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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. 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.

  5. Yield of HIV-associated tuberculosis during intensified case finding in resource-limited settings: a systematic review and meta-analysis

    PubMed Central

    Kranzer, Katharina; Houben, Rein MGJ; Glynn, Judith R; Bekker, Linda-Gail; Wood, Robin; Lawn, Stephen D

    2010-01-01

    Summary Intensified case finding is the regular screening for evidence of tuberculosis in people infected with HIV, at high risk of HIV, or living in congregate settings. We systematically reviewed studies of intensified case finding published between January, 1994, and April, 2009. In 78 eligible studies, the number of people with tuberculosis detected during intensified case finding varied substantially between countries and target groups of patients. Median prevalence of newly diagnosed tuberculosis was 0·7% in population-based surveys, 2·2% in contact-tracing studies, 2·3% in mines, 2·3% in programmes preventing mother-to-child transmission of HIV, 2·5% in prisons, 8·2% in medical and antiretroviral treatment clinics, and 8·5% in voluntary counselling and testing services. Metaregression analysis of studies that included only people with HIV showed that for each increment in national prevalence of tuberculosis of 100 cases per 100 000 population, intensified case finding identified an additional one case per 100 screened individuals (p=0·03). Microbiological sputum examination of all individuals without prior selection by symptom screening yielded an additional four cases per 100 individuals screened (p=0·05). Data on the use of serial screening, treatment outcomes in actively identified cases of tuberculosis, and cost-effectiveness, however, were lacking. Concerted action is needed to develop intensified case finding as an important method for control of tuberculosis. PMID:20113978

  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. The Diagnostic Performance of a Single GeneXpert MTB/RIF Assay in an Intensified Tuberculosis Case Finding Survey among HIV-Infected Prisoners in Malaysia

    PubMed Central

    Al-Darraji, Haider Abdulrazzaq Abed; Razak, Humaira Abd; Ng, Kee Peng; Altice, Frederick L.; Kamarulzaman, Adeeba

    2013-01-01

    Background Delays in tuberculosis (TB) diagnosis, particularly in prisons, is associated with detrimental outcomes. The new GeneXpert MTB/RIF assay (Xpert) offers accurate and rapid diagnosis of active TB, but its performance in improving case detection in high-transmission congregate settings has yet to be evaluated. We assessed the diagnostic accuracy of a single Xpert assay in an intensified case finding survey among HIV-infected prisoners in Malaysia. Methods HIV-infected prisoners at a single site provided two early-morning sputum specimens to be examined using fluorescence smear microscopy, BACTEC MGIT 960 liquid culture and a single Xpert. The sensitivity, specificity, negative and positive predictive values of Xpert were calculated relative to gold-standard results using MGIT 960 liquid culture. Relevant clinical and demographic data were used to examine correlates of active TB disease. Results The majority of enrolled subjects with complete data (N=125) were men (90.4%), age <40 years (61.6%) and had injected drugs (75.2%). Median CD4 lymphocyte count was 337 cells/µL (IQR 149-492); only 19 (15.2%) were receiving antiretroviral therapy. Of 15 culture-positive TB cases, single Xpert assay accurately detected only eight previously undiagnosed TB cases, resulting in a sensitivity, specificity, positive predictive value and negative predictive value of 53.3% (95% CI 30.12-75.2%), 100% (95% CI 96.6-100%), 100% (95% CI 67.56-100%) and 94.0% (95% CI 88.2-97.1%), respectively. Only 1 of 15 (6.7%) active TB cases was smear-positive. The prevalence (12%) of undiagnosed active pulmonary TB (15 of 125 prisoners) was high and associated with longer duration of drug use (AOR 1.14, 95% CI 1.03-1.26, for each year of drug use). Conclusions Single Xpert assay improved TB case detection and outperformed AFB smear microscopy, but yielded low screening sensitivity. Further examination of the impact of HIV infection on the diagnostic performance of the new assay alongside

  9. Intensified tuberculosis case finding, implementation of isoniazid preventive therapy and associated factors among people living with human immunodeficiency virus at public health facilities of Harari Region, Eastern Ethiopia: A cross-sectional study

    PubMed Central

    Geleto, Ayele; Abate, Degu; Egata, Gudina

    2017-01-01

    Objective: Globally, the number of people living with human immunodeficiency virus (PLHIV) particularly in sub-Saharan Africa is growing. This has been resulted in increased number of tuberculosis (TB) new cases. To control burden of TB among PLHIV, a number of collaborative TB/HIV activities were recommended. However, data about collaborative TB/HIV services in the study area is scarce. The objective of this study is to assess intensified TB case finding, implementation of isoniazid preventive therapy (IPT) and associated factors among PLHIV. Methods: A facility based cross-sectional study design was employed among 419 randomly selected PLHIV from public health facilities of Harari region. Systematic sampling method was used to obtain sample from each health facilities. Interviewer-administered questionnaire was used to collect data. Data were entered into EpiData and analyzed by SPSS statistical software. Multivariate logistic regression analysis was conducted to determine the presence of association between variables using odds ratio with 95% confidence interval and association was declared significant at P ≤ 0.05. Results: One hundred fifteen (75.2%) of the respondents reported that they offered screening for TB during their HIV chronic cares and 94 (29.8%) of them were found to be positive for active TB. Female sex [AOR 2.51; 95%CI (1.52, 6.14)], educated patients [AOR 0.52; 95%CI (0.21, 0.83)], CD4 count greater than 350 cells/dl3 [AOR 0.62; 95%CI(0.22,0.82)], Antiretroviral Therapy (ART) initiation [AOR 0.50; 95%CI (0.35, 0.88)] and missing dose of ART [AOR 2.57; 95%CI (1.21, 5.32)] were significantly associated with TB infection. Nearly four-fifth (78.7 %) of the study participants were provided IPT. Conclusions: Screening of TB among PLHIV and implementation of IPT in the region is lower when compared to the findings of other studies conducted in different parts of the country and needs to be improved through implementation of national and international

  10. Generalization of Findings From Single Case Studies.

    ERIC Educational Resources Information Center

    Kennedy, Mary M.

    Although single case studies might be useful to evaluators for a variety of purposes, there are no generally accepted ways for drawing inferences about the generality of findings from a case study. Single case studies are defined in this paper as either studies of single events, or disaggregated studies of multiple events. The data may be…

  11. FOC/48 Intensifier HV Tests

    NASA Astrophysics Data System (ADS)

    Miebach, Manfred

    1991-07-01

    This is an FOC engineering needed to verify a new HV transition command sequence after the failure of the Intensifier HV Power Supply and tube. SCHEDULING REQUIREMENTS: A time window of 300 min after the transistion to HV must be scheduled providing opportunities to use generic uplinks to execute PSTOL in case the IEHT HV will not come or stay up.

  12. 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

  13. Imagery intensifier for recce

    NASA Astrophysics Data System (ADS)

    Sturz, Richard A.

    1998-11-01

    The image intensifier based night vision goggle which has proven so useful in low light or night observation applications, can be mated to the typical CD video camera for imaging under these adverse lighting conditions. Image intensifiers have specific spectral response, low light sensitivity, resolution, and electronic characteristics to augment standard CCD camera capability and thus provide video suited for reconnaissance. The variety of these devices include the Gen I, Gen II and the Gen II series of image intensifiers. Recent developments have increased the variety of spectral response, quantum efficiencies and spatial resolution within the Gen II and Gen III types. The SPIE Airborne Reconnaissance session paper presented in 1995 entitled 'Advanced in Low Light Level Video Imaging' described the then available image intensifiers. This paper explores and updates the data of the 1995 paper and discusses the changes and improvements in image intensifiers since the original paper. Additional information concerning the CCD camera and image intensification for reconnaissance applications is also presented.

  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. Magnifying image intensifier

    NASA Technical Reports Server (NTRS)

    Vine, J. (Inventor)

    1978-01-01

    A magnetically focused image intensifier was improved to increase the usable range of magnification without degradation of image quality. The power requirements of the focusing coils are minimal. The arrangement of the focusing coils reverses the direction of the axial magnetic field distribution between the planes of the photocathode and the phosphor screen.

  16. Reporting a Case of Injecting Methylphenidate (Ritalin) Tablets, Intensified Symptoms of Schizoph-renia or Induce Separate Mental Disorder?

    PubMed Central

    Ghaffarinejad, Alireza; Kheradmand, Ali

    2009-01-01

    Background: Methylphenidate is one of the classic amphetamines which can cause or exacerbate psychotic symptoms in schizophrenia patients. Case Report: In this paper, a young man is presented with injection of methylphenidate tablets with acute cellulitis due to this injection and the related symptoms. In the first hospitalization and after recovery from psychotic disorder due to tablet injections, he was under treatment with anti-psychotics because of other symptoms related to schizophrenia. Although the patient was regularly under schizophrenic medication after discharge, he was hospitalized twice more due to psychotic symptoms that appeared after injecting methylphenidate. Conclusion: This report shows psychotic symptoms in schizophrenic patients after injecting methylphenidate. These symptoms cannot be prevented even by anti-psychotic medication of background disease. This case shows the existence of two kinds of psychoses, functional (due to schizophrenia) and organic psychoses (due to methylphenidate use) in the same patient. PMID:24494093

  17. Identifying dynamic tuberculosis case-finding policies for HIV/TB coepidemics.

    PubMed

    Yaesoubi, Reza; Cohen, Ted

    2013-06-04

    The global tuberculosis (TB) control plan has historically emphasized passive case finding (PCF) as the most practical approach for identifying TB suspects in high burden settings. The success of this approach in controlling TB depends on infectious individuals recognizing their symptoms and voluntarily seeking diagnosis rapidly enough to reduce onward transmission. It now appears, at least in some settings, that more intensified case-finding (ICF) approaches may be needed to control TB transmission; these more aggressive approaches for detecting as-yet undiagnosed cases obviously require additional resources to implement. Given that TB control programs are resource constrained and that the incremental yield of ICF is expected to wane over time as the pool of undiagnosed cases is depleted, a tool that can help policymakers to identify when to implement or suspend an ICF intervention would be valuable. In this article, we propose dynamic case-finding policies that allow policymakers to use existing observations about the epidemic and resource availability to determine when to switch between PCF and ICF to efficiently use resources to optimize population health. Using mathematical models of TB/HIV coepidemics, we show that dynamic policies strictly dominate static policies that prespecify a frequency and duration of rounds of ICF. We also find that the use of a diagnostic tool with better sensitivity for detecting smear-negative cases (e.g., Xpert MTB/RIF) further improves the incremental benefit of these dynamic case-finding policies.

  18. Pulmonary talcosis: CT findings in three cases.

    PubMed

    Padley, S P; Adler, B D; Staples, C A; Miller, R R; Müller, N L

    1993-01-01

    The authors describe the computed tomographic (CT) appearances in three patients with pulmonary talcosis resulting from chronic intravenous drug abuse. There was widespread ground-glass attenuation in one case and an appearance similar to that of progressive massive fibrosis in two cases. In the latter cases, there were confluent perihilar masses with areas of high attenuation. While the CT appearances may be suggestive of pulmonary talcosis, tissue sampling is required for definitive diagnosis.

  19. Atmospheric Storm Triggered and Intensified by Geodynamics: Case Studies from Andaman Sea and Bay of Bengal Region in the Indian Ocean

    NASA Astrophysics Data System (ADS)

    Akilan, A.; Azeez, K. K. Abdul; Schuh, H.

