave human and environmental consequences over a broad spectrum, including implications for neurological diseases and biota debilitation. The ability of coal fly ash to release heavy metals and radioactive elements upon exposure to body moisture has potentially grave human health implications including cancer, cardiovascular disease, diabetes, respiratory diseases, reduced male fertility, and stroke. The fibrous mesh data admit the possibility of environmentally disastrous formation of methylmercury and ozone-depleting chlorinated-fluorinated hydrocarbons in jet exhaust. Geophysical implications include atmospheric warming and rainfall retardation.

Nitrous Oxide Abuse and Vitamin B12 Action in a 20-Year-Old Woman: A Case Report.

PubMed

Duque, Miriam Andrea; Kresak, Jesse L; Falchook, Adam; Harris, Neil S

2015-01-01

Herein, we report a case of a 20-year-old (ethnicity not reported) woman with a history of nitrous oxide abuse and clinical symptoms consistent with spinal cord subacute combined degeneration with associated low serum concentrations of vitamin B12, elevated methylmalonic acid levels, and radiologic evidence of demyelination of the dorsal region of the spinal column. The health of the patient improved dramatically with B12 supplementation. In this case, we discuss the interaction of nitrous oxide with the enzymatic pathways involved in the biochemistry of vitamin B12. Copyright© by the American Society for Clinical Pathology (ASCP).

A case of a brain stem abscess with a favorable outcome

PubMed Central

Bulthuis, Vincent J.; Gubler, Felix S.; Teernstra, Onno P. M.; Temel, Yasin

2015-01-01

Background: A brain stem abscess is a rare and severe medical condition. Here, we present a rare case of a brain stem abscess in a young pregnant woman, requiring acute stereotactic intervention. Case Description: A 36-year-old woman presented with a headache, nausea, and vomiting, and computed tomography showed a space-occupying lesion in the brain stem. She became shortly after comatose, and we decided to perform an acute stereotactic aspiration of the abscess. Soon after surgery, her neurological condition improved dramatically. Conclusion: A brainstem abscess is a life-threatening condition with a potentially good outcome if treated adequately. PMID:26543670

Sonographic Findings in Necrotizing Fasciitis: Two Ends of the Spectrum.

PubMed

Shyy, William; Knight, Roneesha S; Goldstein, Ruth; Isaacs, Eric D; Teismann, Nathan A

2016-10-01

Necrotizing fasciitis is a rare but serious disease, and early diagnosis is essential to reducing its substantial morbidity and mortality. The 2 cases presented show that the key clinical and radiographic features of necrotizing fasciitis exist along a continuum of severity at initial presentation; thus, this diagnosis should not be prematurely ruled out in cases that do not show the dramatic features familiar to most clinicians. Although computed tomography and magnetic resonance imaging are considered the most effective imaging modalities, the cases described here illustrate how sonography should be recommended as an initial imaging test to make a rapid diagnosis and initiate therapy.

Xanthogranulomatous Pyelonephritis Can Simulate a Complex Cyst: Case Description and Review of Literature☆

PubMed Central

Butticè, Salvatore; Antonino, Inferrera; Giorgio, Ascenti; Valeria, Barresi; Stefano, Pergolizzi; Giuseppe, Mucciardi; Carlo, Magno

2014-01-01

Xanthogranulomatous pyelonephritis is a rare and peculiar form of chronic pyelonephritis and is generally associated with renal lithiasis. Its incidence is higher in females. The peculiarity of this disease is that it requires a differential diagnosis, because it can often simulate dramatic pathologic conditions. In fact, in the literature are also described cases in association with squamous cell carcinoma of the kidney The radiologic clinical findings simulate renal masses, sometimes in association with caval thrombus. We describe a case of xanthogranulomatous pyelonephritis with radiologic aspects of a complex cyst of Bosniak class III in a man 40-year old. PMID:26955560

Xanthogranulomatous Pyelonephritis Can Simulate a Complex Cyst: Case Description and Review of Literature.

PubMed

Butticè, Salvatore; Antonino, Inferrera; Giorgio, Ascenti; Valeria, Barresi; Stefano, Pergolizzi; Giuseppe, Mucciardi; Carlo, Magno

2014-05-01

Xanthogranulomatous pyelonephritis is a rare and peculiar form of chronic pyelonephritis and is generally associated with renal lithiasis. Its incidence is higher in females. The peculiarity of this disease is that it requires a differential diagnosis, because it can often simulate dramatic pathologic conditions. In fact, in the literature are also described cases in association with squamous cell carcinoma of the kidney The radiologic clinical findings simulate renal masses, sometimes in association with caval thrombus. We describe a case of xanthogranulomatous pyelonephritis with radiologic aspects of a complex cyst of Bosniak class III in a man 40-year old.

The Case for Medieval Drama in the Classroom: An Approach through Performance.

ERIC Educational Resources Information Center

Lieblein, Leanore; Pare, Anthony

1983-01-01

Argues that medieval drama in performance suggests a number of important issues about the nature of literature, particularly about the way narrative and dramatic art can express the life of a community. Presents a series of exercises that start with familiar, nonthreatening situations in order to approach the richness of medieval plays and the…

Urbanization dramatically altered the water balances of a paddy field dominated basin in southern China

Treesearch

L. Hao; G. Sun; Y. Liu; J. Wan; M. Qin; H. Qian; C. Liu; R. John; P. Fan; J. Chen

2015-01-01

Rice paddy fields provide important ecosystem services (e.g., food production, water retention, carbon sequestration) to a large population globally. However, these benefits are declining as a result of rapid environmental and socioeconomic transformations characterized by population growth, urbanization, and climate change in many Asian countries. This case study...

Continuous Quality Improvement: A Roadmap for Rural School Improvement.

ERIC Educational Resources Information Center

Kilmer, Lloyd C.

A case study documented a continuous quality improvement approach to school improvement in a rural Nebraska high school over a 2-year period. Data gathered from surveys, portfolios, pilot results, and test scores indicated that the changes during the 2-year period were not dramatic, but significant and consistent with the Total Quality literature.…

Transnational Corporations as Educational Institutions for National Development: The Contrasting Cases of Mexico and South Korea

ERIC Educational Resources Information Center

Hanson, Mark

2006-01-01

Economic development in South Korea, Singapore, Hong Kong, Taiwan, and Ireland has accelerated dramatically since the 1960s, as it has in China more recently. These areas share a common element in their development strategies--the aggressive pursuit, acquisition, and incorporation of knowledge from industrialized nations. In this article, the…

Power, Prayers, and Protection: Comb Ridge as a Case Study in Navajo Thought

ERIC Educational Resources Information Center

McPherson, Robert S.

2010-01-01

Beginning in 2005, a five-year survey of cultural resources began to unfold in southeastern Utah along a prominent sandstone rock formation known as Comb Ridge. This visually dramatic monocline stretches a considerable distance from the southwestern corner of Blue Mountain (Abajos) in Utah to Kayenta, Arizona, approximately one hundred miles to…

The Case of the Pilfered Paper: Implications of Online Writing Assistance and Web-Based Plagiarism Detection Services

ERIC Educational Resources Information Center

Morgan, Phoebe; Vaughn, Jacqueline

2010-01-01

While there is nothing new about academic dishonesty, how it is committed, prevented, and detected has been dramatically transformed by the advent of online technologies. This article briefly describes the concurrent emergence of online writing assistance services and Web-based plagiarism detection tools and examines the implications of both for…

The Case for Neo-Keynesianism: In Defence of the Welfare State

ERIC Educational Resources Information Center

Van Heertum, Richard

2013-01-01

Neoliberalism is the dominant economic paradigm in the globe today. It has led to stagnant wages, high unemployment, increased income inequality and a decline in quality of life for the average citizen in the industrialised world over the past 30?years. It has also fomented a dramatic increase in economic instability, culminating in the 2007…

Controlling herbicide-resistant weeds: consider incorporating alfalfa in a corn/soybean rotation

USDA-ARS?s Scientific Manuscript database

Herbicide resistant weeds (HRW) are a serious problem in the U.S. In 1968, the first confirmed case of herbicide resistance in weeds was reported in Washington state. In the 46 years since, the number of HRW in the U.S. has increased dramatically. A major reason for the recent increase in HRW has be...

Learners' Preferences regarding Types of Language School: An Exploratory Market Research

ERIC Educational Resources Information Center

Cristobal, E.; Llurda, E.

2006-01-01

The use of multimedia technologies in language teaching and learning has become very popular in the last few years. In the case of countries like Spain, multimedia language schools have experienced a great boom and a dramatic fall in the last 10 years. This study applies marketing research techniques to the study of Catalan learners' preferences…

Looking Out for Eliza Doolittle: The Ethical Treatment of Education Research Subjects. Working Paper.

ERIC Educational Resources Information Center

Pritchard, Ivor

George Bernard Shaw's play, "Pygmalion," tells the story of an educational experiment involving Eliza Doolittle and Henry Higgins. The characters set out to achieve a dramatic alteration in Eliza's linguistic ability, and they succeed. This paper uses "Pygmalion" as a case study in the treatment of education research subjects.…

Localized blastomycosis-like pyoderma with good response to cotrimoxazol and cryotherapy.

PubMed

Su, Ozlem; Demirkesen, Cuyan; Onsun, Nahide

2004-05-01

Blastomycosis-like pyoderma is an unusual, exaggerated, vegetative-tissue reaction to a prolonged primary or secondary bacterial infection. It is a rare disease, usually seen in immunocompromized patients. We report a case of localized blastomycosis-like pyoderma responding poorly to classic treatments, but that gave a dramatic response to a combination treatment of cotrimoxazol and cryotherapy.

Superhero Physiology: The Case for Captain America

ERIC Educational Resources Information Center

Brown, Stanley P.; Smith, JohnEric W.; McAllister, Matthew; Joe, LeeAnn

2017-01-01

Using pop icons in the science classroom represents a creative way to engage often-distracted students in a relevant and, perhaps more importantly, fun way. When the pop icon is as universally known as Captain America, the pedagogical stage is set. However, when the movies can also be employed to link dramatic references to the science concepts at…

Case Studies of Minority Students in a Transitional Bilingual Education Program "(Continues)"

ERIC Educational Resources Information Center

Romandia, Mona

2008-01-01

The educational system in many schools fails to meet the academic needs of minority students. The dramatic shifts in student demographics are demanding changes in the ways teachers are teaching them. It is essential to understand the long term effects of past educational practices and bilingual programs. Research indicates that there are many…

Case Studies of Minority Students in a Transitional Bilingual Education Program

ERIC Educational Resources Information Center

Romandia, Mona

2007-01-01

The educational system in many schools fails to meet the academic needs of minority students. The dramatic shifts in student demographics are demanding changes in the ways teachers are teaching them. It is essential to understand the long term effects of past educational practices and bilingual programs. Research indicates that there are many…

Integrating CALL in ESOL Classrooms: Understanding Teachers' Perspectives and Meeting Students' Needs

ERIC Educational Resources Information Center

Nia, Sara Farshad; Davey, Ronnie

2014-01-01

In line with the needs of the 21st century learners and dramatic improvements in schools' technological infrastructures, it is expected that the integration of digital tools into language learning courses would take a quicker pace and a smoother path. However, current research indicates that although this might be the case for foreign language…

Bosnia-Herzegovina's Higher Education System: Issues of Governance and Quality

ERIC Educational Resources Information Center

Tiplic, Dijana; Welle-Strand, Anne

2006-01-01

Bosnia-Herzegovina (BiH) is seen as an intriguing case. Often described as a "miniature" of the Balkans due to its demographic pattern, the country has been exposed to a number of dramatic events during the past fifteen years. Today, international actors administer it as a sort of "semi-protectorate" concept, the definition of…

An Evaluation of the Effects of Variable Sampling on Component, Image, and Factor Analysis.

ERIC Educational Resources Information Center

Velicer, Wayne F.; Fava, Joseph L.

1987-01-01

Principal component analysis, image component analysis, and maximum likelihood factor analysis were compared to assess the effects of variable sampling. Results with respect to degree of saturation and average number of variables per factor were clear and dramatic. Differential effects on boundary cases and nonconvergence problems were also found.…

Beyond Echoplaylia: Promoting Language in Children with Autism.

ERIC Educational Resources Information Center

Schuler, Adriana L.

2003-01-01

This article discusses the use of play as a medium for extending and enriching the communication exchanges and symbolic language of children with autism. It provides a case illustration of how an adult-facilitated dramatic peer play led to a breakthrough in symbolic behaviors in a 9-year-old girl with autism. (Contains references.) (Author/CR)

Integrating a process-based ecosystem model with Landsat imagery to assess impacts of forest disturbance on terrestrial carbon dynamics: Case studies in Alabama and Mississippi

USDA-ARS?s Scientific Manuscript database

Forest ecosystems in the southern United States are dramatically altered by three major 26 disturbances: timber harvesting, hurricane, and permanent land conversion. Understanding and quantifying effects of disturbance on forest carbon, nitrogen, and water cycles is critical for sustainable forest m...

