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Sample records for intensified case finding

  1. Intensified tuberculosis case finding amongst vulnerable communities in southern India.

    PubMed

    Reddy, K K; Ananthakrishnan, R; Jacob, A G; Das, M; Isaakidis, P; Kumar, A M V

    2015-12-21

    India mainly uses passive case finding to detect tuberculosis (TB) patients through the Revised National Tuberculosis Control Programme (RNTCP). An intensified case finding (ICF) intervention was conducted among vulnerable communities in two districts of Karnataka during July-December 2013; 658 sputum smear-positive TB cases were detected. The number of smear-positive cases detected increased by 8.8% relative to the pre-intervention period (July-December 2012) in intervention communities as compared to an 8.6% decrease in communities without the ICF intervention. ICF activities brought TB services closer to vulnerable communities, moderately increasing TB case detection rates.

  2. Implementing intensified tuberculosis case-finding among street-connected youth and young adults in Kenya

    PubMed Central

    Mercer, T.; Kimani, S.; Braitstein, P.; Buziba, N.; Carter, E. J.

    2016-01-01

    Background: Street-connected youth and young adults (SCY) suffer a myriad of health problems. In Kenya, SCY are at high risk for tuberculosis (TB) due to their congregate living situations. TB screening is not routinely implemented in SCY and there has been no published literature on the burden of TB in SCY in western Kenya. Program description: In 2011, the AMPATH TB Program, an experienced TB screening program, partnered with the Tumaini Center, a trusted street youth organization, to conduct intensified case finding (ICF) for pulmonary TB among SCY. Our program aimed to investigate the numbers of SCY who reported symptoms and those diagnosed with smear-positive pulmonary TB, and link SCY with TB to treatment. Results: Of 116 SCY who were screened, 114 (98%) had a positive questionnaire; 104 (90%) provided a spot sputum sample, 39 (34%) provided a morning sputum sample, and 111 (97%) reported cough of >2 weeks. One street youth tested smear-positive for TB and was treated through to cure. Conclusions: Implementing TB ICF is feasible in low-resource settings through unique collaborations between health care programs and community-based organizations. In addition to identifying smear-positive TB, our program uncovered a high burden of respiratory symptoms among SCY in Eldoret, Kenya. PMID:27358809

  3. Impact of intensified case-finding strategies on childhood TB case registration in Nepal.

    PubMed

    Joshi, B; Chinnakali, P; Shrestha, A; Das, M; Kumar, A M V; Pant, R; Lama, R; Sarraf, R R; Dumre, S P; Harries, A D

    2015-06-21

    Contexte : Sept districts d'intervention avec des stratégies intensifiées de recherche active des cas de tuberculose (TB) mis en œuvre par une organisation non gouvernementale et sept districts témoins gérés par le Programme National Tuberculose au Népal.Objectifs : Evaluer les différences en termes d'enregistrement des cas de TB de l'enfant et de taux d'enregistrement pour 100 000 population entre deux périodes (année 1 = mars 2012 à mars 2013 et année 2 = mars 2013 à mars 2014) dans les districts d'intervention et les districts témoins.Schéma : Revue de dossiers rétrospective grâce aux données recueillies en routine.Résultats : Les cas de TB de l'enfant ont augmenté de 271 à 360 entre l'année 1 et l'année 2 dans les districts d'intervention (le taux d'enregistrement est passé de 18,2 à 24,2/100 000) et de 97 à 113 dans les districts témoins (13,4 à 15,6/100 000) : les augmentations ont été significativement plus importantes dans les districts d'intervention par rapport aux districts témoins. Les augmentations ont également été plus importantes chez les enfants de 0 à 4 ans et chez ceux qui ont eu une TB pulmonaire à frottis négatif et extra-pulmonaire. Parmi diverses stratégies de recherche des cas, le dépistage des contacts familiaux, les services conjoints privés-publics et les camps de santé mobiles pour la TB ont été les plus performants.Conclusion : Un paquet de stratégies intensifiées de recherche des cas a été associé à une augmentation des enregistrements de cas de TB de l'enfant au Népal. Il faut également envisager des approches diagnostiques supplémentaires pour augmenter encore l'enregistrement des cas.

  4. Can Intensified Tuberculosis Case Finding Efforts at Nutrition Rehabilitation Centers Lead to Pediatric Case Detection in Bihar, India?

    PubMed Central

    Mishra, Bal Krishna; Moonan, Patrick K.; Nair, Sreenivas A.; Kumar, Ajay M. V.; Gandhi, Mohit P.; Mannan, Shamim

    2016-01-01

    Introduction Seven district-level Nutritional Rehabilitation Centres (NRCs) in Bihar, India provide clinical and nutritional care for children with severe acute malnutrition (SAM). Aim To assess whether intensified case finding (ICF) strategies at NRCs can lead to pediatric case detection among SAM children and link them to TB treatment under the Revised National Tuberculosis Control Programme (RNTCP). Materials and Methods A retrospective cohort study was conducted that included medical record reviews of SAM children registered for TB screening and RNTCP care during July–December 2012. Results Among 440 SAM children screened, 39 (8.8%) were diagnosed with TB. Among these, 34 (87%) initiated TB treatment and 18 (53%) were registered with the RNTCP. Of 16 children not registered under the RNTCP, nine (56%) weighed below six kilograms—the current weight requirement for receiving drugs under RNTCP. Conclusion ICF approaches are feasible at NRCs; however, screening for TB entails diagnostic challenges, especially among SAM children. However, only half of the children diagnosed with TB were treated by the RNTCP. More effort is needed to link this vulnerable population to TB services in addition to introducing child-friendly drug formulations for covering children weighing less than six kilograms. PMID:27066518

  5. Implementing intensified tuberculosis case-finding among street-connected youth and young adults in Kenya.

    PubMed

    Szkwarko, D; Mercer, T; Kimani, S; Braitstein, P; Buziba, N; Carter, E J

    2016-06-21

    Contexte : Les jeunes et les adultes vivant dans la rue (SCY) souffrent d'une myriade de problèmes de santé. Au Kenya, les SCY ont un risque élevé de tuberculose (TB) à cause de la promiscuité de leur habitat. Le dépistage de la TB n'est pas mis en œuvre en routine parmi les SCY et il n'y a eu aucune littérature publiée sur le poids de la TB chez les SCY de l'ouest du Kenya.Description du programme : En 2011, le programme TB AMPATH, un programme de dépistage de TB expérimenté, a établi un partenariat avec le Tumaini Center, une organisation fiable de jeunes de la rue, afin de réaliser une recherche de cas intensifiée (ICF) de la TB pulmonaire parmi les SCY. Notre programme a eu pour but de rechercher le nombre de SCY qui présentaient des symptômes et ceux qui ont eu un diagnostic de TB pulmonaire à frottis positif, et enfin de mettre en contact les SCY avec un site de traitement de la TB.Résultats : De 116 SCY qui ont été dépistés, 114 (98%) ont remis un questionnaire positif, 104 (90%) ont fourni un échantillon de crachats, 39 (34%) un échantillon matinal et 111 (97%) ont fait état d'une toux de >2 semaines. Un jeune de la rue a eu un frottis positif pour la TB et a été traité avec succès.Conclusions: La mise en œuvre de l'ICF de TB est faisable dans un contexte de faibles ressources à travers une unique collaboration entre les programmes de soins de santé et les organisations communautaires. En plus d'identifier la TB à frottis positif, notre programme a révélé un lourd fardeau de symptômes respiratoires parmi les SCY d'Eldoret, au Kenya.

  6. Yield of intensified tuberculosis case-finding activities using Xpert® MTB/RIF among risk groups in Nepal

    PubMed Central

    Baral, S.; Shrestha, P.; Puri, M.; Kandel, S.; Lamichanne, B.; Elsey, H.; Brouwer, M.; Goel, S.; Chinnakali, P.

    2016-01-01

    Setting: Twenty-two districts of Nepal, where intensified case-finding (ICF) activities for tuberculosis (TB) were implemented among risk groups under the TB REACH initiative in collaboration with the National TB Programme from July 2013 to November 2015. Objectives: To assess the yield of TB screening using an algorithm with smear microscopy followed by Xpert® MTB/RIF. Design: A descriptive study using routinely collected data. Results: Of 145 679 individuals screened, 28 574 (19.6%) had presumptive TB; 1239 (4.3%) of these were diagnosed with TB and 1195 (96%) were initiated on anti-tuberculosis treatment. The yield of screening was highest among people living with the human immunodeficiency virus (PLHIV) (6.1%), followed by household contacts (3.5%) and urban slum dwellers (0.5%). Among other risk groups, such as prisoners, factory workers, refugees and individuals with diabetes, the yield was less than 0.5%. The number needed to screen to diagnose an active TB case was 17 for PLHIV, 29 for household contacts and 197 for urban slum dwellers. Of 11 525 patients from ICF and the routine programme, 112 (1%) were diagnosed with multidrug-resistant TB. Conclusion: There was a substantial yield of TB cases among risk groups such as PLHIV and household contacts. Although the yield in urban slum dwellers was found to be moderate, some intervention should nonetheless be targeted because of the large population and poor access to care in this group. PMID:27358808

  7. Yield of intensified tuberculosis case-finding activities using Xpert(®) MTB/RIF among risk groups in Nepal.

    PubMed

    Khanal, S; Baral, S; Shrestha, P; Puri, M; Kandel, S; Lamichanne, B; Elsey, H; Brouwer, M; Goel, S; Chinnakali, P

    2016-06-21

    Contexte : Vingt-deux districts du Népal où des activités intensifiées de recherche des cas (ICF) de la tuberculose (TB) ont été mises en œuvre au sein de groupes à risque sous l'égide du projet TB REACH en collaboration avec le programme national TB entre juillet 2013 et novembre 2015.Objectifs : Evaluer le rendement du dépistage de la TB grâce à un algorithme basé sur la microscopie de frottis suivie d'un test Xpert(®) MTB/RIF.Schéma : Etude descriptive basée sur des données recueillies en routine.Résultats : Sur un total de 145 679 individus dépistés, 28 574 (19,6%) ont été présumés atteints de TB ; 1239 (4,3%) d'entre eux ont eu une confirmation du diagnostic de TB ; parmi ces derniers, 1195 (96%) ont mis en route un traitement anti-tuberculose. Le rendement a été le plus élevé parmi les personnes vivant avec le virus l'immunodéficience humaine (PVVIH) (6,1%) suivies par les contacts domiciliaires (3,5%) et les habitants des bidonvilles (0,5%). Dans d'autres groupes à risque comme les prisonniers, les travailleurs d'usine, les réfugiés et les diabétiques, le rendement a été inférieur à 0,5%. Le nombre de personnes à dépister (NNS) pour diagnostiquer un cas de TB active a été de 17 pour les PVVIH, de 29 pour les contacts domiciliaires et de 197 pour les habitants des bidonvilles urbains. Sur 11 525 patients émanant soit du programme ICF soit du dépistage de routine, 112 (1%) ont eu un diagnostic de TB multirésistante.Conclusion : Le rendement en termes de cas de TB dépistés parmi les groupes à risque comme les PVVIH et les contacts domiciliaires a été substantiel. Même si ce rendement a été modeste parmi les habitants des bidonvilles, ceux-ci justifient néanmoins une intervention en raison de leur nombre élevé et de leur médiocre accès aux soins.

  8. Reinforcing element and demand sensitive pressure intensifier for sealing a well casing

    SciTech Connect

    Wambaugh, J. O.

    1985-10-08

    A reinforcing element for an elastomeric sealing element for use within a well casing and passable through production tubing is formed of two metallic plate members having a plurality of radially extending projections, and the radially extending projections are bent and joined to one another to allow the reinforcing element to be passed through production tubing. A demand sensitive pressure intensifier for use with a hydraulic fluid pump and passable through production tubing has a means for compressing hydraulic fluid to a pressure which exceeds the maximum output pressure of the pump, and the compression means is selectively actuated when the output pressure of the pump reaches a predetermined pressure value.

  9. Demography and findings of reported rape cases.

    PubMed

    Quader, M M; Rahman, M H; Kamal, M; Ahmed, A U; Saha, S K

    2010-01-01

    Six hundred and ninety nine cases of alleged rape were studied by the authors during the period from 2007-2008 at the Mymensingh Medical College, Mymensingh. Of these cases, 122 had positive findings of recent sexual intercourse; 250 cases had the positive findings of habituated sexual intercourse, and 327 cases had no findings of sexual intercourse but they complained of forcible sexual intercourse and found no sign of sexual intercourse. Most of the alleged victims of rape were nulliparous 87.12% and parous was only 12.87%. 430 (61.51%) cases of reported victims who were students of schools and colleges were not considered as rape cases considering their victim's history of love affairs, leaving home secretly with their lovers, living with them for many days. Gang rape was not so common (4.29% of raped cases) in our study. Age groups, their occupations, living areas, time of arrival for medico-legal examination have been studied. Most of the cases were students (61.51%). A few numbers of victims were subjected to gang rape. Examination and reporting the cases have been discussed.

  10. New psychopathologic findings in AIDS: case report.

    PubMed

    Kermani, E J; Borod, J C; Brown, P H; Tunnell, G

    1985-06-01

    A 33-year-old male homosexual AIDS patient was initially admitted to a psychiatric hospital for treatment of a manic episode. Over a 2-month hospitalization, the patient developed progressively severe memory and cognitive impairments which were documented by neuropsychologic testing and were consistent with abnormal EEG and CT scan findings. This case illustrates that major psychiatric symptoms can be profoundly involved early in the natural course of AIDS. PMID:3997789

  11. Value of intensified nursing

    PubMed Central

    Frank, Wilhelm; Konta, Brigitte; Prusa, Nina; Raymann, Cornelia

    2006-01-01

    The concept "intensified nursing" is mentioned in differentiation to concepts of "nursing care" or "nursing" which intensifies resources or patient contact. Especially psychic and social needs of patients are very appreciated in nursing. A similar type of nursing is known under the concept "advanced nursing practice" (ANP) which means, that a specialised, academically trained nurse offers an extended nursing care in which a focus on the published knowledge of evidence based research is made. From the thin literature to this topic a selection of predetermined topics was analysed where at least two articles with a sufficient high methodical quality were available. The selected topic groups were: „Infant and paediatric nursing", "gerontology" and "oncology". Generally the five publications concerning infant and paediatric nursing could conclusive show a benefit of intensified nursing. Further research is still needed to prove intensified nursing care. Two publications could be found to the gerontological intensified nursing; both used an extended nursing model and an enlarged use of resources. Both studies demonstrated a measurable success in the applied parameters. Two studies also could be analysed in the oncological field in which successes were also provable by the applied parameters. The success was given especially in a higher patient satisfaction, one study showed an improved scheduling (time planning) of nurses. There was not one article concerning economic questions of intensified nursing care. It has to be taken into account that the financial resources have to be used effectively also in nursing nowadays. It has to be assumed that the costs are driven by increased use of resources. Savings can be achieved, however, in the form of avoided therapies and days in hospital by intensified nursing. The intensified nursing can be considered as similar cost-effective as conventional models of nursing. Ethically it is necessary to consider that the possibilities of

  12. Tuberculosis case-finding in Eastern Nepal.

    PubMed

    Cassels, A; Heineman, E; LeClerq, S; Gurung, P K; Rahut, C B

    1982-09-01

    Two methods of case-finding used in Eastern Nepal have been compared. The differences in terms of outcome and patient compliance in one district have been examined in detail and compared with results in 4 other neighbouring districts. The 2 methods compared were active case-finding (ACF) carried out by mobile teams and self referral (SR) of patients to the existing services. The results can be summarised thus: 1 In a district with established tuberculosis services an active case-finding campaign revealed patients that had not presented for treatment of their own accord. 2 These patients tended to be older than self-referred patients and there was a higher proportion of women. 3 ACF patients defaulted from treatment more than SR patients and older women were more likely to default than older men. 4 Proximity to a health facility or treatment at a health post (HP) did not decrease the proportion defaulting in the ACF group but both these factors positively influenced the default rate in SR patients. 5 Over 90% of ACF patients had their first period of default within 6 months of starting treatment and if they returned they were more likely than SR patients to default again. 6 The number of ACF patients completing 1 year's treatment with sputum conversion was significantly lower than SR patients in this and 3 other districts. 7 In a district where no separate tuberculosis services existed the cure rate among ACF patients was significantly lower than in 4 districts where separate services had been established.

  13. Radiographic intensifying screen

    SciTech Connect

    Ochiai, T.

    1985-02-26

    A radiographic intensifying screen comprising a substrate and a fluorescent layer provided thereon and consisting essentially of a binder and a radioluminescent phosphor dispersed therein. The binder comprises linear polyester resin or linear polyester resin crosslinked with a crosslinking agent. The screen exhibits improved physical properties.

  14. Neutron-image intensifier

    NASA Technical Reports Server (NTRS)

    Berger, H.

    1970-01-01

    Electronic intensifier tube with a demagnification ratio of 9-1 enhances the usefulness of neutron-radiographic techniques. A television signal can be obtained by optical coupling of a small-output phosphor-light image to a television camera.

  15. DQE of image-intensifier-CCD fluoroscopic systems: a nonseparable case of the spatial-temporal approach

    NASA Astrophysics Data System (ADS)

    Kaltschmidt, Rainer G.; Baetz, Lothar; Ludwig, Markus

    2002-05-01

    In a real fluoroscopic system experimental evaluations of the DQE may pretty soon run into difficulties. Easy as it might be to satisfy the need for linearity by means of correction look-up tables, the evaluation of the NPS is more tricky, because of various time integration mechanisms. In order to deal with such effects in a quantitatively correct manner the concept of a spatial-temporal1 DQE has been suggested. We have performed computer-aided DQE-evaluations 2,4,5 on a surgical C-arm, using MTF and NPS. Furthermore, we have attempted to estimate the time behavior of the spatial-temporal system transfer function. Using X-ray pulses in the ms regime, we have generated nearly 'lag-free' flat-field images. Our experiments showed two interesting results. The comparison of flat-field images in the continuous 'Fluoro' mode and the 'lag-free' mode revealed the theoretically expected highly overestimated DQE in the first case. The corresponding scaling factor could be derived quantitatively from the motion experiments with an X-ray contrast pulse (Cu-rod). More worth while noticing is the fact that we observed structural anomalies in the two-dimensional NPS that could not compensated for by a simple scaling factor but vanished only in the 'lag-free' mode. This can be explained theoretically by taking into account a mixing behavior between the spatial and temporal NPS components, i.e. the failure of the spatial-temporal separability of the system transfer function.

  16. Cytogenetics findings in a histiocytic sarcoma case.

    PubMed

    Alonso-Dominguez, J M; Calbacho, M; Talavera, M; Villalon, C; Abalo, L; Garcia-Gutierrez, J V; Lozano, S; Tenorio, M; Villarrubia, J; Lopez-Jimenez, J; Ferro, M T

    2012-01-01

    Histiocytic sarcoma (HS) is a neoplasm derived from histiocytes. Its diagnosis was not clear until its immunohistochemistry profile was correctly established. Not much is known about its genetic properties. We report a case of a 48-year-old male patient whose bone marrow was almost completely occupied by monomorphic medium size neoplastic cellularity. Its immunohistochemical profile was CD68(+), CD4(+), CD45(+) with negativity of other dendritic cells, and other lineage markers. Cytogenetic study showed 4 related clones: one with trisomy 8 and extra material on the short arms of chromosome 4; a second line with tetrasomy of chromosome 8, add(4)(p16); the third clone had the same alterations as the previous and deletion of chromosome 3 at q11; the fourth line had tetrasomy 8 and translocation t(3;5)(q25;q35). To our knowledge this is the first HS case showing chromosome 8 trisomy and tetrasomy and the other described alterations. PMID:22937328

  17. Ultrasonographic findings in a cow with abomasal lymphosarcoma: Case report

    PubMed Central

    2011-01-01

    Background This case report describes the clinical and ultrasonographic findings in a Swiss Braunvieh cow with lymphosarcoma of the abomasum. Case Presentation The main clinical findings were vomiting in response to eating and melena. The results of serum biochemistry and rumen fluid analysis were indicative of abomasal reflux syndrome. The main ultrasonographic findings were two enlarged lymph nodes caudal to the reticulum and a severely enlarged abomasum with thickening of the abomasal wall and folds. Based on all the findings, pyloric stenosis caused by lymphosarcoma was tentatively diagnosed and later confirmed at postmortem examination. Conclusions This is an interesting case, which broadens the spectrum of abomasal reflux syndrome. PMID:21612590

  18. Active case finding of tuberculosis: historical perspective and future prospects

    PubMed Central

    Golub, J. E.; Mohan, C. I.; Comstock, G. W.; Chaisson, R. E.

    2015-01-01

    SUMMARY Despite a history of remarkable scientific achievements in microbiology and therapeutics, tuberculosis (TB) continues to pose an extraordinary threat to human health. Case finding and treatment of TB disease are the principal means of controlling transmission and reducing incidence. This review presents a historical perspective of active case finding (ACF) of TB, detailing case detection strategies that have been used over the last century. This review is divided into the following sections: mass radiography, house-to-house surveys, out-patient case detection, enhanced case finding, high-risk populations and cost-effectiveness. The report concludes with a discussion and recommendations for future case finding strategies. Understanding the strengths and weaknesses of these methods will help inform and shape ACF as a TB control policy in the twenty-first century. PMID:16333924

  19. Hypertension Case-Finding in a Rural Family Practice Clinic

    PubMed Central

    Lindberg, Alexandra

    1992-01-01

    The effectiveness of the hypertension case-finding program in place at the Port McNeill medical clinic was evaluated by comparing rates of blood pressure notation and case-finding for hypertension with those of a clinic with purely opportunistic screening. The program was very effective at ensuring a blood pressure reading was noted on all charts and showed an increased rate of hypertension case-finding for young men (aged 18 to 49) and women (aged 18 to 34). PMID:21221256

  20. Third-generation image intensifier

    NASA Astrophysics Data System (ADS)

    Roaux, E.; Richard, J. C.; Piaget, C.

    The general design and performance characteristics of third-generation image intensifiers are discussed. The third-generation image intensifier is a double proximity image tube with a GaAs photocathode, this photocathode being the principal difference between second- and third-generation tubes. Depending on weather conditions, night illumination, and target reflectivities, the third-generation image intensifier provides an average improvement in the range of detection of a factor of 1.5-3 (for L equal to or less than 0.001 lux).

  1. The Educational System in Japan: Case Study Findings.

    ERIC Educational Resources Information Center

    Stevenson, Harold; Lee, Shin-Ying; Nerison-Low, Roberta

    This document summarizes the findings of a year-long study that used case studies of specific schools in Japan to collect qualitative data on the Japanese educational experience. From 1994-95 the Case Study Project (a component of the Third International Mathematics and Science Study) collected information from interviews with students, parents,…

  2. School-Based Asthma Case Finding: The Arkansas Experience

    ERIC Educational Resources Information Center

    Vargas, Perla A.; Magee, James S.; Bushmiaer, Margo; Simpson, Pippa M.; Jones, Craig A.; Feild, Charles R.; Jones, Stacie M.

    2006-01-01

    This population-based case-finding study sought to determine asthma prevalence and characterize disease severity and burden among school-aged children in the Little Rock School District. Asthma cases were identified by validated algorithm and parental report of asthma diagnosis. The overall response rate was low. Among schools with greater than…

  3. Computed Tomographic Findings of Syphilitic Aortitis: A Case Report

    SciTech Connect

    Kimura, Fumiko; Satoh, Hideyuki; Sakai, Fumikazu; Nishii, Noriko; Tohda, Joe; Fujimura, Mikihiko; Haruta, Shoji; Yamazaki, Kenji; Endo, Masahiro; Sakomura, Yasunari; Kurosama, Hiromi; Kasanuki, Hiroshi

    2004-03-15

    We describe the computerized tomographic (CT) findings of the aortic wall in a case of acute-phase syphilitic arteritis. The delayed phase of the contrast-enhanced CT shows a double-ring configuration of the thick thoracic aortic wall, which is similar to CT findings previously reported for Takayasu arteritis. We speculate that the resemblance of the CT findings for these two diseases accounts for their similar histopathological features.

  4. Clinicopathological Findings of Suicide in the Elderly: Three Cases

    ERIC Educational Resources Information Center

    Peisah, Carmelle; Snowdon, John; Kril, Jillian; Rodriguez, Michael

    2007-01-01

    The neuropathological correlates of suicide in older persons have received little research attention. Our recent study of elderly suicide victims from an Australian forensic medicine department (n = 143), unlike a previous case-control study, did not find an increased prevalence of Alzheimer's disease (AD) in older persons who committed suicide…

  5. Using Death Certificate Reports to Find Severe Leptospirosis Cases, Brazil

    PubMed Central

    Spichler, Anne; Athanazio, Daniel; Buzzar, Marcia; Castro, Bronislawa; Chapolla, Erica; Seguro, Antonio

    2007-01-01

    Severe leptospirosis with pulmonary hemorrhage is emerging globally. Measures to control leptospirosis through sanitation depend on accurate case finding and reporting. Rapid death certificate reporting, plus necropsy of persons who died of leptospirosis, facilitates public health intervention and could provide an important tool in assessing the global burden of leptospirosis. PMID:18258007

  6. Human water consumption intensifies hydrological drought worldwide

    NASA Astrophysics Data System (ADS)

    Wada, Yoshihide; van Beek, Ludovicus P. H.; Wanders, Niko; Bierkens, Marc F. P.

    2013-09-01

    Over the past 50 years, human water use has more than doubled and affected streamflow over various regions of the world. However, it remains unclear to what degree human water consumption intensifies hydrological drought (the occurrence of anomalously low streamflow). Here, we quantify over the period 1960-2010 the impact of human water consumption on the intensity and frequency of hydrological drought worldwide. The results show that human water consumption substantially reduced local and downstream streamflow over Europe, North America and Asia, and subsequently intensified the magnitude of hydrological droughts by 10-500%, occurring during nation- and continent-wide drought events. Also, human water consumption alone increased global drought frequency by 27 (±6)%. The intensification of drought frequency is most severe over Asia (35 ± 7%), but also substantial over North America (25 ± 6%) and Europe (20 ± 5%). Importantly, the severe drought conditions are driven primarily by human water consumption over many parts of these regions. Irrigation is responsible for the intensification of hydrological droughts over the western and central US, southern Europe and Asia, whereas the impact of industrial and households’ consumption on the intensification is considerably larger over the eastern US and western and central Europe. Our findings reveal that human water consumption is one of the more important mechanisms intensifying hydrological drought, and is likely to remain as a major factor affecting drought intensity and frequency in the coming decades.

  7. On the Subjectivity of Intensifiers

    ERIC Educational Resources Information Center

    Athanasiadou, Angeliki

    2007-01-01

    Intensification is a means of indexing the speakers' perspective. This paper attempts to show the semantic development of particular intensifiers following Langacker's framework of subjectivity. In this framework, the focus lies on the way the conceptualizer construes an event or a situation as an observer or as an experiencer with degrees of…

  8. Temporal bone findings in cases of salt water drowning.

    PubMed

    Kelemen, G

    1983-01-01

    The otologic literature contains no description of the histopathological features of temporal bones of persons who perished in drowning accidents. Three temporal bones from two fatal cases of drowning were studied in serial sections. Two temporal bones were from a man aged 31 years who collapsed after scuba diving and died three days later. One temporal bone was from a 32-year-old man, serving in the navy, who drove his car, probably accidentally, into the sea and drowned in it. Histopathological findings appeared to be similar in the two cases. Diffuse hemorrhage was evident throughout the middle ear and inner ear. The tympanic and round window membranes appeared to be intact although hemorrhage had occurred within the tissue layers of the membranes. This finding contrasts with observations of ruptured membranes by other investigators.

  9. A Case of Neurocutaneous Melanosis and Neuroimaging Findings

    PubMed Central

    Gocmen, Rahsan; Guler, Ezgi; Arslan, Elif Acar

    2015-01-01

    Neurocutaneous melanosis is a rare congenital disorder which presents with congenital cutaneous nevi and involvement of the central nervous system. We herein present a rare case of a 2-year-old girl who had central nervous system melanosis and giant congenital melanocytic nevi. Magnetic resonance imaging, especially precontrast T1 images play a crucial role in making the diagnosis combined with the skin findings of physical examination. PMID:25926927

  10. Nursing home case mix in Wisconsin. Findings and policy implications.

    PubMed

    Arling, G; Zimmerman, D; Updike, L

    1989-02-01

    Along with many other states, Wisconsin is considering a case mix approach to Medicaid nursing home reimbursement. To support this effort, a nursing home case mix model was developed from a representative sample of 410 Medicaid nursing home residents from 56 facilities in Wisconsin. The model classified residents into mutually exclusive groups that were homogeneous in their use of direct care resources, i.e., minutes of direct care time (weighted for nurse skill level) over a 7-day period. Groups were defined initially by intense, Special, or Routine nursing requirements. Within these nursing requirement categories, subgroups were formed by the presence/absence of behavioral problems and dependency in activities of daily living (ADL). Wisconsin's current Skilled/Intermediate Care (SNF/ICF) classification system was analyzed in light of the case mix model and found to be less effective in distinguishing residents by resource use. The case mix model accounted for 48% of the variance in resource use, whereas the SNF/ICF classification system explained 22%. Comparisons were drawn with nursing home case mix models in New York State (RUG-II) and Minnesota. Despite progress in the study of nursing home case mix and its application to reimbursement reform, methodologic and policy issues remain. These include the differing operational definitions for nursing requirements and ADL dependency, the inconsistency in findings concerning psychobehavioral problems, and the problem of promoting positive health and functional outcomes based on models that may be insensitive to change in resident conditions over time. PMID:2493112

  11. MRI Findings of Talocalcaneal Coalition: Two Case Reports

    PubMed Central

    Umul, Ayşe

    2015-01-01

    Introduction: Tarsal coalition is abnormal fusion of two or more tarsal bones and is a common cause of foot pain. There are osseous, cartilaginous and fibrous subtypes. Calcaneonavicular and talocalcaneal coalitions are more frequent. Radiography is the primary diagnostic tool, however CT and MRI are precious examinations for differential diagnosis of osseous /non-osseous coalitions separations. Furthermore, cross-sectional imaging methods indicate the extension and secondary degenerative joint changes. Case reports: The detection of bone marrow of edema in the articulation area is valuable for diagnosis Hereby, we present two cases, 24 years old female and 35 years old male, with the diagnosis of talocalcaneal coaliation. We also discuss MRI and radiographic findings. PMID:26483601

  12. Lateral cervical sinus: specific sonographic findings in two pediatric cases.

    PubMed

    Hosokawa, Takahiro; Yamada, Yoshitake; Sato, Yumiko; Tanami, Yutaka; Amano, Hizuru; Fujiogi, Michimasa; Kawashima, Hiroshi; Oguma, Eiji

    2015-10-01

    A lateral cervical sinus, also known as a second pharyngeal or branchial cleft fistula/sinus, occurs when the second pharyngeal arch fails to grow caudally over the third and fourth arches, leaving remnants of the second branchial clefts in contact with the surface of the neck via a narrow canal. This type of sinus is detected on the lateral aspect of the neck directly anterior to the sternocleidomastoid muscle. We report two pediatric cases with lateral cervical sinus, and pathognomonic sonographic findings to confirm the diagnosis. The first case involved a 3-month-old boy with a sinus on the lateral neck and occasional drainage from a cervical sinus opening. Sonography revealed that the sinus tract extended between the external and internal carotid arteries. In case two, a 1-month-old girl presented with a sinus on the lateral neck and signs of acute infection at the site of a pinpoint opening. Sonography revealed an oval-shaped cystic lesion and sinus tract extending between the external and internal carotid arteries. Sonography does not require radiation or sedation for children. The best choice for the first examination for lateral cervical sinus is sonography, rather than CT, MRI, or contrast fistulograms. PMID:26576989

  13. Increased Case Notification through Active Case Finding of Tuberculosis among Household and Neighbourhood Contacts in Cambodia

    PubMed Central

    Morishita, Fukushi; Eang, Mao Tan; Nishikiori, Nobuyuki; Yadav, Rajendra-Prasad

    2016-01-01

    Background Globally, there has been growing evidence that suggests the effectiveness of active case finding (ACF) for tuberculosis (TB) in high-risk populations. However, the evidence is still insufficient as to whether ACF increases case notification beyond what is reported in the routine passive case finding (PCF). In Cambodia, National TB Control Programme has conducted nationwide ACF with Xpert MTB/RIF that retrospectively targeted household and neighbourhood contacts alongside routine PCF. This study aims to investigate the impact of ACF on case notifications during and after the intervention period. Methods Using a quasi-experimental cluster randomized design with intervention and control arms, we compared TB case notification during the one-year intervention period with historical baseline cases and trend-adjusted expected cases, and estimated additional cases notified during the intervention period (separately for Year 1 and Year 2 implementation). The proportion of change in case notification was compared between intervention and control districts for Year 1. The quarterly case notification data from all intervention districts were consolidated, aligning different implementation quarters, and separately analysed to explore the additionality. The effect of the intervention on the subsequent case notification during the post-intervention period was also assessed. Results In Year 1, as compared to expected cases, 1467 cases of all forms (18.5%) and 330 bacteriologically-confirmed cases (9.6%) were additionally notified in intervention districts, whereas case notification in control districts decreased by 2.4% and 2.3%, respectively. In Year 2, 2737 cases of all forms (44.3%) and 793 bacteriologically-confirmed cases (38%) were additionally notified as compared to expected cases. The proportions of increase in case notifications from baseline cases and expected cases to intervention period cases were consistently higher in intervention group than in control

  14. A case of trichotillomania with recently defined trichoscopic findings.

    PubMed

    Yorulmaz, Ahu; Artuz, Ferda; Erden, Orkun

    2014-04-01

    Trichotillomania (TTM) is an impulse control disorder characterized by repetitive behavior of hair pulling resulting in secondary alopecia. It is among the psychocutaneous diseases known to be associated with psychiatric comorbidity, social, and functional impairment. Although most of the time, an experienced dermatologist easily recognizes the key features of TTM, a history and physical examination alone might not be enough to make a definitive diagnosis. As an effective noninvasive technique for the evaluation of scalp and hair diseases, trichoscopy also has proven to be a valuable tool in the diagnosis of TTM. Currently, new trichoscopic findings of TTM have been described. Here, we report a case of TTM with recently defined trichoscopic features. PMID:25191044

  15. Unusual autopsy finding in a case of metastatic teratocarcinoma.

    PubMed

    Nath, Pramod; Bhattacharya, Shilajit; Bharadwaj, Reena

    2011-01-01

    An unusual autopsy finding was seen in a young case of metastatic teratocarcinoma of the right testis. The patient presented with features of myocardial ischemia and died of sudden cardiac arrest. At autopsy, the lungs were studded with variably sized metastatic nodules composed of glistening hyaline cartilage. Examination of the coronary arteries revealed complete occlusion of the left anterior descending and left circumflex artery lumina by tumor emboli composed of glistening white chondromyxoid material. Histopathology confirmed the presence of mature hyaline cartilage and chondromyxoid material in tumor emboli. The individual died due to severe coronary insufficiency and sudden cardiac arrest secondary to complete luminal occlusion of the left anterior descending and left circumflex artery lumina by tumor emboli composed of hyaline cartilage. PMID:21109467

  16. Intensified coastal development behind nourished beaches

    NASA Astrophysics Data System (ADS)

    Armstrong, Scott; Lazarus, Eli; Limber, Patrick; Goldstein, Evan; Thorpe, Curtis; Ballinger, Rhoda

    2016-04-01

    Population density, housing development, and property values in coastal counties along the U.S. Atlantic and Gulf Coasts continue to rise despite increasing hazard from storm impacts. Since the 1970s, beach nourishment, which involves importing sand to deliberately widen an eroding beach, has been the main strategy in the U.S. for protecting coastal properties from erosion and flooding hazards. Paradoxically, investment in hazard protection may intensify development. Here, we examine the housing stock of all existing shorefront single-family homes in Florida - a microcosm of U.S. coastal hazards and development - to quantitatively compare development in nourishing and non-nourishing towns. We find that nourishing towns now account for more than half of Florida's coastline, and that houses in nourishing towns are larger and more numerous. Even as the mean size of single-family homes nationwide has grown steadily since 1970, Florida's shorefront stock has exceeded the national average by 34%, and in nourishing towns by 45%. This emergent disparity between nourishing and non-nourishing towns in Florida demonstrates a pattern of intensifying coastal risk, and is likely representative of a dominant trend in coastal development more generally. These data lend empirical support to the hypothesis that US coastal development and hazard mitigation through beach nourishment have become dynamically coupled.

  17. Findings

    MedlinePlus

    ... Issue All Issues Explore Findings by Topic Cell Biology Cellular Structures, Functions, Processes, Imaging, Stress Response Chemistry ... Glycobiology, Synthesis, Natural Products, Chemical Reactions Computers in Biology Bioinformatics, Modeling, Systems Biology, Data Visualization Diseases Cancer, ...

  18. [A case of Plasmodium vivax malaria with findings of DIC].

    PubMed

    Takaki, K; Aoki, T; Akeda, H; Kajiwara, T; Honda, S; Maeda, Y; Okada, K; Sawae, Y

    1991-04-01

    We reported a rare case of Plasmodium vivax malaria who showed findings of disseminated intravascular coagulation (DIC). A 50-year-old Japanese male was sent to our hospital with the diagnosis of Plasmodium vivax malaria on the 26th of April, 1990. He had stayed in the Solomon Islands from Oct. 1987 to Dec. 1989, and had febrile episodes during his stay in the island. On April 18, 1990, he complained of a high fever with chills, and showed the same episodes on the 20th, 22th and was diagnosed as malaria. He was treated successfully with the sulfadoxine 500 mg and pyrimethamine 25mg (Fansidar), following the normal temperature on the 4th day and disappearance of malarial parasites in the peripheral blood smear on the 6th day. Interestingly, he had thrombocytopenia and a high titer serum level of fibrin degradation product (FDP) supporting the questionable diagnosis of DIC. Even on the 12th day after improved thrombocytopenia by treatment with Gabexate (FOY), the serum level of FDP, D-dimer and thrombin-nati-thrombin (TAT)III complex still remained at high titer levels. One month later he was readmitted for a relapse of Plasmodium vivax malaria, when he showed thrombocytopenia but the serum level of FDP, D-dimer, TAT III complex and PM.alpha 2 PI complex were normal levels. We concluded that the thrombocytopenia and the high titer of FDP at his first admission was a manifestation of DIC. PMID:2071964

  19. Case-finding for pulmonary tuberculosis in Penang.

    PubMed

    Hooi, L N

    1994-09-01

    The process of case-finding was studied in 100 consecutive patients with pulmonary tuberculosis treated by the Chest Clinic, Penang Hospital. The median time from the onset of the illness until the initial medical consultation was two weeks (patient's delay). This delay was longer in males, patients with lower than secondary education and drug abusers. Only 47% of patients were put on treatment with a correct diagnosis within one month of the first consultation (doctor's delay). Almost all patients had at least one symptom suggestive of tuberculosis at presentation and the mean number of consultations before diagnosis was three. Patients who first visited government medical facilities had shorter doctor's delay than those who first saw private practitioners, and patients who first consulted a private practitioner were the least likely to be appropriately investigated by sputum examination and chest radiography. The median total delay was three months and at the time of diagnosis, 95% of patients had moderate or far advanced disease radiologically. In order to shorten doctor's delay, all medical practitioners, especially those in the private sector, should be made aware of the importance of early diagnosis and the proper management of tuberculosis. Health education campaigns for the public should also be undertaken to shorten patient's delay.

  20. Drivers of Learning Cultures within Organisations: Findings from Case Studies.

    ERIC Educational Resources Information Center

    Johnston, Robyn; Hawke, Geof

    The factors driving learning cultures within organizations were examined in case studies of seven organizations in New South Wales and South Australia. The seven organizations represented the pharmaceutical manufacturing, community services and health, agriculture, information technology, and local government sectors. In some cases, organizations'…

  1. [Mandibular fractures in street accidents. Etiopathogenetic findings in 680 cases].

    PubMed

    Nardi, P; Montecchi, M

    1989-02-28

    The authors have studied 680 cases of mandibular fractures by traffic accident that have been observed during a 10 years period in the department of Maxillo-Facial Surgery of the Florence University. Some interesting results have been found: male are more often injured than female (about 70% of all cases) during their second and third decades of life. Among the means of transport authors have found that the motorcycles (motorbikes included) and cars are more often involved, both with an equal number of cases; but the motorcycles are to be considered more dangerous because they are around in a smaller number. PMID:2636166

  2. Sonographic Findings of Subcutaneous Sarcoidosis in 3 Cases.

    PubMed

    Tada, Saori; Watanabe, Tsuneo; Suzuki, Chigusa; Nohisa, Yuzuru; Shinoda, Koichi; Furuta, Nobuyuki; Ito, Hiroyasu; Okumura, Yoko; Shu, En; Seishima, Mariko

    2015-08-01

    Subcutaneous sarcoidosis occurs infrequently among cases of cutaneous sarcoidosis. To our knowledge, few studies have described the sonographic characteristics of subcutaneous sarcoidosis. Here we report the sonographic characteristics of 3 cases of this condition. Our results revealed 4 features: (1) an irregular hypoechoic appearance, (2) heterogeneous echogenicity, (3) perilesional hyperechoic changes, and (4) abnormal Doppler signals. Sonography is a rapid, simple, and noninvasive procedure that is useful for initial evaluation of granulomatous lesions such as subcutaneous sarcoidosis.

  3. Hypothermia secondary to glioblastoma multiforme? Autopsy findings in two cases.

    PubMed

    Morgan, Matthew; Schwartz, Liliana; Duflou, Johan

    2015-03-01

    Death due to accidental primary hypothermia in cold climates is relatively common, with previous case series reflecting this. In contrast, hypothermia-related death as a result of an underlying medical cause, such as a brain tumor, is rare. The literature clearly illustrates a theoretical causal relationship between brain neoplasms and hypothermia through the infiltration of the hypothalamus; however, the number of reported cases is minimal. Two cases are presented where autopsy confirmed hypothermia as the cause of death with both cases revealing widespread glioblastoma multiforme in the brain. Both decedents were elderly with a number of comorbidities identified during autopsy that could explain death; however, hypothermia was deemed the most likely cause. It is proposed that both decedents died of hypothermia as a result of the tumor's effect on thermoregulation. These cases underline the importance of forensic pathologists to be aware of the relationship between brain tumors and hypothermia and to not dismiss death as being due to other disease processes. PMID:25644717

  4. The placenta findings from an XYY abortus: a case report

    PubMed Central

    2013-01-01

    Introduction The placenta morphology from an XYY pregnancy abortus has not been reported in the medical literature. This case report consists of the first detailed documentation. The reported case is also highly unusual because the mother had two prior pregnancies with fetuses being confirmed to have Zellweger syndrome and one prior molar pregnancy. Case presentation A 43-year-old Caucasian woman presented for induction of labor secondary to diagnosis of XYY chromosomes by chorionic villus sample. Conclusions This is the first detailed observation of placenta morphology in an XYY abortus. Although not highly specific, the observation is very unique and should prompt further investigation of karyotyping of the fetus or infant because an XYY individual may be viable and grow to adulthood. The association of an XYY abortus and prior pregnancies with Zellweger syndrome and one prior molar pregnancy is also highly notable. PMID:24083480

  5. Cardiac beriberi: morphological findings in two fatal cases

    PubMed Central

    2011-01-01

    Cardiovascular beriberi is categorized into two main groups, according to its cause: alcoholic and non-alcoholic (dietary). Cardiovascular beriberi can also be divided into a fulminant form (Shoshin beriberi) and a chronic form. Shoshin beriberi is characterized by hypotension, tachycardia, and lactic acidosis and is mainly encountered in non-alcoholic patients in Asian countries, although it has also been seen in alcoholics in Western countries. Due to the complex clinical presentation and to the lack of diagnostic tests, thiamine deficiency is still being missed, especially among non-alcoholics patients. We present two fatal cases of non - alcohol associated cardiac beriberi. An acute myocardial infarction was observed in one case; extensive colliquative myocytolisis (grade 2) was described in the second case respectively. Morphologically, myocardial necrosis and colliquative myocytolysis are the histologic hallmarks of this acute, rare clinical entity. An increase in apoptotic myocytes was demonstrated probably sustaining the cardiogenic shock. PMID:21244717

  6. Operational life prediction on gating image intensifier

    NASA Astrophysics Data System (ADS)

    Dong, Yu-hui; Shen, Zhi-guo; Li, Zhong-li

    2009-07-01

    Operational life is one of the important parameters to evaluate second and super second generation image intensifiers. It can be used not only to monitor manufacturing technique in product line, then the technology on photocathode processing, MCP degassing and MCP producing can be adjusted promptly, but also to eliminate the image intensifiers which have hidden risk on operational life as early as possible. Recently gating image intensifiers are used widely, method to estimate the operational life of gating image intensifier related to its practical operate mode and working condition need to be established urgently. The least square method to analyze the operational life test data in product line was introduced in this paper. Now the data can be analyzed with convenient statistic analyze function on Excel. Using "worksheet function" and "chart wizard" and "data analysis" on Excel to do the least square method calculation, spreadsheets are established to do complex data calculation with worksheet functions. Based on them, formulas to monitor the technology parameters were derived, and the conclusion that the operational life was only related to the decrease slope of photocathode exponential fit curve was made. The decrease slope of photocathode sensitivity exponential fit curve and the decrease percent of the exponential fit photocathode sensitivity can be used to evaluate the qualification of the operational life rapidly. The mathematic models for operational life prediction on image intensifier and gating image intensifier are established respectively based on the acceptable values of the decrease percent of the exponential fit photocathode sensitivity and the expecting signal to noise ratio. The equations predicting the operational life related to duty cycle and input light level on gating image intensifier were derived, and the relationship between them were discussed too. The theory foundation were made herein, so the user can select proper gating image

  7. Monilethrix: a typical case report with microscopic and dermatoscopic findings.

    PubMed

    Oliveira, Elisa Fontenelle de; Araripe, Ana Luiza Cotta de Alencar

    2015-01-01

    Monilethrix is a rare hereditary condition generally considered to be an autosomal dominant disorder with variable penetrance. A case of a 6-year-old girl without a familial background for this disease is reported. The diagnosis was made by optic microscopy and dermoscopy. A therapeutic trial with topical minoxidil was conducted. PMID:25672313

  8. Monilethrix: a typical case report with microscopic and dermatoscopic findings*

    PubMed Central

    de Oliveira, Elisa Fontenelle; Araripe, Ana Luiza Cotta de Alencar

    2015-01-01

    Monilethrix is a rare hereditary condition generally considered to be an autosomal dominant disorder with variable penetrance. A case of a 6-year-old girl without a familial background for this disease is reported. The diagnosis was made by optic microscopy and dermoscopy. A therapeutic trial with topical minoxidil was conducted. PMID:25672313

  9. Microbial keratitis in Gujarat, Western India: findings from 200 cases

    PubMed Central

    Kumar, Anil; Pandya, Snehal; Kavathia, Ghanshyam; Antala, Sejul; Madan, Molly; Javdekar, Tanuja

    2011-01-01

    Introduction The objective of this study was to study the epidemiological characteristics and the microbiological profile of patients suspected with microbial keratitis in Gujarat. Methods Corneal scraping was collected from 200 consecutive cases of suspected microbial keratitis and was subjected to direct examination and culture. Results Of the 200 ulcers 55% were culture positive, 26.5% were bacterial ulcers of which 47% were due to Staphylococcus spp. Pure fungal growth was seen in 22% while 6% were mixed ulcers. Fusarium spp. (30%) was the most common fungus followed by Aspergillus spp. (21%). Only one case of Acanthamoeba keratitis was encountered. Patients were mainly from rural areas (61.5%) with male preponderance (61.5%). Corneal injury was seen in 78.5% cases of which 53% had injury with vegetative matter. Prior treatment was seen in 58% of which 5% had been treated by village healers. Nineteen patients (9.5%) also used some kind of traditional topical treatment. Increased incidence was seen from August to December. Five case of fugal ulcers lead to perforation of which three were due to Fusarium spp. whereas perforation was seen in only two cases of bacterial ulcers due to Pseudomonas aeruginosa. Conclusion Staphylococcus and Fusarium spp. were the most common etiological agents in our region. Predominant outdoor agricultural activity is the principal causative factor for corneal injury. Corneal ulcers complicated due to treatment by village healers are another important concern. The information regarding regional etiology will help empirical management as many eye clinics do not have microbiological facilities. PMID:22384294

  10. Facial features in Harlequin ichthyosis: Clinical findings about 4 cases.

    PubMed

    Kün-Darbois, J-D; Molin, A; Jeanne-Pasquier, C; Paré, A; Bénateau, H; Veyssière, A

    2016-02-01

    We report 4 cases of Harlequin ichthyosis, which is a rare and severe congenital ichthyosis involving the face. Facial appearance consists in severe ectropion, conjonctival edema, eclabium, flattened ears, broadened nose and large, thick, plate-like skin scales. Recent advances in neonatal care have been made, such as retinoid therapy, and have led to an increased survival rate. Early surgical correction of ectropion may be required because of ocular complications. PMID:26740202

  11. Herpes zoster granulomatous dermatitis: histopathologic findings in a case series.

    PubMed

    Ferenczi, Katalin; Rosenberg, Arlene S; McCalmont, Timothy H; Kwon, Eun Ji; Elenitsas, Rosalie; Somach, Stephen C

    2015-10-01

    Several types of cutaneous reactions have been reported to arise at the site of herpes zoster (HZ) infection weeks to years after the acute disease. Among these, granulomatous reactions are the most frequently reported. In this study, we describe the spectrum of histopathologic findings of HZ granulomatous reactions observed in 26 patients with cutaneous lesions confined to the area of previous HZ eruption and compare them with biopsy specimens taken from 25 patients with acute HZ. All patients with persistent reactions from whom history was available presented within 12 weeks of the onset of the acute eruption. The most frequent findings were interstitial granulomatous dermatitis with lymphocytes, histiocytes and multinucleated giant cells displaying elastophagocytosis and a perineural, perivascular and perieccrine mononuclear inflammatory infiltrate rich in lymphocytes and plasma cells. Less common features included intra-arrector and peri-arrector pili granulomas, follicular dilatation and hyperkeratosis, and vasculitis. Specimens from patients with acute HZ were found to have small numbers of perineural plasma cells and most had subtle granulomatous inflammation, in patterns similar to the group with late granulomatous reactions. Our findings suggest that granulomatous reactions to varicella zoster virus represent a persistent evolving inflammatory reaction after acute infection.

  12. Anterior Segment Findings in Vitamin A Deficiency: A Case Series.

    PubMed

    Rubino, Pierangela; Mora, Paolo; Ungaro, Nicola; Gandolfi, Stefano A; Orsoni, Jelka G

    2015-01-01

    Vitamin A deficiency is a rare but vision threatening disorder in the developed world, which can lead to blindness for severe keratomalacia with cornea scarring and perforation or night blindness due to impaired dark adaptation. Conversely, the disease is quite common in developing countries, as a consequence of chronic malnutrition. The correct diagnosis and therapy with prompt vitamin A supplementation avoid blindness. We report a series of 3 local cases with different age and causes for vitamin A deficiency. The diagnostic workup, therapy, and prognosis are discussed. PMID:26509090

  13. Case reports of oculofaciocardiodental syndrome with unusual dental findings.

    PubMed

    Oberoi, Snehlata; Winder, Alison E; Johnston, Jennifer; Vargervik, Karin; Slavotinek, Anne M

    2005-07-30

    We report on two new cases of oculofaciocardiodental (OFCD) syndrome characterized by cataracts, microphthalmia, facial anomalies, cleft palate, cardiac septal defects, and canine radiculomegaly. We also review previous patients. The syndrome is caused by mutations in the BCOR gene, which maps to Xp11.4. Mutational analysis in one of our patients showed a deletion of a single nucleotide, c.2613delC, predicting a novel frameshift mutation with a premature stop codon, p.F871Lfs8X. PMID:15957158

  14. Rapidly Intensifying Typhoon Examined By NASA's GPM

    NASA Video Gallery

    The GPM core observatory satellite flew above Nepartak on July 4 at 2151 UTC (5:51 p.m. EDT). GPM identified very tall thunderstorm towers near the center of the intensifying tropical storm. These ...

  15. Clinical Needs Finding: Developing the Virtual Experience, A Case Study

    PubMed Central

    Mittal, Vaishali; Thompson, Megan; Altman, Stuart M; Taylor, Peter; Summers, Alexander; Goodwin, Kelsey; Louie, Angelique Y

    2013-01-01

    We describe an innovative program at the University of California, Davis for students to engage in clinical needs finding. Using a team-based approach, students participated in clinical rotations to observe firsthand the needs of clinicians at the university affiliated medical center. The teams were asked to develop documentary-style videos to capture key experiences that would allow future viewers to use the videos as “virtual” clinical rotations. This was conceived as a strategy to allow students in prohibitively large classes, or students in programs at institutions without associated medical or veterinary school programs, to experience clinical rotations and perform needs assessments. The students' perspectives on the experience as well as instructor analysis of best practices for this type of activity are presented and discussed. We found that the internship experience was valuable to the students participating, by not only introducing the practice of needs finding but for increasing the students' confidence in the practice of engineering design and their ability to work independently. The videos produced were of such high quality that instructors from other institutions have requested copies for instructional use. Virtual clinical rotations through video experiences may provide a reasonable substitute for students who do not have the ability to participate in rotations in person. PMID:23483373

  16. Imaging findings of hepatosplenic schistosomiasis: a case report.

    PubMed

    Bilgin, Sabriye Sennur; Toprak, Huseyin; Seker, Mehmet

    2016-09-01

    In our study, in a 52-year-old man, specific and nonspecific findings of Schistosoma infestation were examined using ultrasonography, computed tomography, and magnetic resonance imaging. On computed tomography, capsular and septal calcifications and contrast enhancement of the liver capsule were seen. On T1-weighted magnetic resonance images diffuse hypointensity was seen in periportal spaces; on T2-weighted images in the same spaces, diffuse hyperintensity was seen. On dynamic contrast-enhanced T1-weighted images, in these same spaces marked contrast enhancement was manifested in the late venous phase. These signal changes indicate edema due to periportal fibrotic tissue inflammation and are accepted as pathognomonic for a liver infested by Schistosoma. PMID:27594939

  17. Radiological findings of retroperitoneal leiomyoma and leiomyosarcoma: report of two cases.

    PubMed

    Arakawa, A; Yasunaga, T; Yano, S; Morishita, K; Nakashima, K; Sato, R; Matsukawa, T; Yamashita, Y; Ishihara, A; Miyayama, H

    1993-01-01

    Radiologic findings in cases of retroperitoneal leiomyosarcoma and leiomyoma were reported. These cases showed very similar findings: irregularly marginated large masses with central cyst formation and no calcification on CT and ultrasonography. Angiography showed tumor vessels and tumor stains. Cystic region due to central necrosis or hemorrhage was the most prominent radiologic finding in these cases. However, it was difficult to distinguish leiomyosarcoma from leiomyoma on the basis of the radiologic findings alone.

  18. A case of Wilson's disease with characteristic laparoscopic findings.

    PubMed

    Muro, Shin-Ichiro; Yasunaka, Tetsuya; Wada, Nozomu; Morimoto, Yuki; Ikeda, Fusao; Shiraha, Hidenori; Takaki, Akinobu; Noso, Kazuhiro; Iwasaki, Hiroaki; Yamamoto, Kazuhide

    2014-04-01

    A 44-year-old male was pointed out liver function abnormality by medical check-up. Blood examination and computed tomography showed liver cirrhosis. Then, he was referred to our hospital for further examination. After blood test, viral markers revealed previous infection of hepatitis B virus (HBV). We estimated the etiology of his liver disease as previous HBV infection. On laparoscopic examination, his liver surface was nodular with mixed yellowish nodules and ash gray to copper-colored nodules in the diameter of 3-10 mm. There were large regenerative nodules in segments 3 and 4. Large regenerative nodules and irregular steatosis were contradictory to HBV-related liver cirrhosis, so then we supposed Wilson's disease. The amount of copper excretion in the urine was 326.6 μg (>100 μg/24 h). After D-penicillamine administration, urinary copper excretion increased to 2151.5 μg/24 h. Though hepatic copper concentration was 174.5 μg/g wet tissue (>200 μg/g wet tissue), his laboratory data fulfilled the Leipzig diagnostic criteria proposed by EASL. Laparoscopic examination with liver biopsy has advantages to survey many disease-specific findings on liver surface and to obtain adequate liver sample. Laparoscopic examination is one of the effective procedures for diagnosing relatively rare liver disease like Wilson's disease.

  19. CT and MRI findings in a case of pelvic schwannoma.

    PubMed

    Nasu, K; Arima, K; Yoshimatsu, J; Miyakawa, I

    1998-08-01

    We compared the diagnostic utility of computed tomography (CT) and magnetic resonance imaging (MRI) in a patient with a pelvic schwannoma. This 46-year-old woman was admitted for evaluation of a retroperitoneal pelvic mass and myoma uteri. The retroperitoneal pelvic mass had been detected by a CT scan at a routine health examination. A CT scan revealed a well-circumscribed cystic tumor (4 x 3 cm) at the right internal obturator muscle portion. The CT number of the inner part of the tumor was 21. Only the cyst wall was enhanced by injection of a contrast medium. MRI showed a 4 x 3 x 3-cm retroperitoneal cystic tumor that demonstrated low-intensity signals on T1-weighted images and high-intensity signals on T2-weighted images. Small areas of low intensity inside the tumor were observed on T2-weighted images. Histological examination revealed a typical schwannoma of mixed Antoni type A and type B. These findings indicate that both MRI and CT are useful for diagnosis of retroperitoneal schwannomas.

  20. 5 CFR 890.1037 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Suspension § 890.1037 Cases where additional fact-finding is not required. The suspending official may decide a contest without an additional fact-finding...

  1. 5 CFR 890.1039 - Cases where additional fact-finding is required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Cases where additional fact-finding is... Imposed Against Health Care Providers Suspension § 890.1039 Cases where additional fact-finding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request...

  2. 5 CFR 890.1037 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Suspension § 890.1037 Cases where additional fact-finding is not required. The suspending official may decide a contest without an additional fact-finding...

  3. 5 CFR 890.1039 - Cases where additional fact-finding is required.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cases where additional fact-finding is... Imposed Against Health Care Providers Suspension § 890.1039 Cases where additional fact-finding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request...

  4. A Classic Case of Subcutaneous Cysticercosis: A Rare Case with Sonological Findings and Review of Literature

    PubMed Central

    Naren Satya, Srinivas M.; Mayilvaganan, Kamala Retnam; Amogh, V.N.; Balakrishna, B.V.; Gautam, Munnangi Satya; Prathyusha, Ivvala Sai

    2016-01-01

    Summary Background Cysticercosis is a parasitic infection caused by the larval stages of the pork tapeworm, Taenia solium. The subcutaneous form of the disease is a relatively rare clinical entity. Despite its rarity, it is imperative for a radiologist to be aware of this subcutaneous form of the disease and its various radiological patterns while evaluating any subcutaneous swelling. In this paper, we aimed to describe a typical case of ‘subcutaneous cysticercosis involving the left anterior chest wall’ with high resolution ultrasound findings. We also discussed the role of other imaging modalities in a case of subcutaneous cysticercosis. To the best of our knowledge, our case is only the second documented case report of sonological evaluation of subcutaneous cysticercosis involving the left anterior chest wall and the first case with high resolution ultrasound images of the lesion. Case Report An 11-year-old male presented with a painless, subcutaneous swelling over the left anterior chest wall for the last 2 months. High resolution ultrasound showed a well-defined, thin-walled, cystic lesion with an eccentric, echogenic focus in the subcutaneous plane. On change of the posture of the patient, this focus showed mobility. The hypoechoic area surrounding this cyst showed significant exudative fluid collection with diffuse, floating echoes and thin, incomplete internal septations. The adjacent soft tissues were thickened and irregular, suggestive of edema. This was followed by an excision biopsy. Histopathological examination revealed cysticercus cellulose parasite with an extensive mixed inflammatory cell infiltrate in the surrounding tissue. The patient was also administered oral antihelminthic therapy. Repeat ultrasound examination at the end of this management regimen showed complete healing with no e/o any remnant or recurrent cystic lesion, abscess or edema in the subcutaneous plane. Conclusions Subcutaneous cysticercosis is a relatively rare form of

  5. Demountable readout technologies for optical image intensifiers

    NASA Astrophysics Data System (ADS)

    Lapington, J. S.; Howorth, J. R.; Milnes, J. S.

    2007-04-01

    We describe a generic microchannel plate intensifier design for use with a variety of demountable readout devices manufactured using standard multi-layer PCB techniques. We present results obtained using a 50 Ω multi-element design optimized for high speed operation and a four electrode multi-layer device developed from the wedge and strip anode with enhanced image resolution. The benefits of this intensifier design are discussed and a project to develop a detector system for bio-medical applications using a demountable readout device with integrated multi-channel ASIC-based electronics is announced.

  6. 5 CFR 890.1025 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1025 Cases where additional fact-finding is not required. In each contest, the debarring official shall determine whether a further...

  7. 5 CFR 890.1025 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1025 Cases where additional fact-finding is not required. In each contest, the debarring official shall determine whether a further...

  8. Impact of awareness drives and community-based active tuberculosis case finding in Odisha, India.

    PubMed

    Parija, D; Patra, T K; Kumar, A M V; Swain, B K; Satyanarayana, S; Sreenivas, A; Chadha, V K; Moonan, P K; Oeltmann, J E

    2014-09-01

    India's Revised National Tuberculosis Control programme employs passive case detection. The new sputum smear-positive case detection rate is less than 70% in Odisha State. During April-June 2012, active case finding (ACF) was conducted through awareness drives and field-based tuberculosis (TB) screening in select communities with the lowest case detection rates. During the campaign, 240 sputum smear-positive TB cases were detected. The number of smear-positive cases detected increased by 11% relative to April-June 2011 in intervention communities compared to an 0.8% increase in non-intervention communities. ACF brought TB services closer to the community and increased TB case detection.

  9. 5 CFR 890.1027 - Cases where an additional fact-finding proceeding is required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Cases where an additional fact-finding... fact-finding proceeding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request another OPM official (“presiding official”) to hold an additional...

  10. 5 CFR 890.1027 - Cases where an additional fact-finding proceeding is required.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cases where an additional fact-finding... fact-finding proceeding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request another OPM official (“presiding official”) to hold an additional...

  11. Naeglaeria infection of the central nervous system, CT scan findings: a case series.

    PubMed

    Naqi, Rohana; Azeemuddin, Muhammad

    2013-03-01

    The imaging findings in four cases of a rare infection of the central nervous system caused by amoebae, Naeglaeria fowleri are presented. Naeglaeria fowleri are pathogenic free-living amoebae. They cause primary amoebic meningoencephalitis (PAM), a rapidly fatal disease of the central nervous system. The computed tomography brain findings in 3 (75%) of our cases of pan amoebic meningoencephalitis showed non-specific brain oedema; 2 (66%) of these cases also had moderate hydrocephalus and among that 1 (50%) case showed an old lacunar infarction in peri-ventricular region. In the remaining 1 (25%) case the scan was normal with no evidence of oedema or abnormal lesion. Out of three cases with diffuse brain oedema, postcontrast images showed abnormal meningeal enhancement throughout the brain parenchyma in 1 (33%) case. However, no definite focal enhancing lesion was noted. In the rest of the cases, no abnormal parenchymal or meningeal enhancement was seen on post-contrast images. PMID:23914650

  12. Turning off the tap: stopping tuberculosis transmission through active case-finding and prompt effective treatment.

    PubMed

    Yuen, Courtney M; Amanullah, Farhana; Dharmadhikari, Ashwin; Nardell, Edward A; Seddon, James A; Vasilyeva, Irina; Zhao, Yanlin; Keshavjee, Salmaan; Becerra, Mercedes C

    2015-12-01

    To halt the global tuberculosis epidemic, transmission must be stopped to prevent new infections and new cases. Identification of individuals with tuberculosis and prompt initiation of effective treatment to rapidly render them non-infectious is crucial to this task. However, in settings of high tuberculosis burden, active case-finding is often not implemented, resulting in long delays in diagnosis and treatment. A range of strategies to find cases and ensure prompt and correct treatment have been shown to be effective in high tuberculosis-burden settings. The population-level effect of targeted active case-finding on reducing tuberculosis incidence has been shown by studies and projected by mathematical modelling. The inclusion of targeted active case-finding in a comprehensive epidemic-control strategy for tuberculosis should contribute substantially to a decrease in tuberculosis incidence. PMID:26515675

  13. Perimesencephalic subarachnoid hemorrhage with a positive angiographic finding: case report and review of the literature.

    PubMed

    Hafez, Ahmad; Numminen, Jussi; Rahul, Raj; Järveläinen, Juha; Niemelä, Mika

    2016-06-01

    The vast majority of perimesencephalic subarachnoid hemorrhage cases are reported as negative-finding etiologies. Recently, high-resolution images allowed us to overcome the previous difficulty of finding the source of bleeding, which underlies the concept of a "negative finding". We discovered a venous etiology, hidden behind the tip of the basilar artery; namely, the lateral pontine vein. Here, we review the literature on perimesencephalic subarachnoid hemorrhage and on venous aneurysm. We highlight this type of aneurysm as a candidate source of perimesencephalic hemorrhage. This case may change our way of dealing with what we have termed a negative finding of subarachnoid hemorrhage. PMID:27106848

  14. Cytomorphologic findings of intraosseous notochordal rest on touch preparation: a case report.

    PubMed

    Bovbel, Alexandra; Zaheer, Atif; Maleki, Zahra

    2015-03-01

    Intraosseous notochordal rest is a rare intravertebral lesion of notochord origin which is presumably benign. It is usually an incidental finding in microscopic examination of vertebrectomy due to unrelated lesions or autopsy cases. Chordoma is a malignant neoplasm originating from notochord with a different clinicoradiographic presentation, prognosis, and treatment. However, the histology of intraosseous notochordal rest and chordoma is almost identical. Herein, we report cytomorphologic findings of a case of intraossous notochordal rest on touch preparation.

  15. Systemic Shifts in Instructional Technology: Findings of a Comparative Case Study of Two University Mathematics Departments

    ERIC Educational Resources Information Center

    Jarvis, Daniel H.; Lavicza, Zsolt; Buteau, Chantal

    2014-01-01

    This paper reports on the findings of an international case study in which researchers examined two mathematics departments (Canada/UK) in which the sustained use of technology was strategically established in a mathematics degree program. This case study forms part of a larger research initiative which involved an extensive literature review…

  16. Adenocarcinoma arising in colonic duplication cysts with calcification: CT findings of two cases.

    PubMed

    Inoue, Y; Nakamura, H

    1998-01-01

    We report the computed tomographic findings of mucinous adenocarcinoma with calcification arising from duplication cyst of the colon in two adult cases. In both cases, serum levels of carcinoembryonic antigen (CEA) were high. Differential diagnosis of intraperitoneal or retroperitoneal cystic tumors with mucinous density includes duplication cyst, and its malignant change should be considered when serum level of CEA is high.