    2017-03-01

    The study analyses the possible connection between the onset of cyclone and volcano-tectonic seismicity in the Andaman region. The historical data of the major volcanic, seismic, and atmospheric events from the region show that several of the geodynamic activities were followed by severe atmospheric disturbances over the region. In this study, we consider the case of three recent cyclones (Phailin, Hudhud, and Nilam) that either originated or were intensified over the Andaman Sea and Bay of Bengal, and examine their correlation with the volcano-tectonic seismic events during the cyclone occurrence. The zenith total delay (ZTD) time series, derived from Global Positioning System data from the PBR2 station on Andaman Island, overlapping with the period of the cyclone occurrence were examined to distinguish the onset and intensification of the atmospheric events. The comparison of the sharp changes in ZTD associated with the cyclone and the seismic events during the period indicates that the atmospheric changes almost coincide or follow the geodynamic activity. Our study illustrates that volcano-tectonics of the region plays a role in the triggering of atmospheric disturbances.

  20. Cytogenetics Findings in a Histiocytic Sarcoma Case

    PubMed Central

    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

  1. Two Cases of Melasma with Unusual Histopathologic Findings

    PubMed Central

    Kang, Won-Hyoung

    2006-01-01

    We reported two cases of clinically typical melasma presenting with unusual histopathologic findings. In one case, the epidermal melanocytes were markedly increased in number and protruded into the dermis, and in the other case, increased epidermal pigmentation as well as dermal melanocytosis were found. We suggested that the various treatment modalities of melasma should be applied depend on its histopathologic finding. PMID:16614533

  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. [Two cases of herpes encephalitis with normal cerebrospinal fluid findings].

    PubMed

    Avkan Oğuz, Vildan; Yapar, Nur; Sezak, Nurbanu; Alp Cavuş, Sema; Kuruüzüm, Ziya; Sayiner, Arzu; Ada, Emel; Cakir, Nedim; Yüce, Ayşe

    2006-01-01

    In this report, characteristics of two cases of Herpes simplex virus (HSV) encephalitis with normal cerebrospinal fluid (CSF) findings at the time of admission have been discussed and the current literature has been reviewed. The diagnosis of the cases (one was 23 years old male, and the other was 75 years old female patient) was made on the magnetic resonance imaging (MRI) findings concordant with HSV encephalitis, together with HSV-1 DNA positivity by polymerase chain reaction (PCR). Both of the patients were treated with acyclovir (3 x 750 mg/day) lasting for 15 days and 21 days, respectively. The first male patient recovered with mild neurological defects, whereas the second female patient died because of nosocomial pneumonia and septicemia. In conclusion, even the CSF findings are normal, in cases considered to be HSV encephalitis, MRI should be the first radiological diagnostic step and the diagnosis should be confirmed by the detection of HSV DNA in CSF by PCR.

  5. 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…

  6. Clinical and radiological findings of a bilateral coronoid hyperplasia case

    PubMed Central

    Torenek, Kubra; Duman, Suayip Burak; Bayrakdar, Ibrahim Sevki; Miloglu, Ozkan

    2015-01-01

    Coronoid hyperplasia (CH) is an infrequent condition that can be defined as an abnormal bony elongation of histologically normal bone. Progressive and painless difficulty in opening the mouth is the main clinical finding of CH. In this case report, the clinical and radiological findings for a 23-year-old male patient with bilateral CH are presented. When plain radiographies are not sufficient for diagnosis and evaluation of the CH, cone-beam computed tomography can be used. PMID:25713499

  7. Autoimmune Pancreatitis: A Case of Atypical Radiographic Findings

    PubMed Central

    Karimi, Shawhin; Bharill, Parth

    2016-01-01

    Autoimmune pancreatitis (AIP) is a rare pancreatic disorder that can present as a manifestation of a broader systemic inflammatory disease known as immunoglobulin G4-related systemic disease (IGG4-RSD). AIP is divided into two subtypes based on clinical, radiological, and histological findings. The disease can be mistaken for pancreatic cancer because of overlapping clinical and radiological findings, but early recognition can help avoid unnecessary surgery. We present a case of a 65-year-old female with suspected acute gallstone pancreatitis found to have AIP based on serology, radiological findings, and response to steroids. PMID:27920645

  8. Iniencephaly Clausus: A New Case With Clinical and Imaging Findings

    PubMed Central

    Khatami, Alireza; Hasanzadeh, Mohsen; Norouzi, Hedayat; Esfandiari, Ehasn; Mehrafarin, Mastooreh

    2015-01-01

    Iniencephaly is a rare kind of neural tube defect that is classified into two types of iniencephaly apertus and iniencephaly clausus. This anomaly could be diagnosed prenatally by obstetric ultrasonography and terminated by therapeutic abortion; however, it could be undiagnosed until birth similar to our case due to the abnormal position of the fetus or lack of experience of the sonographer. Due to abnormality of the neural tube, which causes abnormal head and neck position, all these cases will die shortly after birth. We hereby introduce the photos and imaging findings of a case of an alive neonate with iniencephaly clausus. PMID:26528385

  9. Iniencephaly Clausus: A New Case With Clinical and Imaging Findings.

    PubMed

    Khatami, Alireza; Hasanzadeh, Mohsen; Norouzi, Hedayat; Esfandiari, Ehasn; Mehrafarin, Mastooreh

    2015-07-01

    Iniencephaly is a rare kind of neural tube defect that is classified into two types of iniencephaly apertus and iniencephaly clausus. This anomaly could be diagnosed prenatally by obstetric ultrasonography and terminated by therapeutic abortion; however, it could be undiagnosed until birth similar to our case due to the abnormal position of the fetus or lack of experience of the sonographer. Due to abnormality of the neural tube, which causes abnormal head and neck position, all these cases will die shortly after birth. We hereby introduce the photos and imaging findings of a case of an alive neonate with iniencephaly clausus.

  10. 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…

  11. An unusual case of KBG syndrome with unique oral findings.

    PubMed

    Hafiz, Abdul; Mufeed, Abdulla; Ismael, Mohamad; Alam, Mheboob

    2015-07-17

    KBG syndrome is a condition characterised by macrodontia, neurological disturbance, short stature, a distinct cranio-facial appearance, and skeletal anomalies. The authors describe what appears to be the first case of KBG syndrome reported from the Indian subcontinent. Meticulous evaluation of the dental findings helps to identify such cases which may otherwise remain undiagnosed. Further research is warranted to determine the classic and variant presentations of this condition, with follow-up data providing valuable insights into its natural history and long-term prognosis.

  12. Finding meaning in everyday life with dementia: A case study.

    PubMed

    Robertson, Jane M

    2014-07-01

    This paper presents a case study exploring an older woman's perspective on the quality of her life with dementia. The case study establishes the importance of coherence across the life course in understanding how she evaluates her changed situation in the present compared to the past. The metaphoric description of moving from 'up there' to 'down here' represents the perceived struggle to maintain a sense of worth despite a marginalised social position. Being able to define self and social identity in ways that preserve a sense of social status is important to find meaning in everyday life. Finding meaning involves looking backwards to sustain continuity with the past and looking forwards to maintain momentum and keep going. A narrative framework is valuable in showing that quality of life is a dimension of meaning associated with maintaining a sense of social worth.

  13. A new case of Grange syndrome without cardiac findings.

    PubMed

    Wallerstein, Robert; Augustyn, Ann Marie; Wallerstein, Donna; Elton, Leslie; Tejeiro, Beatriz; Johnson, Valerie; Lieberman, Kenneth

    2006-06-15

    Grange syndrome comprises arterial stenoses with hypertension, brachysyndactyly, bone fragility, learning disability, and cardiac defects. To date, we know of two reported families with five affected individuals. We report on one of the youngest cases, in a third family, a 3-year-old girl with brachysyndactyly, renal artery stenosis with hypertension, and bone fragility. She does not have apparent cardiac disease, suggesting cardiac anomalies may not be an obligatory finding in this syndrome.

  14. Laryngeal schwannoma: a case report with emphasis on sonographic findings.

    PubMed

    de Souza, Luis Ronan Marquez Ferreira; De Nicola, Harley; Yamasaki, Rosiane; Pedroso, José Eduardo; do Brasil, Osíris de Oliveira Camponês; Yamashita, Hélio

    2014-01-01

    Schwannomas are benign nerve sheath tumors composed of Schwann cells, which normally produce the insulating myelin sheath covering peripheral, cranial and autonomic nerves. Twenty-five to forty-five percent of all schwannomas occur in the head and neck region, but location of such tumors in the larynx is rarely observed. The present report is aimed at describing a clinical case of laryngeal schwannoma, with emphasis on sonographic findings.

  15. 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

  16. Histopatholological Findings in a Fatal Case of Rinkhals Envenomation: A New Forensic Pathology Finding?

    PubMed

    Moar, Jacob Joseph; Hill, Lawrence; Stewart, Michael

    2016-12-01

    Although cobra envenomation continues to pose a threat to life and therefore constitutes a major cause of death in Africa, India, and Sri Lanka, the forensic pathology reports are not always histologically well documented or illustrated. The reports in the literature, although providing graphic evidence of the macroscopic appearances of the bite and its ensuing tissue necrosis, should the victim survive, often do not illustrate the histopathological findings to a sufficient degree. We present an unusual case of fatal envenomation by a rinkhals (Hemachatus haemachatus) in which the victim had been bitten a second time after a previous rinkhals' bite. Two issues therefore arose: (a) whether the histopathological findings in the spleen were an acute reaction to the snake bite or were due to immunostimulation as a consequence of the previously inflicted bite, and (b) the previously undocumented finding of extravasation of erythrocytes into the surrounding Virchow-Robin spaces in the brain, a finding usually associated with blunt head trauma and therefore interpreted as a cortical contusion hemorrhage by forensic pathologists.

  17. Multidrug-resistant tuberculosis: epidemiology, risk factors and case finding.

    PubMed

    Caminero, J A

    2010-04-01

    Although the multidrug-resistant tuberculosis (MDR-TB) epidemic is a very recent problem, many studies have attempted to understand it. We now have good estimates of the current burden (approximately 500 000 MDR-TB cases worldwide), and following the introduction of potential MDR-TB control strategies projections of these figures are being estimated. The projected trends in tuberculosis (TB) and MDR-TB incidence vary. Risk factors for resistance can be divided into two categories: 1) those facilitating the selection of resistance in the community and 2) the specific conditions that appear to increase some patients' vulnerability to resistance. The epidemiological situation varies greatly across countries, principally due to poor treatment practices and poor implementation of control programmes in the past-and even today, to a lesser degree-and recent data have suggested that national TB programmes that use existing drugs efficiently can postpone and even reverse the MDR-TB epidemic. Other factors that have also contributed to this epidemic situation are analysed in this article. The recognition of factors leading to the epidemic in some regions and the identification of populations at risk will assist in focusing case-finding efforts. From an individual perspective, treatment failures with first-line rifampicin-containing regimens and contacts of MDR-TB cases have the highest rates of resistance. Patients previously treated for TB and the other risk factors analysed in this article should be prioritised in case finding.

  18. Aquagenic syringeal acrokeratoderma: report of a case with histologic findings.

    PubMed

    Baldwin, Brooke T; Prakash, Amy; Fenske, Neil A; Messina, Jane L

    2006-05-01

    Aquagenic syringeal acrokeratoderma is a rare acquired condition characterized by painful symmetric swelling and hypopigmentation of the palms and lateral fingers, which develops after brief exposure to water. Histopathologic examination suggests that an aberration in the eccrine sweat gland apparatus may be the underlying cause of this condition. The "hand-in-the-bucket sign," in which patients arrive in their physician's office with their hand in a bucket of water to more readily demonstrate their lesions, is such a common presentation that it almost can be regarded as pathognomonic. All 12 cases reported to date have been in young females. We report a case of aquagenic syringeal acrokeratoderma in a male with unique histologic findings.

  19. 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.

  20. 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

  1. 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, ...

  2. Bilateral invasive lobular breast cancer in a female teenager: a rare finding of a common disease--case report and review of literature.