Educational Leadership and Im/Migration: Preparation, Practice and Policy--The Swedish Case

ERIC Educational Resources Information Center

Norberg, Katarina

2017-01-01

Purpose: Migration to Sweden dramatically increased in 2015 and challenged the reception system at all levels and societal institutions, one of which was the school. As a response to the lack of a comprehensive educational strategy for newly arrived students, new regulations were passed in January 2016, the purpose of which was to guarantee equity…

Two new virus diseases in Rubus: Blackberry yellow vein and raspberry crumbly fruit

USDA-ARS?s Scientific Manuscript database

Blackberry production area has increased dramatically in the Southeast in recent years with the release of new cultivars suitable for the region and due to elevated customer demand for high quality fruit, which has led to high prices enjoyed by the growers. As in almost all cases where a crop is int...

Demonstrating the benefits of phytosanitary regulations: the case of ISPM 15

Treesearch

Eckehard G. Brockerhoff; Juliann E. Aukema; Joseph F. Cavey; Lynn J. Garrett; Robert A. Haack; Mark Kimberley; Andrew M. Liebhold; Frank L. Lowenstein; Carissa Marasas; Amelia Nuding; Lars Olson; Christa Speekmann; Michael Springborn; Christina Vieglais; James Turner

2011-01-01

Invasions of non-indigenous insects and pathogens threaten trees and forest ecosystems worldwide. For example, the arrival and spread of the pathogens causing chestnut blight and Dutch elm disease, along with the bark beetles vectoring the latter, had dramatic effects on North American forests. Despite our improved awareness of the risks associated with biological...

On the history of New York Medical College.

PubMed

Greenberg, S J

1986-01-01

The history of New York Medical College reflects three distinct trends in the development of medical education: the rise and fall of homeopathy, the input of civic leaders (in this case, William Cullen Bryant) and the uneasy relationship between medical schools and hospitals caused by the dramatic increase in the complexity and cost of hospital care.

First-Grade Teachers' Perception and Implementation of a Semi-Scripted Reading Curriculum

ERIC Educational Resources Information Center

Ainsworth, Mary Taylor; Ortlieb, Evan; Cheek, Earl H., Jr.; Pate, Roberta Simnacher; Fetters, Carol

2012-01-01

A teacher's role was dramatically changed from that of an educator to that of a facilitator with the adoption of semi-scripted curriculums. This case study explores teachers' perception and implementation of a state's English Language Arts curriculum in first-grade classrooms. Four first-grade teachers from a large urban school district were…

High Education as a Common Good in China: A Case Study for Ideas and Practice

ERIC Educational Resources Information Center

Zhu, Jiangang

2016-01-01

China began its modern system of higher education with the establishment of the former Peking University in Beijing in 1898. The traditional Confucian philosophy of education has been replaced dramatically by modern western philosophy. However, since the communist party came to power in 1949, the philosophy of higher education has experienced many…

Using the Story of Cinderella To Teach the Major Approaches to Treatment and Therapy.

ERIC Educational Resources Information Center

Kaminski, Patricia L.; Haynes, Sandra D.

2000-01-01

Describes a classroom activity to enhance understanding of how major theorists differ in their conceptualization and treatment of a client's problems. Participants either watched a dramatized play in which prominent clinicians discuss a case, or attended a comparable lecture. Results of a quiz indicate that students who watched the play…

The Role of Extracurricular Activities in Active Citizenship Education

ERIC Educational Resources Information Center

Keser, Filiz; Akar, Hanife; Yildirim, Ali

2011-01-01

There have been multiple trends of building democratic citizens through formal education, and in the European context the trials have been dramatically increased with the Europeanization process since the 1980s. In line with this trend, an in-depth qualitative case study was carried out in a private primary school in Turkey to shed light on the…

E-Learning Implications for Adult Learning

ERIC Educational Resources Information Center

Criu, Roxana; Ceobanu, Ciprian

2013-01-01

If a few decades ago, "the education received in school could be in most of the cases enough to go with for the rest of one's entire life," today the situation has changed dramatically. The individual has to be prepared for a new type of life and training, namely lifelong learning. The individual's survival in society could…

Dramatic dilatation of the upper airway secondary to a Valsalva manoeuvre in a lateral cephalometric teleradiograph of a child

PubMed Central

Varela, M; Quiñones, D; Martínez-Pérez, D

2010-01-01

Radiographs are routinely used by orthodontists for the planning of treatment for their patients and they can, in some cases, play a decisive role in the early diagnosis of some unexpected medical or surgical disorders. This report presents the case of a substantial dilatation of the upper airway in a 10-year-old girl, which was attributed to a forced Valsalva manoeuvre. The diagnosis was confirmed upon repetition of the teleradiograph with the mouth open. PMID:21062946

A dramatic response to a single dose of infliximab in a patient with prolonged pustular psoriasis derived from inverse psoriasis.

PubMed

Li, Mengmeng; Dai, Weiwei; Yan, Wei; Liu, Yuanzhen; Wang, Lian; Li, Wei

2017-07-01

We report a case of a 25-year-old Chinese man with an exceptionally prolonged history of pustular psoriasis derived from inverse psoriasis who was unsatisfied with conventional treatment and was successfully treated with a single dose of infliximab without noticeable adverse effects. No recurrence or flaring was observed after 3 months of follow-up. This case illustrates that infliximab may be an effective and safe therapeutic option for patients with refractory pustular psoriasis derived from inverse psoriasis. © 2017 Wiley Periodicals, Inc.

Reversible catecholamine-induced cardiomyopathy due to pheochromocytoma: case report.

PubMed

Satendra, Milan; de Jesus, Cláudia; Bordalo e Sá, Armando L; Rosário, Luís; Rocha, José; Bicha Castelo, Henrique; Correia, Maria José; Nunes Diogo, António

2014-03-01

Pheochromocytoma is a tumor originating from chromaffin tissue. It commonly presents with symptoms and signs of catecholamine excess, such as hypertension, tachycardia, headache and sweating. Cardiovascular manifestations include catecholamine-induced cardiomyopathy, which may present as severe left ventricular dysfunction and congestive heart failure. We report a case of pheochromocytoma which was diagnosed following investigation of dilated cardiomyopathy. We highlight the dramatic symptomatic improvement and reversal of cardiomyopathy, with recovery of left ventricular function after treatment. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Chronic inflammatory demyelinating polyneuropathy after treatment with interferon-alpha.

PubMed

Hirotani, Makoto; Nakano, Hitoshi; Ura, Shigehisa; Yoshida, Kazuto; Niino, Masaaki; Yabe, Ichiro; Sasaki, Hidenao

2009-01-01

Interferon-alpha (IFN-alpha), though widely used for the treatment of chronic viral hepatitis, may be associated with the occurrence of autoimmune disorders. In this case report, a patient with chronic hepatitis C virus infection had chronic inflammatory demyelinating polyneuropathy (CIDP) after the initiation of IFN-alpha therapy. The neurological symptoms of this patient continued to progress even though the treatment with IFN-alpha had been withdrawn; the symptoms improved dramatically following treatment with intravenous immunoglobulin. This case may therefore provide an important clue to understand the immune mechanism of CIDP and IFN-alpha.

Repetitive Transcranial Magnetic Stimulation for Wernicke-Korsakoff Syndrome: A Case Report.

PubMed

Chung, So Won; Park, Shin Who; Seo, Young Jae; Kim, Jae-Hyung; Lee, Chan Ho; Lim, Jong Youb

2017-02-01

A 57-year-old man who was diagnosed with Wernicke-Korsakoff syndrome showed severe impairment of cognitive function and a craving for alcohol, even after sufficient supplementation with thiamine. After completing 10 sessions of 10 Hz repetitive transcranial magnetic stimulation (rTMS) at 100% of the resting motor threshold over the left dorsolateral prefrontal cortex, dramatic improvement in cognitive function and a reduction in craving for alcohol were noted. This is the first case report of the efficacy of a high-frequency rTMS in the treatment of Wernicke-Korsakoff syndrome.

Food-borne botulism: still actual topic.

PubMed

Brola, Waldemar; Fudala, Malgorzata; Gacek, Szymon; Gruenpeter, Pawel

2013-02-06

Even though since the mid-1990s the number of food-borne botulism cases has systematically decreased and it now occurs in Poland relatively rarely, it is still a real epidemiological problem. There are about 30 cases of botulism in Poland a year, which ranks Poland the first among the European Union. In most cases the symptomatology of botulism is typical, however it does not always fully coincide with the one described in medical manuals which emphasise the dramatic clinical course of botulism with its frequent fatal consequences. Diagnosis of botulism may be difficult because of its rare prevalence and a variable clinical course, especially in old patients. Authors of this paper describe two cases of botulism and diagnostic problems associated with it.

Food-borne botulism: still actual topic

PubMed Central

Brola, Waldemar; Fudala, Malgorzata; Gacek, Szymon; Gruenpeter, Pawel

2013-01-01

Even though since the mid-1990s the number of food-borne botulism cases has systematically decreased and it now occurs in Poland relatively rarely, it is still a real epidemiological problem. There are about 30 cases of botulism in Poland a year, which ranks Poland the first among the European Union. In most cases the symptomatology of botulism is typical, however it does not always fully coincide with the one described in medical manuals which emphasise the dramatic clinical course of botulism with its frequent fatal consequences. Diagnosis of botulism may be difficult because of its rare prevalence and a variable clinical course, especially in old patients. Authors of this paper describe two cases of botulism and diagnostic problems associated with it. PMID:23391950

Rapid amelioration of severe manic episodes with right unilateral ultrabrief pulse ECT: a case series of four patients.

PubMed

Sidorov, Alexey; Mayur, Prashanth

2017-02-01

The aim of this small case series is to describe four cases of severe mania, where ultrabrief pulse electroconvulsive therapy (ECT) was used as a primary mode of treatment. A retrospective file review was undertaken of four patients identified as having received ultrabrief pulse ECT for severe mania. The outcome measures for treatment efficacy were the Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI). All the patients showed significant clinical improvement. A comparison of pre- and post-treatment YMRS and CGI scores showed a dramatic decrease in all four cases. However, one patient was shifted to brief pulse ECT due to inadequate response. Ultrabrief pulse ECT may be an effective treatment in cases of severe mania. Due to the very small number of cases in the current case series, no specific conclusions regarding efficacy may be drawn; however, larger, controlled studies would be indicated.

Frequency of Cushing's syndrome due to ACTH-secreting adrenal medullary lesions: a retrospective study over 10 years from a single center.

PubMed

Falhammar, Henrik; Calissendorff, Jan; Höybye, Charlotte

2017-01-01

Cushing's syndrome due to ectopic adrenocorticotropic hormone production from adrenal medullary lesions has occasionally been described. We retrospectively reviewed all 164 cases of Cushing's syndrome and 77 cases of pheochromocytomas during 10 years. Of all cases with Cushing's syndrome, only two cases (1.2 %) were due to ectopic adrenocorticotropic hormone production from adrenal medullary lesions (one case of pheochromocytoma and one case of adrenal medullary hyperplasia). Of all pheochromocytomas only the above-mentioned case (1.3 %) also gave rise to an ectopic adrenocorticotropic hormone syndrome. The clinical presentation of adrenocorticotropic hormone-secreting pheochromocytoma and adrenal medullary hyperplasia can be anything from mild to dramatic. These are rare conditions important to bear in mind in the workup of a patient with Cushing's syndrome or with pheochromocytoma. The identification of ectopic adrenocorticotropic hormone secretion from adrenal medullary lesions can be life-saving.

Treatment with teriparatide in a patient with pregnancy-associated osteoporosis.

PubMed

Hellmeyer, Lars; Boekhoff, Jelena; Hadji, Peyman

2010-10-01

The decrease of BMD during a physiological pregnancy can in rare cases be intensified and lead to dramatic microarchitectural changes, which causes an increase incidence of fractures, preferably at the spine. This dramatic clinical picture is called pregnancy-associated osteoporosis. We present the case of a 40-year-old woman (gravida IV, para II) with acute back pain right after delivery due to four fractures of the spine. The diagnosis was confirmed by dual-energy X-ray absorptiometry measurement result (T-score -4.1 SD (0.598 g/cm(2)) at the lumbar spine (L1-L4), T-score -1.5 SD (0.759 g/cm(2)) at the total hip). Due to the severity of symptoms, a therapy with teriparatide (20 mg daily) was started for a period of 18 months. After end of therapy, the T-score had significantly increased at the lumbar spine as well as at the hip (T-score of -2.1 (0.813 g/cm(2)) and -0.6 (0.864 g/cm(2)), respectively. The relative increase of BMD at the spine and total hip was 36% and 13.8%, respectively. Our report demonstrates the successful use of teriparatide underlined by the increase of bone mineral density and the improvement of clinical symptoms in a case of severe pregnancy-associated osteoporosis for the first time.

Human chimera-type galectin-3: defining the critical tail length for high-affinity glycoprotein/cell surface binding and functional competition with galectin-1 in neuroblastoma cell growth regulation.