  17. Students with Disabilities and Accountability Reform: Findings from the California Case Study

    ERIC Educational Resources Information Center

    Nagle, Katherine M.; McLaughlin, Margaret J.; Nolet, Victor; Malmgren, Kimber

    2007-01-01

    This paper is one of four individual case study reports presenting the qualitative findings from a five-year investigation of the impact of accountability reform on students with disabilities in four states, eight districts, and twenty schools. This case study report presents qualitative data collected over a four-year period--2001-2004--from…

  18. Students with Disabilities and Accountability Reform: Findings from the Maryland Case Study

    ERIC Educational Resources Information Center

    Nagle, Katherine M.; McLaughlin, Margaret J.; Nolet, Victor; Malmgren, Kimber

    2007-01-01

    This paper is one of four individual case study reports presenting the qualitative findings from a five-year investigation of the impact of accountability reform on students with disabilities in four states, eight districts, and twenty schools. This case study report presents qualitative data collected over a four-year period--2001-2004--from…

  19. Students with Disabilities and Accountability Reform: Findings from the New York Case Study

    ERIC Educational Resources Information Center

    Nagle, Katherine M.; McLaughlin, Margaret J.; Nolet, Victor; Malmgren, Kimber

    2007-01-01

    This document is one of four individual case study reports presenting the qualitative findings from a five-year investigation of the impact of accountability reform on students with disabilities in four states, eight districts, and twenty schools. This case study report presents qualitative data, collected over a two-year period--2001 and…

  20. Students with Disabilities and Accountability Reform: Findings from the Texas Case Study

    ERIC Educational Resources Information Center

    Nagle, Katherine M.; McLaughlin, Margaret J.; Nolet, Victor; Malmgren, Kimber

    2007-01-01

    This paper is one of four individual case study reports presenting the qualitative findings from a five-year investigation of the impact of accountability reform on students with disabilities in four states, eight districts, and twenty schools. This case study report presents qualitative data collected over a four-year period--2001-2004--from…

  1. A Transdisciplinary Approach to Training: Preliminary Research Findings Based on a Case Analysis

    ERIC Educational Resources Information Center

    Bimpitsos, Christos; Petridou, Eugenia

    2012-01-01

    Purpose: The purpose of this paper is to discuss the benefits, barriers and challenges of the transdisciplinary approach to training, and to present findings of a case analysis. Design/methodology/approach: The paper is based on the research findings of an experimental training program for Greek local government managers co-funded by the European…

  2. A Unique Incidental Finding in Two Young Dancers: A Case Series.

    PubMed

    Miller, Marshal N; Close, Jeremy D

    2015-01-01

    Dancers frequently present to the sports medicine clinic with a variety of lower extremity complaints ranging from acute and traumatic injuries to more chronic, overuse injuries. This case series depicts a similar and unique incidental radiographic finding found in 2 young dancers seen at the same sports medicine clinic. While the findings are likely benign and unrelated to both patients' initial presentation, the finding of acroosteolysis can be found in more serious systemic and genetic processes as well an early finding in repetitive trauma. PMID:26502417

  3. Intensified solid state sensor cameras: ICCD and IAPS

    NASA Astrophysics Data System (ADS)

    Schuhle, Udo

    We describe the general design of intensified charge coupled devices and intensified active pixel sensors: cameras using microchannel plate intensifiers in combination with imaging arrays, like CCDs or CMOS-APS sensors. Several design options are compared and the capabilities and shortcomings of these devices will be highlighted and discussed. We describe, in particular, the properties of the intensifiers, phosphor anodes, and coupling schemes. The coupling between the intensifier and the image sensor is a special technological step that adds to this type of camera a great amount of flexibility and design options.

  4. Feeling more together: group attention intensifies emotion.

    PubMed

    Shteynberg, Garriy; Hirsh, Jacob B; Apfelbaum, Evan P; Larsen, Jeff T; Galinsky, Adam D; Roese, Neal J

    2014-12-01

    The idea that group contexts can intensify emotions is centuries old. Yet, evidence that speaks to how, or if, emotions become more intense in groups remains elusive. Here we examine the novel possibility that group attention--the experience of simultaneous coattention with one's group members--increases emotional intensity relative to attending alone, coattending with strangers, or attending nonsimultaneously with one's group members. In Study 1, scary advertisements felt scarier under group attention. In Study 2, group attention intensified feelings of sadness to negative images, and feelings of happiness to positive images. In Study 3, group attention during a video depicting homelessness led to greater sadness that prompted larger donations to charities benefiting the homeless. In Studies 4 and 5, group attention increased the amount of cognitive resources allocated toward sad and amusing videos (as indexed by the percentage of thoughts referencing video content), leading to more sadness and happiness, respectively. In all, these effects could not be explained by differences in physiological arousal, emotional contagion, or vicarious emotional experience. Greater fear, gloom, and glee can thus result from group attention to scary, sad, and happy events, respectively. PMID:25151520

  5. Intensifying groundwater acidification at Birkenes, southern Norway

    NASA Astrophysics Data System (ADS)

    de Caritat, Patrice

    1995-08-01

    Groundwater chemical data from Birkenes, southern Norway, collected during the period October 1980 to November 1993, reveal intensifying acidification in the 1990s, as evidenced by decreases in pH, acid-neutralising capacity and alkalinity, and increases in hardness/alkalinity ratio, 'acidification', nitrate, non-marine sulphate (SO 4∗), non-marine hardness (Ca ∗ + Mg ∗) and dissolved aluminium. The whole monitoring period is characterised by slopes of four or more on a plot of (Ca ∗ + Mg ∗) vs. alkalinity. Owing to its proximity to the sea, the Birkenes catchment receives seasalt-influenced precipitation, which results in episodic, natural acidification of the groundwater via cation exchange of marine Na + with soil-bound H + and/or Al 3+. However, it is uncertain whether all of the recent groundwater acidification can be attributed to intensifying seasalt deposition alone: the steep slopes on the (Ca ∗ + Mg ∗) vs. alkalinity plot and the increase in groundwater SO 4∗ suggest that strong acids, of possible anthropogenic origin, may be involved. Additionally, seasalt deposition appears not to have increased during the 1990s: Cl - content in precipitation has not increased significantly and river water pH has not decreased significantly over the period 1990-1993. The suggestion is made that the observed intensification in groundwater acidification at Birkenes partly results from the exhaustion or weakening of an acid buffering system caused by soil acidification, under persisting, even if abating, anthropogenic acid loading.

  6. The significance of medico-legal findings for behavioural analysis in unsolved homicide cases.

    PubMed

    Schröer, Judith; Trautmann, Karin; Dern, Harald; Baurmann, Michael C; Püschel, Klaus

    2003-03-01

    In recent years, behavioural analysis in unsolved homicide cases is playing a more and more important role in the field of police work in Germany. The method of behavioural analysis was developed in the USA and first carried out in Germany at the end of the 80s by the Federal Criminal Police Office (BKA). Since 1998 each Federal State has set up behavioural analysis units. In Germany, behavioural analysis is defined as complex information processing system for the purpose of enabling an overall view of a case and of supporting the case work in ongoing investigations. The procedure of behavioural analysis is based on empirically and scientifically proven knowledge, on case information (e.g. crime scene characteristics, medico-legal findings) and on methods of combining the existing knowledge on statements relevant to the case. To assess the role of legal medicine in the process of behavioural analysis, a retrospective examination of more than 40 case analyses in unsolved homicide cases was performed. It turned out that medico-legal findings played a major role in the process of case analysis because the results were of central importance for the case reconstruction and further deductions (e.g. offender aims, organized/disorganized components, escalation). In a vast majority of cases though, the autopsy reports did not provide sufficiently detailed information, explanations and/or interpretations of injuries, wound patterns and sequence of events. Various examples are presented to elucidate the significance of medico-legal findings for the process of behavioural analysis. As a basic principle, the role of the forensic scientist as independent, unbiased, unprejudiced expert for the court should not be influenced by speculative interpretations within the process of behavioural analysis. This can be established by a very precise and comprehensive autopsy protocol on the one hand and - separately - an interpretation by another experienced specialist who works for the

  7. Solitary fibrous tumor of the pleura: ultrasonographic imaging findings of 3 cases.

    PubMed

    Sekiya, Mitsuaki; Yoshimi, Kaku; Muraki, Keiko; Suzuki, Kenji; Dambara, Takashi; Uekusa, Toshimasa; Takahashi, Kazuhisa

    2013-09-01

    Solitary fibrous tumor (SFT) of the pleura is a rare tumor of mesenchymal origin. Although radiographic findings of thoracic computed tomography and magnetic resonance imaging in the evaluation of SFTs of the pleura have been documented, the value of ultrasonography is uncertain. We presented the ultrasonographic findings of 3 pathologically proven cases of SFTs arising from the visceral pleura. In all the cases, thoracic ultrasonography demonstrated homogeneous, hypoechoic, hemicycle, extrapulmonary lesions, which showed respiratory movement with the adjacent lung, consistent with pedunculated tumors. Preoperative thoracic ultrasonography could be useful in the evaluation of patients with pleural tumors, especially SFTs.

  8. A Case of Bell’s Palsy with an Incidental Finding of a Cerebellopontine Angle Lipoma

    PubMed Central

    Choy, Winward; Lee, Seung J; Chung, Lawrance K; Bui, Timothy T; Yang, Isaac; Goldman, Howard W

    2016-01-01

    This case report illustrates the potential fallacy of attributing a patient’s symptoms to an incidental finding. Serial imaging of small, asymptomatic cerebellopontine angle (CPA) lipomas is favored. It is imperative to accurately diagnose CPA lipoma on imaging and differentiate it from more common CPA lesions. We herein present a patient with symptoms consistent with Bell’s palsy and an incidental finding of a CPA lipoma. Additionally, we performed a review of the literature for case reports of patients presenting with facial symptoms and diagnosed with a CPA lipoma. PMID:27733958

  9. Radiologist Agreement for Mammographic Recall by Case Difficulty and Finding Type

    PubMed Central

    Onega, Tracy; Smith, Megan; Miglioretti, Diana L.; Carney, Patricia A.; Geller, Berta; Kerlikowske, Karla; Buist, Diana SM; Rosenberg, Robert D.; Smith, Robert; Sickles, Edward A.; Haneuse, Sebastien; Anderson, Melissa L.; Yankaskas, Bonnie

    2012-01-01

    INTRODUCTIONS To assess agreement of mammography interpretations by community radiologists with consensus interpretations of an expert radiology panel, to inform approaches that improve mammography performance. METHODS From six mammography registries, 119 community-based radiologists were recruited to assess one of four randomly assigned test sets of 109 screening mammograms with comparison studies for no recall or recall, giving the most significant finding type [mass, calcifications, asymmetric density or architectural distortion] and location. The mean proportion of agreement with an expert radiology panel was calculated by cancer status, finding type, and difficulty level of identifying the finding at the woman, breast, and lesion level. We also examined concordance in finding type between study radiologists and the expert panel. For each finding type, we determined the proportion of unnecessary recalls, defined as study radiologist recalls that were not expert panel recalls. RESULTS Recall agreement was 100% for masses and for exams with obvious findings in both cancer and non-cancer cases. Among cancer cases, recall agreement was lower for lesions that were subtle (50%) or asymmetric (60%). Subtle non-cancer findings and benign calcifications showed 33% agreement for recall. Agreement for finding responsible for recall was low, especially for architectural distortions (43%) and asymmetric densities (40%). Most unnecessary recalls (51%) were asymmetric densities. CONCLUSION Agreement in mammography interpretation was low for asymmetric densities and architectural distortions. Training focused on these interpretations could improve mammography accuracy and reduce unnecessary recalls. PMID:23122345

  10. Perinatal Autopsy Findings in a Case of De Novo Hypohidrotic Ectodermal Dysplasia

    PubMed Central

    Chikkannaiah, Panduranga; Nagaraju, Smitha; Kangle, Rajit; Gosavi, Mansi

    2015-01-01

    Ectodermal dysplasia are group of inherited disorders involving the developmental defects of ectodermal structures like hair, teeth, nails, sweat glands, and others. X-linked recessive inheritance is most common. Here we describe perinatal autopsy findings in a case of de novo ectodermal dysplasia in a female fetus. To the best of our knowledge, this is the first fetal autopsy description in a case of ectodermal dysplasia. PMID:26417167

  11. Cost-Effectiveness Analysis of Community Active Case Finding and Household Contact Investigation for Tuberculosis Case Detection in Urban Africa

    PubMed Central

    Sekandi, Juliet N.; Dobbin, Kevin; Oloya, James; Okwera, Alphonse; Whalen, Christopher C.; Corso, Phaedra S.

    2015-01-01

    Introduction Case detection by passive case finding (PCF) strategy alone is inadequate for detecting all tuberculosis (TB) cases in high burden settings especially Sub-Saharan Africa. Alternative case detection strategies such as community Active Case Finding (ACF) and Household Contact Investigations (HCI) are effective but empirical evidence of their cost-effectiveness is sparse. The objective of this study was to determine whether adding ACF or HCI compared with standard PCF alone represent cost-effective alternative TB case detection strategies in urban Africa. Methods A static decision modeling framework was used to examine the costs and effectiveness of three TB case detection strategies: PCF alone, PCF+ACF, and PCF+HCI. Probability and cost estimates were obtained from National TB program data, primary studies conducted in Uganda, published literature and expert opinions. The analysis was performed from the societal and provider perspectives over a 1.5 year time-frame. The main effectiveness measure was the number of true TB cases detected and the outcome was incremental cost-effectiveness ratios (ICERs) expressed as cost in 2013 US$ per additional true TB case detected. Results Compared to PCF alone, the PCF+HCI strategy was cost-effective at US$443.62 per additional TB case detected. However, PCF+ACF was not cost-effective at US$1492.95 per additional TB case detected. Sensitivity analyses showed that PCF+ACF would be cost-effective if the prevalence of chronic cough in the population screened by ACF increased 10-fold from 4% to 40% and if the program costs for ACF were reduced by 50%. Conclusions Under our baseline assumptions, the addition of HCI to an existing PCF program presented a more cost-effective strategy than the addition of ACF in the context of an African city. Therefore, implementation of household contact investigations as a part of the recommended TB control strategy should be prioritized. PMID:25658592

  12. Renal Biopsy Findings in Patients with Hypothyroidism: Report of 16 cases

    PubMed Central

    Singh, Usha; Singh, Rajeev; Santosh, Deepa; Parkash, Jai; Singh, Rana Gopal; Singh, Shivendra

    2016-01-01

    Introduction Hypothyroidism is prevalent in India. Its association with renal diseases though not very common but have been described in many studies. Here we are reporting renal biopsy findings in 16 cases, all of whom were already diagnosed cases of hypothyroidism. Aim To study renal parenchymal diseases associated in patients with hypothyroidism. Materials and Methods Formalin fixed paraffin embedded sections of renal biopsy were examined after staining with H&E, PAS and Acid Fuschin Orange G (AFOG) stain. Serum urea/creatinine measurements done by semi-autoanalysers and urine analysis were done by using urine strips and light microscopy. Results In 16 cases, M:F ratio was 9:7. Duration of disease varied from 6 months to 14 years. Blood urea and serum creatinine were raised in 10 cases (62.5%) and nephrotic range proteinuria was present in 13 cases (81.25%). Two of the patients had co existing systemic lupus erythaematous. Renal pathology revealed membranous glomerulonephritis (GN) in both cases. In renal biopsy seven cases (43.75%) had pure Membranous Glomerulonephritis (MGN), 4 cases (25%) had mixture of Mesan-gial cell proliferation and membranous Glomerulonephritis(GN) also called MembranoProliferative GN (MPGN). Another four cases (25%) had Focal Segmental Glomerulosclerosis (FSGS) with chronic interstitial nephritis and one case was having minimal change disease. Conclusion Thus present study concludes that hypothyroidism can cause renal parenchymal disease like membranous GN, mesangiocapillary GN which is also called as membranoproliferative GN and FSGS. PMID:27656449

  13. A Putative Case of Methotrexate-Related Lymphoma: Clinical Course and PET/CT Findings

    PubMed Central

    Jankowitz, Rachel C.; Ganon, James; Blodgett, Todd; Garcia, Christine; Jacobs, Samuel

    2009-01-01

    Patients with autoimmune conditions develop lymphoproliferative disorders (LPDs) at a higher frequency than normal both in association with and independent of Methotrexate (MTX). We describe a case of MTX-associated lymphoma in a patient with psoriasis on long-standing MTX. The case is notable for the initial tumor burden, the dramatic disappearance of the PET-CT findings on discontinuation of MTX, and the subsequent early regrowth of disease. Our case report is illustrative of an MTX-related NHL in an autoimmune patient. Conclusion. Withdrawal of MTX in a patient with lymphoma is reasonable before initiating chemotherapy, but observation for early regrowth of disease is necessary. PMID:20069057

  14. 5 CFR 890.1037 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Cases where additional fact-finding is not required. 890.1037 Section 890.1037 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... professional licensure during the pendency of a disciplinary hearing, entering a guilty plea or confession...

  15. 5 CFR 890.1037 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Cases where additional fact-finding is not required. 890.1037 Section 890.1037 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... professional licensure during the pendency of a disciplinary hearing, entering a guilty plea or confession...

  16. 5 CFR 890.1025 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Cases where additional fact-finding is not required. 890.1025 Section 890.1025 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... pendency of a disciplinary hearing, entering a guilty plea or confession of judgment in a...

  17. 5 CFR 890.1037 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Cases where additional fact-finding is not required. 890.1037 Section 890.1037 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... professional licensure during the pendency of a disciplinary hearing, entering a guilty plea or confession...

  18. 5 CFR 890.1025 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Cases where additional fact-finding is not required. 890.1025 Section 890.1025 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... pendency of a disciplinary hearing, entering a guilty plea or confession of judgment in a...

  19. 5 CFR 890.1025 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Cases where additional fact-finding is not required. 890.1025 Section 890.1025 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... pendency of a disciplinary hearing, entering a guilty plea or confession of judgment in a...

  20. An unusual endoscopic finding: Trichuris trichiura. Case report and review of the literature.

    PubMed

    Lorenzetti, R; Campo, S M A; Stella, F; Hassan, C; Zullo, A; Morini, S

    2003-11-01

    Detection of Trichuris trichiura during colonoscopic examination is an unusual finding, at least in developed countries. We report a case of a coincidental endoscopic diagnosis of whipworm infestation performed in a patient referred to our open-access endoscopy even before a faecal examination for ova and/or parasites had been performed. Review of literature on colonoscopic diagnosis of T. trichuria is provided.

  1. CT findings associated with blastic plasmacytoid dendritic cell neoplasm: a case report

    PubMed Central

    Choi, Jung W; Jeong, Katherine; Sokol, Lubomir

    2016-01-01

    Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy that is frequently misdiagnosed. We present a case of a 53-year-old man diagnosed with blastic plasmacytoid dendritic cell neoplasm with extensive computed tomography (CT) findings and provide an imaging focused review of this uncommon malignancy. PMID:27504192

  2. Electrostatically focused intensified charge coupled devices

    NASA Technical Reports Server (NTRS)

    Walker, J. W.

    1977-01-01

    Work performed to develop intensified charge coupled devices (ICCDs) is presented. Four ICCDs, containing 100 x 160 arrays, were fabricated. Electron gains up to 3200 at 15 keV were achieved. Photocathode sensitivities ranged from 190 to 410 micro A/lumen. Dark currents varied from 11 nA/sq cm to 37 nA/sq cm. There was serious concern about the reliability of the bonding scheme for ICCDs due to occassional bond failure. Two solutions to this problem were developed. One involved a modification of the existing bonding technique, and the other was the development of a protected bond pad employing a barrier metal between the aluminum metallization and the gold bond wire. An accumulation process was characterized with respect to its most critical variable. This characterization led to the achievement of reproducible spectral response and the discovery and elimination of dark current increase associated with this process.

  3. Case finding for COPD in primary care: a qualitative study of the views of health professionals

    PubMed Central

    Haroon, Shamil; Jordan, Rachel E; Fitzmaurice, David A; Adab, Peymane

    2015-01-01

    Background Chronic obstructive pulmonary disease (COPD) is common but largely underdiagnosed. Case-finding initiatives have been evaluated in primary care, but few studies have explored the views of service providers on implementing them in practice. Aim To explore the views of primary health care providers on case finding for COPD. Methods A total of 20 semi-structured interviews were conducted from March 2014 to September 2014 among general practitioners, nurses, and managers from practices participating in a large COPD case-finding trial based in primary care in the West Midlands, UK. Participants’ views were sought to explore perceived benefits, harms, barriers, and facilitators to implementing COPD case finding in practice. Interviews were transcribed and analyzed using the framework method. Results Participants felt that case finding improves patient care but also acknowledged potential harms to providers (increase in workload) and to patients (overdiagnosis). Insufficient resources, poor knowledge of COPD, and limited access to diagnostic services were viewed as barriers to diagnosis, while provision of community respiratory services, including COPD specialist nurses, and support from secondary care were thought to be facilitators. Participants also expressed a need for more education on COPD for both patients and clinicians. Conclusion Care providers believe that early detection of COPD improves patient care but also has accompanying harms. Barriers to diagnosing COPD, such as insufficient expertise in primary care and limited access to diagnostic services in the community, should be explored and addressed. The knowledge and attitudes of the public about COPD and its symptoms should also be investigated to inform future education and awareness-raising strategies. PMID:26357469

  4. Audio Key Finding: Considerations in System Design and Case Studies on Chopin's 24 Preludes

    NASA Astrophysics Data System (ADS)

    Chuan, Ching-Hua; Chew, Elaine

    2006-12-01

    We systematically analyze audio key finding to determine factors important to system design, and the selection and evaluation of solutions. First, we present a basic system, fuzzy analysis spiral array center of effect generator algorithm, with three key determination policies: nearest-neighbor (NN), relative distance (RD), and average distance (AD). AD achieved a 79% accuracy rate in an evaluation on 410 classical pieces, more than 8% higher RD and NN. We show why audio key finding sometimes outperforms symbolic key finding. We next propose three extensions to the basic key finding system—the modified spiral array (mSA), fundamental frequency identification (F0), and post-weight balancing (PWB)—to improve performance, with evaluations using Chopin's Preludes (Romantic repertoire was the most challenging). F0 provided the greatest improvement in the first 8 seconds, while mSA gave the best performance after 8 seconds. Case studies examine when all systems were correct, or all incorrect.

  5. Multiple nodular lesions in spleen associated with visceral leishmaniasis: a case report of MRI-findings.

    PubMed

    Mao, Guoqun; Yang, Guangzhao; Cheng, Yougen; Zee, Chi S; Huang, Wenmin; Ni, Weiyang; Meng, Guanmin; Chen, Zhilu

    2014-12-01

    The spleen is one of the most commonly involved organs of visceral leishmaniasis (VL). However, there were few reports about imaging findings of splenic leishmaniasis, especially regarding MRI findings. This case report describes a 45 years old male patient from Zhejiang province of southeastern China, who was admitted for persistent fever of unknown origin, with splenomegaly and multiple hypodense/low echo nodules on CT/ultrasonography (USG) studies. MRI showed multiple nodules with concentric rings in the spleen on T2-weighted imaging (T2WI), with no obvious diffusion restriction on diffusion weighted imaging (DWI), and gradual ring-like enhancement after intravenous administration of contrast medium. So MRI suggested necrotic granulomatous lesion. By reviewing the clinical history and following positive serological leishmania antibody test, the patient was finally confirmed a recent infection with VL. The patient received antimony gluconate therapy intravenously. At 4 months follow-up, the contrast-enhanced abdominal MRI showed that the size of the spleen was returned to normal and the splenic lesions were completely resolved except for reduced infarction compared with the previous MRI. This is the first case which was performed MRI examination completely. Meanwhile, it is the second case which MRI findings were reported. As for the characteristics of MRI in this case, there are several features, which are helpful for giving the diagnosis and differential diagnosis of VL.

  6. Cobalamin (Cbl) C/D deficiency: clinical, neurophysiological and neuroradiologic findings in 14 cases.

    PubMed

    Biancheri, R; Cerone, R; Schiaffino, M C; Caruso, U; Veneselli, E; Perrone, M V; Rossi, A; Gatti, R

    2001-02-01

    The early onset type of cobalamin (Cbl) C/D deficiency is characterised by feeding difficulties, failure to thrive, hypotonia, seizures, microcephaly and developmental delay. It has an unfavourable outcome, often with early death and significant neurological impairment in survivors. While clinical and biochemical features of Cbl C/D deficiency are well known, only a few isolated case reports are available concerning neurophysiological and neuroimaging findings. We carried out clinical, biochemical, neurophysiological and neuroradiologic investigations in 14 cases with early-onset of the Cbl CID defect. Mental retardation was identified in most of the cases. A variable degree of supratentorial white matter atrophy was detected in 11 cases by MR imaging and tetraventricular hydrocephalus was present in the remaining 3 patients. Waking EEG showed a clear prevalence of epileptiform abnormalities, possibly related to the high incidence of seizures in these cases. Increased latency of evoked responses and/or prolongation of central conduction time were the most significant neurophysiological abnormalities. The selective white matter involvement, shown both by neuroradiologic and neurophysiological studies, seems to be the most consistent finding of Cbl C/D deficiency and may be related to a reduced supply of methyl groups, possibly caused by the dysfunction in the methyl-transfer pathway. PMID:11315197

  7. Clinical findings in children with congenital anomalies and misoprostol intrauterine exposure: a study of 38 cases

    PubMed Central

    Vendramini-Pittoli, Siulan; Guion-Almeida, Maria L.; Richieri-Costa, Antonio; Santos, Juliana M.; Kokitsu-Nakata, Nancy M.

    2013-01-01

    The authors describe the clinical findings of 38 children with congenital anomalies and misoprostol intrauterine exposure. This study included 38 cases, ascertained from case series of the Hospital of Rehabilitation of Craniofacial Anomalies from University of São Paulo, with evidence of intrauterine exposure to misoprostol in the first trimester of the pregnancy. Information about misoprostol intake and drug administration route was obtained through interviews with mothers. Clinical evaluation showed 18 individuals with facial phenotype compatible with Moebius syndrome; 11 individuals with multiple congenital anomalies; and nine individuals with nonsyndromic cleft lip and/or cleft palate. This study showed a widening of the phenotypic spectrum associated with misoprostol embryotoxicity.

  8. Sudden death in a child following jellyfish envenomation by Chiropsalmus quadrumanus. Case report and autopsy findings.

    PubMed

    Bengtson, K; Nichols, M M; Schnadig, V; Ellis, M D; Bengston, K

    1991-09-11

    Sudden death following coelenterate envenomation is not uncommon in Australia where the Pacific box jellyfish is indigenous. However, few cases of sudden fatal reactions have been reported in the Northern Hemisphere, and those that have occurred have all been attributed to the Portuguese man-of-war, Physalia physalis. We report the case of a child who died within 40 minutes of accidental envenomation with tentacles of a jellyfish, Chiropsalmus quadrumanus, and describe the findings at autopsy. This coelenterate may be of special danger to small children. PMID:1679136

  9. CT and MRI Findings in a Rare Case of Renal Primitive Neuroectodermal Tumor

    PubMed Central

    Akkaya, Zehra; Peker, Elif; Gulpinar, Basak; Karadag, Hale; Erden, Ayse

    2016-01-01

    Summary Background Primary renal primitive neuroectodermal tumor/extraskeletal Ewing’s sarcoma (PNET/EES) is a very rare renal tumor. Case Report We report a case of primary renal PNET/EES of the kidney in an adult patient and describe its computed tomography and magnetic resonance imaging findings, including diffusion weighted images along with a review of the current medical literature. Conclusions Although very rare, a relatively large renal mass which shows very infiltrative growth pattern on CT and MR imaging and striking diffusion restriction should raise the suspicion of a renal primitive neuroectodermal tumor, in a young adult. PMID:27635170

  10. Clinical findings in children with congenital anomalies and misoprostol intrauterine exposure: a study of 38 cases.

    PubMed

    Vendramini-Pittoli, Siulan; Guion-Almeida, Maria L; Richieri-Costa, Antonio; Santos, Juliana M; Kokitsu-Nakata, Nancy M

    2013-12-01

    The authors describe the clinical findings of 38 children with congenital anomalies and misoprostol intrauterine exposure. This study included 38 cases, ascertained from case series of the Hospital of Rehabilitation of Craniofacial Anomalies from University of São Paulo, with evidence of intrauterine exposure to misoprostol in the first trimester of the pregnancy. Information about misoprostol intake and drug administration route was obtained through interviews with mothers. Clinical evaluation showed 18 individuals with facial phenotype compatible with Moebius syndrome; 11 individuals with multiple congenital anomalies; and nine individuals with nonsyndromic cleft lip and/or cleft palate. This study showed a widening of the phenotypic spectrum associated with misoprostol embryotoxicity. PMID:27625856

  11. The imaging findings of infratentorial primitive neuroectodermal tumour: A case report.

    PubMed

    Nekitsing, Indima; Wu, Xing; Tang, Guangyu

    2015-12-01

    Central primitive neuroectodermal tumour (cPNET), a rare malignant neoplasm of embryonal origin, often occurs in children younger than 15 years. This is the first case report of the imaging findings of an infratentorial cPNET to be reported in a patient. Here, is reported the case of a 6-year-old boy presenting with symptoms of diplopia for 14 days. Magnetic resonance imaging revealed a solid mass in the fourth ventricle. The postoperative pathological diagnosis was cPNET. To conclude, whenever a child is diagnosed to have an infratentorial solid tumour in the fourth ventricle, cPNET should always be considered despite its rarity.

  12. Small-bowel Diverticulosis:Imaging Findings and Review of Three Cases

    PubMed Central

    De Peuter, B.; Box, I.; Vanheste, R.; Dymarkowski, S.

    2009-01-01

    Complicated small-bowel diverticulosis is a rather uncommon cause of upper abdominal pain. It may lead to symptoms presenting with an acute onset or to chronic and nonspecific complaints. As the presentation is often similar to other pathologies (acute appendicitis, pancreatitis, or acute cholecystis) and in many cases diagnosis is made on basis of surgical findings, careful analysis of the imaging landmarks may be warranted to aid in the early stages of detection. In this report, we present clinical and morphological findings in three patients where small-bowel diverticulitis was surgically proven. The relevant literature is reviewed, and typical imaging properties are discussed. PMID:19657452

  13. Fine needle aspiration cytologic findings in a benign lymphoepithelial lesion with microcalcifications. A case report.

    PubMed

    Günhan, O; Celasun, B; Doğan, N; Onder, T; Pabuşçu, Y; Finci, R

    1992-01-01

    Aspiration cytologic findings in a case of benign lymphoepithelial lesion (BLL) of the parotid gland are presented. The aspirate contained a polymorphous lymphoid population, histiocytes, myoepithelial and ductal epithelial cells and numerous bluish, calcified bodies. A cytologic diagnosis of benign nonneoplastic lesion, consistent with chronic sialadenitis and microlithiasis, was made. The clinical impression of neoplasia was inconsistent with the cytologic findings. Subsequent histologic examination showed classic BLL with microcalcifications as an unexpected feature. The value and limitations of fine needle aspiration cytology in the diagnosis of nonneoplastic salivary gland lesions and the differential diagnosis of BLL are discussed.

  14. An Unusual Case of Ascending Pancreatitis with Mediastinal Involvement: A Case Report with CT and MRI Findings

    PubMed Central

    Di Cesare, Ernesto; Di Sibio, Alessandra; Gennarelli, Antonio; Felli, Valentina; Vellucci, Valentina; Casazza, Ines; Masciocchi, Carlo

    2014-01-01

    Fluid collections are common findings of pancreatitis and spread, more often, along preferential drainage pathways in the abdomen. In some rare cases, fluid collections may spread towards extra-abdominal sites like the mediastinum leading to the formation of mediastinal collections. We present the case of a 52-years-old man with pain in the right upper quadrant of the abdomen and mid-epigastrium lasting for some hours. Laboratory tests suggested a diagnosis of pancreatitis. CT and subsequent MRI revealed changes consistent with acute exacerbation on chronic pancreatitis spreading to the mediastinum and to the greater omentum. The patient received medical treatment and reported gradual improvement in his laboratory results and CT findings. PMID:24955277

  15. From Noun to Intensifier: Massa and Massa's in Flemish Varieties of Dutch

    ERIC Educational Resources Information Center

    De Clerck, Bernard; Colleman, Timothy

    2013-01-01

    In this paper a case of synchronic layering is examined in which Dutch "massa" ("mass") and plural "massa's" ("masses") are attested with lexical uses as a collective noun, quantifying uses ("a large quantity of") and intensifying uses ("very")--with plural "massa's" only--in some Flemish varieties of Dutch. Against the background of…

  16. A case of May-Thurner syndrome with inconsistent radiological and surgical findings.

    PubMed

    Akin, Fatih; Aygun, Serhat; Gormus, Niyaziv; Kar, Yeter Duzenli; Susam, Hanife Tugce; Ozel, Ahmet

    2015-03-23

    May-Thurner syndrome is the result of compression of the left common iliac vein between the right common iliac artery and the overlying vertebrae. In this case report, we describe an 11-year-old boy presenting with swelling of the left lower extremity. An iliac MR venography showed compression of the left proximal iliac vein between the vertebra and the left iliac artery. In surgery, it was seen that the left common iliac vein was connected to the postero-inferior part of the inferior vena cava, and it was compressed between the right common iliac artery and the columna vertebralis, which was inconsistent with the radiological findings. An interposition of the great saphenous vein graft between the left common iliac vein and the inferior vena cava was made, with a successful outcome. Our case is interesting in that it showed inconsistent findings between the radiological images and surgery.

  17. Choledochal cyst and biliary atresia in the neonate: Imaging findings in five cases

    SciTech Connect

    Torrisi, J.M.; Haller, J.O.; Velcek, F.T. )

    1990-12-01

    The radiologic findings in five neonates with choledochal cyst associated with extra-hepatic biliary atresia are described. All five patients (age range, 13-72 days) presented with jaundice and acholic stools. In all four patients who underwent sonographic examination, a cystic structure separate from the gallbladder representing the choledochal cyst was shown. The diagnosis of atresia of the distal common bile duct was made preoperatively in all cases by hepatobiliary scintigraphy. Diagnosis was confirmed by surgical findings and was demonstrated by intraoperative cholangiography in four cases. All patients were successfully treated with surgical intervention within 1 month from the time of diagnosis. Early detection of this rare disorder, which may be distinct from choledochal cyst found in children and adults, is important to prevent fatal complications of biliary obstruction. The combined use of sonography and hepatobiliary scintigraphy can correctly identify this subset of patients with persistent neonatal jaundice and provide valuable information for prompt surgical management.

  18. Human water consumption intensifies hydrological drought worldwide

    NASA Astrophysics Data System (ADS)

    Wada, Y.; Van Beek, L. P.; Wanders, N.; Bierkens, M. F.

    2012-12-01

    Over the past decades, human water consumption has more than doubled, and reduced streamflow over various regions of the world. However, it remains unclear to what degree human water consumption intensifies hydrological droughts, i.e. the occurrence of anomalously low streamflow. Here, we quantify over the period 1960-2010 the impact of human water consumption on the intensity and frequency of hydrological droughts worldwide. We simulated streamflow by the global hydrological and water resources model PCR-GLOBWB at a 0.5 degree spatial resolution, and reduced the amount of streamflow with different levels of human water consumption over the period 1960-2010. We applied the commonly used variable threshold level method to identify below-normal water availability as the onset of hydrological droughts. We then standardized the deficit volume dividing relative to the threshold level to express the intensity of drought conditions to normal streamflow conditions. The results show that human water consumption substantially reduced local and downstream streamflow in many regions of the world. This subsequently intensified hydrological droughts regionally by 10-500%. Irrigation is responsible for the intensification of hydrological droughts over western and central U.S., southern Europe, Asia, and southeastern Australia, whereas the impact of industrial and households' consumption on the intensification is considerably larger over eastern U.S., and western and central Europe. The results also show that drought frequency increased by more than 27% compared to pristine or natural condition as a result of human water consumption. The intensification of drought frequency is most severe over Asia, but also substantial over North America and Europe. Importantly, global population under severe hydrological droughts considerably increased from 0.7 billion in 1960 to 2.2 billion in 2010 due to rapid population growth. As a limited validation exercise, we compared simulated deficit

  19. Tailgut Cyst and Perineal Hydatid Cyst: A Case Report with Multimodality Imaging Findings

    PubMed Central

    Alghofaily, Khalefa Ali

    2016-01-01

    A tailgut cyst is a rare developmental lesion and usually is located in the retrorectal or presacral space. Extrahepatic hydatid disease has been reported in several locations including the pelvis and it often poses a diagnostic challenge. There are very few reported cases of primary perineal hydatid cysts. We present the multimodality imaging findings of a tailgut cyst and concurrent perineal hydatid disease in a 32-year-old male patient. PMID:27630782

  20. Tailgut Cyst and Perineal Hydatid Cyst: A Case Report with Multimodality Imaging Findings

    PubMed Central

    Alghofaily, Khalefa Ali

    2016-01-01

    A tailgut cyst is a rare developmental lesion and usually is located in the retrorectal or presacral space. Extrahepatic hydatid disease has been reported in several locations including the pelvis and it often poses a diagnostic challenge. There are very few reported cases of primary perineal hydatid cysts. We present the multimodality imaging findings of a tailgut cyst and concurrent perineal hydatid disease in a 32-year-old male patient.

  1. Nevoid Basal Cell Carcinoma Syndrome - Clinical and Radiological Findings of Three Cases

    PubMed Central

    Ali, Ibrahim K; Karjodkar, Freny R; Sansare, Kaustubh; Salve, Prashant; Goyal, Shikha

    2016-01-01

    Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder, characterized by skeletal anomalies and multiple keratocystic odontogenic tumors of the jaws. The skeletal anomalies of this syndrome are mandibular prognathism, bossing of frontal and parietal bones, high-arched palate, and bifid rib. We report three cases with NBCCS, emphasizing the clinical and radiographic findings, the importance of the early diagnosis of NBCCS, and a preventive multidisciplinary approach in the management of NBCCS.

  2. Tailgut Cyst and Perineal Hydatid Cyst: A Case Report with Multimodality Imaging Findings.

    PubMed

    Aljohani, Ibtisam Musallam; Alghofaily, Khalefa Ali; McWilliams, Sebastian R; Bin Saeedan, Mnahi

    2016-01-01

    A tailgut cyst is a rare developmental lesion and usually is located in the retrorectal or presacral space. Extrahepatic hydatid disease has been reported in several locations including the pelvis and it often poses a diagnostic challenge. There are very few reported cases of primary perineal hydatid cysts. We present the multimodality imaging findings of a tailgut cyst and concurrent perineal hydatid disease in a 32-year-old male patient. PMID:27630782

  3. Nevoid Basal Cell Carcinoma Syndrome - Clinical and Radiological Findings of Three Cases

    PubMed Central

    Ali, Ibrahim K; Karjodkar, Freny R; Sansare, Kaustubh; Salve, Prashant; Goyal, Shikha

    2016-01-01

    Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder, characterized by skeletal anomalies and multiple keratocystic odontogenic tumors of the jaws. The skeletal anomalies of this syndrome are mandibular prognathism, bossing of frontal and parietal bones, high-arched palate, and bifid rib. We report three cases with NBCCS, emphasizing the clinical and radiographic findings, the importance of the early diagnosis of NBCCS, and a preventive multidisciplinary approach in the management of NBCCS. PMID:27630800

  4. Dental findings in patients with West syndrome: a report of two cases.

    PubMed

    Khatri, Amit; Kalra, Namita; Tyagi, Rishi; Baweja, Mani; Khandelwal, Deepak

    2014-01-01

    West syndrome a rare, severe form of epilepsy occurs in early infancy. It is characterized by a triad consisting of infantile spasms that occurs in clusters, arrest of psychomotor development and hypsarrhythmia on electroencephalogram. We present here two cases of west syndrome where patients required dental care due to the presence of certain dental findings. Preventive measurements such as controlled diet and proper oral hygiene along with professional dental management are recommended in patients with west syndrome to avoid dental problems.

  5. Gingival fibromatosis with multiple unusual findings: report of a rare case

    PubMed Central

    He, Long; Ping, Fei-Yun

    2012-01-01

    Gingival fibromatosis is a rare disease, especially its syndromic form. Here, we review the literatures on gingival fibromatosis and briefly summarize some characters on clinical, etiological, genetic and histopathological aspects. We also present a rare case of gingival fibromatosis with multiple unusual findings in a 21-year-old man. And we differentiate it from some well-known syndromes including gingival fibromatosis. Maybe it implies a new syndrome within the spectrum of those including gingival fibromatosis. PMID:22955199

  6. (18)F-FDG PET/CT findings in a case with HIV (-) Kaposi sarcoma.

    PubMed

    Ozdemir, E; Poyraz, N Y; Keskin, M; Kandemir, Z; Turkolmez, S

    2014-01-01

    Although mucocutaneous sites are the most frequently encountered sites of involvement, Kaposi Sarcoma (KS) may also occasionally involve the breast and the skeletal, endocrine, urinary and nervous systems.. Various imaging modalities may be used to delineate the extent of the disease by detecting unexpected sites of involvement. Herein, we report a case of classical type KS, in whom staging with (18)F-FDG PET/CT imaging disclosed widespread disease and unexpected findings of bone and salivary gland involvement.

  7. CBCT findings of periapical cemento-osseous dysplasia: A case report.

    PubMed

    Eskandarloo, Amir; Yousefi, Faezeh

    2013-09-01

    Periapical cemento-osseous dysplasia (PCOD) is a subtype of cemento-osseous dysplasia that usually occurs in middle-aged black women. This report described a case of a 45-year-old Iranian woman who was diagnosed with PCOD on the basis of cone beam computed tomographic (CBCT) findings. CBCT enabled detailed visualization of the bone changes. This report described the special radiographic characteristics of PCOD, including discontinuity of the lingual cortex on the CBCT sectional and three-dimensional images.

  8. Experience of active tuberculosis case finding in nearly 5 million households in India.

    PubMed

    Prasad, B M; Satyanarayana, S; Chadha, S S; Das, A; Thapa, B; Mohanty, S; Pandurangan, S; Babu, E R; Tonsing, J; Sachdeva, K S

    2016-03-21

    In India, to increase tuberculosis (TB) case detection under the National Tuberculosis Programme, active case finding (ACF) was implemented by the Global Fund-supported Project Axshya, among high-risk groups in 300 districts. Between April 2013 and December 2014, 4.9 million households covering ~20 million people were visited. Of 350 047 presumptive pulmonary TB cases (cough of ⩾2 weeks) identified, 187 586 (54%) underwent sputum smear examination and 14 447 (8%) were found to be smear-positive. ACF resulted in the detection of a large number of persons with presumptive pulmonary TB and smear-positive TB. Ensuring sputum examination of all those with presumptive TB was a major challenge.

  9. Secondary injury potential of assistive technologies used by farmers with disabilities: findings from case studies.

    PubMed

    Mathew, Samuel N; Field, William E; French, Brian F

    2011-01-01

    In order to complete essential tasks, farmers with disabilities often make and use assistive technology (AT), which itself may cause further injuries known as secondary injuries. A set of 19 case studies was used to investigate the potential for injury on home-fabricated assistive technologies (ATs) used by farmers with disabilities. The case studies consisted of close-ended and open-ended interviews that were designed to help understand the farmers' perception of potential for injuries and safety measures implemented or not implemented. The qualitative study used grounded theory principles and the collected data were analyzed to arrive at a list of features on ATs that have substantial potential to cause injury to the user. Based on the case study results, AT user characteristics and environmental factors were also considered as factors that contribute to potential injuries. Findings were used to develop an instrument for use by rehabilitation professionals to evaluate ATs for potential injury causing hazards.

  10. Ultrasonographic findings in a cow with vascular hamartoma of the liver: case report

    PubMed Central

    2011-01-01

    Background This is the first description of the ultrasonographic findings in a cow with vascular hamartoma of the liver. Case presentation Ultrasonographic examination of a six-year-old Swiss Braunvieh cow revealed an excessive number of hypoechogenic blood vessels in the liver parenchyma and a thrombus in the right hepatic vein. The activities of the liver enzymes and the concentration of bilirubin were within the reference ranges. At postmortem examination, a poorly delineated, non-encapsulated lesion, measuring approximately 10 cm × 10 cm in diameter, was found in the right liver lobe. The cut surface of the lesion was sponge-like and contained extremely dilated blood vessels, one of which was occluded with a branching red thrombus. A vascular hamartoma of the liver with thrombosis was diagnosed based on the histological findings. Conclusions To our knowledge, this is the first description of the ultrasonographic findings of vascular hamartoma of the liver in a cow. Hamartoma should be considered part of the differential diagnosis in cows with an abnormally large number of blood vessels in the liver parenchyma. This case report broadens the spectrum of liver diseases and ultrasonographic findings of the liver in cattle. PMID:21888668

  11. Population-Level Impact of Active Tuberculosis Case Finding in an Asian Megacity

    PubMed Central

    Dowdy, David W.; Lotia, Ismat; Azman, Andrew S.; Creswell, Jacob; Sahu, Suvanand; Khan, Aamir J.

    2013-01-01

    Background The potential population-level impact of private-sector initiatives for tuberculosis (TB) case finding in Southeast Asia remains uncertain. In 2011, the Indus Hospital TB Control Program in Karachi, Pakistan, undertook an aggressive case-finding campaign that doubled notification rates, providing an opportunity to investigate potential population-level effects. Methods We constructed an age-structured compartmental model of TB in the intervention area. We fit the model using field and literature data, assuming that TB incidence equaled the estimated nationwide incidence in Pakistan (primary analysis), or 1.5 times greater (high-incidence scenario). We modeled the intervention as an increase in the rate of formal-sector TB diagnosis and evaluated the potential impact of sustaining this rate for five years. Results In the primary analysis, the five-year intervention averted 24% (95% uncertainty range, UR: 18-30%) of five-year cumulative TB cases and 52% (95% UR: 45-57%) of cumulative TB deaths. Corresponding reductions in the high-incidence scenario were 12% (95% UR: 8-17%) and 27% (95% UR: 21-34%), although the absolute number of lives saved was higher. At the end of five years, TB notification rates in the primary analysis were below their 2010 baseline, incidence had dropped by 45%, and annual mortality had fallen by 72%. About half of the cumulative impact on incidence and mortality could be achieved with a one-year intervention. Conclusions Sustained, multifaceted, and innovative approaches to TB case-finding in Asian megacities can have substantial community-wide epidemiological impact. PMID:24147015

  12. Surface Signature of Subsurface-Intensified Vortices

    NASA Astrophysics Data System (ADS)

    Ciani, D.; Carton, X. J.; Chapron, B.; Bashmachnikov, I.

    2014-12-01

    The ocean at mesoscale (20-200 km) and submesoscale (0.5-20km) is highly populated by vortices. These recirculating structures are more energetic than the mean flow, they trap water masses from their origin areas and advect them across the ocean, with consequent impact on the 3D distribution of heat and tracers. Mesoscale and submesoscale structures characterize the ocean dynamics both at the sea surface and at intrathermocline depths (0-1500m), and are presently investigated by means of model outputs, in-situ and satellite (surface) data, the latest being the only way to get high resolution and synoptic observations at planetary scale (e.g., thermal-band observations, future altimetric observations given by the SWOT satellite mission). The scientific question arising from this context is related to the role of the ocean surface for inferring informations on mesoscale and submesoscale vortices at depth. This study has also been motivated by the recent detection of subsurface eddies east of the Arabian Peninsula (PHYSINDIEN experiment - 2011).Using analytical models in the frame of the QG theory, we could describe the theoretical altimetric signature of non-drifting and of drifting subsurface eddies. Numerical experiments, using both coupled QG-SQG and primitive equations models, allowed us to investigate the surface expression of intrathermocline eddies interacting with baroclinic currents or evolving under planetary beta-effect. The eddy characteristics (radius, depth, thickness, velocity) were varied, to represent various oceanic examples (Meddies, Swoddies, Reddies, Peddies, Leddies). Idealized simulations with the ROMS model, confirming theoretical estimates, showed that drifting subsurface-intensified vortices can induce dipolar sea level anomalies, up to 3 cm. This result, compatibly with future SWOT measurement accuracies (about 2 cm), is a first step towards systematic and synoptic detection of subsurface vortices.

  13. Relations among synovial membrane histopathologic findings, synovial fluid cytologic findings, and bacterial culture results in horses with suspected infectious arthritis: 64 cases (1979-1987).

    PubMed

    Madison, J B; Sommer, M; Spencer, P A

    1991-05-01

    A retrospective evaluation of 64 cases of suspected infectious arthritis in horses was undertaken to determine the relations among histopathologic findings in synovial membrane specimens, cytologic findings in synovial fluid samples, and bacterial culture results. Positive cultures were obtained from 55% of the joints, and 18 different bacterial organisms were cultured. Culturing of synovial fluid yielded bacterial growth more often than did culturing of synovial membrane. Histologic evaluation (H&E and Gram stain) of synovial membrane specimens provided little information to help distinguish infected from culture-negative joints. We do not advocate the routine use of closed synovial biopsy in suspected cases of equine septic arthritis.

  14. Barriers to the effective use of medico-legal findings in sexual assault cases worldwide.

    PubMed

    Mont, Janice Du; White, Deborah

    2013-09-01

    Despite the increasing implementation of standardized rape kits across jurisdictions, the medico-legal findings generated by these tools are often not related to positive criminal justice outcomes. Given that there has been no global investigation of the factors that might impede their successful use in cases of sexual assault, we conducted a review of relevant scholarly and "grey" literature from industrialized and less-developed regions. One key theme to emerge from the analysis concerned certain problematic practices and behaviors of professional groups involved in the various stages of the post-sexual assault process. We found that a lack of competence in handling sexual assault cases, contempt for women who have been victimized, and corruption among some forensic examiners, police, scientists, and legal personnel often have shaped the collection, processing, analysis, and use of medico-legal evidence. We discuss recent initiatives and future directions for research that might serve to address these issues.

  15. Second case of histoplasmosis in a captive mara (Dolichotis patagonum): pathological findings.

    PubMed

    Pérez-Torres, A; Rosas-Rosas, A; Parás-García, A; Juan-Sallés, C; Taylor, M L

    2009-08-01

    A second case of histoplasmosis in a captive mara (Dolichotis patagonum) from a colony at the wildlife park Africam Safari, Puebla, Mexico, is described, and the mara died with disseminated clinical form of the disease, affecting mostly the large intestine and adrenal. The pathological findings of this case 2 revealed severe granulomatous typhlocolitis and moderate granulomatous gastrohepatic lymphadenitis with numerous yeast-like cells, 2-4 mum in diameter, with a clear halo surrounding them inside the cytoplasm of macrophages, suggesting the parasitic form of Histoplasma capsulatum. Adrenocortical cells had abundant similar microorganisms in their cytoplasm without any associated lesion. Gomori's methenamine silver and periodic acid Schiff stained positively these microorganisms. Immunohistochemistry, using a rabbit anti-H. capsulatum serum, and transmission electron microscopy supported the diagnosis of H. capsulatum infection. PMID:19360479

  16. Late onset epilepsy associated with marijuana abuse: a case report with MRI findings

    PubMed Central

    Fogang, Yannick Fogoum; Camara, Massaman; Mbonda, Paul Chimi; Toffa, Dènahin; Touré, Kamadore

    2014-01-01

    Marijuana is the most widely used illicit substance in the world. The relation between marijuana use and epileptic seizures is still controversial. We report a case of late onset epilepsy associated with marijuana abuse, with brain magnetic resonance imaging (MRI) findings. A 44-year-old patient was admitted for 03 isolated episodes of secondary generalized tonic-clonic seizures. He had a history of 26 years regular marijuana smoking. On admission, we found a tachycardia, psychomotor slowing, asymmetric hyperreflexia, bilateral Babinski sign without weakness. Laboratory work-up showed a high level of urine of Δ-9-tétrahydroxycannabinol. Electroencephalogram was normal. Brain MRI revealed abnormal signal intensities in the right frontal lobe and basal ganglia. Seizures cessation was obtained with anti-epileptic treatment. We suggest that marijuana abuse through vascular and toxic mechanisms could explain seizures in this case. PMID:25120871

  17. [Fatal familial insomnia: case presentation and discussion of typical clinical and imaging findings].

    PubMed

    Thomas, A V; Klein, J C; Brockhaus-Dumke, A; Heiss, W D; Jacobs, A H; Petereit, H F

    2006-06-01

    Fatal familial insomnia (FFI) is a hereditary prion disease caused by a mutation in codon 178 of the prion protein gene PRNP on chromosome 20. It is characterized by disturbed night sleep, resulting in daily vigilance perturbations and a variety of other neurological symptoms. We present the case of a 46-year-old woman deteriorating despite immunosuppressive treatment which was initiated suspecting cerebral vasculitis as the cause of her progressive neurological symptoms. The correct diagnosis was established only post mortem. Based on the case presented here, we discuss typical clinical symptoms and imaging findings. In particular, we outline how modern diagnostic methods such as positron emission tomography with [(15)O]H(2)O and [(18)F]FDG and single photon emission computed tomography can add valuable information to results from conventionally performed imaging techniques and genetic testing.

  18. Retroaortic left renal vein in a case of left adrenal adenoma: radiological findings.

    PubMed

    Dilli, Alper; Ayaz, Umit Yasar; Karabacak, Osman Raif; Hekimoglu, Baki

    2011-01-01

    It is important to diagnose retroaortic left renal vein (RLRV) before a probable retroperitoneal surgery in a case of a suspicious adrenal mass. Our purpose is to present the ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) findings in a case of left adrenal adenoma with a coincidental RLRV and to discuss the clinical importance of their imaging. Abdominal and scrotal US, abdominal CT and MRI were performed for a 50-year-old male patient who was referred with continuous abdominal pain, intractable hypertension, high levels of blood cortisol and proteinuria. On US, a hypoechoic solid mass measuring 4 × 3 cm in the left adrenal location and coincidental RLRV, besides multiple renal cysts, hepatomegaly, left-sided varicocele, and small-sized left testis were detected. CT and MRI also revealed the mass in the left adrenal gland which was consistent with adenoma. With CT and MRI, presence of RLRV was also verified.

  19. Neuropsychological findings in a case of punding before and after cessation of pramipexole.

    PubMed

    Larson, Eric R

    2015-01-01

    Clinical neuropsychologists are well trained to recognize neurological and psychiatric conditions that impact behavior, but tend to have less familiarity with iatrogenic consequences of various pharmacological treatments. One such consequence is the development of an impulse control disorder (ICD), which can result from treatment with dopamine agonists. Knowledge of ICDs is important because they can mimic obsessive-compulsive disorder, mania, or the behavioral variant of frontotemporal dementia. The current case examines a patient who developed punding, which is a type of ICD characterized by repetitive behavior, as a result of treatment with pramipexole. Neuropsychological testing was conducted before and after cessation of pramipexole, and showed that the removal of the medication was consistent with improvement in frontal-subcortical-mediated cognitive functions. Findings suggest that neuropsychologists should be familiar with the symptoms of ICDs and incorporate such knowledge into their case conceptualizations.

  20. Reactive lymphoid hyperplasia of the liver mimicking hepatocellular carcinoma: incidental finding of two cases.

    PubMed

    Lv, Ang; Liu, Wendy; Qian, Hong-Gang; Leng, Jia-Hua; Hao, Chun-Yi

    2015-01-01

    Reactive lymphoid hyperplasia is a rare disease that forms a mass-like lesion and is characterized by the proliferation of non-neoplastic, polyclonal lymphocytes forming follicles. We recently encountered 2 cases of reactive lymphoid hyperplasia of liver, both of which were asymptomatic and mimicked hepatocellular carcinoma by various imaging modalities. Based on the clinical impression of hepatocellular carcinoma, surgical resections were performed. Microscopic findings revealed that both lesions consisted of an aggregation of lymphocytes consisting of predominantly B-cells, with multiple lymphoid follicles positive for CD10 and negative for bcl-2, consistent with the diagnosis of reactive lymphoid hyperplasia. Polyclonality of both lesions was further confirmed by B cell receptor gene rearrangement study. The incidence of reactive lymphoid hyperplasia in the liver is exceedingly rare, and it is difficult to differentiate such lesions from hepatic malignancies based upon clinical grounds. The clinicopathological findings and literature review of this report may be helpful to improve the clinical decision-making.

  1. Hepatic morphopathologic findings of lead poisoning in a drug addict: a case report.

    PubMed

    Verheij, Joanne; Voortman, Jens; van Nieuwkerk, Carin M J; Jarbandhan, S Vijay A; Mulder, Chris J J; Bloemena, Elisabeth

    2009-06-01

    We describe the case of a 40-year old Iranian man who was admitted to our hospital with severe abdominal pain, abnormal liver function tests and normocytic anemia. Suffering from multiple sclerosis, he was a regular user of opium for pain relief. Basophilic stippling of erythrocytes pointed towards the diagnosis of lead intoxication, the most likely source being contaminated Iranian opium. Serum lead and zinc protoporphyrin levels were strongly elevated. To assess the hepatotoxic effects of lead poisoning a liver biopsy was performed. Pathomorphologic findings of hepatotoxicity, rarely reported in humans, included active hepatitis together with extensive microvesicular and macrovesicular steatosis, hemosiderosis and cholestasis, and a lymphocytic cholangitis. Whilst treated with chelating therapy, liver enzymes returned to normal, suggesting reversibility of the histological findings.

  2. Radiological Findings and Endovascular Management of Three Cases with Segmental Arterial Mediolysis

    SciTech Connect

    Davran, Ramazan; Cinar, Celal; Parildar, Mustafa; Oran, Ismail

    2010-06-15

    Segmental arterial mediolysis (SAM) is an uncommon self-limited disorder that can cause abdominal catastrophes through massive bleeding or bowel infarction. The former arise from arterial aneurysms, and the latter from arterial stenosis or occlusions. Although this is an acute self-limiting disease, the catastrophic consequence, originating from intra-abdominal hemorrhage (arterial dilatation, aneurysms, dissecting hematomas) or bowel infarction (arterial stenosis, arterial occlusions), is not rare. The identification of these lesions is very important in the differential diagnosis of suspected patients with complaints of abdominal pain with hemorrhage. We report computerized tomography angiography and digital subtraction angiography findings of three cases with abdominal SAM, who were treated with endovascular management due to abdominal bleeding. Angiography showed arterial dilatations, aneurysms, and occlusions of visceral arteries in all three cases, The string-of-beads appearance was present in only one case. Bleeding stopped immediately after embolization of three cases and follow-up revealed no evidence of recurrences at 23, 18, and 15 months, respectively, Arterial coil embolization is an effective treatment modality for bleeding complications of SAM. Close follow-up is recommended, primarily to ascertain the fate of the nontreated arterial lesions.

  3. Music evoked autobiographical memory after severe acquired brain injury: preliminary findings from a case series.

    PubMed

    Baird, A; Samson, S

    2014-01-01

    Music evoked autobiographical memories (MEAMs) have been characterised in the healthy population, but not, to date, in patients with acquired brain injury (ABI). Our aim was to investigate music compared with verbal evoked autobiographical memories. Five patients with severe ABI and matched controls completed the experimental music (MEAM) task (a written questionnaire) while listening to 50 "Number 1 Songs of the Year" (from 1960 to 2010). Patients also completed the Autobiographical Memory Interview (AMI) and a standard neuropsychological assessment. With the exception of Case 5, who reported no MEAMs and no autobiographical incidents on the AMI and who also had impaired pitch perception, the range of frequency and type of MEAMs in patients was broadly in keeping with their matched controls. The relative preservation of MEAMs in four cases was particularly noteworthy given their impaired verbal and/or visual anterograde memory, and in three cases, autobiographical memory impairment. The majority of MEAMs in both cases and matched controls were of a person/people or a period of life. In three patients music was more efficient at evoking autobiographical memories than the AMI verbal prompts. This is the first study of MEAMs after ABI. The findings suggest that music is an effective stimulus for eliciting autobiographical memories, and may be beneficial in the rehabilitation of autobiographical amnesia, but only in patients without a fundamental deficit in autobiographical recall memory and intact pitch perception.

  4. Incidental optochiasmatic cavernoma: Case report of an unusual finding on 3 Tesla MRI.

    PubMed

    Trentadue, Mirko; Pozzi Mucelli, Roberto; Piovan, Enrico; Pizzini, Francesca Benedetta

    2016-08-01

    Cavernoma is a vascular hamartoma, which represents 10-20% of all central nervous system vascular malformations. The majority (80%) of them are supratentorial, while involvement of the cranial nerves and the optic pathways is extremely rare. The main clinical presentation of optochiasmatic cavernomas consists of chiasmatic apoplexy, which is a neurosurgical emergency. Here, we report a case in which the finding was incidentally detected in a 49-year-old man. We describe the imaging characteristics of the lesion in such a rare location, highlighting the role of magnetic resonance imaging (MRI) (specifically 3 Tesla) in the management of asymptomatic patients.

  5. An Adult Case of Unicommissural Unicuspid Aortic Valve Diagnosed Based on the Intraoperative Findings.

    PubMed

    Yamanaka, Tetsuo; Fukatsu, Toru; Ichinohe, Yoshimaro; Komatsu, Hirotaka; Seki, Masahiro; Sasaki, Kenichi; Takai, Hideaki; Kunihara, Takashi; Hirata, Yasunobu

    2016-01-01

    We herein report an adult case of unicommissural unicuspid aortic valve (UAV). A 59-year-old man, who was noted to have a cardiac murmur at 31 years of age, was admitted to our hospital due to acute heart failure. Severe calcification in the aortic valve with severe low-flow/low-gradient aortic stenosis and moderate aortic regurgitation was observed and thought to be the cause of heart failure, however, the etiology of aortic valve dysfunction was not clear. Aortic valve replacement was subsequently performed, and unicommissural UAV was diagnosed according to the intraoperative findings. UAV is very rare congenital aortic valve disease which is rarely diagnosed preoperatively.

  6. Case report. Peripancreatic intranodal haemangioma mimicking pancreatic neuroendocrine tumour: imaging and pathological findings.

    PubMed

    Karaosmanoglu, A D; Arellano, R; Baker, G

    2011-12-01

    Haemangiomas are common benign tumours that are generally detected within the skin, mucosal surfaces and soft tissues. However, intranodal haemangiomas are extremely rare and are among the benign primary vascular abnormalities of the lymph nodes that include lymphangioma, haemangioendothelioma, angiomyomatous hamartoma and haemangiomas. In this case report, we present the imaging and pathological findings of an intranodal haemangioma in the pancreatic head simulating a pancreatic neuroendocrine tumour. To the best of our knowledge, this is the first report of an intranodal haemangioma in this location.

  7. An Adult Case of Unicommissural Unicuspid Aortic Valve Diagnosed Based on the Intraoperative Findings.

    PubMed

    Yamanaka, Tetsuo; Fukatsu, Toru; Ichinohe, Yoshimaro; Komatsu, Hirotaka; Seki, Masahiro; Sasaki, Kenichi; Takai, Hideaki; Kunihara, Takashi; Hirata, Yasunobu

    2016-01-01

    We herein report an adult case of unicommissural unicuspid aortic valve (UAV). A 59-year-old man, who was noted to have a cardiac murmur at 31 years of age, was admitted to our hospital due to acute heart failure. Severe calcification in the aortic valve with severe low-flow/low-gradient aortic stenosis and moderate aortic regurgitation was observed and thought to be the cause of heart failure, however, the etiology of aortic valve dysfunction was not clear. Aortic valve replacement was subsequently performed, and unicommissural UAV was diagnosed according to the intraoperative findings. UAV is very rare congenital aortic valve disease which is rarely diagnosed preoperatively. PMID:27629961

  8. CBCT findings of periapical cemento-osseous dysplasia: A case report.

    PubMed

    Eskandarloo, Amir; Yousefi, Faezeh

    2013-09-01

    Periapical cemento-osseous dysplasia (PCOD) is a subtype of cemento-osseous dysplasia that usually occurs in middle-aged black women. This report described a case of a 45-year-old Iranian woman who was diagnosed with PCOD on the basis of cone beam computed tomographic (CBCT) findings. CBCT enabled detailed visualization of the bone changes. This report described the special radiographic characteristics of PCOD, including discontinuity of the lingual cortex on the CBCT sectional and three-dimensional images. PMID:24083217

  9. An Unusual Case of Laryngeal Paraganglioma in a Patient with Carotid Body Paraganglioma: Multimodality Imaging Findings

    PubMed Central

    Dogan, Serap; Senol, Serkan; Imamoglu, Hakan; Abdulrezzak, Ummuhan; Ekinci, Afra; Yuce, Imdat; Ozturk, Mustafa

    2015-01-01

    Multiple paragangliomas of the head and neck are rare conditions. Carotid paragangliomas are most common multiple paragangliomas. Laryngeal paragangliomas are very rare neuroendocrine tumors and usually are seen as symptomatic solitary lesions. We present multimodality imaging findings of incidentally detected laryngeal paraganglioma in a woman with synchronous carotid body paraganglioma and positive family history. To the best of our knowledge, this is the first case of laryngeal and carotid body paragangliomas in a patient with positive family history. Radiologists should keep in mind that paragangliomas may occur in various locations as multiple tumors. PMID:26649218

  10. Quantification of neuropathological findings by image data for the diagnosis of dementia in forensic autopsy cases.

    PubMed

    Takayama, Mio; Kashiwagi, Masayuki; Matsusue, Aya; Waters, Brian; Hara, Kenji; Ikematsu, Natsuki; Kubo, Shin-ichi

    2016-01-01

    The aim of the present study was to quantify neuropathological findings using image analysis software for the diagnosis of dementia in deceased who underwent forensic autopsy. Of the autopsies performed within 48 hours of death and excluding those of patients with head injury, thermal injury, heat stroke, or intracranial lesions, 8 were of autopsy cases clinically diagnosed with dementia and thus included in the dementia group (D). The non-dementia group (non-D) consisted of 6 deceased without dementia. To compare the D and non-D groups, 6 regions and 7 types of pathological findings were observed semi-quantitatively using 4 conventional stainings. Quantitative analysis of collected image data was performed using image analysis software. Semiquantitative analysis of senile plaques and neurofibrillary tangles was performed with Bielschowsky-Hirano's silver staining image data. An easy, simple, and effective quantification method of the pathological findings was achieved. However, no significant differences were observed between the two groups, and diagnosis of dementia by the quantification of pathological findings was not successful. Diagnosis of dementia using image data may be possible in future studies with an increased number of autopsies, and by utilizing staining techniques with higher specificity and sensitivity, such as immunohistochemical staining. PMID:27040064

  11. Ocular, Neurologic and Systemic Findings of the Cases with Optic Nerve Hypoplasia

    PubMed Central

    Karahan, Eyyup; Tulin Berk, Ayse

    2016-01-01

    Aim: To describe the associated ocular, neurologic, and systemic findings in a population of children with optic nerve hypoplasia (ONH) and to evaluate the relationship between ocular signs and neurologic findings. Method: A retrospective chart review of 53 patients with the diagnosis of ONH seen between December 1998 and September 2012 was performed. All neurodevelopmental anomalies, neuroradiologic findings, endocrinologic and systemic findings were recorded. Poor vision was defined as the visual acuity poorer than logMAR 1.0 or inadequate central steady maintained fixation. Results: Thirty (56.6%) of the 53 children with ONH were boys. Mean age at presentation was 56.2±46.8 months (range; 3 months to 18 years). Poor vision defined for the purpose of this study was found in 47.2% of 53 patients. Thirty-three (62.3%) children had nystagmus. Thirty-four (64.2%) children had strabismus. Thirteen (38.2%) of those with strabismus had esotropia, 20 (58.8%) had exotropia. The total number of the children with neurodevelopmental deficit was 22 (41.5%) in our study. Conclusion: The vision of young children with ONH should be monitored at least annually, and any refractive errors should be treated. Neuroimaging of the brain and endocrinologic evaluation is necessary in all cases with ONH. PMID:27014380

  12. Early MRI and intraoperative findings in rapidly destructive osteoarthritis of the hip: A case report

    PubMed Central

    Fukui, Kiyokazu; Kaneuji, Ayumi; Fukushima, Mana; Matsumoto, Tadami

    2015-01-01

    Introduction The pathophysiology of rapidly destructive hip osteoarthritis (OA) of the hip is still unclear. Also, there have been only few reports on the initial stage of the disease. We report a case of an initial-stage rapidly destructive hip OA, documented by magnetic resonance imaging and intraoperative findings. Presentation of case A 77-year-old woman reported left hip pain without any antecedent trauma. Initial radiographs showed no obvious abnormality. After 4 months of conservative therapy, radiographs showed progressive joint-space narrowing and T1-weighted magnetic resonance images revealed a bone-marrow edema pattern not only on the femoral head but also on the lateral side of the acetabulum. Then during total hip arthroplasty, we found extensive inversion of the anterosuperior portion of the acetabular labrum, and the location was mostly consistent with the bone-marrow edema lesions in the femoral head and acetabulum. Discussion Several theories for the etiology of rapidly destructive hip OA have been proposed, including idiopathic chondrolysis, abnormal immunoreaction, intra-articular deposition of hydroxyapatite crystals, and subchondral insufficiency fracture. One of the reasons rapidly destructive hip OA is still considered idiopathic is the lack of reports regarding the initial stage of the disease. Our report is the first to demonstrate magnetic resonance imaging for initial-stage disease with intraoperative findings before collapse of the femoral head. Conclusion Inversion of the acetabular labrum may be a mechanism of rapidly destructive hip OA. PMID:25603485

  13. [Case finding in family practice and neuropsychological diagnosis at a memory clinic].