    PubMed

    Enownchong, Enow-Orock George; Thomas, Egbe Obinchemti; Akum, Achidi Eric; Defang, Asonganyi Etienne; Paul, Ndom; Emmanuel, Fongang; Peter, Ndumbe

    2010-07-19

    Management of cancer patients in low-resource communities presents enormous challenges. Breast cancer is a public health problem in Cameroon and occurs mostly in elderly women. The predominant histological type is a duct carcinoma. Lobular carcinoma in teenagers is rare. In this report we present a case of bilateral invasive lobular carcinoma of the breast that was confirmed on biopsies in a 22-year-old female. We present this rare finding and review the pathological, clinical and radiographic challenges of the disease. Nodules in the breast from patients of any age should be submitted for histology. Public education is beneficial and should be intensified.

  3. Infantile osteopetrosis: a case report on dental findings.

    PubMed

    Droz-Desprez, D; Azou, C; Bordigoni, P; Bonnaure-Mallet, M

    1992-10-01

    In this paper we have described the case of a 7-yr-old Moroccan osteopetrotic boy, who had received a bone marrow transplant (BMT). He was transplanted from his older brother and, despite immunosuppressive therapy, developed chronic graft-versus-host disease and was placed on corticotherapy. Seven months after the bone marrow transplant, graft versus host disease (GVHD) was stabilized, but corticotherapy had inhibited growth. There was evidence of normalizing bone, his hearing was better but he had not recovered vision. Dental findings before the bone marrow transplant revealed some missing teeth, failure of teeth to erupt and decayed teeth but no enamel hypoplasia. The patient had developed one carious lesion on one unerupted tooth: bacteria seem to have found a way through the gubernaculum dentale. The scanning electronmicrographs showed decayed tooth and tissues fitted into each other. Since the bone marrow transplant, no tooth has erupted. We think that, in this case, failure of tooth eruption would be the sign of osteopetrosis.

  4. On the phonetics of intensifying emphasis in German.

    PubMed

    Niebuhr, Oliver

    2010-01-01

    This paper presents an exploratory study in the field of emphasis in German. It provides a comprehensive acoustic analysis for a type of emphasis that intensifies lexical meanings either positively or negatively. A speech corpus was recorded using an elicitation method adapted to yield natural-sounding, conversational, expressive speech under controlled conditions. Supporting the distinction between positive and negative intensification, two clearly different phonetic profiles emerged. These phonetic profiles of positive and negative intensification involve voice quality as well as the dynamics of the speech signal across its segmental and prosodic layers. By means of these profiles, the intensifying emphases were correctly classified by a discriminant analysis as positive or negative in around 90% of the cases. Moreover, indications were found for a third type of intensifying emphasis, which was called 'reinforcement'. Its multidimensional phonetic profile falls in between the ones of positive and negative intensification.

  5. Fibrodysplasia Ossificans Progressiva - Radiological Findings: A Case Report

    PubMed Central

    Al-Salmi, Ishaq; Raniga, Sameer; Hadidi, Aymen Al

    2014-01-01

    Fibrodysplasia ossificans progressiva formerly known as Myositis ossificans progressiva is a rare hereditary mesodermal disorder. It is characterized by congenital skeletal anomalies and progressive ectopic bone formation in connective tissue, resulting in mature ossification within soft tissues and bridging between osseous structures. It is extremely rare and has an incidence of one in two million people. Usually, it has typical clinical and radiographic features. Here, we present a case of a young patient diagnosed to have an advanced fibrodysplasia ossificans progressiva. Plain radiographs provide characteristic findings, and radiologists may play a major role in diagnosing and preventing invasive procedures or further traumatic insults to the affected patient. Though rare, diagnosis of fibrodysplasia ossificans progressiva should be considered whenever characteristic radiographic features of multifocal heterotopic bone formation is seen along with the valgus deformities of the big toes. Being a rare condition, treatment guidelines are not clear and this condition needs further research. Keywords Myositis ossificans progressiva; Fibrodysplasia ossificans progressiva; Heterotopic ossification; Myositis ossificans. PMID:25337316

  6. Coeliac disease in primary care: case finding study

    PubMed Central

    Hin, Harold; Bird, Graham; Fisher, Peter; Mahy, Nick; Jewell, Derek

    1999-01-01

    Objectives To provide evidence of underdiagnosis of coeliac disease and to describe the main presenting symptoms of coeliac disease in primary care. Design Case finding in a primary care setting by testing for coeliac disease by using the endomysial antibody test. Setting Nine surgeries in and around a market town in central England, serving a population of 70 000. Participants First 1000 patients screened from October 1996 to October 1997. Outcome measures Determination of endomysial antibody titre of patients fulfilling the study criteria, followed by small intestine biopsy of those with positive results. Results The 30 patients (out of 1000 samples) with positive results on the endomysial antibody test all had histological confirmation on small intestine biopsy. The commonest mode of presentation (15/30) was anaemia of varying severity. Most patients (25/30) presented with non-gastrointestinal symptoms. Specificity of the endomysial antibody test was 30/30. Conclusions Underdiagnosis and misdiagnosis of coeliac disease are common in general practice and often result in protracted and unnecessary morbidity. Serological screening in primary care will uncover a large proportion of patients with this condition and should be made widely available and publicised. Coeliac disease should be considered in patients who have anaemia or are tired all the time, especially when there is a family history of the disease. Key messagesGeneral practitioners currently see many people with undiagnosed coeliac diseaseThe most likely presentation is a combination of microcytic anaemia, past or present, a family history of the disease, and feeling tired all the timeEstimations of endomysial antibody and IgA are reliable diagnostic toolsThe prevalence of coeliac disease in Britain is higher than the accepted figure of 1:1000 populationIncreased awareness of the extra intestinal manifestations of coeliac disease, coupled with a low threshold for serological testing, will uncover a

  7. Toxicological findings in cases of sexual assault in the Netherlands.

    PubMed

    Bosman, Ingrid J; Verschraagen, Miranda; Lusthof, Klaas J

    2011-11-01

    Reports on cases of alleged drug-facilitated sexual assault (DFSA) have increased since the mid-1990s. The aim of this study was to identify the extent and types of drugs found in cases of alleged sexual assault (DFSA) in the Netherlands. In total, 135 cases of alleged DFSA were identified. Most of the victims were women (94%), and the mean age of the victims was 25 years. Blood and urine samples were tested for the presence of alcohol, drugs (drugs of abuse and prescription drugs), or both. In 27% of the cases, no alcohol and/or drugs were found. With increasing time delay, more cases were found to be negative. Alcohol is the most commonly found drug followed by nonopiate analgesics, illicit drugs, and benzodiazepines. In some cases, the absence of alcohol and drugs may represent false-negative results owing to the time delay between alleged sexual assault and sampling.

  8. Southwest Research Institute intensified detector development capability

    NASA Astrophysics Data System (ADS)

    Wilkinson, Erik; Vincent, Michael; Kofoed, Christopher; Andrews, John; Brownsberger, Judith; Siegmund, Oswald

    2012-09-01

    Imaging detectors for wavelengths between 10 nm and 105 nm generally rely on microchannel plates (MCPs) to provide photon detection (via the photo-electric effect) and charge amplification. This is because silicon-based detectors (CCD or APS) have near zero quantum detection efficiency (QDE) over this wavelength regime. Combining a MCP based intensifier tube with a silicon detector creates a detector system that can be tuned to the wavelength regime of interest for a variety of applications. Intensified detectors are used in a variety of scientific (e.g. Solar Physics) and commercial applications (spectroscopic test instrumentation, night vision goggles, low intensity cameras, etc.). Building an intensified detector requires the mastery of a variety of technologies involved in integrating and testing of these detector systems. We report on an internally funded development program within the Southwest Research Institute to architect, design, integrate, and test intensified imaging detectors for space-based applications. Through a rigorous hardware program the effort is developing and maturing the technologies necessary to build and test a large format (2k × 2k) UV intensified CCD detector. The intensified CCD is designed around a commercially available CCD that is optically coupled to a UV Intensifier Tube from Sensor Sciences, LLC. The program aims to demonstrate, through hardware validation, the ability to architect and execute the integration steps necessary to produce detector systems suitable for space-based applications.

  9. 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'…

  10. 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.

  11. 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

  12. The KBG syndrome, characteristic dental findings: a case report.

    PubMed

    Dowling, P A; Fleming, P; Gorlin, R J; King, M; Nevin, N C; McEntagart, M

    2001-03-01

    Short stature and developmental delay may be observed in many genetic conditions and well-defined syndromes. A 7-year-old girl presented with the non-specific findings of subtle dysmorphism, short stature and developmental delay. Although a genetic syndrome was suspected, a definitive diagnosis was not made until the dental findings of KBG syndrome were recognised, namely grossly enlarged maxillary permanent central incisors and hypodontia.

  13. Medico-Legal Findings, Legal Case Progression, and Outcomes in South African Rape Cases: Retrospective Review

    PubMed Central

    Jewkes, Rachel; Christofides, Nicola; Vetten, Lisa; Jina, Ruxana; Sigsworth, Romi; Loots, Lizle

    2009-01-01

    Background Health services for victims of rape are recognised as a particularly neglected area of the health sector internationally. Efforts to strengthen these services need to be guided by clinical research. Expert medical evidence is widely used in rape cases, but its contribution to the progress of legal cases is unclear. Only three studies have found an association between documented bodily injuries and convictions in rape cases. This article aims to describe the processing of rape cases by South African police and courts, and the association between documented injuries and DNA and case progression through the criminal justice system. Methods and Findings We analysed a provincially representative sample of 2,068 attempted and completed rape cases reported to 70 randomly selected Gauteng province police stations in 2003. Data sheets were completed from the police dockets and available medical examination forms were copied. 1,547 cases of rape had medical examinations and available forms and were analysed, which was at least 85% of the proportion of the sample having a medical examination. We present logistic regression models of the association between whether a trial started and whether the accused was found guilty and the medico-legal findings for adult and child rapes. Half the suspects were arrested (n = 771), 14% (209) of cases went to trial, and in 3% (31) of adults and 7% (44) of children there was a conviction. A report on DNA was available in 1.4% (22) of cases, but the presence or absence of injuries were documented in all cases. Documented injuries were not associated with arrest, but they were associated with children's cases (but not adult's) going to trial (adjusted odds ratio [AOR] for having genital and nongenital injuries 5.83, 95% confidence interval [CI] 1.87–18.13, p = 0.003). In adult cases a conviction was more likely if there were documented injuries, whether nongenital injuries alone AOR 6.25 (95% CI 1.14–34.3, p = 0

  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. [Intensified insulin treatment is cost-effective].

    PubMed

    Reichard, P; Alm, C; Andersson, E; Wärn, I; Rosenqvist, U

    1999-01-20

    Both the Diabetes Control and Complications Trial (DCCT) in USA/Canada, and Stockholm Diabetes Intervention Study (SDIS) showed intensified insulin treatment and reduced glycaemia to prevent complications in patients with insulin-dependent (type I) diabetes mellitus. In the DCCT, the intensified treatment was considered cost-effective. In the SDIS, investigation of the direct increase in costs due to the intensified insulin treatment showed the saving in direct costs due to the reduction in photocoagulation requirements, and in the prevalence of renal insufficiency and of amputation, to correspond to 10 years' intensive insulin treatment. Thus, as intensified insulin treatment in type I diabetes reduces direct suffering at a low cost, it may be regarded as 'evidence-based' and mandatory.