PubMed

Kopitz, Jürgen; Vértesy, Sabine; André, Sabine; Fiedler, Sabine; Schnölzer, Martina; Gabius, Hans-Joachim

2014-09-01

Many human proteins have a modular design with receptor and structural domains. Using adhesion/growth-regulatory galectin-3 as model, we describe an interdisciplinary strategy to define the functional significance of its tail established by nine non-triple helical collagen-like repeats (I-IX) and the N-terminal peptide. Genetic engineering with sophisticated mass spectrometric product analysis provided the tools for biotesting, i.e. eight protein variants with different degrees of tail truncation. Evidently,various aspects of galectin-3 activity (cis binding and cell bridging) are affected by tail shortening in a different manner. Thus, this combined approach reveals an unsuspected complexity of structure-function relationship, encouraging further application beyond this chimera-type galectin. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Novel pebbles in the mosaic of autoimmunity.

PubMed

Perricone, Carlo; Agmon-Levin, Nancy; Shoenfeld, Yehuda

2013-04-04

Almost 25 years ago, the concept of the 'mosaic of autoimmunity' was introduced to the scientific community, and since then this concept has continuously evolved, with new pebbles being added regularly. We are now looking at an era in which the players of autoimmunity have changed names and roles. In this issue of BMC Medicine, several aspects of autoimmunity have been addressed, suggesting that we are now at the forefront of autoimmunity science. Within the environmental factors generating autoimmunity are now included unsuspected molecules such as vitamin D and aluminum. Some adjuvants such as aluminum are recognized as causal factors in the development of the autoimmune response. An entirely new syndrome, the autoimmune/inflammatory syndrome induced by adjuvants (ASIA), has been recently described. This is the new wind blowing within the branches of autoimmunity, adding knowledge to physicians for helping patients with autoimmune disease.

Post-traumatic intracranial epidural Aspergillus fumigatus abscess.

PubMed

Letscher, V; Herbrecht, R; Gaudias, J; Taglang, G; Koenig, H; Dupuis, M G; Waller, J

1997-01-01

We report an intracranial epidural abscess caused by Aspergillus fumigatus in an immunocompetent patient. Infection occurred in a 20-year-old man 2 months after a frontal craniotomy following trauma. The abscess was encapsulated by a thickened dura and although the fungus did not invade the brain, frontal bone was infected and the patient presented with a subcutaneous frontal cellulitis. Initial management combined surgical drainage, resection of necrotic bone and liposomal amphotericin B (1 mg kg-1 per day). After 3 weeks of antifungal treatment a second evaluation surgery was performed. A clinically and radiologically unsuspected new abscess was found and evacuated. Treatment was completed with instillation into the cavity of amphotericin B at a concentration of 5 mg ml-1 and prolonged oral itraconazole (400-600 mg day-1). Treatment was successful and the patient is free of infection after 3 years.

DETECTION OF SMALL LESIONS OF THE LARGE BOWEL—Barium Enema Versus Double Contrast

PubMed Central

Robinson, J. Maurice

1954-01-01

Roentgen study with the so-called opaque barium enema with some modifications is superior to double contrast study as the primary means of demonstrating polyps in the colon as well as other lesions. The method described combines fluoroscopy, high kilovoltage radiography, fluoroscopically aimed “spot films” taken with compression, suction and evacuation studies. In this way unsuspected as well as suspected polyps can be demonstrated, particularly if attention is directed to the region where polyps are most likely to be found—namely, the distal third of the large bowel. Double contrast study is quite valuable as a supplement to the modified “single contrast” barium enema, but it has not been sufficiently perfected to replace the modified opaque barium enema as a primary procedure. In many instances a combination of methods will, of course, be required. PMID:13209360

Discovery of CLC transport proteins: cloning, structure, function and pathophysiology

PubMed Central

Jentsch, Thomas J

2015-01-01

Abstract After providing a personal description of the convoluted path leading 25 years ago to the molecular identification of the Torpedo Cl− channel ClC-0 and the discovery of the CLC gene family, I succinctly describe the general structural and functional features of these ion transporters before giving a short overview of mammalian CLCs. These can be categorized into plasma membrane Cl− channels and vesicular Cl−/H+-exchangers. They are involved in the regulation of membrane excitability, transepithelial transport, extracellular ion homeostasis, endocytosis and lysosomal function. Diseases caused by CLC dysfunction include myotonia, neurodegeneration, deafness, blindness, leukodystrophy, male infertility, renal salt loss, kidney stones and osteopetrosis, revealing a surprisingly broad spectrum of biological roles for chloride transport that was unsuspected when I set out to clone the first voltage-gated chloride channel. PMID:25590607

Clinics in diagnostic imaging (163). Transient lateral patellar dislocation with trochlear dysplasia

PubMed Central

Zhang, Junwei; Lee, Chin Hwee

2015-01-01

A 14-year-old girl presented with left knee pain and swelling after an injury. Magnetic resonance (MR) imaging showed a transient lateral patellar dislocation with patellar osteochondral fracture, medial patellofemoral ligament tear and underlying femoral trochlear dysplasia. Open reduction and internal fixation of the osteochondral fracture, plication of the medial patellar retinaculum and lateral release were performed. As lateral patellar dislocation is often clinically unsuspected, an understanding of its characteristic imaging features is important in making the diagnosis. Knowledge of the various predisposing factors for patellar instability may also influence the choice of surgical management. We also discuss signs of acute injury and chronic instability observed on MR imaging, and the imaging features of anatomical variants that predispose an individual to lateral patellar dislocation. Treatment options and postsurgical imaging appearances are also briefly described. PMID:26512145

Sudden headache, third nerve palsy and visual deficit: thinking outside the subarachnoid haemorrhage box.

PubMed

Ní Chróinín, Danielle; Lambert, John

2013-11-01

A 75-year-old lady presented with sudden severe headache and vomiting. Examination was normal, and CT and lumbar puncture not convincing for subarachnoid haemorrhage. Shortly thereafter, she developed painless diplopia. Examination confirmed right third cranial nerve palsy plus homonymous left inferior quadrantanopia. Urgent cerebral MRI with angiography was requested to assess for a possible posterior communicating artery aneurysm, but revealed an unsuspected pituitary mass. Pituitary adenoma with pituitary apoplexy was diagnosed. Pituitary apopolexy is a syndrome comprising sudden headache, meningism, visual and/or oculomotor deficits, with an intrasellar mass. It is commonly due to haemorrhage or infarction within a pituitary adenoma. Treatment includes prompt steroid administration, and potentially surgical decompression. While subarachnoid haemorrhage is an important, well-recognised cause of sudden severe headache, other aetiologies, including pituitary apoplexy, should be considered and sought.

Hunger-promoting hypothalamic neurons modulate effector and regulatory T-cell responses

PubMed Central

Matarese, Giuseppe; Procaccini, Claudio; Menale, Ciro; Kim, Jae Geun; Kim, Jung Dae; Diano, Sabrina; Diano, Nadia; De Rosa, Veronica; Dietrich, Marcelo O.; Horvath, Tamas L.

2013-01-01

Whole-body energy metabolism is regulated by the hypothalamus and has an impact on diverse tissue functions. Here we show that selective knockdown of Sirtuin 1 Sirt1 in hypothalamic Agouti-related peptide-expressing neurons, which renders these cells less responsive to cues of low energy availability, significantly promotes CD4+ T-cell activation by increasing production of T helper 1 and 17 proinflammatory cytokines via mediation of the sympathetic nervous system. These phenomena were associated with an impaired thymic generation of forkhead box P3 (FoxP3+) naturally occurring regulatory T cells and their reduced suppressive capacity in the periphery, which resulted in increased delayed-type hypersensitivity responses and autoimmune disease susceptibility in mice. These observations unmask a previously unsuspected role of hypothalamic feeding circuits in the regulation of adaptive immune response. PMID:23530205

Salt tolerance and methionine biosynthesis in Saccharomyces cerevisiae involve a putative phosphatase gene.

PubMed Central

Gläser, H U; Thomas, D; Gaxiola, R; Montrichard, F; Surdin-Kerjan, Y; Serrano, R

1993-01-01

The progressive salinization of irrigated land poses a threat to the future of agriculture in arid regions. The identification of crucial metabolic steps in salt tolerance is important for the understanding of stress physiology and may provide the tools for its genetic engineering. In the yeast Saccharomyces cerevisiae we have isolated a gene, HAL2, which upon increase in gene dosage improves growth under NaCl and LiCl stresses. The HAL2 protein is homologous to inositol phosphatases, enzymes known to be inhibited by lithium salts. Complementation analysis demonstrated that HAL2 is identical to MET22, a gene involved in methionine biosynthesis. Accordingly, methionine supplementation improves the tolerance of yeast to NaCl and LiCl. These results demonstrate an unsuspected interplay between methionine biosynthesis and salt tolerance. Images PMID:8393782

Overview of lunar-based astronomy

NASA Technical Reports Server (NTRS)

Smith, Harlan J.

1988-01-01

The opportunities along with the advantages and disadvantages of the Moon for astronomical observatories are carefully and methodically considered. Taking a relatively unbiased approach, it was concluded that lunar observatories will clearly be a major factor in the future of astronomy in the next century. He concludes that ground based work will continue because of its accessibility and that Earth orbital work will remain useful, primarily for convenience of access in constructing and operating very large space systems. Deep space studies will feature not only probes but extensive systems for extremely long baseline studies at wavelengths from gamma rays through visible and IR out to radio is also a conclusion drawn, along with the consideration that lunar astronomy will have found important permanent applications along lines such as are discussed at the present symposium and others quite unsuspected today.

Addictive consumption of avatars in cyberspace.

PubMed

Lee, Ook; Shin, Mincheol

2004-08-01

Avatars are a unique cyber product that hold much potential to be a market success because they provide consumers with various psychological benefits such as anonymous personalization and an artificial sense of well-being in cyberspace. However, due to the very nature of avatars, consumer psychology, and the way that they are marketed to teenage consumers, avatars may also pose considerable threat to unsuspecting teenagers through addictive consumption and associated negative social consequences causing harm to the teenagers and the general public. This study deals with Korean teenagers' addiction to avatar consumption. Korean teenagers can be very stressed due to the pressure to excel in school. Addictive avatar consumption is thought to be a behavior that might reduce stress. An empirical study was conducted to elucidate this claim. Self-control theory is suggested as an explanation for addictive consumption of avatars.

Evidence of nonvagal neural stimulation of canine gastric acid secretion.

PubMed

Tansy, M F; Probst, S J; Martin, J S

1975-06-01

In this study, we confirmed our original findings that central vagus stimulation is significantly associated with a subsequent increase in gastric mucus secretion. Central vagus stimulation following phenoxybenzamine hydrochloride administration was associated significantly with protracted elevations in secretory volume and titratable acid. We were unable to conclude that phenoxybenzamine itself in several pharmacologic dosages was associated with an increase in titratable acid. The acid secretory responses could be abolished by transection of the splanchnic nerves. Electrical stimulation of the peripheral part of the splanchnic nerve following administration of phenoxybenzamine was also associated with significant increases in secretory volume and titrable acidity. These secretory responses were not blocked by atropine but were diminished by burimamide. It is concluded that, in the dog, a largely heretofore unsuspected second neural pathway exists which is capable of influencing gastric acid secretion.

Metabolic control of vesicular glutamate transport and release.

PubMed

Juge, Narinobu; Gray, John A; Omote, Hiroshi; Miyaji, Takaaki; Inoue, Tsuyoshi; Hara, Chiaki; Uneyama, Hisayuki; Edwards, Robert H; Nicoll, Roger A; Moriyama, Yoshinori

2010-10-06

Fasting has been used to control epilepsy since antiquity, but the mechanism of coupling between metabolic state and excitatory neurotransmission remains unknown. Previous work has shown that the vesicular glutamate transporters (VGLUTs) required for exocytotic release of glutamate undergo an unusual form of regulation by Cl(-). Using functional reconstitution of the purified VGLUTs into proteoliposomes, we now show that Cl(-) acts as an allosteric activator, and the ketone bodies that increase with fasting inhibit glutamate release by competing with Cl(-) at the site of allosteric regulation. Consistent with these observations, acetoacetate reduced quantal size at hippocampal synapses and suppresses glutamate release and seizures evoked with 4-aminopyridine in the brain. The results indicate an unsuspected link between metabolic state and excitatory neurotransmission through anion-dependent regulation of VGLUT activity. Copyright © 2010 Elsevier Inc. All rights reserved.

Impact of selective use of breast MRI on surgical decision-making in women with newly diagnosed operable breast cancer.

PubMed

Brennan, Meagan E; McKessar, Merran; Snook, Kylie; Burgess, Ian; Spillane, Andrew J

2017-04-01

This study evaluated the impact of breast MRI on surgical planning in selected cases of breast malignancy (invasive cancer or DCIS). MRI was used when there was ambiguity on clinical and/or conventional imaging assessment. Consecutive women with breast malignancy undergoing breast MRI were included. Clinical, mammogram and ultrasound findings and surgical plan before and after MRI were recorded. MRI findings and histopathology results were documented and the impact of MRI on treatment planning was evaluated. MRI was performed in 181/1416 (12.8%) cases (invasive cancer 155/1219 (12.7%), DCIS 26/197 (13.2%)). Indications for MRI were: clinically dense breast tissue difficult to assess (n = 66; 36.5%), discordant clinical/conventional imaging assessment (n = 61; 33.7%), invasive lobular carcinoma in clinically dense breast tissue (n = 22; 12.2%), palpable/mass-forming DCIS (n = 11; 6.1%); other (n = 19; 10.5%). The recall rate for assessment of additional lesions was 35% (63/181). Additional biopsy-proven malignancy was found in 11/29 (37.9%) ipsilateral breast recalls and 8/34 (23.5%) contralateral breast recalls. MRI detected contralateral malignancy (unsuspected on conventional imaging) in 5/179 (2.8%). The additional information from MRI changed management in 69/181 (38.1%), with more unilateral surgery (wider excision or mastectomy) in 53/181 (29.3%), change to bilateral surgery in 12/181 (6.6%), less surgery in 4/181 (2.2%). Clinical examination estimated histological size within 20 mm in 57%, conventional imaging in 55% and MRI in 71%. MRI was most likely to show concordance with histopathology in the 'discordant assessment' and 'invasive lobular' groups and less likely for 'challenging clinically dense breast tissue.' MRI changed management in 69/181 (38.1%). Copyright © 2017 Elsevier Ltd. All rights reserved.