    PubMed

    Monsch, Andreas U

    2015-04-01

    To improve early diagnosis of cognitive impairment in the elderly a case-finding strategy should be adopted: general practitioners should only examine "suspicious" patients with a very efficient tool. The BrainCheck, a new case-finding tool from Switzerland, comprises of three questions for the patient and the clock drawing test. In addition the family member fills out a short questionnaire. In a validation study with 113 patients and 70 cognitively healthy individuals the BrainCheck showed a correct classification rate of 89 % (sensitivity = 97 %; specificity = 82 %). Within the work of a memory clinic the neuropsychological assessment should use appropriately normed cognitive instruments, especially if one is to detect subtle cognitive impairment. DSM-5 proposes to replace the terms mild cognitive impairment and dementia with mild and severe neurocognitive disorder, respectively. A major improvement in DSM-5 is the list of cognitive domains, which need to be examined. However, no standardized or widely accepted tool exists today to assess the domain of social cognition. PMID:25791043

  14. Unexpected Histopathological Findings in Appendectomy Specimens: a Retrospective Study of 1627 Cases.

    PubMed

    Limaiem, Faten; Arfa, Nafaa; Marsaoui, Lobna; Bouraoui, Saadia; Lahmar, Ahlem; Mzabi, Sabeh

    2015-12-01

    Pathologic evaluation of the appendix after appendectomy is routine and can occasionally identify unexpected findings. The aim of the present study was to determine the incidence and type of pathologic diagnoses found in appendectomy specimens at our institution. The clinicopathological data of 1627 patients who underwent appendectomies for presumed acute appendicitis from January 2008 to October 2014 were reviewed retrospectively. There were 986 men and 641 women (sex ratio M/F = 1.5) aged between 16 months and 90 years (mean = 30 years). All patients underwent appendectomy (either open or laparoscopic). Histological examination of the surgical specimen showed acute inflammation of the appendix in 1455 cases (89.42 %), fibrosed appendix in 37 cases (2.27 %), and Enterobius vermicularis (n = 23). In 101 cases (6.2 %), the appendix was histologically normal. Incidental unexpected pathological diagnoses were noted in 57 appendectomy specimens. They included pinworm (n = 23), mucinous neoplasms (n = 12), neuroendocrine tumors (NET) (n = 8), adenocarcinoma (n = 2), granulomatous inflammation (n = 5), tuberculosis (n = 2), hyperplastic polyp (n = 1), tubular adenoma (n = 1), diverticulitis (n = 1), endometriosis (n = 1), and actinomycosis (n = 1). The routine histopathological examination of the appendix is of value for identifying unsuspected conditions requiring further postoperative management. Gross examination alone does not appear to be a good indicator of an unexpected finding on microscopic exam. It is recommended that in order to avoid misdiagnoses, all appendices should be histopathologically examined. PMID:27011552

  15. [Evaluation of clinical and laboratory findings of adult visceral leishmaniasis cases].

    PubMed

    Ural, Serap; Kaptan, Figen; Sezak, Nurbanu; El, Sibel; Örmen, Bahar; Türker, Nesrin; Demirdal, Tuna; Vardar, İlknur; Özkan Çayıröz, Pınar; Çakalağaoğlu, Fulya

    2015-10-01

    Visceral leishmaniasis (VL, kala-azar) is a zoonotic infection caused by Leishmania species which are transmitted to humans by the bites of infected female phlebotomine sandflies. Leishmania infantum is the responsible species of VL in Aegean, Mediterranean, and Central Anatolia regions of Turkey mainly observed sporadically in pediatric age groups. The aim of this study was to evaluate the clinical and laboratory findings of adult patients with VL who were admitted to our hospital. A total of 10 patients (3 female, 7 male; age range: 18-67 years, mean age: 39.3 ± 16.51) followed in the infectious diseases clinic of the hospital between 2000 and 2013 were evaluated retrospectively. The diagnosis of VL was based on the presence of appropriate clinical and physical examination, as well as biochemical findings, positive serological test results (indirect fluorescent antibody test, and rK39 rapid antigen test) and/or detection of amastigote forms of parasite in the bone marrow aspiration samples. Of the cases three were diagnosed with both bone marrow and serology positivity, five with bone marrow positivity and one of each only with liver biopsy and positive serology result. Time interval from onset of the symptoms until the establishment of the specific clinical diagnosis was ranged from 2 to 12 weeks. The most frequent initial symptoms were fever, fatigue and abdominal distension. None of the patients had immunosupressive conditions such as HIV infection, corticosteroid use, immunosupressive treatment, or transplantation. All the patients were from Aegean region and six were living in rural areas. In all cases, hepatosplenomegaly, increased erythrocyte sedimentation rate, albumin/globulin ratio inversion, anemia, leukopenia and among nine cases trombocytopenia were detected. In one case acute renal failure has been developed before treatment and the patient was admitted to dialysis program. Bacterial superinfection occurred in two cases. Patients were treated with

  16. A case-control study of osteopathic palpatory findings in type 2 diabetes mellitus

    PubMed Central

    Licciardone, John C; Fulda, Kimberly G; Stoll, Scott T; Gamber, Russell G; Cage, A Clifton

    2007-01-01

    Background Although type 2 diabetes mellitus is often managed by osteopathic physicians, osteopathic palpatory findings in this disease have not been adequately studied. Methods A case-control study was used to measure the association between type 2 diabetes mellitus and a series of 30 osteopathic palpatory findings. The latter included skin changes, trophic changes, tissue changes, tenderness, and immobility at spinal segmental levels T5–T7, T8–T10, and T11-L2 bilaterally. Logistic regression models that adjusted for age, sex, and comorbid conditions were used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between type 2 diabetes mellitus and each of these findings. Results and discussion A total of 92 subjects were included in the study. After controlling for age, sex, hypertension, and clinical depression, the only significant finding was an association between type 2 diabetes mellitus and tissue changes at T11-L2 on the right side (OR, 5.54; 95% CI, 1.76–17.47; P = .003). Subgroup analyses of subjects with type 2 diabetes mellitus and hypertension demonstrated significant associations with tissue changes at T11-L2 bilaterally (OR, 27.38; 95% CI, 1.75–428; P = .02 for the left side and OR, 24.00; 95% CI, 1.51–382; P = .02 for the right side). Among subjects with type 2 diabetes mellitus and hypertension, there was also a strong diabetes mellitus duration effect for tissue changes at T11-L2 bilaterally (OR, 12.00; 95% CI, 1.02–141; P = .05 for short duration vs. OR, 32.00; 95% CI, 2.29–448; P = .01 for long duration on the left side; and OR, 17.33; 95% CI, 1.39–217; P = .03 for short duration vs. OR, 32.00; 95% CI, 2.29–448; P = .01 for long duration on the right side). Conclusion The only consistent finding in this study was an association between type 2 diabetes mellitus and tissue changes at T11-L2 on the right side. Potential explanations for this finding include reflex viscerosomatic changes directly

  17. The Evaluation of the Clinical, Laboratory, and Radiological Findings of 16 Cases of Brucellar Spondylitis

    PubMed Central

    Yang, Baohui; Hu, Hongbo; Chen, Jie; He, Xijing

    2016-01-01

    Objective. To evaluate the clinical, laboratory, and radiological presentation of 16 cases of brucellar spondylitis. Methods. The clinical manifestations, laboratory tests, and imaging findings of 16 patients (aged from 24 to 66 years) with brucellar spondylitis treated between September 2012 and September 2014 at the Second Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China) were retrospectively analyzed. Results. Clinical manifestations included high fever, severe pain, sweating, and fatigue. One patient had epididymitis, and two showed clear signs of spinal nerve damage. Laboratory tests showed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein content. Serum brucella agglutination tests were positive, and 11 brucella blood cultures were positive. Imaging manifestations mainly consisted of abnormal signals in the intervertebral space or abnormal signals in the adjacent vertebral bodies (16/16, 100%) in magnetic resonance imaging (MRI), disc space narrowing (14/16, 88%) in X-ray and MRI, or bone destruction and sclerosis around the damaged zone (13/16, 81%) in computed tomography, with rare cases of psoas abscess (2/16, 13%) and sequestrum (1/16, 6%). Conclusion. Since brucellar spondylitis exhibited characteristic clinical and imaging manifestations, it could be diagnosed with specific laboratory tests. Early MRI examination of suspected cases could improve rapid diagnosis. PMID:27672661

  18. The Evaluation of the Clinical, Laboratory, and Radiological Findings of 16 Cases of Brucellar Spondylitis

    PubMed Central

    Yang, Baohui; Hu, Hongbo; Chen, Jie; He, Xijing

    2016-01-01

    Objective. To evaluate the clinical, laboratory, and radiological presentation of 16 cases of brucellar spondylitis. Methods. The clinical manifestations, laboratory tests, and imaging findings of 16 patients (aged from 24 to 66 years) with brucellar spondylitis treated between September 2012 and September 2014 at the Second Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China) were retrospectively analyzed. Results. Clinical manifestations included high fever, severe pain, sweating, and fatigue. One patient had epididymitis, and two showed clear signs of spinal nerve damage. Laboratory tests showed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein content. Serum brucella agglutination tests were positive, and 11 brucella blood cultures were positive. Imaging manifestations mainly consisted of abnormal signals in the intervertebral space or abnormal signals in the adjacent vertebral bodies (16/16, 100%) in magnetic resonance imaging (MRI), disc space narrowing (14/16, 88%) in X-ray and MRI, or bone destruction and sclerosis around the damaged zone (13/16, 81%) in computed tomography, with rare cases of psoas abscess (2/16, 13%) and sequestrum (1/16, 6%). Conclusion. Since brucellar spondylitis exhibited characteristic clinical and imaging manifestations, it could be diagnosed with specific laboratory tests. Early MRI examination of suspected cases could improve rapid diagnosis.

  19. [Tuberculosis annual report 2012--(3). Case finding and condition of tuberculosis on diagnosis].

    PubMed

    2014-10-01

    Tuberculosis (TB) case findings from 2012 nationwide TB surveillance data in Japan were reviewed for diagnosis delay, proportion of far-advanced cavitary lesions, coexisting human immunodeficiency virus (HIV) infection and diabetes mellitus (DM), and drug susceptibility'testing (DST). Among 21,283 new TB cases in 2012, 82.4% were detected when patients sought medical attention for TB symptoms or visited medical facilities for other chief complaints. Among 16,432 patients with pulmonary TB, 25.8% had only respiratory symptoms, 31.7% had both respiratory and non-respiratory symptoms, 16.7% had only non-respiratory symptoms, and 0.6% had unknown symptoms. The rest (25.2%) were asymptomatic. The proportion of patient and doctor delays among 12,197 symptomatic pulmonary TB cases was analyzed. A large proportion--approximately 25-30%--of patients aged 35-64 years with symptomatic pulmonary TB exhibited a patient delay of 2 months. Like patient delay, the proportion of patients with a total delay (i.e., the sum of the patient and doctor delays) of ≥ 3 months decreased after 55 years of age. Moreover, the proportion of patients aged ≥ 65 years with a doctor delay of ≥ 1 month was higher than patients aged < 65 years. A large proportion--approximately 30%--of patients with symptomatic smear-positive TB were < 60 years of age with a total delay of ≥ 3 months due to longer patient delays. Meanwhile, the proportion of patients-approximately 15%--with a doctor delay ≥ 1 month was relatively stable across all age groups. The proportion of patients with pulmonary TB with advanced lung cavities increased from 1.5% in 1975 to approximately 2% and remained stable from 1985 to 2007. From 2007 to 2012, 366 patients with HIV infection had newly notified TB, 314 (85.8%) and 52 (14.2%) men and women, respectively, including 76 (20.8%) non-Japanese patients. Newly notified TB cases with DM comprised 14.3% (3,036/ 21,283) of the total cases in 2012 : 16.4% (2,127/12,988) of men

  20. Van der Woude syndrome: report of two cases with supplementary findings.

    PubMed

    More, Chandramani B; Varma, Saurabh; Tailor, Mansi; Bhavsar, Khushbu

    2013-01-01

    Van der Woude syndrome (VWS) is a rare developmental disorder with an autosomal dominant inheritance and variable expressivity, occurring in about 1 of every 1,00,000-2,00,000 people. This syndrome is remarkably variable. It is characterized by orofacial manifestations like lower lip pits, cleft lip and/or cleft palate, hypodontia, cleft or bifid uvula, syngnathia, narrow high arched palate, ankyloglossia and hyper nasal voice. We report two interesting cases of VWS with characteristic orofacial features and an unusual additional finding of bilateral commissural pits. The purpose of this article is to facilitate understanding of etio-pathogenesis, clinical manifestations, role of genetic counseling and with special emphasis on commissural pits as an additional feature in VWS. PMID:24025891

  1. [MRI findings in iliotibial band friction syndrome: a report of two cases].

    PubMed

    Isusi, M; Oleaga, L; Campo, M; Grande, D

    2007-01-01

    We present the magnetic resonance imaging (MRI) findings in two males clinically diagnosed with iliotibial band friction syndrome (IBFS), a frequent cause of pain in the lateral compartment of the knee. Coronal T2-weighted images with fat saturation show an ill-defined area of high signal intensity in the soft tissues situated immediately below the iliotibial band lateral to the external condyle of the femur. No thickening of the iliotibial band or changes in its signal intensity were observed. Osseous edema and subchondral osseous erosion in the external condyle of the femur were observed in both cases. Pain in the lateral compartment of the knee might be due to multiple causes that should be included in the differential diagnosis and MRI can play a significant role in reaching the definitive diagnosis.

  2. Imaging findings of anaplastic astrocytoma in a child with maple syrup urine disease: a case report.

    PubMed

    Aw-Zoretic, Jessie; Wadhwani, Nitin R; Lulla, Rishi R; Rishi, Lulla R; Ryan, Maura E

    2015-09-01

    Maple syrup urine disease (MSUD) is an inborn error of branched-chain amino acid metabolism, which usually presents in childhood with encephalopathy due to cerebral edema and dysmyelination. Even with treatment, metabolic stressors may precipitate later episodes of acute decompensation. Changes related to cerebral and white matter edema have been described by magnetic resonance imaging (MRI), and imaging can aid in both initial diagnosis and evaluation of decompensation. To date, there are no published known reports of cancer in patients with MSUD. Here, we present the first case report of an anaplastic astrocytoma in a teenager with MSUD, with a discussion of imaging findings and the use of magnetic resonance spectroscopy (MRS) to help distinguish between tumor and metabolic changes. PMID:26084772

  3. A sensitive image intensifier which uses inert gas

    NASA Technical Reports Server (NTRS)

    Kerns, Q. A.; Miller, H. M.

    1972-01-01

    High gain optical image intensifier utilizes inert gas cavity with copper electrodes to form electron avalanches without excessive pulse voltages. Estimated optical gain for device is two times 10 to the power of seven.

  4. NASA's GPM Sees Towering Thunderstorms in Intensifying Tropical Storm Earl

    NASA Video Gallery

    The Global Precipitation Measurement mission, or GPM, core observatory satellite passed over intensifying tropical storm Earl in the Caribbean Sea northeast of Honduras on Aug. 2, 2016 at 11:56 p.m...

  5. Death following the ingestion of detergent: an autopsy case with special regard to the histochemical findings.

    PubMed

    Kawamoto, Osamu; Ishikawa, Takaki; Oritani, Shigeki; Kuramoto, Yuko; Michiue, Tomomi; Maeda, Hitoshi

    2013-06-01

    We report an autopsy case of death due to accidental ingestion of a liquid laundry detergent with special regard to the histochemical findings. A female inpatient suffering from schizophrenia in a psychiatric institution, was found unconscious lying on the floor of her room, with a container of detergent nearby, and died despite intensive life-support measures. At autopsy, the stomach and duodenum contained whitish translucent foamy viscous fluid, and the mucous membranes, from the esophagus to the duodenum, had diffuse erosions with congestion and edema. There was otherwise no significant pathology other than signs of acute death and hemolysis. Toxicological investigations detected 1-methyl-4-prop-1-en-2-ylcyclohexene (detergent additive) in the gastric contents using headspace-gas chromatography/mass spectrometry, and a nonionic surfactant by a color identification test. Although these substances could not be detected in the blood, body fluid or viscera, histochemical examination using Oil red O demonstrated droplet-like staining in the pulmonary alveoli, suggesting aspiration of detergent, and similar staining in the vasculature of the lung, Kupffer cells of the liver, Bowman capsules of the kidney, and capillaries of the brain, suggesting the systemic effect of ingested/aspirated detergent. These findings were in keeping with death from ingestion of detergent and demonstrated the importance of preventing accidents such as this in healthcare facilities for elderly people.

  6. Reactive lymphoid hyperplasia of the liver mimicking hepatocellular carcinoma: incidental finding of two cases.

    PubMed

    Lv, Ang; Liu, Wendy; Qian, Hong-Gang; Leng, Jia-Hua; Hao, Chun-Yi

    2015-01-01

    Reactive lymphoid hyperplasia is a rare disease that forms a mass-like lesion and is characterized by the proliferation of non-neoplastic, polyclonal lymphocytes forming follicles. We recently encountered 2 cases of reactive lymphoid hyperplasia of liver, both of which were asymptomatic and mimicked hepatocellular carcinoma by various imaging modalities. Based on the clinical impression of hepatocellular carcinoma, surgical resections were performed. Microscopic findings revealed that both lesions consisted of an aggregation of lymphocytes consisting of predominantly B-cells, with multiple lymphoid follicles positive for CD10 and negative for bcl-2, consistent with the diagnosis of reactive lymphoid hyperplasia. Polyclonality of both lesions was further confirmed by B cell receptor gene rearrangement study. The incidence of reactive lymphoid hyperplasia in the liver is exceedingly rare, and it is difficult to differentiate such lesions from hepatic malignancies based upon clinical grounds. The clinicopathological findings and literature review of this report may be helpful to improve the clinical decision-making. PMID:26191310

  7. Atypical Findings in Massive Bupropion Overdose: A Case Report and Discussion of Psychopharmacologic Issues.

    PubMed

    Zhu, Yuanjia; Kolawole, Tiwalola; Jimenez, Xavier F

    2016-09-01

    Bupropion is an atypical antidepressant that is structurally similar to amphetamines. Its primary toxic effects include seizure, sinus tachycardia, hypertension, and agitation; however, at higher amounts of ingestion, paradoxical cardiac effects are seen. We report the case of a 21-year-old woman who ingested 13.5 g of bupropion, a dose higher than any other previously reported. The patient presented with seizure, sinus tachycardia with prolonged QTc and QRS intervals, dilated pupils, and agitation. Four days after overdose, the patient's sinus tachycardia and prolonged QTc and QRS intervals resolved with symptomatic management, but she soon developed sinus bradycardia, hypotension, and mild transaminitis. With continued conservative management and close monitoring, her sinus bradycardia resolved 8 days after the overdose. The transaminitis resolved 12 days after the overdose. Our findings are consistent with previously reported toxic effects associated with common overdose amounts of bupropion. In addition, we have observed transient cardiotoxicity manifesting as sinus bradycardia associated with massive bupropion overdose. These findings are less frequently reported and must be considered when managing patients with massive bupropion overdose. We review the psychopharmacologic implications of this and comment on previous literature. PMID:27648505

  8. Cutaneous mucormycosis and motor vehicle accidents: Findings from an Australian case series.

    PubMed

    Ingram, Paul R; Suthananthan, Arul E; Rajan, Ruben; Pryce, Todd M; Sieunarine, Kishore; Gardam, Dianne J; Heath, Christopher H

    2014-11-01

    Cutaneous disease is the third most frequent manifestation of mucormycosis. The clinical manifestations of and subsequent mortality due to cutaneous mucormycosis are dependent on the mode of acquisition and the host immune status. Here, we describe the epidemiology, clinical presentation, microbiology, and outcomes of 16 cutaneous mucormycosis infections managed in an Australian tertiary hospital over a 15-year period. The proportion with localized (56%), deep (38%), and disseminated (6%) cutaneous disease as well as the overall mortality (25%) were consistent with findings reported in the published literature. Two novel forms of hospital-acquired infection were reported following a sacral pressure sore and insertion of a foreign body during a bone graft procedure. The majority of patients were immunocompetent (75%) and/or suffered trauma (56%) with associated environmental contamination. A novel finding was that motor vehicle accidents (MVAs) accounted for 78% of all trauma-related cases, suggesting MVAs should receive greater recognition as a potential precipitant of cutaneous mucormycosis. Aggressive decontamination and debridement of devitalized tissue following trauma is therefore likely to play an important role in the prevention of this rare but potentially devastating infection. PMID:25288654

  9. Agriculture intensifies soil moisture decline in Northern China

    NASA Astrophysics Data System (ADS)

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; Miralles, Diego G.; Teuling, Adriaan J.; Zhang, Tonglin; An, Pingli; Dong, Zhiqiang; Zhang, Jingting; He, Di; Wang, Liwei; Pan, Xuebiao; Bai, Wei; Niyogi, Dev

    2015-07-01

    Northern China is one of the most densely populated regions in the world. Agricultural activities have intensified since the 1980s to provide food security to the country. However, this intensification has likely contributed to an increasing scarcity in water resources, which may in turn be endangering food security. Based on in-situ measurements of soil moisture collected in agricultural plots during 1983-2012, we find that topsoil (0-50 cm) volumetric water content during the growing season has declined significantly (p < 0.01), with a trend of -0.011 to -0.015 m3 m-3 per decade. Observed discharge declines for the three large river basins are consistent with the effects of agricultural intensification, although other factors (e.g. dam constructions) likely have contributed to these trends. Practices like fertilizer application have favoured biomass growth and increased transpiration rates, thus reducing available soil water. In addition, the rapid proliferation of water-expensive crops (e.g., maize) and the expansion of the area dedicated to food production have also contributed to soil drying. Adoption of alternative agricultural practices that can meet the immediate food demand without compromising future water resources seem critical for the sustainability of the food production system.

  10. Agriculture intensifies soil moisture decline in Northern China.

    PubMed

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; Miralles, Diego G; Teuling, Adriaan J; Zhang, Tonglin; An, Pingli; Dong, Zhiqiang; Zhang, Jingting; He, Di; Wang, Liwei; Pan, Xuebiao; Bai, Wei; Niyogi, Dev

    2015-01-01

    Northern China is one of the most densely populated regions in the world. Agricultural activities have intensified since the 1980s to provide food security to the country. However, this intensification has likely contributed to an increasing scarcity in water resources, which may in turn be endangering food security. Based on in-situ measurements of soil moisture collected in agricultural plots during 1983-2012, we find that topsoil (0-50 cm) volumetric water content during the growing season has declined significantly (p < 0.01), with a trend of -0.011 to -0.015 m(3) m(-3) per decade. Observed discharge declines for the three large river basins are consistent with the effects of agricultural intensification, although other factors (e.g. dam constructions) likely have contributed to these trends. Practices like fertilizer application have favoured biomass growth and increased transpiration rates, thus reducing available soil water. In addition, the rapid proliferation of water-expensive crops (e.g., maize) and the expansion of the area dedicated to food production have also contributed to soil drying. Adoption of alternative agricultural practices that can meet the immediate food demand without compromising future water resources seem critical for the sustainability of the food production system. PMID:26158774

  11. Intensified deep Pacific inflow and ventilation in Pleistocene glacial times.

    PubMed

    Hall, I R; McCave, I N; Shackleton, N J; Weedon, G P; Harris, S E

    2001-08-23

    The production of cold, deep waters in the Southern Ocean is an important factor in the Earth's heat budget. The supply of deep water to the Pacific Ocean is presently dominated by a single source, the deep western boundary current east of New Zealand. Here we use sediment records deposited under the influence of this deep western boundary current to reconstruct deep-water properties and speed changes during the Pleistocene epoch. In physical and isotope proxies we find evidence for intensified deep Pacific Ocean inflow and ventilation during the glacial periods of the past 1.2 million years. The changes in throughflow may be directly related to an increased production of Antarctic Bottom Water during glacial times. Possible causes for such an increased bottom-water production include increasing wind strengths in the Southern Ocean or an increase in annual sea-ice formation, leaving dense water after brine rejection and thereby enhancing deep convection. We infer also that the global thermohaline circulation was perturbed significantly during the mid-Pleistocene climate transition between 0.86 and 0.45 million years ago.

  12. Agriculture intensifies soil moisture decline in Northern China

    DOE PAGES

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; Miralles, Diego; Teuling, Adriann; Zhang, Tonglin; An, Pingli; Dong, Zhiqiang; Zhang, Jingting; He, Di; et al

    2015-07-09

    Northern China is one of the most densely populated regions in the world. Agricultural activities have intensified since the 1980s to provide food security to the country. However, this intensification has likely contributed to an increasing scarcity in water resources, which may in turn be endangering food security. Based on in-situ measurements of soil moisture collected in agricultural plots during 1983–2012, we find that topsoil (0–50 cm) volumetric water content during the growing season has declined significantly (p<0.01), with a trend of -0.011 to -0.015 m3 m-3 per decade. Observed discharge declines for the three large river basins are consistentmore » with the effects of agricultural intensification, although other factors (e.g. dam constructions) likely have contributed to these trends. Practices like fertilizer application have favoured biomass growth and increased transpiration rates, thus reducing available soil water. In addition, the rapid proliferation of water-expensive crops (e.g., maize) and the expansion of the area dedicated to food production have also contributed to soil drying. Adoption of alternative agricultural practices that can meet the immediate food demand without compromising future water resources seem critical for the sustainability of the food production system.« less

  13. Agriculture intensifies soil moisture decline in Northern China

    SciTech Connect

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; Miralles, Diego; Teuling, Adriann; Zhang, Tonglin; An, Pingli; Dong, Zhiqiang; Zhang, Jingting; He, Di; Wang, Liwei; Pan, Xuebiao; Bai, Wei; Niyogi, Dev

    2015-07-09

    Northern China is one of the most densely populated regions in the world. Agricultural activities have intensified since the 1980s to provide food security to the country. However, this intensification has likely contributed to an increasing scarcity in water resources, which may in turn be endangering food security. Based on in-situ measurements of soil moisture collected in agricultural plots during 1983–2012, we find that topsoil (0–50 cm) volumetric water content during the growing season has declined significantly (p<0.01), with a trend of -0.011 to -0.015 m3 m-3 per decade. Observed discharge declines for the three large river basins are consistent with the effects of agricultural intensification, although other factors (e.g. dam constructions) likely have contributed to these trends. Practices like fertilizer application have favoured biomass growth and increased transpiration rates, thus reducing available soil water. In addition, the rapid proliferation of water-expensive crops (e.g., maize) and the expansion of the area dedicated to food production have also contributed to soil drying. Adoption of alternative agricultural practices that can meet the immediate food demand without compromising future water resources seem critical for the sustainability of the food production system.

  14. Agriculture intensifies soil moisture decline in Northern China.

    PubMed

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; Miralles, Diego G; Teuling, Adriaan J; Zhang, Tonglin; An, Pingli; Dong, Zhiqiang; Zhang, Jingting; He, Di; Wang, Liwei; Pan, Xuebiao; Bai, Wei; Niyogi, Dev

    2015-07-09

    Northern China is one of the most densely populated regions in the world. Agricultural activities have intensified since the 1980s to provide food security to the country. However, this intensification has likely contributed to an increasing scarcity in water resources, which may in turn be endangering food security. Based on in-situ measurements of soil moisture collected in agricultural plots during 1983-2012, we find that topsoil (0-50 cm) volumetric water content during the growing season has declined significantly (p < 0.01), with a trend of -0.011 to -0.015 m(3) m(-3) per decade. Observed discharge declines for the three large river basins are consistent with the effects of agricultural intensification, although other factors (e.g. dam constructions) likely have contributed to these trends. Practices like fertilizer application have favoured biomass growth and increased transpiration rates, thus reducing available soil water. In addition, the rapid proliferation of water-expensive crops (e.g., maize) and the expansion of the area dedicated to food production have also contributed to soil drying. Adoption of alternative agricultural practices that can meet the immediate food demand without compromising future water resources seem critical for the sustainability of the food production system.

  15. Intensified deep Pacific inflow and ventilation in Pleistocene glacial times.

    PubMed

    Hall, I R; McCave, I N; Shackleton, N J; Weedon, G P; Harris, S E

    2001-08-23

    The production of cold, deep waters in the Southern Ocean is an important factor in the Earth's heat budget. The supply of deep water to the Pacific Ocean is presently dominated by a single source, the deep western boundary current east of New Zealand. Here we use sediment records deposited under the influence of this deep western boundary current to reconstruct deep-water properties and speed changes during the Pleistocene epoch. In physical and isotope proxies we find evidence for intensified deep Pacific Ocean inflow and ventilation during the glacial periods of the past 1.2 million years. The changes in throughflow may be directly related to an increased production of Antarctic Bottom Water during glacial times. Possible causes for such an increased bottom-water production include increasing wind strengths in the Southern Ocean or an increase in annual sea-ice formation, leaving dense water after brine rejection and thereby enhancing deep convection. We infer also that the global thermohaline circulation was perturbed significantly during the mid-Pleistocene climate transition between 0.86 and 0.45 million years ago. PMID:11518963

  16. Agriculture intensifies soil moisture decline in Northern China

    PubMed Central

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; Miralles, Diego G.; Teuling, Adriaan J.; Zhang, Tonglin; An, Pingli; Dong, Zhiqiang; Zhang, Jingting; He, Di; Wang, Liwei; Pan, Xuebiao; Bai, Wei; Niyogi, Dev

    2015-01-01

    Northern China is one of the most densely populated regions in the world. Agricultural activities have intensified since the 1980s to provide food security to the country. However, this intensification has likely contributed to an increasing scarcity in water resources, which may in turn be endangering food security. Based on in-situ measurements of soil moisture collected in agricultural plots during 1983–2012, we find that topsoil (0–50 cm) volumetric water content during the growing season has declined significantly (p < 0.01), with a trend of −0.011 to −0.015 m3 m−3 per decade. Observed discharge declines for the three large river basins are consistent with the effects of agricultural intensification, although other factors (e.g. dam constructions) likely have contributed to these trends. Practices like fertilizer application have favoured biomass growth and increased transpiration rates, thus reducing available soil water. In addition, the rapid proliferation of water-expensive crops (e.g., maize) and the expansion of the area dedicated to food production have also contributed to soil drying. Adoption of alternative agricultural practices that can meet the immediate food demand without compromising future water resources seem critical for the sustainability of the food production system. PMID:26158774

  17. Report of a new case with pentasomy X and novel clinical findings

    PubMed Central

    Demirhan, O; Tanriverdi, N; Yilmaz, MB; Kocaturk-Sel, S; Inandiklioglu, N; Luleyap, U; Akbal, E; Comertpay, G; Tufan, T; Dur, O

    2015-01-01

    Pentasomy X is an extremely rare sex chromosome abnormality, a condition that only affects females, in which three more X chromosomes are added to the normally present two chromosomes in females. We investigated the novel clinical findings in a 1-year-old female baby with pentasomy X, and determined the parental origins of the X chromosomes. Our case had thenar atrophy, postnatal growth deficiency, developmental delay, mongoloid slant, microcephaly, ear anomalies, micrognathia and congenital heart disease. A conventional cytogenetic technique was applied for the diagnosis of the polysomy X, and quantitative fluorescent polymerase chain reaction (QF-PCR) using 11 inherited short tandem repeat (STR) alleles specific to the chromosome X for the determination of parental origin of X chromosomes. A cytogenetic evaluation revealed that the karyotype of the infant was 49,XXXXX. Comparison of the infant’s features with previously reported cases indicated a clinically recognizable specific pattern of malformations referred to as the pentasomy X syndrome. However, to the best of our know-ledge, this is the first report of thenar atrophy in a patient with 49,XXXXX. The molecular analysis suggested that four X chromosomes of the infant originated from the mother as a result of the non disjunction events in meiosis I and meiosis II. We here state that the clinical manifestations seen in our case were consistent with those described previously in patients with pentasomy X. The degree of early hypotonia constitutes an important early prognostic feature in this syndrome. The pathogenesis of pentasomy X is not clear at present, but it is thought to be caused by successive maternal non disjunctions. PMID:26929910

  18. Early diagnostic imaging findings in juvenile dogs with presumed diskospondylitis: 10 cases (2008-2014).

    PubMed

    Kirberger, Robert M

    2016-09-01

    OBJECTIVE To describe early diagnostic imaging findings in juvenile dogs with diskospondylitis. DESIGN Retrospective case series. ANIMALS 10 client-owned dogs < 6 months of age. PROCEDURES Medical records were searched to identify juvenile dogs with a presumptive diagnosis of diskospondylitis. Signalment, history, examination findings, diagnostic test results, and imaging procedures were reviewed. Archived diagnostic images were retrieved and retrospectively evaluated. Data analysis was descriptive. RESULTS All dogs were evaluated for signs of vertebral pain ≤ 3 weeks after treatment for blunt trauma, bite wounds, or systemic illness. The earliest radiographic change was a narrowed intervertebral disk space (found for 28 disk spaces ≤ 2 weeks after evaluation for signs of vertebral pain); subluxation of adjacent vertebrae was identified for 8 of 28 affected disks, either initially or within the following 2 weeks. Vertebral end plate lysis was not an initial radiographic feature but was evident in follow-up radiographs. Ultrasonographic and transverse, multiformatted, volume-rendered CT images were obtained for 5 and 4 dogs, respectively. Ultrasonographic changes included ventrally bulging hypoechoic material at the affected disk site and loss of typical normal reverberation artifact in 4 dogs; these were detected prior to radiographic changes in 2 dogs. Affected disks on volume-rendered CT images had altered coloration in 3 of 4 dogs, and this was identified prior to radiographic changes in 1 dog. CONCLUSIONS AND CLINICAL RELEVANCE Juvenile dogs with a presumptive diagnosis of diskospondylitis had early imaging findings that were atypical, compared with the changes described for adult dogs with this condition. PMID:27556268

  19. Atmospheric science: Pacific trade wind intensifier

    NASA Astrophysics Data System (ADS)

    Collier, Mark

    2016-08-01

    The unprecedented recent intensification of the Pacific trade winds cannot simply be explained by natural variability alone. Now research finds that the more local influence of sulfate aerosols of human and volcanic origin play a significant role, in addition to the Pacific's coupling to the Atlantic Ocean via the 'atmospheric bridge'.

  20. Randomized Trial of Case-Finding for Depression in Elderly Primary Care Patients

    PubMed Central

    Whooley, Mary A; Stone, Barry; Soghikian, Krikor

    2000-01-01

    OBJECTIVE To determine the effect of case-finding for depression on frequency of depression diagnoses, prescriptions for antidepressant medications, prevalence of depression, and health care utilization during 2 years of follow-up in elderly primary care patients. DESIGN Randomized controlled trial. SETTING Thirteen primary care medical clinics at the Kaiser Permanente Medical Center, an HMO in Oakland, Calif, were randomly assigned to intervention conditions (7 clinics) or control conditions (6 clinics). PARTICIPANTS A total of 2,346 patients aged 65 years or older who were attending appointments at these clinics and completed the 15-item Geriatric Depression Scale (GDS). GDS scores of 6 or more were considered suggestive of depression. INTERVENTIONS Primary care physicians in the intervention clinics were notified of their patients' GDS scores. We suggested that participants with severe depressive symptoms (GDS score ≥ 11) be referred to the Psychiatry Department and participants with mild to moderate depressive symptoms (GDS score of 6 –10) be evaluated and treated by the primary care physician. Intervention group participants with GDS scores suggestive of depression were also offered a series of organized educational group sessions on coping with depression led by a psychiatric nurse. Primary care physicians in the control clinics were not notified of their patients' GDS scores or advised of the availability of the patient education program (usual care). Participants were followed for 2 years. MEASUREMENTS AND MAIN RESULTS Physician diagnosis of depression, prescriptions for antidepressant medications, prevalence of depression as measured by the GDS at 2-year follow-up, and health care utilization were determined. A total of 331 participants (14%) had GDS scores suggestive of depression (GDS ≥ 6) at baseline, including 162 in the intervention group and 169 in the control group. During the 2-year follow-up period, 56 (35%) of the intervention participants

  1. Mitigating Financial Burden of Tuberculosis through Active Case Finding Targeting Household and Neighbourhood Contacts in Cambodia

    PubMed Central

    Morishita, Fukushi; Yadav, Rajendra-Prasad; Eang, Mao Tan; Saint, Saly; Nishikiori, Nobuyuki

    2016-01-01

    Background Despite free TB services available in public health facilities, TB patients often face severe financial burden due to TB. WHO set a new global target that no TB-affected families experience catastrophic costs due to TB. To monitor the progress and strategize the optimal approach to achieve the target, there is a great need to assess baseline cost data, explore potential proxy indicators for catastrophic costs, and understand what intervention mitigates financial burden. In Cambodia, nationwide active case finding (ACF) targeting household and neighbourhood contacts was implemented alongside routine passive case finding (PCF). We analyzed household cost data from ACF and PCF to determine the financial benefit of ACF, update the baseline cost data, and explore whether any dissaving patterns can be a proxy for catastrophic costs in Cambodia. Methods In this cross-sectional comparative study, structured interviews were carried out with 108 ACF patients and 100 PCF patients. Direct and indirect costs, costs before and during treatment, costs as percentage of annual household income and dissaving patterns were compared between the two groups. Results The median total costs were lower by 17% in ACF than in PCF ($240.7 [IQR 65.5–594.6] vs $290.5 [IQR 113.6–813.4], p = 0.104). The median costs before treatment were significantly lower in ACF than in PCF ($5.1 [IQR 1.5–25.8] vs $22.4 [IQR 4.4–70.8], p<0.001). Indirect costs constituted the largest portion of total costs (72.3% in ACF and 61.5% in PCF). Total costs were equivalent to 11.3% and 18.6% of annual household income in ACF and PCF, respectively. ACF patients were less likely to dissave to afford TB-related expenses. Costs as percentage of annual household income were significantly associated with an occurrence of selling property (p = 0.02 for ACF, p = 0.005 for PCF). Conclusions TB-affected households face severe financial hardship in Cambodia. ACF has the great potential to mitigate the costs

  2. Targeted case finding for dementia in primary care: Surrey Downs dementia diagnosis project.

    PubMed

    Kallumpuram, Sen; Sudhir Kumar, C T; Khan, Bilal; Gavins, Victoria; Khan, Aalia; Iliffe, Steve

    2015-01-01

    Currently less than half of the estimated number of people with dementia in England receive a formal diagnosis of dementia or have contact with specialist dementia services. Case finding focused on high risk groups may be an effective way to identify the undiagnosed. This joint Surrey Downs Clinical Commissioning Group and Surrey and Borders NHS Foundation Trust quality improvement project aimed to increase the rate of dementia diagnosis across Surrey Downs using specialist link nurses (SLNs). Thirty three GP surgeries covering the entire Surrey Downs area took part in the project. Individuals at high risk of developing dementia were identified from GP electronic disease registers, and were offered screening at their GP practices by SLNs, using a combination of mini cognitive test (Mini-Cog) and functional assessment questionnaire (FAQ). Suitable individuals who screened positive were seen by their GP and where appropriate referred to secondary care services for further evaluation. Based on the presence of risk factors, 6657 (11.9%) people were identified from a total population of 55 845 over 65s, and 1980 (29.7%) completed the screening assessment. Three hundred and fifty eight (18.1%) individuals screened positive and were referred to their GP, who referred 205 (57.2%) of them to the memory services for further assessment. Of those referred, 164 (80%) had a comprehensive specialist assessment. Forty one (20%) declined further assessment, and their GPs were informed. The mean age of the cohort who completed the comprehensive assessment was 82.3 years (SD=4.26), and were predominantly white and male. Fifty four (32.9%) had mild cognitive disorder (MCD), and 101 (61.6%) patients were diagnosed with dementia. The most common dementia was mixed type (43; 42.6%), followed by Alzheimer's dementia (32; 31.7%). The most common risk factor among patients with cognitive impairment (MCD or dementia) was hypertension (69; 44.5 %), followed by ischemic heart disease (64, 41

  3. Magnetic resonance imaging findings of extraventricular anaplastic ependymoma: A report of 11 cases

    PubMed Central

    Leng, Xi; Tan, Xin; Zhang, Chi; Lin, Huan; Qiu, Shijun

    2016-01-01

    Anaplastic ependymomas are rare malignant tumors of the central nervous system. Few studies are available regarding their neuroradiological characteristics. The present study aimed to retrospectively review a series of patients with extraventricular anaplastic ependymoma and to analyze the magnetic resonance imaging (MRI) characteristics to distinguish anaplastic ependymoma from other intracranial tumors. The clinical and pathological images of 11 patients who presented with histologically proven anaplastic ependymoma at Nanfang Hospital (Southern Medical University, Guangzhou, Guangdong, China) between September 2004 and March 2015 were retrospectively reviewed. MRI scans were obtained in all 11 cases. Computed tomography scans were obtained in only 3 cases. In total, 8 tumors were located at the supratentorial parenchyma, and 3 tumors were derived from the cerebellar hemisphere. Images displayed quasi-circular (4/11), irregularly-lobulated (7/11) variable-intensity masses. The masses presented with cysts or necrosis (8/11), hemorrhage (7/11), marked (9/11) or mild (2/11) enhancement, and moderate (4/11), mild (3/11) or absent (4/11) peritumoral edema. The tumors were also frequently closely associated with the lateral ventricle (6/11). Tumors appeared isointense to hypointense on T1-weighted imaging (T1WI) and heterogeneously hyperintense or hypointense on T2WI, demonstrating wreath-like and ring-like characteristics, with intratumoral nodules (3/11) or marked flake-like inhomogeneous (6/11) enhancement on post-contrast MRI. Only 2 solid lesions showed mild enhancement (2/11). Although the MRI features of the extraventricular anaplastic ependymomas varied and were non-specific, these characteristic MRI findings, combined with the locations of the lesions, the age of onset and the short disease course, could be useful in differentiating anaplastic ependymomas from other intracranial neoplasms in the future.

  4. Drivers of routine immunization coverage improvement in Africa: findings from district-level case studies.

    PubMed

    LaFond, Anne; Kanagat, Natasha; Steinglass, Robert; Fields, Rebecca; Sequeira, Jenny; Mookherji, Sangeeta

    2015-04-01

    There is limited understanding of why routine immunization (RI) coverage improves in some settings in Africa and not in others. Using a grounded theory approach, we conducted in-depth case studies to understand pathways to coverage improvement by comparing immunization programme experience in 12 districts in three countries (Ethiopia, Cameroon and Ghana). Drawing on positive deviance or assets model techniques we compared the experience of districts where diphtheria-tetanus-pertussis (DTP3)/pentavalent3 (Penta3) coverage improved with districts where DTP3/Penta3 coverage remained unchanged (or steady) over the same period, focusing on basic readiness to deliver immunization services and drivers of coverage improvement. The results informed a model for immunization coverage improvement that emphasizes the dynamics of immunization systems at district level. In all districts, whether improving or steady, we found that a set of basic RI system resources were in place from 2006 to 2010 and did not observe major differences in infrastructure. We found that the differences in coverage trends were due to factors other than basic RI system capacity or service readiness. We identified six common drivers of RI coverage performance improvement-four direct drivers and two enabling drivers-that were present in well-performing districts and weaker or absent in steady coverage districts, and map the pathways from driver to improved supply, demand and coverage. Findings emphasize the critical role of implementation strategies and the need for locally skilled managers that are capable of tailoring strategies to specific settings and community needs. The case studies are unique in their focus on the positive drivers of change and the identification of pathways to coverage improvement, an approach that should be considered in future studies and routine assessments of district-level immunization system performance. PMID:24615431

  5. Drivers of routine immunization coverage improvement in Africa: findings from district-level case studies.

    PubMed

    LaFond, Anne; Kanagat, Natasha; Steinglass, Robert; Fields, Rebecca; Sequeira, Jenny; Mookherji, Sangeeta

    2015-04-01

    There is limited understanding of why routine immunization (RI) coverage improves in some settings in Africa and not in others. Using a grounded theory approach, we conducted in-depth case studies to understand pathways to coverage improvement by comparing immunization programme experience in 12 districts in three countries (Ethiopia, Cameroon and Ghana). Drawing on positive deviance or assets model techniques we compared the experience of districts where diphtheria-tetanus-pertussis (DTP3)/pentavalent3 (Penta3) coverage improved with districts where DTP3/Penta3 coverage remained unchanged (or steady) over the same period, focusing on basic readiness to deliver immunization services and drivers of coverage improvement. The results informed a model for immunization coverage improvement that emphasizes the dynamics of immunization systems at district level. In all districts, whether improving or steady, we found that a set of basic RI system resources were in place from 2006 to 2010 and did not observe major differences in infrastructure. We found that the differences in coverage trends were due to factors other than basic RI system capacity or service readiness. We identified six common drivers of RI coverage performance improvement-four direct drivers and two enabling drivers-that were present in well-performing districts and weaker or absent in steady coverage districts, and map the pathways from driver to improved supply, demand and coverage. Findings emphasize the critical role of implementation strategies and the need for locally skilled managers that are capable of tailoring strategies to specific settings and community needs. The case studies are unique in their focus on the positive drivers of change and the identification of pathways to coverage improvement, an approach that should be considered in future studies and routine assessments of district-level immunization system performance.

  6. Magnetic resonance imaging findings of extraventricular anaplastic ependymoma: A report of 11 cases

    PubMed Central

    Leng, Xi; Tan, Xin; Zhang, Chi; Lin, Huan; Qiu, Shijun

    2016-01-01

    Anaplastic ependymomas are rare malignant tumors of the central nervous system. Few studies are available regarding their neuroradiological characteristics. The present study aimed to retrospectively review a series of patients with extraventricular anaplastic ependymoma and to analyze the magnetic resonance imaging (MRI) characteristics to distinguish anaplastic ependymoma from other intracranial tumors. The clinical and pathological images of 11 patients who presented with histologically proven anaplastic ependymoma at Nanfang Hospital (Southern Medical University, Guangzhou, Guangdong, China) between September 2004 and March 2015 were retrospectively reviewed. MRI scans were obtained in all 11 cases. Computed tomography scans were obtained in only 3 cases. In total, 8 tumors were located at the supratentorial parenchyma, and 3 tumors were derived from the cerebellar hemisphere. Images displayed quasi-circular (4/11), irregularly-lobulated (7/11) variable-intensity masses. The masses presented with cysts or necrosis (8/11), hemorrhage (7/11), marked (9/11) or mild (2/11) enhancement, and moderate (4/11), mild (3/11) or absent (4/11) peritumoral edema. The tumors were also frequently closely associated with the lateral ventricle (6/11). Tumors appeared isointense to hypointense on T1-weighted imaging (T1WI) and heterogeneously hyperintense or hypointense on T2WI, demonstrating wreath-like and ring-like characteristics, with intratumoral nodules (3/11) or marked flake-like inhomogeneous (6/11) enhancement on post-contrast MRI. Only 2 solid lesions showed mild enhancement (2/11). Although the MRI features of the extraventricular anaplastic ependymomas varied and were non-specific, these characteristic MRI findings, combined with the locations of the lesions, the age of onset and the short disease course, could be useful in differentiating anaplastic ependymomas from other intracranial neoplasms in the future. PMID:27602137

  7. Two cases of myotonic dystrophy manifesting various ophthalmic findings with genetic evaluation.

    PubMed

    Kang, Min Ji; Yim, Hye Bin; Hwang, Hyung Bin

    2016-07-01

    We report two cases of myotonic dystrophy in one family; both diagnosed from genetic analysis following ophthalmic indications, but before the manifestation of systemic symptoms. A 39-year-old female visited our clinic for routine examination. Mild ptosis, sluggish pupillary response, and bilateral snowflake cataracts were found. Fundus examination revealed an increased cup-to-disc ratio (CDR) in both eyes and a defect in the retinal nerve fiber layer in the right eye. Intraocular pressure was low, but within the normal range in both eyes. Because cataracts are characteristic of myotonic dystrophy, we suggested that her 14-year-old daughter, who did not have any systemic complaints, undergo ophthalmic examination. She also had mild ptosis and snowflake cataracts. Both patients underwent genetic evaluation and were diagnosed with myotonic dystrophy caused by unstable expansion of cytosine-thymine-guanine trinucleotide repeats in the dystrophia myotonica-protein kinase gene. Ophthalmologists can diagnose myotonic dystrophy based on clinical and genetic findings, before the manifestation of systemic abnormalities. PMID:27609169

  8. [A case of pulmonary actinomycosis with a unique finding in the chest MR image].

    PubMed

    Sito, Tsuyako; Kobayashi, Makoto; Harada, Rhoji; Kubota, Tetsuya; Nakata, Hideshi; Uemura, Yoshiki; Nonami, Yoshiki; Yamashiro, Toshiyuki; Taguchi, Hirokuni

    2003-04-01

    A 57-year old man, who was complaining of a productive cough and right shoulder pain, was admitted to our hospital because of an irregularly shaped mass located at rt. S1 on a chest radiograph. Bronchoscopy revealed no evidence suggesting lung cancer or any specific infection, either pathologically or microbiologically. CT-guided biopsy revealed changes resembling lymphocytic or plasmocytic interstitial pneumonitis with thickening of the alveolar septum and with accumulations of mononuclear cells and plasma cells, indicating the proliferation of bronchus-associated lymphoid tissue (BALT system). Since no definitive diagnosis was considered possible, a right upper lobectomy was performed. Histopathologic examination of tissue from the right upper lobe revealed sulfur granules and branching Gram-positive filamentous bacteria, and the condition was pathologically diagnosed as pulmonary actinomycosis. In the center of the mass lesion, the patient's chest MRI showed a very small area with a low signal intensity in T1- and a high signal in T2-weighted images, which suggested an accumulation of fluid in the actinomycotic abscess. As detailed MR findings in this condition have not been well described in the literature, the MRI evidence seen in this case may be useful for the diagnosis of actinomycosis.

  9. Active Tuberculosis Case Finding Interventions Among Immigrants, Refugees and Asylum Seekers in Italy

    PubMed Central

    Schepisi, Monica Sañé; Gualano, Gina; Piselli, Pierluca; Mazza, Marta; D’Angelo, Donatella; Fasciani, Francesca; Barbieri, Alberto; Rocca, Giorgia; Gnolfo, Filippo; Olivani, Piefranco; Ferrarese, Maurizio; Codecasa, Luigi Ruffo; Palmieri, Fabrizio; Girardi, Enrico

    2016-01-01

    In Italy tuberculosis (TB) is largely concentrated in vulnerable groups such as migrants and in urban settings. We analyzed three TB case finding interventions conducted at primary centers and mobile clinics for regular/irregular immigrants and refugees/asylum seekers performed over a four-year period (November 2009-March 2014) at five different sites in Rome and one site in Milan, Italy. TB history and presence of symptoms suggestive of active TB were investigated by verbal screening through a structured questionnaire in migrants presenting for any medical condition to out-patient and mobile clinics. Individuals reporting TB history or symptoms were referred to a TB clinic for diagnostic workup. Among 6347 migrants enrolled, 891 (14.0%) reported TB history or symptoms suggestive of active TB and 546 (61.3%) were referred to the TB clinic. Of them, 254 (46.5%) did not present for diagnostic evaluation. TB was diagnosed in 11 individuals representing 0.17% of those screened and 3.76% of those evaluated. The overall yield of this intervention was in the range reported for other TB screening programs for migrants, although we recorded an unsatisfactory adherence to diagnostic workup. Possible advantages of this intervention include low cost and reduced burden of medical procedures for the screened population. PMID:27403270

  10. Two cases of myotonic dystrophy manifesting various ophthalmic findings with genetic evaluation

    PubMed Central

    Kang, Min Ji; Yim, Hye Bin; Hwang, Hyung Bin

    2016-01-01

    We report two cases of myotonic dystrophy in one family; both diagnosed from genetic analysis following ophthalmic indications, but before the manifestation of systemic symptoms. A 39-year-old female visited our clinic for routine examination. Mild ptosis, sluggish pupillary response, and bilateral snowflake cataracts were found. Fundus examination revealed an increased cup-to-disc ratio (CDR) in both eyes and a defect in the retinal nerve fiber layer in the right eye. Intraocular pressure was low, but within the normal range in both eyes. Because cataracts are characteristic of myotonic dystrophy, we suggested that her 14-year-old daughter, who did not have any systemic complaints, undergo ophthalmic examination. She also had mild ptosis and snowflake cataracts. Both patients underwent genetic evaluation and were diagnosed with myotonic dystrophy caused by unstable expansion of cytosine-thymine-guanine trinucleotide repeats in the dystrophia myotonica-protein kinase gene. Ophthalmologists can diagnose myotonic dystrophy based on clinical and genetic findings, before the manifestation of systemic abnormalities. PMID:27609169

  11. Rhino-orbital Mucormycosis: Clinical Findings and Treatment Outcomes of Four Cases

    PubMed Central

    Karadeniz Uğurlu, Şeyda; Selim, Sedat; Kopar, Aylin; Songu, Murat

    2015-01-01

    In this case report, we present the clinical findings and therapeutic outcomes of four rhino-orbital mucormycosis patients. The four patients (1 female, 3 male; age range, 55-77 years) all had diabetes mellitus and two also had chronic renal failure. All patients exhibited proptosis, sinusitis, and dark-colored lesions on the nasopharynx and/or hard palate; three patients had ipsilateral peripheral facial paralysis. Visual acuity was no light perception in the two patients with severe orbital involvement and 0.8 in two patients with limited orbital involvement. Histopathological examination of the hard palate, nasopharynx or sinus biopsy revealed typical Mucor hyphae. Systemic liposomal amphotericin B was initiated in all patients. The patients with limited ocular involvement received amphotericin B both intravenously and by local irrigation; both patients had complete recovery. The other two patients underwent orbital exenteration; one patient died after declining systemic treatment postoperatively. Rapid diagnosis and treatment are important for the survival of rhino-orbital mucormycosis patients. With orbital involvement, surgical debridement and systemic and local treatment with antifungal agents may help avoid mutilating surgery like exenteration. PMID:27800226

  12. A fatal case of a paint thinner ingestion: comparison between toxicological and histological findings.

    PubMed

    Argo, Antonina; Bongiorno, David; Bonifacio, Antonino; Pernice, Valentina; Liotta, Rosa; Indelicato, Serena; Zerbo, Stefania; Fleres, Pierangela; Ceraulo, Leopoldo; Procaccianti, Paolo

    2010-06-01

    Toluene and xylene are aromatic hydrocarbons commonly used as an industrial solvent for the manufacturing of pharmaceuticals, paints, and chemicals. The Occupational Safety and Health Administration has determined that toluene levels of 2000 parts per million (ppm) are considered dangerous to life and health. Several studies have examined the absorption of toluene and xylene following inhalation and oral ingestion in humans. Volatile organic compounds that are absorbed into the blood are distributed throughout the body; in particular, distribution of absorbed toluene and xylene in humans and rodents is characterized by preferential uptake in well-perfused and lipophil tissues such as the brain, liver, lungs, and body fat and also in central nervous system. The available studies indicate that xylenes are rapidly absorbed independently from the kind of exposition. We illustrate a fatal case of self-poisoning by ingestion of varnishes diluting solvents, reporting the identification and quantification of volatile organic compounds (toluene, o-m-p xylene) from human biologic liquids and viscera samples using the Solid-Phase Microextraction-Headspace-Gas Chromatography/Mass Spectrometry to toxicological analysis, and the histopathological findings evaluated in liver, kidney, and lungs. PMID:20010286

  13. Active Tuberculosis Case Finding Interventions Among Immigrants, Refugees and Asylum Seekers in Italy.

    PubMed

    Schepisi, Monica Sañé; Gualano, Gina; Piselli, Pierluca; Mazza, Marta; D'Angelo, Donatella; Fasciani, Francesca; Barbieri, Alberto; Rocca, Giorgia; Gnolfo, Filippo; Olivani, Piefranco; Ferrarese, Maurizio; Codecasa, Luigi Ruffo; Palmieri, Fabrizio; Girardi, Enrico

    2016-06-24

    In Italy tuberculosis (TB) is largely concentrated in vulnerable groups such as migrants and in urban settings. We analyzed three TB case finding interventions conducted at primary centers and mobile clinics for regular/irregular immigrants and refugees/asylum seekers performed over a four-year period (November 2009-March 2014) at five different sites in Rome and one site in Milan, Italy. TB history and presence of symptoms suggestive of active TB were investigated by verbal screening through a structured questionnaire in migrants presenting for any medical condition to out-patient and mobile clinics. Individuals reporting TB history or symptoms were referred to a TB clinic for diagnostic workup. Among 6347 migrants enrolled, 891 (14.0%) reported TB history or symptoms suggestive of active TB and 546 (61.3%) were referred to the TB clinic. Of them, 254 (46.5%) did not present for diagnostic evaluation. TB was diagnosed in 11 individuals representing 0.17% of those screened and 3.76% of those evaluated. The overall yield of this intervention was in the range reported for other TB screening programs for migrants, although we recorded an unsatisfactory adherence to diagnostic workup. Possible advantages of this intervention include low cost and reduced burden of medical procedures for the screened population. PMID:27403270

  14. Synthetic cathinone pharmacokinetics, analytical methods, and toxicological findings from human performance and postmortem cases.

    PubMed

    Ellefsen, Kayla N; Concheiro, Marta; Huestis, Marilyn A

    2016-05-01

    Synthetic cathinones are commonly abused novel psychoactive substances (NPS). We present a comprehensive systematic review addressing in vitro and in vivo synthetic cathinone pharmacokinetics, analytical methods for detection and quantification in biological matrices, and toxicological findings from human performance and postmortem toxicology cases. Few preclinical administration studies examined synthetic cathinone pharmacokinetic profiles (absorption, distribution, metabolism, and excretion), and only one investigated metabolite pharmacokinetics. Synthetic cathinone metabolic profiling studies, primarily with human liver microsomes, elucidated metabolite structures and identified suitable biomarkers to extend detection windows beyond those provided by parent compounds. Generally, cathinone derivatives underwent ketone reduction, carbonylation of the pyrrolidine ring, and oxidative reactions, with phase II metabolites also detected. Reliable analytical methods are necessary for cathinone identification in biological matrices to document intake and link adverse events to specific compounds and concentrations. NPS analytical methods are constrained in their ability to detect new emerging synthetic cathinones due to limited commercially available reference standards and continuous development of new analogs. Immunoassay screening methods are especially affected, but also gas-chromatography and liquid-chromatography mass spectrometry confirmation methods. Non-targeted high-resolution-mass spectrometry screening methods are advantageous, as they allow for retrospective data analysis and easier addition of new synthetic cathinones to existing methods. Lack of controlled administration studies in humans complicate interpretation of synthetic cathinones in biological matrices, as dosing information is typically unknown. Furthermore, antemortem and postmortem concentrations often overlap and the presence of other psychoactive substances are typically found in combination

  15. Active case finding for tuberculosis among people who inject drugs on methadone treatment in Dar es Salaam, Tanzania

    PubMed Central

    Gupta, A.; Mbwambo, J.; Mteza, I.; Shenoi, S.; Lambdin, B.; Nyandindi, C.; Doula, B. I.; Mfaume, S.; Bruce, R. D.

    2015-01-01

    SUMMARY SETTING Active case finding is a World Health Organization (WHO) endorsed strategy for improving tuberculosis (TB) case detection. Despite WHO recommendations for active case finding among people who inject drugs (PWID), few studies have been published. The historical focus of case finding has been in populations that are human immunodeficiency virus-positive, incarcerated or at higher occupational risk. OBJECTIVE We sought to examine the yield of active case finding among PWID newly started on methadone in Tanzania. DESIGN Of 222 methadone clients, 156 (70%) met with study administrators; 150 consented to participate, 139 (93%) of whom were male. The median age was 34 years. A symptom-based questionnaire was developed by the investigators and administered to every consenting patient by a native Swahili speaker. RESULTS Of the 150 patients surveyed, 16 (11%) had one or more TB symptoms and were referred for laboratory testing. Six new TB cases were identified in this active case finding program, with a prevalence of 4%. CONCLUSION This study presents the first data on TB prevalence in a population of PWID in Tanzania. This prevalence is 23 times that of the general Tanzanian TB prevalence of 0.2%. These results have significant implications for TB control. PMID:24902554

  16. Feline cholecystitis and acute neutrophilic cholangitis: clinical findings, bacterial isolates and response to treatment in six cases.

    PubMed

    Brain, Philip H; Barrs, Vanessa R; Martin, Patricia; Baral, Randolph; White, Joanna D; Beatty, Julia A

    2006-04-01

    Clinicopathological findings from six cats with confirmed cholecystitis or acute neutrophilic cholangitis are presented. Historical findings included lethargy and anorexia or inappetence of up to five days duration. On physical examination all cats were pyrexic and four out of six were jaundiced and had cranial abdominal pain. Bile samples were obtained by cholecystocentesis at exploratory coeliotomy (two cases) or by percutaneous, ultrasound-guided cholecystocentesis (four cases). Gall bladder rupture and bile peritonitis occurred subsequent to ultrasound-guided cholecystocentesis in one case. The most common bacterial isolate was Escherichia coli (four cases); E coli was isolated alone in two cases, in combination with a Streptococcus species (one case) and in combination with a Clostridium species (one case). Streptococcus species alone was isolated from one case, as was Salmonella enterica serovar Typhimurium. The latter is the first reported case of Salmonella-associated cholecystitis in a cat. Concurrent pancreatic or intestinal disease was detected histologically in three cases. All cases were treated with antimicrobials based on in vitro susceptibility results. Treatment was successful in five cases. One cat with concurrent diffuse epitheliotropic intestinal lymphoma was euthanased. Percutaneous ultrasound-guided cholecystocentesis is an effective, minimally-invasive technique enabling identification of bacterial isolates in cats with inflammatory hepatobiliary disease.

  17. Finding a Balance: Fifteen Institutional Case Studies on the Relationship between Part-Time Work and Advanced Level Study. Report.

    ERIC Educational Resources Information Center

    Hodgson, Ann, Ed.; Spours, Ken, Ed.

    This document presents and discusses case studies that examined the relationship between part-time employment and advanced level study at 15 schools in Essex, England. "Foreword" (David Jones) provides a brief overview of the project. "Finding a Balance--Fifteen Institutional Case Studies on the Relationship between Part-time Work and Advanced…

  18. Clinical presentation and laboratory findings for the first autochthonous cases of dengue fever in Madeira island, Portugal, October 2012.

    PubMed

    Alves, M J; Fernandes, P L; Amaro, F; Osório, H; Luz, T; Parreira, P; Andrade, G; Zé-Zé, L; Zeller, H

    2013-01-01

    An outbreak of dengue fever in Madeira island was reported in 2012. Clinical and laboratory findings of the first two laboratory-confirmed autochthonous cases are reported. Both cases had fever (≥38 °C) and petechial rash. Symptoms also included myalgia, asthenia, nausea, vomiting, anorexia, diffuse abdominal pain, and diarrhoea. The two cases were confirmed by serology and one tested positive for a dengue viral sequence. Dengue virus serotype DEN-1 was identified with probable Central or South American origin.

  19. Active Tuberculosis Case Finding in Port-au-Prince, Haiti: Experiences, Results, and Implications for Tuberculosis Control Programs

    PubMed Central

    Delva, Guesly J.; Fort, Dumesle St.

    2016-01-01

    Background. Haiti has the highest tuberculosis (TB) prevalence in the Americas with 254 cases per 100,000 persons. Case detection relies on passive detection and TB services in many regions suffer from poor diagnostic and clinical resources. Methods. Mache Chache (“Go and Seek”) was a TB REACH Wave 3 funded TB case finding project in Port-au-Prince between July 2013 and September 2014, targeting four intervention areas with insufficient TB diagnostic performance. Results. Based on a verbal symptom screen emphasizing the presence of cough, the project identified 11,150 (11.75%) of all screened persons as TB subjects and 2.67% as smear-positive (SS+) TB cases. Enhanced case finding and strengthening of laboratory services led to a 59% increase in bacteriologically confirmed cases in the evaluation population. In addition, smear grades dropped significantly, suggesting earlier case detection. Xpert® MTB/RIF was successfully introduced and improved TB diagnosis in HIV-infected, smear-negative clinic patients, but not in HIV-negative, smear-negative TB suspects in the community. However, the number needed to screen for one additional SS+ case varied widely between clinic and community screening activities. Conclusion. Enhanced and active TB case finding in Haiti can improve TB diagnosis and care. However, screening algorithms have to be tailored to individual settings, necessitating long-term commitment.

  20. Active Tuberculosis Case Finding in Port-au-Prince, Haiti: Experiences, Results, and Implications for Tuberculosis Control Programs

    PubMed Central

    Delva, Guesly J.; Fort, Dumesle St.

    2016-01-01

    Background. Haiti has the highest tuberculosis (TB) prevalence in the Americas with 254 cases per 100,000 persons. Case detection relies on passive detection and TB services in many regions suffer from poor diagnostic and clinical resources. Methods. Mache Chache (“Go and Seek”) was a TB REACH Wave 3 funded TB case finding project in Port-au-Prince between July 2013 and September 2014, targeting four intervention areas with insufficient TB diagnostic performance. Results. Based on a verbal symptom screen emphasizing the presence of cough, the project identified 11,150 (11.75%) of all screened persons as TB subjects and 2.67% as smear-positive (SS+) TB cases. Enhanced case finding and strengthening of laboratory services led to a 59% increase in bacteriologically confirmed cases in the evaluation population. In addition, smear grades dropped significantly, suggesting earlier case detection. Xpert® MTB/RIF was successfully introduced and improved TB diagnosis in HIV-infected, smear-negative clinic patients, but not in HIV-negative, smear-negative TB suspects in the community. However, the number needed to screen for one additional SS+ case varied widely between clinic and community screening activities. Conclusion. Enhanced and active TB case finding in Haiti can improve TB diagnosis and care. However, screening algorithms have to be tailored to individual settings, necessitating long-term commitment. PMID:27668093

  1. Active Tuberculosis Case Finding in Port-au-Prince, Haiti: Experiences, Results, and Implications for Tuberculosis Control Programs.