  16. Tuberculous sacro-ileitis: two cases and radiological findings.

    PubMed

    Sirmatel, Ocal; Yazgan, Pelin; Gursoy, Bensu; Sirmatel, Fatma; Zeyrek, Fadile Yildiz; Ozturk, Adil

    2007-06-01

    Infective sacro-ileitis is due to common bacteria, 25% being tuberculosis and 10% brucellosis. Slow progression characterizes joint tuberculosis, an uncommon variant of this disease. The onset is usually insidious, and early diagnosis requires a high index of clinical suspicion. We report two cases with tuberculous sacro-ileitis which initially mimicked brucellosis infiltration. Diagnosis of tuberculosis of the sacroiliac joint was established by fine-needle aspiration of joint and radiological imaging methods such as computerized tomography, magnetic resonance and three-phase bone scan. The current diagnosis and treatment of this condition is discussed based on these cases and a literature review.

  17. Case Studies in Science Education, Booklet XIII: Findings II.

    ERIC Educational Resources Information Center

    Illinois Univ., Urbana. Center for Instructional Research and Curriculum Evaluation.

    This booklet is the fourteenth of a series of 16 booklets that together describe and present findings for a study which involved field observations and a survey of science teaching and learning in American public schools during the school year 1976-77. The study was undertaken to provide the National Science Foundation with a portrayal of current…

  18. Case Studies in Science Education, Booklet XIV: Survey Findings.

    ERIC Educational Resources Information Center

    Illinois Univ., Urbana. Center for Instructional Research and Curriculum Evaluation.

    This booklet is the fifteenth of a series of 16 booklets that together describe and present findings for a study which involved field observations and a survey of science teaching and learning in American public schools during the school year 1976-77. The study was undertaken to provide the National Science Foundation with a portrayal of current…

  19. Ischiogluteal bursitis: a report of three cases with MR findings.

    PubMed

    Hitora, Toshiaki; Kawaguchi, Yoji; Mori, Masaki; Imaizumi, Yasuhiko; Akisue, Toshihiro; Sasaki, Kanji; Yamada, Eiji; Yamamoto, Tetsuji

    2009-02-01

    Ischiogluteal bursitis is an uncommon disorder which can be confused with neoplastic conditions in the buttock. Three cases of ischiogluteal bursitis in a 57-year-old man, a 73-year-old woman and a 73-year-old man are presented. All patients presented with a gradually increasing, painful buttock mass. Magnetic resonance imaging (MRI) revealed a soft tissue mass around the ischial tuberosity and showed various features in the three cases. Two patients underwent excision of the lesion, which was histologically diagnosed as ischiogluteal bursitis. One patient was conservatively treated and the symptoms gradually decreased. MRI was very useful in diagnosing and detecting the lesion. Ischiogluteal bursitis should be considered in the differential diagnosis of a buttock mass.

  20. Cheilitis glandularis: Case report with respect to immunohistochemical findings.

    PubMed

    Friedrich, Reinhard E; Löning, Thomas

    2016-01-01

    Cheilitis glandularis (CG) is a rare benign affection of the lip mucosa. The etiology and pathogenesis of CG are unknown. Surgical measures are the leading therapeutic options to treat CG. This case report on a 55-year-old female illustrates the recurrent affection of the lips over several years and local therapy. Furthermore, the study of the resected glands intends to differentiate the lesions with respect to the recently introduced concept of immunoglobulin G4-related diseases.

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

    PubMed Central

    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

  2. Case Report: Incidental Finding of a Giant Cardiac Mass

    PubMed Central

    2014-01-01

    Coronary artery fistula (CAF) is a rare anomalous connection between a coronary artery and another coronary artery, major vessel, or cardiac chamber. Prevalence of CAF is reportedly 1% to 2% in patients who undergo coronary angiography.1 One of the most common complications of CAF is formation of a coronary artery aneurysm (CAA). A study conducted by Said and colleagues in 1995 found that CAA formation was present in 26% of patients who had proven CAF by way of angiography.2 Although a precise definition of the term “giant” CAA is still lacking, it generally refers to a dilatation that exceeds the reference vessel diameter by four times.3 We report an interesting case of a 38-year-old patient who was incidentally found to have a presumed large right ventricular aneurysm, which after an open-heart surgery was identified as a CAF with formation of an unruptured giant CAA. PMID:25114764

  3. Doppler findings in chronic ectopic pregnancy: case report.

    PubMed

    Abramov, Y; Nadjari, M; Shushan, A; Prus, D; Anteby, S O

    1997-05-01

    Chronic ectopic pregnancy is an uncommon form of tubal pregnancy manifested as a pelvic mass with minimal symptoms and a low or absent titer of human chorionic gonadotropin. For this reason, most of the reported cases have been diagnosed only after explorative laparotomy. The value of Doppler ultrasonography for preoperative diagnosis of this entity has not yet been established. We report on a 36-year-old patient who was admitted for intermittent right lower quadrant abdominal pain of 3 months' duration, and a right adnexal mass found on pelvic examination. On Doppler ultrasonography, a right complex adnexal mass was demonstrated, characterized by extensive external vascularization, aberrant vessels and arteriovenous shunting, but with no internal blood flow. Explorative laparotomy revealed a right tubal mass adherent to the omentum, and covered by numerous enlarged and tortuous blood vessels originating in the omentum. Pathological examination of the mass revealed a chronic ectopic pregnancy. The possible contribution of Doppler-specific characteristics for the diagnosis of chronic ectopic pregnancy is described and discussed.

  4. Leber's congenital amaurosis. Retrospective review of 43 cases and a new fundus finding in two cases.

    PubMed

    Schroeder, R; Mets, M B; Maumenee, I H

    1987-03-01

    Leber's congenital amaurosis is a hereditary clinical disorder that may be associated with several different diseases. This study consists of a retrospective review of 43 cases. Twenty of our patients had fundus appearances that resembled retinitis pigmentosa. Five had normal-appearing fundi. The remainder had other, previously reported fundus abnormalities, with the exception of two patients who demonstrated a new fundus finding, a nummular pigmentary pattern. Other associated eye anomalies included cataracts, keratoconus, ptosis, and strabismus. The most frequent systemic associations were mental retardation, cystic renal disease, skeletal disorders, and hydrocephalus.

  5. 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...

  6. A vortex flow intensified by thermal convection

    NASA Astrophysics Data System (ADS)

    Makhmalbaf, M. H.; Liu, Tianshu; Merati, Parviz

    2017-01-01

    This paper describes a thermal-convection-intensified vortex flow within a rotating cylinder with a counter-rotating heated disk located below. This flow tends to mimic certain aspects of the intriguing flow structure of the great red spot in Jupiter by using a simple laboratory setup. Particle image velocimetry measurements reveal the counter-rotating torus vortices in the lower and upper domains and the complex mixing-layer features in the transitional domain between them. In particular, it is found that the vortex structures are significantly intensified by the thermal convection from the heated disk.

  7. 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

  8. 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 required. 890.1039 Section 890.1039 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED... Imposed Against Health Care Providers Suspension § 890.1039 Cases where additional fact-finding...

  9. 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 not required. 890.1037 Section 890.1037 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... Sanctions Imposed Against Health Care Providers Suspension § 890.1037 Cases where additional fact-finding...

  10. 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...

  11. 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...

  12. Case report. Isolated left ventricular myocardium non-compaction: MR imaging findings from three cases.

    PubMed

    Junqueira, F P; Fernandes, F D B; Coutinho, A C; De Pontes, P V; Domingues, R C

    2009-02-01

    The purpose of this study is to report three cases of left ventricular myocardium non-compaction (LVNC), with emphasis on the MRI findings. From May 2006 to February 2007, three patients -- 2 females (6 years and 42 years of age) and 1 male (18 years of age) -- presented to our radiology department, two of them with fatigue, shortness of breath and episodes of syncope and arrhythmia, for further investigation by cardiac MRI because an apparent asymmetrical pattern of hypertrophy of the left ventricular myocardium was suspected by transthoracic echocardiography. The 18-year-old patient was only experiencing arrhythmia, and arrhythmogenic right ventricular dysplasia was suspected. The images (produced by a 1.5T MRI system) were interpreted by two experienced radiologists and post-processed with Argus software (Siemens, Germany) for ejection fraction calculation. In all three patients, MRI aided in the correct identification of prominent ventricular myocardial trabeculations and deep intertrabecular recesses communicating with the ventricular cavity, as well as areas of hypokinesia with depressed systolic function, and showed the absence of myocardial delayed enhancement and other structural heart defects. In conclusion, cardiac MRI was useful for correctly identifying this rare congenital heart disorder and appears to increase diagnostic accuracy. Although considered a rare anomaly, radiologists should be capable of recognizing LVNC, as current non-invasive imaging methods have increased the frequency of this diagnosis and timely detection is vital in considering early-stage transplantation.

  13. [Surgical findings in 260 cases of basilar impression and/or Arnold-Chiari malformation].

    PubMed

    da Silva, J A; Brito, J C; da Nóbrega, P V; Costa, M do D; de Souza, A B

    1994-09-01

    The surgical findings observed in a series of 260 patients with craniovertebral anomaly are presented. There were 29 (11.1%) patients only with basilar impression, 18 (6.9%) cases of pure Arnold-Chiari malformation and 213 (81.9%) cases of basilar impression associated with Chiari malformation. The surgical findings on bone, dura-mater, nervous tissue and blood vessels of this region are reported.

  14. Characteristics of a microchannel plate intensifier

    NASA Technical Reports Server (NTRS)

    Sandie, W. G.; Mende, S. B.

    1982-01-01

    A telephoto optical system has been designed for imaging applications involving a use of the spectral region from 2000 to 7500 A. The optics images onto the photocathode of a multichannel plate photomultiplier (PMT). Interference filters are employed to provide spectral selectivity. The PMT consists of three microchannel plate intensifiers (MCP), arranged in a 'Z' configuration. MCP photomultiplier pulse height distributions are discussed along with aspects of spatial distribution, the electron gain pulse height distribution, and the charge loss due to edge effects. Attention is given to the electron gain pulse height distribution obtained from four anodes connected in parallel, taking into account a uniform illumination of the photocathode.

  15. 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…

  16. 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 proceeding is required. 890.1027 Section 890.1027 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1027 Cases where an...

  17. 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 not required. 890.1025 Section 890.1025 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1025 Cases where additional...

  18. 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…

  19. Enhancing HIV Testing and Treatment among Men Who Have Sex with Men in China: A Pilot Model with Two-Rapid Tests, Single Blood Draw Session, and Intensified Case Management in Six Cities in 2013

    PubMed Central

    Zhang, Dapeng; Li, Chengmei; Meng, Sining; Fu, Xiaojing; Qi, Jinlei; Wang, Peng; Luo, Mei; Dai, Min; Yip, Ray; Sun, Jiangping; Wu, Zunyou

    2016-01-01

    Objectives To explore models to improve HIV testing, linkage to care and treatment among men who have sex with men (MSM) in cooperation with community-based organizations (CBOs) in China. Methods We introduced a new model for HIV testing services targeting MSM in six cities in 2013.These models introduced provision of rapid HIV testing by CBO staff and streamlined processes for HIV screening, confirmation of initial reactive screening results, and linkage to care among diagnosed people. We monitored attrition along each step of the continuum of care from screening to treatment and compared program performance between 2012 and 2013. According to the providers of two rapid tests (HIV screening), four different services delivery models were examined in 2013: Model A = first screen at CDC, second at CDC (Model A = CDC+CDC), Model B = first and second screens at CBOs (Model B = CBO+CBO), Model C = first screen at CBO, second at Hospital (Model C = CBO+Hosp), and Model D = first screen at CBO, second at CDC (Model D = CBO+CDC). Logistic regressions were performed to assess advantages of different screening models of case finding and case management. Results Compared to 2012, the number of HIV screening tests performed for MSM increased 35.8% in 2013 (72,577 in 2013 vs. 53,455 in 2012). We observed a 5.6% increase in proportion of cases screened reactive receiving HIV confirmatory tests (93.9% in 2013 vs. 89.2% in 2012, χ2 = 48.52, p<0.001) and 65% reduction in loss to CD4 cell count tests (15% in 2013 vs. 43% in 2012, χ2 = 628.85, p<0.001). Regarding linkage to care and treatment, the 2013 pilot showed that the Model D had the highest rate of loss between screening reactive and confirmatory test among the four models, with 18.1% fewer receiving a second screening test and a further 5.9% loss among those receiving HIV confirmatory tests. The Model B and the Model C showed lower losses (0.8% and 1.3%) for newly diagnosed HIV positives receiving CD4 cell count tests, and