Chorioretinal Lesions Presumed Secondary to Zika Virus Infection in an Immunocompromised Adult.

PubMed

Henry, Christopher R; Al-Attar, Luma; Cruz-Chacón, Alexis M; Davis, Janet L

2017-04-01

Zika virus has spread rapidly throughout the Americas since 2015. The public health implications of Zika virus infection lend special importance to identifying the virus in unsuspected hosts. To describe relevant imaging studies and clinical features of chorioretinal lesions that are presumably associated with Zika virus and that share analogous features with chorioretinal lesions reported in cases of Dengue fever and West Nile virus. This is a case report from an academic referral center in Miami, Florida, of a woman in her 60s from Guaynabo, Puerto Rico, who presented with reduced visual acuity and bilateral diffuse, subretinal, confluent, placoid, and multifocal chorioretinal lesions. The patient was observed over a 5-month period. Visual acuity, clinical course, and multimodal imaging study results. Fluorescein angiography revealed early hypofluorescence and late staining of the chorioretinal lesions. Optical coherence tomography demonstrated outer retinal disruption in the placoid macular lesions. Zika RNA was detected in a plasma sample by real-time reverse transcription polymerase chain reaction testing and was suspected to be the cause of chorioretinal lesions after other viral and infectious causes were ruled out. Three weeks after the onset of symptoms, the patient's visual acuity had improved to 20/60 OD and 20/25 OS, with intraocular pressures of 18 mm Hg OD and 19 mm Hg OS. In 6 weeks, the chorioretinal lesions had healed and visual acuity had improved to 20/25 OD and 20/20 OS. Follow-up optical coherence tomography demonstrated interval recovery of the outer retina and photoreceptors. Acute-onset, self-resolving, placoid, or multifocal nonnecrotizing chorioretinal lesions may be a feature of active Zika virus chorioretinitis, as reported in other Flavivirus infections in adults. Similar findings in potentially exposed adults suggest that clinicians should consider IgM antibody or polymerase chain reaction testing for Zika virus as well as diagnostic testing for Dengue fever and West Nile virus.

[Fertility and characteristics of ovulation after discontinuing oral contraception].

PubMed

Gaspard, U; Lambotte, R

1984-09-01

A brief review of the literature is the basis for this discussion of residual effects of oral contraceptives (OCs) on fertility and the quality of ovulation after pill use is terminated. A 1982 study of the delay to conception attempted to avoid methological difficulties of earlier studies by comparing previous contraceptive usage among 7000 women hospitalized for childbirth. The analysis showed that the monthly percentage of pregnancies after OC use was significantly decreased for the 1st 3 months compared to levels in former IUD and diaphragm users. 13 months after OCs, 24.8% of OC users still had not conceived, compared to 12.4% if IUD and 8.5% of diaphragm users. Post-pill amenorrhea of longer than 6 months occurs in about 1% of cases. It is now agreed that post-pill amenorrhea is rare, nonspecific, and of multifactorial etiology. The previous existence of menstrual irregularity, stress, psychological troubles, malnutrition, and anorexia are particularly significant. OC use seems to mask the natural occurrence of secondary amenorrhea rather than to cause it. The most careful of available studies document that, although OC use may because of its estrogen content reveal an unsuspected prolactinemia, there is no increase in prolactinemia among OC users. A consensus exists that, excluding patients developing amenorrhea due to ovarian insufficiency, post-pill amenorrhea responds to ovulation inducing treatment exactly as do amenorrheas with no history of pill use. In cases of conception after failure of OCs and continued treatment with OCs, the aging of sperm or hypermaturation of ova at the time of fertilization is accompanied by a very slight increase in the proportion of male fetuses. The teratogenic risk appears to be negligable among former OC users and perhaps slightly greater if OCs, hormonal tests, or supplementary hormonal therapy are continued during pregnancy. The increased risk is not even seen in many studies and does not appear to indicate pregnancy termination as a general rule.

Cryptic diversity and deep divergence in an upper Amazonian leaflitter frog, Eleutherodactylus ockendeni

PubMed Central

Elmer, Kathryn R; Dávila, José A; Lougheed, Stephen C

2007-01-01

Background The forests of the upper Amazon basin harbour some of the world's highest anuran species richness, but to date we have only the sparsest understanding of the distribution of genetic diversity within and among species in this region. To quantify region-wide genealogical patterns and to test for the presence of deep intraspecific divergences that have been documented in some other neotropical anurans, we developed a molecular phylogeny of the wide-spread terrestrial leaflitter frog Eleutherodactylus ockendeni (Leptodactylidae) from 13 localities throughout its range in Ecuador using data from two mitochondrial genes (16S and cyt b; 1246 base pairs). We examined the relation between divergence of mtDNA and the nuclear genome, as sampled by five species-specific microsatellite loci, to evaluate indirectly whether lineages are reproductively isolated where they co-occur. Our extensive phylogeographic survey thus assesses the spatial distribution of E. ockendeni genetic diversity across eastern Ecuador. Results We identified three distinct and well-supported clades within the Ecuadorean range of E. ockendeni: an uplands clade spanning north to south, a northeastern and central lowlands clade, and a central and southeastern clade, which is basal. Clades are separated by 12% to 15% net corrected p-distance for cytochrome b, with comparatively low sequence divergence within clades. Clades marginally overlap in some geographic areas (e.g., Napo River basin) but are reproductively isolated, evidenced by diagnostic differences in microsatellite PCR amplification profiles or DNA repeat number and coalescent analyses (in MDIV) best modelled without migration. Using Bayesian (BEAST) and net phylogenetic estimates, the Southeastern Clade diverged from the Upland/Lowland clades in the mid-Miocene or late Oligocene. Lowland and Upland clades speciated more recently, in the early or late Miocene. Conclusion Our findings uncover previously unsuspected cryptic species diversity within the common leaflitter frog E. ockendeni, with at least three different species in Ecuador. While these clades are clearly geographically circumscribed, they do not coincide with any existing landscape barriers. Divergences are ancient, from the Miocene, before the most dramatic mountain building in the Ecuadorean Andes. Therefore, this diversity is not a product of Pleistocene refuges. Our research coupled with other studies suggests that species richness in the upper Amazon is drastically underestimated by current inventories based on morphospecies. PMID:18154647

Destalking the Wily Tomato: A Case Study in Social Consequences in California Agricultural Research. Research Monograph No. 15.

ERIC Educational Resources Information Center

Friedland, William H.; Barton, Amy

The end of the bracero program after 1965 brought about a major change in the growing, harvesting, and processing of California tomatoes which dramatically influenced the structure of the harvesting labor force. In order to determine the social consequences of the transition from man to mechanized harvesting procedures, the following areas of…

Development of a Multimarker Urine Test for Prostate Cancer

DTIC Science & Technology

2017-10-01

which can, for example, range dramatically from monitoring, in the case of low-risk cancers, to radiation or surgical procedures for higher risk...surgery, radiation , hormone therapy, chemotherapy, brachytherapy, cryotherapy, ultrasound, bisphosphate therapy, biologic 15 therapy, or vaccine therapy...a monokine involved in the acute inflammatory state of polymorphonuclear leukocyte recruitment and activation. CCL3 is expressed in many cell types

America's Children: Resources from Family, Government, and the Economy. A Census Monograph Series.

ERIC Educational Resources Information Center

Hernandez, Donald J.

Drawing on census and survey data from 1940 to 1990, this book offers an overview of the dramatic transformations in American childhood over the past 50 years and presents the case for overhauling national child welfare policies. The first chapter examines the life course of children and provides an introduction to the remainder of the book.…

Multiple Factors in the Long-Term Effectiveness of Contingent Electric Shock Treatment for Self-Injurious Behavior: A Case Example.

ERIC Educational Resources Information Center

Linscheid, Thomas R.; Reichenbach, Heidi

2002-01-01

Data are presented to document the initial dramatic reduction in self-injurious behavior and the ongoing effectiveness of contingent electric shock treatment of an adolescent. Positive effects of the intervention are documented, as is information on the interaction of a medical condition, psychoactive mediation status, and staff changes. (Contains…

Incarceration, Identity Formation, and Race in Young Adult Literature: The Case of "Monster" versus "Hole in My Life"

ERIC Educational Resources Information Center

Engles, Tim; Kory, Fern

2013-01-01

English teachers can heighten awareness of the factors that influence racial disparities in arrest and incarceration rates by working with literature that dramatizes the differences between white and nonwhite experiences within the US criminal justice system. Tim Engles and Fern Kory demonstrate some methods for doing so by juxtaposing two…

Potential effects of foundation species loss on wetland communities: A case study of black ash wetlands threatened by emerald ash borer

Treesearch

Melissa B. Youngquist; Sue L. Eggert; Anthony W. D' Amato; Brian J. Palik; Robert A. Slesak

2017-01-01

The emerald ash borer (EAB; Agrilus planipennis) is an invasive beetle that causes almost complete mortality of ash trees (Fraxinus spp.) in North America and Europe. Northern temperate wetlands, where black ash (F. nigra) is a dominant and foundation species, will likely undergo dramatic shifts after EAB...

Achieving Dramatic School Improvement: An Exploratory Study. A Cross-Site Analysis from the Evaluation of Comprehensive School Reform Program Implementation and Outcomes Study

ERIC Educational Resources Information Center

Aladjem, Daniel K.; Birman, Beatrice F.; Orland, Martin; Harr-Robins, Jenifer; Heredia, Alberto; Parrish, Thomas B.; Ruffini, Stephen J.

2010-01-01

This exploratory study describes approaches to improving schools through retrospective, in-depth qualitative case studies. To select schools to be examined, the authors sought to identify Comprehensive School Reform (CSR) schools demonstrating two distinctive patterns of improved student achievement between 2000 and 2005, rapid-improvement (i.e.,…

Staging Gender: The Articulation of Tacit Gender Dimensions in Drama Classes in a Swedish Context

ERIC Educational Resources Information Center

Lund, Anna

2013-01-01

This article engages with gender, performance and embodiment in drama classes in a Swedish context. It presents a case study of how instructors at an academy of dramatic arts integrate theoretical knowledge on gender into their students' creative and pedagogical practice, as well as an analysis of why this approach works. Visualisation of how the…

The Next Revolution Will Be In Education: A New Marketing Approach for Schools

ERIC Educational Resources Information Center

Suss, Gavin

2013-01-01

The past 15 years have been a dramatic and unique period for education systems all over the world. The challenges have become more complex and the need for schools to promote their agenda has become cardinal and, in some cases, even critical. Today, parents, children, pupils and teachers are motivated by their senses and the positioning of leading…

Opportunities for development of local forest markets: the case of Amish furniture manufacturing

Treesearch

Matt Bumgardner; Gary Graham; Charles Goebel

2012-01-01

A dramatic decline in the production of hardwood furniture in the United States has had profound impacts on employment and hardwood markets. Against this backdrop, the Amish-based furniture manufacturing cluster in Ohio has expanded and hardwood lumber consumption by the cluster is significant. Recent research suggests that 71 percent of firms in the cluster expanded...

Using Socio-Dramatic Play to Support a Beginning Writer: "Daniel, the Doctor and the Bleeding Ball"

ERIC Educational Resources Information Center

Boyle, Bill; Charles, Marie

2010-01-01

This article reports on a case study of a young child (aged five) at a very early stage of his journey as a writer, evidencing "pre-alphabetic tendencies", who has not yet internalised the construction of his name. Analysis of a "baseline" piece of Daniel's writing demonstrates his awareness that the production of random…

The Preservation of Schwa in the Converging Phonological System of Frenchville (PA) French

ERIC Educational Resources Information Center

Bullock, Barbara E.; Gerfen, Chip

2005-01-01

The phonological system of the French of Frenchville, Pennsylvania (USA) demonstrates a dramatic case of transfer in the latest (and last) generation of bilingual French-English speakers: the mid front round vowels, [ligature of o and e] and [slashed o], have often been replaced by the English rhoticized schwa as found in the word "sir."…

Language as a Window into the Mind: The Case of Space

ERIC Educational Resources Information Center

Holmes, Kevin J.

2012-01-01

Many cognitive scientists regard language as a rich source of evidence about the human mind. Much research over the past forty years has been driven by the assumption that words reveal underlying concepts. At the same time, cross-linguistic work has shown that languages differ dramatically in how they partition the world by name. To maintain the…

A Stakeholder View of Organizational Adaptation to Technological Change: The Case of U. S. State Universities, 2003-2012

ERIC Educational Resources Information Center

Gould, Robert W.