    PubMed

    Delva, Guesly J; Francois, Ingrid; Claassen, Cassidy W; Dorestan, Darwin; Bastien, Barbara; Medina-Moreno, Sandra; Fort, Dumesle St; Redfield, Robert R; Buchwald, Ulrike K

    2016-01-01

    Background. Haiti has the highest tuberculosis (TB) prevalence in the Americas with 254 cases per 100,000 persons. Case detection relies on passive detection and TB services in many regions suffer from poor diagnostic and clinical resources. Methods. Mache Chache ("Go and Seek") was a TB REACH Wave 3 funded TB case finding project in Port-au-Prince between July 2013 and September 2014, targeting four intervention areas with insufficient TB diagnostic performance. Results. Based on a verbal symptom screen emphasizing the presence of cough, the project identified 11,150 (11.75%) of all screened persons as TB subjects and 2.67% as smear-positive (SS+) TB cases. Enhanced case finding and strengthening of laboratory services led to a 59% increase in bacteriologically confirmed cases in the evaluation population. In addition, smear grades dropped significantly, suggesting earlier case detection. Xpert® MTB/RIF was successfully introduced and improved TB diagnosis in HIV-infected, smear-negative clinic patients, but not in HIV-negative, smear-negative TB suspects in the community. However, the number needed to screen for one additional SS+ case varied widely between clinic and community screening activities. Conclusion. Enhanced and active TB case finding in Haiti can improve TB diagnosis and care. However, screening algorithms have to be tailored to individual settings, necessitating long-term commitment. PMID:27668093

  2. Effect of temperature gradient of EBI of image intensifier

    SciTech Connect

    Chen, Q.

    1994-12-31

    In this paper the authors give the experiments for the measurement of EBI of an image intensifier with the change of temperature gradient of it. At the same time, the authors give the curves of EBI versus the different temperature gradients. The paper shows the causes for EBI of an image intensifier with the change of temperature gradient. The paper concluded, from the calculations and experiments, that there is need for the waiting measurement time for us to minimize the measuremental difference of EBI caused by temperature gradient. It is also indicated that the paper provides some scientific basis for improving possibly detecting objective performance of low light level night vision system in field if they adopt the scheme for the effect of temperature gradient on EBI of an image intensifier.

  3. Halo performance on low light level image intensifiers

    NASA Astrophysics Data System (ADS)

    Cui, Dongxu; Ren, Ling; Chang, Benkang; Shi, Feng; Shi, Jifang; Qian, Yunsheng; Wang, Honggang; Zhang, Junju

    To analyze the formation mechanism of the halo on low light level image intensifiers and the influencing factors on the halo size, a halo tester has been designed. Under the illumination between 10-2 lx and 10-4 lx, we use the tester to collect a 0.1922 mm hole image directly with CoolSNAPK4 charge-coupled device (CCD) in a darkroom. The practical measurement result shows that the amplification ratio is 343.4. Then we put the super second and third generation image intensifiers after the hole, and the halo sizes of the hole images on the screens are determined as 0.2388 and 0.5533 mm respectively. The results are helpful to improve the quality of the low light level image intensifiers.

  4. Case-finding for hepatitis C in primary care: a mixed-methods service evaluation

    PubMed Central

    Datta, Shivani; Horwood, Jeremy; Hickman, Matthew; Sharp, Debbie

    2014-01-01

    Background Hepatitis C is often asymptomatic, presenting with liver failure and cancer decades after infection. People who inject drugs (PWID) and immigrant populations from countries with a moderate-to-high prevalence of hepatitis C virus (HCV) are the main risk groups. Deaths and hospital admissions due to HCV cirrhosis tripled between 1998 and 2010, but the majority of people with chronic HCV are unaware of it. Aim To identify patients at risk of developing hepatitis C using routine GP data, to determine the proportion not tested, and to explore GPs’ views regarding testing. Design and setting Mixed-methods service evaluation (density-based selection of PWID) in six NHS practices in Bristol. Method Patients at risk of HCV were identified. The Health Protection Agency laboratory (now part of Public Health England) provided test results. Semi-structured interviews with 17 GPs were audiorecorded and thematic analyses conducted on anonymised transcripts. Results Of 3765 patients identified as being at risk of developing hepatitis C, 3051 (81%) had no test result, including 53% of PWID and 93% of the ‘ethnicity’ group. All GPs said they usually test PWID. Most GPs test for HIV and hepatitis B in immigrants more often than they test for HCV. Barriers to testing included not questioning patients about risk factors, competing priorities, the chaotic lifestyle of PWID, difficulty extracting information from computerised records, and forgetting to address HCV. Conclusion Computer prompts and GP education on whom to test are warranted. Ensuring that country of origin and drug use is included on the new-patient questionnaire might also aid case-finding for HCV. PMID:24567619

  5. Cryptosporidium infection causes undernutrition and, conversely, weanling undernutrition intensifies infection.

    PubMed

    Coutinho, Bruna P; Oriá, Reinaldo B; Vieira, Carlos M G; Sevilleja, Jesus Emmanuel A D; Warren, Cirle A; Maciel, Jamilly G; Thompson, Meghan R; Pinkerton, Relana C; Lima, Aldo A M; Guerrant, Richard L

    2008-12-01

    Cryptosporidium parvum is a leading pathogen in children in developing countries. To investigate whether early postnatal malnutrition leads to heavier C. parvum infections, we assessed intestinal adaptation and parasite load in suckling mice during the first 2 wk of life, analogous to the first postnatal yr in humans. Undernutrition was induced by daily C57BL6J pup separation from lactating dams. Half of the pups were separated daily, for 4 hr on day 4, 8 hr on day 5, and for 12 hr from day 6 until day 14. On day 6, each pup received an oral inoculum of 10(5) to 10(7) parasites in 10-25 microl of PBS. Littermate controls received PBS alone. Stools were assessed from days 8, 11, and 14 for oocyst counts. Mice were killed on day 14, 8 days postinoculation, at the peak of the infection. Ileal and colon segments were obtained for histology, real-time and reverse transcriptase PCR, and immunoassays. Villus and crypt lengths and cross-sectional areas were also measured. Undernourished and nourished mice infected with excysted 10(6) or 10(7) oocysts exhibited the poorest growth outcomes compared with their uninfected controls. Nourished 10(6)-infected mice had comparable weight decrements to uninfected undernourished mice. Body weight and villi were additively affected by malnutrition and cryptosporidiosis. Hyperplastic crypts and heavier inflammatory responses were found in the ilea of infected malnourished mice. Undernourished infected mice exhibited greater oocyst shedding, TNF-alpha and IFN-gamma intestinal levels, and mRNA expression compared to nourished mice infected with either 10(5) or 10(6) oocysts. Taken together, these findings show that Cryptosporidium infection can cause undernutrition and, conversely, that weanling undernutrition intensifies infection and mucosal damage.

  6. Does GRACE see the water cycle 'intensifying'?

    NASA Astrophysics Data System (ADS)

    Eicker, Annette; Kusche, Jürgen; Forootan, Ehsan; Springer, Anne; Schumacher, Maike; Ohlwein, Christian

    2014-05-01

    Several researchers have postulated that, under a changing climate due to anthropogenic forcing, an intensification of the water cycle is already under way (Huntington, 2006). This is usually related to increases in hydrological fluxes such as precipitation (P), evapotranspiration (E), and river discharge (R). It is under debate, however, whether such observed or reconstructed flux changes are real and on what scales. Large-scale increase or decrease of the flux deficit (P-E) would lead to acceleration or deceleration of water storage anomalies possibly visible in GRACE time series, when discharge variability is small or properly accounted for. We investigate to what extent such accelerations, which are indeed found in maps of global gridded GRACE water storage anomalies, can be explained using output fields derived from global and regional atmospheric (re-)analyses and from hydrological models. We find this analysis challenging, since the GRACE time series is short and dominated by ENSO-type natural variability. Observed accelerations strongly depend on the analysis time frame, and may be explained to a large percentage by natural variability, thus masking a possible anthropogenically driven intensification of the terrestrial water cycle. This motivates us to apply statistical decomposition techniques in order to identify modes of natural variabilities and to remove them from the GRACE time series prior to the estimation of accelerations. Huntington T.G. (2006): Evidence for intensification of the global water cycle: Review and synthesis. J. Hydrology, 319:83-95

  7. Narrative-Based Intervention for Word-Finding Difficulties: A Case Study

    ERIC Educational Resources Information Center

    Marks, Ian; Stokes, Stephanie F.

    2010-01-01

    Background: Children with word-finding difficulties manifest a high frequency of word-finding characteristics in narrative, yet word-finding interventions have concentrated on single-word treatments and outcome measures. Aims: This study measured the effectiveness of a narrative-based intervention in improving single-word picture-naming and…

  8. Persistence of phosphor glow in microchannel plate image intensifiers

    NASA Technical Reports Server (NTRS)

    Torr, M. R.

    1985-01-01

    Image intensifier tubes using microchannel plate amplification stages and phosphor output stages are being increasingly used in various detection applications. In this paper, measurements of the decay times of what are attributed to be the P20 phosphors in various image intensifiers are reported. It is found that the long tail on the decay curve of the phosphor following illumination can be a limitation for certain observations. In addition, the background level of phosphor glow (which is seen by the subsequent detection system as a light signal) continues to build with continuing illumination.

  9. Tuberculosis Case Finding in Benin, 2000–2014 and Beyond: A Retrospective Cohort and Time Series Study

    PubMed Central

    Ade, Serge; Békou, Wilfried; Adjobimey, Mênonli; Adjibode, Omer; Ade, Gabriel; Harries, Anthony D.; Anagonou, Séverin

    2016-01-01

    Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The “R” software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22%) were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT) represented 78%  ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15–34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country. PMID:27293887

  10. Tuberculosis Case Finding in Benin, 2000-2014 and Beyond: A Retrospective Cohort and Time Series Study.

    PubMed

    Ade, Serge; Békou, Wilfried; Adjobimey, Mênonli; Adjibode, Omer; Ade, Gabriel; Harries, Anthony D; Anagonou, Séverin

    2016-01-01

    Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The "R" software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22%) were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT) represented 78%  ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15-34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country. PMID:27293887

  11. Effectiveness of case finding strategies for COPD in primary care: a systematic review and meta-analysis

    PubMed Central

    Haroon, Shamil MM; Jordan, Rachel E; O’Beirne-Elliman, Joanne; Adab, Peymane

    2015-01-01

    Background: Chronic obstructive pulmonary disease (COPD) is widely underdiagnosed, but the most effective approach for identifying these patients is unknown. Aims: The aim of this study was to summarise and compare the effectiveness of different case finding approaches for undiagnosed COPD in primary care. Methods: A systematic review of primary studies of any design evaluating case finding strategies for COPD in primary care among individuals aged ⩾35 years with no prior diagnosis was conducted. Medline, Embase and other bibliographic databases were searched from 1997 to 2013, and methodological quality was assessed using standard tools. Results were described and meta-analysis of the uptake and yield from different approaches was performed where there was sufficient homogeneity. Results: Three randomised controlled trials (RCTs), 1 controlled trial and 35 uncontrolled studies were identified that assessed the identification of new cases of COPD through systematic case finding. A range of approaches were used including pre-screening with questionnaires (n=13) or handheld flow meters (n=5) or direct invitation to diagnostic spirometry (n=30). Overall, any approach identified more undiagnosed COPD compared with usual care. Targeting those at higher risk (e.g., smokers) and pre-screening (e.g., using questionnaires) is likely to increase the yield. However, studies were heterogeneous and were limited by a lack of comparison groups, inadequate reporting and diversity in the definition of COPD, which limited our ability to draw firm conclusions. Conclusions: There is extensive heterogeneity among studies evaluating case finding strategies for COPD, with few RCTs. Well-conducted RCTs comparing case finding approaches are needed to identify the most effective target population, recruitment strategy and screening tests, using a clinical definition of COPD, and addressing the limitations highlighted in this review. There is also a need to evaluate the impact of case

  12. Building Strong Geoscience Departments: Case Studies and Findings from Six Years of Programming

    NASA Astrophysics Data System (ADS)

    Iverson, E. A.; Lee, S.; Ormand, C. J.; Feiss, P. G.; Macdonald, H.; Manduca, C. A.; Richardson, R. M.

    2011-12-01

    Begun in 2005, the Building Strong Geoscience Departments project sought to help geoscience departments respond to changes in geosciences research, academic pressures, and the changing face of the geosciences workforce by working as a team, planning strategically, and learning from the experiences of other geoscience departments. Key strategies included becoming more central to their institution's mission and goals; articulating the department's learning goals for students; designing coordinated curricula, co-curricular activities, and assessments to meet these goals; and recruiting students effectively. A series of topical workshops identified effective practices in use in the U.S. and Canada. These practices were documented on the project website and disseminated through a national workshop for teams of faculty, through activities at the AGU Heads and Chairs workshops, and in a visiting workshop program bringing leaders to campuses. The program has now involved over 450 participants from 185 departments. To understand the impact of the program, we engaged in ongoing discussion with five departments of various sizes and institutional types, and facing a variety of immediate challenges. In aggregate they made use of the full spectrum of project offerings. These departments all reported that the project brought an important new perspective to their ability to work as a department: they have a better understanding of how their departments' issues relate to the national scene, have more strategies for making the case for the entire department to college administrators, and are better poised to make use of campus resources including the external review process. These results were consistent with findings from end-of-workshop surveys. Further they developed the ability to work together as a team to address departmental challenges through collective problem solving. As a result of their workshop participation, two of the departments who considered their department to be

  13. Student Perceptions of Peer versus Instructor Facilitation of Asynchronous Online Discussions: Further Findings from Three Cases

    ERIC Educational Resources Information Center

    Hew, Khe Foon

    2015-01-01

    This study aims to extend a previous work on the role of peer facilitation of asynchronous online discussions. Specifically, in this paper I report three cases that examine students' preference for peer or instructor facilitation of online discussion forums, as well as their respective reasons for it. These three cases involved the following…

  14. Case Studies on the Symbolism of Difference-Finding Problems in First Grade.

    ERIC Educational Resources Information Center

    Hasegawa, Junichi

    2002-01-01

    Discusses a class on subtraction or difference-finding, problems such as "There are eight white flowers and five red flowers, how many more white flowers are there than red flowers?" used in the teaching of Japanese first grade children. Describes three instances of introductory teaching of "difference-finding" problems in the first grade.…

  15. Thermal neutron image intensifier tube provides brightly visible radiographic pattern

    NASA Technical Reports Server (NTRS)

    Berger, H.; Kraska, I.; Niklas, W.; Schmidt, A.

    1967-01-01

    Vacuum-type neutron image intensifier tube improves image detection in thermal neutron radiographic inspection. This system converts images to an electron image, and with electron acceleration and demagnification between the input target and output screen, produces a bright image viewed through a closed circuit television system.

  16. The Effect of Intensified Language Exposure on Accommodating Talker Variability

    ERIC Educational Resources Information Center

    Antoniou, Mark; Wong, Patrick C. M.; Wang, Suiping

    2015-01-01

    Purpose: This study systematically examined the role of intensified exposure to a second language on accommodating talker variability. Method: English native listeners (n = 37) were compared with Mandarin listeners who had either lived in the United States for an extended period of time (n = 33) or had lived only in China (n = 44). Listeners…

  17. Statistical performance of the intensified charged coupled device

    NASA Astrophysics Data System (ADS)

    Sandel, B. R.; Broadfoot, A. L.

    1986-11-01

    The first analysis of the statistical performance of the intensified charge coupled device (CCD) is presented. The Poisson statistics of the arriving photons, the exponential pulse height distribution of the microchannel plate in the image intensifier, and the effects of discrete digitization of the charge in reading the CCD are included. A range of intensifier gains from the high levels that permit pulse counting to the low levels that can be used with the accumulation of charge on the CCD is considered. As a tool for this analysis, an analytical model of the performance of the detector system that is generally useful for predicting many aspects of system performance under a wide range of conditions is developed. The statistical penalty for operating the intensified CCD in the charge accumulation mode is not severe, and in some applications it may be desirable to accept this penalty to gain the advantages of increased dynamic range through charge accumulation. This investigation has revealed no pathological aspects of the operation of the detector system.

  18. Use of Linguistic Qualifiers and Intensifiers in a Computer Conference.

    ERIC Educational Resources Information Center

    Fahy, Patrick J.

    2002-01-01

    Describes a study that investigated a possible gender-related communications difference, the use of linguistic qualifiers and intensifiers, in the online computer conference transcript in a graduate course. Explains the use of sentences as the units of analysis and the use of a new tool for coding, the Transcript Analysis Tool. (Author/LRW)

  19. Final Report for the Intensified Career Exploration Program.

    ERIC Educational Resources Information Center

    McCauley, Lynne D.; Rusling, Diane E.

    An intensified Career Exploration Program was evaluated through an analysis of the cognitive and affective learning resulting from ninth- and tenth-grade students' participation in the program. Designed to supplement the existing ninth- and tenth-grade components of the Ohio Career Development Program, this three-year program offered additional…

  20. Using Brief Experimental Analysis to Intensify Tier 3 Reading Interventions

    ERIC Educational Resources Information Center

    Coolong-Chaffin, Melissa; Wagner, Dana

    2015-01-01

    As implementation of multi-tiered systems of support becomes common practice across the nation, practitioners continue to need strategies for intensifying interventions and supports for the subset of students who fail to make adequate progress despite strong programs at Tiers 1 and 2. Experts recommend making several changes to the structure and…

  1. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    .... (a) Identification. A radiographic intensifying screen is a device that is a thin radiolucent sheet coated with a luminescent material that transforms incident x-ray photons into visible light and intended for medical purposes to expose radiographic film. (b) Classification. Class I (general controls)....

  2. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... (a) Identification. A radiographic intensifying screen is a device that is a thin radiolucent sheet coated with a luminescent material that transforms incident x-ray photons into visible light and intended for medical purposes to expose radiographic film. (b) Classification. Class I (general controls)....

  3. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .... (a) Identification. A radiographic intensifying screen is a device that is a thin radiolucent sheet coated with a luminescent material that transforms incident x-ray photons into visible light and intended for medical purposes to expose radiographic film. (b) Classification. Class I (general controls)....

  4. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... (a) Identification. A radiographic intensifying screen is a device that is a thin radiolucent sheet coated with a luminescent material that transforms incident x-ray photons into visible light and intended for medical purposes to expose radiographic film. (b) Classification. Class I (general controls)....

  5. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .... (a) Identification. A radiographic intensifying screen is a device that is a thin radiolucent sheet coated with a luminescent material that transforms incident x-ray photons into visible light and intended for medical purposes to expose radiographic film. (b) Classification. Class I (general controls)....

  6. Cytogenetic findings in 21 cases of peripheral T-cell lymphoma.

    PubMed

    Inwards, D J; Habermann, T M; Banks, P M; Colgan, J P; Dewald, G W

    1990-10-01

    Although numerous publications have described the chromosome abnormalities in B-cell non-Hodgkin lymphoma and their significance, sparse literature exists pertaining to the chromosome abnormalities in T-cell lymphoma. We did cytogenetic analyses in 21 cases of peripheral T-cell lymphoma (PTCL). Chromosomally abnormal clones were identified in 15 (71%) of the cases, including 7 of the 10 cases in which the histologic distinction between a malignant and benign process was difficult. Abnormalities of chromosome 1 were observed in 10 cases; a breakpoint at 1p36 was demonstrated in 5 of these cases. Chromosome abnormalities previously attributed to B-cell malignancies were infrequent. These results suggest an association between 1p36 breakpoints and PTCL and emphasize the utility of cytogenetic analysis for documenting clonality among the histologically diverse groupings of PTCL.

  7. Intralobar pulmonary sequestration in elderly woman: a rare case report with emphasis on imaging findings.

    PubMed

    Al-Timimy, Qays Ahmed Hassan; Al-Shamseei, Hind Fadhil

    2016-09-01

    Intralobar pulmonary sequestration is a rare malformation that predisposes to recurrent respiratory infections. It is difficult to diagnose unless a more extensive directed investigation (to the vasculature and pulmonary parenchyma) is take on. Failure to diagnose and treat this condition can lead to recurrent pneumonia and fatal hemoptysis. Most cases are diagnosed before the age of 20 years. In this report, we present an extremely rare case of elderly woman with initial diagnosis of intralobar sequestration, and to our knowledge, this case represents the oldest diagnosed patient in the literature. PMID:27594937

  8. Synchronous bilateral multifocal canalicular adenoma: a case report of an unusual finding.

    PubMed

    Mansueto, G; Falleti, J; De Cecio, R; Papa, F; De Rosa, G

    2009-12-01

    Canalicular adenoma is a benign neoplasm of the minor salivary glands. The most common site is the upper lip, and the adenoma usually appears as a single lesion. Few cases of multiple foci of canalicular adenoma (CA) have been reported in literature. We report a case of a 78-year-old woman with CA of the nasolabial wrinkle on both sides of the nose, which occurred at the same time. The lesions recurred after about 1 year. This report adds to the literature another case of multiple, bilateral CA with synchronous occurrence.

  9. Clinicopathologic findings associated with chronic renal disease in cats: 74 cases (1973-1984).

    PubMed

    DiBartola, S P; Rutgers, H C; Zack, P M; Tarr, M J

    1987-05-01

    The historic, physical, laboratory, and histologic findings for 74 cats with chronic renal disease were reviewed. Most cats were older, and no breed or sex predilection was detected. This most common clinical signs detected by owners were lethargy, anorexia, and weight loss. Dehydration and emaciation were common physical examination findings. Common laboratory findings were nonregenerative anemia, lymphopenia, azotemia, hypercholesterolemia, metabolic acidosis, hyperphosphatemia, and isosthenuria. The most common morphologic diagnosis was chronic tubulointerstitial nephritis of unknown cause. The other pathologic diagnoses were renal lymphosarcoma, renal amyloidosis, chronic pyelonephritis, chronic glomerulonephritis, polycystic renal disease, and pyogranulomatous nephritis secondary to feline infectious peritonitis. PMID:3583899

  10. Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series*

    PubMed Central

    Nogueira-Barbosa, Marcello H.; Gregio-Junior, Everaldo; Lorenzato, Mario Muller

    2015-01-01

    Objective The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Materials and Methods Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Results Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5%) patients (mean age, 50.9 years; age range, 42-58 years; 42% female). Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Conclusion Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion. PMID:26811551

  11. Plain film and CBCT findings in a case of bisphosphonate-related osteonecrosis of the jaw.

    PubMed

    Singer, Steven R; Mupparapu, Muralidhar

    2009-02-01

    Imaging, along with clinical examination, plays a key role in determining the presence and extent of bisphosphonate-related osteonecrosis of the jaw (BRONJ). In this case, cone-beam computerized tomography (CBCT) was used to detect a large sequestrum and hyperstotic bone, leading to a diagnosis of bisphosphonate-related osteonecrosis of the jaw in a patient with a history of oral bisphosphonate use for treatment of osteoporosis. The radiographic features of this case of BRONJ are discussed.

  12. MR findings of fibrodysplasia ossificans progressiva complicated by acute cord compression: Case report and literature review.

    PubMed

    Gebara, Nathalie V; Heller, Gordon D; Phillips, C Douglas; Hatzoglou, Vaios

    2011-01-01

    We report a case of fibrodysplasia ossificans progressive in a 34-year-old male who presented with bilateral lower-extremity numbness. This rare disease results in abnormal ossification of various muscles, tendons, and ligaments. In this case, there was ossification of the posterior longitudinal ligament and resultant thoracic spinal-cord compression. Recognizing the MR features of this disease and this serious complication is very important in the management of these complex patients.

  13. CT and orbital ultrasound findings in a case of Castleman disease.

    PubMed

    Brubaker, Jacob W; Harrie, Roger P; Patel, Bhupendra C; Davis, Don K; Mamalis, Nick

    2011-01-01

    A 53-year-old man with a 2-month history of left periorbital swelling was found to have a large solid intraconal mass on CT scan. Orbital ultrasound showed that the lesion had a cavernous pattern of internal reflectivity. Histopathology revealed hyaline-vascular type Castleman disease (CD). This article represents the first reported orbital ultrasound findings in CD. The findings of CT scan and ultrasound may be useful in the preoperative evaluation of orbital hyaline-vascular type CD.

  14. Phenazepam abuse in Finland: findings from apprehended drivers, post-mortem cases and police confiscations.

    PubMed

    Kriikku, Pirkko; Wilhelm, Lars; Rintatalo, Janne; Hurme, Jukka; Kramer, Jan; Ojanperä, Ilkka

    2012-07-10

    Phenazepam is a long-acting benzodiazepine that, unlike other benzodiazepines, is currently not scheduled as a narcotic in Finland, most other European countries or the USA. It is used as an anxiolytic, sedative-hypnotic and anti-epileptic, mainly in Russia. In Finland, as well as in some other countries, an increase in the unauthorized use of phenazepam has been observed in recent years. In the one year period between July 1, 2010 and June 30, 2011 the prevalence of phenazepam in Finland was assessed among drivers apprehended for driving under the influence of drugs (DUID), in medico-legal autopsy cases and in police confiscations of illicit drugs. In DUID cases an LC-MS/MS method preceded by solid phase extraction was used for the determination of phenazepam. In the post-mortem investigations the sample preparation consisted of liquid-liquid extraction followed by derivatization and the determination was carried out by GC-MS. The police confiscations were analysed by GC-MS. There were 141 positive phenazepam cases among apprehended drivers, representing approximately 3.5% of all confirmed drug cases (n=4007) in this time period. The median (range) phenazepam blood concentration in DUID cases was 0.061 mg/L (0.004-3.600 mg/L). The median phenazepam concentration in cases with no concomitant stimulant use was significantly higher than the overall median concentration. Phenazepam was found in 17 medico-legal autopsy cases and the median (range) blood concentration was 0.048 mg/L (0.007-1.600 mg/L). Phenazepam was not considered by the medico-legal team to be the sole cause of death in any of the cases, the majority of them being accidental opiod overdoses. There were 26 seizures of phenazepam by the Police in the time period studied, some of the batches consisted of a mixture of phenazepam and stimulant designer drugs. The data show that phenazepam abuse is a widespread phenomenon in Finland. A typical user was a male multi-drug user in his 30s. The concentration

  15. Idiopathic muscular hypertrophy of the esophagus. Postmortem incidental finding in six cases and review of the literature.

    PubMed

    Demian, S D; Vargas-Cortes, F

    1978-01-01

    Six cases of idiopathic muscular hypertrophy of the esophagus were found at autopsy in a relatively short period of time. As has been the experience in previously reported cases, our finding was incidental at the autopsy in all of the cases. In only one of our patients were there relevant symptoms and radiographic changes that could be attributed to the disease. How often patients with muscular hypertrophy of the esophagus have the clinical syndrome of diffuse esophageal spasm remains unclear. It is therefore evident that only by awareness of this entity can studies of esophageal funtion, x-ray films, and appropriate treatment prevent serious morbidity and occasional mortality from the disease.

  16. Pathological findings in 2 cases of fatal 25I-NBOMe toxicity.

    PubMed

    Walterscheid, Jeffrey P; Phillips, Garrett T; Lopez, Ana E; Gonsoulin, Morna L; Chen, Hsin-Hung; Sanchez, Luis A

    2014-03-01

    The research compound 25I-NBOMe, also known as CIMBI-5 or INBMeO, was created in academic laboratories as a potent serotonin 2A receptor agonist. Because of its high affinity and ambiguous legal status, recreational drug enthusiasts have used this compound as a powerful alternative to other hallucinogenic drugs such as lysergic acid diethylamide. We report 2 deaths after 25I-NBOMe ingestion by decedents who attended separate "rave" parties. The first case involved a 21-year-old male who admitted taking "acid" to his friend. A sudden violent rage caused him to flail about, and he subsequently became unresponsive. The postmortem examination revealed numerous external injuries that were consistent with physical aggression. The second case involved a 15-year-old female who was socializing outside a rave party, became ill, and rapidly deteriorated as her friend transported her to the hospital. The postmortem assessment was similar to the first case in that external contusions featured prominently. Comprehensive toxicology screens in both cases revealed only evidence of marijuana use. A deeper analysis using time-of-flight mass spectrometry revealed the presence of 25I-NBOMe, which was further confirmed by tandem-mass spectrometry. The behavior and injuries in these cases reveal a consistent pattern preceding fatal 25I-NBOMe toxicity.

  17. Childhood Leukemia and 50 Hz Magnetic Fields: Findings from the Italian SETIL Case-Control Study

    PubMed Central

    Salvan, Alberto; Ranucci, Alessandra; Lagorio, Susanna; Magnani, Corrado

    2015-01-01

    We report on an Italian case-control study on childhood leukemia and exposure to extremely low frequency magnetic fields (ELF-MF). Eligible for inclusion were 745 leukemia cases, aged 0–10 years at diagnosis in 1998–2001, and 1475 sex- and age-matched population controls. Parents of 683 cases and 1044 controls (92% vs. 71%) were interviewed. ELF-MF measurements (24–48 h), in the child’s bedroom of the dwelling inhabited one year before diagnosis, were available for 412 cases and 587 controls included in the main conditional regression analyses. The magnetic field induction was 0.04 μT on average (geometric mean), with 0.6% of cases and 1.6% of controls exposed to >0.3 μT. The impact of changes in the statistical model, exposure metric, and data-set restriction criteria was explored via sensitivity analyses. No exposure-disease association was observed in analyses based on continuous exposure, while analyses based on categorical variables were characterized by incoherent exposure-outcome relationships. In conclusion, our results may be affected by several sources of bias and they are noninformative at exposure levels >0.3 μT. Nonetheless, the study may contribute to future meta- or pooled analyses. Furthermore, exposure levels among population controls are useful to estimate attributable risk. PMID:25689995

  18. Tuberculosis case-finding through a village outreach programme in a rural setting in southern Ethiopia: community randomized trial.

    PubMed Central

    Shargie, Estifanos Biru; Mørkve, Odd; Lindtjørn, Bernt

    2006-01-01

    OBJECTIVE: To ascertain whether case-finding through community outreach in a rural setting has an effect on case-notification rate, symptom duration, and treatment outcome of smear-positive tuberculosis (TB). METHODS: We randomly allocated 32 rural communities to intervention or control groups. In intervention communities, health workers from seven health centres held monthly diagnostic outreach clinics at which they obtained sputum samples for sputum microscopy from symptomatic TB suspects. In addition, trained community promoters distributed leaflets and discussed symptoms of TB during house visits and at popular gatherings. Symptomatic individuals were encouraged to visit the outreach team or a nearby health facility. In control communities, cases were detected through passive case-finding among symptomatic suspects reporting to health facilities. Smear-positive TB patients from the intervention and control communities diagnosed during the study period were prospectively enrolled. FINDINGS: In the 1-year study period, 159 and 221 cases of smear-positive TB were detected in the intervention and control groups, respectively. Case-notification rates in all age groups were 124.6/10(5) and 98.1/10(5) person-years, respectively (P = 0.12). The corresponding rates in adults older than 14 years were 207/10(5) and 158/10(5) person-years, respectively (P = 0.09). The proportion of patients with >3 months' symptom duration was 41% in the intervention group compared with 63% in the control group (P<0.001). Pre-treatment symptom duration in the intervention group fell by 55-60% compared with 3-20% in the control group. In the intervention and control groups, 81% and 75%, respectively of patients successfully completed treatment (P = 0.12). CONCLUSION: The intervention was effective in improving the speed but not the extent of case finding for smear-positive TB in this setting. Both groups had comparable treatment outcomes. PMID:16501728

  19. Clinical and oral findings in an Afro-Brazilian family with Gorlin-Goltz syndrome: case series and literature review.

    PubMed

    da Silva Pierro, Viviane Santos; Marins, Marcello Roter; Borges de Oliveira, Renata Cabral; Cortezzi, Wladimir; Janini, Maria Elisa; Maia, Lucianne Cople

    2015-01-01

    Gorlin-Goltz syndrome (GGS) seems to be unusual in black persons. The authors present an Afro-Brazilian family case report of GGS. The main complaint of the index case was a painless swelling of the left mandible, which was diagnosed as an odontogenic keratocyst. Further classical features of the Syndrome were present in this patient. Other two family members were diagnosed as cases of GGS and one of them presented 11 clinical findings characteristic of the syndrome. From the three cases reported, two of them presented five major diagnostic criteria for the GGS, and the diagnosis was only made because of an oral complaint. This case series emphasizes the importance of carefully examining the patient and close relatives for signs of GGS, even if they belong to an ethnic group in which this diagnosis is unusual. PMID:25039802

  20. Case Report of Fire Eater’s Pneumonia in Adolescent Female Patient – Evolution of Radiologic Findings

    PubMed Central

    Olchowy, Cyprian; Łasecki, Mateusz; Inglot, Marcin; Zaleska-Dorobisz, Urszula

    2015-01-01

    Summary Background We present a case of a 16-year-old girl with fire-eater’s pneumonia (hydrocarbon pneumonitis). The goal of this report was to assess evolution of radiological findings. Case Report The reported case was unique because that was the first completely described case of fire-eater’s pneumonia reported in an under-aged person. Moreover, this disease is very rare even in adults and only a few scientific reports can be found, mostly because of a small occupational group. Conclusions The aim of this report was to show that the problem of fire-eater’s pneumonia can occur in under-aged patients and should be taken into consideration in case of severe pneumonia. Another objective was to point out that chest radiograph is not sufficient to depict the evolution of radiological manifestations. PMID:25593634

  1. Multiple idiopathic external and internal resorption: Case report with cone-beam computed tomography findings

    PubMed Central

    Uzuntas, Ceren Feriha; Kurt, Hakan

    2014-01-01

    Root resorption is loss of dental hard tissue as a result of clastic activities. The dental hard tissue of permanent teeth does not normally undergo resorption, except in cases of inflammation or trauma. However, there are rare cases of tooth resorption of an unknown cause, known as "idiopathic root resorption." This report would discuss a rare case of multiple idiopathic resorption in the permanent maxillary and mandibular teeth of an otherwise healthy 36-year-old male patient. In addition to a clinical examination, the patient was imaged using conventional radiography and cone-beam computed tomography (CBCT). The examinations revealed multiple external and internal resorption of the teeth in all four quadrants of the jaws with an unknown cause. Multiple root resorption is a rare clinical phenomenon that should be examined using different radiographic modalities. Cross-sectional CBCT is useful in the diagnosis and examination of such lesions. PMID:25473640

  2. Endobronchial tumor in children: Unusual finding in recurrent pneumonia, report of three cases.

    PubMed

    Madafferi, Silvia; Catania, Vincenzo D; Accinni, Antonella; Boldrini, Renata; Inserra, Alessandro

    2015-05-01

    We are reporting 3 cases of pediatric endobronchial tumors presented with recurrent pneumonia. The median age of patients, at time of presentation, was 10.6 years. All patients presented with recurrent pneumonia with a mean time to occurrence, after onset of symptoms, of 14 mo. Bronchoscopy was early performed as part of diagnostic work-up and it revealed an endobronchial mass in every case. Complete surgical resection was performed in all cases, with lung preservation in two of them. Neither post-operative chemotherapy nor radiotherapy was required. The mean duration of follow-up was 7 years and all patients are still alive and disease-free. Recurrent pneumonia, in pediatrics, should raise the suspicion of an obstructing lesion, congenital malformation or systemic disease. A systematic approach is useful for organize the clinicians initial workup. Prompt diagnosis allows parenchymal-sparing surgery, which offers the best chance of cure and reduces clinical and functional complications in these patients. PMID:26015878

  3. Sonographic findings in horses with mediastinal lymphosarcoma: 13 cases (1985-1992).

    PubMed

    Garber, J L; Reef, V B; Reimer, J M

    1994-11-15

    Sonographic findings correlated with necropsy findings in 8 of 9 horses in which the cranial portion of the mediastinum was evaluated by use of both methods. Cranial mediastinal masses were imaged as multilobular and homogeneously hypoechoic; a complex echogenic pattern was observed with necrosis within the mass. Pleural effusion was a common finding in horses with mediastinal lymphosarcoma. Cytologic evaluation of pleural fluid samples was useful in diagnosis of lymphosarcoma in 10 of 12 horses that had thoracentesis. Sonographic examination of the thorax and cranial portion of the mediastinum can aid in the diagnosis of mediastinal lymphosarcoma in horses. Such examination should be performed in horses with clinical signs of cranial vena cava obstruction in which pleural effusion is detected, or when thoracic lymphosarcoma is suspected. PMID:7698925

  4. Renal cell carcinomas with t(6;11) (p21;q12): presentation of two cases with computed tomography findings.

    PubMed

    Zhao, YiJun; Yao, Jin; Chen, Ni; Zeng, Hao; Zhang, Wei

    2015-06-01

    Renal cell carcinomas with t(6;11) (p21;q12) translocation are extremely rare and primarily affect children and young adults. To our knowledge, there has been no case report focusing on the imaging manifestations in the existing literature. Hence, we describe the computed tomography findings of two young adults.

  5. Pleomorphic adenoma in the breast of a human female. Aspiration biopsy findings and receptor determinations. Case report.

    PubMed

    Willén, R; Uvelius, B; Cameron, R

    1986-11-01

    A case of multiple pleomorphic adenomas ("mixed" tumour of salivary gland type) of the breast is reported. This rare benign tumour can be misinterpreted as a malignant tumour both clinically and radiologically. The aspiration biopsy findings suggested cystosarcoma phyllodes. Oestrogen and progesterone receptor determinations revealed medium high levels, comparable to carcinoma of the breast.

  6. Dystonia an unusual presentation in pediatric moyamoya disease: Imaging findings of a case.

    PubMed

    Kumar, Suresh; Sharma, Sudhir; Jhobta, Anupam; Sood, Ram Gopal

    2016-01-01

    Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by idiopathic occlusion of bilateral internal carotid arteries and the development of characteristic leptomeningeal collateral vessels along anterior or posterior circulation. We present an unusual case of MMD presenting with generalized dystonia as the predominant manifestation. PMID:27606018

  7. Finding Boundaries Inside Prison Walls: Case Study of a Terminally Ill Inmate

    ERIC Educational Resources Information Center

    O'Connor, Mary-Frances

    2004-01-01

    The number of terminally ill prison inmates rises each year. Mental health professionals are uniquely prepared to provide therapy during the end-of-life process with their assessment, training, empathy, and communication skills. This case study examines the six-month therapy of one terminally ill inmate, using a client-centered approach. Drawing…

  8. Problems Teachers Face When Doing Action Research and Finding Possible Solutions: Three Cases

    ERIC Educational Resources Information Center

    Zhou, Jun

    2012-01-01

    Through case studies, this paper explores problems teachers face when doing action research: for instance, teachers may misunderstand the research, mistrust university researchers, lack the time or adequate library resources to conduct research, lack theoretical guidance or knowledge of research methodology, and feel pressure or frustration during…

  9. The Place of Peer Interaction in Teacher Development: Findings from a Case Study.

    ERIC Educational Resources Information Center

    Chism, Nancy Van Note

    This paper reports on work done as a part of a broader case study on conditions influencing staff development in an elementary school setting. It found that although teachers universally emphasized the importance of peer interaction in their development, their descriptions of the actual interactions in which they took part were modest in scope.…

  10. Grammatical Constructions in Cri du Chat Syndrome--Findings from a Case Study

    ERIC Educational Resources Information Center

    Kristoffersen, Kristian Emil

    2009-01-01

    The literature on grammatical skills in persons with Cri du chat syndrome (CCS) is very limited, and the need for more knowledge in this area is thus evident, in particular for speech and language therapists working with individuals with this syndrome. This case study report describes the syntactic skills of a 14-year-old Norwegian girl with CCS.…

  11. Dystonia an unusual presentation in pediatric moyamoya disease: Imaging findings of a case

    PubMed Central

    Kumar, Suresh; Sharma, Sudhir; Jhobta, Anupam; Sood, Ram Gopal

    2016-01-01

    Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by idiopathic occlusion of bilateral internal carotid arteries and the development of characteristic leptomeningeal collateral vessels along anterior or posterior circulation. We present an unusual case of MMD presenting with generalized dystonia as the predominant manifestation. PMID:27606018

  12. Radiologic Findings of Primary Mucinous Cystadenocarcinoma of the Breast: A Report of Two Cases and a Literature Review

    PubMed Central

    Seong, Minjung; Han, Boo-Kyung; Cho, Soo Youn; Cho, Eun Yoon; Lee, Se Kyung; Lee, Jeong Eon

    2016-01-01

    Primary mucinous cystadenocarcinoma (MCA) of the breast is a rare but pathologically distinct breast tumor. There have been some case reports on primary MCA of the breast; however, they have all focused on pathologic findings. Here, we report the radiologic findings of two cases of MCA along with a review of the literature. Breast MCA shows a circumscribed mass with some calcifications on mammography, an intracystic solid mass without increased vascularity or a vascular stalk on ultrasound, and a heterogeneously enhancing mass within a rim-enhancing cyst with intermediate signal intensity on T2-weighted magnetic resonance imaging. These radiologic findings and the presence of mucin in the percutaneous biopsy specimen should suggest the possibility of MCA in the differential diagnosis of a breast tumor. PMID:27721884

  13. Open market customer: Volume 1 -- Methods and case findings. Final report

    SciTech Connect

    Kotowski, J.; Wikler, G.; Milward, R.; Gudger, K.

    1998-06-01

    The Open Market Customer (OMC) report categorized nine specific choices by annual industry revenue; developed some of the inter-relationships between the various customer choices; and predicted how the customers, suppliers, technologies, energy products, and services may change given the basic restructuring of the industry. Gellings and Gudger estimate that the OMC market has annual expenditures of $780 billion and over $2 trillion in total investment. The purposes of this study were to illustrate the OMC principle and improve upon its numeric precision, develop a methodology for conducting an OMC assessment, and develop baseline data for future OMC assessments. The approach involved carrying out eight case study assessments of various commercial/industrial facilities. For each OMC case study, the annual energy expenditures and total investments for energy-related capital were determined for all types of fuel used at the facility. Annual expenditures include both the cost of energy, maintenance of the energy-related equipment, and labor. All annual expenditures and investments were assigned to one of nine business function areas depending on the function of the expenditure or investment. Eight types of commercial and industrial facilities were characterized. Four case studies were of actual facilities; four were of prototype facilities. The actual case studies consisted of Logan International Airport, Boston, MA; Washington University, St. Louis, MO; Cook County Hospital, Chicago, IL; and Sierra Pine Limited (a medium-density fiberboard manufacturer), Rocklin, CA. The four prototype case studies consisted of a 7,000 square foot retail building; a 3,500 square foot sit-down restaurant; and 50,000 square foot primary school; and a 782 home, 160 acre planned residential community.

  14. Some improvements on the auto-gated power for low-light level image intensifier

    NASA Astrophysics Data System (ADS)

    Yang, Ye; Yan, Bo; Zhi, Qiang; Yao, Ze; Li, Jun-guo; Fu, Ling-yun; Yuan, Yuan; Deng, Guang-xu

    2014-09-01

    The basic principle and formation of the auto-gated power using hybrid automatic brightness control scheme were described in detail. The auto-gated power supply in the application process because the device precision and the low-light level image intensifier between individual differences, fall may cause some products in some cases the SNR and resolution, and decrease the consistency of the product. This paper puts forward the corresponding solutions to these problems. And through experiments on the improved auto gated power supply with automatic gated power has not been improved compared. Applications of the auto-gated power in military, police and civil area were forecasted.

  15. Collimator application for microchannel plate image intensifier resolution improvement

    DOEpatents

    Thomas, Stanley W.

    1996-02-27

    A collimator is included in a microchannel plate image intensifier (MCPI). Collimators can be useful in improving resolution of MCPIs by eliminating the scattered electron problem and by limiting the transverse energy of electrons reaching the screen. Due to its optical absorption, a collimator will also increase the extinction ratio of an intensifier by approximately an order of magnitude. Additionally, the smooth surface of the collimator will permit a higher focusing field to be employed in the MCP-to-collimator region than is currently permitted in the MCP-to-screen region by the relatively rough and fragile aluminum layer covering the screen. Coating the MCP and collimator surfaces with aluminum oxide appears to permit additional significant increases in the field strength, resulting in better resolution.

  16. Collimator application for microchannel plate image intensifier resolution improvement

    DOEpatents

    Thomas, S.W.

    1996-02-27

    A collimator is included in a microchannel plate image intensifier (MCPI). Collimators can be useful in improving resolution of MCPIs by eliminating the scattered electron problem and by limiting the transverse energy of electrons reaching the screen. Due to its optical absorption, a collimator will also increase the extinction ratio of an intensifier by approximately an order of magnitude. Additionally, the smooth surface of the collimator will permit a higher focusing field to be employed in the MCP-to-collimator region than is currently permitted in the MCP-to-screen region by the relatively rough and fragile aluminum layer covering the screen. Coating the MCP and collimator surfaces with aluminum oxide appears to permit additional significant increases in the field strength, resulting in better resolution. 2 figs.

  17. Osteosarcoma arising from osteochondroma of the tibia: case report and cytogenetic findings.

    PubMed

    Engel, E E; Nogueira-Barbosa, M H; Brassesco, M S; Silva, G E B; Valera, E T; Peria, F M; Motta, T C; Tone, L G

    2012-01-01

    Osteochondroma is a cartilage capped benign tumor developing mainly at the juxta-epiphyseal region of long bones. The rate of malignant transformation, mainly into chondrosarcoma, is estimated to be less than 1-3%. Transformation into osteosarcoma is very rare and has been reported only thirteen times. There is little information on treatment and outcome. We report the case of a secondary osteosarcoma arising in the left tibia of a 23-year-old male, 10 years after the initial diagnosis of osteochondroma and after two partial resections. Malignant transformation occurred at the stalk and not at the cartilage cap, as would normally be expected. Chromosome banding analysis revealed the karyotype: 46,XY, t(3;13)(q21;q34) [2]/46,XY [18]. Records from additional cases will help determine the parameters that define these rare secondary bone lesions. PMID:22427037

  18. Incidental finding of two rare developmental anomalies: Fusion and dilaceration: A case report and literature review

    PubMed Central

    Sultan, Nishat

    2015-01-01

    A number of developmental anomalies of morphology are there. However, as compared to the more common oral diseases like caries or periodontal problems, they account for a relatively lower number. When present, they may pose various problems of esthetic, function, malocclusion, or possible disposition to other oral problems. Hence, though rare, their timely diagnosis is very vital in proper treatment planning to avoid unseen complications during extractions, endodontic or orthodontic treatment. The present case is of a patient reporting with two very rare developmental anomalies, that is, fusion and root dilaceration, in contralateral sides of the same patient. To the knowledge of the author, reportedly it is the first such case. The terminologies, etiology, and epidemiology of both these anomalies are also discussed. PMID:26604610

  19. Ictal hallucination and hemispheric specialization: findings from 217 cases with a unilateral epileptic focus.

    PubMed

    Guimond, Anik; Braun, Claude M J; Daigneault, Rafael

    2009-10-01

    Epileptic populations are generally considered inappropriate to investigate hemispheric specialization. However, (1) because hallucination occurs in the early stage of the ictus during which activation is observed in and around the focus, the former could be a direct result of the latter (hypothesis 1), and (2) the type of psychological content of ictal hallucination could depend on which hemisphere is ictally activated (hypothesis 2). It was predicted that, on the basis of quantitative analysis of previously published singles case reports, unilateral ictal hallucinations should occur in the visual field, ear or hemibody contralateral to the side of the ictal focus (test of hypothesis 1). It was also predicted that verbal ictal auditory hallucinations should result more often from left hemisphere foci, and non-verbal auditory ictal hallucinations from right hemisphere foci (test of hypothesis 2). Previously published cases (N=217) of ictal hallucination from a unilateral epileptic focus were reviewed and analyzed with multivariate statistics. Both predictions were strongly supported.

  20. Hot water epilepsy with cerebral lesion: a report of five cases with cranial MRI findings.

    PubMed

    Tezer, F Irsel; Ertas, Nalan; Yalcin, Destina; Saygi, Serap

    2006-05-01

    Hot water epilepsy (HWE) is included in the reflex epilepsies. Although, in general, not common, HWE is concentrated in certain regions of the world. Different bathing habits and genetic factors may be responsible for the high incidence of HWE in these regions. However, the exact pathogenesis of HWE is not known. The facts that complex partial seizures are the most common clinical presentation and EEG recordings show an epileptic focus in the temporal lobe suggested the presence of a structural lesion in the temporal lobe. To our knowledge, however, there were no demonstrable structural changes on MRI and CT scans except in a few case reports. Here, we describe an additional five cases of HWE having an intracranial pathology, for example, hippocampal sclerosis, dysplasia, and a huge cystic lesion. We believe that investigations with new detailed neuroimaging techniques, in addition to experimental and clinical studies, might help us to understand the mechanism of this reflex epilepsy. PMID:16546449

  1. Cone Beam Computed Tomography Findings in Calcifying Cystic Odontogenic Tumor Associated with Odontome: A Case Report

    PubMed Central

    Phulambrikar, Tushar; Vilas Kant, Sanchita; Kode, Manasi; Magar, Shaliputra

    2015-01-01

    The calcifying cystic odontogenic tumor (CCOT) is a rare cystic odontogenic neoplasm frequently found in association with odontome. This report documents a case of CCOT associated with an odontome arising in the anterior maxilla in a 28-year-old man. Conventional radiographs showed internal calcification within the lesion but were unable to visualize its relation with the adjacent structures and its accurate extent. In this case cone beam computed tomography (CBCT) could accurately reveal the extent and the internal structure of the lesion which aided the presumptive diagnosis of the lesion as CCOT. This advanced imaging technique proved to be extremely useful in the radiographic assessment and management of this neoplasm of the maxilla. PMID:26636128

  2. Osteosarcoma arising from osteochondroma of the tibia: case report and cytogenetic findings.

    PubMed

    Engel, E E; Nogueira-Barbosa, M H; Brassesco, M S; Silva, G E B; Valera, E T; Peria, F M; Motta, T C; Tone, L G

    2012-03-01

    Osteochondroma is a cartilage capped benign tumor developing mainly at the juxta-epiphyseal region of long bones. The rate of malignant transformation, mainly into chondrosarcoma, is estimated to be less than 1-3%. Transformation into osteosarcoma is very rare and has been reported only thirteen times. There is little information on treatment and outcome. We report the case of a secondary osteosarcoma arising in the left tibia of a 23-year-old male, 10 years after the initial diagnosis of osteochondroma and after two partial resections. Malignant transformation occurred at the stalk and not at the cartilage cap, as would normally be expected. Chromosome banding analysis revealed the karyotype: 46,XY, t(3;13)(q21;q34) [2]/46,XY [18]. Records from additional cases will help determine the parameters that define these rare secondary bone lesions.

  3. Carcinosarcoma of the parotid gland: report of a case with cytohistologic and immunohistochemical findings.

    PubMed

    Latkovich, P; Johnson, R L

    1998-08-01

    True malignant mixed tumors (carcinosarcomas) of salivary gland origin are exceedingly rare and demonstrate malignant epithelial and stromal components. We report a case of parotid gland carcinosarcoma that showed squamous cell carcinoma and malignant fibrous hystiocytoma without clinical or histologic evidence of a preexisting pleomorphic adenoma. This tumor consisted of 2 histologically different populations of cells without evidence of a common origin from the myoepithelial cell, which is the putative precursor cell of pleomorphic adenoma and its derived carcinosarcoma. In addition to supplementing the literature, this case report includes cytohistologic and immunohistochemical analyses that provide further insights into the variable histogenesis of this neoplasm and the distinction between de novo carcinosarcoma and carcinosarcoma originating from pleomorphic adenoma.

  4. Repackaging prostate cancer support group research findings: an e-KT case study.

    PubMed

    Oliffe, John L; Han, Christina S; Lohan, Maria; Bottorff, Joan L

    2015-01-01

    In the context of psychosocial oncology research, disseminating study findings to a range of knowledge "end-users" can advance the well-being of diverse patient subgroups and their families. This article details how findings drawn from a study of prostate cancer support groups were repackaged in a knowledge translation website--www.prostatecancerhelpyourself.ubc.ca--using Web 2.0 features. Detailed are five lessons learned from developing the website: the importance of pitching a winning but feasible idea, keeping a focus on interactivity and minimizing text, negotiating with the supplier, building in formal pretests or a pilot test with end-users, and completing formative evaluations based on data collected through Google™ and YouTube™ Analytics. The details are shared to guide the e-knowledge translation efforts of other psychosocial oncology researchers and clinicians.

  5. A case of a giant pseudoangiomatous stromal hyperplasia of the breast: magnetic resonance imaging findings.

    PubMed

    Solomou, Ekaterini; Kraniotis, Pantelis; Patriarcheas, Georgios

    2012-04-12

    Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign myofibroblastic process. We present the case of a 17-year-old girl who underwent diagnostic work-up due to an enlargement of her left breast. She was submitted to ultrasounds and magnetic resonance imaging (MRI) which depicted a 14 cm lesion in her left breast. The patient was later operated and histology revealed PASH. Although PASH may range from 0.6-12 cm, a few lesions over 12 cm have been described, the largest being 20 cm. Large series present mammographic and ultrasonographic features of PASH in the literature, but little has been reported on the MR characteristics of PASH up to today. Signal on the T1-weighted image (T1WI) and T2-weighted image (T2WI) may vary. Curves generated from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) studies are mainly type I or less frequently type II. There are no reports about diffusion-weighted imaging and corresponding apparent diffusion coefficient (ADC) values for PASH in the literature. ADC values in our case lie within the range of values reported for other benign breast lesions. The presence of slit-like spaces within the lesion on MR imaging along with DCE-MRI type I curve and ADC values consistent with a benign lesion may favour the diagnosis of PASH. Tissue biopsy is necessary, however for the final diagnosis. This case report will further contribute to the understanding of MR imaging features of PASH, especially in cases where mammography is not indicated.

  6. A prospective study of the clinical findings, treatment and histopathology of 44 cases of pyotraumatic dermatitis.

    PubMed

    Holm, Birgit R; Rest, Joan R; Seewald, Wolfgang

    2004-12-01

    Pyotraumatic dermatitis (hot spot) is a common clinical syndrome in dogs but there are few prospective scientific studies related to it. The aim of this study was to investigate correlations among clinical pyotraumatic dermatitis, histopathology of the lesions and possible predisposing causes. The relationship of these with breed, age, sex and location of lesion was assessed statistically. A clinical diagnosis of acute pyotraumatic dermatitis was made in 44 privately owned dogs. Males exceeded females (P = 0.0348) and lesions were more common in dogs aged 4 years or less (P < 0.0001). Lesions were most often seen on the cheek, neck and lateral thigh with a significant correlation between breed and site of lesion (P < 0.0001). In 31 cases a possible underlying cause was found or suspected. In contrast to previous studies, no otitis externa was recorded and the study was conducted in an area without endemic fleas. Fourteen breeds were represented of which Rottweiler, German shepherd dog and golden retriever were most common. There was no significant seasonal incidence and no correlation among site of lesion and cause, time of year, age or sex. Histopathologically, the dogs could be separated into four patterns by the presence or absence of eosinophils and/or folliculitis. Eosinophils have not previously been recorded in pyotraumatic dermatitis but were seen in 29 cases. Acute folliculitis was seen in 20 cases. However, no correlation was seen among age, sex, breed, underlying cause or site of lesion and histopathology. Twenty-seven cases were cultured for bacteria of which 25 grew Staphylococcus intermedius and two were negative.

  7. Gross Findings of Widespread Visceral Metastasis of Prostatic Adenocarcinoma With Neuroendocrine Features: A Case Report.

    PubMed

    Habibian, David J; Dao, Alexander E; Kumar, Shauna; Schiff, Jeffrey; Kosinski, Kaitlin E; Katz, Aaron E

    2016-09-01

    Although prostate cancer is common in the western world and is associated with favorable overall survival, neuroendocrine prostate cancer is difficult to detect and is known to aggressively metastasize throughout the body. This subset of disease thus has a poor prognosis, and early detection and treatment of neuroendocrine prostate cancer may increase overall survival. We present a case of a now deceased 63 year old male with extensive epicardial, respiratory, hepato-bilary, adrenal, genitourinary, and osseous tissue metastasis. PMID:27489779

  8. Colonic angiolipoma - a rare finding in the gastrointestinal tract. Case report and review of literature.

    PubMed

    Molinares, Beatriz; Goldstein, Andrés; Varela, Gabriel J; Mesa, Sara

    2012-06-01

    Angiolipomas are benign lesions that are frequently found in subcutaneous cellular tissue, but are rarely located in the gastrointestinal tract. Here we discuss a case of colonic angiolipoma that presented as a mass near the hepatic flexure, occupying approximately 90% of the colonic lumen. The diagnosis was made by endoscopy and computed tomography. The mass was resected successfully and diagnosis was confirmed by histological studies and immunohistochemical tests.

  9. Case Example of Dose Optimization Using Data From Bortezomib Dose-Finding Clinical Trials

    PubMed Central

    Backenroth, Daniel; Cheung, Ying Kuen Ken; Hershman, Dawn L.; Vulih, Diana; Anderson, Barry; Ivy, Percy; Minasian, Lori

    2016-01-01

    Purpose The current dose-finding methodology for estimating the maximum tolerated dose of investigational anticancer agents is based on the cytotoxic chemotherapy paradigm. Molecularly targeted agents (MTAs) have different toxicity profiles, which may lead to more long-lasting mild or moderate toxicities as well as to late-onset and cumulative toxicities. Several approved MTAs have been poorly tolerated during long-term administration, leading to postmarketing dose optimization studies to re-evaluate the optimal treatment dose. Using data from completed bortezomib dose-finding trials, we explore its toxicity profile, optimize its dose, and examine the appropriateness of current designs for identifying an optimal dose. Patients and Methods We classified the toxicities captured from 481 patients in 14 bortezomib dose-finding studies conducted through the National Cancer Institute Cancer Therapy Evaluation Program, computed the incidence of late-onset toxicities, and compared the incidence of dose-limiting toxicities (DLTs) among groups of patients receiving different doses of bortezomib. Results A total of 13,008 toxicities were captured: 46% of patients’ first DLTs and 88% of dose reductions or discontinuations of treatment because of toxicity were observed after the first cycle. Moreover, for the approved dose of 1.3 mg/m2, the estimated cumulative incidence of DLT was > 50%, and the estimated cumulative incidence of dose reduction or treatment discontinuation because of toxicity was nearly 40%. Conclusions When considering the entire course of treatment, the approved bortezomib dose exceeds the conventional ceiling DLT rate of 20% to 33%. Retrospective analysis of trial data provides an opportunity for dose optimization of MTAs. Future dose-finding studies of MTAs should take into account late-onset toxicities to ensure that a tolerable dose is identified for future efficacy and comparative trials. PMID:26926682

  10. Plasmacytoid myoepithelioma of minor salivary glands: report of case with emphasis in the immunohistochemical findings

    PubMed Central

    2011-01-01

    Myoepithelioma is a rare benign tumor of the salivary glands and is usually seen in the parotid gland and the minor salivary glands. It was once considered to be a type of pleomorphic adenoma (PA), but myoepitheliomas are today believed to be relatively aggressive tumors. Myoepitheliomas are most common in young adults between the ages of 30 and 50 and there are very few cases reported in individuals less than 18 years of age. We report a case of myoepithelioma located in the hard palate in a 15-year-old Brazilian male. The tumor was composed of plasmacytoid myoepithelial cells. An analysis of the immunohistochemical profile of the tumor cells showed positivity for vimentin, S-100 protein, and glial fibrillary acidic protein (GFAP), but not for smooth muscle actin (α-SMA) and cytokeratin 14 (CK14). We report this case because of the rarity of this tumor, especially in adolescents. We also discuss the histological parameters of the differential diagnosis of this tumor as well as its immunohistochemical profile. PMID:22152025

  11. [Results of selective kidney DSA in suspicious computerized tomography findings--retrospective evaluation of 122 cases].

    PubMed

    Will, C H; Bach, D; Koop, H

    1994-09-01

    The superiority of computer tomography in the detection and staging of renal malignomas has been proven in numerous studies. In this retrospective analysis, the significance of the pre-surgically still widely and routinely performed, selective kidney angiography was investigated. The written computer tomographical and angiographic findings of 122 patients were classified according to malignancy stage urgency. They were then compared to progression, and surgical finding respectively. Angiography had the greatest influence on the therapeutic procedure in those patients having only a slight computer-tomographical suspicion of tumor. An operation was waived by 12 patients. A small hypernephroma (pT 2 showing typical tumor vessels was found in two patients. Inoperability excepted, a surgical denudation was performed in all patients with computer tomographical tumor typical, or suspicious finding, irrespective of the angiographic result. The diagnosis was surgically confirmed in all patients having a tumor-specific angiogram. Yet besides benign tumors, 4 hypernephromas and 5 other malignomas were found in those patients showing an angiographically classified, vessel-free formation.

  12. Intensifying Insulin Therapy in Type 2 Diabetes: Choices & Challenges.

    PubMed

    Kumar, Ajay; Kesavadev, Jothydev; Sethi, Bipin; Jain, Sunil M; Guruprasad, C S; Shah, Siddharth N

    2015-05-01

    Insulin therapy remains the cornerstone of effective diabetes management. Timely intensification of insulin therapy reduces the progression of diabetes and the development of diabetes-related complications. Given that overall hyperglycaemia is a relative contribution of both fasting and postprandial hyperglycaemia, use of basal insulin alone may not achieve optimal glucose control due to its inability to cover postprandial glucose excursions. Intensifying therapy with addition of bolus insulin or switching to premixed insulin is a viable option in patients failing on basal alone therapy. Although the benefits of early insulin treatment are well established, a considerable delay in intensifying insulin therapy in patients with sub-optimal glycaemic control is still observed. Most of the patients and physicians are reluctant to intensify therapy due to the fear of hypoglycaemia, regimen complexity, and increased burden of multiple daily injections. In this context, there is a need for a flexible, alternative intensification option taking into account individual patient considerations to achieve or maintain individual glycaemic targets. An ideal insulin regimen should mimic physiological insulin release while providing optimal glycaemic control with low risk of hypoglycaemia, weight gain and fewer daily injections. The current paper reviews the challenges of insulin intensification in patients with type 2 diabetes mellitus poorly controlled on current treatment regimens. PMID:26548029

  13. Test and analysis of spectral response for UV image intensifier

    NASA Astrophysics Data System (ADS)

    Qian, Yunsheng; Liu, Jian; Feng, Cheng; Lv, Yang; Zhang, Yijun

    2015-10-01

    The UV image intensifier is one kind of electric vacuum imaging device based on principle of photoelectronic imaging. To achieve solar-blind detection, its spectral response characteristic is extremely desirable. A broad spectrum response measurement system is developed. This instrument uses EQ-99 laser-driven light source to get broad spectrum in the range of 200 nm to 1700 nm. A special preamplifier as well as a test software is work out. The spectral response of the image intensifier can be tested in the range of 200~1700 nm. Using this spectrum response measuring instrument, the UV image intensifiers are tested. The spectral response at the spectral range of 200 nm to 600 nm are obtained. Because of the quantum efficiency of Te-Cs photocathode used in image intens ifier above 280nm wavelength still exists, especially at 280 nm to 320nm.Therefore, high-performance UV filters is required for solar blind UV detection. Based on two sets of UV filters, the influence of solar radiation on solar blind detection is calculated and analyzed.

  14. Variation of ultrasound findings in the first trimester examination of recurrent cases with trisomy 21.

    PubMed

    Daniilidis, Aggelos; Balaouras, Dimitrios; Chitzios, Dimitrios; Balaouras, Georgios; Capilna, Mihai; Asimakopoulos, Efstratios

    2015-06-01

    Increased nuchal translucency (NT) is present in about 50% of cases with trisomy 21. Very often the nuchal edema evolves in hydrops fetalis until the second trimester. Furthermore, a small amount of cases with a normal NT and trisomy 21 exhibit anatomical anomalies. We present a case of a 21-year-old woman, nulliparous, with a history of one termination of pregnancy and a smoking quitter. The prenatal control was negative for TORCH. During the first trimester scan on the 13th week, the NT was found 2.7 mm, the ductus venosus Doppler was normal, and the nasal bone was present. Hydrops fetalis was present though, and the parents were advised for chorionic villus sampling (CVS), but they opted for termination of pregnancy. The molecular control by QF-PCR showed normal karyotype for 13 and 18, a male fetus, but non-dysjunction trisomy 21 was present. Parental karyotype was advised, but they refused to perform it. One year later, the couple had another pregnancy. On the 12th week scan, the NT was found 1.0 mm, the ductus venosus Doppler was normal, and the nasal bone was present, but encephalocele was also found, and the parents consented again for termination of pregnancy. The new molecular control showed the same results. This time parental karyotype was performed. The father had a normal one, whereas the mother showed reversed p11 and q13 zones in chromosome 2. Genetical consulting and prenatal cytological control was advised in before next pregnancy. PMID:25883716

  15. Clinical, Radiologic, and Pathologic Findings of Subdural Osteoma: A Case Report

    PubMed Central

    Kim, Eun Young; Hyun, Dong Keun; Park, Hyeonseon; Oh, Se Yang; Yoon, Seung Hwan

    2016-01-01

    We present a case of a subdural osteoma. A 29-year-old female presented with a 3-year history of headaches. Computed tomography scan revealed a homogeneous high-density lesion isolated from the inner table of the frontal bone (a lucent dural line) in the right frontal convexity. Magnetic resonance imaging revealed an extra-axial lesion with a broad base without dural tail sign and punctate enhancement pattern characteristic of abundant adipose tissue. Upon surgical excision, we found a hard bony mass clearly demarcated from the dura. The mass displayed characteristics of an osteoma upon histological examination. The symptom was relieved after operation. PMID:27195262

  16. Congenital gluteus maximus contracture syndrome - a case report with review of imaging findings

    PubMed Central

    Kotha, Vamshi Krishna; Reddy, Rajasekhar; Reddy, M. Venkateshwar; Moorthy, Rangubatla Sathyanrayana; Kishan, Tatikonda Venkat

    2014-01-01

    Although the clinical features of gluteus maximus contracture syndrome have been frequently described, imaging features have been seldom described. Most commonly reported cases are those following intramuscular injection in the gluteal region although congenital contracture is an uncommon but important occurrence. This condition has most often been reported in children of school going age. These patients often present with difficulty in squatting, limitation of hip motion or specific deformities and often require surgical correction. We describe the plain radiography, ultrasonography (USG) and magnetic resonance imaging (MRI) features of this condition in a patient with no previous known history of intramuscular injections. PMID:24967033

  17. Roster process review: a case study on the implications of preliminary findings.

    PubMed

    Eather, Bernadette; Malica, Emma; Walton, Cassandra; Hollmann, Peter; Kwong, Wyman

    2015-09-01

    Rostering is an important process to enable efficient, effective and safe delivery of health care, and one which receives little attention. The work outlined in this case study demonstrates that the analysis of rostering processes from a range of perspectives including the organisation, staff and the roster manager can identify significant opportunities for improvement. Roster governance is not universally applied, nor understood, which can result in dissonant expectations between managers and staff and a lack of transparency in how and why decisions about rostering are made. Redesigning roster processes can promote more effective governance and improve organisational efficiency.