  20. Familial Adult-onset Alexander Disease: Clinical and Neuroradiological Findings of Three Cases

    PubMed Central

    ELMALI, Ayşe Deniz; ÇETİNÇELİK, Ümran; IŞLAK, Civan; UZUN ADATEPE, Nurten; KARAALİ SAVRUN, Feray; YALÇINKAYA, Cengiz

    2016-01-01

    The adult-onset Alexander disease (AOAD) dramatically differs from the early onset AD with respect to clinical and neuroradiological findings. Herein we report the detailed clinical and neuroradiological findings of a Turkish family with AOAD. In all three cases, magnetic resonance imaging revealed marked atrophy of the mesencephalon, bulbus, and cervical spinal cord accompanied with signal abnormalities in the same regions along with supratentorial white matter. Basal ganglia were affected in two cases. Molecular genetic analysis revealed heterozygous mutation in the 8th exon of the glial fibrillary acidic protein gene M451I (c.1245G>A), leading to the diagnosis of AOAD in all cases. PMID:28360791

  1. Modeling of intensified high dynamic star tracker.

    PubMed

    Yan, Jinyun; Jiang, Jie; Zhang, Guangjun

    2017-01-23

    An intensified high dynamic star tracker (IHDST) is a photoelectric instrument and stably outputs three-axis attitude for a spacecraft at very high angular velocity. The IHDST uses an image intensifier to multiply the incident starlight. Thus, high sensitivity of the star detection is achieved under short exposure time such that extremely high dynamic performance is achieved. The IHDST differs from a traditional star tracker in terms of the imaging process. Therefore, we establish a quantum transfer model of IHDST based on stochastic process theory. By this model, the probability distribution of the output quantum number is obtained accurately. Then, we introduce two-dimensional Lorentz functions to describe the spatial spreading process of the IHDST. Considering the interaction of these two processes, a complete star imaging model of IHDST is provided. Using this model, the centroiding accuracy of the IHDST is analyzed in detail. Accordingly, a working parameter optimizing strategy is developed for high centroiding accuracy and improved dynamic performance. Finally, the laboratory tests and the night sky experiment support the conclusions.

  2. 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.

  3. Brachialis periosteal avulsion injury: case report with magnetic resonance imaging findings.

    PubMed

    Lam, Justin Chak Yiu; Lee, Ka Lok Ryan; Griffith, James F

    2016-11-01

    Brachialis periosteal avulsion injury is an uncommon injury occurring in young children. The injury may be misinterpreted or overlooked because of misleading or subtle radiological findings. A case of 7-year-old child with post-traumatic elbow pain and subtle findings on elbow radiography is presented. The injury was initially misinterpreted as an avulsion fracture of the medial epicondyle. Following radiological review, a diagnosis of brachialis periosteal avulsion injury was made. The radiographic and magnetic resonance imaging (MRI) findings of this injury are presented to stress the value of comparing the radiographic findings with previous imaging and to increase awareness of this uncommon injury.

  4. Benchmarking Alumni Relations in Community Colleges: Findings from a 2015 CASE Survey. CASE White Paper

    ERIC Educational Resources Information Center

    Paradise, Andrew

    2016-01-01

    Building on the inaugural survey conducted three years prior, the 2015 CASE Community College Alumni Relations survey collected additional insightful data on staffing, structure, communications, engagement, and fundraising. This white paper features key data on alumni relations programs at community colleges across the United States. The paper…

  5. Benchmarking Alumni Relations in Community Colleges: Findings from a 2012 CASE Survey. CASE White Paper

    ERIC Educational Resources Information Center

    Paradise, Andrew; Heaton, Paul

    2013-01-01

    In 2011, CASE founded the Center for Community College Advancement to provide training and resources to help community colleges build and sustain effective fundraising, alumni relations and communications and marketing programs. This white paper summarizes the results of a groundbreaking survey on alumni relations programs at community colleges…

  6. Comparison of symptoms and treatment outcomes between actively and passively detected tuberculosis cases: the additional value of active case finding.

    PubMed

    den Boon, S; Verver, S; Lombard, C J; Bateman, E D; Irusen, E M; Enarson, D A; Borgdorff, M W; Beyers, N

    2008-10-01

    Passive detection of tuberculosis (TB) cases may lead to delay in treatment which may contribute to increased severity of disease and mortality. Active case finding may be an alternative. In a community survey in Cape Town, South Africa, we actively detected 27 bacteriologically positive TB cases and compared those with 473 passively detected TB cases. Seven of 27 (26%) actively detected TB cases did not start treatment within 2 months and were considered initial defaulters. Those who did start treatment had similar treatment success rates as passively detected TB cases (both 80%) (OR 1.01, CI 0.33-3.09). Passively detected cases reported the presence of the symptoms cough (OR 3.72, 95% CI 1.47-9.39), haemoptysis (OR 3.20, 95% CI 1.03-9.93), night sweats (OR 3.35, 95% CI 1.40-7.99), fever (OR 4.28, 95% CI 1.21-15.14), and weight loss (OR 11.14, 95% CI 4.17-29.74) more often than those detected actively. We conclude that although TB cases detected by a community survey are less symptomatic and are prone to a high initial default rate, active case finding can potentially identify a substantial portion of the existing caseload at an earlier stage of disease, thereby reducing the risk of transmission.

  7. Active Community-Based Case Finding for Tuberculosis With Limited Resources

    PubMed Central

    Karki, Bindu; Kittel, Guenter; Bolokon, Ignatius; Duke, Trevor

    2016-01-01

    Papua New Guinea is one of the 14 highest-burden countries for tuberculosis (TB) infection, but few community-based studies exist. We evaluated a low-cost method of active community case finding in Kabwum and Wasu in Morobe Province, Papua New Guinea. Over 3 months we visited 26 villages and screened adults and children for symptoms and signs of TB. Sputum samples were examined using smear microscopy. A total of 1700 people had chronic symptoms, of which 267 were suspicious for TB on further examination. Sputum from 230 symptomatic adults yielded 97 samples that were positive for acid-fast bacilli. In addition, 15 cases of extrapulmonary TB in adults and 17 cases of TB in children were identified. One hundred and thirty people were identified with active TB disease among the source population of approximately 17 000, giving an estimated prevalence of 765 per 100 000. One hundred and six (82%) cases were not previously diagnosed. The cost per case identified was US$146. It is feasible to conduct active community-based case finding and treatment initiation for TB with limited resources and in remote areas, and in Papua New Guinea the yield was high. Active case finding and follow-up of treatment in villages is needed to address the hidden burden of TB in Papua New Guinea and other high-burden Asia Pacific countries. PMID:28033717

  8. Range gated imaging experiments using gated intensifiers

    SciTech Connect

    McDonald, T.E. Jr.; Yates, G.J.; Cverna, F.H.; Gallegos, R.A.; Jaramillo, S.A.; Numkena, D.M.; Payton, J.; Pena-Abeyta, C.R.

    1999-03-01

    A variety of range gated imaging experiments using high-speed gated/shuttered proximity focused microchannel plate image intensifiers (MCPII) are reported. Range gated imaging experiments were conducted in water for detection of submerged mines in controlled turbidity tank test and in sea water for the Naval Coastal Sea Command/US Marine Corps. Field experiments have been conducted consisting of kilometer range imaging of resolution targets and military vehicles in atmosphere at Eglin Air Force Base for the US Air Force, and similar imaging experiments, but in smoke environment, at Redstone Arsenal for the US Army Aviation and Missile Command (AMCOM). Wavelength of the illuminating laser was 532 nm with pulse width ranging from 6 to 12 ns and comparable gate widths. These tests have shown depth resolution in the tens of centimeters range from time phasing reflected LADAR images with MCPII shutter opening.

  9. 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.

  10. Clinical utility of the informant AD8 as a dementia case finding instrument in primary healthcare.

    PubMed

    Chan, Qun Lin; Xu, Xin; Shaik, Muhammad Amin; Chong, Steven Shih Tsze; Hui, Richard Jor Yeong; Chen, Christopher Li-Hsian; Dong, YanHong

    2016-01-01

    The informant AD8 has excellent discriminant ability for dementia case finding in tertiary healthcare settings. However, its clinical utility for dementia case finding at the forefront of dementia management, primary healthcare, is unknown. Therefore, we recruited participants from two primary healthcare centers in Singapore and measured their performance on the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clinical Dementia Rating (CDR), and a local formal neuropsychological battery, in addition to the AD8. Logistic regression was conducted to examine the associations between demographic factors and dementia. Area under the receiver operating characteristics (ROC) curve analysis was used to establish the optimal cut-off points for dementia case finding. Of the 309 participants recruited, 243 (78.7%) had CDR = 0, 22 (7.1%) CDR = 0.5, and 44 (14.2%) CDR ≥1. Age was strongly associated with dementia, and the optimal age for dementia case finding in primary healthcare settings was ≥75 years. In this age group, the AD8 has excellent dementia case finding capability and was superior to the MMSE and equivalent to the MoCA [AD8 AUC (95% CI): 0.95 (0.91-0.99), cut-off: ≥3, sensitivity: 0.90, specificity: 0.88, PPV: 0.79 and NPV: 0.94; MMSE AUC (95% CI): 0.87 (0.79-0.94), p = 0.04; MoCA AUC (95% CI): 0.88 (0.82-0.95), p = 0.06]. In conclusion, the AD8 is well suited for dementia case finding in primary healthcare settings.

  11. 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

  12. A Case of Bell's Palsy with an Incidental Finding of a Cerebellopontine Angle Lipoma.

    PubMed

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

    2016-08-24

    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.

  13. 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

  14. A case report of a rare finding of supernumerary primary and permanent canines

    PubMed Central

    Parker, Kate; Hay, Norman

    2014-01-01

    A supernumerary tooth is a tooth that is additional to the normal series of teeth. These can occur anywhere in the primary or permanent dentition and are most commonly found in the anterior maxilla. Supernumerary canines are rare with little available literature and case reports in this area. This case presents a patient with a unilateral maxillary supernumerary deciduous and permanent canine associated with an unusual cleft of the alveolus. How to cite the article: Parker K, Hay N. A case report of a rare finding of supernumerary primary and permanent canines. J Int Oral Health 2014;6(2):129-131. PMID:24876714

  15. Marfan syndrome gene search intensifies following identification of basic defect

    SciTech Connect

    Randall, T.

    1990-10-03

    Somewhere, quite possible along chromosomes 8 and/or 15, the gene(s) for Marfan syndrome will be found. The search is intensifying following a report that faulty scaffolding in the body's connective tissue appears to be the long sought after defect behind the syndrome, and inherited disorder that has caused the premature death of young, healthy-looking individuals. Finding that something in the living masonry of the human body has proven to be a 30-year inquisition of nearly two dozen molecules that has engaged investigators worldwide. Historically, researchers have searched for a structural flaw in one of the collagen molecules to explain the cause of Marfan Syndrome. Using monoclonal antibodies, researchers have implicated microfibrils, the extracellular filaments that provide a matrix for the deposit of elastin during embryonic development.

  16. Word-Finding Intervention for Children with Specific Language Impairment: A Multiple Single-Case Study

    ERIC Educational Resources Information Center

    Bragard, Anne; Schelstraete, Marie-Anne; Snyers, Perrine; James, Deborah G. H.