2013-01-01

This study addressed technological change in the core processes of teaching and learning in U. S. state universities in the decade from 2003-2012. Institutions of higher education in the U. S. have faced dramatically complex and rapidly changing operating environments. In response to these conditions, institutions of higher education have…

Evaluating the Effectiveness of the New Jersey Leaders to Leaders Induction Program: A Case Study

ERIC Educational Resources Information Center

Parent, Michael

2012-01-01

Since the publication of the groundbreaking 1983 report A Nation At Risk: The Imperative For Educational Reform and the enactment of No Child Left Behind (NCLB) in 2001, America's public schools have undergone dramatic changes. These significant changes have required school administrators to be more of an educational leader to students and staff,…

Private forest landowner attitudes toward off-highway vehicle access: A Minnesota case study

Treesearch

Dennis R. Becker; Grant L. Wilson; Stephanie A. Snyder

2010-01-01

Off-highway vehicle (OHV) riding has increased dramatically in the past decade, creating challenges for finding suitable places to ride, particularly where access to public lands is limited. This research examines the attitudes and willingness of private forest and seasonal recreation landowners to provide OHV access. A series of focus groups was conducted to inform a...

Dramatic intracranial response to osimertinib in a poor performance status patient with lung adenocarcinoma harboring the epidermal growth factor receptor T790M mutation: A case report.

PubMed

Uemura, Takehiro; Oguri, Tetsuya; Okayama, Minami; Furuta, Hiromi; Kanemitsu, Yoshihiro; Takakuwa, Osamu; Ohkubo, Hirotsugu; Takemura, Masaya; Maeno, Ken; Ito, Yutaka; Niimi, Akio

2017-04-01

We herein report a case of dramatic intracranial response to osimertinib in a poor performance status patient with lung adenocarcinoma harboring the epidermal growth factor receptor ( EGFR ) T790M mutation encoded in exon 20. The patient was a 59-year-old woman with EGFR exon 19 deletion-positive lung adenocarcinoma, who relapsed with multiple brain metastases. Computed tomography-guided biopsy of the left pleural tumor revealed adenocarcinoma harboring an EGFR exon 19 deletion and an EGFR T790M mutation encoded in exon 20. The patient was treated with osimertinib, a third-generation EGFR tyrosine kinase inhibitor. Two days after treatment initiation, the patient displayed profound disturbance of consciousness, possibly due to carcinomatous meningitis, and treatment had to be discontinued due to difficulty in taking osimertinib. However, the patient gradually started to recover consciousness and, after 3 days, she was again able to take osimertinib. One month after the initiation of osimertinib treatment, magnetic resonance imaging revealed an apparent reduction in brain metastases. The patient is currently under continued treatment with osimertinib. At the last follow-up (February, 2017) she exhibited partial response to the treatment.

Are we losing the battle against cardiometabolic disease? The case for a paradigm shift in primary prevention.

PubMed

Kraushaar, Lutz E; Krämer, Alexander

2009-02-21

Cardiovascular and diabetic disease are the leading and preventable causes of death worldwide. The currently prognosticated dramatic increase in disease burden over the next two decades, however, bespeaks a low confidence in our prevention ability. This conflicts with the almost enthusiastic reporting of study results, which demonstrate substantial risk reductions secondary to simple lifestyle changes. There is a case to be made for a disregard of the difference between statistical significance and clinical relevance of the reported data. Nevertheless, lifestyle change remains the main weapon in our battle against the epidemic of cardiometabolic disease. But along the way from risk screening to intervention to maintenance the compound inefficiencies of current primary preventive strategies marginalize their impact. Unless we dramatically change the ways in which we deploy preventive interventions we will inevitably lose the battle. In this paper we will argue for three provocative strategy changes, namely (a) the disbanding of screening in favor of population-wide enrollment into preventive interventions, (b) the substitution of the current cost utility analysis for a return-on-investment centered appraisal of interventions, and (c) the replacement of standardized programs modeled around acute care by individualized and perpetual interventions.

[Treatment of early-onset generalized dystonia by chronic bilateral stimulation of the internal globus pallidus. Apropos of a case].

PubMed

Coubes, P; Echenne, B; Roubertie, A; Vayssière, N; Tuffery, S; Humbertclaude, V; Cambonie, G; Claustres, M; Frerebeau, P

1999-05-01

Dystonia musculorum deformans is an inherited severe disease, with a wide clinical polymorphism. The most severe clinical forms with early onset carry a high risk of life-threatening complications. In the absence of any efficient medical treatment, bilateral pallidotomy has previously been reported to be of value in the management of this disease. We report the first clinical case of a severe early-onset generalized dystonia dramatically improved by a bilateral stimulation of the internal globus pallidus. In November 1996, we proposed this neurosurgical procedure for a 8-year-old girl, who had suffered since the age of 3 from severe generalized dystonia, and who progressively became totally dependent and bedridden. She had been under sedation and permanent controlled respiratory assistance for the last two months. The etiology of the disease remained unknown (the DYT1 mutation was absent). Under general anesthesia, we bilaterally implanted a four-contacts electrode in the internal globus pallidus, using the Leksell's stereotactic frame and a 1.5 tesla MRI control. A dramatic improvement was noted 6 weeks later and led us to connect the two electrodes to neurostimulators inserted under the abdominal skin.

DNA fingerprinting on trial: the dramatic early history of a new forensic technique.

PubMed

Aronson, Jay D

2005-09-01

The early history of "DNA fingerprinting" in the UK might have been different were it not for the accounts of two dramatic courtroom trials, made by the participants and the media, in the mid-1980s. But these reports, which misrepresented the importance DNA evidence had in the trials, left a strong impression on the British public and on judges on both sides of the Atlantic. These trials, widely considered to be the first "victories" for DNA fingerprinting, have been frequently cited as proof of the utility and reliability of the technique, in both the UK and beyond. But in reality, it was the threat of DNA evidence being used rather than the integrity or validity of it that resolved these cases. At that time, DNA fingerprinting was still in its infancy, an untried and untested technology.

Technology and politics: The regional airport experience

NASA Technical Reports Server (NTRS)

Starling, J. D.; Brown, J.; Gerhardt, J. M.; Dominus, M. I.

1976-01-01

The findings of a comparative study of the following six regional airports were presented: Dallas/Fort Worth, Kansas City, Washington, D.C., Montreal, Tampa, and St. Louis. Each case was approached as a unique historical entity, in order to investigate common elements such as: the use of predictive models in planning, the role of symbolism to heighten dramatic effects, the roles of community and professional elites, and design flexibility. Some of the factors considered were: site selection, consolidation of airline service, accessibility, land availability and cost, safety, nuisance, and pollution constraints, economic growth, expectation of regional growth, the demand forecasting conundrum, and design decisions. The hypotheses developed include the following: the effect of political, social, and economic conflicts, the stress on large capacity and dramatic, high-technology design, projections of rapid growth to explain the need for large capital outlays.

[Treatment of the infected wound with exposed silver-ring vascular graft and delayed Thiersch method of skin transplant covering ].

PubMed

Nenezić, Dragoslav; Pandaitan, Simon; Ilijevski, Nenad; Matić, Predrag; Gajin, Predag; Radak, Dorde

2005-01-01

Although the incidence of prosthetic infection is low (1%-6%), the consequences (limb loss or death) are dramatic for a patient, with high mortality rate (25%-75%) and limb loss in 40%-75% of cases. In case of Szilagyi's grade III infection, standard procedure consists of the excision of prosthesis and wound debridement. Alternative method is medical treatment. This is a case report of a patient with prosthetic infection of Silver-ring graft, used for femoropopliteal reconstruction, in whom an extreme skin necrosis developed in early postoperative period. This complication was successfully treated medically. After repeated debridement and wound-packing, the wound was covered using Thiersch skin graft.

A rare case of Weil's disease with alveolar haemorrhage.

PubMed

Chakrabarti, Abhiram; Nandy, Manab; Pal, Dipankar; Mallik, Sudesna

2014-05-01

Leptospirosis, a disease of protean manifestations occurs sporadically throughout the year with a peak seasonal incidence during the rainy season mimicking other febrile viral illness. In the rare case, the disease leads to renal and hepatic involvement with hemorrhage which may be associated with multisystem organ dysfunction in form of pulmonary, cardiac and central nervous system, when it is known as Weil's disease. Rarely haemorrhagic manifestations are assosciated. Early diagnosis is important as sometimes the disease may be life threatening. Proper antibiotics results in dramatic improvement. We hereby presented a case that had clinical features of Weil's disease with cough, dyspnoea and haemoptysis. Leptospirosis was detected on ELISA testing. Patient was cured rapidly with antibiotics.

Serratia marcescens Bullous Cellulitis in a Splenectomized Patient: A Case Report and Review of the Literature.

PubMed

Fournier, John B; Dabiri, Ganary; Thomas, Vinod; Skowron, Gail; Carson, Polly; Falanga, Vincent

2016-06-01

Serratia marcescens is a Gram-negative bacillus belonging to the Enterobacteriaceae family. Cutaneous infection with Serratia is rare, and usually occurs in immunocompromised individuals. Primary cutaneous infections are uncommon, but they are typically severe and are associated with significant morbidity and mortality. The pathogenetic factors leading to S. marcescens infection are not fully understood, but contributing virulence factors include proteases, secreted exotoxins, and the formation of biofilm. We report a case of cellulitis occurring in a splenectomized patient, which led to multiple wound debridements and a transmetatarsal amputation. This dramatic case led us to review the published literature on soft tissue infections caused by S. marcescens. © The Author(s) 2016.

[Inflammatory rheumatism flare-up after surgical treatment of Cushing's disease: two cases].

PubMed

Raccah, D; Zeitoun, C; Lafforgue, P; Lassmann-Vague, V; Mallet, B; Vialettes, B; Weiller, P J; Vague, P

1992-01-01

The anti-inflammatory effect of natural glucocorticoids is often overlooked, as shown by these two cases of inflammatory rheumatism flare-up which occurred after surgical treatment of Cushing's syndrome. The disorder in the first case was exacerbation of a probable rheumatoid arthritis; in the second case an unlabelled inflammatory rheumatism appeared in a context of postoperative corticotropic deficiency. In both cases a purely substitutive hydrocortisone therapy resulted in dramatic regression of the articular symptoms. It is well known that rheumatismal manifestations may occur in patients with slow adrenal failure. The determinant factor seems to be a glucocorticoid deficiency, either isolated or associated with others, since cortisol exerts and anti-inflammatory activity. In patients with corticotropic deficiency following surgical treatment of Cushing's disease, the endogenous corticosteroid therapy of hypercortisolism is interrupted, allowing the aggravation or emergence of inflammatory rheumatism.

The Use of Interrupted Case Studies to Enhance Critical Thinking Skills in Biology

PubMed Central

White, Tracy K.; Whitaker, Paul; Gonya, Terri; Hein, Richard; Kroening, Dubear; Lee, Kevin; Lee, Laura; Lukowiak, Andrea; Hayes, Elizabeth

2009-01-01

There has been a dramatic increase in the availability of case studies for use in the biology classroom, and perceptions of the effectiveness of case-study-based learning are overwhelmingly positive. Here we report the results of a study in which we evaluated the ability of interrupted case studies to improve critical thinking in the context of experimental design and the conventions of data interpretation. Students were assessed using further case studies designed to evaluate their ability to recognize and articulate problematic approaches to these elements of experimentation. Our work reveals that case studies have broad utility in the classroom. In addition to demonstrating a small but statistically significant increase in the number of students capable of critically evaluating selected aspects of experimental design, we also observed increased student engagement and documented widespread misconceptions regarding the conventions of data acquisition and analysis. PMID:23653687

Levey-Jennings Analysis Uncovers Unsuspected Causes of Immunohistochemistry Stain Variability.

PubMed

Vani, Kodela; Sompuram, Seshi R; Naber, Stephen P; Goldsmith, Jeffrey D; Fulton, Regan; Bogen, Steven A

Almost all clinical laboratory tests use objective, quantitative measures of quality control (QC), incorporating Levey-Jennings analysis and Westgard rules. Clinical immunohistochemistry (IHC) testing, in contrast, relies on subjective, qualitative QC review. The consequences of using Levey-Jennings analysis for QC assessment in clinical IHC testing are not known. To investigate this question, we conducted a 1- to 2-month pilot test wherein the QC for either human epidermal growth factor receptor 2 (HER-2) or progesterone receptor (PR) in 3 clinical IHC laboratories was quantified and analyzed with Levey-Jennings graphs. Moreover, conventional tissue controls were supplemented with a new QC comprised of HER-2 or PR peptide antigens coupled onto 8 μm glass beads. At institution 1, this more stringent analysis identified a decrease in the HER-2 tissue control that had escaped notice by subjective evaluation. The decrement was due to heterogeneity in the tissue control itself. At institution 2, we identified a 1-day sudden drop in the PR tissue control, also undetected by subjective evaluation, due to counterstain variability. At institution 3, a QC shift was identified, but only with 1 of 2 controls mounted on each slide. The QC shift was due to use of the instrument's selective reagent drop zones dispense feature. None of these events affected patient diagnoses. These case examples illustrate that subjective QC evaluation of tissue controls can detect gross assay failure but not subtle changes. The fact that QC issues arose from each site, and in only a pilot study, suggests that immunohistochemical stain variability may be an underappreciated problem.