  18. Roster process review: a case study on the implications of preliminary findings.

    PubMed

    Eather, Bernadette; Malica, Emma; Walton, Cassandra; Hollmann, Peter; Kwong, Wyman

    2015-09-01

    Rostering is an important process to enable efficient, effective and safe delivery of health care, and one which receives little attention. The work outlined in this case study demonstrates that the analysis of rostering processes from a range of perspectives including the organisation, staff and the roster manager can identify significant opportunities for improvement. Roster governance is not universally applied, nor understood, which can result in dissonant expectations between managers and staff and a lack of transparency in how and why decisions about rostering are made. Redesigning roster processes can promote more effective governance and improve organisational efficiency. PMID:25844568

  19. Scintigraphic and CT findings of Tietze's syndrome: Report of a case and review of the literature

    SciTech Connect

    Honda, N.; Machida, K.; Mamiya, T.; Takahashi, T.; Takishima, T.; Hasegawa, N.; Kamano, T.; Hashimoto, M.; Ohno, K.; Itoyama, S.; )

    1989-08-01

    A case of Tietze's syndrome is reported. A 43-year-old woman, who had experienced right anterior chest pain and tender swelling of the right first costosternal junction for seven months, showed increased accumulation of the right first, the right fourth, and the left first costochondral junction on bone imaging. Ga-67 imaging showed increased accumulation at the right first costosternal junction. CT showed sclerosis of the sternal manubrium, partial calcification of costal cartilage, and soft tissue swelling. Biopsy of the right first costal cartilage showed chronic inflammation with fibrosis and ossification. Increased uptake of bone gallium imaging is consistent with Tietze's syndrome.15 references.

  20. Imaging Finding of Malignant Melanoma of Eustachian Tube with Extension to Middle Ear Cavity: Case Report

    PubMed Central

    Kim, Hong Chul; Jang, Han Won

    2012-01-01

    We report a case of malignant melanoma of Eustachian tube with extension to the middle ear cavity and nasopharynx in a 51-year-old woman who presented with right ear fullness. Computed tomography showed a soft tissue mass in the middle ear cavity and causedthe widening and eroding of the bony eustachian tube. Magnetic resonance imaging showed well enhancing mass in eustachian tube extending nasopharynx to middle ear cavity. A biopsy of the middle ear cavity mass revealed a malignant amelanotic melanoma. PMID:23118582

  1. Clinical, radiographic, and histological findings of florid cemento-osseous dysplasia: a case report.

    PubMed

    Kim, Jeong-Hee; Song, Byeong-Chul; Kim, Sun-Ho; Park, Yang-Soon

    2011-09-01

    Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissue and involve, essentially, the same pathological process. They are usually classified into three main groups: periapical, florid, and focal cemental dysplasias depending on their extent and radiographic appearances. Radiographically, florid cementoosseous dysplasia (FCOD) appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. The best management for the asymptomatic FCOD patient consists of regular recall examinations with prophylaxis. The management of the symptomatic patient is more difficult. A case of FCOD occurring in a 52-year-old edentulous Korean female is reported which is rare with regard to race and sex.

  2. CT Findings of Axillary Tuberculosis Lymphadenitis: A Case Detected by Breast Cancer Screening Examination

    PubMed Central

    Tanada, Yasuko; Yoshida, Kouichi; Adachi, Yasuko; Matsui, Kazuhiro

    2016-01-01

    We report the first description of CT findings of axillary tuberculous lymphadenitis confirmed by the pathological specimen. The breast cancer screening examination is one of the prime methods of detection of axillary tuberculous lymphadenitis. The most common site of axillary tuberculous lymphadenitis is the deep axilla. Screening mammography often fails to cover the whole axilla. The presence on the contrast-enhanced CT of unilateral multiple circumscribed dense nodes, some of which have large and dotted calcifications, might suggest tuberculous lymphadenitis in axillary region. PMID:27379192

  3. Ethmoid sinus disease: CT evaluation in 400 cases. Part II: Postoperative findings

    SciTech Connect

    Som, P.M.; Lawson, W.; Biller, H.F.; Lanzieri, C.F.

    1986-06-01

    Clinical, pathological, and computed tomographic (CT) findings were reviewed in 400 patients with ethmoid sinus disease, including 272 who had undergone surgery. The postoperative appearance of ethmoid sinuses on CT scans is a highly neglected subject in radiologic literature. The unique ethmoid anatomy permits a variety of surgical approaches, and radiologists must be familiar with the postoperative appearances if they are to recognize the effects of prior surgery and detect, when possible, the recurrence of disease. It is often difficult to evaluate the clinical significance of soft-tissue disease, despite good clinical correlation.

  4. Case study findings of PHOTON problem-based learning (PBL) with high school photonics outreach programs

    NASA Astrophysics Data System (ADS)

    Hilliard-Clark, Joyce; Gilchrist, Pamela; Allgood, Sherri

    2009-08-01

    Using the Photonics Leaders program model, recruitment and retention, photonics content, parental engagement, internship, and PHOTON PBL challenges, the session's goal is to inform educators of strategies that can be used to motivate and develop cognitive skills in the discipline of Physics. The program caters to ethnically diverse students who traditionally lack experiences in the discipline. This paper discusses the initial findings of the National Science Foundation (NSF) Innovative Technology Experiences for Students and Teachers (ITEST) program through which high school students and teachers were given the opportunity to participate in shared lessons, and coordinate projects through cooperative learning at The Science House at North Carolina State University.

  5. Organisational readiness and Lean Thinking implementation: findings from three emergency department case studies in New Zealand.

    PubMed

    Rees, Gareth H

    2014-01-01

    This paper describes and contrasts the implementation of Lean Thinking – a quality methodology that emphasises waste reduction and performing at higher levels of productivity with the same or less resources – into New Zealand's healthcare system. As the field is relatively new, three literature-based exemplar cases were developed to provide an analysis framework to analyse the three New Zealand research sites, which had activities, teamwork, leadership and sustainability as its core themes. Each research site's case was developed from primary data gathered through interviews, augmented by secondary data from project reports, District Health Board websites and media stories. The results highlight the benefits of a supportive quality-focussed organisational culture, executive management involvement and cross-functional teams as enablers. Further, work intensification and workplace resistance were also evident in varying levels within the sites. The study, while reiterating the problems of introducing quality methods from other domains into healthcare, presents the New Zealand context and reinforces that organisational preparedness as a significant factor which contributes to implementation success. This study goes beyond investigations of the use of Lean tools, changing improvement metrics and descriptive statistics to identify the contexts and variables which surround quality and process improvement implementations.

  6. Neuroimaging findings in a woman with brainstem paragonimiasis: a case report and review of the literature

    PubMed Central

    2014-01-01

    Introduction The most serious erratic migration of paragonimiasis is a cerebral paragonimiasis. Infection in the temporal and occipital lobes of the brain has been previously reported in cerebral paragonimiasis. Here, we report a case of chronic brainstem paragonimiasis. Case presentation A 29-year-old Chinese woman presented to our hospital complaining of a sudden onset, three days previously, of double vision and dizziness. A computed tomography scan and diffusion-weighted images looked like an ischemic stroke. However, conglomerates of multiple ring-like enhancements on contrast magnetic resonance imaging, and the characteristic appearance of the ‘tunnel sign’, were found on further examination. Our patient was treated with praziquantel to prevent the spread of the paragonimiasis. She was followed up three months later and showed good recovery. Conclusions Conglomerates of multiple ring-like enhancements on contrast magnetic resonance imaging and the characteristic appearance of the ‘tunnel sign’ were important for the diagnosis of chronic brainstem paragonimiasis. PMID:24499485

  7. A prenatal case with discrepant findings between non-invasive prenatal testing and fetal genetic testings.

    PubMed

    Pan, Qiong; Sun, Baojuan; Huang, Xiaoli; Jing, Xin; Liu, Hailiang; Jiang, Fuman; Zhou, Jie; Lin, Mengmeng; Yue, Hongni; Hu, Ping; Ning, Ying

    2014-01-01

    At 17(+4) week, non-invasive prenatal testing (NIPT) results of a 24-years-old mother showed high risk of monosomy X (45, X). Abnormally shaped head and cardiac defects were observed in prenatal ultrasound scan at 19(+3) week. Amniocentesis conducted at 19(+3) week identified karyotype 47, XX, +18, which suggested that the NIPT failed to detect trisomy 18 (T18) in this case. With a further massively parallel sequencing (MPS) of maternal blood, fetal and placental tissues, we found a confined placental mosaicism (CPM) with non-mosaic T18 fetus and multiclonal placenta with high prevalence of 45, X and low level of T18 cells. FISH and SNP-array evidence from the placental tissue confirmed genetic discrepancy between the fetus and placenta. Because the primary source of the fetal cell-free DNA that NIPT assesses is mostly originated from trophoblast cells, the level of T18 placental mosaicism may cause false negative NIPT result in this rare case of double aneuploidy.

  8. Imaging findings in Idiopathic lobular granulomattous mastitis, case report and review of literature.

    PubMed

    Boarki, K; Labib, M

    2010-01-01

    Idiopathic lobular granulomatous mastititis is a rare inflammatory disease of the breast. Since the clinical manifestations simulate those of mammary malignancy, it is often misdiagnosed. We report a case in a 25 yrs old Egyptian woman who had presented with complaint of a painful mass in her right breast of 3 months duration. Clinical and radiological examinations were indeterminate of its nature and the diagnosis was established by histopathogical, microbiological and serological tests. Review of relevant literature mention the features of Idiopathic lobular granulomatous mastititis, which impose significant challenge on clinical, radiological and even histopathological diagnosis. These correlate well with our case scenario also. Complete resection of the lesions and/or administration of steroids are usually the recommended treatment, however about 38% patients may experience recurrence. Hence proper post treatment follow up is mandatory. Awareness among the clinicians, radiologists and pathologists about this disease entity is required and multi disciplinary approach is imperative to establish the diagnosis. We hope to convey these facts through this article with the review of relevant literature. PMID:20164009

  9. Organisational readiness and Lean Thinking implementation: findings from three emergency department case studies in New Zealand.

    PubMed

    Rees, Gareth H

    2014-01-01

    This paper describes and contrasts the implementation of Lean Thinking – a quality methodology that emphasises waste reduction and performing at higher levels of productivity with the same or less resources – into New Zealand's healthcare system. As the field is relatively new, three literature-based exemplar cases were developed to provide an analysis framework to analyse the three New Zealand research sites, which had activities, teamwork, leadership and sustainability as its core themes. Each research site's case was developed from primary data gathered through interviews, augmented by secondary data from project reports, District Health Board websites and media stories. The results highlight the benefits of a supportive quality-focussed organisational culture, executive management involvement and cross-functional teams as enablers. Further, work intensification and workplace resistance were also evident in varying levels within the sites. The study, while reiterating the problems of introducing quality methods from other domains into healthcare, presents the New Zealand context and reinforces that organisational preparedness as a significant factor which contributes to implementation success. This study goes beyond investigations of the use of Lean tools, changing improvement metrics and descriptive statistics to identify the contexts and variables which surround quality and process improvement implementations. PMID:25595012

  10. Intramedullary spinal cord ganglioglioma presenting as hyperhidrosis: unique symptoms and magnetic resonance imaging findings: case report.

    PubMed

    Murakami, Tomohiro; Koyanagi, Izumi; Kaneko, Takahisa; Yoneta, Akihiro; Keira, Yoshiko; Wanibuchi, Masahiko; Hasegawa, Tadashi; Mikuni, Nobuhiro

    2013-02-01

    Hyperhidrosis is caused by a sympathetic dysfunction of the central or peripheral nervous system. Intramedullary spinal cord lesions can be a cause of hyperhidrosis. The authors report a rare case of intramedullary thoracic spinal cord ganglioglioma presenting as hyperhidrosis. This 16-year-old boy presented with abnormal sweating on the right side of the neck, chest, and the right arm that had been occurring for 6 years. Neurological examination revealed mild motor weakness of the right lower extremity and slightly decreased sensation in the left lower extremity. Hyperhidrosis was observed in the right C3-T8 dermatomes. Magnetic resonance imaging showed an intramedullary tumor at the right side of the spinal cord at the T2-3 level. The tumor showed partial enhancement after Gd administration. The patient underwent removal of the tumor via hemilaminectomy of T2-3. Only subtotal resection was achieved because the margins of the tumor were unclear. Histopathological examination revealed ganglioglioma. Hyperhidrosis gradually improved after surgery. Hyperhidrosis is a rare clinical manifestation of intramedullary spinal cord tumors, and only a few cases have been reported in the literature. The location of the tumor origin, around the right gray matter of the lateral spinal cord, may account for the hyperhidrosis as the initial symptom in this patient. Physicians should examine the spinal cord using MRI studies when a patient has hyperhidrosis with some motor or sensory symptoms of the extremities.

  11. Clinical needs finding: developing the virtual experience-a case study.

    PubMed

    Mittal, Vaishali; Thompson, Megan; Altman, Stuart M; Taylor, Peter; Summers, Alexander; Goodwin, Kelsey; Louie, Angelique Y

    2013-09-01

    We describe an innovative program at the University of California, Davis for students to engage in clinical needs finding. Using a team-based approach, students participated in clinical rotations to observe firsthand the needs of clinicians at the university affiliated medical center. The teams were asked to develop documentary-style videos to capture key experiences that would allow future viewers to use the videos as "virtual" clinical rotations. This was conceived as a strategy to allow students in prohibitively large classes, or students in programs at institutions without associated medical or veterinary school programs, to experience clinical rotations and perform needs assessments. The students' perspectives on the experience as well as instructor analysis of best practices for this type of activity are presented and discussed. We found that the internship experience was valuable to the students participating, by not only introducing the practice of needs finding but also increasing the students' confidence in the practice of engineering design and their ability to work independently. The videos produced were of such high quality that instructors from other institutions have requested copies for instructional use. Virtual clinical rotations through video experiences may provide a reasonable substitute for students who do not have the ability to participate in rotations in person. PMID:23483373

  12. Medical-dental findings and management of a child with infantile Refsum disease: a case report.

    PubMed

    Acharya, Bhavini S; Ritwik, Priyanshi; Velasquez, Gisela M; Fenton, Sanford J

    2012-06-01

    Infantile Refsum disease (IRD) is a peroxisome biogenesis disorder (PBD), and is part of a larger group of diseases called leukodystrophies, which are inherited conditions that damage the white matter of the brain and affect motor movements. Multiple signs and symptoms of IRD begin in infancy and progress through early childhood, including hearing and visual impairment, intellectual and growth impairment, seizures, liver involvement, and orofacial and dental abnormalities. This paper presents a case history of a 12-year-old female patient with IRD who underwent dental rehabilitation in the operating room under general anesthesia and includes a 2-year follow-up. Medical, dental, and management considerations in the care of this child's condition are presented. This paper also discusses the importance of a multidisciplinary approach in the management of children with special needs.

  13. Clinical and Radiological Findings of Autosomal Dominant Osteopetrosis Type II: A Case Report

    PubMed Central

    Kant, Priyanka; Sharda, Neelkamal; Bhowate, Rahul R.

    2013-01-01

    Osteopetrosis is a rare inherited genetic disease characterized by sclerosis of the skeleton caused by the absence or malfunction of osteoclasts. Three distinct forms of the disease have been recognized, autosomal dominant osteopetrosis being the most common. Autosomal dominant osteopetrosis exhibits a heterogeneous trait with milder symptoms, often at later childhood or adulthood. The aim of this case report is to present the clinical and radiographic features of a 35-year-old female patient with autosomal dominant osteopetrosis type II who exhibited features of chronic generalised periodontitis, and the radiographs revealed generalised osteosclerosis and hallmark radiographic features of ADO type II, that is, “bone-within-bone appearance” and “Erlenmeyer-flask deformity.” PMID:24260721

  14. Primary pulmonary synovial sarcoma: a case report with unique and impressive computed tomography findings.

    PubMed

    Kambo, Jaspreet S; Richardson, Bonnie; Ionescu, Diana N; Tucker, Tracy; Kraushaar, Greg

    2015-01-01

    Primary pulmonary synovial sarcoma (PPSS) is a rare malignancy. Its etiology, imaging features and optimal treatment are not well understood. Pulmonary pseudoaneurysms and lymphadenopathy are rare complications of synovial sarcomas. A 40-year-old woman with mild hemoptysis and thoracic back pain underwent a computed tomography scan that revealed multiple pulmonary lesions, paraesophageal lymphadenopathy and incidental bilateral pulmonary emboli. A diagnosis of PPSS was made through the identification of an SS18 translocation by fluorescence in situ hybridization. She was started on adriamycin, ifosfamide and mesna chemotherapy. Over the subsequent two months, she developed three pulmonary artery pseudoaneurysms, ultimately requiring endovascular coiling. Seven months after starting treatment, the patient was asymptomatic. The lesions and lymphadenopathy decreased in size. The present case highlights complications of a rare malignancy and demonstrates positive response to ifosfamide-based chemotherapy in the setting of PPSS. PMID:25664459

  15. Conversion, dissociative amnesia, and Ganser syndrome in a case of "chameleon" syndrome: anatomo-functional findings.

    PubMed

    Magnin, Eloi; Thomas-Antérion, Catherine; Sylvestre, Geraldine; Haffen, Sophie; Magnin-Feysot, Virgile; Rumbach, Lucien

    2014-01-01

    The term "chameleon" was first used in the seventeenth century by Sydenham to describe a patient with a protean semiology. We report a single case of "chameleon" syndrome that challenges the current international criteria for somatoform disorders, dissociative amnesia, and Ganser syndrome. The florid symptoms were as follows: anterograde and retrograde amnesia (including semantic, episodic, and procedural deficits), loss of identity, atypical neuropsychological impairment (approximate answers), left sensitive and motor deficit, and left pseudochoreoathetosis movement disorders. Additional behavioral disorders included the following: anxiety, clouded consciousness, hallucinations, and "belle indifference". A single photon emission computed tomography examination showed bilateral temporal, frontal and a right caudate (in the head of the caudate nucleus) hypoperfusion concordant with a common mechanism of repression in these disorders.

  16. Susceptibility-weighted imaging findings of subacute delayed carbon monoxide intoxication: a report of five cases.

    PubMed

    Bae, Jin-Won; Cha, Seong-Yi; Kang, Tae-Ho; Lee, Jae-Hyeok; Kim, Hak-Jin; Jung, Dae Soo; Kim, Eun-Joo

    2012-01-15

    Brain injury from carbon monoxide (CO) poisoning occurs due to tissue hypoxia and direct CO-mediated histotoxicity. Recently developed susceptibility-weighted imaging (SWI) is sensitive for the detection of accumulated hemosiderin and iron secondary to cerebral hemorrhage. Therefore, we hypothesized that SWI may be helpful for identifying petechial hemorrhagic transformation secondary to acute hypoxic damage during subacute CO intoxication. Our case series with subacute CO intoxication revealed that the SWIs of all patients showed low signal intensities in the globus pallidus, representing the accumulation of iron or calcium secondary to hypoxic damage from acute CO intoxication. These results suggest that SWI may be a useful MR technique for illustrating brain damage in subacute delayed CO intoxication. PMID:21914555

  17. Hepatobiliary and gallium imaging findings in gallbladder perforation: A case report and review of the literature

    SciTech Connect

    Yeo, E.; Chen, D.C.; Siegel, M.E.

    1989-02-01

    Gallbladder perforation is an unusual condition with a high mortality rate. Early detection with prompt surgical intervention can increase the survival rate. Hepatobiliary imaging using Technetium-99m-labeled iminodiacetic acid has been used for the diagnosis of gallbladder perforation. However, the results vary and are somewhat confusing. The authors report a case of gallbladder perforation with hepatobiliary imaging and an unusual gallium image; review the literature; and propose a classification of three different imaging patterns: (1) visualization of the gallbladder with bile leakage, (2) nonvisualization of the gallbladder with a photopenic fluid collection, and (3) nonvisualization of the gallbladder with bile leakage. These patterns may provide pathophysiologic information for the surgeon. 27 references.

  18. Finding Bent-double Radio Galaxies: A Case Study in Data Mining

    SciTech Connect

    Fodor, I.K; Cantu-Paz, E.; Kamath, C.; Tang, N.

    2000-04-11

    This paper presents our early results in applying data mining techniques to the problem of finding radio-emitting galaxies with a bent-double morphology. In the past, astronomers on the FIRST (Faint Images of the Radio Sky at Twenty-cm) survey have detected such galaxies by first inspecting the radio images visually to identify probable bent-doubles, and then conducting observations to confirm that the galaxy is indeed a bent-double. Our goal is to replace this visual inspection by a semi-automated approach. In this paper, we present a brief overview of data mining, describe the features we use to discriminate bent-doubles from non-bent-doubles, and discuss the challenges faced in defining meaningful features in a robust manner. Our experiments show that data mining, using decision trees, can indeed be a viable alternative to the visual identification of bent-double galaxies.

  19. Behçet's Disease Presenting with Acute Transverse Myelitis: MRI Findings and Review of the Nosology. A Case Report.

    PubMed

    Sanal, H T; Bulakbasi, N; Kocaoglu, M; Tayfun, C

    2007-04-30

    Spinal cord involvement, either isolated or together with brain, in Behçet's disease (BD) has been reported. In these cases the existence of the disease was previously known or the classical triad of disease such as oral and genital ulcers with uveitis/iritis was present. Here we describe a 22-year-old man in whom acute transverse myelitis diagnosed with MRI was the first finding of BD. PMID:24299651

  20. An unusual case of disseminated toxoplasmosis in a previously healthy pregnant patient: radiographic, CT, and MRI findings.

    PubMed

    Paruthikunnan, Samir; Shankar, Balasubramanyam; Kadavigere, Rajagopal; Prabhu, Mukhyaprana; Narayanan, Ramakrishna; Jain, Harshwardhan

    2014-11-01

    Toxoplasmosis is a ubiquitous protozoal infection that during pregnancy commonly affects the fetus severely, with maternal infection usually being mild self-limiting. Disseminated toxoplasmosis in a healthy pregnant woman has, to the best of our knowledge, not been reported before. We present a case of disseminated toxoplasmosis involving pulmonary, central nervous system, and lymph nodes in a pregnant woman and imaging findings on radiography, computed tomography, and magnetic resonance imaging.

  1. Interpretation of hair findings in children: about a case involving carbamazepine.

    PubMed

    Kintz, Pascal

    2014-06-01

    This office has been recently involved in a case dealing with child custody, where the final outcome was difficult to establish. The following concentrations were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in the hair of a 21-month-old girl: 154 (0-1 cm), 198 (1-2 cm), 247 (2-3 cm), and 368 pg/mg (3-4 cm) after decontamination. Obviously, the concentrations measured in the hair were much lower than those observed in patients under daily treatment. In this sense, the frequency of exposures appears as infrequent (low level of exposure), with marked decrease in the more recent period. However, the girl was never prescribed carbamazepine and the mother, who was under carbamazepine therapy, denied any administration. The Judge asked if this could result from a single exposure and at which period. At least, three possible interpretations of the measured carbamazepine concentrations were addressed: (1) decrease in administration in the more recent period; (2) increase of body weight due to growing, so the same dosage will result in lower concentrations in hair; and (3) sweat contamination from the mother at the time the girl is with her in bed, the older hair being in contact longer with the bedding. In this case, it was impossible to conclude that the child was deliberately administered carbamazepine. The results of the analysis of hair could indicate that she was in an environment where carbamazepine was being used and where the drug was not being handled and stored with appropriate care. There are many differences between the hair from children and those from adults: hair from children is thinner and more porous, the ratio anagen and catagen phases are not maintained, and the growth rate can be different, at some periods, from the usual 1 cm/month. These differences, together with the influence of PK-PD parameters are reviewed in this paper, as a basis for suitable interpretation. In view of these results it is proposed that a single hair

  2. Complex Odontoma: A Case Report with Micro-Computed Tomography Findings

    PubMed Central

    Santos, L. A. N.; Roque-Torres, G. D.; Oliveira, V. F.; Freitas, D. Q.

    2016-01-01

    Odontomas are the most common benign tumors of odontogenic origin. They are normally diagnosed on routine radiographs, due to the absence of symptoms. Histopathologic evaluation confirms the diagnosis especially in cases of complex odontoma, which may be confused during radiographic examination with an osteoma or other highly calcified bone lesions. The micro-CT is a new technology that enables three-dimensional analysis with better spatial resolution compared with cone beam computed tomography. Another great advantage of this technology is that the sample does not need special preparation or destruction in the sectioned area as in histopathologic evaluation. An odontoma with CBCT and microtomography images is presented in a 26-year-old man. It was first observed on panoramic radiographs and then by CBCT. The lesion and the impacted third molar were surgically excised using a modified Neumann approach. After removal, it was evaluated by histopathology and microtomography to confirm the diagnostic hypothesis. According to the results, micro-CT enabled the assessment of the sample similar to histopathology, without destruction of the sample. With further development, micro-CT could be a powerful diagnostic tool in future research. PMID:27293913

  3. Pathological and toxicological findings in glyphosate-surfactant herbicide fatality: a case report.

    PubMed

    Sribanditmongkol, Pongruk; Jutavijittum, Prapan; Pongraveevongsa, Pattaravadee; Wunnapuk, Klintean; Durongkadech, Piya

    2012-09-01

    Glyphosate herbicide is promoted by the manufacturer as having no risks to human health, with acute toxicity being very low in normal use. In Thailand, however, poisoning from glyphosate agricultural herbicides has been increasing. A case of rapid lethal intoxication from glyphosate-surfactant herbicide involved a 37-year-old woman, who deliberately ingested approximately 500 mL of concentrated Roundup formulation (41% glyphosate as the isopropylamine salt and 15% polyoxyethylene amine; Mosanto Company). The postmortem examination revealed that the stomach contained 550 mL of yellow fluid. The gastric mucosa of anterior fundus revealed hemorrhage and the small intestines had marked dilatation and thin walls. We used the high-performance liquid chromatography method for determination of serum and gastric content levels of glyphosate. The glyphosate levels of serum and gastric content were 3.05 and 59.72 mg/mL, respectively. Toxic effects of polyoxyethylene amine and Roundup were caused by their ability to erode tissues including mucous membranes and linings of the gastrointestinal and respiratory tracts. A mild degree of pulmonary congestion and edema was observed in both lungs. We proposed that the characteristic picture of microvesicular steatosis of the hepatocytes, seen predominantly in centrilobular zones of the liver, resembled drug-induced hepatic toxicity or secondary hypoxic stress.

  4. Complex Odontoma: A Case Report with Micro-Computed Tomography Findings.

    PubMed

    Santos, L A N; Lopes, L J; Roque-Torres, G D; Oliveira, V F; Freitas, D Q

    2016-01-01

    Odontomas are the most common benign tumors of odontogenic origin. They are normally diagnosed on routine radiographs, due to the absence of symptoms. Histopathologic evaluation confirms the diagnosis especially in cases of complex odontoma, which may be confused during radiographic examination with an osteoma or other highly calcified bone lesions. The micro-CT is a new technology that enables three-dimensional analysis with better spatial resolution compared with cone beam computed tomography. Another great advantage of this technology is that the sample does not need special preparation or destruction in the sectioned area as in histopathologic evaluation. An odontoma with CBCT and microtomography images is presented in a 26-year-old man. It was first observed on panoramic radiographs and then by CBCT. The lesion and the impacted third molar were surgically excised using a modified Neumann approach. After removal, it was evaluated by histopathology and microtomography to confirm the diagnostic hypothesis. According to the results, micro-CT enabled the assessment of the sample similar to histopathology, without destruction of the sample. With further development, micro-CT could be a powerful diagnostic tool in future research.

  5. [Tumors of the vaterian region indications, findings and prognosis : about 49 cases].

    PubMed

    Beyrouti, Mohamed Issam; Beyrouti, Ramez; Louhichi, Skander; Ben Amar, Mohamed; Gargouri, Faouzi; Frikha, Foued; Bouaziz, Mounir; Karoui, Abdelhamid; Boudawara, Tahia; Krichen, Mohamed Salah; Sellami, Abdelhafidh

    2006-04-01

    This retrospective study is about 49 cases of tumors of the vaterian region collected between 1976 and 2001. Tumors of the vaterian region represented 7% of the bilio-pancreatic tumors. The study was about 18 women and 31 men, with sex-ratio of 1.7. The mean age was 61 years. Treatment was surgical : cephalic duodeno-pancreatectomy (28 patients) or ampullectomy (5 patients). Rate of tumor resectability was 69.4%. Bilio-digestive derivation was practiced on 13 patients and therapeutic abstention was decided for 3 patients. Age over 65 years, rate of bilirubine superior to 120 mmol/l and surgery done in emergency were elements of bad prognosis that increased post-operative mortality of following cephalic duodeno-pancreatectomy. Global mortality and morbidity were respectively 16% and 24%. Factors of poor prognosis were essentially: Tumor of large size, infiltration of the surrounding structures and tumor with metastases. The survival after bilio-digestive derivation didn't pass the 8 months. Five year survivals cephalic duodeno-pancréatectomy represented 20%. It depended on the degree of the local invasion. This 5 years survival rate to was 85% for stage I (classification of Martin) and 10% for stage IV.

  6. Narratives, memorable cases and metaphors of night nursing: findings from an interpretative phenomenological study.

    PubMed

    Zannini, Lucia; Ghitti, Maria Grazia; Martin, Sonia; Palese, Alvisa; Saiani, Luisa

    2015-09-01

    The aim of the study was to explore the experiences of night nurses. An interpretative phenomenological study was undertaken, and 35 nurses working in Italian medical, surgical and intensive care units were purposely recruited. Data were gathered in 2010 by semi-structured interviews, collecting nurses' narratives, memorable cases and metaphors, aimed at summarising the essence of work as a nurse during the night. The experience of night nursing is based on four interconnected themes: (i) working in a state of alert, (ii) growing by expanding autonomy and responsibility, (iii) assuring sensitive surveillance and (iv) experiencing deep intimacy. Memorable episodes were polarised along (i) expected/unexpected events; (ii) positive/negative epilogues; and (iii) life/death issues. Many of the emergent metaphors described working during the night as being in the middle of a space where an apparent calm scene takes place, but unpredictable factors may suddenly change the order of events and the outcomes, creating chaos. Working during the night alerts nurses, who increase autonomy, expanding their role and assuming more responsibility with respect to that assumed during daily shifts. The nurses' clinical reasoning is based on data they carefully listen to, and on the meaning that nurses give time by time to different noises and silence. While in the past a sense of companionships was reported, a loneliness or a 'neutral' experience concerning the relationships with colleagues seems to prevail during night nursing. Working night shifts is a complex task, and specific training must be assured to students/novices.

  7. Pharmacists' participation in research: a case of trying to find the time.

    PubMed

    Cvijovic, Kosta; Boon, Heather; Jaeger, Walter; Vohra, Sunita

    2010-12-01

    Objective  The objective of this case study was to explore how pharmacists involved in the Pharmacy Study Of Natural Health Product Adverse Reactions (SONAR) project perceived the barriers and facilitators to participating in clinical research. Methods  A total of 19 semi-structured interviews were completed with pharmacy staff members who had recently completed data collection in the SONAR study which involved asking patients if they had experienced any unwanted effects while taking natural products. Other data sources included detailed field notes and interviews with SONAR researchers. Basic content analysis with multiple coders was used to analyse the data and triangulation was used to highlight areas of consistency and contrasting view points across the data types. Key findings  None of the participating pharmacies was able to collect as much data as expected by the SONAR team. Lack of time was stated as the main reason why pharmacy staff had trouble with the data collection. However, observational data and detailed probing in interviews confirmed that data collection itself took very little time (seconds per patient). Lack of time was provided as a socially acceptable excuse that masked deeper issues related to fears associated with challenges modifying established work routines and perceived lack of value associated with research participation. Conclusion  To successfully engage pharmacists in practice-based natural health product research it is necessary to establish the direct and indirect benefits of participation because those that believe in the value of the research will make the time for participation.

  8. Chemical and physical oral findings in a case of anorexia nervosa and bulimia.

    PubMed

    Jensen, O E; Featherstone, J D; Stege, P

    1987-09-01

    The deleterious effect on enamel of continual acid challenge from regurgitation of gastric contents in bulimic subjects is well documented. No previous reports, however, have been published on chemical and physical measurements of teeth from such subjects, or on the importance of fluoride in maintaining their dentition. Teeth were obtained from a deceased anorexic and bulimic patient. Shortly before death this patient had saliva analyses and in vivo enamel biopsies at our clinic, before and after a 3-week regimen of daily rinsing with 0.05% NaF. After 4 years of daily regurgitation there was an almost normal thickness of the enamel surfaces typically "at risk", i.e. the palatal surfaces of the maxillary anterior teeth, with normal hardness measurements 10 micron away from the outer surface. SEM micrographs showed an irregular topography, with crystalline deposits rich in calcium, phosphate and fluoride. These surfaces were more reactive to uptake of additional fluoride when given as a daily rinse, than the more protected, and therefore, presumed unaffected surfaces. Our findings suggest that frequent and meticulous oral hygiene measures can substantially minimize the erosive effect on tooth enamel of gastric contents in bulimic patients, especially if fluoride products are used regularly.

  9. Anabolic androgenic steroids abuse and cardiac death in athletes: morphological and toxicological findings in four fatal cases.

    PubMed

    Montisci, Massimo; El Mazloum, Rafi; Cecchetto, Giovanni; Terranova, Claudio; Ferrara, Santo Davide; Thiene, Gaetano; Basso, Cristina

    2012-04-10

    Anabolic androgenic steroids (AAS) are the main class of doping agents and their consumption produces adverse effects involving several organs and systems. Three cases of sudden cardiac death (SCD) and one of death due to congestive heart failure of previously healthy athletes who were AAS users are herein reported. Concentric cardiac hypertrophy with focal fibrosis (one case), dilated cardiomyopathy with patchy myocyte death (two cases) and eosinophilic myocarditis (one case) were observed and most probably relate to the final event. Molecular investigation for viral genomes was positive in one case (Ebstein virus). Our data confirm previous findings, showing that the most typical cardiac abnormality in AAS abusers is left ventricular hypertrophy, associated with fibrosis and myocytolysis. An exceptional cardiovascular substrate was represented by the case with drug induced eosinophilic myocarditis. These features are at risk of ventricular arrhythmias as well as congestive heart failure. The cause-effect relationship between AAS abuse and cardiac death can be established only by a rigorous methodology with the use of standardized protocols, including precise morphological studies of all target organs to search for chronic toxic effects. Laboratory investigations should focus on AAS searching on a wide range of biological matrices to demonstrate type, magnitude and time of exposure.

  10. Tuberculosis case--finding and treatment in the central prison of Qazvin province, Islamic Republic of Iran.

    PubMed

    Assefzadeh, M; Barghi, R Gh; Shahidi, Sh S

    2009-01-01

    As a part of a comprehensive programme of tuberculosis (TB) control in the central prison in Qazvin, Islamic Republic of Iran, a programme of active case-finding was carried out from February 2004 to July 2005. From the 768 prisoners examined, 41 (5.3%) were suspected of TB and gave sputum samples. A total of 7 smear-positive TB cases were found, giving a TB prevalence in the prison of 910 per 100,000, 113 times the total TB prevalence in Qazvin province in the same year. From 7 diagnosed and treated patients, 4 were cured with the category 1 standard regimen, 1 completed treatment and 2 failed to complete treatment. Improvements are needed in TB case recognition of prisoners, especially newcomers.

  11. [Robot-asssisted laparoscopic radical prostatectomy (ralp). Oncological and functional findings after 90 cases].

    PubMed

    Gilberti, C; Schenone, M; Cortese, P; Gallo, F; Gastaldi, E; Ninotta, G

    2009-01-01

    The RALP is the most modern technology available for the treatment of intracapsular prostate cancer (CaP), which can produce a shorter learning curve and better results than the traditional techniques. METHODS. Between March 2005 and March 2008, 90 patients (64.3 ys, range 52-71) with intracapsular CaP underwent RALP at our institute. Before surgery the patients underwent routine examinations and filled in IIEF, IPSS and EORTC-QLQC30/PR 25 questionnaires. Patients were followed up with PSA assay, physical examination and compilation of the questionnaires. Median follow-up was 12.5 months (range 1-35 months). RESULTS. Mean operative time was 230 min. Discharge and catheter removal were at day 7.4 and 8.2, respectively, after surgery. Pathological staging reported pT2 and pT3 in 57 (63%) and 33 patients (37%), respectively. Positive surgical margins were assessed in 30 patients (33%), particularly 8.7% in pT2 tumors. The one-year biochemical disease-free survival rate was 90%. Regarding the functional results, 81 patients (90%) were perfectly continent while a mild and a moderate incontinence were reported in 7 (8%) and 2 (2%) patients, respectively. Mean IPSS score decreased from 8 to 4; among the patients who underwent bilateral nerve sparing RALP and no adjuvant therapy, 31 (70.4%) reported satisfactory sexual intercourses. Concerning postoperative quality of life, mean EORTC-QLQC30/PR 25 questionnaires scores were very similar before and after RALP. CONCLUSIONS. After 90 cases of RALP the oncological and functional results are definitely promising. However, a wider number of patients and a greater follow-up are needed to confirm these data particularly as regards the functional results.

  12. Neuroradiological, neurophysiological and molecular findings in infantile Krabbe disease: two case reports

    PubMed Central

    Vargiami, E; Papathanasiou, E; Batzios, S; Kyriazi, M; Dimitriou, E; Anastasiou, A; Michelakakis, H; Giese, A-K

    2016-01-01

    Abstract Krabbe disease is an autosomal recessive neurodegenerative disorder due to a defect of the lysosomal enzyme β-galactocerebrosidase (β-GALC). Depending on the age of onset, the disease is classified into infantile and later-onset forms. We report neuroradiological, neurophysiological and molecular findings in two Greek patients with the infantile form of Krabbe disease. The index patients presented at the age of 3.5 and 6 months, respectively, due to developmental delay. Magnetic resonance imaging (MRI) of the first patient’s brain demonstrated signs of leukodystrophy, while nerve conduction velocities (NCVs) were significantly decreased. The second patient’s MRI at the age of 4 months was initially normal, but at 18 months demonstrated leukodystrophic alterations as well, whereas NCVs were also significantly delayed. In both patients, a severe decrease in β-GALC, activity supported the diagnosis of Krabbe disease, while the final diagnosis was confirmed by molecular genetic testing. Two homozygous mutations of the GALC gene, the c.411_413delTAA [p.K139del] mutation in the first patient, and the c.749T>C [p.I250T] mutation in the second patient, were identified. At their last follow-up visit at the age of 4 and 6 years, respectively, both patients were bedridden and quadri-plegic, suffering from frequent respiratory tract infections and fed through a gastrostomy. Both mutations found in homozygosity in these two unrelated patients of Greek ancestry, could pinpoint a common origin. Genotyping of patients with Krabbe disease is important, in order to contribute to the creation of a European mutation database and to further study possible genotype-phenotype correlations of the disease. PMID:27785412

  13. Case Finding of Mild Cognitive Impairment and Dementia and Subsequent Care; Results of a Cluster RCT in Primary Care

    PubMed Central

    van den Dungen, Pim; Moll van Charante, Eric P.; van de Ven, Peter M.; van Marwijk, Harm W. J.; van der Horst, Henriëtte E.; van Hout, Hein P. J.

    2016-01-01

    Purpose Despite a call for earlier diagnosis of dementia, the diagnostic yield of case finding and its impact on the mental health of patients and relatives are unclear. This study assessed the effect of a two-component intervention of case finding and subsequent care on these outcomes. Methods In a cluster RCT we assessed whether education of family physicians (FPs; trial stage 1) resulted in more mild cognitive impairment (MCI) and dementia diagnoses among older persons in whom FPs suspected cognitive decline and whether case finding by a practice nurse and the FP (trial stage 2) added to this number of diagnoses. In addition, we assessed mental health effects of case finding and subsequent care (trial stage 2). FPs of 15 primary care practices (PCPs = clusters) judged the cognitive status of all persons ≥ 65 years. The primary outcome, new MCI and dementia diagnoses by FPs after 12 months as indicated on a list, was assessed among all persons in whom FPs suspected cognitive impairment but without a formal diagnosis of dementia. The secondary outcome, mental health of patients and their relatives, was assessed among persons consenting to participate in trial stage 2. Trial stage 1 consisted of either intervention component 1: training FPs to diagnose MCI and dementia, or control: no training. Trial stage 2 consisted of either intervention component 2: case finding of MCI and dementia and care by a trained nurse and the FP, or control: care as usual. Results Seven PCPs were randomized to the intervention; eight to the control condition. MCI or dementia was diagnosed in 42.3% (138/326) of persons in the intervention, and in 30.5% (98/321) in the control group (estimated difference GEE: 10.8%, OR: 1.51, 95%-CI 0.60–3.76). Among patients and relatives who consented to stage 2 of the trial (n = 145; 25%), there were no differences in mental health between the intervention and control group. Conclusions We found a non-significant increase in the number of new MCI

  14. Problematic Incinerator Ash: A Case Study of Finding a Successful Treatment Approach

    SciTech Connect

    K. L. Gering

    1999-03-01

    The Idaho National Engineering and Environmental Laboratory (INEEL) produces incinerator flyash and bottom ash as a consequence of burning low-level radioactive waste materials at the Waste Experimental Reduction Facility (WERF). The incineration process greatly reduces original waste volumes but concentrates the metals that are present, such as toxic metals (most notably cadmium, lead, and antimony) and nuisance metals (e.g., zinc). Anion species also become predominant in flyash produced by INEEL incineration, where chloride and sulfate are at concentrations that can approach 15-20 wt% each. In addition, treatment of the WERF flyash is further complicated by a significant fraction of ignitables composed of carbon soot and various hydrocarbon species that have been measured in some cases at 30% net by Loss-on-Ignition tests. Bottom ash produced at the WERF site is generally much less toxic, if not nontoxic, as compared to the flyash. Due to the complex composition of the flyash material, stabilization attempts at the INEEL have been only partly successful, causing the effectiveness and viability of treatment methods to be revisited. Breakthroughs in flyash stabilization came in 1998 when more complete characterization data gave us further insight into the chemical and physical nature of the flyash. These breakthroughs were also facilitated by the use of a computer model for electrolytes that allowed us to simulate stabilization options prior to started laboratory studies. This paper summarizes efforts at the INEEL, spanning the past three years, that have focused on stabilizing flyash. A brief history of INEEL treatability studies is given, showing that the degree of effective flyash stabilization was proportional to the amount of meaningful characterization data that was available. Various binders have been used in these treatability studies, including Portland cement type I/II, Portland cement type V, JGC Super Cement (blast furnace slag cement), a Fluid Tech

  15. Photon-counting-intensified CID detector for space astronomy

    NASA Astrophysics Data System (ADS)

    Morrissey, Patrick F.; Norton, Timothy J.; Kimble, Randy A.

    1998-08-01

    We are developing a novel solar blind, high resolution, photon counting detector for applications in space UV astronomy. Our concept is to utilize a charge injection device (CID) as the readout stage behind a microchannel plate (MCP) intensifier. This detector will take advantage of the flexible readout options afforded by the addressable CID architecture to provide high local frame rates around bright features in an image. In this concept, the detector bandwidth can be used most efficiently, reading pixels around a bright star more frequently than those in a nearby dim cloud of gas, for example. The demonstration apparatus described in this paper incorporates a 25 mm diameter intensifier tube fiber optically coupled to a commercially available 30 frame-s(superscript -1), 512 X 512 pixel, progressive-scan CID2250 camera. The 10 MHz analog video from this camera is digitized and processed by a centroider module that calculates the position of each event in real time with subpixel precision, thus providing high spatial resolution limited by the MCPs. The pore-resolved images presented in this paper validate the intensified CID concept. We plan to incorporates custom driving electronics and an experimental CID with on-chip address decoders for high speed random access of detector subarrays of arbitrary size and location. Our goal is to demonstrate a solar-blind UV photon counter with 200-300 counts-s(superscript -1) point source and 3 X 10(superscript 5) counts-s(superscript -1) global rate capability with up to 4000 by 4000 elements.

  16. Ways of intensifying liquid dispersion in gas flow

    NASA Astrophysics Data System (ADS)

    Bazarov, V. G.

    Ways of intensifying liquid dispersion in gas flow are examined with a view to increasing the efficiency of the existing atomizing nozzles. It is noted that the most economical method of dispersion intensification, without using any additional power, is the excitation of auto-oscillations in liquid and gas flows. Several methods of generating auto-oscillations in commonly used centrifugal nozzles are discussed. Other developments include the spraying of viscous and contaminated fluids in a field of forced pressure, velocity, and vorticity fluctuations, and also gas saturation of liquids prior to spraying in nozzles with porous elements.

  17. Magnetic field mapping using an image-intensifying fluorescent probe

    NASA Astrophysics Data System (ADS)

    Tou, T. Y.; Blackwell, B. D.; Sharp, L. E.

    1991-05-01

    A simple, cost-effective image-intensifying fluorescent probe designed for mapping the magnetic surfaces in the heliac sheila is described. It consists of a phosphor-coated metal plate which is enclosed in a grounded U-channel that provides electrostatic shielding. An adjustable accelerating voltage is applied to the metal plate to greatly increase the cathodoluminescence produced by the directed electron beam from an electron gun, and the visible electron-beam image is recorded by a CCD camera. The gain in the image brightness allows significant reduction of the electron-beam energy to minimize the deviation of the measured drift surfaces from the true magnetic surfaces, and to improve resolution for detailed studies of surfaces in the newer stellarator experiments. This technique is particularly suited to electron energies below the phosphor activation threshold, when external image intensifying systems are likely to be very inefficient. Up to 36 toroidal rotations have been observed, limited mainly by the effective cross sections of the fluorescent probe and the electron gun. Mapping at low magnetic field strengths allows detection of small fixed amplitude field errors. Measurements of the gain characteristics and resolution are presented, with an example of the electrically variable resolution achievable with this design. The effect of electron energy on drift surfaces of a heliac is demonstrated.

  18. Performance of a 20-in. photoelectric lens image intensifier tube

    NASA Astrophysics Data System (ADS)

    Asaoka, Yoichi; Sasaki, Makoto

    2011-08-01

    We have evaluated a 20-in. photoelectric lens image intensifier tube (PLI) to be mounted on the spherical focal surface of the Ashra light collectors, where Ashra stands for All-sky Survey High Resolution Air-shower Detector, an unconventional optical collector complex that images air showers produced by very high energy cosmic-ray particles in a 42°-diameter field of view with a resolution of a few arcminutes. The PLI, the worlds largest image intensifier, has a very large effective photocathode area of 20-in. diameter and reduces an image size to less than 1-in. diameter using the electric lens effect. This enables us to use a solid-state imager to take focal surface images in the Ashra light collector. Thus, PLI is a key technology for the Ashra experiment to realize a much lower pixel cost in comparison with other experiments using photomultiplier arrays at the focal surface. In this paper we present the design and performance of the 20-in. PLI.

  19. A Case of Probable Mixed-Infection with Clonorchis sinensis and Fasciola sp.: CT and Parasitological Findings

    PubMed Central

    Kim, Tae Yun; Lee, Yun-Sik; Yun, Ji Hye; Kim, Jeong Ju; Choi, Won Hyung; Oh, In Hwan; Song, Hyun Ouk

    2010-01-01

    We report here a human case probably mixed-infected with Clonorchis sinensis and Fasciola sp. who was diagnosed by computed tomography (CT) scan, serological findings, and/or fecal examination. The patient was a 43-year-old Korean female and was admitted to Kyung Hee University Hospital with the complaints of fever and abdominal pain. On admission, marked eosinophilia was noted in her peripheral blood. CT scan showed specific lesions for clonorchiasis and fascioliasis in the liver, along with lesions suggestive of amebic abscess. Micro-ELISA revealed positive results for the 2 helminthic infections. Eggs of C. sinensis and trophozoites of Entamoeba histolytica were observed in the stool. Treatment with praziquantel followed by metronidazole and tinidazole reduced abnormalities in the liver and eosinophilia. This is the first case report of a possible co-infection with 2 kinds of liver flukes in the Republic of Korea. PMID:20585533

  20. Sonographic findings in a case of tetrasomy 9p associated with increased nuchal translucency and Dandy-Walker malformation.

    PubMed

    Nakamura-Pereira, Marcos; Cima, Luciana Carneiro do; Llerena, Juan Clinton; Guerra, Fernando Antonio Ramos; Peixoto-Filho, Fernando Maia

    2009-10-01

    We report a case of a 23-year-old pregnant woman, who underwent amniocentesis after ultrasound (US) examination in the first trimester which revealed a nuchal translucency thickness of 2.9 mm. Cytogenetic analysis revealed complete tetrasomy of the short arm of chromosome 9. Further US evaluation in the second trimester revealed Dandy-Walker malformation, ventriculomegaly, bilateral clubfoot, lip and palate clefts, arthrogryposis and hyperechoic kidneys with bilateral pelvic dilatation. At 30 weeks of gestation, a placental abruption was noted and a Cesarean section was performed. The infant died shortly after birth. A review of previous cases of tetrasomy 9p shows that the remarkable sonographic findings are ventriculomegaly, intrauterine growth restriction, genitourinary anomaly, Dandy-Walker malformation, cleft lip/palate and limb malformation, but the association of tetrasomy 9p and increased nuchal translucency had not been reported. PMID:19655321

  1. Congenital absence of the mammillary bodies: a novel finding in a well-studied case of developmental amnesia.

    PubMed

    Rosenbaum, R Shayna; Gao, Fuqiang; Honjo, Kie; Raybaud, Charles; Olsen, Rosanna K; Palombo, Daniela J; Levine, Brian; Black, Sandra E

    2014-12-01

    Individuals with developmental amnesia experience compromised development of episodic memory for details of personal life events, believed to relate to changes to the hippocampus after birth. Here we report the very rare discovery of aplasia of the mammillary bodies, hypogenesis of the fornix, and abnormal hippocampal shape and orientation in H.C., a well-documented case of selectively compromised episodic memory development who is the subject of numerous published empirical articles. These anatomical abnormalities are highly suggestive of disrupted extended hippocampal system development very early in gestation, despite an original diagnosis of developmental amnesia and assumed perinatal hypoxia. These findings provide a unique window into the normal function of the mammillary bodies, fornices, and related anterior nuclei of the thalamus bilaterally. The results also encourage re-examination of the pathological basis of developmental amnesia in other cases reported in the literature.

  2. Predominant diffuse ground glass opacity in both lung fields: A case of sarcoidosis with atypical CT findings

    PubMed Central

    Ma, Chunmei; Zhao, Yadong; Wu, Taihua

    2016-01-01

    Sarcoidosis can cause fatal diffuse lung fibrosis in the end stage, so its early diagnosis and treatment can prevent the progression of fibrosis. Predominant ground glass opacity on high-resolution CT (HRCT) scans is a rare presentation of sarcoidosis. We report the case of a patient who presented with very few symptoms and signs of sarcoidosis; HRCT revealed large-scale ground glass opacity and minor lymphadenopathy. Bronchoalveolar lavage fluid contained turbid liquid. Sarcoidosis could be confirmed only based on pathological examination of the resected tissue. The patient was administrated prednisone at 40 mg/d orally with tapering of the dose. Lung HRCT scans taken 6 months after the prednisone treatment showed ablation of the ground glass opacity. This case report sheds light on an atypical HRCT presentation of sarcoidosis; the findings here will be useful for the early diagnosis of sarcoidosis and prevention of fatal complications. PMID:27222788

  3. Pleural-based neuroblastoma-like schwannoma: a case report with cytologic findings and review of literature.

    PubMed

    Adams, Kristen; Liu, Xuehui Susan; Akhtar, Israh; Flowers, Rhyne; Baliga, Mithra

    2015-08-01

    We report a rare case of a 45-year-old African American woman with Neuroblastoma-like Schwannoma (Neurilemmoma) occurring in the posterior mediastinum as a pleural-based mass noted on computed tomography (CT) scan. A CT-guided core biopsy of the mass was performed and core biopsy imprints were prepared during the procedure. A Diff-Quik stain was performed for on-site evaluation of specimen adequacy. The hematoxylin and eosin (H&E) staining was evaluated subsequently. Immunohistochemistry panels were applied to the same specimen. The cytologic findings of the core biopsy imprints showed hypercellular smears with a predominance of small cells with atypical features including hyperchromatic, round nuclei and occasional nucleoli. Neurocytic rosettes were particularly appreciated on H&E stain. The immunohistochemical results exhibited strong and diffuse immunoreactivity for S-100 and vimentin. This case enriches the cytopathology literature by providing awareness of this tumor presenting as a posterior mediastinal mass.

  4. Continuous Production of Biodiesel Via an Intensified Reactive/Extractive Process

    SciTech Connect

    Tsouris, Costas; McFarlane, Joanna; Birdwell Jr, Joseph F; Jennings, Hal L

    2008-01-01

    Biodiesel is considered as a means to diversify our supply of transportation fuel, addressing the goal of reducing our dependence on oil. For a number of reasons ranging from production issues to end use, biodiesel represents only a small fraction of the transportation fuel used worldwide. This work addresses the aspect of biodiesel production that limits it to a slow batch process. Conventional production methods are batch in nature, based on the assumption that the rates of the key chemical reactions are slow. The hypothesis motivating this work is that the reaction kinetics for the transesterification of the reagent triglyceride is sufficiently fast, particularly in an excess of catalyst, and that interfacial mass transfer and phase separation control the process. If this is the case, an intensified two-phase reactor adapted from solvent extraction equipment may be utilized to greatly increase biodiesel production rates by increasing interphase transport and phase separation. To prove this idea, we are investigating two aspects: (1) determining the rate-limiting step in biodiesel production by evaluating the reaction kinetics, and (2) enhancing biodiesel production rates by using an intensified reactor. A centrifugal contactor combining interphase mass transfer, chemical reaction, and phase separation is employed for process intensification.

  5. An Enhanced Seasonal Transition that Intensified Summer Drought in the Central U.S.

    NASA Technical Reports Server (NTRS)

    Wang, S.-Y.Simon; Santanello, Joseph; Wang, Hailan; Barandiaran, Daniel; Pinker, Rachel; Schubert, Siegfried; Gillies, Robert R.; Oglesby, Robert; Hilburn, Kyle; Kilic, Ayse; Houser, Paul

    2015-01-01

    Precipitation in the central U.S. decreases by about 25% during the seasonal transition from June to July, and this precipitation decrease has been observed to have intensified since 1979. Such an intensification could enhance future spring drought occurrences such as was the case in the 2012 "flash drought" in the Midwestern U.S., where conditions evolved quickly from being abnormally dry to exceptionally dry within a mere month from June to July. In this study, various atmospheric and land reanalysis datasets were analyzed to examine the trend calculated from 1979 to 2012 in the June-to-July seasonal transition. It was found that the change in precipitation deficit was accompanied by increased downward shortwave radiation flux and tropospheric subsidence, enhanced evaporative fraction, as well as an elevated planetary boundary layer height. The change in the tropospheric circulation encompassed an anomalous ridge over the western U.S. and a trough on either side; this wave-form circulation pattern is known to induce dry conditions in the central U.S. Possibly, the trends in the June-to-July seasonal shifts in precipitation, drought severity and tropospheric circulation intensified the 2012 "flash drought" in timing and extent. The knowledge of the trends allows one to anticipate the evolution of spring onset of drought into the summer.

  6. Histological variety of localized lymphoid hyperplasia of the large intestine: histopathological, immunohistochemical and genotypic findings of 16 cases.

    PubMed

    Kojima, Masaru; Nakamura, Naoya; Itoh, Hideaki; Motoori, Tadashi; Hoshi, Kazue; Enomoto, Yasunari; Johshita, Takashi; Nakamine, Hirokazu

    2009-05-01

    Previous reports emphasized that localized lymphoid hyperplasia (LLH) of the large intestine is usually histologically characterized by large lymphoid follicles with striking enlarged germinal centers, and a narrow surrounding mantle zone and marginal zone (MZ). To clarify the histological varieties of LLH of the large intestine, 16 such cases have been studied. The present study demonstrated histological diversity of the LLH of the large intestine including (i) reactive follicular hyperplasia (RFH) (n=8), (ii) RFH with progressive transformation of the germinal center (PTGC) (n=3), (iii) RFH with MZ hyperplasia (n=3) and (iv) RFH with PTGC and MZ hyperplasia (n=2). Overall histomorphological findings of the present series appear quite different from previous descriptions of LLH of the large intestine. The present study showed histological variety of the LLH of the large intestine. Moreover, LLH of the large intestine should be differentiated from extranodal marginal zone B-cell lymphoma and nodular lymphocyte predominant Hodgkin lymphoma as well as follicular lymphoma. Immunohistological studies demonstrated the reactive nature of all 16 lesions. However, three cases showing RFH demonstrated immunoglobulin heavy chain gene rearrangement by polymerase chain reaction study in 12 cases examined. It remains unclear whether these three cases showing RFH could be a sign of the prelymphomatous stage (incipient follicular lymphoma) or representing merely an exaggeration of normal B-cell clonal response in the germinal centers.

  7. Dynamic ultrasound with postural change facilitated the detection of an incisional hernia in a case with negative MRI findings.

    PubMed

    Wongsithichai, Patcharaporn; Chang, Ke-Vin; Hung, Chen-Yu; Wang, Tyng-Guey

    2015-09-01

    Incisional hernias commonly develop after abdominal surgeries with a lower incidence in patients receiving laparoscopy. Diagnosis through a non-surgical approach is usually made by computed tomography or magnetic resonance images (MRI) but both image modalities require patients to be examined in a supine position. We reported a case noticing a mass over her right lower abdomen after a laparoscopic liver segmentectomy with negative findings of hernia on MRI. A hernia sac was found by ultrasound with the patient being standing, highlighting the utility of dynamic ultrasound with postural change in investigation of incisional hernias.

  8. Hypoxia and hydrothoraces in a case of liver cirrhosis: correlation of physiological, radiographic, scintigraphic, and pathological findings

    PubMed Central

    Stanley, N. N.; Williams, A. J.; Dewar, C. A.; Blendis, L. M.; Reid, Lynne

    1977-01-01

    Stanley, N. N., Williams, A. J., Dewar, C. A., Blendis, L. M., and Reid, Lynne (1977).Thorax, 32, 457-471. Hypoxia and hydrothoraces in a case of liver cirrhosis: correlation of physiological, radiographic, scintigraphic, and pathological findings. A case is reported of liver cirrhosis complicated by cyanosis and recurrent right hydrothorax. A diagnostic pneumoperitoneum demonstrated that direct movement of ascites through a diaphragmatic defect was responsible for the hydrothoraces. Pulmonary function tests between episodes of hydrothorax showed severe arterial hypoxaemia, a 23% right-to-left shunt, and a reduction in the carbon monoxide transfer factor to less than half of the predicted value. Evidence of abnormal intrapulmonary arteriovenous communications was obtained by perfusion scanning. At necropsy the central tendon of the diaphragm showed numerous areas of thinning which were easily ruptured. Injection of the pulmonary arterial tree demonstrated precapillary arteriovenous anastomoses and pleural spider naevi. A morphometric analysis provided quantitative evidence of pulmonary vasodilatation limited to the intra-acinar arteries, consistent with the effect of a circulating vasodilator. The scintigraphic and pathological findings suggested that shunting had been greater in the right than the left lung. Examination of thin lung sections by light microscopy showed that the walls of small veins were thickened, and electron microscopy showed that this was due to a layer of collagen. The walls of capillaries were similarly thickened, which caused an approximately two-fold increase in the minimum blood-gas distance and contributed to the reduction in transfer factor. Images PMID:929488

  9. Three rounds as "tandem bullets": unusual findings in a case of a suicidal gunshot to the head.

    PubMed

    Tattoli, Lucia; Schmid, Simone; Tsokos, Michael

    2014-12-01

    We report an unusual case of suicide in which three 7.65 caliber projectiles were found in the single gunshot wound to the head of a 53-year-old man. Based on data collected at the death scene, CT scan, autopsy findings, and ballistics analysis, the events were reconstructed as follows: two 7.65 mm rounds had already been fired from the 9 mm Makarov pistol the subject was using but, being a smaller caliber, the cartridges had slipped forward and lodged within the barrel. When a third 7.65 mm cartridge was chambered and the gun fired for the third time, the nose of the last bullet hit the lodged bullets and all three rounds were propelled out of the muzzle in tandem as a single shot. Ballistic investigations confirmed that the kinetic energy of the three tandem bullets would have been sufficient to perforate the skull. In cases of gunshot wounds where the manner of death is unclear, a number of well-described circumstantial parameters, such as an atypical anatomical location of the gunshot, unusual firearm, or ammunition, as well as ambiguous autopsy findings, can raise doubts about the manner of death. In very rare cases, despite a single entrance wound, two or more bullets are recovered from the body, fired by the same weapon at the same time (the so-called "tandem bullet" phenomenon). Injuries by "tandem bullets" have crucial implications in gunshot deaths because of the mismatch between the number of entrance and exit wounds and the number of bullets found in or near the body.

  10. Intensifying weathering and land use in Iron Age Central Africa.

    PubMed

    Bayon, Germain; Dennielou, Bernard; Etoubleau, Joël; Ponzevera, Emmanuel; Toucanne, Samuel; Bermell, Sylvain

    2012-03-01

    About 3000 years ago, a major vegetation change occurred in Central Africa, when rainforest trees were abruptly replaced by savannas. Up to this point, the consensus of the scientific community has been that the forest disturbance was caused by climate change. We show here that chemical weathering in Central Africa, reconstructed from geochemical analyses of a marine sediment core, intensified abruptly at the same period, departing substantially from the long-term weathering fluctuations related to the Late Quaternary climate. Evidence that this weathering event was also contemporaneous with the migration of Bantu-speaking farmers across Central Africa suggests that human land-use intensification at that time had already made a major impact on the rainforest.

  11. Intensified charge-coupled-device-based eyetracker and image stabilizer.

    PubMed

    Milbocker, M T; Feke, G T

    1992-07-01

    An electro-optical eyetracker measures eye movement to stabilize a laser beam on the fundus in one dimension. Motion is detected by laser illumination of a fundus feature. The illuminated area is imaged on an intensified linear CCD. Electronics determine the intensity centroid of this image. Centroid motion on the CCD corresponds to eye movement in one dimension. Galvanometer-controlled mirrors reposition (at a 1-kHz rate) the illuminating beam on the fundus. The same mirrors reposition the centroid at the CCD center. Additional beams are also stabilized on the fundus. For typical fixational eye movement amplitudes and frequencies the beams follow the fundus feature within +/-10 microm. PMID:20725345

  12. The AAPM/RSNA physics tutorial for residents: X-ray image intensifiers for fluoroscopy.

    PubMed

    Wang, J; Blackburn, T J

    2000-01-01

    The x-ray image intensifier converts the transmitted x rays into a brightened, visible light image. Within an image intensifier, the input phosphor converts the x-ray photons to light photons, which are then converted to photoelectrons within the photocathode. The electrons are accelerated and focused by a series of electrodes striking the output phosphor, which converts the accelerated electrons into light photons that may be captured by various imaging devices. Through this process, several thousand light photons are produced for each x-ray photon reaching the input phosphor. Most modern image intensifiers use cesium iodide for the input phosphor because it has a high absorption efficiency and thus decreases patient dose. Image intensifiers come in various sizes, most having more than one input image size or magnification mode. Modern image intensifiers are specified by conversion factors, which is the measure of how efficiently an image intensifier converts x rays to light. Because of design restrictions, image intensifiers are subject to inherent and induced artifacts that contribute to image degradation. Both spatial and contrast resolution gradually decrease during the lifetime of the image intensifier because the brightness gain of an image intensifier decreases with time as the phosphor ages. A well-run quality control program for the image intensifier is needed to detect the inevitable changes in settings before they appear on clinical images.

  13. The Use of Xpert MTB/Rif for Active Case Finding among TB Contacts in North West Province, South Africa.

    PubMed

    Lebina, Limakatso; Fuller, Nigel; Osoba, Tolu; Scott, Lesley; Motlhaoleng, Katlego; Rakgokong, Modiehi; Abraham, Pattamukkil; Variava, Ebrahim; Martinson, Neil Alexander

    2016-01-01

    Introduction. Tuberculosis is a major cause of morbidity and mortality especially in high HIV burden settings. Active case finding is one strategy to potentially reduce TB disease burden. Xpert MTB/Rif has recently been recommended for diagnosis of TB. Methods. Pragmatic randomized trial to compare diagnosis rate and turnaround time for laboratory testing for Xpert MTB/Rif with TB microscopy and culture in household contacts of patients recently diagnosed with TB. Results. 2464 household contacts enrolled into the study from 768 active TB index cases. 1068 (44%) were unable to give sputum, but 24 of these were already on TB treatment. 863 (53%) participants sputum samples were tested with smear and culture and 2.7% (23/863; CI: 1.62-3.78) were diagnosed with active TB. Xpert MTB/Rif was used in 515 (21%) participants; active TB was diagnosed in 1.6% (8/515; CI: 0.52-2.68). Discussion and Conclusions. Additional 31 cases were diagnosed with contact tracing of household members. When Xpert MTB/Rif is compared with culture, there is no significant difference in diagnostic yield. PMID:27493800

  14. The Use of Xpert MTB/Rif for Active Case Finding among TB Contacts in North West Province, South Africa

    PubMed Central

    Osoba, Tolu; Scott, Lesley; Motlhaoleng, Katlego; Rakgokong, Modiehi; Martinson, Neil Alexander

    2016-01-01

    Introduction. Tuberculosis is a major cause of morbidity and mortality especially in high HIV burden settings. Active case finding is one strategy to potentially reduce TB disease burden. Xpert MTB/Rif has recently been recommended for diagnosis of TB. Methods. Pragmatic randomized trial to compare diagnosis rate and turnaround time for laboratory testing for Xpert MTB/Rif with TB microscopy and culture in household contacts of patients recently diagnosed with TB. Results. 2464 household contacts enrolled into the study from 768 active TB index cases. 1068 (44%) were unable to give sputum, but 24 of these were already on TB treatment. 863 (53%) participants sputum samples were tested with smear and culture and 2.7% (23/863; CI: 1.62–3.78) were diagnosed with active TB. Xpert MTB/Rif was used in 515 (21%) participants; active TB was diagnosed in 1.6% (8/515; CI: 0.52–2.68). Discussion and Conclusions. Additional 31 cases were diagnosed with contact tracing of household members. When Xpert MTB/Rif is compared with culture, there is no significant difference in diagnostic yield. PMID:27493800

  15. The Use of Xpert MTB/Rif for Active Case Finding among TB Contacts in North West Province, South Africa.

    PubMed

    Lebina, Limakatso; Fuller, Nigel; Osoba, Tolu; Scott, Lesley; Motlhaoleng, Katlego; Rakgokong, Modiehi; Abraham, Pattamukkil; Variava, Ebrahim; Martinson, Neil Alexander

    2016-01-01

    Introduction. Tuberculosis is a major cause of morbidity and mortality especially in high HIV burden settings. Active case finding is one strategy to potentially reduce TB disease burden. Xpert MTB/Rif has recently been recommended for diagnosis of TB. Methods. Pragmatic randomized trial to compare diagnosis rate and turnaround time for laboratory testing for Xpert MTB/Rif with TB microscopy and culture in household contacts of patients recently diagnosed with TB. Results. 2464 household contacts enrolled into the study from 768 active TB index cases. 1068 (44%) were unable to give sputum, but 24 of these were already on TB treatment. 863 (53%) participants sputum samples were tested with smear and culture and 2.7% (23/863; CI: 1.62-3.78) were diagnosed with active TB. Xpert MTB/Rif was used in 515 (21%) participants; active TB was diagnosed in 1.6% (8/515; CI: 0.52-2.68). Discussion and Conclusions. Additional 31 cases were diagnosed with contact tracing of household members. When Xpert MTB/Rif is compared with culture, there is no significant difference in diagnostic yield.

  16. [Case of interval form of carbon monoxide poisoning without increased carboxyhemoglobin level diagnosed by characteristic MR spectroscopy findings].