    2012-01-01

    Purpose: This study examined the effectiveness of a combined phonological and semantic intervention for children with specific language impairment who had word-finding difficulties (WFDs). Method: To evaluate the intervention, a multiple single-case design was implemented with 4 children, ages 9;6 (years;months) to 13;9, who had WFDs. Some items…

  17. Imaging findings in a case of mixed acinar-endocrine carcinoma of the pancreas.

    PubMed

    Chung, Won Jung; Byun, Jae Ho; Lee, Seung Soo; Lee, Moon-Gyu

    2010-01-01

    Mixed acinar-endocrine carcinoma (MAEC) of the pancreas is extremely uncommon. We report here a rare case of MAEC of the pancreas presenting as watery diarrhea. This is the first report in the English-language literature that describes the imaging findings of MAEC of the pancreas, including computed tomography (CT), magnetic resonance (MR) imaging, and MR cholangiopancreatography features.

  18. 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... for medical purposes to expose radiographic film. (b) Classification. Class I (general controls)....

  19. 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... for medical purposes to expose radiographic film. (b) Classification. Class I (general controls)....

  20. Diagnosis of Sanfilippo disease correlating clinical, radiological and biochemical findings-a case report.

    PubMed

    Agrawal, Udit; Meshram, Ajay; Vagha, Jayant; Swarnkar, Kirti; Palandurkar, Kamlesh

    2012-10-01

    Mucopolysaccharidoses (MPS) are a group of genetic diseases and its diagnosis is a challenging task due to multiple differential diagnosis. We had combined clinical findings, radiological and ophthalmological features. Biochemical test for urine glycosaminoglycans (GAG) was done for confirmation of diagnosis in the patient. The case of Sanfilippo disease was characterized by slowly progressive, severe CNS involvement with mild somatic disease. Radiological features were suggestive of Sanfilippo disease and urine GAG test for MPS was positive in the case. With the clinical features we had multiple differential diagnoses. The radiological investigations minimized the list and the biochemical test confirmed GAG in urine. In this case the combination of clinical, radiological and biochemical findings confirmed the diagnosis of Sanfilippo disease.

  1. Low input and intensified crop production systems effects on soil health and environment

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The material in this chapter covers the concepts of "low-input" and "intensified" production systems in the context of input intensity and sustainability. Research-based case studies are presented that draw out the practicalities of implementing production practices on an input intensity gradient fr...

  2. 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…

  3. Fatal tolperisone poisoning: autopsy and toxicology findings in three suicide cases.

    PubMed

    Sporkert, Frank; Brunel, Christophe; Augsburger, Marc P; Mangin, Patrice

    2012-02-10

    Tolperisone (Mydocalm) is a centrally acting muscle relaxant with few sedative side effects that is used for the treatment of chronic pain conditions. We describe three cases of suicidal tolperisone poisoning in three healthy young subjects in the years 2006, 2008 and 2009. In all cases, macroscopic and microscopic autopsy findings did not reveal the cause of death. Systematic toxicological analysis (STA) including immunological tests, screening for volatile substances and blood, urine and gastric content screening by GC-MS and HPLC-DAD demonstrated the presence of tolperisone in all cases. In addition to tolperisone, only the analgesics paracetamol (acetaminophen), ibuprofen and naproxen could be detected. The blood ethanol concentrations were all lower than 0.10 g/kg. Tolperisone was extracted by liquid-liquid extraction using n-chlorobutane as the extraction solvent. The quantification was performed by GC-NPD analysis of blood, urine and gastric content. Tolperisone concentrations of 7.0 mg/l, 14 mg/l and 19 mg/l were found in the blood of the deceased. In the absence of other autopsy findings, the deaths in these three cases were finally explained as a result of lethal tolperisone ingestion. To the best of our knowledge, these three cases are the first reported cases of suicidal tolperisone poisonings.

  4. Veterans Health Administration multiple sclerosis surveillance registry: The problem of case-finding from administrative databases.

    PubMed

    Culpepper, William J; Ehrmantraut, Mary; Wallin, Mitchell T; Flannery, Kathleen; Bradham, Douglas D

    2006-01-01

    Establishment of a national multiple sclerosis (MS) surveillance registry (MSSR) is a primary goal of the Department of Veterans Affairs (VA) MS Center of Excellence. The initial query of Veterans Health Administration (VHA) databases identified 25,712 patients (labeled "VHA MS User Cohort") from fiscal years 1998 to 2002 based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code; service-connection for MS; and/or disease-modifying agent (DMA) use. Because of ICD-9-CM limitations, the initial query was overinclusive and resulted in many non-MS cases. Thus, we needed a more rigorous case-finding method. Our gold standard was chart review of the Computerized Patient Record System for the mid-Atlantic VA medical centers. After chart review, we classified patients as not having MS or having MS/possible MS. We also applied a statistical algorithm to classify cases based on service-connection for MS, DMA use, and/or at least one healthcare encounter a year with MS coded as the primary diagnosis. We completed two analyses with kappa coefficient and sensitivity analysis. The first analysis (efficacy) was limited to cases with a definitive classification based on chart review (n = 600). The kappa coefficient was 0.85, sensitivity was 0.93, and specificity was 0.92. The second analysis (effectiveness) included unknown cases that were classified as MS/possible MS (N = 682). The kappa coefficient was 0.82, sensitivity was 0.93, and specificity was 0.90. These findings suggest that the database algorithm reliably eliminated non-MS cases from the initial MSSR population and is a reasonable case-finding method at this intermediate stage of MSSR development.

  5. Inducible defenses in prey intensify predator cannibalism.

    PubMed

    Kishida, Osamu; Trussell, Geoffrey C; Nishimura, Kinya; Ohgushi, Takayuki

    2009-11-01

    Trophic cascades are often a potent force in ecological communities, but abiotic and biotic heterogeneity can diffuse their influence. For example, inducible defenses in many species create variation in prey edibility, and size-structured interactions, such as cannibalism, can shift predator diets away from heterospecific prey. Although both factors diffuse cascade strength by adding heterogeneity to trophic interactions, the consequences of their interactioh remain poorly understood. We show that inducible defenses in tadpole prey greatly intensify cannibalism in predatory larval salamanders. The likelihood of cannibalism was also strongly influenced by asymmetries in salamander size that appear to be most important in the presence of defended prey. Hence, variation in prey edibility and the size structure of the predator may synergistically affect predator-prey population dynamics by reducing prey mortality and increasing predator mortality via cannibalism. We also suggest that the indirect effects of prey defenses may shape the evolution of predator traits that determine diet breadth and how trophic dynamics unfold in natural systems.

  6. Radiological Imaging Findings of a Case with Vertebral Osteoid Osteoma Leading to Brachial Neuralgia

    PubMed Central

    Gokce, Erkan; Ayan, Erdoğan; Çelikyay, Fatih; Acu, Berat

    2013-01-01

    Osteoid osteoma is a small, benign osteoblastic tumor consisting of a highly vascularized nidus of connective tissue surrounded by sclerotic bone. Three-quarters of osteoid osteomas are located in the long bones, and only 7-12% in the vertebral column. The classical clinical presentation of spinal osteoid osteoma is that of painful scoliosis. Other clinical features include nerve root irritation and night pain. Osteoid osteoma has characteristic computed tomography (CT) findings. Because magnetic resonance imaging (MRI) findings of the osteoid osteomas causing intense perinidal edema can be confusing, these patients should be evaluated with clinical findings and other imaging techniques. In this study, we present X-ray, CT, and MRI findings of a case with osteoid osteoma located in thoracic 1 vertebra left lamina and transverse process junction leading to brachial neuralgia symptoms. PMID:24404413

  7. Radiological imaging findings of a case with vertebral osteoid osteoma leading to brachial neuralgia.

    PubMed

    Gokce, Erkan; Ayan, Erdoğan; Celikyay, Fatih; Acu, Berat

    2013-01-01

    Osteoid osteoma is a small, benign osteoblastic tumor consisting of a highly vascularized nidus of connective tissue surrounded by sclerotic bone. Three-quarters of osteoid osteomas are located in the long bones, and only 7-12% in the vertebral column. The classical clinical presentation of spinal osteoid osteoma is that of painful scoliosis. Other clinical features include nerve root irritation and night pain. Osteoid osteoma has characteristic computed tomography (CT) findings. Because magnetic resonance imaging (MRI) findings of the osteoid osteomas causing intense perinidal edema can be confusing, these patients should be evaluated with clinical findings and other imaging techniques. In this study, we present X-ray, CT, and MRI findings of a case with osteoid osteoma located in thoracic 1 vertebra left lamina and transverse process junction leading to brachial neuralgia symptoms.

  8. Various Upper Endoscopic Findings of Acute Esophageal Thermal Injury Induced by Diverse Food: A Case Series

    PubMed Central

    Lee, Yu Mi; Kim, Ji Young; Song, Hyun Jung; Koo, Hoon Sup; Song, Kyung Ho; Kim, Yong Seok; Huh, Kyu Chan

    2014-01-01

    Esophageal thermal injury caused by food has been reported to occur mostly after drinking hot liquid food, and is known to produce alternating white and red linear mucosal bands. In addition, thermal injury caused by ingestion of hot solid foods is documented to be a cause of esophageal ulcers or pseudomembranes. From January 2006 to August 2012, five patients with suspected esophageal thermal injury underwent esophagogastroduodenoscopy with biopsy. A "candy-cane" appearance was observed in one case, pseudomembrane was observed in two cases, an esophageal ulcer was observed in one case, and a friable and edematous mucosa was noted in one case. We believe that the endoscopic findings of esophageal thermal injury depend on the following factors: causative materials, amount of food consumed, exposure period, and time to endoscopy after the incident. Therefore, physicians who encounter patients with suspected esophageal thermal injury should carefully take the patient's history considering these factors. PMID:25325006

  9. Case-finding options for COPD: Results from the BOLD Study

    PubMed Central

    Jithoo, Anamika; Enright, Paul; Burney, Peter; Buist, A Sonia; Bateman, Eric D; Tan, Wan C; Studnicka, Michael; Mejza, Filip; Gillespie, Suzanne; Vollmer, William M

    2012-01-01

    Aim To compare strategies for COPD case-finding using data from the Burden of Obstructive Lung Disease (BOLD) study. Methods Population-based samples of adults aged ≥40 years (n= 9390) from 14 countries completed a questionnaire and spirometry. We compared the screening efficiency of different staged algorithms that used questionnaire data and/or PEF to identify persons at risk for COPD and hence needing confirmatory spirometry. Separate algorithms were fitted for moderate/severe COPD and for severe COPD. We estimated the cost of each algorithm in 1000 people. Results For moderate/severe COPD, use of questionnaire data alone permitted high sensitivity (97%), but required confirmatory spirometry on 80% of participants. Use of PEF only required confirmatory spirometry in only 19-22% of subjects with 83-84% sensitivity. For severe COPD, use of PEF achieved 91-93% sensitivity, requiring confirmatory spirometry in <9% of participants. Cost analysis suggested that a staged screening algorithm using only PEF initially, followed by confirmatory spirometry as needed, was the most cost-effective case finding strategy. Conclusion Our results support the use of PEF as a simple, cost-effective initial screening tool for conducting COPD case-finding in adults ≥40 years. These findings should be validated in real-world settings such as the primary care environment. PMID:22743668

  10. An evaluation of clinical, radiological and three-dimensional dental tomography findings in ectodermal dysplasia cases

    PubMed Central

    Doğan, Mehmet-Sinan; Callea, Michele; Aksoy, Orhan; Clarich, Gabriella; Günay, Ayşe; Günay, Ahmet; Güven, Sedat; Maglione, Michele; Akkuş, Zeki