Signs of preclinical Wernicke's encephalopathy and thiamine levels as predictors of neuropsychological deficits in alcoholism without Korsakoff's syndrome.

PubMed

Pitel, Anne-Lise; Zahr, Natalie M; Jackson, Karen; Sassoon, Stephanie A; Rosenbloom, Margaret J; Pfefferbaum, Adolf; Sullivan, Edith V

2011-02-01

The purpose of this study was to determine whether meeting historical criteria for unsuspected Wernicke's encephalopathy (WE), largely under-diagnosed in vivo, explains why some alcoholics have severe neuropsychological deficits, whereas others, with a similar drinking history, exhibit preserved performance. Demographic, clinical, alcohol related, and neuropsychological measures were collected in 56 abstinent alcoholics and 38 non-alcohol-dependent volunteers. Alcoholics were classified using the clinical criteria established by Caine et al (1997) and validated in their neuropathological study of alcoholic cases. Our alcoholics who met a single criterion were considered 'at risk for WE' and those with two or more criteria with 'signs of WE'. Whole blood thiamine was also measured in 22 of the comparison group and 28 alcoholics. Of the alcoholics examined, 27% met no criteria, 57% were at risk for WE, and 16% had signs of WE. Neuropsychological performance of the alcoholic subgroups was graded, with those meeting zero criteria not differing from controls, those meeting one criterion presenting mild-to-moderate deficits on some of the functional domains, and those meeting two or more criteria having the most severe deficits on each of the domains examined. Thiamine levels were selectively related to memory performance in the alcoholics. Preclinical signs of WE can be diagnosed in vivo, enabling the identification of ostensibly 'uncomplicated' alcoholics who are at risk for neuropsychological complications. The graded effects in neuropsychological performance suggest that the presence of signs of WE explains, at least partially, the heterogeneity of alcoholism-related cognitive and motor deficits.

The Psychiatric Genomics Consortium Posttraumatic Stress Disorder Workgroup: Posttraumatic Stress Disorder Enters the Age of Large-Scale Genomic Collaboration

PubMed Central

Logue, Mark W; Amstadter, Ananda B; Baker, Dewleen G; Duncan, Laramie; Koenen, Karestan C; Liberzon, Israel; Miller, Mark W; Morey, Rajendra A; Nievergelt, Caroline M; Ressler, Kerry J; Smith, Alicia K; Smoller, Jordan W; Stein, Murray B; Sumner, Jennifer A; Uddin, Monica

2015-01-01

The development of posttraumatic stress disorder (PTSD) is influenced by genetic factors. Although there have been some replicated candidates, the identification of risk variants for PTSD has lagged behind genetic research of other psychiatric disorders such as schizophrenia, autism, and bipolar disorder. Psychiatric genetics has moved beyond examination of specific candidate genes in favor of the genome-wide association study (GWAS) strategy of very large numbers of samples, which allows for the discovery of previously unsuspected genes and molecular pathways. The successes of genetic studies of schizophrenia and bipolar disorder have been aided by the formation of a large-scale GWAS consortium: the Psychiatric Genomics Consortium (PGC). In contrast, only a handful of GWAS of PTSD have appeared in the literature to date. Here we describe the formation of a group dedicated to large-scale study of PTSD genetics: the PGC-PTSD. The PGC-PTSD faces challenges related to the contingency on trauma exposure and the large degree of ancestral genetic diversity within and across participating studies. Using the PGC analysis pipeline supplemented by analyses tailored to address these challenges, we anticipate that our first large-scale GWAS of PTSD will comprise over 10 000 cases and 30 000 trauma-exposed controls. Following in the footsteps of our PGC forerunners, this collaboration—of a scope that is unprecedented in the field of traumatic stress—will lead the search for replicable genetic associations and new insights into the biological underpinnings of PTSD. PMID:25904361

Internal derangement of the knee after ipsilateral femoral shaft fracture: MR imaging findings.

PubMed

Blacksin, M F; Zurlo, J V; Levy, A S

1998-08-01

This study uses magnetic resonance (MR) imaging to delineate the types and frequencies of injuries seen in the knee after ipsilateral femoral shaft fracture. We also compare the results of the orthopedic knee examination with the MR findings. MR imaging of the ipsilateral knee was performed on 34 patients with closed femoral shaft fractures. Indications for knee MR imaging included knee pain at the time of fracture, soft tissue swelling or an effusion of the knee, or a positive knee examination under anesthesia. The patients had a mean age of 27 years and all were stabilized with intramedullary nails. Imaging was performed a mean time of 2.5 days after surgery. All patients had knee examinations done under anesthesia, and the MR results were compiled and compared with the clinical examinations. Ninety-seven percent of patients demonstrated knee effusions. Twenty-seven percent of patients demonstrated meniscal tears, with the posterior horn of the medial meniscus most frequently torn. The medial collateral ligament was the most frequent site of ligamentous injury (38%) followed by the posterior cruciate ligament (21%). Fifty percent of patients had injuries of the extensor mechanism. Bone bruises were noted in 32% of patients. Articular cartilage injuries were confined to the patella in four cases. One occult tibial plateau fracture and one meniscocapsular separation were seen. There is a common incidence of both ligamentous and meniscal injury to the knee after ipsilateral femoral shaft fracture. MR imaging can be useful in assessing the extent of injury, and may reveal findings unsuspected after clinical examination of the knee.

Capsule endoscopy in neoplastic diseases

PubMed Central

Pennazio, Marco; Rondonotti, Emanuele; de Franchis, Roberto

2008-01-01

Until recently, diagnosis and management of small-bowel tumors were delayed by the difficulty of access to the small bowel and the poor diagnostic capabilities of the available diagnostic techniques. An array of new methods has recently been developed, increasing the possibility of detecting these tumors at an earlier stage. Capsule endoscopy (CE) appears to be an ideal tool to recognize the presence of neoplastic lesions along this organ, since it is non-invasive and enables the entire small bowel to be visualized. High-quality images of the small-bowel mucosa may be captured and small and flat lesions recognized, without exposure to radiation. Recent studies on a large population of patients undergoing CE have reported small-bowel tumor frequency only slightly above that reported in previous surgical series (range, 1.6%-2.4%) and have also confirmed that the main clinical indication to CE in patients with small-bowel tumors is obscure gastrointestinal (GI) bleeding. The majority of tumors identified by CE are malignant; many were unsuspected and not found by other methods. However, it remains difficult to identify pathology and tumor type based on the lesion’s endoscopic appearance. Despite its limitations, CE provides crucial information leading in most cases to changes in subsequent patient management. Whether the use of CE in combination with other new diagnostic (MRI or multidetector CT enterography) and therapeutic (Push-and-pull enteroscopy) techniques will lead to earlier diagnosis and treatment of these neoplasms, ultimately resulting in a survival advantage and in cost savings, remains to be determined through carefully-designed studies. PMID:18785274

Impact of a chromosome X STR Decaplex in deficiency paternity cases.

PubMed

Trindade-Filho, Aluisio; Ferreira, Samuel; Oliveira, Silviene F

2013-12-01

Deficiency paternity cases, characterized by the absence of the alleged father, are a challenge for forensic genetics. Here we present four cases with a female child and a deceased alleged father in which the analysis of a set of 21 or 22 autosomal STRs (AS STRs) produced results within a range of doubt when genotyping relatives of the alleged father. Aiming to increase the Paternity Index (PI) and obtain more reliable results, a set of 10 X-linked STR markers, developed by the Spanish and Portuguese Group of the International Society for Forensic Genetics (ISFG), was then added. Statistical analysis substantially shifted the results towards the alleged fatherhood in all four cases, with more dramatic changes when the supposed half-sister and respective mother were the relatives tested.

Impact of a chromosome X STR Decaplex in deficiency paternity cases

PubMed Central

Trindade-Filho, Aluisio; Ferreira, Samuel; Oliveira, Silviene F.

2013-01-01

Deficiency paternity cases, characterized by the absence of the alleged father, are a challenge for forensic genetics. Here we present four cases with a female child and a deceased alleged father in which the analysis of a set of 21 or 22 autosomal STRs (AS STRs) produced results within a range of doubt when genotyping relatives of the alleged father. Aiming to increase the Paternity Index (PI) and obtain more reliable results, a set of 10 X-linked STR markers, developed by the Spanish and Portuguese Group of the International Society for Forensic Genetics (ISFG), was then added. Statistical analysis substantially shifted the results towards the alleged fatherhood in all four cases, with more dramatic changes when the supposed half-sister and respective mother were the relatives tested. PMID:24385853

Environmental effects on long term behavior of composite laminates

NASA Astrophysics Data System (ADS)

Singhal, S. N.; Chamis, C. C.

Model equations are presented for approximate methods simulating the long-term behavior of composite materials and structures in hot/humid service environments. These equations allow laminate property upgradings with time, and can account for the effects of service environments on creep response. These methodologies are illustrated for various individual and coupled temperature/moisture, longitudinal/transverse, and composite material type cases. Creep deformation is noted to rise dramatically for cases of matrix-borne, but not of fiber-borne, loading in hot, humid environments; the coupled influence of temperature and moisture is greater than a mere combination of their individual influences.

Environmental effects on long term behavior of composite laminates

NASA Technical Reports Server (NTRS)

Singhal, S. N.; Chamis, C. C.

1992-01-01

Model equations are presented for approximate methods simulating the long-term behavior of composite materials and structures in hot/humid service environments. These equations allow laminate property upgradings with time, and can account for the effects of service environments on creep response. These methodologies are illustrated for various individual and coupled temperature/moisture, longitudinal/transverse, and composite material type cases. Creep deformation is noted to rise dramatically for cases of matrix-borne, but not of fiber-borne, loading in hot, humid environments; the coupled influence of temperature and moisture is greater than a mere combination of their individual influences.

Repetitive Transcranial Magnetic Stimulation for Wernicke-Korsakoff Syndrome: A Case Report

PubMed Central

2017-01-01

A 57-year-old man who was diagnosed with Wernicke-Korsakoff syndrome showed severe impairment of cognitive function and a craving for alcohol, even after sufficient supplementation with thiamine. After completing 10 sessions of 10 Hz repetitive transcranial magnetic stimulation (rTMS) at 100% of the resting motor threshold over the left dorsolateral prefrontal cortex, dramatic improvement in cognitive function and a reduction in craving for alcohol were noted. This is the first case report of the efficacy of a high-frequency rTMS in the treatment of Wernicke-Korsakoff syndrome. PMID:28289650

Use of letter writing as a means of integrating an altered body image: a case study.

PubMed

Rancour, Patricia; Brauer, Kathryn

2003-01-01

To describe the use of letter writing as a technique to assist patients in adjusting to an altered body image after dramatic cancer treatment. Published articles and books. Gestalt therapy, psychosynthesis, and journaling techniques evolve into a technique that can assist patients who are challenged to accept altered body parts. Described in a case study presentation, letter writing was found to assist female patients with recurrent breast cancer in adjusting to reconstruction of lost breasts. Nurses can use letter writing as a means of assisting patients through the grief process associated with body image alterations.

Examining How Video-Elicited Reflection Mediates Teacher Candidates' Beliefs about English Language Learners: A Multiple Case Study

ERIC Educational Resources Information Center

Gonzalez, Monica M.

2017-01-01

English Language Learners (ELLs) are students who speak a language other than English; they are the fastest growing student population in United States' (US) public schools and will include over 17 million students by the year 2020 (NCES,2015). The dramatic increase in the ELL student population means that all mainstream classroom teachers will…

The Relationship of Child Neglect and Physical Maltreatment to Placement Outcomes and Behavioral Adjustment in Children in Foster Care: A Canadian Perspective

ERIC Educational Resources Information Center

Marquis, Robyn A.; Leschied, Alan W.; Chiodo, Debbie; O'Neill, Arlene

2008-01-01

Dramatic increases in child welfare rates in Canada over recent years have been largely driven by an increased reporting of neglect cases (Trocme, Fallon, MacLaurin, & Neves, 2005). To a large extent, exploring the importance of neglect separate from physical maltreatment has been ignored in the child maltreatment literature. This study…

Popular Visual Images and the (Mis)Reading of Black Male Youth: A Case for Racial Literacy in Urban Preservice Teacher Education

ERIC Educational Resources Information Center

Sealey-Ruiz, Yolanda; Greene, Perry

2015-01-01

In the majority of public schools across the nation, Black male youth are undergoing what can be deemed as "educational genocide"--the killing off of any chances for an equitable education. This dramatically decreases opportunities for Black male youth to develop into fully participating citizens in a democratic society. In many ways,…

Western equine encephalitis with rapid onset of parkinsonism.

PubMed

Schultz, D R; Barthal, J S; Garrett, G

1977-11-01

A patient with confirmed western equine encephalitis had the rapid onset of postencephalitic parkinsonian sequelae. This observation corroborates similar previous but rare reports. Response to therapy with levodopa, dopa decarboxylase inhibitor, and trihexyphenidyl was dramatic. However, remission maintained for 12 months without medication suggests that the parkinsonism would have remitted spontaneously. In either case, this has not previously been reported with the western equine togavirus.