    PubMed

    Kamisawa, Tomoko; Ikawa, Masamichi; Hamano, Tadanori; Nagata, Miwako; Kimura, Hirohiko; Yoneda, Makoto

    2014-01-01

    A 67-year-old man living alone was admitted for acute disturbance of consciousness during winter. He presented with semicoma, a decorticate posture, and exaggerated tendon reflexes of the limbs, but brainstem reflexes were intact. The carboxyhemoglobin (COHb) level was normal in arterial blood gas on admission, and protein in cerebrospinal fluid was increased without pleocytosis. Brain MRI showed diffuse T2 high intensities in the deep white matter bilaterally without a contrast effect and abnormal T1 intensity in the pallidum. (1)H-MR spectroscopy (MRS) of the white matter lesion demonstrated findings suggesting demyelination as an increased choline peak, enhanced anaerobic metabolism as increased lactate and lipids peaks, and reduced neurons as a decreased N-acetylaspartate peak, which corresponded to delayed encephalopathy due to the interval form of carbon monoxide (CO) poisoning. The possibility of CO exposure due to coal briquette use 2 weeks before the symptomatic onset was indicated by his family, so he was diagnosed with CO poisoning. His consciousness slightly improved with corticosteroid therapy and repetitive hyperbaric oxygen therapy, but brain MRI and MRS findings did not improve. Characteristic MRS findings of leukoencephalopathy are helpful for diagnosing the interval form of CO poisoning in the case of a normal COHb level.

  17. Performance evaluation of a photon-counting intensified CCD

    NASA Astrophysics Data System (ADS)

    Bergamini, Paolo; Bonelli, Giuseppe; D'Angelo, Sergio; Latorre, Stefano; Poletto, Luca; Sechi, Giacomo; Tanzi, Enrico G.; Tondello, Giuseppe; Uslenghi, Michela

    1997-10-01

    The performance of a prototype photon counting imaging detector, being developed for the international UV space mission spectrum-UV, is presented. The detector is based on a 4-cm diameter, Z stack, high gain microchannel plate (MCP) intensifier endowed with a RbTe photocathode. The electron cascade generated by the MCP intensifier is transduced, via a phosphor screen and a 1:3.6 fiber optics reducer, into a 5 by 5 pixel(superscript 2), quasi-Gaussian charge distribution on a 15 micrometer, 512 by 512 pixel(superscript 2) format CCD matrix read out in the frame-transfer mode at 20 MHz, corresponding to 60 frame sec(superscript -1) in the full frame mode and to 220 frame sec(superscript -1) in the window (128 by 512 pixel(superscript 2)) mode. The data flow is acquired serially as to generate a 5 by 5 pixel(superscript 2) event sash that sweeps dynamically the CCD matrix at the 50 ns place of the readout clock. Each and every event sash is searched for the presence of events whose charge distribution lie within set thresholds and satisfy given morphological rules, i.e. a peaked charge profile. The centroid coordinates of identified events are subsequently determined with sub-pixel accuracy and stored in an external, high resolution memory. The data acquisition and processing system, based on field programmable gate array technology, is well able to resolve the front MCP pore geometry (10 micrometer diameter pores at 12 micrometer pitch).

  18. Physiological responses to an intensified period of rugby league competition.

    PubMed

    Johnston, Rich D; Gibson, Neil V; Twist, Craig; Gabbett, Tim J; MacNay, Sophie A; MacFarlane, Niall G

    2013-03-01

    This study investigated the physiological responses to an intensified period of rugby league competition and the subsequent impact on match performance. The participants were 7 rugby league players competing in an international student tournament. The tournament involved three 80-minute games over a 5-day period, with 48 hours between each match. Baseline measures of upper and lower body neuromuscular functions via a plyometric press-up (PP) and countermovement jump (CMJ), respectively (peak power and peak force were measured), blood creatine kinase (CK), and perceptions of well-being were assessed with a questionnaire. These measures were repeated every morning of the competition; neuromuscular fatigue and CK were additionally assessed within 2 hours after the cessation of each game. During each match, player movements were recorded via global positioning system units. There were meaningful reductions in upper (effect size [ES] = -0.55) and lower body (ES = -0.73) neuromuscular functions, and perceptual well-being (ES = -1.56) and increases in blood CK (ES = 2.32) after game 1. These changes increased in magnitude as the competition progressed. There were large reductions in the relative distance covered in high-speed running (ES = -1.49) and maximal accelerations (ES = -0.85) during game 3. Additionally, moderate reductions in the percentage of successful tackles completed were observed during game 3 (ES = -0.59). Collectively, these results demonstrate that during an intensified period of rugby league competition, characterized by only 48 hours between matches, fatigue will accumulate. This cumulative fatigue may compromise high-intensity match activities such as high-speed running, accelerations, and tackling. Furthermore, CMJs and PPs appear to be sensitive measures for monitoring neuromuscular function in rugby league players.

  19. Chemoradiotherapy of Newly Diagnosed Glioblastoma With Intensified Temozolomide

    SciTech Connect

    Weiler, Markus; Hartmann, Christian; Wiewrodt, Dorothee; Herrlinger, Ulrich

    2010-07-01

    Purpose: To evaluate the toxicity and efficacy of chemoradiotherapy with temozolomide (TMZ) administered in an intensified 1-week on/1-week off schedule plus indomethacin in patients with newly diagnosed glioblastoma. Patients and Methods: A total of 41 adult patients (median Karnofsky performance status, 90%; median age, 56 years) were treated with preirradiation TMZ at 150 mg/m{sup 2} (1 week on/1 week off), involved-field radiotherapy combined with concomitant low-dose TMZ (50 mg/m{sup 2}), maintenance TMZ starting at 150 mg/m{sup 2} using a 1-week on/1-week off schedule, plus maintenance indomethacin (25 mg twice daily). Results: The median follow-up interval was 21.7 months. Grade 4 hematologic toxicity was observed in 15 patients (36.6%). Treatment-related nonhematologic Grade 4-5 toxicity was reported for 2 patients (4.9%). The median progression-free survival was 7.6 months (95% confidence interval, 6.2-10.4). The 1-year survival rate was 73.2% (95% confidence interval, 56.8-84.2%). The presence of O{sup 6}-methylguanine-DNA methyltransferase (MGMT) gene promoter methylation in the tumor tissue was associated with significantly superior progression-free survival. Conclusion: The dose-dense regimen of TMZ administered in a 1-week on/1-week off schedule resulted in acceptable nonhematologic toxicity. Compared with data from the European Organization for Research and Treatment of Cancer/National Cancer Institute of Canada trial 26981-22981/CE.3, patients with an unmethylated MGMT gene promoter appeared not to benefit from intensifying the TMZ schedule regarding the median progression-free survival and overall survival. In contrast, data are promising for patients with a methylated MGMT promoter.

  20. Quantification of immunohistochemical findings of neurofibrillary tangles and senile plaques for a diagnosis of dementia in forensic autopsy cases.

    PubMed

    Takayama, Mio; Kashiwagi, Masayuki; Matsusue, Aya; Waters, Brian; Hara, Kenji; Ikematsu, Natsuki; Kubo, Shin-Ichi

    2016-09-01

    We report the quantification of immunohistochemical findings for a diagnosis of dementia in autopsy cases among older decedents. Autopsy cases were selected with the following requirements: >65yo; no head injuries, thermal injuries, or heat stroke; no intracranial lesions; and within 48h of death. Among cases that met all requirements, 10 had a clinical diagnosis of dementia were included in dementia group. Non-dementia group consisted of 38 cases without any record of dementia. To compare these groups, immunohistochemically, beta-amyloid, tau protein, gephyrin, and IL-33 were examined in five regions. Quantitative analysis was performed by collecting with image data analyzed using analysis software. Image data on tau-immunopositive neurofibrillary tangles (NFT) and beta-amyloid-positive senile plaques (SP) were photographed. Criteria for dementia were made by counting and measuring NFT and SP from image data using software. Differences in SP and NFT were effective for discriminating between the two groups. These criteria may reveal the presence and progression of dementia. Total of tau-positive NFT in Ammon's horn (AH) may be useful for diagnosing dementia. When the total is more than 41 in approximately 6mm(2) of AH, the possibility of dementia is considered. Total of beta-amyloid-positive SP in the parahippocampal gyrus (PHG) may be useful for diagnosing dementia. When the total in approximately 5mm(2) of PHG is more than 47, the possibility of dementia is considered. Immunohistochemical staining may be more useful for obtaining image data for quantification than conventional staining techniques, such as Bielschowsky-Hirano's silver staining. PMID:27591545

  1. [Dose output at an image intensifier with peak value- or mean value-control].

    PubMed

    Bronder, T

    1985-01-01

    X-ray fluoroscopy equipment with automatic brightness control works either on the principle of peak value control or mean value control. The different modes of operation of both control types have the consequence that different dose rate values are regulated if a homogeneous phantom is used. The controlled value using peak value control lies a factor of 1.4 higher than by mean value control. A theoretical consideration about the effect of different dose rate contrast distributions at the image intensifier with regard to the peak and mean values of both types of brightness control results in conditions, which an inhomogeneous phantom must satisfy to yield the same mean dose rate in both cases. By means of an inhomogeneous phantom construction in accordance with these conditions it is possible to compare the dose rate and also image quality parameters of different X-ray units with different types of brightness control. PMID:3969693

  2. Negative frequency-dependent selection is intensified at higher population densities in protist populations

    PubMed Central

    Minter, Ewan J. A.; Watts, Phillip C.; Lowe, Chris D.; Brockhurst, Michael A.

    2015-01-01

    Natural populations of free-living protists often exhibit high-levels of intraspecific diversity, yet this is puzzling as classic evolutionary theory predicts dominance by genotypes with high fitness, particularly in large populations where selection is efficient. Here, we test whether negative frequency-dependent selection (NFDS) plays a role in the maintenance of diversity in the marine flagellate Oxyrrhis marina using competition experiments between multiple pairs of strains. We observed strain-specific responses to frequency and density, but an overall signature of NFDS that was intensified at higher population densities. Because our strains were not selected a priori on the basis of particular traits expected to exhibit NFDS, these data represent a relatively unbiased estimate of the role for NFDS in maintaining diversity in protist populations. These findings could help to explain how bloom-forming plankton, which periodically achieve exceptionally high population densities, maintain substantial intraspecific diversity. PMID:26063750

  3. Negative frequency-dependent selection is intensified at higher population densities in protist populations.

    PubMed

    Minter, Ewan J A; Watts, Phillip C; Lowe, Chris D; Brockhurst, Michael A

    2015-06-01

    Natural populations of free-living protists often exhibit high-levels of intraspecific diversity, yet this is puzzling as classic evolutionary theory predicts dominance by genotypes with high fitness, particularly in large populations where selection is efficient. Here, we test whether negative frequency-dependent selection (NFDS) plays a role in the maintenance of diversity in the marine flagellate Oxyrrhis marina using competition experiments between multiple pairs of strains. We observed strain-specific responses to frequency and density, but an overall signature of NFDS that was intensified at higher population densities. Because our strains were not selected a priori on the basis of particular traits expected to exhibit NFDS, these data represent a relatively unbiased estimate of the role for NFDS in maintaining diversity in protist populations. These findings could help to explain how bloom-forming plankton, which periodically achieve exceptionally high population densities, maintain substantial intraspecific diversity.

  4. A case of acute interstitial pneumonia indistinguishable from bronchiolitis obliterans organizing pneumonia/cryptogenic organizing pneumonia: high-resolution CT findings and pathologic correlation.

    PubMed

    Ichikado, K; Johkoh, T; Ikezoe, J; Yoshida, S; Honda, O; Mihara, N; Nakamura, H; Tsujimura, T; Suga, M; Ando, M

    1998-01-01

    We report a case of histologically proved acute interstitial pneumonia (AIP) with subacute onset whose high-resolution CT (HRCT) findings were indistinguishable from those of bronchiolitis obliterans organizing pneumonia (BOOP)/cryptogenic organizing pneumonia (COP). The HRCT findings were air-space consolidation with air-bronchiologram associated with little ground-glass attenuation, and nodules. Some cases of AIP present HRCT findings indistinguishable from those of BOOP/COP.

  5. Avoiding Complications and Technical Variability During Arthroscopically Assisted Transtibial ACL Reconstructions by Using a C-Arm With Image Intensifier

    PubMed Central

    Trentacosta, Natasha; Fillar, Allison Liefeld; Liefeld, Cynthia Pierce; Hossack, Michael D.; Levy, I. Martin

    2014-01-01

    Background: Surgical reconstruction of the anterior cruciate ligament (ACL) can be complicated by incorrect and variable tunnel placement, graft tunnel mismatch, cortical breaches, and inadequate fixation due to screw divergence. This is the first report describing the use of a C-arm with image intensifier employed for the sole purpose of eliminating those complications during transtibial ACL reconstruction. Purpose: To determine if the use of a C-arm with image intensifier during arthroscopically assisted transtibial ACL reconstruction (IIAA-TACLR) eliminated common complications associated with bone–patellar tendon–bone ACL reconstruction, including screw divergence, cortical breaches, graft-tunnel mismatch, and improper positioning of the femoral and tibial tunnels. Study Design: Case series; Level of evidence, 4. Methods: A total of 110 consecutive patients (112 reconstructed knees) underwent identical IIAA-TACLR using a bone–patellar tendon–bone autograft performed by a single surgeon. Intra- and postoperative radiographic images and operative reports were evaluated for each patient looking for evidence of cortical breeching and screw divergence. Precision of femoral tunnel placement was evaluated using a sector map modified from Bernard et al. Graft recession distance and tibial α angles were recorded. Results: There were no femoral or tibial cortical breaches noted intraoperatively or on postoperative images. There were no instances of loss of fixation screw major thread engagement. There were no instances of graft-tunnel mismatch. The positions of the femoral tunnels were accurate and precise, falling into the desired sector of our location map (sector 1). Tibial α angles and graft recession distances varied widely. Conclusion: The use of the C-arm with image intensifier enabled accurate and precise tunnel placement and completely eliminated cortical breach, graft-tunnel mismatch, and screw divergence during IIAA-TACLR by allowing incremental

  6. Contrast-enhanced ultrasound findings in a case of primary chest chondrosarcoma mimicking a porta hepatis mass.

    PubMed

    Liu, Jin-Ya; Zhou, Lu-Yao; Liang, Jin-Yu; Lu, Ming-De; Wang, Wei

    2015-04-01

    We report a case of a 32-year-old woman who presented with upper abdominal pain. The physical examination revealed a palpable hard mass with a well-demarcated lower margin. Laboratory tests indicated hepatitis B viral infection. Computed tomography scan with intravenous contrast depicted a huge well-demarcated heterogeneous mass at the porta hepatis with irregular peripheral rim enhancement. Contrast-enhanced ultrasound showed peripheral irregular hyper-enhancement in the artery phase and hypo-enhancement in the portal and late phases. The postoperative histopathologic examination confirmed the diagnosis of low-grade chondrosarcoma. This is the first report of contrast-enhanced ultrasound findings of chondrosarcoma. There is some differential diagnosis to be discussed.

  7. 99mTc(V)-DMSA SPECT-CT findings in a case of Gorham-Stout disease.

    PubMed

    Alves, Victor M; Vieira, Tiago S; Amorim, Nelson S; Oliveira, Ana; Rodrigues, André; Pereira, Jorge G

    2015-01-01

    The Gorham-Stout disease is a very rare condition, characterized by lymphovascular proliferation and massive bone resorption. We present a 48-year-old male patient with osteolysis involving the left femoral head and neck, as well as to the ipsilateral acetabulum. Besides the morphological imaging, he underwent bone scintigraphy, technetium-99m-V-dimercaptosuccinic acid [99mTc(V)-DMSA] single photon emission computed tomography/computed tomography (SPECT/CT) and histological examination. Together these findings gave the definitive diagnosis. This is the first case ever published with 99mTc(V)-DMSA SPECT-CT. Advances on the knowledge of disease suggests that this imaging procedure could have utility in diagnosis and evaluation of the disease activity and therapy response.

  8. Pseudogout in the temporomandibular joint with imaging, arthroscopic, operative, and pathologic findings. Report of an unusual case.

    PubMed

    Laviv, Amir; Sadow, Peter M; Keith, David A

    2015-06-01

    The authors present a case of a 60-year-old woman with a destructive painful condition in the right temporomandibular joint (TMJ) that proved to be calcium pyrophosphate crystal deposits at subsequent biopsy examination. The patient presented with the chief complaints of pain and limitation that had not resolved with splint therapy, medications, and habit control. Magnetic resonance imaging studies showed internal derangement without reduction. Right TMJ arthroscopy with manipulation of the jaw under anesthesia showed unique findings of fronds of synovial tissue in the posterior joint space and areas of white matter. Because there was no long-term improvement in her clinical symptoms, she subsequently underwent arthroplasty of the right joint, with the white material clearly seen at surgery, and the biopsy examination confirmed the clinical and arthroscopic impression of pseudogout. The presentation, diagnosis, pathology, and treatment of pseudogout of the TMJ are discussed.

  9. A Case of an 11-year-old With Cough, Diarrhea, and Findings of Concern in His Lungs and Spleen.

    PubMed

    Darby, John B; Rees, Chris A; Bocchini, Claire E; Cruz, Andrea T; Kellermayer, Richard; Finegold, Milton J; Barlow, Sarah E

    2016-03-01

    This is the case of a previously healthy, 11-year-old male of Indian descent who presented to the emergency department with a 2-month history of nausea, vomiting, diarrhea, fatigue, cough, and 7-lb weight loss. Acutely, he developed 5 days of fever as high as 39.4°C. He had a remote travel history to the Middle East. On physical examination, he was febrile and tachycardic, was thin but otherwise had a normal examination. His inflammatory markers were elevated: erythrocyte sedimentation rate was 93 mm/hour and his C-reactive protein was 25.4 mg/L. A complete blood count revealed a white blood cell count of 17,000 × 10(3)/µL with increased bands. His hemoglobin level was 8.8 g/dL with a mean corpuscular volume of 81 fl. Platelets were 556 × 10(3)/µL. A chest radiograph was concerning for a cavitary lung lesion and an abdominal ultrasound revealed multiple hypoechoic lesions in his spleen. Our panel of experts reviews his case and examines the workup of this patient with diverse symptoms and focal findings on chest radiograph and abdominal ultrasound. PMID:26908705

  10. Florid cemento-osseous dysplasia: Report of a case documented with clinical, radiographic, biochemical and histological findings.

    PubMed

    Kutluay Köklü, Harika; Cankal, Dilek A; Bozkaya, Süleyman; Ergün, Gülfem; Bar, Emre

    2013-02-01

    Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. It usually exhibits as multiple radiopaque cementum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This article reports the case of a 45-year-old white man who was diagnosed with FCOD on the basis of clinical, radiographic, biochemical and histological findings. It is of major importance to realize that all dentists have a unique opportunity as well as ethical obligation to assist in the struggle against wrong dental treatments that might save patients dental health. This case report illustrates the point that periapical radiolucencies may represent benign fibro-osseous lesions that may be overlooked or result in unnecessary endodontic treatment. Key words:Florid cemento-osseous dysplasia, florid osseous dysplasia, fibro-osseous lesions. PMID:24455053

  11. Florid cemento-osseous dysplasia: Report of a case documented with clinical, radiographic, biochemical and histological findings.

    PubMed

    Kutluay Köklü, Harika; Cankal, Dilek A; Bozkaya, Süleyman; Ergün, Gülfem; Bar, Emre

    2013-02-01

    Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. It usually exhibits as multiple radiopaque cementum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This article reports the case of a 45-year-old white man who was diagnosed with FCOD on the basis of clinical, radiographic, biochemical and histological findings. It is of major importance to realize that all dentists have a unique opportunity as well as ethical obligation to assist in the struggle against wrong dental treatments that might save patients dental health. This case report illustrates the point that periapical radiolucencies may represent benign fibro-osseous lesions that may be overlooked or result in unnecessary endodontic treatment. Key words:Florid cemento-osseous dysplasia, florid osseous dysplasia, fibro-osseous lesions.

  12. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON THYROID DYSFUNCTION CASE FINDING.

    PubMed

    Hennessey, James V; Garber, Jeffrey R; Woeber, Kenneth A; Cobin, Rhoda; Klein, Irwin

    2016-02-01

    Hypothyroidism and hyperthyroidism can be readily diagnosed and can be treated in a safe, cost-effective manner. Professional organizations have given guidance on how and when to employ thyroid-stimulating hormone testing for the detection of thyroid dysfunction. Most recently, the United States Preventive Services Task Force did not endorse screening for thyroid dysfunction based on a lack of proven benefit and potential harm of treating those with thyroid dysfunction, which is mostly subclinical disease. The American Association of Clinical Endocrinologists (AACE) is concerned that this may discourage physicians from testing for thyroid dysfunction when clinically appropriate. Given the lack of specificity of thyroid-associated symptoms, the appropriate diagnosis of thyroid disease requires biochemical confirmation. The Thyroid Scientific Committee of the AACE has produced this White Paper to highlight the important difference between screening and case-based testing in the practice of clinical medicine. We recommend that thyroid dysfunction should be frequently considered as a potential etiology for many of the nonspecific complaints that physicians face daily. The application and success of safe and effective interventions are dependent on an accurate diagnosis. We, therefore, advocate for an aggressive case-finding approach, based on identifying those persons most likely to have thyroid disease that will benefit from its treatment. PMID:26848631

  13. The optic nerve sheath hemorrhage is a non-specific finding in cases of suspected child abuse.

    PubMed

    Leeuw, Marc De; Beuls, Emile; Jorens, Philippe G; Parizel, Paul; Jacobs, Werner

    2015-11-01

    In young infants, the triad consisting of acute encephalopathy, retinal hemorrhages, and a subdural hematoma is a nonspecific finding. It has traumatic and non-traumatic etiologies. The triad may be found among a vast spectrum of natural diseases. Optic nerve sheath hemorrhage in infants is typically detected at autopsy. It is a nonspecific finding that can be found in traumatic and non-traumatic etiologies. Neither the triad nor the ONSH are pathognomonic for an abusive head injury. Opposite to the triad, the spectrum of non-traumatic etiologies of ONSH is limited. In infants ONSH rarely occurs in spontaneous subarachnoidal hemorrhage or in infectious conditions. Our results show that the clinical significance of the optic nerve sheath hemorrhage in the forensic work-up of fatal cases of alleged abusive head injury is its limited differential diagnosis. Only after careful differential diagnosis ONSH may contribute to the diagnosis of AHT. However, the main limitation of our study is the sampling bias, as the eyes are usually removed when abusive head trauma is suspected. PMID:26386200

  14. Active Case Finding of Tuberculosis (TB) in an Emergency Room in a Region with High Prevalence of TB in Brazil

    PubMed Central

    Silva, Denise Rossato; Müller, Alice Mânica; Tomasini, Karina da Silva; Dalcin, Paulo de Tarso Roth; Golub, Jonathan E.; Conde, Marcus Barreto

    2014-01-01

    Setting Public hospital emergency room (ER) in Porto Alegre, Brazil, a setting with high prevalence of tuberculosis (TB) and human immunodeficiency virus (HIV) infection. Objective To determine the prevalence of PTB, using a symptom based active case finding (ACF) strategy in the ER of a public hospital in an area with high prevalence of TB and HIV, as well as variables associated with pulmonary TB diagnosis. Methods Cross sectional study. All patients ≥18 years seeking care at the ER were screened for respiratory symptoms and those with cough ≥2 weeks were invited to provide a chest radiograph and two unsupervised samples of sputum for acid-fast bacilli smear and culture. Results Among 31,267 admissions, 6,273 (20.1%) reported respiratory symptoms; 197 reported cough ≥2 weeks, of which pulmonary TB was diagnosed in 30. In multivariate analysis, the variables associated with a pulmonary tuberculosis diagnosis were: age (OR 0.94, 95% CI: 0.92–0.97; p<0.0001), sputum production (OR 0.18, 95% CI 0.06–0.56; p = 0.003), and radiographic findings typical of TB (OR 12.11, 95% CI 4.45–32.93; p<0.0001). Conclusions This study identified a high prevalence of pulmonary TB among patients who sought care at the emergency department of a tertiary hospital, emphasizing the importance of regular screening of all comers for active TB in this setting. PMID:25211158

  15. Concept Formation in Environmental Education: 14-Year Olds' Work on the Intensified Greenhouse Effect and the Depletion of the Ozone Layer. Research Report

    ERIC Educational Resources Information Center

    Osterlind, Karolina

    2005-01-01

    A case study is presented describing the work of three pupils in the upper level of compulsory school. The pupils were learning about the intensified greenhouse effect and the depletion of the ozone layer. In their work, the need for certain domain-specific knowledge becomes apparent; for example, understanding such concepts as photosynthesis,…

  16. POTENTIAL OF MRI FINDINGS TO REFINE CASE DEFINITION FOR MECHANICAL LOW BACK PAIN IN EPIDEMIOLOGICAL STUDIES: A SYSTEMATIC REVIEW

    PubMed Central

    Endean, Alison; Palmer, Keith T; Coggon, David

    2011-01-01

    Study design Systematic review and meta-analysis Objective To assess how confidently LBP can be attributed to abnormalities on MRI, and thereby explore the potential value of MRI abnormalities in refining case definition for mechanical low back pain (LBP) in epidemiological research. Summary of background data Most epidemiological studies of mechanical LBP have defined cases only by reported symptoms, but it is possible that the potency of causes differs according to whether or not there is demonstrable underlying spinal pathology. Methods We reviewed the published literature on MRI abnormalities, looking for data on the repeatability of their assessment, their prevalence in people free from LBP, and their association with LBP. Where data were sufficient, we calculated a summary estimate of prevalence in people without LBP and a meta-estimate of the odds ratio for the association with LBP. A formula was then applied to estimate the corresponding prevalence rate ratio (PRR), assuming three possible prevalence rates for LBP in the general population. Results Data were most extensive for disc protrusion, nerve root displacement/compression, disc degeneration and high intensity zone (HIZ), all of which could be assessed repeatably. All were associated with LBP, meta-estimates of odds ratios ranging from 2.3 (nerve root displacement/compression) to 3.6 (disc protrusion). However, even for disc protrusion, estimates of the corresponding PRRs were mostly less than two. Conclusion MRI findings of disc protrusion, nerve root displacement/compression, disc degeneration and HIZ are all associated with LBP, but individually, none of these abnormalities provides a strong indication that LBP is attributable to underlying pathology. This limits their value in refining epidemiological case definitions for LBP. PMID:20739918

  17. Image intensifiers. (Latest citations from the US Patent database). Published Search

    SciTech Connect

    Not Available

    1993-01-01

    The bibliography contains citations of selected patents concerning classifications, components, and applications of image intensifiers. Classifications include x-ray, gamma-ray, electron beam, and neutron beam image intensifiers. Design and fabrication methods of image intensifier tubes, input phosphor screens, photocathodes, resolution enhancers, brightness control devices, color contrast devices, and power supply circuits are presented. Patent applications of image intensifiers used in x-ray and gamma-ray imaging systems, electron microscopes, charge coupled image sensors, television cameras, photographic apparatus, and underwater viewing systems are included. Patents concerning night vision devices are examined in a separate bibliography. (Contains 250 citations and includes a subject term index and title list.)

  18. Intensified autophagy compromises the efficacy of radiotherapy against prostate cancer

    SciTech Connect

    Koukourakis, Michael I.

    2015-05-29

    Introduction: Radiotherapy is an equivalent alternative or complement to radical prostatectomy, with high therapeutic efficacy. High risk patients, however, experience high relapse rates, so that research on radio-sensitization is the most evident route to improve curability of this common disease. Materials and methods: In the current study we investigated the autophagic activity in a series of patients with localized prostate tumors treated with radical radiotherapy, using the LC3A and the LAMP2a proteins as markers of autophagosome and lysosome cellular content, respectively. The role of autophagy on prostate cancer cell line resistance to radiation was also examined. Results: Using confocal microscopy on tissue biopsies, we showed that prostate cancer cells have, overall, high levels of LC3A and low levels of LAMP2a compared to normal prostate glands. Tumors with a ‘highLC3A/lowLAMP2a’ phenotype, suggestive of intensified lysosomal consumption, had a significantly poorer biochemical relapse free survival. The PC3 radioresistant cell line sustained remarkably its autophagic flux ability after radiation, while the DU145 radiosensitive one experiences a prolonged blockage of the autophagic process. This was assessed with aggresome accumulation detection and LC3A/LAMP2a double immunofluorescence, as well as with sequestrosome/p62 protein detection. By silencing the LC3A or LAMP2a expression, both cell lines became more sensitive to escalated doses of radiation. Conclusions: High base line autophagy activity and cell ability to sustain functional autophagy define resistance of prostate cancer cells to radiotherapy. This can be reversed by blocking up-regulated components of the autophagy pathway, which may prove of importance in the field of clinical radiotherapy. - Highlights: • High LC3A and low LAMP2a levels is a frequent expression pattern of prostate carcinoma. • This pattern of intensified autophagic flux relates with high relapse rates after

  19. [A case of subacute combined degeneration of the spinal cord diagnosed by characteristic findings of magnetic resonance imaging: case report and review of 22 cases].

    PubMed

    Morishita, Akitsugu; Tomita, Hiroshi; Takaishi, Yosiyuki; Nishihara, Masamitsu; Kohmura, Eiji

    2005-05-01

    Subacute combined degeneration (SCD) is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord, and is a neurogenic complication due to vitamin B12 deficiency. This report concerns a patient with progressive sensory disturbance, but no abnormal neurological findings. A 73-year-old man with gastrectomy presented with a 6-month history of gradually worsening tingling in both hands. Magnetic resonance imaging (MRI) of the cervical spine clearly showed symmetrical high-signal areas on T2WI involving the posterior columns of the cervical cord from C2 through C6. A diagnosis of SCD of the spinal cord was considered and confirmed by laboratory findings. The patient was treated with vitamin B12 supplements and showed gradual improvement in his clinical symptoms. Repeat MRI of the cervical spine after 3 months indicated a slight decrease in the area of the abnormal signal. Among all the possible causes of myelopathy, SCD of the spinal cord, involving neurological complications due to vitamin B12 deficiency, is one of the less often encountered diseases. Nevertheless, SCD should be considered in the differential diagnosis of all spinal cord, peripheral nerve, and neuropsychiatric disorders.

  20. A qualitative study of primary care professionals’ views of case finding for depression in patients with diabetes or coronary heart disease in the UK

    PubMed Central

    2013-01-01

    Background Routinely conducting case finding (also commonly referred to as screening) in patients with chronic illness for depression in primary care appears to have little impact. We explored the views and experiences of primary care nurses, doctors and managers to understand how the implementation of case finding/screening might impact on its effectiveness. Methods Two complementary qualitative focus group studies of primary care professionals including nurses, doctors and managers, in five primary care practices and five Community Health Partnerships, were conducted in Scotland. Results We identified several features of the way case finding/screening was implemented that may lead to systematic under-detection of depression. These included obstacles to incorporating case finding/screening into a clinical review consultation; a perception of replacing individualised care with mechanistic assessment, and a disconnection for nurses between management of physical and mental health. Far from being a standardised process that encouraged detection of depression, participants described case finding/screening as being conducted in a way which biased it towards negative responses, and for nurses, it was an uncomfortable task for which they lacked the necessary skills to provide immediate support to patients at the time of diagnosis. Conclusion The introduction of case finding/screening for depression into routine chronic illness management is not straightforward. Routinized case finding/screening for depression can be implemented in ways that may be counterproductive to engagement (particularly by nurses), with the mental health needs of patients living with long term conditions. If case finding/screening or engagement with mental health problems is to be promoted, primary care nurses require more training to increase their confidence in raising and dealing with mental health issues and GPs and nurses need to work collectively to develop the relational work required to

  1. Glacial aridity in central Indonesia coeval with intensified monsoon circulation

    NASA Astrophysics Data System (ADS)

    Konecky, Bronwen; Russell, James; Bijaksana, Satria

    2016-03-01

    The Last Glacial Maximum was cool and dry over the Indo-Pacific Warm Pool (IPWP), a key region driving global oceanic-atmospheric circulation. Both low- and high-latitude teleconnections with insolation, ice sheets, and sea level have been suggested to explain the pervasive aridity observed in paleoecological and geomorphic data. However, proxies tracking the H- and O-isotopic composition of rainfall (e.g., speleothems, sedimentary biomarkers) suggest muted aridity or even wetter conditions than the present, complicating interpretations of glacial IPWP climate. Here we use multiproxy reconstructions from lake sediments and modern rainfall isotopic measurements from central Indonesia to show that, contrary to the classical "amount effect," intensified Australian-Indonesian monsoon circulation drove lighter H- and O-isotopic composition of IPWP rainfall during the LGM, while at the same time, dry conditions prevailed. Precipitation isotopes are particularly sensitive to the apparent increase in monsoon circulation and perhaps also decreased moisture residence time implied by our data, explaining contrasts among proxy records while illuminating glacial IPWP atmospheric circulation, a key target for climate models.

  2. 40° image intensifier tubes in an integrated helmet system

    NASA Astrophysics Data System (ADS)

    Schreyer, Herbert; Boehm, Hans-Dieter V.; Svedevall, B.

    1993-12-01

    EUROCOPTER has been under contract to the French and German ministries of defence for five years to develop the TIGER, a second generation anti-tank helicopter. A piloting thermal imager has been installed on a steerable platform in the helicopter nose in order to achieve the possibility of flying round the clock. In addition to this sensor, which is sensitive at a wavelength of 10 micrometers , the German side has proposed using an Integrated Helmet System in the PAH 2. This helmet, manufactured by GEC-Marconi Avionics, incorporates two cathode ray tubes (CRT) and two image intensifier tubes which allow the pilot to use an additional sensor in the visible and near infrared spectrum. The electronic part will be built by Teldix. EUROCOPTER DEUTSCHLAND has received the first demonstrator of this helmet for testing in the EUROCOPTER Visionics Laboratory. Later, the C-prototype will be integrated into a BK 117 helicopter (AVT Avionik Versuchstrager). This new helmet has a field of view of 40 degree(s), and exit pupil of 15 mm and improved possibilities of adjusting the optical part. Laboratory tests have been carried out to test important parameters like optical resolution under low light level conditions, field of view, eye relief or exit pupil. The CRT channels have been tested for resolution, distortion, vignetting and homogeneity. The requirements and the properties of the helmet, test procedures and the results of these tests are presented in the paper.

  3. Social exclusion intensifies anxiety-like behavior in adolescent rats.

    PubMed

    Lee, Hyunchan; Noh, Jihyun

    2015-05-01

    Social connection reduces the physiological reactivity to stressors, while social exclusion causes emotional distress. Stressful experiences in rats result in the facilitation of aversive memory and induction of anxiety. To determine the effect of social interaction, such as social connection, social exclusion and equality or inequality, on emotional change in adolescent distressed rats, the emotional alteration induced by restraint stress in individual rats following exposure to various social interaction circumstances was examined. Rats were assigned to one of the following groups: all freely moving rats, all rats restrained, rats restrained in the presence of freely moving rats and freely moving rats with a restrained rat. No significant difference in fear-memory and sucrose consumption between all groups was found. Change in body weight significantly increased in freely moving rats with a restrained rat, suggesting that those rats seems to share the stressful experience of the restrained rat. Interestingly, examination of the anxiety-like behavior revealed only rats restrained in the presence of freely moving rats to have a significant increase, suggesting that emotional distress intensifies in positions of social exclusion. These results demonstrate that unequally excluded social interaction circumstances could cause the amplification of distressed status and anxiety-related emotional alteration.

  4. The Effect of Intensified Language Exposure on Accommodating Talker Variability

    PubMed Central

    Antoniou, Mark; Wong, Patrick C. M.

    2015-01-01

    Purpose This study systematically examined the role of intensified exposure to a second language on accommodating talker variability. Method English native listeners (n = 37) were compared with Mandarin listeners who had either lived in the United States for an extended period of time (n = 33) or had lived only in China (n = 44). Listeners responded to target words in an English word-monitoring task in which sequences of words were randomized. Half of the sequences were spoken by a single talker and the other half by multiple talkers. Results Mandarin listeners living in China were slower and less accurate than both English listeners and Mandarin listeners living in the United States. Mandarin listeners living in the United States were less accurate than English natives only in the more cognitively demanding mixed-talker condition. Conclusions Mixed-talker speech affects processing in native and nonnative listeners alike, although the decrement is larger in nonnatives and further exaggerated in less proficient listeners. Language immersion improves listeners' ability to resolve talker variability, and this suggests that immersion may automatize nonnative processing, freeing cognitive resources that may play a crucial role in speech perception. These results lend support to the active control model of speech perception. PMID:25811169

  5. 21 CFR 892.1660 - Non-image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Non-image-intensified fluoroscopic x-ray system... fluoroscopic x-ray system. (a) Identification. A non-image-intensified fluoroscopic x-ray system is a device... of x-radiation into a visible image. This generic type of device may include signal analysis...

  6. 21 CFR 892.1660 - Non-image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Non-image-intensified fluoroscopic x-ray system... fluoroscopic x-ray system. (a) Identification. A non-image-intensified fluoroscopic x-ray system is a device... of x-radiation into a visible image. This generic type of device may include signal analysis...

  7. 21 CFR 892.1660 - Non-image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Non-image-intensified fluoroscopic x-ray system... fluoroscopic x-ray system. (a) Identification. A non-image-intensified fluoroscopic x-ray system is a device... of x-radiation into a visible image. This generic type of device may include signal analysis...

  8. 21 CFR 892.1650 - Image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Image-intensified fluoroscopic x-ray system. 892... fluoroscopic x-ray system. (a) Identification. An image-intensified fluoroscopic x-ray system is a device intended to visualize anatomical structures by converting a pattern of x-radiation into a visible...

  9. 21 CFR 892.1650 - Image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Image-intensified fluoroscopic x-ray system. 892... fluoroscopic x-ray system. (a) Identification. An image-intensified fluoroscopic x-ray system is a device intended to visualize anatomical structures by converting a pattern of x-radiation into a visible...

  10. 21 CFR 892.1660 - Non-image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Non-image-intensified fluoroscopic x-ray system... fluoroscopic x-ray system. (a) Identification. A non-image-intensified fluoroscopic x-ray system is a device... of x-radiation into a visible image. This generic type of device may include signal analysis...

  11. 21 CFR 892.1650 - Image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Image-intensified fluoroscopic x-ray system. 892... fluoroscopic x-ray system. (a) Identification. An image-intensified fluoroscopic x-ray system is a device intended to visualize anatomical structures by converting a pattern of x-radiation into a visible...

  12. 21 CFR 892.1650 - Image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Image-intensified fluoroscopic x-ray system. 892... fluoroscopic x-ray system. (a) Identification. An image-intensified fluoroscopic x-ray system is a device intended to visualize anatomical structures by converting a pattern of x-radiation into a visible...

  13. 21 CFR 892.1660 - Non-image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Non-image-intensified fluoroscopic x-ray system... fluoroscopic x-ray system. (a) Identification. A non-image-intensified fluoroscopic x-ray system is a device... of x-radiation into a visible image. This generic type of device may include signal analysis...

  14. 21 CFR 892.1650 - Image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Image-intensified fluoroscopic x-ray system. 892... fluoroscopic x-ray system. (a) Identification. An image-intensified fluoroscopic x-ray system is a device intended to visualize anatomical structures by converting a pattern of x-radiation into a visible...

  15. Finding the Little 'c' in Physics: A Multiple Case Study Examining the Development of Creative Activities in the Physics Classroom

    NASA Astrophysics Data System (ADS)

    Wheeler, Christopher

    This study focused on how physics teachers develop and implement activities that promote creative thinking strategies in the standards based physics classroom. A particular focus was placed on every day or little "c", creativity, which can be taught in the high school classroom. The study utilized a multiple case study design, which allows for in-depth study in a variety of settings. Four participants from various high schools were identified utilizing administrator recommendations. Data were then collected via interviews, observations, and documents. The data were coded and analyzed for emerging themes. The themes were then merged to determine findings to the stated research questions. The research demonstrated the importance of modifying activities for student interest and understanding through effective use of scientific inquiry. The past experiences and professional development of the participants served as a vital piece to the development of their educational pedagogy especially concerning inquiry and questioning strategies. It was also established that an unstructured, positive classroom environment is a vital aspect of teaching while supporting creative thinking skills.

  16. Medical leadership arrangements in English healthcare organisations: findings from a national survey and case studies of NHS trusts.

    PubMed

    Dickinson, Helen; Ham, Chris; Snelling, Iain; Spurgeon, Peter

    2013-11-01

    This project sought to describe the involvement of doctors in leadership roles in the NHS and the organisational structures and management processes in use in NHS trusts. A mixed methods approach was adopted combining a questionnaire survey of English NHS trusts and in-depth case studies of nine organisations who responded to the survey. Respondents identified a number of challenges in the development of medical leadership, and there was often perceived to be an engagement gap between medical leaders and doctors in clinical roles. While some progress has been made in the development of medical leadership in the NHS in England, much remains to be done to complete the journey that started with the Griffiths Report in 1983. We conclude that a greater degree of professionalism needs to be brought to bear in the development of medical leadership. This includes developing career structures to make it easier for doctors to take on leadership roles; providing training, development and support in management and leadership at different stages of doctors' careers; and ensuring that pay and other rewards are commensurate with the responsibilities of medical leaders. The time commitment of medical leaders and the proportion of doctors in leadership roles both need to increase. The paper concludes considering the implications of these findings for other health systems.

  17. An interprofessional education pilot program in maternity care: findings from an exploratory case study of undergraduate students.

    PubMed

    Meffe, Filomena; Claire Moravac, Catherine; Espin, Sherry

    2012-05-01

    An interprofessional team of maternity care providers and academics developed a pilot interprofessional education (IPE) program in maternity care for undergraduate students in nursing, midwifery and medicine. There are few published studies examining IPE programs in maternity care, particularly at the undergraduate level, that examine long-term outcomes. This paper outlines findings from a case study that explored how participation in an IPE program in maternity care may enhance student knowledge, skills/attitudes, and may promote their collaborative behavior in the practice setting. The program was launched at a Canadian urban teaching hospital and consisted of six workshops and two clinical shadowing experiences. Twenty-five semi-structured, in-depth interviews were completed with nine participants at various time points up to 20 months post-program. Qualitative analysis of transcripts revealed the emergence of four themes: relationship-building, confident communication, willingness to collaborate and woman/family-centered care. Participant statements about their intentions to continue practicing interprofessional collaboration more than a year post-program lend support to its sustained effectiveness. The provision of a safe learning environment, the use of small group learning techniques with mixed teaching strategies, augmented by exposure to an interprofessional faculty, contributed to the program's perceived success. PMID:22251306

  18. Case-finding of chronic obstructive pulmonary disease with questionnaire, peak flow measurements and spirometry: a cross-sectional study

    PubMed Central

    2014-01-01

    Background Spirometry is commonly accepted as the gold standard for the diagnosis of COPD, but the reality remains that quality assured spirometry is not or cannot be provided universally around the globe. Adding PEF measurement to a screening questionnaire may rule out airflow limitation compatible with COPD rationalizing spirometry testing. Methods We conducted a cross-sectional survey in a sample of individuals 40–80 yrs. old in Dubai, UAE. They were invited to answer a short socio-demographic questionnaire including a report on current, past history of smoking, and had PEF measured, then they conducted spirometry to identify airflow limitation compatible with COPD. Results Overall, 525 (91.0%) participants performed PEF and spirometry (68% male, with a mean age of 59 years, 17% UAE Nationals), 24% reported smoking of different sorts. Overall, 68 participants (12.9%, 95% C.I. 10.3% to 16.1%) had airflow limitation compatible with COPD. PEFR alone identified 141participants with airflow limitation compatible with COPD, with specificity of 80% and sensitivity of 73.5%. Conclusions PEFR could be an easy, cheap, and non-biased tool to assist with the case-finding of COPD before confirmation with spirometry. PMID:24739210

  19. Intervening to alleviate word-finding difficulties in children: case series data and a computational modelling foundation.

    PubMed

    Best, W; Fedor, A; Hughes, L; Kapikian, A; Masterson, J; Roncoli, S; Fern-Pollak, L; Thomas, M S C

    2015-01-01

    We evaluated a simple computational model of productive vocabulary acquisition, applied to simulating two case studies of 7-year-old children with developmental word-finding difficulties across four core behavioural tasks. Developmental models were created, which captured the deficits of each child. In order to predict the effects of intervention, we exposed the computational models to simulated behavioural interventions of two types, targeting the improvement of either phonological or semantic knowledge. The model was then evaluated by testing the predictions from the simulations against the actual results from an intervention study carried out with the two children. For one child it was predicted that the phonological intervention would be effective, and the semantic intervention would not. This was borne out in the behavioural study. For the second child, the predictions were less clear and depended on the nature of simulated damage to the model. The behavioural study found an effect of semantic but not phonological intervention. Through an explicit computational simulation, we therefore employed intervention data to evaluate our theoretical understanding of the processes underlying acquisition of lexical items for production and how they may vary in children with developmental language difficulties.

  20. An autopsy case of neuroleptic malignant syndrome (NMS) and its immunohistochemical findings of muscle-associated proteins and mitochondria.

    PubMed

    Kubo, S; Orihara, Y; Kitamura, O; Ikematsu, K; Tsuda, R; Nakasono, I

    2001-01-01

    Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal disorder. In forensic cases, post-mortem diagnosis of NMS is sometimes difficult if ante-mortem information, such as neuroleptic ingestion or signs and symptoms, cannot be obtained. A 39-year-old Japanese male on a neuroleptic treatment regimen suddenly became agitated and died. Autopsy revealed muscle rigidity and hyperthermia. Post-mortem examination of blood revealed elevation of creatine phosphokinase-MM (CK-MM) and lactate dehydrogenase-4 and dehydrogenase-5 (LDH-4 and LDH-5). In renal glomeruli and tubules, myoglobin was stained immunohistochemically. From these findings, the cause of death was considered to be NMS. To support the diagnosis of NMS, both skeletal and cardiac muscles were stained with actin, myoglobin, desmin and mitochondria antibodies immunohistochemically. Actin, myoglobin, desmin, and mitochondria had been lost from skeletal, but not from the cardiac muscle, which suggested that only the skeletal muscle was damaged. Moreover, because mitochondria had disappeared only from the skeletal muscle, it was considered that skeletal muscle degeneration was caused by mitochondrial damage. Therefore, it is suggested that immunostaining of skeletal muscle by antibodies for muscle-associated proteins and mitochondria is useful to corroborate a diagnosis of NMS.

  1. Medical leadership arrangements in English healthcare organisations: findings from a national survey and case studies of NHS trusts.

    PubMed

    Dickinson, Helen; Ham, Chris; Snelling, Iain; Spurgeon, Peter

    2013-11-01

    This project sought to describe the involvement of doctors in leadership roles in the NHS and the organisational structures and management processes in use in NHS trusts. A mixed methods approach was adopted combining a questionnaire survey of English NHS trusts and in-depth case studies of nine organisations who responded to the survey. Respondents identified a number of challenges in the development of medical leadership, and there was often perceived to be an engagement gap between medical leaders and doctors in clinical roles. While some progress has been made in the development of medical leadership in the NHS in England, much remains to be done to complete the journey that started with the Griffiths Report in 1983. We conclude that a greater degree of professionalism needs to be brought to bear in the development of medical leadership. This includes developing career structures to make it easier for doctors to take on leadership roles; providing training, development and support in management and leadership at different stages of doctors' careers; and ensuring that pay and other rewards are commensurate with the responsibilities of medical leaders. The time commitment of medical leaders and the proportion of doctors in leadership roles both need to increase. The paper concludes considering the implications of these findings for other health systems. PMID:25595009

  2. Salivary gland manifestations of sinus histiocytosis with massive lymphadenopathy: fine-needle aspiration cytology findings. A case report.

    PubMed

    Panikar, Nirupma; Agarwal, Sarla

    2005-09-01

    Sinus histiocytosis with massive lymphadenopathy (SHML or Rosai-Dorfman disease) is a nonneoplastic, usually self-limiting disease. Alhough it affects all age groups, it is more commonly seen in young males in their first or second decades. The disease primarily manifests as painless lymphadenopathy of cervical region, but other nodal groups and extranodal sites may also be affected. Seldom SHML may involve the salivary glands. We present the cytologic features and differential diagnoses of one such case.A 45-yr-old woman presented with an enlarged submandibular gland on the left side with ipsilateral cervical lymphadenopathy that had been persisting for 1 mo. The gland and the two enlarged nodes measured 2.5 x 2.5 cm(2) each and were firm in consistency. Clinically, tumor of the salivary glands was suspected. Fine-needle aspiration (FNA) smears showed moderate cellularity, with large histiocytes dispersed in the background of intense lymphoplasmacytic infiltrate. These histiocytes showed lymphophagocytosis. Isolated stromal fragments consisting of fibrocytes were seen separate from salivary acinar clusters on repeat aspirations. The diagnosis of SHML involving left submandibular gland and ipsilateral lymph nodes was returned. When analyzed in the context of clinical findings (laboratory data), the cytologic features of SHML involving salivary gland could be differentiated from those of malignancies and other benign lesions, especially Kuttner's tumor of the submandibular gland, which mimics neoplasm clinically.

  3. Intensified-CCD focal plane detector for space applications A second generation

    NASA Technical Reports Server (NTRS)

    Torr, M. R.; Torr, D. G.; Baum, R.; Spielmaker, R.

    1986-01-01

    An intensified-CCD detector system developed for space applications from commercially available components is described. This detector uses components which are readily available and are mechanically, thermally, and optically coupled to produce the final compact system. The CCD is cooled using a Peltier-effect thermoelectric cooler to reduce thermal noise. The image is formed on the photocathode of a proximity-focused image intensifier and is transferred fiber-optically from the intensifier to the CDD. Various photocathode and window materials are used to optimize the system for use within the wavelength range extending from the far UV to the near IR. The basic design, including the image intensifier, intensifier-CCD interface, CCD array, cooling, electronics, and mounting, and the detector performance are described in detail.

  4. Predator cannibalism can intensify negative impacts on heterospecific prey.

    PubMed

    Takatsu, Kunio; Kishida, Osamu

    2015-07-01

    Although natural populations consist of individuals with different traits, and the degree of phenotypic variation varies among populations, the impact of phenotypic variation on ecological interactions has received little attention, because traditional approaches to community ecology assume homogeneity of individuals within a population. Stage structure, which is a common way of generating size and developmental variation within predator populations, can drive cannibalistic interactions, which can affect the strength of predatory effects on the predator's heterospecific prey. Studies have shown that predator cannibalism weakens predatory effects on heterospecific prey by reducing the size of the predator population and by inducing less feeding activity of noncannibal predators. We predict, however, that predator cannibalism, by promoting rapid growth of the cannibals, can also intensify predation pressure on heterospecific prey, because large predators have large resource requirements and may utilize a wider variety of prey species. To test this hypothesis, we conducted an experiment in which we created carnivorous salamander (Hynobius retardatus) populations with different stage structures by manipulating the salamander's hatch timing (i.e., populations with large or small variation in the timing of hatching), and explored the resultant impacts on the abundance, behavior, morphology, and life history of the salamander's large heterospecific prey, Rana pirica frog tadpoles. Cannibalism was rare in salamander populations having small hatch-timing variation, but was frequent in those having large hatch-timing variation. Thus, giant salamander cannibals occurred only in the latter. We clearly showed that salamander giants exerted strong predation pressure on frog tadpoles, which induced large behavioral and morphological defenses in the tadpoles and caused them to metamorphose late at large size. Hence, predator cannibalism arising from large variation in the timing

  5. Two micron pore size MCP-based image intensifiers

    NASA Astrophysics Data System (ADS)

    Glesener, John; Estrera, Joseph

    2010-02-01

    Image intensifiers (I2) have many advantages as detectors. They offer single photon sensitivity in an imaging format, they're light in weight and analog I2 systems can operate for hours on a single AA battery. Their light output is such as to exploit the peak in color sensitivity of the human eye. Until recent developments in CMOS sensors, they also were one of the highest resolution sensors available. The closest all solid state solution, the Texas Instruments Impactron chip, comes in a 1 megapixel format. Depending on the level of integration, an Impactron based system can consume 20 to 40 watts in a system configuration. In further investing in I2 technology, L-3 EOS determined that increasing I2 resolution merited a high priority. Increased I2 resolution offers the system user two desirable options: 1) increased detection and identification ranges while maintaining field-of-view (FOV) or 2) increasing FOV while maintaining the original system resolution. One of the areas where an investment in resolution is being made is in the microchannel plate (MCP). Incorporation of a 2 micron MCP into an image tube has the potential of increasing the system resolution of currently fielded systems. Both inverting and non-inverting configurations are being evaluated. Inverting tubes are being characterized in night vision goggle (NVG) and sights. The non-inverting 2 micron tube is being characterized for high resolution I2CMOS camera applications. Preliminary measurements show an increase in the MTF over a standard 5 micron pore size, 6 micron pitch plate. Current results will be presented.

  6. Restraint Stress Intensifies Interstitial K+ Accumulation during Severe Hypoxia

    PubMed Central

    Schnell, Christian; Janc, Oliwia A.; Kempkes, Belinda; Callis, Carolina Araya; Flügge, Gabriele; Hülsmann, Swen; Müller, Michael

    2012-01-01

    Chronic stress affects neuronal networks by inducing dendritic retraction, modifying neuronal excitability and plasticity, and modulating glial cells. To elucidate the functional consequences of chronic stress for the hippocampal network, we submitted adult rats to daily restraint stress for 3 weeks (6 h/day). In acute hippocampal tissue slices of stressed rats, basal synaptic function and short-term plasticity at Schaffer collateral/CA1 neuron synapses were unchanged while long-term potentiation was markedly impaired. The spatiotemporal propagation pattern of hypoxia-induced spreading depression episodes was indistinguishable among control and stress slices. However, the duration of the extracellular direct current potential shift was shortened after stress. Moreover, K+ fluxes early during hypoxia were more intense, and the postsynaptic recoveries of interstitial K+ levels and synaptic function were slower. Morphometric analysis of immunohistochemically stained sections suggested hippocampal shrinkage in stressed rats, and the number of cells that are immunoreactive for glial fibrillary acidic protein was increased in the CA1 subfield indicating activation of astrocytes. Western blots showed a marked downregulation of the inwardly rectifying K+ channel Kir4.1 in stressed rats. Yet, resting membrane potentials, input resistance, and K+-induced inward currents in CA1 astrocytes were indistinguishable from controls. These data indicate an intensified interstitial K+ accumulation during hypoxia in the hippocampus of chronically stressed rats which seems to arise from a reduced interstitial volume fraction rather than impaired glial K+ buffering. One may speculate that chronic stress aggravates hypoxia-induced pathophysiological processes in the hippocampal network and that this has implications for the ischemic brain. PMID:22470344

  7. Relationship between Urinary N-Desmethyl-Acetamiprid and Typical Symptoms including Neurological Findings: A Prevalence Case-Control Study.

    PubMed

    Marfo, Jemima Tiwaa; Fujioka, Kazutoshi; Ikenaka, Yoshinori; Nakayama, Shouta M M; Mizukawa, Hazuki; Aoyama, Yoshiko; Ishizuka, Mayumi; Taira, Kumiko

    2015-01-01

    Neonicotinoid insecticides are nicotinic acetylcholine receptor agonists used worldwide. Their environmental health effects including neurotoxicity are of concern. We previously determined a metabolite of acetamiprid, N-desmethyl-acetamiprid in the urine of a patient, who exhibited some typical symptoms including neurological findings. We sought to investigate the association between urinary N-desmethyl-acetamiprid and the symptoms by a prevalence case-control study. Spot urine samples were collected from 35 symptomatic patients of unknown origin and 50 non-symptomatic volunteers (non-symptomatic group, NSG, 4-87 year-old). Patients with recent memory loss, finger tremor, and more than five of six symptoms (headache, general fatigue, palpitation/chest pain, abdominal pain, muscle pain/weakness/spasm, and cough) were in the typical symptomatic group (TSG, n = 19, 5-69 year-old); the rest were in the atypical symptomatic group (ASG, n = 16, 5-78 year-old). N-desmethyl-acetamiprid and six neonicotinoids in the urine were quantified by liquid chromatography-tandem mass spectrometry. The detection of N-desmethyl-acetamiprid was the most frequent and highest in TSG (47.4%, 6.0 ppb (frequency, maximum)), followed by in ASG (12.5%, 4.4 ppb) and in NSG (6.0%, 2.2 ppb), however acetamiprid was not detected. Thiamethoxam was detected in TSG (31.6%, 1.4 ppb), in ASG (6.3%, 1.9 ppb), but not in NSG. Nitenpyram was detected in TSG (10.5%, 1.2 ppb), in ASG (6.3%, not quantified) and in NSG (2.0%, not quantified). Clothianidin was only detected in ASG (6.3%, not quantified), and in NSG (2.0%, 1.6 ppb). Thiacloprid was detected in ASG (6.3%, 0.1 ppb). The cases in TSG with detection of N-desmethyl-acetamiprid and thiamethoxam were aged 5 to 62 years and 13 to 62 years, respectively. Detection of N-desmethyl-acetamiprid was associated with increased prevalence of the symptoms (odds ratio: 14, 95% confidence interval: 3.5-57). Urinary N-desmethyl-acetamiprid can be used as a

  8. Relationship between Urinary N-Desmethyl-Acetamiprid and Typical Symptoms including Neurological Findings: A Prevalence Case-Control Study

    PubMed Central

    Ikenaka, Yoshinori; Nakayama, Shouta M. M.; Mizukawa, Hazuki; Aoyama, Yoshiko; Ishizuka, Mayumi; Taira, Kumiko

    2015-01-01

    Neonicotinoid insecticides are nicotinic acetylcholine receptor agonists used worldwide. Their environmental health effects including neurotoxicity are of concern. We previously determined a metabolite of acetamiprid, N-desmethyl-acetamiprid in the urine of a patient, who exhibited some typical symptoms including neurological findings. We sought to investigate the association between urinary N-desmethyl-acetamiprid and the symptoms by a prevalence case-control study. Spot urine samples were collected from 35 symptomatic patients of unknown origin and 50 non-symptomatic volunteers (non-symptomatic group, NSG, 4–87 year-old). Patients with recent memory loss, finger tremor, and more than five of six symptoms (headache, general fatigue, palpitation/chest pain, abdominal pain, muscle pain/weakness/spasm, and cough) were in the typical symptomatic group (TSG, n = 19, 5–69 year-old); the rest were in the atypical symptomatic group (ASG, n = 16, 5–78 year-old). N-desmethyl-acetamiprid and six neonicotinoids in the urine were quantified by liquid chromatography-tandem mass spectrometry. The detection of N-desmethyl-acetamiprid was the most frequent and highest in TSG (47.4%, 6.0 ppb (frequency, maximum)), followed by in ASG (12.5%, 4.4 ppb) and in NSG (6.0%, 2.2 ppb), however acetamiprid was not detected. Thiamethoxam was detected in TSG (31.6%, 1.4 ppb), in ASG (6.3%, 1.9 ppb), but not in NSG. Nitenpyram was detected in TSG (10.5%, 1.2 ppb), in ASG (6.3%, not quantified) and in NSG (2.0%, not quantified). Clothianidin was only detected in ASG (6.3%, not quantified), and in NSG (2.0%, 1.6 ppb). Thiacloprid was detected in ASG (6.3%, 0.1 ppb). The cases in TSG with detection of N-desmethyl-acetamiprid and thiamethoxam were aged 5 to 62 years and 13 to 62 years, respectively. Detection of N-desmethyl-acetamiprid was associated with increased prevalence of the symptoms (odds ratio: 14, 95% confidence interval: 3.5–57). Urinary N-desmethyl-acetamiprid can be used as a

  9. Concerns About Climate Change Mitigation Projects: Summary of Findings from Case Studies in Brazil, India, Mexico, and South Africa

    SciTech Connect

    Sathaye, Jayant A.; Andrasko, Kenneth; Makundi, Willy; La Rovere, Emilio Lebre; Ravinandranath, N.H.; Melli, Anandi; Rangachari, Anita; Amaz, Mireya; Gay, Carlos; Friedmann, Rafael; Goldberg, Beth; van Horen, Clive; Simmonds, Gillina; Parker, Gretchen

    1998-11-01

    The concept of joint implementation as a way to implement climate change mitigation projects in another country has been controversial ever since its inception. Developing countries have raised numerous issues at the project-specific technical level, and broader concerns having to do with equity and burden sharing. This paper summarizes the findings of studies for Brazil, India, Mexico and South Africa, four countries that have large greenhouse gas emissions and are heavily engaged in the debate on climate change projects under the Kyoto Protocol. The studies examine potential or current projects/programs to determine whether eight technical concerns about joint implementation can be adequately addressed. They conclude that about half the concerns were minor or well managed by project developers, but concerns about additionality of funds, host country institutions and guarantees of performance (including the issues of baselines and possible leakage) need much more effort to be adequately addressed. All the papers agree on the need to develop institutional arrangements for approving and monitoring such projects in each of the countries represented. The case studies illustrate that these projects have the potential to bring new technology, investment, employment and ancillary socioeconomic and environmental benefits to developing countries. These benefits are consistent with the goal of sustainable development in the four study countries. At a policy level, the studies' authors note that in their view, the Annex I countries should consider limits on the use of jointly implemented projects as a way to get credits against their own emissions at home, and stress the importance of industrialized countries developing new technologies that will benefit all countries. The authors also observe that if all countries accepted caps on their emissions (with a longer time period allowed for developing countries to do so) project-based GHG mitigation would be significantly

  10. Clinical and Laboratory Findings of the First Imported Case of Middle East Respiratory Syndrome Coronavirus to the United States

    PubMed Central

    Kapoor, Minal; Pringle, Kimberly; Kumar, Alan; Dearth, Stephanie; Liu, Lixia; Lovchik, Judith; Perez, Omar; Pontones, Pam; Richards, Shawn; Yeadon-Fagbohun, Jaime; Breakwell, Lucy; Chea, Nora; Cohen, Nicole J.; Schneider, Eileen; Erdman, Dean; Haynes, Lia; Pallansch, Mark; Tao, Ying; Tong, Suxiang; Gerber, Susan; Swerdlow, David; Feikin, Daniel R.

    2014-01-01

    Background. The Middle East respiratory syndrome coronavirus (MERS-CoV) was discovered September 2012 in the Kingdom of Saudi Arabia (KSA). The first US case of MERS-CoV was confirmed on 2 May 2014. Methods. We summarize the clinical symptoms and signs, laboratory and radiologic findings, and MERS-CoV–specific tests. Results. The patient is a 65-year-old physician who worked in a hospital in KSA where MERS-CoV patients were treated. His illness onset included malaise, myalgias, and low-grade fever. He flew to the United States on day of illness (DOI) 7. His first respiratory symptom, a dry cough, developed on DOI 10. On DOI 11, he presented to an Indiana hospital as dyspneic, hypoxic, and with a right lower lobe infiltrate on chest radiography. On DOI 12, his serum tested positive by real-time reverse transcription polymerase chain reaction (rRT-PCR) for MERS-CoV and showed high MERS-CoV antibody titers, whereas his nasopharyngeal swab was rRT-PCR negative. Expectorated sputum was rRT-PCR positive the following day, with a high viral load (5.31 × 106 copies/mL). He was treated with antibiotics, intravenous immunoglobulin, and oxygen by nasal cannula. He was discharged on DOI 22. The genome sequence was similar (>99%) to other known MERS-CoV sequences, clustering with those from KSA from June to July 2013. Conclusions. This patient had a prolonged nonspecific prodromal illness before developing respiratory symptoms. Both sera and sputum were rRT-PCR positive when nasopharyngeal specimens were negative. US clinicians must be vigilant for MERS-CoV in patients with febrile and/or respiratory illness with recent travel to the Arabian Peninsula, especially among healthcare workers. PMID:25100864

  11. Predator cannibalism can intensify negative impacts on heterospecific prey.

    PubMed

    Takatsu, Kunio; Kishida, Osamu

    2015-07-01

    Although natural populations consist of individuals with different traits, and the degree of phenotypic variation varies among populations, the impact of phenotypic variation on ecological interactions has received little attention, because traditional approaches to community ecology assume homogeneity of individuals within a population. Stage structure, which is a common way of generating size and developmental variation within predator populations, can drive cannibalistic interactions, which can affect the strength of predatory effects on the predator's heterospecific prey. Studies have shown that predator cannibalism weakens predatory effects on heterospecific prey by reducing the size of the predator population and by inducing less feeding activity of noncannibal predators. We predict, however, that predator cannibalism, by promoting rapid growth of the cannibals, can also intensify predation pressure on heterospecific prey, because large predators have large resource requirements and may utilize a wider variety of prey species. To test this hypothesis, we conducted an experiment in which we created carnivorous salamander (Hynobius retardatus) populations with different stage structures by manipulating the salamander's hatch timing (i.e., populations with large or small variation in the timing of hatching), and explored the resultant impacts on the abundance, behavior, morphology, and life history of the salamander's large heterospecific prey, Rana pirica frog tadpoles. Cannibalism was rare in salamander populations having small hatch-timing variation, but was frequent in those having large hatch-timing variation. Thus, giant salamander cannibals occurred only in the latter. We clearly showed that salamander giants exerted strong predation pressure on frog tadpoles, which induced large behavioral and morphological defenses in the tadpoles and caused them to metamorphose late at large size. Hence, predator cannibalism arising from large variation in the timing

  12. Characterization study of an intensified complementary metal-oxide-semiconductor active pixel sensor

    NASA Astrophysics Data System (ADS)

    Griffiths, J. A.; Chen, D.; Turchetta, R.; Royle, G. J.

    2011-03-01

    An intensified CMOS active pixel sensor (APS) has been constructed for operation in low-light-level applications: a high-gain, fast-light decay image intensifier has been coupled via a fiber optic stud to a prototype "VANILLA" APS, developed by the UK based MI3 consortium. The sensor is capable of high frame rates and sparse readout. This paper presents a study of the performance parameters of the intensified VANILLA APS system over a range of image intensifier gain levels when uniformly illuminated with 520 nm green light. Mean-variance analysis shows the APS saturating around 3050 Digital Units (DU), with the maximum variance increasing with increasing image intensifier gain. The system's quantum efficiency varies in an exponential manner from 260 at an intensifier gain of 7.45 × 103 to 1.6 at a gain of 3.93 × 101. The usable dynamic range of the system is 60 dB for intensifier gains below 1.8 × 103, dropping to around 40 dB at high gains. The conclusion is that the system shows suitability for the desired application.

  13. [Influence of human body target's spectral characteristics on visual range of low light level image intensifiers].

    PubMed

    Zhang, Jun-Ju; Yang, Wen-Bin; Xu, Hui; Liu, Lei; Tao, Yuan-Yaun

    2013-11-01

    To study the effect of different human target's spectral reflective characteristic on low light level (LLL) image intensifier's distance, based on the spectral characteristics of the night-sky radiation and the spectral reflective coefficients of common clothes, we established a equation of human body target's spectral reflective distribution, and analyzed the spectral reflective characteristics of different human targets wearing the clothes of different color and different material, and from the actual detection equation of LLL image intensifier distance, discussed the detection capability of LLL image intensifier for different human target. The study shows that the effect of different human target's spectral reflective characteristic on LLL image intensifier distance is mainly reflected in the average reflectivity rho(-) and the initial contrast of the target and the background C0. Reflective coefficient and spectral reflection intensity of cotton clothes are higher than polyester clothes, and detection capability of LLL image intensifier is stronger for the human target wearing cotton clothes. Experimental results show that the LLL image intensifiers have longer visual ranges for targets who wear cotton clothes than targets who wear same color but polyester clothes, and have longer visual ranges for targets who wear light-colored clothes than targets who wear dark-colored clothes. And in the full moon illumination conditions, LLL image intensifiers are more sensitive to the clothes' material.