    2015-01-01

    Background This study aimed to review the results related to head and jaw disorders in cases of ectodermal dysplasia. The evaluation of ectodermal dysplasia cases was made by clincal examination and examination of the jaw and facial areas radiologically and on cone-beam 3-dimensional dental tomography (CBCT) images. Material and Methods In the 36 cases evaluated in the study, typical clinical findings of pure hypohidrotic ectodermal displasia (HED) were seen, such as missing teeth, dry skin, hair and nail disorders. CBCT images were obtained from 12 of the 36 cases, aged 1.5- 45 years, and orthodontic analyses were made on these images. Results The clinical and radiological evaluations determined, hypodontia or oligodontia, breathing problems, sweating problems, a history of fever, sparse hair, saddle nose, skin peeling, hypopigmentation, hyperpigmentation, finger and nail deformities, conical teeth anomalies, abnormal tooth root formation, tooth resorption in the root, gingivitis, history of epilepsy, absent lachrymal canals and vision problems in the cases which included to the study. Conclusions Ectodermal dysplasia cases have a particular place in dentistry and require a professional, multi-disciplinary approach in respect of the chewing function, orthognathic problems, growth, oral and dental health. It has been understood that with data obtained from modern technologies such as three-dimensional dental tomography and the treatments applied, the quality of life of these cases can be improved. Key words: Ectodermal dysplasia, three-dimensional dental tomography. PMID:25662550

  11. Imaging Findings in Dysgerminoma in a Case of 46 XY, Complete Gonadal Dysgenesis (Swyer syndrome)

    PubMed Central

    Khaladkar, Sanjay; Gujrati, Aditi

    2016-01-01

    A 46 XY pure gonadal dysgenesis also known as Swyer syndrome. These patients are phenotypic females with normal female external genitalia and absent testicular tissue. The patients with swyer syndrome have streak gonads and increased risk of dysgerminoma and gonadoblastoma. We present a case of dysgerminoma in dysgenetic gonads of swyer syndrome. A 23-year-old female had come with complaints of primary amenorrhea, pelvic mass and abdominal pain. Clinical findings, pathology investigation and imaging findings revealed swyer syndrome. On MRI it showed a large lobulated mass in the pelvis. Mass was excised and dysgerminoma was given on the histopathology. PMID:27790550

  12. Basilar impression and Arnold-Chiari malformation. Surgical findings in 209 cases.

    PubMed

    da Silva, J A

    1992-11-01

    The surgical findings observed in a series of 209 consecutive patients with craniovertebral anomaly are presented. The high prevalence of basilar impression in the Northeast of Brazil is noteworthy. There were 28 (13.3%) patients with basilar impression alone, 10 (4.7%) cases of pure Arnold-Chiari malformation and in 171 (81.8%) cases the basilar impression was associated with Arnold-Chiari malformation. This study reflects our surgical experience of the pathology in a 17-year period (1971-1987). It reflects also the peculiarities of neurosurgical practice in an undeveloped region of this Country. The literature is extensively reviewed.

  13. 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

  14. 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.

  15. Star centroiding error compensation for intensified star sensors.

    PubMed

    Jiang, Jie; Xiong, Kun; Yu, Wenbo; Yan, Jinyun; Zhang, Guangjun

    2016-12-26

    A star sensor provides high-precision attitude information by capturing a stellar image; however, the traditional star sensor has poor dynamic performance, which is attributed to its low sensitivity. Regarding the intensified star sensor, the image intensifier is utilized to improve the sensitivity, thereby further improving the dynamic performance of the star sensor. However, the introduction of image intensifier results in star centroiding accuracy decrease, further influencing the attitude measurement precision of the star sensor. A star centroiding error compensation method for intensified star sensors is proposed in this paper to reduce the influences. First, the imaging model of the intensified detector, which includes the deformation parameter of the optical fiber panel, is established based on the orthographic projection through the analysis of errors introduced by the image intensifier. Thereafter, the position errors at the target points based on the model are obtained by using the Levenberg-Marquardt (LM) optimization method. Last, the nearest trigonometric interpolation method is presented to compensate for the arbitrary centroiding error of the image plane. Laboratory calibration result and night sky experiment result show that the compensation method effectively eliminates the error introduced by the image intensifier, thus remarkably improving the precision of the intensified star sensors.

  16. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiographic intensifying screen. 892.1960 Section 892.1960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1960 Radiographic intensifying...

  17. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiographic intensifying screen. 892.1960 Section 892.1960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1960 Radiographic intensifying...

  18. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiographic intensifying screen. 892.1960 Section 892.1960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1960 Radiographic intensifying...

  19. Beyond early infant diagnosis: case finding strategies for identification of HIV-infected infants and children

    PubMed Central

    Ahmed, Saeed; Kim, Maria H.; Sugandhi, Nandita; Phelps, B. Ryan; Sabelli, Rachael; Diallo, Mamadou O.; Young, Paul; Duncan, Dana; Kellerman, Scott E.

    2014-01-01

    There are 3.4 million children infected with HIV worldwide, with up to 2.6 million eligible for treatment under current guidelines. However, roughly 70% of infected children are not receiving live-saving HIV care and treatment. Strengthening case finding through improved diagnosis strategies, and actively linking identified HIV-infected children to care and treatment is essential to ensuring that these children benefit from the care and treatment available to them. Without attention or advocacy, the majority of these children will remain undiagnosed and die from complications of HIV. In this article, we summarize the challenges of identifying HIV-infected infants and children, review currently available evidence and guidance, describe promising new strategies for case finding, and make recommendations for future research and interventions to improve identification of HIV-infected infants and children. PMID:24361633

  20. Imaging findings in a case of Gorlin-Goltz syndrome: a survey using advanced modalities.

    PubMed

    Bronoosh, Pegah; Shakibafar, Ali Reza; Houshyar, Maneli; Nafarzade, Shima

    2011-12-01

    Gorlin-Goltz syndrome is an infrequent multi-systemic disease which is characterized by multiple keratocysts in the jaws, calcification of falx cerebri, and basal cell carcinomas. We report a case of Gorlin-Goltz syndrome in a 23-year-old man with emphasis on image findings of keratocyctic odontogenic tumors (KCOTs) on panoramic radiograph, computed tomography, magnetic resonance (MR) imaging, and Ultrasonography (US). In this case, pericoronal lesions were mostly orthokeratinized odontogenic cyst (OOC) concerning the MR and US study, which tended to recur less. The aim of this report was to clarify the characteristic imaging features of the syndrome-related keratocysts that can be used to differentiate KCOT from OOC. Also, our findings suggested that the recurrence rate of KCOTs might be predicted based on their association to teeth.

  1. Unusual findings in inguinal hernia surgery: Report of 6 rare cases

    PubMed Central

    Ballas, K; Kontoulis, Th; Skouras, Ch; Triantafyllou, A; Symeonidis, N; Pavlidis, Th; Marakis, G; Sakadamis, A

    2009-01-01

    Background and aim: To present our experience with unexpected findings during hernia surgery, either unusual hernial contents or pathologic entities, like neoplastic masses, masquerading as a hernia. Patients and methods: We studied retrospectively 856 patients with inguinal hernia who were admitted to our surgical department over a 9-year period. In addition, our study included patients complaining of inguinal protrusion, even without a definitive diagnosis of inguinal hernia upon admission. Results: Five patients presented with unusual hernial contents. Three of them had a vermiform appendix in their sac. Acute appendicitis (Amyands hernia) was found in only one case. One patient had epiploic appendagitis related with a groin hernia. Moreover, an adult woman was diagnosed with ovarian and tubal inguinal hernia. Finally, we report a case of a massive extratesticular intrascrotal lipoma, initially misdiagnosed as a scrotal hernia. Conclusion: a hernia surgeon may encounter unexpected intraoperative findings. It is important to be prepared to detect them and apply the appropriate treatment. PMID:19918306

  2. China intensifies IEC programme for family planning.

    PubMed

    She, W

    1997-10-01

    This article describes the aims of family planning (FP) departments to strengthen IEC for the control of population growth and effective improvement in the quality of human resources in China. The IEC directive was promoted by Madam Peng Peiyun of the State Family Planning Commission in May 1997. In 1996, the birth rate was 16.98/1000. The total fertility rate was below replacement level in 1996. These achievements were accomplished with effective IEC over the past 30 years. The Ninth Five Year Plan for 1996-2000 offers many challenges for the national FP program. The aim is to continue to strictly control population growth in order to keep population below 1.3 billion by the year 2000, and below 1.4 billion by the year 2010. The aim is to improve the quality of life, to improve population structure, to meet the needs of reproductive-age women for services, and to promote socioeconomic and sustainable development. IEC needs to be intensified and to use improved techniques. IEC funding should be increased. Information should be promoted about the importance of educating people about the basic national conditions and the state's basic policies. People need to be informed about the need for a balanced population and socioeconomic development at all cadre levels. FP workers need to be encouraged to serve the people's needs "wholeheartedly." The aim is to provide quality services. People need to be informed that the advantages of fewer births are greater prosperity and comfortable living. FP is an integral part of poverty alleviation. The State Commission plans to conduct a new round of training for cadres.

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

    PubMed

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

    1995-04-01

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

  4. 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

  5. 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.

  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. 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.

  8. Bone scan findings in Kienböck's disease. A case report with atypical findings and literature review.

    PubMed

    Stuckey, S L; Kalff, V; Hoy, G

    1997-07-01

    The authors present an 18-year-old man who had a 5-month history of a painful left wrist. Despite the prolonged history, discrete photopenia on the blood-pool phase and photopenia relative to the remainder of the ipsilateral carpus on the delayed phase of a bone scan in the region of the lunate was shown. When Kienböck's disease is seen in its late phase, the bone scan findings may be atypical in that they may not show the usual three-phase bone scintigraphic evidence of bone remodeling expected in delayed diagnosis avascular necrosis. A review of the previous literature is presented.

  9. New image intensifier family for military and homeland defense

    NASA Astrophysics Data System (ADS)

    Floryan, Richard F.; DeVoe, Nelson; Peck, Thomas

    2003-09-01

    ITT Industries Night Vision has developed a new high-performance image intensifier for use in existing aviation and ground night vision systems. This intensifier, called the "Pinnacle" by ITT, provides substantial performance increases in low light detection, high light resolution, and intra-scene dynamic range (the ability to see detail in dark areas of a scene where bright cultural lighting is present -- for example, into a dark alley where streetlights are also in the scene). The new Pinnacle intensifier can be used in all aviation and ground systems that currently accept 18 mm image intensifiers. The performance improvements offered in the Pinnacle intensifier are made possible by three factors: (1) a new high-performance micro-channel plate (MCP), (2) a newly designed gating power supply, and (3) manufacturing processes that have been optimized through design-of-experiments and six-sigma methods. With the higher signal-to-noise, resolution, and bright-light halo performance levels, the Pinnacle image intensifier substantially outperforms all previously fielded intensifiers, and greatly enhances the user's ability to operate at night.