Suprathreshold Contrast Sensitivity Vision Test Chart

DTIC Science & Technology

1991-07-14

with data collected on patients having amblyopia , glaucoma and macular degeneration showed that the SCTS may be effectively used as an initial...dramatically in certain cases of abnormal vision, such as amblyopia (Ginsburg, 1978, 1981; Hess, Bradley and Piotrowski, 1983; Loshin and Levi, 1983). The...combination of frequencies. Amblyopia results in marked losses of contrast sensitivity particularly at high spatial frequencies, but may also result in

Supporting and Scaling Change: Lessons from the First Round of the Investing in Innovation (i3) Program

ERIC Educational Resources Information Center

Smith, Kim; Petersen, Julie

2011-01-01

It is widely acknowledged that innovation will be necessary to dramatically improve public services in America. But innovation in the public sector doesn't happen in a vacuum; innovation happens at the nexus of policy, research, capital, and practice. This project looks at one case study--education--by analyzing some of the key aspects of an…

Teaching and Learning the Language of Science: A Case Study of Academic Language Acquisition in a Dual Language Middle School

ERIC Educational Resources Information Center

Gose, Robin Margaretha

2013-01-01

English language learners (EL) are the fastest growing sub-group of the student population in California, yet ELs also score the lowest on the science section of the California Standardized Tests. In the area of bilingual education, California has dramatically changed its approach to English learners since the passage of Proposition 227 in 1998,…

Scoping a perforated bleeding peptic ulcer: learning points.

PubMed

Wani, Abdul Majid; Hussain, Waleed Mohd; AlMiamini, Wail; Khoujah, Amer M; Diari, Mohd S; Akhtar, Mubeena; Alharbi, Zeyad S

2011-03-24

Peptic ulcer perforation and haemorrhage is not unusual as a complication of peptic ulcer disease. In the older patientspresentation can be dramatic and atypical. The authors are presenting a case of duodenal ulcer perforation and haemorrhage which was misdiagnosed as a gastric malignancy and thus failure to have Helicobacter pylori eradication, recurrence with complication and hesitancy in surgical intervention due to initial label of malignancy.

Balanced Codon Usage Optimizes Eukaryotic Translational Efficiency

PubMed Central

Qian, Wenfeng; Yang, Jian-Rong; Pearson, Nathaniel M.; Maclean, Calum; Zhang, Jianzhi

2012-01-01

Cellular efficiency in protein translation is an important fitness determinant in rapidly growing organisms. It is widely believed that synonymous codons are translated with unequal speeds and that translational efficiency is maximized by the exclusive use of rapidly translated codons. Here we estimate the in vivo translational speeds of all sense codons from the budding yeast Saccharomyces cerevisiae. Surprisingly, preferentially used codons are not translated faster than unpreferred ones. We hypothesize that this phenomenon is a result of codon usage in proportion to cognate tRNA concentrations, the optimal strategy in enhancing translational efficiency under tRNA shortage. Our predicted codon–tRNA balance is indeed observed from all model eukaryotes examined, and its impact on translational efficiency is further validated experimentally. Our study reveals a previously unsuspected mechanism by which unequal codon usage increases translational efficiency, demonstrates widespread natural selection for translational efficiency, and offers new strategies to improve synthetic biology. PMID:22479199

When not to copy: female fruit flies use sophisticated public information to avoid mated males

NASA Astrophysics Data System (ADS)

Loyau, Adeline; Blanchet, Simon; van Laere, Pauline; Clobert, Jean; Danchin, Etienne

2012-10-01

Semen limitation (lack of semen to fertilize all of a female's eggs) imposes high fitness costs to female partners. Females should therefore avoid mating with semen-limited males. This can be achieved by using public information extracted from watching individual males' previous copulating activities. This adaptive preference should be flexible given that semen limitation is temporary. We first demonstrate that the number of offspring produced by males Drosophila melanogaster gradually decreases over successive copulations. We then show that females avoid mating with males they just watched copulating and that visual public cues are sufficient to elicit this response. Finally, after males were given the time to replenish their sperm reserves, females did not avoid the males they previously saw copulating anymore. These results suggest that female fruit flies may have evolved sophisticated behavioural processes of resistance to semen-limited males, and demonstrate unsuspected adaptive context-dependent mate choice in an invertebrate.

Diagnosis and evaluation of gastric cancer by positron emission tomography

PubMed Central

Wu, Chen-Xi; Zhu, Zhao-Hui

2014-01-01

Gastric cancer is the second leading cause of cancer mortality worldwide. The diagnosis of gastric cancer has been significantly improved with the broad availability of gastrointestinal endoscopy. Effective technologies for accurate staging and quantitative evaluation are still in demand to merit reasonable treatment and better prognosis for the patients presented with advanced disease. Preoperative staging using conventional imaging tools, such as computed tomography (CT) and endoscopic ultrasonography, is inadequate. Positron emission tomography (PET), using 18F-fluorodeoxyglucose (FDG) as a tracer and integrating CT for anatomic localization, holds a promise to detect unsuspected metastasis and has been extensively used in a variety of malignancies. However, the value of FDG PET/CT in diagnosis and evaluation of gastric cancer is still controversial. This article reviews the current literature in diagnosis, staging, response evaluation, and relapse monitoring of gastric cancer, and discusses the current understanding, improvement, and future prospects in this area. PMID:24782610

Molecular epidemiology of tuberculosis: achievements and challenges to current knowledge.

PubMed Central

Murray, Megan; Nardell, Edward

2002-01-01

Over the past 10 years, molecular methods have become available with which to strain-type Mycobacterium tuberculosis. They have allowed researchers to study certain important but previously unresolved issues in the epidemiology of tuberculosis (TB). For example, some unsuspected microepidemics have been revealed and it has been shown that the relative contribution of recently acquired disease to the TB burden in many settings is far greater than had been thought. These findings have led to the strengthening of TB control. Other research has demonstrated the existence and described the frequency of exogenous reinfection in areas of high incidence. Much recent work has focused on the phenotypic variation among strains and has evaluated the relative transmissibility, virulence, and immunogenicity of different lineages of the organism. We summarize the recent achievements in TB epidemiology associated with the introduction of DNA fingerprinting techniques, and consider the implications of this technology for the design and analysis of epidemiological studies. PMID:12132006

[Traumatic rupture of a horseshoe kidney].

PubMed

Pascual Samaniego, M; Bravo Fernández, I; Ruiz Serrano, M; Ramos Martín, J A; Lázaro Méndez, J; García González, A

2006-04-01

One-third to one-half of all patients with horseshoe kidney are asymptomatic and the condition is found incidentally. This congenital renal anomaly has shown as a predisponent condition for renal injury in blunt abdominal trauma, but often the degree of injury has a nonoperative therapy. Horseshoe kidney rupture is an exceptional pathology that require a complete diagnostic study to make an adequate management when surgical therapy is indicated. We present a fifteen-year-old male with previously unsuspected horseshoe kidney that suffered an atypical right upper-pole and mesorrenal kidney rupture after low-velocity-impact blunt abdominal trauma. A correct presurgical diagnose let a deferred surgical approach with right lower pole and horseshoe renal isthmus preservation. The trauma conditions, an excesive clinic manifestation, a clinical investigation about known congenital simultaneous anomallies and typical radiological signs, can suggest this infrequent patology. Computed tomography provides the best radiological information.

Nature of alpha and beta particles in glycogen using molecular size distributions.

PubMed

Sullivan, Mitchell A; Vilaplana, Francisco; Cave, Richard A; Stapleton, David; Gray-Weale, Angus A; Gilbert, Robert G

2010-04-12

Glycogen is a randomly hyperbranched glucose polymer. Complex branched polymers have two structural levels: individual branches and the way these branches are linked. Liver glycogen has a third level: supramolecular clusters of beta particles which form larger clusters of alpha particles. Size distributions of native glycogen were characterized using size exclusion chromatography (SEC) to find the number and weight distributions and the size dependences of the number- and weight-average masses. These were fitted to two distinct randomly joined reference structures, constructed by random attachment of individual branches and as random aggregates of beta particles. The z-average size of the alpha particles in dimethylsulfoxide does not change significantly with high concentrations of LiBr, a solvent system that would disrupt hydrogen bonding. These data reveal that the beta particles are covalently bonded to form alpha particles through a hitherto unsuspected enzyme process, operative in the liver on particles above a certain size range.

Cholera toxin structure, gene regulation and pathophysiological and immunological aspects.

PubMed

Sánchez, J; Holmgren, J

2008-05-01

Many notions regarding the function, structure and regulation of cholera toxin expression have remained essentially unaltered in the last 15 years. At the same time, recent findings have generated additional perspectives. For example, the cholera toxin genes are now known to be carried by a non-lytic bacteriophage, a previously unsuspected condition. Understanding of how the expression of cholera toxin genes is controlled by the bacterium at the molecular level has advanced significantly and relationships with cell-density-associated (quorum-sensing) responses have recently been discovered. Regarding the cell intoxication process, the mode of entry and intracellular transport of cholera toxin are becoming clearer. In the immunological field, the strong oral immunogenicity of the non-toxic B subunit of cholera toxin (CTB) has been exploited in the development of a now widely licensed oral cholera vaccine. Additionally, CTB has been shown to induce tolerance against co-administered (linked) foreign antigens in some autoimmune and allergic diseases.

[Channels: a new way to revisit pathology].

PubMed

Fournier, Emmanuel

2014-02-01

Many "essential" diseases that manifest themselves in the form of crises or fits (epilepsies, episodic ataxia, periodic paralyses, myotonia, heart rhythm disorders, etc.) are due to ionic channel dysfunction and are thus referred to as "channelopathies". Some of these disorders are congenital, due to mutations of genes encoding channel subunits, while others result from toxic, immune or hormonal disturbances affecting channelfunction. Channelopathies take on a wide variety of clinical forms, depending on the type of channel (sodium, potassium, calcium, chloride...) and the type of dysfunction (loss or gain of function). Some apparently unrelated diseases affecting distinct organs are due to a similar dysfunction of the same channel, revealing unsuspected relationships between organs and between medical specialties. In addition, a given syndrome can be caused by distinct channel dysfunctions. This provides new opportunities for diferential diagnosis and specific correction of the causal defects, although some treatments find applications across multiple medical specialties.

A technetium-labeled monoclonal antibody for imaging metastatic melanoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Frytak, S.; Creagan, E.T.; Brown, M.L.

1991-04-01

Twenty patients with histologically proven metastatic melanoma were scanned with a 99mtechnetium ({sup 99}mTc)-labeled melanoma antibody to determine the detection rate of known malignant lesions and to evaluate the antibody's ability to discover occult metastases. Isotope localization in different organs was as follows: liver 100%, bone 100%, subcutaneous lesions 80%, lymph nodes 54%, and lung 33%. Four unsuspected bone lesions and 16 occult subcutaneous lesions were found. False positive lesions were noted in two instances--one benign thyroid adenoma, and one arthritic bone lesion. One patient developed an atypical serum sickness reaction with a rash and arthralgias that responded rapidly tomore » treatment. The {sup 99}mTc antimelanoma antibody is a safe and effective method to detect metastatic melanoma. It has potential use for screening newly diagnosed melanomas that carry an increased risk of recurrence.« less

Adults Can Be Trained to Acquire Synesthetic Experiences

PubMed Central

Bor, Daniel; Rothen, Nicolas; Schwartzman, David J.; Clayton, Stephanie; Seth, Anil K.

2014-01-01

Synesthesia is a condition where presentation of one perceptual class consistently evokes additional experiences in different perceptual categories. Synesthesia is widely considered a congenital condition, although an alternative view is that it is underpinned by repeated exposure to combined perceptual features at key developmental stages. Here we explore the potential for repeated associative learning to shape and engender synesthetic experiences. Non-synesthetic adult participants engaged in an extensive training regime that involved adaptive memory and reading tasks, designed to reinforce 13 specific letter-color associations. Following training, subjects exhibited a range of standard behavioral and physiological markers for grapheme-color synesthesia; crucially, most also described perceiving color experiences for achromatic letters, inside and outside the lab, where such experiences are usually considered the hallmark of genuine synesthetes. Collectively our results are consistent with developmental accounts of synesthesia and illuminate a previously unsuspected potential for new learning to shape perceptual experience, even in adulthood. PMID:25404369

Exceptionally preserved Cambrian loriciferans and the early animal invasion of the meiobenthos.

PubMed

Harvey, Thomas H P; Butterfield, Nicholas J

2017-01-30

Microscopic animals that live among and between sediment grains (meiobenthic metazoans) are key constituents of modern aquatic ecosystems, but are effectively absent from the fossil record. We describe an assemblage of microscopic fossil loriciferans (Ecdysozoa, Loricifera) from the late Cambrian Deadwood Formation of western Canada. The fossils share a characteristic head structure and minute adult body size (~300 μm) with modern loriciferans, indicating the early evolution and subsequent conservation of an obligate, permanently meiobenthic lifestyle. The unsuspected fossilization potential of such small animals in marine mudstones offers a new search image for the earliest ecdysozoans and other animals, although the anatomical complexity of loriciferans points to their evolutionary miniaturization from a larger-bodied ancestor. The invasion of animals into ecospace that was previously monopolized by protists will have contributed considerably to the revolutionary geobiological feedbacks of the Proterozoic/Phanerozoic transition.