  14. The typical and atypical MR imaging findings of central neurocytomas: Report on eighteen cases and review of the literature.

    PubMed

    Ma, Zhanlong; Yan, Hailang; Shi, Haibin; Li, Yan; Song, Jiacheng; Huang, Junwen; Hong, Xiongning

    2016-07-01

    There were few studies have documented the MRI features of typical and atypical CNCs for diagnosis and therapeutic modalities. Here, 18 histopathologically confirmed cases of intracranial CNCs (8 men and 10 women with a mean age of 28.3 years, range 10-64 years) were retrospectively analyzed. The histopathological and immunohistochemical features were also assessed. On MR imaging, the 14 typical cases of CNCs showed relatively round, lobulated tumor masses in the body of the right lateral ventricle (5 cases), left lateral ventricle (4 cases), third ventricles (2 cases), and midline (3 cases). These typical CNCs masses contained clusters of cysts of varying sizes and "soap bubble" appearance on T2WI; they showed mild to moderate heterogeneously enhancement on T1WI. The 4 atypical cases of CNCs showed as strongly contrast enhancement of the tumors with the attachment or infiltrate of the wall of the ventricle than the typical benign cases. These atypical CNCs were in the right lateral ventricle (2 cases), left lateral ventricle (1 case), and third ventricle (1 case). Microscopically, the typical CNCs were well-differentiated tumors with benign histological features. The typical and atypical CNCs were composed of uniform, small to medium-sized cells with rounded nuclei and scant cytoplasm. Immunohistochemically, the typical CNCs were strong in Syn immunopositive (14/14) and neuron-specific enolase (12/14). The atypical CNC tumor cells showed malignant behavior and more positive expression of Ki67 than the benign cases. Surgery is the first choice of treatment, and radiotherapy may be beneficial to postoperative patients. PMID:27132079

  15. Case Studies of Schools Receiving School Improvement Grants: Findings after the First Year of Implementation. NCEE 2014-4015

    ERIC Educational Resources Information Center

    Le Floch, Kerstin Carlson; Birman, Beatrice; O'Day, Jennifer; Hurlburt, Steven; Mercado-Garcia, Diana; Goff, Rose; Manship, Karen; Brown, Seth; Therriault, Susan Bowles; Rosenberg, Linda; Angus, Megan Hague; Hulsey, Lara

    2014-01-01

    The Study of School Turnaround examines the improvement process in a purposive sample of 35 case study schools receiving federal School Improvement Grants (SIG) over a three-year period (2010-11 to 2012-13 school years). Using site visit, teacher survey, and fiscal data, the case studies describe the school contexts, the principals' leadership…

  16. Monomorphic lymphomas arising in patients with Hodgkin's disease. Correlation of morphologic, immunophenotypic, and molecular genetic findings in 12 cases.

    PubMed Central

    Casey, T. T.; Cousar, J. B.; Mangum, M.; Williams, M. E.; Lee, J. T.; Greer, J. P.; Collins, R. D.

    1990-01-01

    Patients with Hodgkin's Disease (HD) occasionally develop monomorphic lymphomas in which mononuclear cells, usually large in size, grow in sheets, and in which there are few reacting cells or classic Reed-Sternberg (RS) cells. Twelve patients of this type were reviewed to determine the nature of the monomorphic growth. Paraffin-embedded tissue sections from the original diagnostic HD and the monomorphic growths were stained for Leu-M1 (CD15), leukocyte common antigen (LCA, CD45), pan B-cell markers LN1, LN2, and L26, and pan T-cell marker UCHL1 (CD45R) reactive in paraffin-embedded tissues. Cases were included only if the original diagnostic material had the classic histopathologic features of HD, if there was a separate monomorphic growth (in place or time), and if sufficient materials from both phases were available for study. Original diagnoses of HD included nodular sclerosing (NS; 8 cases); lymphocyte predominant (LP; 2 cases); mixed cellularity (MC; 1 case); and lymphocyte depleted (LD: 1 case) types. RS cells in the eight cases of NS HD and one case of MC HD were generally Leu-M1 and LN2 positive, and L26, LN1, UCHL1, and LCA negative. RS cells in one case of NS HD were LCA positive in addition to Leu-M1, LN1, and LN2. Two cases of NS HD showed L26 positive RS cells. Conversely, RS cells and lymphocytic-histiocytic (L and H) variants in the cases of LP HD were Leu-M1 and LN2 negative, and LCA and LN1 positive. The one case of LD HD possessed RS cells that were negative for Leu-M1, but positive for LCA, L26, LN1, and LN2. In seven cases (4 NS, 2 LP, 1 LD) the monomorphic growths possessed a B-cell phenotype (LCA, L26, and LN1 positive; Leu-M1 and UCHL1 negative). In the remaining cases (4 NS, 1 MC), the monomorphic growths were Leu-M1 positive, and displayed phenotypes similar to the RS cells of the original NS HD. Southern blot analysis was performed on the monomorphic components of five cases and showed some form of immunoglobulin gene rearrangement in each

  17. CT Findings of Intrarenal Yolk Sac Tumor with Tumor Thrombus Extending into the Inferior Vena Cava: A Case Report

    PubMed Central

    Lin, ShaoChun; Li, XueHua; Feng, ShiTing; Peng, ZhenPeng; Huang, SiYun; Li, ZiPing

    2014-01-01

    Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement. PMID:25246826

  18. Method of obtaining intensified image from developed photographic films and plates

    NASA Technical Reports Server (NTRS)

    Askins, B. S. (Inventor)

    1978-01-01

    A method is explained of obtaining intensified images from silver images on developed photographic films and plates. The steps involve converting silver of the developed film or plate to a radioactive compound by treatment with an aqueous alkaline solution of an organo-S35 compound; placing the treated film or plate in direct contact with a receiver film which is then exposed by radiation from the activated film; and developing and fixing the resulting intensified image on the receiver film.

  19. Engineering design criteria for an image intensifier/image converter camera

    NASA Technical Reports Server (NTRS)

    Sharpsteen, J. T.; Lund, D. L.; Stoap, L. J.; Solheim, C. D.

    1976-01-01

    The design, display, and evaluation of an image intensifier/image converter camera which can be utilized in various requirements of spaceshuttle experiments are described. An image intensifier tube was utilized in combination with two brassboards as power supply and used for evaluation of night photography in the field. Pictures were obtained showing field details which would have been undistinguishable to the naked eye or to an ordinary camera.

  20. Photogrammetric calibration of the NASA-Wallops Island image intensifier system

    NASA Technical Reports Server (NTRS)

    Harp, B. F.

    1972-01-01

    An image intensifier was designed for use as one of the primary tracking systems for the barium cloud experiment at Wallops Island. Two computer programs, a definitive stellar camara calibration program and a geodetic stellar camara orientation program, were originally developed at Wallops on a GE 625 computer. A mathematical procedure for determining the image intensifier distortions is outlined, and the implementation of the model in the Wallops computer programs is described. The analytical calibration of metric cameras is also discussed.

  1. Multimodality imaging in cranial blastomycosis, a great mimicker: Case-based illustration with review of clinical and imaging findings

    PubMed Central

    Kochar, Puneet S; Lath, Chinar O; Klein, Andrew P; Ulmer, John L

    2016-01-01

    We describe the clinical, laboratory, and imaging data of three patients who are proven cases of blastomycosis with cranial involvement. In this review, we discuss the imaging features of cranial blastomycosis with relevant clinical case examples including computed tomography (CT), magnetic resonance imaging (MRI), and advanced MR imaging techniques like magnetic resonance spectroscopy (MRS) and MR perfusion. Literature is reviewed for modern-day diagnosis and treatment of this fatal intracranial infection, if not diagnosed promptly and managed effectively. PMID:27081235

  2. Precipitation Isotopes Reveal Intensified Indonesian Monsoon Circulation During the Dry Last Glacial Maximum

    NASA Astrophysics Data System (ADS)

    Konecky, B. L.; Russell, J. M.; Vogel, H.; Bijaksana, S.; Huang, Y.

    2014-12-01

    The Indo-Pacific Warm Pool (IPWP) invigorates the oceanic-atmospheric circulation in the tropics, with far-reaching climate impacts that extend into the high latitudes. A growing number of deglacial proxy reconstructions from the region have revealed the importance of both high- and low-latitude climate processes to IPWP rainfall during the late Pleistocene. Many of these proxies reconstruct the oxygen and hydrogen isotopic composition of rainfall (δ18Oprecip, δDprecip), a powerful tool for understanding changes in climate. However, an increasing number of studies from the region have highlighted the tendency for δ18Oprecip and δDprecip to reflect regional and/or remote circulation processes rather than local rainfall amounts, complicating the reconstruction of IPWP hydroclimate. To better understand high- and low-latitude drivers of late Pleistocene hydroclimate in the IPWP, precipitation isotopic reconstructions must be constrained with both modern observations and independent proxies for rainfall amount. We present a reconstruction of δDprecip using leaf wax compounds preserved in the sediments of Lake Towuti, Sulawesi, from 60,000 years before present to today. We interpret our proxy record with the aid of a new precipitation isotopic dataset from our study site, with daily rainfall isotope measurements to constrain the processes controlling δDprecip. Our Lake Towuti δDwax record is strikingly similar to a speleothem δ18O record from southern Indonesia (Ayliffe et al., 2013) and shares features with other nearby records spanning the Last Glacial Maximum to present. Together, these records indicate that monsoon circulation was intensified in central and southern Indonesia during the glacial period. However, other independent rainfall proxies from Lake Towuti indicate that dry conditions accompanied the intensified monsoon. Regional-scale isotopic depletion during the dry glacial period may have arisen from dynamical and other fractionating processes that

  3. Multimodal imaging findings of SAPHO syndrome with no skin lesions: A report of three cases and review of the literature

    PubMed Central

    Duan, Na; Chen, Xiao; Liu, Yongkang; Wang, Jianhua; Wang, Zhongqiu

    2016-01-01

    Synovitis, acne, palmoplantar pustulosis, hyperostosis and osteitis syndrome (SAPHO) is a rare syndrome that affects the skin, bones and joints. Diagnosis of SAPHO syndrome is established on clinical appearance and imaging features. The present case report described the imaging features of three cases of SAPHO with sternoclavicular joint arthritis but without skin manifestations using multiple imaging modalities, including computed tomography (CT), magnetic resonance imaging (MRI) and bone scintigraphy. The first case was a 52-year-old male who suffered from progressive sternoclavicular arthritis for 2 years. The second case was a 62-year-old female with arthritis in the larger joints for 5 years, particularly on the right thoracic area. The third case was a 44-year-old male who exhibited a slight bulge accompanied by pain in the upper anterior chest wall for 4 years. All of them lacked cutaneous lesions. CT demonstrated sclerosis and hyperostosis with subchondral erosions in the sternocostoclavicular joints. MRI revealed bone marrow edema that was slightly hypointense on T1-weighted imaging, and hyperintense on T2-weighted imaging. Typical ‘bull head’ signs were observed in bone scintigraphy images. The present case study demonstrated that SAPHO syndrome should be suspected in patients with multifocal osteitis or arthritis affecting the chest wall that lack skin manifestations. Multimodal imaging modalities in combination are helpful for SAPHO diagnosis.

  4. Multimodal imaging findings of SAPHO syndrome with no skin lesions: A report of three cases and review of the literature

    PubMed Central

    Duan, Na; Chen, Xiao; Liu, Yongkang; Wang, Jianhua; Wang, Zhongqiu

    2016-01-01

    Synovitis, acne, palmoplantar pustulosis, hyperostosis and osteitis syndrome (SAPHO) is a rare syndrome that affects the skin, bones and joints. Diagnosis of SAPHO syndrome is established on clinical appearance and imaging features. The present case report described the imaging features of three cases of SAPHO with sternoclavicular joint arthritis but without skin manifestations using multiple imaging modalities, including computed tomography (CT), magnetic resonance imaging (MRI) and bone scintigraphy. The first case was a 52-year-old male who suffered from progressive sternoclavicular arthritis for 2 years. The second case was a 62-year-old female with arthritis in the larger joints for 5 years, particularly on the right thoracic area. The third case was a 44-year-old male who exhibited a slight bulge accompanied by pain in the upper anterior chest wall for 4 years. All of them lacked cutaneous lesions. CT demonstrated sclerosis and hyperostosis with subchondral erosions in the sternocostoclavicular joints. MRI revealed bone marrow edema that was slightly hypointense on T1-weighted imaging, and hyperintense on T2-weighted imaging. Typical ‘bull head’ signs were observed in bone scintigraphy images. The present case study demonstrated that SAPHO syndrome should be suspected in patients with multifocal osteitis or arthritis affecting the chest wall that lack skin manifestations. Multimodal imaging modalities in combination are helpful for SAPHO diagnosis. PMID:27698770

  5. Transcriptional Changes in CD8+ T Cells During Antiretroviral Therapy Intensified With Raltegravir

    PubMed Central

    Ouyang, Zhengyu; Buzon, Maria J.; Zheng, Lu; Sun, Hong; Yu, Xu G.; Bosch, Ronald J.; Mellors, John W.; Eron, Joseph J.; Gandhi, Rajesh T.; Lichterfeld, Mathias

    2015-01-01

    Background. Intensification of antiretroviral therapy with raltegravir does not affect levels of residual human immunodeficiency virus (HIV)-1 viremia, but it has led to increased levels of episomal HIV-1 DNA in some patients, suggesting antiviral activity against otherwise unresponsive components of the viral reservoir. Effects of raltegravir on host cells remain less well understood. Methods. We used comprehensive and unbiased microarray-based transcriptional profiling to analyze gene expression changes in CD8+ T cells from participants in a randomized clinical trial (AIDS Clinical Trials Group [ACTG] A5244) comparing raltegravir-intensified to nonintensified antiretroviral therapy. Results. Although raltegravir intensification failed to induce statistically significant changes in HIV-1 DNA or residual plasma viremia, we observed significant increases in the expression intensity of 121 host gene transcripts. In functional annotations of these transcripts, we found that they were mainly involved in glucose and carbohydrate metabolism, immune regulation, control of cell proliferation, and tumor suppression. Two of the raltegravir-responsive gene transcripts were statistically correlated with levels of residual HIV-1 RNA, but none of the remaining 119 transcripts were associated with immunologic or virologic characteristics of the study patients. Conclusions. Together, these findings demonstrate that raltegravir intensification can induce previously unrecognized, statistically significant gene expression changes in host CD8+ T lymphocytes. PMID:26380343

  6. Abnormal striatal circuitry and intensified novelty seeking among adolescents who abuse methamphetamine and cannabis.

    PubMed

    Churchwell, John C; Carey, Paul D; Ferrett, Helen L; Stein, Dan J; Yurgelun-Todd, Deborah A

    2012-01-01

    It has been hypothesized that changes in striatal-mediated dopamine modulation during adolescence may increase the risk for initiating substance abuse as a result of its fundamental role in arbitrating reward sensitivity and motivation during learning and decision making. However, substance abuse during adolescence may also significantly modify striatal structure and function and concomitantly alter reward sensitivity and action control while this brain region is undergoing remodeling. In the present investigation, to assess the relationship of methamphetamine (Meth) or Meth and cannabis (CA) abuse to regional striatal morphology, we acquired structural magnetic resonance images, using a 3T Siemens Trio scanner, from three groups of adolescents composed of healthy controls (n = 10), Meth abusers (n = 9) and combined Meth and CA abusers (Meth+CA, n = 8). We also assessed novelty seeking using the novelty seeking subscale of Cloninger's Tridimensional Character Inventory. The results indicate that adolescent Meth+CA abusers have increased regional striatal volume and show intensified novelty seeking in contrast to the controls. The degree of Meth exposure was also positively correlated with regional striatal volume and novelty seeking in both the Meth and Meth+CA users. These preliminary findings support theories that propose a role for the striatum in adolescent substance abuse and further indicate that novelty seeking may be related to the initiation of, or sustained, drug use.

  7. Investigation of the Intrinsic Spatial Resolution of an Intensified EMCCD Scintillation Camera

    PubMed Central

    Meng, L. J.; Fu, G.

    2016-01-01

    In this paper, we present an experimental and Monte Carlo investigation of the intrinsic spatial resolution that can be achieved with the intensified electron-multiplying charge-coupled device (I-EMCCD) gamma camera [1]–[4]. This detector has a very low readout noise, an ultra-high spatial resolution and a large active area of ~ 80 mm diameter, which is well-suited for small animal imaging applications. The intrinsic detector resolutions achieved with different scintillators and under different experimental conditions were compared. In this study, the simple centroiding method was compared with two model-fitting approaches for finding the locations of gamma ray interactions. The results from Monte Carlo simulation have demonstrated that with an appropriate detector configuration, it is possible to achieve an intrinsic resolution of ~ 30 µm FWHM for detecting 27–35 keV gamma rays. The I-EMCCD scintillation camera offers a promising candidate for future ultra-high resolution SPECT imaging applications.

  8. Diagnosis, management and post-mortem findings of a human case of rabies imported into the United Kingdom from India: a case report

    PubMed Central

    2014-01-01

    Background Human rabies infection continues to be a significant public health burden globally, and is occasionally imported to high income settings where the Milwaukee Protocol for intensive care management has recently been employed, with limited success in improving survival. Access to molecular diagnostics, pre- and post-mortem, and documentation of pathophysiological responses while using the Milwaukee protocol, can add useful insights for the future of rabies management. Case presentation A 58-year-old British Asian woman was referred to a regional general hospital in the UK with hydrophobia, anxiety and confusion nine weeks after receiving a dog bite in North West India. Nuchal skin biopsy, saliva, and a skin biopsy from the site of the dog bite wound, taken on the day of admission, all demonstrated the presence of rabies virus RNA. Within 48 hours sequence analysis of viral RNA confirmed the diagnosis and demonstrated that the virus was a strain closely related to canine rabies viruses circulating in South Asia. Her condition deteriorated rapidly with increased agitation and autonomic dysfunction. She was heavily sedated and intubated on the day after admission, treated according to a modified Milwaukee protocol, and remained stable until she developed heart block and profound acidosis and died on the eighth day. Analysis of autopsy samples showed a complete absence of rabies neutralizing antibody in cerebrospinal fluid and serum, and corresponding high levels of virus antigen and nucleic acid in brain and cerebrospinal fluid. Quantitative PCR showed virus was also distributed widely in peripheral tissues despite mild or undetectable histopathological changes. Vagus nerve branches in the heart showed neuritis, a probable Negri body but no demonstrable rabies antigen. Conclusion Rapid molecular diagnosis and strain typing is helpful in the management of human rabies infection. Post-mortem findings such as vagal neuritis highlight clinically important effects

  9. Electronic Support for Public Health: Validated Case Finding and Reporting for Notifiable Diseases Using Electronic Medical Data

    PubMed Central

    Lazarus, Ross; Klompas, Michael; Campion, Francis X.; McNabb, Scott J.N.; Hou, Xuanlin; Daniel, James; Haney, Gillian; DeMaria, Alfred; Lenert, Leslie; Platt, Richard

    2009-01-01

    Health care providers are legally obliged to report cases of specified diseases to public health authorities, but existing manual, provider-initiated reporting systems generally result in incomplete, error-prone, and tardy information flow. Automated laboratory-based reports are more likely accurate and timely, but lack clinical information and treatment details. Here, we describe the Electronic Support for Public Health (ESP) application, a robust, automated, secure, portable public health detection and messaging system for cases of notifiable diseases. The ESP application applies disease specific logic to any complete source of electronic medical data in a fully automated process, and supports an optional case management workflow system for case notification control. All relevant clinical, laboratory and demographic details are securely transferred to the local health authority as an HL7 message. The ESP application has operated continuously in production mode since January 2007, applying rigorously validated case identification logic to ambulatory EMR data from more than 600,000 patients. Source code for this highly interoperable application is freely available under an approved open-source license at http://esphealth.org. PMID:18952940

  10. A new case of interstitial 1q 25.3-32.1 deletion: cytogenetic analysis molecular characterization and ultrasound findings

    PubMed Central

    Libotte, Francesco; Bizzoco, Domenico; Gabrielli, Ivan; Tamburrino, Caterina; Ernandez, Cristina; Carpineto, Lorena; D’Aleo, Maria Pia; Cima, Antonella; Mesoraca, Alvaro; Cignini, Pietro; Aloisi, Alessia; Angioli, Roberto; Vitale, Salvatore Giovanni; Giorlandino, Claudio

    2015-01-01

    Introduction deletion of long arm of chromosome 1(1q-) is a rare condition. Clinical features include Dwarfism, severe mental retardation, microcephaly and short neck delineating the “intermediate 1q deletion syndrome”. Case Report we report a new case of interstitial deletion of the long arm of chromosome 1, diagnosed in a 22+3 weeks gestation fetus in which cytogenetic analysis localized a loss of genetic materials of 18Mb in the 1q25.3-32.1. Fetal ultrasound showed neurodegenerative defects resembling Dandy-Walker’s syndrome and bilateral clubfoot. Conclusions clinical characteristics of our case are markedly mild. This suggests that the type and the extension of the mutation obtained through cytogenetic studies, CGH array and ultrasound evaluation should be taken into account for prognostic evaluation and management of these patients. PMID:26918092

  11. Clinical and Pathological Findings on Intoxication by Yellow Phosphorus After Ingesting Firework Cracker: A Rare Case of Autopsy.

    PubMed

    Türkmen Şamdanci, Emine; Çakir, Ebru; Şahin, Nurhan; Elmali, Candan; Sayin, Sadegül

    2016-01-01

    Yellow phosphorus is a toxic substance used in the production of firework cracker, fireworks, ammunition and agricultural dung. When ingested, it shows its effects mainly in the liver, the kidneys, and the brain. A four-year-old girl had died as a result of acute hepatic failure caused by ingesting a firework cracker. The case showed high levels of hepatic enzymes, along with non-specific signs such as nausea, vomiting and diarrhea. Autopsy revealed diffuse microvesicular steatosis in the liver and disseminated degeneration in the proximal tubules of the kidneys. In cases with concomitant hepatorenal failure and cardiovascular collapse, death is inevitable. However, when only hepatic failure develops, hepatic transplantation may be lifesaving. Although intoxication from ingesting yellow phosphorus has a very high rate of mortality, forensic cases are extremely rare in the literature. PMID:24272931

  12. The barriers to the application of the research findings from the nurses’ perspective: A case study in a teaching hospital

    PubMed Central

    Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Mahaki, Behzad

    2016-01-01

    Background: The application of the nursing research findings is one of the most important indicators of development in the nursing profession, which leads to providing efficient and effective patient care and improving the quality of nursing care. According the result of some studies, transferring the evidence-based findings to the nurses’ practice and education in the world has been slow and sometimes unsuccessful. This study aimed to investigate the most important barriers to the application of research findings from the nurses’ perspective. Materials and Methods: This cross-sectional study conducted on a sample of 210 nurses in a teaching hospital in Tehran in 2013. The data were collected using a researcher-made questionnaire consisted of two parts, including items about nurses’ demographic characteristics and 30 items to identify the most important barriers to the application of research findings from the studied nurses’ perspective. Results: “The lack of sufficient time for reading the studies,” “the lack of sufficient time to implement the new ideas,” “the lack of adequate facilities to implement the ideas,” “nurses’ little interest in conducting studies,” and “the lack of authority to change the methods and patterns of care” with, respectively, 85%, 84.6%, 83.8%, 83.4%, and 80.5% agreement with the existence of barriers were the most barriers to application of research findings from the studied nurses’ perspective. Conclusion: The lack of time was the most important barrier to the use of research findings from the perspective of studied nurses. Therefore, some effective strategies should be used by hospital managers and health policy makers to overcome this barrier. Some of these strategies can be employing new personnel and hiring skilled and efficient human resources in order to decrease the workload of nurses, organizing the nurses’ work shifts, providing right balance between patients and nurses in the wards, etc. PMID

  13. Collaborating for Success: Collaborative Arrangements for 14-19 Provision in the West Midlands. Summary and Analysis of Research Findings from Six Case Studies. Research Report

    ERIC Educational Resources Information Center

    Hardman, Jill

    2006-01-01

    These findings from six case study areas in the West Midlands examine how 14-19 collaborative arrangements have developed and changed in response to local circumstances, assess the impact of the developments and changes on the curriculum offer, learner choice and participation, and identify the main success factors for starting and sustaining…

  14. Case Management for Students at Risk of Dropping Out: Implementation and Interim Impact Findings from the Communities in Schools Evaluation

    ERIC Educational Resources Information Center

    Corrin, William; Parise, Leigh M.; Cerna, Oscar; Haider, Zeest; Somers, Marie-Andrée

    2015-01-01

    Too many students drop out and never earn their high school diploma. For students at risk of dropping out, academic, social, and other supports may help. "Communities In Schools" seeks to organize and provide these supports to at-risk students in the nation's poorest-performing schools, including through "case-managed"…

  15. Calcifying Aponeurotic Fibroma with Osseous Involvement of the Finger: a Case Report with Radiologic and US Findings

    PubMed Central

    Ahn, Jae Hong; Kang, Gilhyun; Lee, Jong Hyeog; Park, Man Soo; Ryu, Dae Sik; Jung, Seung Moon

    2008-01-01

    Calcifying aponeurotic fibroma is a rare soft tissue tumor that occurs in the distal extremities of children and adolescents. We report ultrasound and X-ray findings of a calcifying aponeurotic fibroma in the finger of a 36-year-old woman, associated with distal phalangeal bone involvement. PMID:18253083

  16. A rare case of a false-negative finding in both direct and culture of a chorionic villus sample.

    PubMed

    Pindar, L; Whitehouse, M; Ocraft, K

    1992-06-01

    A discrepancy is reported between the karyotype of both direct and cultured chorionic villus cells (46,XX) and a fetal skin biopsy (47,XX, +18). The significance of this result is discussed and compared with similar discordant findings reported in the literature.

  17. Clinical and cytogenetic findings in seven cases of inverted duplication of 8p with evidence of a telomeric deletion using fluorescence in situ hybridization

    SciTech Connect

    Guo, Wen-Jun; Callif-Daley, F.; Zapata, M.C.; Miller, M.E.

    1995-09-11

    We report on the clinical and cytogenetic findings in 7 cases of inverted duplication of region 8p11.2-p23. The phenotype of inv dup (8p) compiled from this series and the literature (N = 29) consists of severe mental retardation (100%), minor facial alterations (97%), agenesis of the corpus callosum (80%), hypotonia (66%), orthopedic abnormalities (58%), scoliosis/kyphosis (40%), and congenital heart defect (26%). A telomeric deletion of region 8p23.3-pter was confirmed in 3 of our cases studied using fluorescent in situ hybridization with a telomeric probe for 8p. Thus, these karyotypes are inv dup del(8) (qter{r_arrow} p23.1::p23.1{r_arrow}p11.2:). Our findings suggest that most cases of inv dup(8p) probably have a telomeric deletion. 20 refs., 4 figs., 2 tabs.

  18. Why Most Biomedical Findings Echoed by Newspapers Turn Out to be False: The Case of Attention Deficit Hyperactivity Disorder

    PubMed Central

    Gonon, François; Konsman, Jan-Pieter; Cohen, David; Boraud, Thomas

    2012-01-01

    Context Because positive biomedical observations are more often published than those reporting no effect, initial observations are often refuted or attenuated by subsequent studies. Objective To determine whether newspapers preferentially report on initial findings and whether they also report on subsequent studies. Methods We focused on attention deficit hyperactivity disorder (ADHD). Using Factiva and PubMed databases, we identified 47 scientific publications on ADHD published in the 1990s and soon echoed by 347 newspapers articles. We selected the ten most echoed publications and collected all their relevant subsequent studies until 2011. We checked whether findings reported in each “top 10” publication were consistent with previous and subsequent observations. We also compared the newspaper coverage of the “top 10” publications to that of their related scientific studies. Results Seven of the “top 10” publications were initial studies and the conclusions in six of them were either refuted or strongly attenuated subsequently. The seventh was not confirmed or refuted, but its main conclusion appears unlikely. Among the three “top 10” that were not initial studies, two were confirmed subsequently and the third was attenuated. The newspaper coverage of the “top 10” publications (223 articles) was much larger than that of the 67 related studies (57 articles). Moreover, only one of the latter newspaper articles reported that the corresponding “top 10” finding had been attenuated. The average impact factor of the scientific journals publishing studies echoed by newspapers (17.1 n = 56) was higher (p<0.0001) than that corresponding to related publications that were not echoed (6.4 n = 56). Conclusion Because newspapers preferentially echo initial ADHD findings appearing in prominent journals, they report on uncertain findings that are often refuted or attenuated by subsequent studies. If this media reporting bias generalizes to health

  19. Intensified prophylaxis of febrile neutropenia with ofloxacin plus rifampin during severe short-duration neutropenia in patients with lymphoma.

    PubMed

    Muñoz, L; Martino, R; Subirà, M; Brunet, S; Sureda, A; Sierra, J

    1999-08-01

    To analyse the impact of intensified prophylaxis with ofloxacin plus rifampin (O+R) in neutropenic patients we used this combination in 40 consecutive cycles of ifosfamide, cytarabine, prednisolone and etoposide (IAPVP-16). This salvage chemotherapy regimen for lymphoma usually produces four to six days of severe neutropenia without significant extrahematologic toxicities. We compared the infectious morbidity during neutropenia under O+R with 58 consecutives cycles using either norfloxacin or no prophylaxis (control group). Fifty-three percent of control group patients and 20% of the O+R group developed febrile neutropenia that required hospital admission (p<0.001, 95% CI for the difference between both proportions of 16% to 51%). Bacteremia was documented in two patients in the O+R group and six in the control group (p=0.08). Gram-positive cocci (GPC) accounted for all six bacteremias in the control group, while both cases in O+R group were due to a quinolone-resistant gram-negative bacteria (GNB) (p<0.01 for GPC). Five patients (13%) who received O+R and 23 (40%) in control group developed fever of unknown origin, p<0.001, while the total duration of hospitalization due to febril neutropenia was 42 days and 158 days, respectively (p<0.001). In conclusion, intensified prophylaxis with O+R appears to reduce the rate of febrile neutropenia and GPC bacteremia in patients with short and severe neutropenia, which translates into a reduction in the need for hospitalization.

  20. High Speed Intensified Video Observations of TLEs in Support of PhOCAL

    NASA Technical Reports Server (NTRS)

    Lyons, Walter A.; Nelson, Thomas E.; Cummer, Steven A.; Lang, Timothy; Miller, Steven; Beavis, Nick; Yue, Jia; Samaras, Tim; Warner, Tom A.

    2013-01-01

    The third observing season of PhOCAL (Physical Origins of Coupling to the upper Atmosphere by Lightning) was conducted over the U.S. High Plains during the late spring and summer of 2013. The goal was to capture using an intensified high-speed camera, a transient luminous event (TLE), especially a sprite, as well as its parent cloud-to-ground (SP+CG) lightning discharge, preferably within the domain of a 3-D lightning mapping array (LMA). The co-capture of sprite and its SP+CG was achieved within useful range of an interferometer operating near Rapid City. Other high-speed sprite video sequences were captured above the West Texas LMA. On several occasions the large mesoscale convective complexes (MCSs) producing the TLE-class lightning were also generating vertically propagating convectively generated gravity waves (CGGWs) at the mesopause which were easily visible using NIR-sensitive color cameras. These were captured concurrent with sprites. These observations were follow-ons to a case on 15 April 2012 in which CGGWs were also imaged by the new Day/Night Band on the Suomi NPP satellite system. The relationship between the CGGW and sprite initiation are being investigated. The past year was notable for a large number of elve+halo+sprite sequences sequences generated by the same parent CG. And on several occasions there appear to be prominent banded modulations of the elves' luminosity imaged at >3000 ips. These stripes appear coincident with the banded CGGW structure, and presumably its density variations. Several elves and a sprite from negative CGs were also noted. New color imaging systems have been tested and found capable of capturing sprites. Two cases of sprites with an aurora as a backdrop were also recorded. High speed imaging was also provided in support of the UPLIGHTS program near Rapid City, SD and the USAFA SPRITES II airborne campaign over the Great Plains.

  1. An unexpected finding in the resection specimen of a carcinoma of the oral cavity: A case report

    PubMed Central

    Olthof, D.C.; Bun, R.J.; Dutrieux, R.P.; Houdijk, A.P.J.

    2015-01-01

    Introduction The occurrence of two synchronous, primary cancers is rare. Thyroid carcinoma is incidentally found in the resection specimen after surgery for head and neck cancer in 0.3–1.9% of the patients. Presentation of case In this report, we describe the case of a 72-year-old patient in whom a primary (synchronous) papillary thyroid carcinoma was found coincidentally upon pathologic examination of lymph nodes recovered from the cervical neck lymph node dissection specimen after a ‘commando’ procedure for carcinoma of the oral cavity. Discussion and conclusion There is no gold standard concerning treatment of the incidentally discovered thyroid gland carcinoma. The decision to perform surgery depends on the life expectancy of the patient, whether the thyroid gland demonstrates clinical or radiologic lesions, the already completed treatment for the head and neck cancer and should always be adjusted to the specific patient. PMID:26710330

  2. How Sensitive Are Multilevel Regression Findings to Defined Area of Context? A Case Study of Mammography Use in California

    PubMed Central

    Mobley, Lee R.; Kuo, Tzy-Mey (May); Andrews, Linda

    2009-01-01

    The authors develop a hybrid model of health care use that blends features of the traditional Aday–Andersen behavioral model with the socioecological modeling perspective. They use the model to conceptualize the various levels of influence expected from socioecological variables in individuals’ mammography use decisions, build contextual variables from fine-grained data into four different types of geographic areas, and then use two- and three-level modeling of personal and area-level contextual factors to explain observed behavior. The central focus is on whether differentiating the conceptualized levels of influence seems to materially affect regression findings. The test could conceivably be confounded by the modifiable areal unit problem, but little evidence for this is found. Findings for California women suggest that distinctions do matter in how the levels of influence are defined for local neighborhood contextual factors. Studies using only county-level contextual factors will miss some meaningful associations related to interpersonal/proximate-level factors. PMID:18259047

  3. Two cases of pediatric bone disease (eosinophilic granuloma and Brodie's abscess) showing similar scintigraphic and radiographic findings.

    PubMed

    Yoshikawa, M; Sugawara, Y; Kikuchi, T; Nakata, S; Mochizuki, T; Ikezoe, J; Sakayama, K

    2000-12-01

    Two 9-year-old patients with femoral bone lesions were referred to the authors' institution within a few days of each other. Both showed similar radiographic, magnetic resonance imaging, and scintigraphic findings. The radiographs showed osteolytic lesions in the right femoral diaphyses, and gadolinium-DTPA-enhanced magnetic resonance imaging revealed inhomogeneous enhancement. Tc-99m HMDP showed marked linear accumulation with relatively low central uptake in the right femoral shafts, and TI-201 scintigraphy showed considerable uptake corresponding to the area seen with Tc-99m HMDP. Histologic analysis confirmed eosinophilic granuloma in the first patient and Brodie's abscess in the second. The radiographic and scintigraphic findings in Brodie's abscess may be similar to those in eosinophilic granuloma.

  4. Pleomorphic rhabdomyosarcoma of the heart metastatic to bone. Report of a case with fine needle aspiration biopsy findings.

    PubMed

    Ali, S Z; Smilari, T F; Teichberg, S; Hajdu, S I

    1995-01-01

    Pleomorphic rhabdomyosarcoma is an extremely rare and highly malignant neoplasm. We report an unusual case of a 14-year-old boy with skeletal metastases from a primary cardiac tumor. Fine needle aspiration biopsy of a lytic lesion in the right iliac wing showed a pleomorphic population of clusters and single cells with hyperchromatic nuclei; granular, pink cytoplasm; and isolated, large cells with whiplike or globoid cytoplasmic processes and occasional striations. Histologic, ultrastructural and radiologic features are also presented.

  5. Orbital solitary fibrous tumor with multinucleate giant cells: case report of an unusual finding in an uncommon tumor.

    PubMed

    Mulay, Kaustubh; Honavar, Santosh G

    2013-01-01

    Solitary fibrous tumor (SFT) is a rare soft-tissue neoplasm which may occur at any site although it is more frequent in the pleura, mediastinum and lung. Orbital involvement by SFT is uncommon. Giant cells are extremely rare to be seen in a SFT and have been described to be immunoreactive for CD34. We present a case of orbital SFT with multinucleate giant cells expressing CD68 and lacking immunoreactivity for CD34. The differential diagnosis is discussed.

  6. [Large solitary fibrous tumors of the pleura as incidental finding. 2 case reports of a rare tumor entity].

    PubMed

    Schwab, R; Schneider, C; Junge, K; Stumpf, M; Becker, H P; Schumpelick, V

    2004-02-01

    The solitary fibrous tumor (SFT) is a very rare and usually benign neoplasm. This tumor is mostly located in the thoracic cavity, but it has also been reported in numerous sites including liver, skin, and meninges. Due to its rarity diagnosis is often difficult. Accordingly, histopathological differentiation is of major importance. Solitary fibrous tumors consistently express CD 34 and react negatively to epithelial markers. This absence of expression of epithelial markers, especially cytokeratin, is also useful to distinguish these rare entities from sarcomatous mesotheliomas. The treatment of choice for solitary fibrous tumors is extensive surgical resection. Up to now there is no evidence that radiation and chemotherapy are effective. The local recurrence or onset of metastases depends on histologic parameters. In cases of benign classification (60-80%), the recurrence rate was only 2% after surgical excision. One-half of the patients with malignant tumors can be cured; the rest develop recurrences and metastases more often. Especially in those cases, emphasis should be placed on continual follow-up examination. We report two cases of a 65- and a 75-year-old male patient with huge intrathoracic solitary fibrous subpleural tumors, discovered incidentally on routine chest X-ray.

  7. Microbiological and histopathological findings in cases of fatal bovine respiratory disease of feedlot cattle in western Canada

    PubMed Central

    Booker, Calvin W.; Abutarbush, Sameeh M.; Morley, Paul S.; Jim, G. Kee; Pittman, Tom J.; Schunicht, Oliver C.; Perrett, Tye; Wildman, Brian K.; Fenton, R. Kent; Guichon, P. Timothy; Janzen, Eugene D.

    2008-01-01

    The aim of this study was to describe the microbiologic agents and pathologic processes in fatal bovine respiratory disease (BRD) of feedlot cattle and to investigate associations between agents and pathologic processes. Ninety feedlot calves diagnosed at necropsy with BRD and 9 control calves without BRD were examined, using immunohistochemical (IHC) staining and histopathologic studies. Mannheimia haemolytica (MH) (peracute, acute, and subacute cases) and Mycoplasma bovis (MB) (subacute, bronchiolar, and chronic cases) were the most common agents identified in fatal BRD cases. Significant associations (P < 0.10) were detected between microbiologic agents and between agents and pathologic processes. When IHC staining was used, 25/26 (96%) of animals that were positive for bovine viral diarrhea virus (BVDV) were also positive for MH; 12/15 (80 %) of animals that were positive for Histophilus somni (HS) were also positive for MB; and all of the animals that were positive for HS were negative for MH and BVDV. This quantitative pathological study demonstrates that several etiologic agents and pathologic processes are involved in fatal BRD of feedlot cattle. PMID:18512458

  8. Hoffmann's syndrome with unusually long duration: Report on clinical, laboratory and muscle imaging findings in two cases

    PubMed Central

    Nalini, Atchayaram; Govindaraju, C.; Kalra, Pramila; Kadukar, Prashanth

    2014-01-01

    Two adult men presented with the rare Hoffmann's syndrome (HS). Case 1: A 35-year-old male patient had progressive stiffness of lower limbs of 13 years and generalized muscle hypertrophy and myalgia of 3 years duration. Had periorbital edema, dry skin, generalized muscle hypertrophy and spastic dysarthria with hoarseness. Muscle power was normal. Jaw jerk and deep tendon reflexes were exaggerated. Case 2: A 24-year-old male patient presented with muscle hypertrophy from childhood, slowness in motor activities and hearing impairment. For 6 months, he had severe muscle pains, cramps and further increase in hypertrophy. He had yellow tinged, dry skin, hoarseness of voice, gross muscle hypertrophy and minimal weakness. Both had markedly elevated serum creatine kinase (CK) levels and high thyroid stimulating hormone, low free triiodothyronine and free thyroxine levels. Levothyroxine treatment demonstrated remarkable reduction in muscle bulk at 2 months in both and no symptoms at 6 months. Magnetic resonance imaging of lower limbs in both cases revealed almost identical features with involvement of the muscles of posterior and adductor compartment of thighs and posterior and lateral compartments of the legs. Differential diagnosis of long duration muscle pseudohypertrophy and elevated CK levels should include HS. PMID:25024579

  9. The ethics of sharing preliminary research findings during public health emergencies: a case study from the 2009 influenza pandemic.

    PubMed

    Crowcroft, N S; Rosella, L C; Pakes, B N

    2014-01-01

    During the 2009 A(H1N1) influenza pandemic, a suite of studies conducted in Canada showed an unexpected finding, that patients with medically attended laboratory-confirmed pandemic influenza were more likely to have received seasonal influenza vaccination than test-negative control patients. Different bodies, including scientific journals and government scientific advisory committees, reviewed the evidence simultaneously to determine its scientific validity and implications. Decision-making was complicated when the findings made their way into the media. The normal trajectory of non-urgent research includes peer-review publication after which decision-makers can process the information taking into account other evidence and logistic considerations. In the situation that arose, however, the congruence of an unexpected finding and the simultaneous review of the evidence both within and outside the traditional peer-review sphere raised several interesting issues about how to deal with emerging evidence during a public health emergency. These events are used in this article to aid discussion of the complex interrelationship between researchers, public health decision-makers and scientific journals, the trade-offs between sharing information early and maintaining the peer-review quality assurance process, and to emphasise the need for critical reflection on the practical and ethical norms that govern the way in which research is evaluated, published and communicated in public health emergencies. PMID:24970372

  10. The ethics of sharing preliminary research findings during public health emergencies: a case study from the 2009 influenza pandemic.

    PubMed

    Crowcroft, N S; Rosella, L C; Pakes, B N

    2014-06-19

    During the 2009 A(H1N1) influenza pandemic, a suite of studies conducted in Canada showed an unexpected finding, that patients with medically attended laboratory-confirmed pandemic influenza were more likely to have received seasonal influenza vaccination than test-negative control patients. Different bodies, including scientific journals and government scientific advisory committees, reviewed the evidence simultaneously to determine its scientific validity and implications. Decision-making was complicated when the findings made their way into the media. The normal trajectory of non-urgent research includes peer-review publication after which decision-makers can process the information taking into account other evidence and logistic considerations. In the situation that arose, however, the congruence of an unexpected finding and the simultaneous review of the evidence both within and outside the traditional peer-review sphere raised several interesting issues about how to deal with emerging evidence during a public health emergency. These events are used in this article to aid discussion of the complex interrelationship between researchers, public health decision-makers and scientific journals, the trade-offs between sharing information early and maintaining the peer-review quality assurance process, and to emphasise the need for critical reflection on the practical and ethical norms that govern the way in which research is evaluated, published and communicated in public health emergencies.

  11. Application and Validation of Case-Finding Algorithms for Identifying Individuals with Human Immunodeficiency Virus from Administrative Data in British Columbia, Canada

    PubMed Central

    Nosyk, Bohdan; Colley, Guillaume; Yip, Benita; Chan, Keith; Heath, Katherine; Lima, Viviane D.; Gilbert, Mark; Hogg, Robert S.; Harrigan, P. Richard; Montaner, Julio S. G.

    2013-01-01

    Objective To define a population-level cohort of individuals infected with the human immunodeficiency virus (HIV) in the province of British Columbia from available registries and administrative datasets using a validated case-finding algorithm. Methods Individuals were identified for possible cohort inclusion from the BC Centre for Excellence in HIV/AIDS (CfE) drug treatment program (antiretroviral therapy) and laboratory testing datasets (plasma viral load (pVL) and CD4 diagnostic test results), the BC Centre for Disease Control (CDC) provincial HIV surveillance database (positive HIV tests), as well as databases held by the BC Ministry of Health (MoH); the Discharge Abstract Database (hospitalizations), the Medical Services Plan (physician billing) and PharmaNet databases (additional HIV-related medications). A validated case-finding algorithm was applied to distinguish true HIV cases from those likely to have been misclassified. The sensitivity of the algorithms was assessed as the proportion of confirmed cases (those with records in the CfE, CDC and MoH databases) positively identified by each algorithm. A priori hypotheses were generated and tested to verify excluded cases. Results A total of 25,673 individuals were identified as having at least one HIV-related health record. Among 9,454 unconfirmed cases, the selected case-finding algorithm identified 849 individuals believed to be HIV-positive. The sensitivity of this algorithm among confirmed cases was 88%. Those excluded from the cohort were more likely to be female (44.4% vs. 22.5%; p<0.01), had a lower mortality rate (2.18 per 100 person years (100PY) vs. 3.14/100PY; p<0.01), and had lower median rates of health service utilization (days of medications dispensed: 9745/100PY vs. 10266/100PY; p<0.01; days of inpatient care: 29/100PY vs. 98/100PY; p<0.01; physician billings: 602/100PY vs. 2,056/100PY; p<0.01). Conclusions The application of validated case-finding algorithms and subsequent hypothesis

  12. The prevalence of lymphogranuloma venereum infection in men who have sex with men: results of a multicentre case finding study

    PubMed Central

    Ward, H; Alexander, S; Carder, C; Dean, G; French, P; Ivens, D; Ling, C; Paul, J; Tong, W; White, J; Ison, C A

    2009-01-01

    Objective: To determine the prevalence of lymphogranuloma venereum (LGV) and non-LGV associated serovars of urethral and rectal Chlamydia trachomatis (CT) infection in men who have sex with men (MSM). Design: Multicentre cross-sectional survey. Setting: Four genitourinary medicine clinics in the United Kingdom from 2006–7. Subjects: 4825 urethral and 6778 rectal samples from consecutive MSM attending for sexual health screening. Methods: Urethral swabs or urine and rectal swabs were tested for CT using standard nucleic acid amplification tests. Chlamydia-positive specimens were sent to the reference laboratory for serovar determination. Main outcome: Positivity for both LGV and non-LGV associated CT serovars; proportion of cases that were symptomatic. Results: The positivity (with 95% confidence intervals) in rectal samples was 6.06% (5.51% to 6.66%) for non-LGV CT and 0.90% (0.69% to 1.16%) for LGV; for urethral samples 3.21% (2.74% to 3.76%) for non-LGV CT and 0.04% (0.01% to 0.16%) for LGV. The majority of LGV was symptomatic (95% of rectal, one of two urethral cases); non-LGV chlamydia was mostly symptomatic in the urethra (68%) but not in the rectum (16%). Conclusions: Chlamydial infections are common in MSM attending for sexual health screening, and the majority are non-LGV associated serovars. We did not identify a large reservoir of asymptomatic LGV in the rectum or urethra. Testing for chlamydia from the rectum and urethra should be included for MSM requesting a sexual health screen, but serovar-typing is not indicated in the absence of symptoms. We have yet to identify the source of most cases of LGV in the UK. PMID:19221105

  13. Fibrosing Cholestatic Hepatitis in a Complicated Case of an Adult Recipient After Liver Transplantation: Diagnostic Findings and Therapeutic Dilemma

    PubMed Central

    Hori, Tomohide; Onishi, Yasuharu; Kamei, Hideya; Kurata, Nobuhiko; Ishigami, Masatoshi; Ishizu, Yoji; Ogura, Yasuhiro

    2016-01-01

    Patient: Male, 66 Final Diagnosis: Fibrosing cholestatic hepatitis Symptoms: Prolonged jaundice and intractable ascites Medication: Steroid pulse therapy and direct-acting antivirals Clinical Procedure: Liver transplantation Specialty: Transplantology Objective: Challenging differential diagnosis Background: Hepatitis C recurrence is a serious matter after liver transplantation (LT). Approximately 10% of hepatitis C virus (HCV) positive recipients develop fibrosing cholestatic hepatitis (FCH). FCH rapidly results in graft loss. Currently, direct-acting antivirals (DAAs) are effective and safe for hepatitis C, even after LT. However, only a few cases of successfully treated FCH after LT have been reported. We present FCH in a complicated case with sepsis and portal flow obstruction after LT. Case Report: A 66-year-old man underwent cadaveric LT. Liver function disorders were observed from post-operative day (POD) 22. Sepsis repeated on POD 38, 74, and 101. Steroid pulse therapy was given from POD 40 to 54. The infectious focus was surgically removed on POD 89. Interventional radiology for portal venous obstruction was completed on POD 96. To make a real-time diagnosis and to investigate the graft condition, repeat liver needle biopsies (LNBs) were taken. Although there was a combined impact of sepsis, portal flow decrease, and recurrent hepatitis C on graft failure, it was interesting that recurrent hepatitis C was consistently detectable from the first LNB. HCV-ribonucleic acid increased on POD 68. Liver function disorders peaked on POD 71 and 72. Jaundice peaked on POD 82. DAA induction was regrettably delayed because of a reluctance to introduce DAAs under conditions of graft dysfunction. DAAs were administered after hospital discharge. Conclusions: A real-time and precise diagnosis based on histopathological examination and viral measurement is important for FCH treatment. Well-considered therapy with DAAs should be aggressively introduced for potentially fatal

  14. Unique cytogenetic findings confirmed by FISH in a rare case of infant MDS with major prognostic implications

    SciTech Connect

    Sutcliffe, M.J.; Haag, M.M.; Dumont, D.P.

    1994-09-01

    An extremely rare finding in the young, the myelodysplastic syndrome (MDS) refractory anemia with excess blasts (RAEB), is distinguished by blood cytopenia, trilineage dyspoiesis and an increase in peripheral and bone marrow blasts. A 3-year-old male presented with arm pain of one week duration followed by progressive bruising, high fever and severe headaches. Bone marrow pathology revealed dysmyelopoietic granulocytic hyperplasia, marked reduction in megakaryocytes and increased blastosis suggestive of RAEB. Peripheral blood smear confirmed leukoerythroblastic anemia, reticulocytopenia and thyrombocytopenia. Cytogenetic bone marrow evaluation showed the majority of cells with ring (11), monosomies No. 17 and No. 20 and a derivative No. 12 chromosome. Due to the structural complexity and diagnostic and prognostic implications of accurate interpretation, analysis was confirmed using FISH COATASOME probes No. 11, No. 12 and No. 20 (Oncor, Inc.). The rearranged chromosome comprised chromosomes 12 and 20. Breakpoints in No. 12 were at p13 and q24.3. The breakpoint in chromosome 20 at q11.2 resulted in attachment of the distal 20q11.2 fragment to 12q and the centromere and p arm to 12p. C-banding confirmed two centromeres. Progression to ANLL is observed in 15-30% of patients with MDS. Distinction between RAEB and ANLL challenges diagnosis and patient management. Clonal chromosomal abnormalities due to RAEB and nonrandom ANLL changes also show considerable overlap, emphasizing their basic pathobiological similarity. However, r(11) has been described in ANLL and although the structurally rearranged No. 12 is believed to be a unique finding, the breakpoints were considered diagnostically significant. The presence of unusual cytogenetic findings may herald progression of MDS to acute leukemia before morphological classification is evident, emphasing the importance of clarifying structural abnormalities that may provide powerful evidence for clinical management.

  15. Asperger syndrome in India: findings from a case-series with respect to clinical profile and comorbidity.

    PubMed

    Sreedaran, Priya; Ashok, M V

    2015-01-01

    Asperger syndrome (AS) is an autism spectrum disorder with a high rate of psychiatric comorbidity. We describe the clinical profile and psychiatric comorbidity in a series of affected individuals referred to an Indian general hospital psychiatry setting. Gilliam Asperger's disorder scale was used to evaluate the clinical characteristics while Mini-International Neuropsychiatric Interview (MINI)-KID and MINI-PLUS were used to assess psychiatric comorbidity. The profile of subjects with AS in our case-series appears similar to that published elsewhere with high rates of psychiatric comorbidity. Mental health professionals should evaluate for psychiatric comorbidity in individuals with autism spectrum disorders.

  16. Asperger syndrome in India: findings from a case-series with respect to clinical profile and comorbidity.

    PubMed

    Sreedaran, Priya; Ashok, M V

    2015-01-01

    Asperger syndrome (AS) is an autism spectrum disorder with a high rate of psychiatric comorbidity. We describe the clinical profile and psychiatric comorbidity in a series of affected individuals referred to an Indian general hospital psychiatry setting. Gilliam Asperger's disorder scale was used to evaluate the clinical characteristics while Mini-International Neuropsychiatric Interview (MINI)-KID and MINI-PLUS were used to assess psychiatric comorbidity. The profile of subjects with AS in our case-series appears similar to that published elsewhere with high rates of psychiatric comorbidity. Mental health professionals should evaluate for psychiatric comorbidity in individuals with autism spectrum disorders. PMID:25969609

  17. Incidental Finding of a Neuroendocrine Tumor Arising from Meckel Diverticulum During Hernia Repair - A Case Report and Literature Review.

    PubMed

    Bacalbasa, Nicolae; Costin, Radu; Orban, Carmen; Iliescu, Laura; Hurjui, Ioan; Hurjui, Marcela; Niculescu, Nicoleta; Cristea, Mirela; Balescu, Irina

    2016-04-01

    Meckel diverticulum is the most common abnormality of the gastrointestinal tract arising from an incomplete obliteration of the vitelline duct during the intrauterine life. Although tumor development in Meckel diverticulum is not a common situation, it can occur due to the persistence of cellular islets with gastric, pancreatic or intestinal origin. The presence of a neuroendocrine tumor arising from Meckel diverticulum is even scarcer. We present the case of a 59-year-old patient in whom a Meckel diverticulum was found during surgery for inguinal hernia; the histopathological and immunohistochemical studies revealed the presence of a well-differentiated neuroendocrine tumor with low mitotic index. PMID:27069171

  18. Reducing Systematic Centroid Errors Induced by Fiber Optic Faceplates in Intensified High-Accuracy Star Trackers

    PubMed Central

    Xiong, Kun; Jiang, Jie

    2015-01-01

    Compared with traditional star trackers, intensified high-accuracy star trackers equipped with an image intensifier exhibit overwhelmingly superior dynamic performance. However, the multiple-fiber-optic faceplate structure in the image intensifier complicates the optoelectronic detecting system of star trackers and may cause considerable systematic centroid errors and poor attitude accuracy. All the sources of systematic centroid errors related to fiber optic faceplates (FOFPs) throughout the detection process of the optoelectronic system were analyzed. Based on the general expression of the systematic centroid error deduced in the frequency domain and the FOFP modulation transfer function, an accurate expression that described the systematic centroid error of FOFPs was obtained. Furthermore, reduction of the systematic error between the optical lens and the input FOFP of the intensifier, the one among multiple FOFPs and the one between the output FOFP of the intensifier and the imaging chip of the detecting system were discussed. Two important parametric constraints were acquired from the analysis. The correctness of the analysis on the optoelectronic detecting system was demonstrated through simulation and experiment. PMID:26016920

  19. The effects of financial incentives for case finding for depression in patients with diabetes and coronary heart disease: interrupted time series analysis

    PubMed Central

    McLintock, Kate; Russell, Amy M; Alderson, Sarah L; West, Robert; House, Allan; Westerman, Karen; Foy, Robbie

    2014-01-01

    Objective To evaluate the effects of Quality and Outcomes Framework (QOF) incentivised case finding for depression on diagnosis and treatment in targeted and non-targeted long-term conditions. Design Interrupted time series analysis. Setting General practices in Leeds, UK. Participants 65 (58%) of 112 general practices shared data on 37 229 patients with diabetes and coronary heart disease targeted by case finding incentives, and 101 008 patients with four other long-term conditions not targeted (hypertension, epilepsy, chronic obstructive pulmonary disease and asthma). Intervention Incentivised case finding for depression using two standard screening questions. Main outcome measures Clinical codes indicating new depression-related diagnoses and new prescriptions of antidepressants. We extracted routinely recorded data from February 2002 through April 2012. The number of new diagnoses and prescriptions for those on registers was modelled with a binomial regression, which provided the strength of associations between time periods and their rates. Results New diagnoses of depression increased from 21 to 94/100 000 per month in targeted patients between the periods 2002–2004 and 2007–2011 (OR 2.09; 1.92 to 2.27). The rate increased from 27 to 77/100 000 per month in non-targeted patients (OR 1.53; 1.46 to 1.62). The slopes in prescribing for both groups flattened to zero immediately after QOF was introduced but before incentivised case finding (p<0.01 for both). Antidepressant prescribing in targeted patients returned to the pre-QOF secular upward trend (Wald test for equivalence of slope, z=0.73, p=0.47); the slope was less steep for non-targeted patients (z=−4.14, p<0.01). Conclusions Incentivised case finding increased new depression-related diagnoses. The establishment of QOF disrupted rising trends in new prescriptions of antidepressants, which resumed following the introduction of incentivised case finding. Prescribing trends are of concern given

  20. Sleep-related eating disorder in a 29 year-old man: a case report with diagnostic polysomnographic findings.

    PubMed

    Yeh, Shih-Bin; Schenck, Carlos H

    2007-06-01

    This is a case of a 29-year-old man with a 6 year history of sleep-related eating disorder (SRED) that occurred with partial consciousness on a nightly basis. His family or wife witnessed up to 5 episodes every night, with each eating episode lasting 8-16 minutes. Polysomnography documented 4 episodes of sleep-related eating arising from stage 2 Non-REM sleep, when he consumed cookies that he had brought to the sleep lab that night. While eating, his EEG remained in stage 2 sleep or else was a wakeful EEG, and the eating episodes lasted for a mean 13.3 minutes. There was no epileptiform EEG activity during the polysomnogrphic study with a seizure montage and fast paper speed. Therapy with clonazepam, 0.5 mg bedtime, did not control the nocturnal eating. The patient tried to limit access to food in his home before bedtime, and this had modest benefit. This case of SRED has both typical and atypical features, which are discussed.

  1. Observations on two cases of apparent submandibular gland cysts in HIV positive patients: MR and CT findings

    SciTech Connect

    Gottesman, R.I.; Som, P.M.; Mester, J.; Silvers, A.R.

    1996-05-01

    To present two cases of probable lymphoepithelial cysts of the submandibular glands in patients who were human immunodeficiency virus (HIV) positive and who also had lymphoepithelial cysts of the parotid glands. Computed tomography and MRI of two HIV positive patients with lymphoepithelial cysts of the parotid glands and cysts in tile submandibular glands were correlated with the histories and the possible presence of other known causes of submandibular gland multiple cysts. Because of the present treatment philosophy regarding HIV positive patients with major salivary gland cysts, surgical resection of these glands was not performed. All other known causes of multiple submandibular gland cysts were excluded by either history or laboratory data. Computed tomography and MRI on two patients with known HIV infection and bilateral parotid lymphoepithelial cysts are presented. Both patients also had bilateral multiple submandibular gland cysts and no evidence of obstructive glandular diseases autoimmune disease, or other organ system cysts. These cases of presumed submandibular gland lymphoepithelial cysts are rare in the literature. They are presented in the hope that other radiologists will be stimulated to document the occurrence of this entity. 22 refs., 2 figs.

  2. Bronchial leiomyoma in a chemical warfare victim—a causative agent or an incidental finding: A case report

    PubMed Central

    Behesthirouy, Samad; Kakaei, Farzad; Azhough, Ramin; Fakhrjou, Ashraf

    2012-01-01

    INTRODUCTION Bronchial leiomyoma is one of the rarest benign tumors of the lower respiratory system, compromising less than 2% of reported benign pulmonary tumors. Chemical warfare is a known cause of chronic pulmonary diseases in soldiers who survives of the chemical wars. Most of these patients are chronically under treatment by respiratory drugs and acute exacerbations of their symptoms prompt for investigations for diagnosis of a new complication in these patients. PRESENTATION OF CASE In this case report we present a 43 y/o male chemical warfare victim who was under treatment for his respiratory disease for near 20 years but at last bronchial leiomyoma was diagnosed as the cause of exacerbation of his symptoms. He was undergone right thoracotomy and sleeve resection of left main bronchus. Severe adhesions plus lymphadenitis in the mediastinum might be due to the effects of prior inflammatory process. DISCUSSION Because of rarity of this tumor, bronchial leiomyoma in this patient may be the result of previous exposure to nitrogen mustard but the exact relationship remained to be confirmed. CONCLUSION Although the association between chemical warfare and lung neoplasias has not been well understood, it is the first time that a bronchial leiomyoma is reported in a nitrogen mustard survivor. PMID:22705579

  3. Sclerosing angiomatoid nodular transformation (SANT) of the spleen: a case report with FDG-PET findings and literature review

    PubMed Central

    Imamura, Yumi; Hatta, Kazuha; Seshimo, Akiyoshi; Sawada, Tatsuo; Abe, Koichiro; Sakai, Shuji

    2016-01-01

    We report the 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings of sclerosing angiomatoid nodular transformation (SANT) of the spleen. The patient was a 37-year-old woman with a splenic mass incidentally found on abdominal ultrasound. FDG-PET/CT showed weak FDG accumulation (maximum standardized uptake value = 3.65). An unenhanced CT scan showed a low density and well-circumscribed splenic tumor that demonstrated weak enhancement from the arterial to delayed phase. Although hemangioma or hamartoma of the spleen was preoperatively diagnosed, histopathological examination revealed SANT. Therefore, when a splenic tumor with weak contrast medium enhancement and low FDG accumulation is observed, SANT should be considered as a differential diagnosis. Although CT and magnetic resonance imaging features of SANT have been reported, there are few reports on FDG-PET/CT findings. We report the radiological features of SANT, including FDG-PET/CT, and review the literature on SANT. PMID:27570634

  4. Clinical Features, Image Findings, and Prognosis of Inflammatory Pseudotumor of the Liver: A Multicenter Experience of 45 Cases

    PubMed Central

    Park, Jun Young; Lim, Young-Suk; Park, Jang Won; Kim, Seung Up; Min, Yang Won; Gwak, Geum-Youn; Paik, Yong-Han; Lee, Joon Hyoek; Koh, Kwang Cheol; Paik, Seung Woon; Yoo, Byung Chul

    2014-01-01

    Background/Aims Inflammatory pseudotumor (IPT) of the liver is a rare disease characterized by chronic infiltration of inflammatory cells. However, the clinical characteristics and outcomes of IPT remain uncertain. Methods Clinical features, image findings, and outcomes of 55 patients with histologically proven IPT were evaluated. Results They consisted of 26 men and 19 women with median age of 65 years. Serum carcinoembryonal antigen and carbohydrate antigen 19-9 levels were normal in 42 patients (93.3%). Enhanced CT scans indicated poorly defined peripheral enhancement (82.5%) at the arterial phase and poorly defined hyperattenuating lesions with internal hypoattenuating areas at the equilibrium phase (77.0%). Gadolinium-enhancement MRI revealed poorly defined peripheral rim-like enhancement (77.8%). Ten patients underwent surgical resection and 35 were treated conservatively with or without antibiotics. No recurrence was noted after surgical resection during follow-up (1 to 48 months). In all patients who received conservative treatment, complete resolution or size reduction was noted during follow-up (1 to 192 months). Conclusions CT and MRI provide clues to the diagnosis of IPT in patients with liver masses and normal tumor markers. However, due to the lack of pathognomonic findings, the clinician's suspicion and histological diagnosis are necessary to make an accurate diagnosis of IPT. PMID:24516702

  5. Marginalization and Precariat: The Challenge of Intensifying Life Construction Intervention

    PubMed Central

    Di Fabio, Annamaria; Palazzeschi, Letizia

    2016-01-01

    This article discusses the case study of a graduate student who, at the time of the study, was doing an internship, considered in the literature as a new form of precariat (temporary or insecure employment). The student participated in a life construction intervention during which he completed two new qualitative instruments: the Life Adaptability Qualitative Assessment (LAQuA) and the Career Counseling Innovative Outcomes (CCIO) before and after the life construction intervention. The results are discussed in the article. The life construction intervention helped the participant understand himself better, develop his life and career paths, and construct his identity. The study confirmed the value of enhancing life construction interventions using a preventive approach, particularly for precarious people (people in temporary or unstable jobs), with early interventions starting with young internees in organizations. PMID:27065914

  6. Marginalization and Precariat: The Challenge of Intensifying Life Construction Intervention.

    PubMed

    Di Fabio, Annamaria; Palazzeschi, Letizia

    2016-01-01

    This article discusses the case study of a graduate student who, at the time of the study, was doing an internship, considered in the literature as a new form of precariat (temporary or insecure employment). The student participated in a life construction intervention during which he completed two new qualitative instruments: the Life Adaptability Qualitative Assessment (LAQuA) and the Career Counseling Innovative Outcomes (CCIO) before and after the life construction intervention. The results are discussed in the article. The life construction intervention helped the participant understand himself better, develop his life and career paths, and construct his identity. The study confirmed the value of enhancing life construction interventions using a preventive approach, particularly for precarious people (people in temporary or unstable jobs), with early interventions starting with young internees in organizations.

  7. Meningioangiomatosis in an otherwise healthy 13 year-old boy: A case report with emphasis on histopathological findings.