Surgical treatments for esophageal cancers

PubMed Central

Allum, William H.; Bonavina, Luigi; Cassivi, Stephen D.; Cuesta, Miguel A.; Dong, Zhao Ming; Felix, Valter Nilton; Figueredo, Edgar; Gatenby, Piers A.C.; Haverkamp, Leonie; Ibraev, Maksat A.; Krasna, Mark J.; Lambert, René; Langer, Rupert; Lewis, Michael P.N.; Nason, Katie S.; Parry, Kevin; Preston, Shaun R.; Ruurda, Jelle P.; Schaheen, Lara W.; Tatum, Roger P.; Turkin, Igor N.; van der Horst, Sylvia; van der Peet, Donald L.; van der Sluis, Peter C.; van Hillegersberg, Richard; Wormald, Justin C.R.; Wu, Peter C.; Zonderhuis, Barbara M.

2015-01-01

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of the nurse in preparation of esophageal resection (ER); the management of patients who develop high-grade dysplasia after having undergone Nissen fundoplication; the trajectory of care for the patient with esophageal cancer; the influence of the site of tumor in the choice of treatment; the best location for esophagogastrostomy; management of chylous leak after esophagectomy; the optimal approach to manage thoracic esophageal leak after esophagectomy; the choice for operational approach in surgery of cardioesophageal crossing; the advantages of robot esophagectomy; the place of open esophagectomy; the advantages of esophagectomy compared to definitive chemoradiotherapy; the pathologist report in the resected specimen; the best way to manage patients with unsuspected positive microscopic margin after ER; enhanced recovery after surgery for ER: expedited care protocols; and long-term quality of life in patients following esophagectomy. PMID:25266029

Presence of cysts on magnetic resonance images (MRIs) in children with asperger disorder and nonverbal learning disabilities.

PubMed

Semrud-Clikeman, Margaret; Fine, Jodene

2011-04-01

The main purpose of this study was to report the existence of previously unidentified brain cysts or lesions in children with nonverbal learning disabilities, Asperger syndrome, or controls. The authors compared the incidence of cysts or lesions on magnetic resonance images (MRIs) in 28 children with nonverbal learning disability, 26 children with Asperger syndrome, and 24 typical controls for abnormalities. In this study, the authors found 25% of children previously diagnosed with nonverbal learning disability to have unsuspected brain abnormalities generally including cysts or lesions in the occipital region, compared with approximately 4% in the Asperger syndrome or control group. The cysts/lesions were found mainly in the occipital lobe, an area responsible for visual/spatial reasoning. It is appropriate to speculate that there might be a connection between anomalous brain development and skill differences among these groups.

The health professional's role in preventing nosocomial infections

PubMed Central

Saloojee, H; Steenhoff, A

2001-01-01

Despite their best intentions, health professionals sometimes act as vectors of disease, disseminating new infections among their unsuspecting clients. Attention to simple preventive strategies may significantly reduce disease transmission rates. Frequent hand washing remains the single most important intervention in infection control. However, identifying mechanisms to ensure compliance by health professionals remains a perplexing problem. Gloves, gowns, and masks have a role in preventing infections, but are often used inappropriately, increasing service costs unnecessarily. While virulent microorganisms can be cultured from stethoscopes and white coats, their role in disease transmission remains undefined. There is greater consensus about sterile insertion techniques for intravascular catheters—a common source of infections—and their care. By following a few simple rules identified in this review, health professionals may prevent much unnecessary medical and financial distress to their patients.


Keywords: infection control; cross infection; hand washing; catheterisation PMID:11123387

Unsuspected task for an old team: succinate, fumarate and other Krebs cycle acids in metabolic remodeling.

PubMed

Bénit, Paule; Letouzé, Eric; Rak, Malgorzata; Aubry, Laetitia; Burnichon, Nelly; Favier, Judith; Gimenez-Roqueplo, Anne-Paule; Rustin, Pierre

2014-08-01

Seventy years from the formalization of the Krebs cycle as the central metabolic turntable sustaining the cell respiratory process, key functions of several of its intermediates, especially succinate and fumarate, have been recently uncovered. The presumably immutable organization of the cycle has been challenged by a number of observations, and the variable subcellular location of a number of its constitutive protein components is now well recognized, although yet unexplained. Nonetheless, the most striking observations have been made in the recent period while investigating human diseases, especially a set of specific cancers, revealing the crucial role of Krebs cycle intermediates as factors affecting genes methylation and thus cell remodeling. We review here the recent advances and persisting incognita about the role of Krebs cycle acids in diverse aspects of cellular life and human pathology. Copyright © 2014 Elsevier B.V. All rights reserved.

Elucidation of the mechanism of homozygous deletion of 3p12-13 in the U2020 cell line reveals the unexpected involvement of other chromosomes.

PubMed

Heppell-Parton, A C; Nacheva, E; Carter, N P; Bergh, J; Ogilvie, D; Rabbitts, P H

1999-06-01

Homozygous deletions in tumor cells have been useful in the localization and validation of tumor suppressor genes. We have described a homozygous deletion in a lung cancer cell line (U2020) which is located within the most proximal of the three regions on the short arm of chromosome 3 believed to be lost in lung cancer development. Construction of a YAC contig map indicates that the deletion spans around 8 Mb, but no large deletion was apparent on conventional cytogenetic analysis of the cell line. To investigate this paradox, whole chromosome, arm-specific, and regional paints have been used. This analysis has revealed that genetic loss has occurred by complex rearrangements of chromosomes 3, rather than simple interstitial deletion. These studies emphasize the power of molecular cytogenetics to disclose unsuspected tumor-specific translocations within the extremely complex karyotypes characteristic of solid tumors.

Identification of embryonic pancreatic genes using Xenopus DNA microarrays.

PubMed

Hayata, Tadayoshi; Blitz, Ira L; Iwata, Nahoko; Cho, Ken W Y

2009-06-01

The pancreas is both an exocrine and endocrine endodermal organ involved in digestion and glucose homeostasis. During embryogenesis, the anlagen of the pancreas arise from dorsal and ventral evaginations of the foregut that later fuse to form a single organ. To better understand the molecular genetics of early pancreas development, we sought to isolate markers that are uniquely expressed in this tissue. Microarray analysis was performed comparing dissected pancreatic buds, liver buds, and the stomach region of tadpole stage Xenopus embryos. A total of 912 genes were found to be differentially expressed between these organs during early stages of organogenesis. K-means clustering analysis predicted 120 of these genes to be specifically enriched in the pancreas. Of these, we report on the novel expression patterns of 24 genes. Our analyses implicate the involvement of previously unsuspected signaling pathways during early pancreas development. Developmental Dynamics 238:1455-1466, 2009. (c) 2009 Wiley-Liss, Inc.

Astrocytic modulation of sleep homeostasis and cognitive consequences of sleep loss.

PubMed

Halassa, Michael M; Florian, Cedrick; Fellin, Tommaso; Munoz, James R; Lee, So-Young; Abel, Ted; Haydon, Philip G; Frank, Marcos G

2009-01-29

Astrocytes modulate neuronal activity by releasing chemical transmitters via a process termed gliotransmission. The role of this process in the control of behavior is unknown. Since one outcome of SNARE-dependent gliotransmission is the regulation of extracellular adenosine and because adenosine promotes sleep, we genetically inhibited the release of gliotransmitters and asked if astrocytes play an unsuspected role in sleep regulation. Inhibiting gliotransmission attenuated the accumulation of sleep pressure, assessed by measuring the slow wave activity of the EEG during NREM sleep, and prevented cognitive deficits associated with sleep loss. Since the sleep-suppressing effects of the A1 receptor antagonist CPT were prevented following inhibition of gliotransmission and because intracerebroventricular delivery of CPT to wild-type mice mimicked the transgenic phenotype, we conclude that astrocytes modulate the accumulation of sleep pressure and its cognitive consequences through a pathway involving A1 receptors.

Systematically frameshifting by deletion of every 4th or 4th and 5th nucleotides during mitochondrial transcription: RNA self-hybridization regulates delRNA expression.

PubMed

Seligmann, Hervé

2016-01-01

In mitochondria, secondary structures punctuate post-transcriptional RNA processing. Recently described transcripts match the human mitogenome after systematic deletions of every 4th, respectively every 4th and 5th nucleotides, called delRNAs. Here I explore predicted stem-loop hairpin formation by delRNAs, and their associations with delRNA transcription and detected peptides matching their translation. Despite missing 25, respectively 40% of the nucleotides in the original sequence, del-transformed sequences form significantly more secondary structures than corresponding randomly shuffled sequences, indicating biological function, independently of, and in combination with, previously detected delRNA and thereof translated peptides. Self-hybridization decreases delRNA abundances, indicating downregulation. Systematic deletions of the human mitogenome reveal new, unsuspected coding and structural informations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Allergic reaction to latex: a risk factor for unsuspected anaphylaxis.

PubMed

Warpinski, J R; Folgert, J; Cohen, M; Bush, R K

1991-01-01

Allergic reactions to latex, including anaphylaxis may be a problem in certain individuals exposed to latex. Four atopic patients with symptoms of rhinitis, asthma, anaphylaxis, and/or urticaria upon contact with latex products were studied. The patients showed IgE binding to latex RAST disks ranging from 1.0 to 27.3 times the negative control. Latex products (gloves, balloons, and condoms) directly bound IgE from all four patients. Eluted proteins from the latex products inhibited IgE binding to commercial latex RAST disks. SDS-PAGE demonstrated multiple latex protein bands by Coomassie Blue staining between 14 and 66 kD. Immunoblotting showed specific IgE binding to latex proteins at 30 and 66 kD. These results indicate that latex-allergic patients have IgE directed against specific latex proteins. Allergy to latex can pose a substantial health risk to susceptible individuals.

Structure-Based Design of Inhibitors Targeting PrfA, the Master Virulence Regulator of Listeria monocytogenes.

PubMed

Kulén, Martina; Lindgren, Marie; Hansen, Sabine; Cairns, Andrew G; Grundström, Christin; Begum, Afshan; van der Lingen, Ingeborg; Brännström, Kristoffer; Hall, Michael; Sauer, Uwe H; Johansson, Jörgen; Sauer-Eriksson, A Elisabeth; Almqvist, Fredrik

2018-05-10

Listeria monocytogenes is a bacterial pathogen that controls much of its virulence through the transcriptional regulator PrfA. In this study, we describe structure-guided design and synthesis of a set of PrfA inhibitors based on ring-fused 2-pyridone heterocycles. Our most effective compound decreased virulence factor expression, reduced bacterial uptake into eukaryotic cells, and improved survival of chicken embryos infected with L. monocytogenes compared to previously identified compounds. Crystal structures identified an intraprotein "tunnel" as the main inhibitor binding site (A I ), where the compounds participate in an extensive hydrophobic network that restricts the protein's ability to form functional DNA-binding helix-turn-helix (HTH) motifs. Our studies also revealed a hitherto unsuspected structural plasticity of the HTH motif. In conclusion, we have designed 2-pyridone analogues that function as site-A I selective PrfA inhibitors with potent antivirulence properties.

Thin blue lines: product placement and the drama of pregnancy testing in British cinema and television.

PubMed

Olszynko-Gryn, Jesse

2017-09-01

This article uses the case of pregnancy testing in Britain to investigate the process whereby new and often controversial reproductive technologies are made visible and normalized in mainstream entertainment media. It shows how in the 1980s and 1990s the then nascent product placement industry was instrumental in embedding pregnancy testing in British cinema and television's dramatic productions. In this period, the pregnancy-test close-up became a conventional trope and the thin blue lines associated with Unilever's Clearblue rose to prominence in mainstream consumer culture. This article investigates the aestheticization of pregnancy testing and shows how increasingly visible public concerns about 'schoolgirl mums', abortion and the biological clock, dramatized on the big and small screen, propelled the commercial rise of Clearblue. It argues that the Clearblue close-up ambiguously concealed as much as it revealed; abstraction, ambiguity and flexibility were its keys to success.

The use of 99mTc-HYNIC-TOC and 18F-FDG PET/CT in the evaluation of duodenal neuroendocrine tumor with atypical and extensive metastasis responding dramatically to a single fraction of PRRT with 177Lu-DOTATATE.

PubMed

Basu, Sandip; Abhyankar, Amit

2014-12-01

This report describes a case of extensive diffuse bone marrow involvement with bilateral breast metastases from duodenal neuroendocrine tumor giving rise to a superscan-like appearance on somatostatin receptor-targeted (99m)Tc-hydrazinonicotinamide-TOC scintigraphy. The metastatic lesions demonstrated partial concordance with (18)F-FDG PET/CT findings, signifying varying tumor biology and heterogeneity among metastatic lesions in the same individual, as illustrated with a dual-tracer approach. There was a dramatic symptomatic and biochemical response and better health-related quality of life with a single fraction of peptide receptor radionuclide therapy with (177)Lu-DOTATATE, and radiologically there was stable disease at that point. © 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.