    PubMed Central

    Motevalli, Dorna; Kamalian, Naser; Tavangar, Seyed Mohammad

    2016-01-01

    Meningioangiomatosis is regarded as a rare benign hamartomatous condition mostly involving the cerebral cortex and overlying leptomeninges. A strong association of MA with neurofibromatosis type 2 has been documented in published articles. Herein we report a case of an otherwise healthy 13-year-old boy with no family history or stigmata of neurofibromatosis who presented with intractable seizures. MRI revealed a 2x2 cm mass lesion in the frontal lobe. The patient underwent complete surgical resection of the lesion. Although the primary radiologic impression of the lesion was glioma, pathological evaluation of the resected specimen showed mainly proliferation of meningothelial cells and fibroblast-like cells with many thickened blood vessels, which are typical for diagnosis of meningioangiomatosis. After surgical removal of the lesion, the patient is free of seizures. PMID:27799981

  8. Magnetic Resonance Neurographic Findings in Classic Idiopathic Neuralgic Amyotrophy in Subacute Stage: A Report of Four Cases

    PubMed Central

    Park, Myung Seok; Kim, Du Hwan

    2014-01-01

    Neuralgic amyotrophy (NA) is characterized by acute onset of severe pain, followed by muscular weakness and wasting of the shoulder girdle. While the diagnosis of NA mainly relies on the clinical history and examination, some investigations including electrophysiologic study and radiologic study may help to confirm the diagnosis. Magnetic resonance neurography (MRN), a new technique for the evaluation of peripheral nerve disorders, can be helpful in the diagnosis of NA. MRN presents additional benefits in comparison to conventional magnetic resonance imaging in the diagnosis of idiopathic NA (INA). In this report, we present the first four cases of classic INA diagnosed with MRN in subacute stage. MRN imaging modality should be considered in patients clinically suspected of INA. PMID:24855627

  9. Spontaneous Pneumothorax as an Atypical Presentation of Pulmonary Paracoccidioidomycosis: A Case Report with Emphasis on the Imaging Findings

    PubMed Central

    Pereira, Mariana Leite; Marchiori, Edson; Zanetti, Gláucia; Abdalla, Guilherme; Ventura, Nina; Constantino, Carolina Pesce Lamas; Brandão, Viviane; Martins, Pedro; Canellas, Rodrigo; Muccillo, Antonio; Varella de Oliveira, Romulo

    2010-01-01

    We describe the case of a 45-year-old male with pulmonary paracoccidioidomycosis and spontaneous pneumothorax. The patient presented to the hospital with sudden and intense chest pain accompanied by dyspnea and had a six-month history of dry cough, weight loss, and progressive dyspnea on exertion. Chest X-ray showed a small right pneumothorax, bilateral nonhomogeneous opacities, and emphysematous areas in the lung base. Chest computed tomography showed consolidation in both lungs, with architectural distortion, nodules, interlobular septal thickening, and emphysema, in addition to the right pneumothorax. A lung biopsy revealed yeast consistent with Paracoccidioides brasiliensis. No drainage was needed, and the lung was re-expanded. The patient was treated with antifungal drugs, showed mild improvement, and was referred to outpatient care. PMID:20592996

  10. A case study of voltage-gated potassium channel antibody-related limbic encephalitis with PET/MRI findings

    PubMed Central

    Day, Brian K.; Eisenman, Lawrence; Black, Joseph; Maccotta, Luigi; Hogan, R. Edward

    2015-01-01

    Preclinical and clinical studies have demonstrated the significance of inflammation and autoantibodies in epilepsy, and the use of immunotherapies in certain situations has become an established practice. Temporal lobe epilepsy can follow paraneoplastic or nonparaneoplastic limbic encephalitis associated with antibodies directed against brain antigens. Here, we focus on a patient with worsening confusion and temporal lobe seizures despite treatment with antiepileptic medications. Serial brain MRIs did not conclusively reveal structural abnormalities, so the patient underwent brain PET/MRI to simultaneously evaluate brain structure and function, revealing bitemporal abnormalities. The patient was diagnosed with voltage-gated potassium channel antibody-related limbic encephalitis based on clinical presentation, imaging findings, and antibody testing. Treatment included the addition of a second antiepileptic agent and oral steroids. His seizures and cognitive deficits improved and stabilized. PMID:26106579

  11. Unusual finding of a mediastinal T-cell lymphoma in a 13-year-old patient - a case report.

    PubMed

    Bălănescu, Radu Ninel; Bălănescu, Laura; Cordoş, Ioan; Sfrijan, Doiniţa; Pop, Florinel; CaragaŢă, Florentina-Ruxandra; Mălăescu, Gheorghe Dan

    2015-01-01

    T-cell lymphoblastic lymphoma is an aggressive malignancy that represents 85% of all lymphoblastic lymphomas. It usually occurs in late childhood, adolescence and young adulthood with a 2:1 male preponderance and it presents with pleural effusion and respiratory symptoms and in rare cases vena cava syndrome can be encountered. We present the case of a 13-year-old patient who was referred to our clinic from a local hospital where he was diagnosed with a mediastinal tumor. The patient presented with thoracic pain, fever, coughing and fatigability for a month prior to admission, after having underwent surgery for abdominal pain (appendectomy). On admission to our hospital, a thoracic computed tomography (CT) scan was performed and showed the presence of an anterior mediastinal mass measuring 109/76/140 mm, well defined, which came in close contact with the superior vena cava, the ascending aorta and the pulmonary artery, right pleural effusion and a collapsed lung on the right side. The decision was taken to perform a tumor biopsy and a right pleural drain was placed. The patient's post-operative evolution was favorable with the remission of the respiratory symptoms. The histopathological result showed the presence of T-cell lymphoblastic lymphoma and the patient was then transferred to the oncology ward where he underwent chemotherapeutic treatment, with a favorable outcome. T-cell lymphoblastic lymphoma is an aggressive type of lymphoma and it is usually hard to diagnose considering the fact that the symptoms are often vague. It is essential to establish the diagnosis without delay and start appropriate chemotherapeutic treatment. PMID:26743307

  12. Case-control approach application for finding a relationship between candidate genes and clinical mastitis in Holstein dairy cattle.

    PubMed

    Bagheri, Masoumeh; Moradi-Sharhrbabak, M; Miraie-Ashtiani, R; Safdari-Shahroudi, M; Abdollahi-Arpanahi, R

    2016-02-01

    Mastitis is a major source of economic loss in dairy herds. The objective of this research was to evaluate the association between genotypes within SLC11A1 and CXCR1 candidate genes and clinical mastitis in Holstein dairy cattle using the selective genotyping method. The data set contained clinical mastitis records of 3,823 Holstein cows from two Holstein dairy herds located in two different regions in Iran. Data included the number of cases of clinical mastitis per lactation. Selective genotyping was based on extreme values for clinical mastitis residuals (CMR) from mixed model analyses. Two extreme groups consisting of 135 cows were formed (as cases and controls), and genotyped for the two candidate genes, namely, SLC11A1 and CXCR1, using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), respectively. Associations between single nucleotide polymorphism (SNP) genotypes with CMR and breeding values for milk and protein yield were carried out by applying logistic regression analyses, i.e. estimating the probability of the heterogeneous genotype in the dependency of values for CMR and breeding values (BVs). The sequencing results revealed a novel mutation in 1139 bp of exon 11 of the SLC11A1 gene and this SNP had a significant association with CMR (P < 0.05). PCR-RFLP analysis leads to three banding patterns for CXCR1c.735C>G and these genotypes had significant relationships with CMR. Overall, the results showed that SLC11A1 and CXCR1 are valuable candidate genes for the improvement of mastitis resistance as well as production traits in dairy cattle populations.

  13. Characterization of a photon-counting intensified active pixel sensor (PC-IAPS): preliminary results

    NASA Astrophysics Data System (ADS)

    Uslenghi, Michela C.; Bonanno, Giovanni; Belluso, Massimiliano; Modica, Angelo; Bergamini, Paolo

    2001-12-01

    We report about preliminary results of the characterization of a new kind of MCP-based detector: a Photon Counting Intensified Active Pixel Sensor (APS). PC-IAPS appears as the natural evolution of the Intensified CCD, maintaining the basic characteristics, but with improved performance in terms of dynamic range, along with some other appealing properties: higher radiation hardness, more compact design, lower requirements on the external electronics, low power consumption. The prototype we realized is currently in an early stage of development. Nevertheless, it allows us to demonstrate the feasibility of the photon counter and to measure some of the basic parameters. Some of the characteristics of the APS, relevant to the use in intensified systems, are analyzed and compared with the CCD ones, demonstrating the potentiality of the new device and allowing us to set the basis of future development.

  14. Night or darkness, which intensifies the feeling of fear?

    PubMed

    Li, Yadan; Ma, Wenjuan; Kang, Qin; Qiao, Lei; Tang, Dandan; Qiu, Jiang; Zhang, Qinglin; Li, Hong

    2015-07-01

    Nighttime fear is a phenomenon in which people feel more afraid of threats at night. Despite the vast amount of psychological research on nighttime fear, previous researchers have not accurately distinguished between "night" and "darkness", both of which play important roles in nighttime fear. We collected physiological (skin conductance response and heart rate) and psychological (self-report) data simultaneously to investigate the effects of "night" and "darkness" on fearful feelings and whether these effects were moderated by the mode of stimulus delivery (i.e., visual or auditory). Specifically, two tasks were employed in which time (day vs. night), illumination (light vs. darkness) and stimulus type (fearful vs. neutral) were manipulated. Participants (n=128) were exposed to visual and auditory oddball tasks consisting of fearful and neutral stimuli. The results indicated that there were significant increases in fear responses at night, and the difference between day and night was significant for fear stimuli but not for neutral events. Furthermore, these effects were consistent over different sensory modalities (visual and auditory). The results of this study underscore the importance of the day-night cycle in fear-related information processing and suggest that further attention needs to be paid to the influence of the biological circadian rhythm on these processes. The current findings could inform a deeper understanding of anxiety and fear-related disorders, and thus, we invite future studies to illuminate the underlying neurobiological mechanisms therein. PMID:25957698

  15. Intensified diapycnal mixing in the midlatitude western boundary currents.

    PubMed

    Jing, Zhao; Wu, Lixin

    2014-12-10

    The wind work on oceanic near-inertial motions is suggested to play an important role in furnishing the diapycnal mixing in the deep ocean which affects the uptake of heat and carbon by the ocean as well as climate changes. However, it remains a puzzle where and through which route the near-inertial energy penetrates into the deep ocean. Using the measurements collected in the Kuroshio extension region during January 2005, we demonstrate that the diapycnal mixing in the thermocline and deep ocean is tightly related to the shear variance of wind-generated near-inertial internal waves with the diapycnal diffusivity 6 × 10(-5) m(2)s(-1) almost an order stronger than that observed in the circulation gyre. It is estimated that 45%-62% of the local near-inertial wind work 4.5 × 10(-3) Wm(-2) radiates into the thermocline and deep ocean and accounts for 42%-58% of the energy required to furnish mixing there. The elevated mixing is suggested to be maintained by the energetic near-inertial wind work and strong eddy activities causing enhanced downward near-inertial energy flux than earlier findings. The western boundary current turns out to be a key region for the penetration of near-inertial energy into the deep ocean and a hotspot for the diapycnal mixing in winter.

  16. Intensified diapycnal mixing in the midlatitude western boundary currents.

    PubMed

    Jing, Zhao; Wu, Lixin

    2014-01-01

    The wind work on oceanic near-inertial motions is suggested to play an important role in furnishing the diapycnal mixing in the deep ocean which affects the uptake of heat and carbon by the ocean as well as climate changes. However, it remains a puzzle where and through which route the near-inertial energy penetrates into the deep ocean. Using the measurements collected in the Kuroshio extension region during January 2005, we demonstrate that the diapycnal mixing in the thermocline and deep ocean is tightly related to the shear variance of wind-generated near-inertial internal waves with the diapycnal diffusivity 6 × 10(-5) m(2)s(-1) almost an order stronger than that observed in the circulation gyre. It is estimated that 45%-62% of the local near-inertial wind work 4.5 × 10(-3) Wm(-2) radiates into the thermocline and deep ocean and accounts for 42%-58% of the energy required to furnish mixing there. The elevated mixing is suggested to be maintained by the energetic near-inertial wind work and strong eddy activities causing enhanced downward near-inertial energy flux than earlier findings. The western boundary current turns out to be a key region for the penetration of near-inertial energy into the deep ocean and a hotspot for the diapycnal mixing in winter. PMID:25491363

  17. Night or darkness, which intensifies the feeling of fear?

    PubMed

    Li, Yadan; Ma, Wenjuan; Kang, Qin; Qiao, Lei; Tang, Dandan; Qiu, Jiang; Zhang, Qinglin; Li, Hong

    2015-07-01

    Nighttime fear is a phenomenon in which people feel more afraid of threats at night. Despite the vast amount of psychological research on nighttime fear, previous researchers have not accurately distinguished between "night" and "darkness", both of which play important roles in nighttime fear. We collected physiological (skin conductance response and heart rate) and psychological (self-report) data simultaneously to investigate the effects of "night" and "darkness" on fearful feelings and whether these effects were moderated by the mode of stimulus delivery (i.e., visual or auditory). Specifically, two tasks were employed in which time (day vs. night), illumination (light vs. darkness) and stimulus type (fearful vs. neutral) were manipulated. Participants (n=128) were exposed to visual and auditory oddball tasks consisting of fearful and neutral stimuli. The results indicated that there were significant increases in fear responses at night, and the difference between day and night was significant for fear stimuli but not for neutral events. Furthermore, these effects were consistent over different sensory modalities (visual and auditory). The results of this study underscore the importance of the day-night cycle in fear-related information processing and suggest that further attention needs to be paid to the influence of the biological circadian rhythm on these processes. The current findings could inform a deeper understanding of anxiety and fear-related disorders, and thus, we invite future studies to illuminate the underlying neurobiological mechanisms therein.

  18. Application of optimization to the inverse problem of finding the worst-case heating configuration in a fire

    SciTech Connect

    Romero, V.J.; Eldred, M.S.; Bohnhoff, W.J.; Outka, D.E.

    1995-07-01

    Thermal optimization procedures have been applied to determine the worst-case heating boundary conditions that a safety device can be credibly subjected to. There are many interesting aspects of this work in the areas of thermal transport, optimization, discrete modeling, and computing. The forward problem involves transient simulations with a nonlinear 3-D finite element model solving a coupled conduction/radiation problem. Coupling to the optimizer requires that boundary conditions in the thermal model be parameterized in terms of the optimization variables. The optimization is carried out over a diverse multi-dimensional parameter space where the forward evaluations are computationally expensive and of unknown duration a priori. The optimization problem is complicated by numerical artifacts resulting from discrete approximation and finite computer precision, as well as theoretical difficulties associated with navigating to a global minimum on a nonconvex objective function having a fold and several local minima. In this paper we report on the solution of the optimization problem, discuss implications of some of the features of this problem on selection of a suitable and efficient optimization algorithm, and share lessons learned, fixes implemented, and research issues identified along the way.

  19. Association of magnetic resonance imaging findings and histologic diagnosis in dogs with nasal disease: 78 cases (2001-2004).

    PubMed

    Miles, Macon S; Dhaliwal, Ravinder S; Moore, Michael P; Reed, Ann L

    2008-06-15

    OBJECTIVE-To determine whether magnetic resonance imaging (MRI) features correlated with histologic diagnosis in dogs with nasal disease. DESIGN-Retrospective case series. ANIMALS-78 Dogs undergoing MRI for evaluation of nasal disease. PROCEDURES-Medical records and MRI reports of dogs were reviewed to identify MRI features associated with histologic diagnosis. Features evaluated were presence of a mass effect, frontal sinus involvement, sphenoid sinus involvement, maxillary recess involvement, nasopharyngeal infiltration by soft tissue, nasal turbinate destruction, vomer bone lysis, paranasal bone destruction, cribriform plate erosion, and lesion extent (ie, unilateral vs bilateral). RESULTS-33 Dogs had neoplastic disease, 38 had inflammatory rhinitis, and 7 had fungal rhinitis. Lesion extent was not significantly associated with histologic diagnosis. Absence of a mass effect was significantly associated with inflammatory disease. However, presence of a mass was not specific for neoplasia. In dogs with evidence of a mass on magnetic resonance (MR) images, nasal turbinate destruction, frontal sinus invasion, and maxillary recess invasion were not useful in distinguishing neoplastic from nonneoplastic disease, but cribriform plate erosion, vomer bone lysis, paranasal bone destruction, sphenoid sinus invasion, and nasopharyngeal invasion were. CONCLUSIONS AND CLINICAL RELEVANCE-Results suggested that in dogs with nasal disease, the lack of a mass effect on MR images was significantly associated with inflammatory disease. In dogs with a mass effect on MR images, vomer bone lysis, cribriform plate erosion, paranasal bone destruction, sphenoid sinus invasion by a mass, and nasopharyngeal invasion by a mass were significantly associated with a diagnosis of neoplasia. PMID:18598154

  20. A novel frameshift mutation and infrequent clinical findings in two cases with Dyggve-Melchior-Clausen syndrome.

    PubMed

    Seven, Mehmet; Koparir, Erkan; Gezdirici, Alper; Aydin, Hatip; Skladny, Heyko; Fenercioğlu, Elif; Güven, Gülgün; Karataş, Ömer Faruk; Koparir, Asuman; Özen, Mustafa; Ulucan, Hakan

    2014-01-01

    Dyggve-Melchior-Clausen syndrome (DMC) (MIM #223800) is a rare autosomal-recessive type of skeletal dysplasia accompanied by variable degrees of intellectual disability (ID). It is characterized by progressive spondyloepimetaphyseal dysplasia leading to disproportionate short stature, microcephaly, and coarse facies. The radiographic appearance of generalized platyspondyly with double-humped end plates and the lace-like appearance of iliac crests are pathognomonic in this syndrome. The disorder results from mutations in the dymeclin (DYM) mapped to the 18q12-12.1 chromosomal region. Here, we report two cases with DMC: one with disproportionate short stature, developmental delay, and severe ID with a novel frameshift mutation (c.1028_1056del29) leading to a premature stop codon, and the second patient with classical clinical and radiological features of DMC with mild ID and rectal prolapse, which is very rare. The clinical diagnosis was confirmed with molecular analysis of DYM with a known mutation at c.580C>T (p.R194X). The parents and sibling of the second patient were heterozygous carriers with mild skeletal changes and short stature.

  1. Analysis of Over 10,000 Cases Finds No Association between Previously-Reported Candidate Polymorphisms and Ovarian Cancer Outcome

    PubMed Central

    White, Kristin L.; Vierkant, Robert A.; Fogarty, Zachary C.; Charbonneau, Bridget; Block, Matthew S.; Pharoah, Paul D.P.; Chenevix-Trench, Georgia; Rossing, Mary Anne; Cramer, Daniel W.; Pearce, C. Leigh; Schildkraut, Joellen M.; Menon, Usha; Kjaer, Susanne Kruger; Levine, Douglas A.; Gronwald, Jacek; Culver, Hoda Anton; Whittemore, Alice S.; Karlan, Beth Y.; Lambrechts, Diether; Wentzensen, Nicolas; Kupryjanczyk, Jolanta; Chang-Claude, Jenny; Bandera, Elisa V.; Hogdall, Estrid; Heitz, Florian; Kaye, Stanley B.; Fasching, Peter A.; Campbell, Ian; Goodman, Marc T.; Pejovic, Tanja; Bean, Yukie; Lurie, Galina; Eccles, Diana; Hein, Alexander; Beckmann, Matthias W.; Ekici, Arif B.; Paul, James; Brown, Robert; Flanagan, James; Harter, Philipp; du Bois, Andreas; Schwaab, Ira; Hogdall, Claus K.; Lundvall, Lene; Olson, Sara H.; Orlow, Irene; Paddock, Lisa E.; Rudolph, Anja; Eilber, Ursula; Dansonka-Mieszkowska, Agnieszka; Rzepecka, Iwona K.; Ziolkowska-Seta, Izabela; Brinton, Louise; Yang, Hannah; Garcia-Closas, Montserrat; Despierre, Evelyn; Lambrechts, Sandrina; Vergote, Ignace; Walsh, Christine; Lester, Jenny; Sieh, Weiva; McGuire, Valerie; Rothstein, Joseph H.; Ziogas, Argyrios; Lubiński, Jan; Cybulski, Cezary; Menkiszak, Janusz; Jensen, Allan; Gayther, Simon A.; Ramus, Susan J.; Gentry-Maharaj, Aleksandra; Berchuck, Andrew; Wu, Anna H.; Pike, Malcolm C.; Van Den Berg, David; Terry, Kathryn L.; Vitonis, Allison F.; Doherty, Jennifer A.; Johnatty, Sharon; deFazio, Anna; Song, Honglin; Tyrer, Jonathan; Sellers, Thomas A.; Phelan, Catherine M.; Kalli, Kimberly R.; Cunningham, Julie M.; Fridley, Brooke L.; Goode, Ellen L.

    2013-01-01

    Background Ovarian cancer is a leading cause of cancer-related death among women. In an effort to understand contributors to disease outcome, we evaluated single-nucleotide polymorphisms (SNPs) previously associated with ovarian cancer recurrence or survival, specifically in angiogenesis, inflammation, mitosis, and drug disposition genes. Methods Twenty-seven SNPs in VHL, HGF, IL18, PRKACB, ABCB1, CYP2C8, ERCC2, and ERCC1 previously associated with ovarian cancer outcome were genotyped in 10,084 invasive cases from 28 studies from the Ovarian Cancer Association Consortium with over 37,000 observed person-years and 4,478 deaths. Cox proportional hazards models were used to examine the association between candidate SNPs and ovarian cancer recurrence or survival with and without adjustment for key covariates. Results We observed no association between genotype and ovarian cancer recurrence or survival for any of the SNPs examined. Conclusions These results refute prior associations between these SNPs and ovarian cancer outcome and underscore the importance of maximally powered genetic association studies. Impact These variants should not be used in prognostic models. Alternate approaches to uncovering inherited prognostic factors, if they exist, are needed. PMID:23513043

  2. Cervix carcinoma and incidental finding of medullary thyroid carcinoma by 18F-FDG PET/CT--clinical case.

    PubMed

    Chaushev, Borislav; Bochev, Pavel; Klisarova, Anelia; Yordanov, Kaloyan; Encheva, Elitsa; Dancheva, Jivka; Yordanova, Cvetelina; Hristozov, Kiril; Krasnaliev, Ivan; Radev, Radoslav; Nenkov, Rumen

    2014-01-01

    Thyroid nodules are encountered in clinical practice during the diagnostic procedures or patients' follow-up due to other diseases quite far from the thyroid gland with prevalence 4-50% in general population, depending on age, diagnostic method and race. The prevalence of thyroid nodules increases with age and their clarification should be done for their adequate treatment. An 18F-FDG PET/CT was done with a PET/CT scanner (Philips Gemini TF), consisting of dedicated lutetium orthosilicate full ring PET scanner and 16 slice CT. The PET/CT scan of the whole-body revealed on the CT portion a hypodense nodular lesion in the left lobe of the thyroid gland with increased uptake of 18F-FDG on the PET with SUVmax 10.3 and demonstrated a complete response to the induction therapy of the main oncological disease of the patient--squamous cell carcinoma. This clinical case demonstrates that whole-body 18F-FDG-PET/CT has an increasingly important role in the early evaluation of thyroid cancer as a second independent malignant localization. Focal thyroid lesion with high risk of thyroid malignancy was incidentally found on 18F-FDG PET/CT. PMID:25088110

  3. Application of optimization to the inverse problem of finding the worst-case heating configuration in a fire

    NASA Astrophysics Data System (ADS)

    Romero, V. J.; Eldred, M. S.; Bohnhoff, W. J.; Outka, D. E.

    1995-05-01

    Thermal optimization procedures have been applied to determine the worst-case heating boundary conditions that a safety device can be credibly subjected to. There are many interesting aspects of this work in the areas of thermal transport, optimization, discrete modeling, and computing. The forward problem involves transient simulations with a nonlinear 3-D finite element model solving a coupled conduction/radiation problem. Coupling to the optimizer requires that boundary conditions in the thermal model be parameterized in terms of the optimization variables. The optimization is carried out over a diverse multi-dimensional parameter space where the forward evaluations are computationally expensive and of unknown duration a priori. The optimization problem is complicated by numerical artifacts resulting from discrete approximation and finite computer precision, as well as theoretical difficulties associated with navigating to a global minimum on a nonconvex objective function having a fold and several local minima. In this paper we report on the solution of the optimization problem, discuss implications of some of the features of this problem on selection of a suitable and efficient optimization algorithm, and share lessons learned, fixes implemented, and research issues identified along the way.

  4. Tubal ligation regret and related risk factors: findings from a case-control study in Pernambuco State, Brazil.

    PubMed

    Ludermir, Ana Bernarda; Machado, Kátia Maria de Melo; Costa, Aurélio Molina da; Alves, Sandra Valongueiro; Araújo, Thália Velho Barreto de

    2009-06-01

    A case-control study was carried out at a public teaching hospital in Recife, Pernambuco State, Brazil in 1997 to investigate risk factors among women who feel regret after undergoing sterilization through tubal ligation. The study compared sterilized women who had requested or undergone a tubal reversal with women who were also sterilized but had not undergone this surgery, nor had requested to do so. Women showing a significantly greater probability of regret were those sterilized at a young age, those who had not themselves made the decision to undergo surgery , those for whom the sterilization was carried out up to the 45th day after childbirth and those who had acquired knowledge about contraceptive methods after the tubal ligation procedure. Having had a deceased child, a partner with no children prior to the current union or a change of partner after the tubal sterilization procedure were also associated to the request for or submission to tubal sterilization reversal. It is necessary to assess women's psycho-socio-demographic profiles, their reasons for requesting tubal ligation and to advise the patient about family planning in order to reduce rates of post-sterilization regret.

  5. Incidental findings during routine pathological evaluation of gallbladder specimens: review of 1,747 elective laparoscopic cholecystectomy cases.

    PubMed

    Basak, F; Hasbahceci, M; Canbak, T; Sisik, A; Acar, A; Yucel, M; Bas, G; Alimoglu, O

    2016-04-01

    Introduction Cholecystectomy for benign gallbladder diseases can lead to previously undiagnosed gallbladder cancer during histopathological evaluation. Despite some controversy over its usefulness, histopathological evaluation of all gallbladder specimens is common in most hospitals. We evaluated the results of routine pathology of the gallbladder after cholecystectomy for benign gallbladder diseases with regard to unexpected primary gallbladder cancer (UPGC). Methods Patients undergoing cholecystectomy because of benign gallbladder diseases between 2009 and 2013 were enrolled in this study. All gallbladder specimens were sent to the pathology department, and histopathological reports were examined in detail. The impact of demographic features on pathological diagnoses and prevalence of UPGC assessed. Data on additional interventions and postoperative survival for patients with UPGC were collected. Results We enrolled 1,747 patients (mean age, 48.7±13.6 years). Chronic cholecystitis was the most common diagnosis (96.3%) and was associated significantly with being female (p=0.001). Four patients had UPGC (0.23%); one was stage T3 at the time of surgery, and the remaining three cases were stage T2. Conclusions Routine histopathological examination of the gallbladder is valuable for identification of cancer that requires further postoperative management.

  6. How People Use Social Information to Find out What to Want in the Paradigmatic Case of Inter-temporal Preferences

    PubMed Central

    Dolan, Raymond J.

    2016-01-01

    The weight with which a specific outcome feature contributes to preference quantifies a person’s ‘taste’ for that feature. However, far from being fixed personality characteristics, tastes are plastic. They tend to align, for example, with those of others even if such conformity is not rewarded. We hypothesised that people can be uncertain about their tastes. Personal tastes are therefore uncertain beliefs. People can thus learn about them by considering evidence, such as the preferences of relevant others, and then performing Bayesian updating. If a person’s choice variability reflects uncertainty, as in random-preference models, then a signature of Bayesian updating is that the degree of taste change should correlate with that person’s choice variability. Temporal discounting coefficients are an important example of taste–for patience. These coefficients quantify impulsivity, have good psychometric properties and can change upon observing others’ choices. We examined discounting preferences in a novel, large community study of 14–24 year olds. We assessed discounting behaviour, including decision variability, before and after participants observed another person’s choices. We found good evidence for taste uncertainty and for Bayesian taste updating. First, participants displayed decision variability which was better accounted for by a random-taste than by a response-noise model. Second, apparent taste shifts were well described by a Bayesian model taking into account taste uncertainty and the relevance of social information. Our findings have important neuroscientific, clinical and developmental significance. PMID:27447491

  7. The moderating role of need for cognition on excessive searching bias: a case of finding romantic partners online.

    PubMed

    Chiou, Wen-Bin; Yang, Mu-Li

    2010-01-01

    Using online-dating websites to expand social networks and form close relationships is popular for people in information technology era. Wu and Chiou (2009) demonstrated that more options triggered excessive searching, leading to poorer decision-making and reduced selectivity. They proposed that the more-means-worse effect refers to more searching leads to worse choices by reducing users' cognitive resources, distracting them with irrelevant information and reducing their ability to screen out inferior options. A 2 by 2 experimental study was conducted to investigate the moderating effect of individual differences in need for cognition (NFC) and number of available options on excessive searching and decision quality. A total of 120 undergraduates with experiences of online romantic relationships participated in the experiment. After participants were administrated their need for cognition, they were assigned to review either a small or a large number of options to search for their most desirable romantic partners via a popular online-dating website in Taiwan. Results indicated that high-NFC participants showed more excessive searching than did low-NFC participants. Moreover, the more-means-worse effect was more salient for high-NFC participants than high-NFC participants. The findings suggest that users with high NFC may be more vulnerable to the negative effect of excessive searching.

  8. An osteological revisitation of autopsies: comparing anthropological findings on exhumed skeletons to their respective autopsy reports in seven cases.

    PubMed

    Cappella, A; Castoldi, E; Sforza, C; Cattaneo, C

    2014-11-01

    Forensic anthropologists and pathologists are more and more requested to answer questions on bone trauma. However limitations still exist concerning the proper interpretation of bone fractures and bone lesions in general. Access to known skeletal populations which derive from cadavers (victims of violent deaths) who underwent autopsy and whose autopsy reports are available are obvious sources of information on what happens to bone trauma when subjected to taphonomic variables, such as burial, decomposition, postmortem chemical and mechanical insults; such skeletal collections are still however quite rare. This study presents the results of the comparative analysis between the autopsy findings on seven cadavers (six of which victims of blunt, sharp or gunshot wounds) and those of the anthropological assessment performed 20 years later on the exhumed dry bones (part of the Milano skeletal collection). The investigation allowed us to verify how perimortem sharp, blunt and gunshot lesions appear after a long inhumation period, whether they are still recognizable, and how many lesions are no longer detectable or were not detectable at all compared to the autopsy report. It also underlines the importance of creating skeletal collections with known information on cause of death and trauma. PMID:25315679

  9. A case-control analysis of smoking and breast cancer in African American women: findings from the AMBER Consortium.

    PubMed

    Park, Song-Yi; Palmer, Julie R; Rosenberg, Lynn; Haiman, Christopher A; Bandera, Elisa V; Bethea, Traci N; Troester, Melissa A; Viscidi, Emma; Kolonel, Laurence N; Olshan, Andrew F; Ambrosone, Christine B

    2016-06-01

    Recent population studies suggest a role of smoking in the etiology of breast cancer, but few have been conducted among African American women. In a collaborative project of four large studies, we examined associations between smoking measures and breast cancer risk by menopause and hormone receptor status [estrogen receptor-positive (ER+), ER-negative (ER-) and triple-negative (ER-, PR-, HER2-)]. The study included 5791 African American women with breast cancer and 17376 African American controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in multivariable logistic regression analysis with adjustment for study and risk factors. Results differed by menopausal status. Among postmenopausal women, positive associations were observed for long duration and greater pack-years of smoking: relative to never smoking, fully adjusted ORs were 1.14 (95% CI: 1.03-1.26) for duration ≥20 years and 1.16 (95% CI: 1.01-1.33) for ≥20 pack-years. By contrast, inverse associations were observed among premenopausal women, with ORs of 0.80 (95% CI: 0.68-95) for current smoking and 0.81 (95% CI: 0.69-0.96) for former smoking, without trends by duration. Associations among postmenopausal women were somewhat stronger for ER+ breast cancer. The findings suggest that the relation of cigarette smoking to breast cancer risk in African American women may vary by menopausal status and breast cancer subtype. PMID:27207658

  10. An osteological revisitation of autopsies: comparing anthropological findings on exhumed skeletons to their respective autopsy reports in seven cases.

    PubMed

    Cappella, A; Castoldi, E; Sforza, C; Cattaneo, C

    2014-11-01

    Forensic anthropologists and pathologists are more and more requested to answer questions on bone trauma. However limitations still exist concerning the proper interpretation of bone fractures and bone lesions in general. Access to known skeletal populations which derive from cadavers (victims of violent deaths) who underwent autopsy and whose autopsy reports are available are obvious sources of information on what happens to bone trauma when subjected to taphonomic variables, such as burial, decomposition, postmortem chemical and mechanical insults; such skeletal collections are still however quite rare. This study presents the results of the comparative analysis between the autopsy findings on seven cadavers (six of which victims of blunt, sharp or gunshot wounds) and those of the anthropological assessment performed 20 years later on the exhumed dry bones (part of the Milano skeletal collection). The investigation allowed us to verify how perimortem sharp, blunt and gunshot lesions appear after a long inhumation period, whether they are still recognizable, and how many lesions are no longer detectable or were not detectable at all compared to the autopsy report. It also underlines the importance of creating skeletal collections with known information on cause of death and trauma.

  11. A large aperture laser triggered intensified charge coupled device using second-harmonic laser light triggering

    NASA Astrophysics Data System (ADS)

    Yamauchi, Toshihiko; Dimock, Dirck

    1997-06-01

    For application to a ruby laser Thomson scattering system, we have developed a laser triggered intensified charge coupled device (CCD) with 80 mm aperture, two stages of intensification, and 80 ns gating. To improve the dynamic range, the CCD is cooled and read out slowly (1 s). To obtain a good extinction ratio (>1.1×107), the zoom electrode of the first intensifier is gated using a ˜10 kV laser triggered spark gap. The stability of this spark gap has been greatly improved by frequency doubling the laser trigger light.

  12. Does GRACE see the terrestrial water cycle "intensifying"?

    NASA Astrophysics Data System (ADS)

    Eicker, Annette; Forootan, Ehsan; Springer, Anne; Longuevergne, Laurent; Kusche, Jürgen

    2016-01-01

    Several researchers have postulated that, under a changing climate due to anthropogenic forcing, an intensification of the water cycle is already under way. This is usually related to increases in hydrological fluxes as precipitation (P), evapotranspiration (E), and river discharge (R). It is under debate, however, whether such observed or reconstructed flux changes are real and on what scales. Large-scale increase or decrease of the flux deficit (P-E-R), i.e., flux changes that do not compensate, would lead to acceleration or deceleration of water storage anomalies potentially visible in Gravity Recovery and Climate Experiment (GRACE) data. In agreement with earlier studies, we do find such accelerations in global maps of gridded GRACE water storage anomalies over 2003-2012. However, these have been generally associated with interannual and decadal climate variability. Yet we show that even after carefully isolating and removing the contribution of El Niño that partially masks long-term changes, using a new method, accelerations of up to 12 mm/yr2 remain in regions such as Australia, Turkey, and Northern India. We repeat our analysis with flux fields from two global atmospheric reanalyses that include land surface models (ERA-Interim and MERRA-Land). While agreeing well with GRACE on shorter time scales, they fall short in displaying long-term trends corresponding to GRACE accelerations. We hypothesize that this may be due to time-varying biases in the reanalysis fluxes as noticed in other studies. We conclude that even though its data record is short, GRACE provides new information that should be used to constrain future reanalyses toward a better representation of long-term water cycle evolution.

  13. Active tuberculosis case finding and detection of drug resistance among HIV-infected patients: A cross-sectional study in a TB endemic area, Gondar, Northwest Ethiopia

    PubMed Central

    Alemayehu, Martha; Gelaw, Baye; Abate, Ebba; Wassie, Liya; Belyhun, Yeshambel; Bekele, Shiferaw; Kempker, Russell R.; Blumberg, Henry M.; Aseffa, Abraham

    2016-01-01

    Background Tuberculosis (TB) patients co-infected with human immunodeficiency virus (HIV) often lack the classic symptoms of pulmonary tuberculosis, making the diagnosis difficult. Current practices in resource-limited settings often indicate that these co-infected patients are diagnosed when they clinically manifest disease symptoms, resulting in a delayed diagnosis and despite continued transmission. The aim of this study is to determine the prevalence of undiagnosed pulmonary tuberculosis cases through active case finding and including multidrug-resistant TB (MDR-TB) among HIV-infected patients. Materials and methods A total of 250 HIV-infected patients, aged 18 years and above were evaluated in a cross-sectional design between February 2012 and November 2012. Socio-demographic and clinical data were collected using a structured questionnaire. Sputum samples were collected from all participants for acid fast bacilli (AFB) direct smear microscopy and Mycobacteria culture. A PCR-based RD9 deletion and genus typing, as well as first-line anti-TB drug susceptibility testing, was performed for all culture-positive isolates. Results Following active TB case finding, a total of 15/250 (6%) cases were diagnosed as TB cases, of whom 9/250 (3.6%) were detected by both smear microscopy and culture and the remaining 6/250 (2.4%) only by culture. All the 15 isolates were typed through RD9 typing of which 10 were Mycobacterium tuberculosis species; 1 belonged to Mycobacterium genus and 4 isolates were non-tuberculous mycobacteria. The prevalence of undiagnosed pulmonary TB disease among the study participants was 4.4%, which implies the possibility of identifying even more undiagnosed cases through active case finding. A multivariate logistic regression showed a statistically significant association between the presence of pneumonia infection and the occurrence of TB (OR = 4.81, 95% CI (1.08–21.43), p = 0.04). In addition, all the isolates were sensitive to all first

  14. Carpal boss in chronic wrist pain and its association with partial osseous coalition and osteoarthritis - A case report with focus on MRI findings.

    PubMed

    Poh, Feng

    2015-01-01

    The carpal boss is a bony prominence at the dorsal aspect of the 2(nd) and/or 3(rd) carpometacarpal joint, which has been linked to various etiologies, including trauma, os styloideum, osteophyte formation, and partial osseous coalition. It may result in symptoms through secondary degeneration, ganglion formation, bursitis, or extensor tendon abnormalities by altered biomechanics of wrist motion. We present a case of symptomatic carpal boss with the finding of a partial osseous coalition at the 2(nd) carpometacarpal (metacarpal-trapezoid) joint and highlight the magnetic resonance imaging (MRI) findings of carpal boss impingement and secondary osteoarthritis. To the best of our knowledge, there is no report in the literature describing the imaging findings of partial osseous coalition and degenerative osteoarthritis in relation to carpal boss.

  15. Solitary fibrous tumor of the lung: a case report with a study of the aspiration biopsy, histopathology, immunohistochemistry, and autopsy findings.

    PubMed

    Baliga, Mithra; Flowers, Rhyne; Heard, Ken; Siddiqi, Anwer; Akhtar, Israh

    2007-04-01

    Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm of ubiquitous location. In addition to its classic presentation as a pleural-based mass, it can be encountered in a variety of other sites. A pleural-based lung lesion can be easily accessed by radiologic guidance for cytologic study. Several reports have described the cytologic findings of SFT at various locations, including the lung. However, diagnostic difficulties can occur due to unusual clinical, radiologic, atypical cytomorphologic, and histologic features. We describe a case of intrapulmonary SFT in which a false-positive malignant diagnosis was rendered on fine-needle aspiration biopsy and concurrent surgical core biopsy prior to radiofrequency ablation. The patient died of procedural complications, and an autopsy was performed. Retrospective study of the case, especially correlation of cytologic, histologic, autopsy findings, and immunohistochemistry results were helpful in correctly diagnosing the case as SFT. We are reporting this case with emphasis on avoiding diagnostic pitfalls by being familiar with the accepted cytohistologic features and appropriate immunohistochemical results.

  16. Comparison of Magnetic Resonance Imaging Findings between Pathologically Proven Cases of Atypical Tubercular Spine and Tumour Metastasis: A Retrospective Study in 40 Patients

    PubMed Central

    Khalid, Mohd; Sabir, Aamir Bin; Khalid, Saifullah

    2016-01-01

    Study Design Retrospective study. Purpose To note the magnetic resonance imaging (MRI) differences between pathologically proven cases of atypical spinal tuberculosis and spinal metastasis in 40 cases. Overview of Literature Spinal tuberculosis, or Pott's spine, constitutes less than 1% of all cases of tuberculosis and can be associated with a neurologic deficit. Breast, prostate and lung cancer are responsible for more than 80% of metastatic bone disease cases, and spine is the most common site of bone metastasis. Thus, early diagnosis and prompt management of these pathologies are essential in preventing various complications. Methods We retrospectively reviewed 40 cases of atypical tuberculosis and metastasis affecting the spine from the year 2012 to 2014, with 20 cases each that were proven by histopathological examination. MR imaging was performed on 1.5 T MR-Scanner (Magnetom Avanto, Siemens) utilizing standard surface coils of spine with contrast injection. Chi-square test was used for determining the statistical significance and p-values were calculated. Results The most common site of involvement was the thoracic spine, seen in 85% cases of metastasis and 65% cases of Pott's spine (p=0.144). The mean age of patients with tubercular spine was found to be 40 years and that of metastatic spine was 56 years. The following MR imaging findings showed statistical significance (p<0.05): combined vertebral body and posterior elements involvement, skip lesions, solitary lesion, intra-spinal lesions, concentric collapse, abscess formation and syrinx formation. Conclusions Tuberculosis should be considered in the differential diagnosis of various spinal lesions including metastasis, fungal spondylodiskitis, sarcoidosis and lymphoma, particularly in endemic countries. Spinal tuberculosis is considered one of the great mimickers of disease as it could present in a variety of typical and atypical patterns, so proper imaging must be performed in order to facilitate

  17. Assessing land take by urban development and its impact on carbon storage: Findings from two case studies in Italy

    SciTech Connect

    Sallustio, L.; Quatrini, V.; Geneletti, D.; Corona, P.; Marchetti, M.

    2015-09-15

    Highlights: • We tested a new methodology for monitoring land take and its effects on C storage. • The ecological impact of urban growth derives from the previous land use. • C loss increases with the naturalness of the territory. • Different urban assets may imply different forms of land take containment. Land take due to urbanization triggers a series of negative environmental impacts with direct effects on quality of life for people living in cities. Changes in ecosystem services are associated with land take, among which is the immediate C loss due to land use conversion. Land use change monitoring represents the first step in quantifying land take and its drivers and impacts. To this end, we propose an innovative methodology for monitoring land take and its effects on ecosystem services (in particular, C loss) under multi-scale contexts. The devised approach was tested in two areas with similar sizes, but different land take levels during the time-span 1990–2008 in Central Italy (the Province of Rome and the Molise Region). The estimates of total coverage of built up areas were calculated using point sampling. The area of the urban patches including each sampling point classified as built up areas in the year 1990 and/or in the year 2008 is used to estimate total abundance and average area of built up areas. Biophysical and economic values for carbon loss associated with land take were calculated using InVEST. Although land take was 7–8 times higher in the Province of Rome (from 15.1% in 1990 to 20.4% in 2008) than in Molise region, our findings show that its relative impact on C storage is higher in the latter, where the urban growth consistently affects not only croplands but also semi-natural land uses such as grasslands and other wooded lands. The total C loss due to land take has been estimated in 1.6 million Mg C, corresponding to almost 355 million €. Finally, the paper discusses the main characteristics of urban growth and their

  18. Primary Chronic Osteomyelitis of the Jaws in Children: An Update on Pathophysiology, Radiological Findings, Treatment Strategies, and Prospective Analysis of Two Cases

    PubMed Central

    Berglund, Caroline; Ekströmer, Karin; Abtahi, Jahan

    2015-01-01

    Objective. Primary chronic osteomyelitis (PCO) of the jaws in children is associated with pain, trismus, and swelling. In children, temporomandibular joint involvement is rare and few studies have been published due to the relatively low incidence. This paper presents two cases of mandibular PCO in children with the involvement of the collum mandibulae. In addition, a review of the literature regarding demographic data, histological, radiological, and laboratory findings, and treatment strategies of PCO was also performed. Material and Methods. Prospective analyses of two PCO cases. A PubMed search was used and the articles were sorted according to their corresponding key area of focus. Results. Review of the literature revealed twenty-four cases of PCO with two cases of mandibular condyle involvement. The mean age was 18 years; the male to female ratio was 1 : 3. Most of the patients were treated with anti-inflammatory drugs in combination with decortication. Clinical recurrence was seen in 7 cases. Conclusion. A combination of anti-inflammatory drugs and surgical intervention appears to be the first choice of treatment. However, surgical removal of necrotic tissue adjacent to collum mandibulae has its limitations in children. Further investigations are of utmost importance in order to increase our knowledge and understanding of this disease. PMID:26435856

  19. Reemergence of Mycobacterium chimaera in Heater-Cooler Units despite Intensified Cleaning and Disinfection Protocol.

    PubMed

    Schreiber, Peter W; Kuster, Stefan P; Hasse, Barbara; Bayard, Cornelia; Rüegg, Christian; Kohler, Philipp; Keller, Peter M; Bloemberg, Guido V; Maisano, Francesco; Bettex, Dominique; Halbe, Maximilian; Sommerstein, Rami; Sax, Hugo

    2016-10-01

    Invasive Mycobacterium chimaera infections after open-heart surgery have been reported internationally. These devastating infections result from aerosols generated by contaminated heater-cooler units used with extracorporeal circulation during surgery. Despite intensified cleaning and disinfection, surveillance samples from factory-new units acquired during 2014 grew nontuberculous mycobacteria after a median of 174 days. PMID:27649345

  20. Reemergence of Mycobacterium chimaera in Heater-Cooler Units despite Intensified Cleaning and Disinfection Protocol.

    PubMed

    Schreiber, Peter W; Kuster, Stefan P; Hasse, Barbara; Bayard, Cornelia; Rüegg, Christian; Kohler, Philipp; Keller, Peter M; Bloemberg, Guido V; Maisano, Francesco; Bettex, Dominique; Halbe, Maximilian; Sommerstein, Rami; Sax, Hugo

    2016-10-01

    Invasive Mycobacterium chimaera infections after open-heart surgery have been reported internationally. These devastating infections result from aerosols generated by contaminated heater-cooler units used with extracorporeal circulation during surgery. Despite intensified cleaning and disinfection, surveillance samples from factory-new units acquired during 2014 grew nontuberculous mycobacteria after a median of 174 days.

  1. 15. 3,000TON DAVYUNITED PRESS AND STEAM INTENSIFIER IN THE BLACKSMITH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. 3,000-TON DAVY-UNITED PRESS AND STEAM INTENSIFIER IN THE BLACKSMITH SHOP. (THIS MACHINE WAS NOT EXTANT AT THE TIME OF THE INVENTORY.) Jet Lowe, Photographer, 1989. - U.S. Steel Homestead Works, Auxiliary Buildings & Shops, Along Monongahela River, Homestead, Allegheny County, PA

  2. Intensified Voice Therapy: A New Model for the Rehabilitation of Patients Suffering from Functional Dysphonias

    ERIC Educational Resources Information Center

    Fischer, Michael J.; Gutenbrunner, Christoph; Ptok, Martin

    2009-01-01

    The objective of this study was to evaluate a new intervention for chronic dysphonias, consisting of a 2-week outpatient treatment period using intensified voice therapy combined with elements of physical medicine, including physiotherapy (orthotherapy, detonisation and training of the trunk muscles, respiratory therapy and others), manual therapy…

  3. Reemergence of Mycobacterium chimaera in Heater–Cooler Units despite Intensified Cleaning and Disinfection Protocol

    PubMed Central

    Schreiber, Peter W.; Kuster, Stefan P.; Hasse, Barbara; Bayard, Cornelia; Rüegg, Christian; Kohler, Philipp; Keller, Peter M.; Bloemberg, Guido V.; Maisano, Francesco; Bettex, Dominique; Halbe, Maximilian; Sommerstein, Rami

    2016-01-01

    Invasive Mycobacterium chimaera infections after open-heart surgery have been reported internationally. These devastating infections result from aerosols generated by contaminated heater–cooler units used with extracorporeal circulation during surgery. Despite intensified cleaning and disinfection, surveillance samples from factory-new units acquired during 2014 grew nontuberculous mycobacteria after a median of 174 days. PMID:27649345

  4. Computer Interfaced Image Tube Intensified Self-Scanned Array Cameras And Instruments

    NASA Astrophysics Data System (ADS)

    Johnson, C. B.; Blank, R. E.

    1984-01-01

    Image tube intensified linear and area self-scanned array (SSA) readout detector assemblies are becoming increasingly important for automatic inspection systems and machine vision. Proximity focused diode and microchannel plate (MCP) image intensifier tubes are being used in conjunction with SSAs because they can be electronically gated, they are physically small, they do not introduce image distortion, and for several other reasons 11,12,30-33. Even single photon events can be detected by using high gain MCP image tubes. Image intensified linear SSA (IL/SSA) detector assemblies can now provide successive 100% duty cycle optical samples in time periods as short as 1 ms for up to 1024 linear array pixels with 8 or 12 bit parallel output. Image intensified area SSA (IA/SSA) detector assemblies with, for example, 488 x 380 pixels in the active image area, can be read out in 33 ms. Both IL/SSA and IA/SSA detector assemblies can be interfaced to computers directly, or through conventional data acquisition systems (DASs) 14,15,35,45,48,51. Depending upon the maximum input data rate to the computer, the DAS either operates in the continuous-mode or in the burst-mode. Virtually any type of linear or area SSA can be image tube intensified and computer interfaced using the methods described 38,42. A new 512 or 1024 pixel IL/SSA instrument detector assembly, the F4560, coupled to an HP-85 microcomputer through an HP-6942A DAS has been developed.

  5. Influence of range-gated intensifiers on underwater imaging system SNR

    NASA Astrophysics Data System (ADS)

    Wang, Xia; Hu, Ling; Zhi, Qiang; Chen, Zhen-yue; Jin, Wei-qi

    2013-08-01

    Range-gated technology has been a hot research field in recent years due to its high effective back scattering eliminating. As a result, it can enhance the contrast between a target and its background and extent the working distance of the imaging system. The underwater imaging system is required to have the ability to image in low light level conditions, as well as the ability to eliminate the back scattering effect, which means that the receiver has to be high-speed external trigger function, high resolution, high sensitivity, low noise, higher gain dynamic range. When it comes to an intensifier, the noise characteristics directly restrict the observation effect and range of the imaging system. The background noise may decrease the image contrast and sharpness, even covering the signal making it impossible to recognize the target. So it is quite important to investigate the noise characteristics of intensifiers. SNR is an important parameter reflecting the noise features of a system. Through the use of underwater laser range-gated imaging prediction model, and according to the linear SNR system theory, the gated imaging noise performance of the present market adopted super second generation and generation Ⅲ intensifiers were theoretically analyzed. Based on the active laser underwater range-gated imaging model, the effect to the system by gated intensifiers and the relationship between the system SNR and MTF were studied. Through theoretical and simulation analysis to the image intensifier background noise and SNR, the different influence on system SNR by super second generation and generation Ⅲ ICCD was obtained. Range-gated system SNR formula was put forward, and compared the different effect influence on the system by using two kind of ICCDs was compared. According to the matlab simulation, a detailed analysis was carried out theoretically. All the work in this paper lays a theoretical foundation to further eliminating back scattering effect, improving

  6. Clinical Findings and Pain Symptoms as Potential Risk Factors for Chronic TMD: Descriptive Data and Empirically Identified Domains from the OPPERA Case-Control Study

    PubMed Central

    Ohrbach, Richard; Fillingim, Roger B.; Mulkey, Flora; Gonzalez, Yoly; Gordon, Sharon; Gremillion, Henry; Lim, Pei-Feng; Ribeiro-Dasilva, Margarete; Greenspan, Joel D.; Knott, Charles; Maixner, William; Slade, Gary

    2011-01-01

    Clinical characteristics might be associated with temporomandibular disorders (TMD) because they are antecedent risk factors that increase the likelihood of a healthy person developing the condition or because they represent signs or symptoms of either subclinical or overt TMD. In this baseline case-control study of the multisite Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) project, 1,633 controls and 185 cases with chronic, painful TMD completed questionnaires and received clinical examinations. Odds ratios measuring association between each clinical factor and TMD were computed, with adjustment for study-site as well as age, sex, and race/ethnicity. Compared to controls, TMD cases reported more trauma, greater parafunction, more headaches and other pain disorders, more functional limitation in using the jaw, more nonpain symptoms in the facial area, more temporomandibular joint noises and jaw locking, more neural or sensory medical conditions, and worse overall medical status. They also exhibited on examination reduced jaw mobility, more joint noises, and a greater number of painful masticatory, cervical, and body muscles upon palpation. The results indicated that TMD cases differ substantially from controls across almost all variables assessed. Future analyses of follow-up data will determine whether these clinical characteristics predict increased risk for developing first-onset pain-related TMD Perspective Clinical findings from OPPERA’s baseline case-control study indicate significant differences between chronic TMD cases and controls with respect to trauma history, parafunction, other pain disorders, health status, and clinical examination data. Future analyses will examine their contribution to TMD onset. PMID:22074750

  7. [Hemispheric functional specialization in motor aphasia. Neurophysiologic findings with computerized electroencephalographic brain mapping during musical and oral sound stimulation. Study of 2 cases].

    PubMed

    Muszkat, M; Correia, C M; Noffs, M H; de Vincenzo, N S; de Campos, C J

    1995-03-01

    This study concerns about brain electrical activity during auditory stimulation in 2 aphasic patients, one with classical (left hemisphere lesion) and another with cross aphasia (right hemisphere lesion). Both cases were submitted to dichotic listening test (consonant-vowel-consonant task) and music audition (gregorian chant), during brain mapping examination. We found, in both cases, a great proportion in delta frequency and power in non-lesional hemisphere during dichotic and musical stimulation. Besides, increasing in frequency of alpha activity was observed only in the non-lesional hemisphere restricted to temporal lobe region. Such findings suggest an interesting field of research about measurements of neurophysiological correlates of auditory stimulation and brain electrical activity in aphasia. PMID:7575214

  8. [Hemispheric functional specialization in motor aphasia. Neurophysiologic findings with computerized electroencephalographic brain mapping during musical and oral sound stimulation. Study of 2 cases].

    PubMed

    Muszkat, M; Correia, C M; Noffs, M H; de Vincenzo, N S; de Campos, C J

    1995-03-01

    This study concerns about brain electrical activity during auditory stimulation in 2 aphasic patients, one with classical (left hemisphere lesion) and another with cross aphasia (right hemisphere lesion). Both cases were submitted to dichotic listening test (consonant-vowel-consonant task) and music audition (gregorian chant), during brain mapping examination. We found, in both cases, a great proportion in delta frequency and power in non-lesional hemisphere during dichotic and musical stimulation. Besides, increasing in frequency of alpha activity was observed only in the non-lesional hemisphere restricted to temporal lobe region. Such findings suggest an interesting field of research about measurements of neurophysiological correlates of auditory stimulation and brain electrical activity in aphasia.

  9. Incidental finding of elongated ventral duct in a case of pancreatic divisum mimicking double pancreatic ducts on magnetic resonance cholangiopancreaticography—a rare normal variant

    PubMed Central

    Rani, Y. Jyotsna

    2015-01-01

    Anatomic variations and developmental anomalies of the pancreas and pancreatic duct are often noticed as an incidental finding on imaging. However, knowledge of these variants may prove to be crucial during surgery as it may prevent unintentional ductal injury. We report a case of pancreatic divisum with codominant ventral duct mimicking double pancreatic ducts along with the elongated uncinate process of pancreas. It was picked incidentally on magnetic resonance cholangiopancreaticography (MRCP) done to rule out cholelithiasis and choledocholithiasis. It is a rare anatomic variant and to the best of our knowledge has not been reported so far. PMID:26682149

  10. Partial deletion of long arm of chromosome 11[del(11)(q23)]: Jacobsen syndrome. Two new cases and review of the clinical findings.

    PubMed Central

    Schinzel, A; Auf der Maur, P; Moser, H

    1977-01-01

    Two cases, a boy and a girl, with the 11q-(Jacobsen) syndrome are reported. Findings common to both and typical for this chromosome aberration include a narrow protruding forehead, hypertelorism, non-horizontal position of the eyes, ptosis, strabismus, broad root, and short upturned tip of thenose, carp mouth, receding chin, misshapen ears, simian creases, and severe mental retardation. In addition, one patient had pyloric stenosis and an inguinal hernia. Growth retardation and microcephaly were not found in either of them. The karyotypes revealed de novo-deletions of the long arm of one chromosome 11,del(11)(q23). Images PMID:604495

  11. Current scientific evidence for integrated community case management (iCCM) in Africa: Findings from the iCCM Evidence Symposium

    PubMed Central

    Diaz, Theresa; Aboubaker, Samira; Young, Mark

    2014-01-01

    In March 2014, over 400 individuals from 35 countries in sub-Saharan Africa and 59 international partner organizations gathered in Accra, Ghana for an integrated Community Case Management (iCCM) Evidence Review Symposium. The objective was 2-fold: first, to review the current state of the art of iCCM implementation and second, to assist African countries to integrate lessons learned and best practices presented during the symposium into their programmes. Based on the findings from the symposium this supplement includes a comprehensive set of articles that provide the latest evidence for improving iCCM programs and ways to better monitor and evaluate such programs. PMID:25520783

  12. Image Intensifier Modules For Use With Commercially Available Solid State Cameras

    NASA Astrophysics Data System (ADS)

    Murphy, Howard; Tyler, Al; Lake, Donald W.

    1989-04-01

    A modular approach to design has contributed greatly to the success of the family of machine vision video equipment produced by EG&G Reticon during the past several years. Internal modularity allows high-performance area (matrix) and line scan cameras to be assembled with two or three electronic subassemblies with very low labor costs, and permits camera control and interface circuitry to be realized by assemblages of various modules suiting the needs of specific applications. Product modularity benefits equipment users in several ways. Modular matrix and line scan cameras are available in identical enclosures (Fig. 1), which allows enclosure components to be purchased in volume for economies of scale and allows field replacement or exchange of cameras within a customer-designed system to be easily accomplished. The cameras are optically aligned (boresighted) at final test; modularity permits optical adjustments to be made with the same precise test equipment for all camera varieties. The modular cameras contain two, or sometimes three, hybrid microelectronic packages (Fig. 2). These rugged and reliable "submodules" perform all of the electronic operations internal to the camera except for the job of image acquisition performed by the monolithic image sensor. Heat produced by electrical power dissipation in the electronic modules is conducted through low resistance paths to the camera case by the metal plates, which results in a thermally efficient and environmentally tolerant camera with low manufacturing costs. A modular approach has also been followed in design of the camera control, video processor, and computer interface accessory called the Formatter (Fig. 3). This unit can be attached directly onto either a line scan or matrix modular camera to form a self-contained units, or connected via a cable to retain the advantages inherent to a small, light weight, and rugged image sensing component. Available modules permit the bus-structured Formatter to be

  13. JC Virus PCR Detection Is Not Infallible: A Fulminant Case of Progressive Multifocal Leukoencephalopathy with False-Negative Cerebrospinal Fluid Studies despite Progressive Clinical Course and Radiological Findings

    PubMed Central

    Babi, Mohamed-Ali; Pendlebury, William; Braff, Steven; Waheed, Waqar

    2015-01-01

    We describe a case with a false-negative PCR-based analysis for JC virus in cerebrospinal fluid (CSF) in a patient with clinical and radiological findings suggestive of progressive multifocal leukoencephalopathy (PML) who was on chronic immunosuppressive therapy for rheumatoid arthritis. Our patient developed rapidly progressive global decline with clinical and radiographic findings suggestive of PML, but JC virus PCR in CSF was negative. The patient passed away 3 months from the onset of her neurological symptoms. Autopsy confirmed the diagnosis of PML with presence of JC-polyoma virus by immunohistochemical staining. This case highlights the potential of false-negative JC virus PCR in CSF when radiographic and clinical features are suggestive of “possible PML.” We review the plausible causes of potential false-negative CSF results and suggest that when the clinical presentation is suspicious for PML repeat CSF analysis utilizing ultrasensitive PCR assay and subsequent brain biopsy should be considered if CSF remains negative. Additionally, appropriate exclusion of other neurologic conditions is essential. PMID:25861493

  14. Active Case Finding of Pulmonary Tuberculosis through Screening of Respiratory Symptomatics Using Sputum Microscopy: Is It Time to Change the Paradigm?

    PubMed Central

    del Portillo-Mustieles, Eva Carolina; Laniado-Laborín, Rafael

    2013-01-01

    Background. One of the main strategies for the early detection of pulmonary tuberculosis (PTB) is through the screening of individuals with symptoms compatible with PTB. Although this is programmatic strategy for active case finding, its yield is not well known. Objective. To determine the yield of pulmonary tuberculosis active case finding through the screening of respiratory symptomatic (RS) patients at a general hospital. Methods. RS patients were defined as subjects complaining of cough and/or sputum for a period of 2 or more weeks. Outpatients and their companions were approached while they waited in the outpatient care areas of the hospital to detect RS. Two samples from different days or 2 samples taken 2 hours apart on the same day were collected. Results. 122 RS patients were identified. Fifty-seven patients (46.7%) had at least one sputum sample analyzed. Three patients presented a positive smear and 2 were culture positive; neither had upper airway symptoms. None of the patients with productive cough and upper airway symptoms had a positive smear (P = 0.07). Only 19 (33.3%) returned to the laboratory to retrieve their results. Conclusion. Current strategy to screen RS patients based only on clinical data has a low compliance. Specific strategies to increase compliance (removal of barriers, incentives, etc.) should be implemented. PMID:23533747

  15. Clinicopathologic, Immunohistochemical, and Ultrastructural Findings of a Fatal Case of Middle East Respiratory Syndrome Coronavirus Infection in the United Arab Emirates, April 2014.

    PubMed

    Ng, Dianna L; Al Hosani, Farida; Keating, M Kelly; Gerber, Susan I; Jones, Tara L; Metcalfe, Maureen G; Tong, Suxiang; Tao, Ying; Alami, Negar N; Haynes, Lia M; Mutei, Mowafaq Ali; Abdel-Wareth, Laila; Uyeki, Timothy M; Swerdlow, David L; Barakat, Maha; Zaki, Sherif R

    2016-03-01

    Middle East respiratory syndrome coronavirus (MERS-CoV) infection causes an acute respiratory illness and is associated with a high case fatality rate; however, the pathogenesis of severe and fatal MERS-CoV infection is unknown. We describe the histopathologic, immunohistochemical, and ultrastructural findings from the first autopsy performed on a fatal case of MERS-CoV in the world, which was related to a hospital outbreak in the United Arab Emirates in April 2014. The main histopathologic finding in the lungs was diffuse alveolar damage. Evidence of chronic disease, including severe peripheral vascular disease, patchy cardiac fibrosis, and hepatic steatosis, was noted in the other organs. Double staining immunoassays that used anti-MERS-CoV antibodies paired with immunohistochemistry for cytokeratin and surfactant identified pneumocytes and epithelial syncytial cells as important targets of MERS-CoV antigen; double immunostaining with dipeptidyl peptidase 4 showed colocalization in scattered pneumocytes and syncytial cells. No evidence of extrapulmonary MERS-CoV antigens were detected, including the kidney. These results provide critical insights into the pathogenesis of MERS-CoV in humans.

  16. Clinicopathologic, Immunohistochemical, and Ultrastructural Findings of a Fatal Case of Middle East Respiratory Syndrome Coronavirus Infection in the United Arab Emirates, April 2014.

    PubMed

    Ng, Dianna L; Al Hosani, Farida; Keating, M Kelly; Gerber, Susan I; Jones, Tara L; Metcalfe, Maureen G; Tong, Suxiang; Tao, Ying; Alami, Negar N; Haynes, Lia M; Mutei, Mowafaq Ali; Abdel-Wareth, Laila; Uyeki, Timothy M; Swerdlow, David L; Barakat, Maha; Zaki, Sherif R

    2016-03-01

    Middle East respiratory syndrome coronavirus (MERS-CoV) infection causes an acute respiratory illness and is associated with a high case fatality rate; however, the pathogenesis of severe and fatal MERS-CoV infection is unknown. We describe the histopathologic, immunohistochemical, and ultrastructural findings from the first autopsy performed on a fatal case of MERS-CoV in the world, which was related to a hospital outbreak in the United Arab Emirates in April 2014. The main histopathologic finding in the lungs was diffuse alveolar damage. Evidence of chronic disease, including severe peripheral vascular disease, patchy cardiac fibrosis, and hepatic steatosis, was noted in the other organs. Double staining immunoassays that used anti-MERS-CoV antibodies paired with immunohistochemistry for cytokeratin and surfactant identified pneumocytes and epithelial syncytial cells as important targets of MERS-CoV antigen; double immunostaining with dipeptidyl peptidase 4 showed colocalization in scattered pneumocytes and syncytial cells. No evidence of extrapulmonary MERS-CoV antigens were detected, including the kidney. These results provide critical insights into the pathogenesis of MERS-CoV in humans. PMID:26857507

  17. Rock Finding

    ERIC Educational Resources Information Center

    Rommel-Esham, Katie; Constable, Susan D.

    2006-01-01

    In this article, the authors discuss a literature-based activity that helps students discover the importance of making detailed observations. In an inspiring children's classic book, "Everybody Needs a Rock" by Byrd Baylor (1974), the author invites readers to go "rock finding," laying out 10 rules for finding a "perfect" rock. In this way, the…

  18. "Finding a way out": Case histories of mental health care-seeking and recovery among long-term internally displaced persons in Georgia.

    PubMed

    Singh, Namrita S; Jakhaia, Nino; Amonashvili, Nino; Winch, Peter J

    2016-04-01

    Trajectories of illness and recovery are ongoing and incomplete processes cocreated by individuals, their informal support networks, formal care-givers and treatment contexts, and broader social systems. This analysis presents two case histories of care-seeking for, and recovery from, mental illness and psychosocial problems in the context of protracted internal displacement. These case histories present individuals with experiences of schizophrenia and depression drawn from a sample of adult long-term internally displaced persons (IDPs) in Georgia, a country in the South Caucasus. Dimensions of care-seeking were compiled into a matrix for analysis. Interviews were open coded, and codes were linked with matrix dimensions to construct each case history. Findings illustrated that individuals moved cyclically among self-care, household support, lay care, and formal services domains to understand and manage their problems. Living with mental illness and within displacement are experiences that intersect at various points, including in the recognition and perceived causes of illness, stressors such as discrimination and isolation, the affordability and availability of services, and the capacity of social networks to provide informal care. Interventions are needed to support informal care-givers and build lay referral networks, as well as to identify intervention points within care-seeking processes. Interventions that target the mental health needs of displaced persons have the potential to contribute to the development of an innovative community mental health care system in Georgia. PMID:26698164

  19. Sequential Evaluation of Pancreato-Biliary Findings in a Case with IgG4-Associated Cholangiopathy and Autoimmune Pancreatitis during Corticosteroid Treatment

    PubMed Central

    Şerifoğlu, İsmail; Öz, İbrahim İlker; Üstündağ, Yücel; İlikhan, Sevil Uygun; Tokgöz, Özlem

    2016-01-01

    Background: Immunoglobulin G4 (IgG4)-associated diseases mostly involve the pancreaticobiliary tree and pancreatic parenchyma. This disease complex is characterized by marked response to corticosteroid therapy and response to steroids is incorporated in the diagnostic algorithm of IgG4 associated diseases. However, there is much unknown about the sequences and duration of healing during the corticosteroid therapy in the literature. Case Report: In this case report, we report a young male patient with IgG4 associated extrahepatic biliary stricture and autoimmune pancreatitis successfully treated with corticosteroids. Recovery in the laboratory and radiological findings seemed to correlate well with the decrease in serum IgG4 levels in this patient. We also discussed sequences and the duration of healing in the pancreaticobiliary tree and pancreatic parenchymal manifestations in this case report. Conclusion: There is a gap in our knowledge about the evaluation of response criteria after steroid trial with regard to the duration and sequences of healing in the pancreaticobiliary involvement in diagnosing IgG4-related biliary and pancreatic diseases. PMID:27606144

  20. Propylthiouracil-Induced Vasculitis With Alveolar Hemorrhage Confirmed by Clinical, Laboratory, Computed Tomography, and Bronchoscopy Findings: A Case Report and Literature Review

    PubMed Central

    Chen, Bo; Yang, Xiaoqing; Sun, Shihai; Guo, Weina; Li, Xiaosheng; Zhang, Lei; Guo, Zhongliang; Han, Jie; Li, Ning

    2016-01-01

    Introduction Propylthiouracil (PTU) is commonly used to treat hyperthyroidism and can induce antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Although this is a rare side effect, ANCA-associated vasculitis can progress to severe disease if its diagnosis and treatment are delayed, leading to a poor prognosis. Case Presentation A 43-year-old woman with Graves’ disease developed pulmonary vasculitis and diffuse alveolar hemorrhage (DAH) associated with ANCA against myeloperoxidase and proteinase-3 that was confirmed by computed tomography (CT) and bronchoscopy and treated with PTU. The symptoms and signs of alveolar hemorrhage were rapidly resolved after PTU withdrawal and treatment with corticosteroids. After 6 months of follow-up, the patient maintained complete ANCA-negative clinical remission status, as confirmed by normal CT and bronchoscopy findings. To our knowledge, this is the first documented case of bronchoscopic comparison of PTU-induced DAH before and after steroid treatment. Conclusions Patients treated with PTU should be closely monitored and followed up, even if the drug has been used for several years. When patients develop progressive dyspnea with alveolar opacities on chest imaging that cannot be explained otherwise, alveolar hemorrhage should be an important differential diagnosis while investigating the case. Early diagnosis and prompt discontinuation of the PTU treatment are essential for improving patient outcomes. PMID:27257510