  10. Severe malaria - a case of fatal Plasmodium knowlesi infection with post-mortem findings: a case report

    PubMed Central

    2010-01-01

    Background Zoonotic malaria caused by Plasmodium knowlesi is an important, but newly recognized, human pathogen. For the first time, post-mortem findings from a fatal case of knowlesi malaria are reported here. Case presentation A formerly healthy 40 year-old male became symptomatic 10 days after spending time in the jungle of North Borneo. Four days later, he presented to hospital in a state of collapse and died within two hours. He was hyponatraemic and had elevated blood urea, potassium, lactate dehydrogenase and amino transferase values; he was also thrombocytopenic and eosinophilic. Dengue haemorrhagic shock was suspected and a post-mortem examination performed. Investigations for dengue virus were negative. Blood for malaria parasites indicated hyperparasitaemia and single species P. knowlesi infection was confirmed by nested-PCR. Macroscopic pathology of the brain and endocardium showed multiple petechial haemorrhages, the liver and spleen were enlarged and lungs had features consistent with ARDS. Microscopic pathology showed sequestration of pigmented parasitized red blood cells in the vessels of the cerebrum, cerebellum, heart and kidney without evidence of chronic inflammatory reaction in the brain or any other organ examined. Brain sections were negative for intracellular adhesion molecule-1. The spleen and liver had abundant pigment containing macrophages and parasitized red blood cells. The kidney had evidence of acute tubular necrosis and endothelial cells in heart sections were prominent. Conclusions The overall picture in this case was one of systemic malaria infection that fit the WHO classification for severe malaria. Post-mortem findings in this case were unexpectedly similar to those that define fatal falciparum malaria, including cerebral pathology. There were important differences including the absence of coma despite petechial haemorrhages and parasite sequestration in the brain. These results suggest that further study of knowlesi malaria

  11. Accuracy of proactive case finding for mental disorders by community informants in Nepal

    PubMed Central

    Jordans, Mark J. D.; Kohrt, Brandon A.; Luitel, Nagendra P.; Komproe, Ivan H.; Lund, Crick

    2015-01-01

    Background Accurate detection of persons in need of mental healthcare is crucial to reduce the treatment gap between psychiatric burden and service use in low- and middle-income (LAMI) countries. Aims To evaluate the accuracy of a community-based proactive case-finding strategy (Community Informant Detection Tool, CIDT), involving pictorial vignettes, designed to initiate pathways for mental health treatment in primary care settings. Method Community informants using the CIDT identified screen positive (n = 110) and negative persons (n = 85). Participants were then administered the Composite International Diagnostic Interview (CIDI). Results The CIDT has a positive predictive value of 0.64 (0.68 for adults only) and a negative predictive value of 0.93 (0.91 for adults only). Conclusions The CIDT has promising detection properties for psychiatric caseness. Further research should investigate its potential to increase demand for, and access to, mental health services. PMID:26450582

  12. 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.

  13. 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.

  14. Correlation of fine needle aspiration cytology findings with thyroid function test in cases of lymphocytic thyroiditis.

    PubMed

    Sood, Neelam; Nigam, Jitendra Singh

    2014-01-01

    Background. Chronic lymphocytic thyroiditis is the second most common thyroid lesion diagnosed on FNAC after goiter. FNAC is reliable tool in the diagnosis of thyroid lesion. Objective. To correlate FNAC cytologic findings with TFT in the lymphocytic thyroiditis. Methods. 175 patients with thyroid swellings were referred for FNAC as well as TFT during 2011-2013. Fine needle aspiration cytology was performed using non-aspiration or aspiration techniques and TFT performed on Beckman culter access 2. Results. Lymphoid infiltrate was seen in 55 cases. The commonest age group of lymphocytic thyroiditis was 21-30 years with male : female ratio being 1 : 10. Anti-TPO and TSH were elevated in 96.16% (25/26) of cases with grade 3 lymphoid infiltrate, 94.12% (16/17) of cases with grade 2, and 91.67% (11/12) of cases with 1 grade. Increased anti-TPO with raised TSH without any lymphoid infiltrate was seen in 5 cases and 5 cases showed only raised TSH without raised anti-TPO and without any lymphoid infiltrate. We observed that grade 3 lymphocytic infiltration has correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. We also observed that anti-TPO and TSH together are significant even if no lymphocytic infiltration is present. Conclusion. Grade 3 lymphocytic infiltration has statistical correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. Anti TPO was adjunct to TSH in grade 3. The presence of Hurthle cell change, giant cells, and granulomas has no statistical correlation with lymphocytic thyroiditis.

  15. Abdominal ultrasonographic findings associated with feline infectious peritonitis: a retrospective review of 16 cases.

    PubMed

    Lewis, Kristin M; O'Brien, Robert T

    2010-01-01

    The feline infectious peritonitis virus (FIPV) is a mutated form of the feline enteric coronavirus (FeCV) that can present with a variety of clinical signs. The purpose of this retrospective study was to analyze abdominal ultrasonographic findings associated with cats with confirmed FIPV infection. Sixteen cases were included in the study from a review of medical records at two academic institutions; inclusion was based either on necropsy lesions (n=13) or a combination of histopathological, cytological, and clinicopathological findings highly suggestive of FIPV infection (n=3). The liver was judged to be normal in echogenicity in 11 (69%) cats, diffusely hypoechoic in three cats, focally hyperechoic in one cat, and focally hypoechoic in one cat. Five cats had a hypoechoic subcapsular rim in one (n=3) or both (n=2) kidneys. Free fluid was present in the peritoneal cavity in seven cats and in the retroperitoneal space in one cat. Abdominal lymphadenopathy was noted in nine cats. The spleen was normal in echogenicity in 14 cats and was hypoechoic in two. One cat had bilateral orchitis with loss of normal testicular architecture. Although none of these ultrasonographic findings are specific for FIPV infection, a combination of these findings should increase the index of suspicion for FIPV infection when considered along with appropriate clinical signs.

  16. 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

  17. Periodic electroencephalogram discharges in a case of Lafora body disease: An unusual finding

    PubMed Central

    Jain, Rajendra Singh; Gupta, Arti; Gupta, Pankaj Kumar; Agrawal, Rakesh

    2016-01-01

    Lafora body disease (LBD) is a form of progressive myoclonic epilepsy, characterized by seizures, myoclonic jerks, cognitive decline, ataxia, and intracellular polyglucosan inclusion bodies (Lafora bodies) in the neurons, heart, skeletal muscle, liver, and sweat gland duct cells. Electroencephalogram (EEG) findings in LBD may include multiple spikes and wave discharges, photosensitivity, multifocal epileptiform discharges, and progressive slowing in background activity. Periodicity in epileptiform discharges has not been frequently depicted in LBD. We herein report an unusual case of LBD who showed generalized periodic epileptiform discharges in EEG. PMID:27293346

  18. Mucinous borderline ovarian tumor: a case report with diagnostic insights on ultrasound findings

    PubMed Central

    Śniadecki, Marcin; Bianek-Bodzak, Agnieszka; Liro, Marcin; Szurowska, Edyta

    2016-01-01

    Borderline ovarian tumors represent about 10% of all epithelial ovarian cancers, but in contrast to epithelial ovarian cancers, they constitute a group of tumors with a much better prognosis. An assessment of clinical presentation, physical examination, radiological and biochemical findings is necessary to tailor management strategies for patients with ovarian tumors. The article, which is based on a case report, describes different approaches for preoperative diagnosis as well as discusses approaches that might bring some insights on tumor histology. Furthermore, it raises a question about which imaging techniques should be proposed for a reliable diagnosis of borderline ovarian tumors to ensure safe surgery planning. PMID:28138412

  19. 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.

  20. Radiological findings and endovascular management of three cases with segmental arterial mediolysis.

    PubMed

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

    2010-06-01

    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.

  1. 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.

  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. Clinical Findings and Results of Surgical Resection in 19 Cases of Spinal Osteoid Osteoma

    PubMed Central

    Etemadifar, Mohammad Reza

    2015-01-01

    Study Design Descriptive cases series. Purpose To evaluate clinical findings and results of conventional surgery in patients with spinal osteoid osteoma (OO). Overview of Literature OO is a rare benign tumor with spinal involvement rate of about 10%-20%. Methods This descriptive study was conducted on 19 patients (11 males and 8 females with an average age of 19.8 years) with documented histopathological and imaging findings of OO referred to a university hospital. Neurologic symptoms and pain were scored before and after the open surgical excision. Data were analyzed by SPSS ver. 16 software using chi-square and significance level of 0.05. Results The most common complaint was back or neck pain (84.2%) and in 68.4% spinal deformity (mostly scoliosis) shown with an average cobb angle of 21° at presentation. The sites of involvement were 35% in the lumbar, 35% in the thoracic, 25% in the cervical, and 5% in the sacrum. Lamina was the most common site (50%) of involvement with predilection for the right side (p=0.001). All patients were treated by conventional surgical excision with a complete recovery of pain and deformity. No recurrence occurred after a mean follow up of 44.5 months, but 4 of 19 cases instrumented because of induced instability. In one case there were two levels of involvement (C7-T1) simultaneously. Interestingly, 10 out of 19 of our cases belonged to a specific race (Bakhtiari). Conclusions Surgical intra-lesional curettage is potentially an effective method without any recurrence, which can lead to spontaneous scoliosis recovery and pain relief. Race may be a potential risk factor for spinal (OO). PMID:26097653

  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. Improved intensifying screen reduces X-ray exposure

    NASA Technical Reports Server (NTRS)

    Buchanan, R. A.

    1972-01-01

    X-ray intensifying screen may make possible radiographic procedures where detection speed and X-ray tube power have been the limiting factors. Device will reduce total population exposure to harmful radiation in the United States.

  6. Intensified hemodialysis regimens: neglected treatment options for children and adolescents.

    PubMed

    Müller, Dominik; Zimmering, Miriam; Chan, Christopher T; McFarlane, Philip A; Pierratos, Andreas; Querfeld, Uwe

    2008-10-01

    During recent years, the importance of intensified dialysis regimens has gathered increasing interest, especially after the Hemodialysis (HEMO) Study Group reported that a higher dose of thrice-weekly hemodialysis failed to improve clinical outcomes. Long nocturnal hemodialysis (three to six times per week) or short daily hemodialysis are the currently used forms of intensified dialysis. There is substantial evidence for cardiovascular and quality-of-life improvements as well as financial benefits with intensified hemodialysis. Preliminary experience with daily hemodialysis and hemodiafiltration in children has been reported. Given the continuing shortage of donor organs for kidney transplantation, the increasing incidence of end-stage renal disease (ESRD) and recognition of the deleterious effects of long-lasting ESRD, growth retardation, and poor social rehabilitation, more intensified dialysis regimens are a much-needed therapeutical option in both adults and children.

  7. 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.

  8. Nanosecond gating properties of proximity focused microchannel plate image intensifiers

    NASA Astrophysics Data System (ADS)

    King, N. S. P.; King, N. S. P.; Yates, G. J.; Jaramillo, S. A.; Noel, B. W.; Detch, J. L., Jr.; Ogle, J. W.

    The optical gating properties of Multichannel plate image intensifiers were characterized. Emphasis was placed on parameters relevant to gating speed and correlations between the applied electrical and resultant optical gates.

  9. [Tuberculosis annual report 2011--(3) case finding and condition of tuberculosis on diagnosis].

    PubMed

    2013-08-01

    Tuberculosis (TB) case findings in 2011 were reviewed, particularly regarding how the cases were detected, the diagnostic delay, the proportion of far-advanced cavitary lesions, coexisting HIV infection and diabetes mellitus (DM), and drug susceptibility testing (DST) using the national TB surveillance database. Among the 22,681 TB patients newly notified in 2011, 82.1 % of the cases were detected when the patient sought healthcare or attended medical facilities because of other chief complaints. Among the 17,519 pulmonary TB patients, 25.6% had only respiratory symptoms, 32.2% had both respiratory and nonrespiratory symptoms, and 17.0% had only non-respiratory symptoms. The rest (24.5%) were asymptomatic. The prevalence of patient's and doctor's delays among the 13,108 symptomatic pulmonary TB cases were analyzed. A large proportion-approximately 25-30%--of symptomatic pulmonary TB patients aged 30-59 years exhibited a total delay (i.e., the sum of the patient's and doctor's delays) of over 3 months. The proportion of patients with a patient's delay of over 2 months exhibited a similar tendency to that of the total delay, decreasing after 60 years of age. Moreover, the proportion of patients aged 65 years or more with a doctor's delay of over 1 month was higher than that of patients aged below 65 years. There was a high proportion-approximately 30%--of symptomatic smear-positive TB patients aged less than 60 years with a total delay of over 3 months, caused by a longer patient's delay. Meanwhile, the proportion of patients--approximately 15%--with a doctor's delay of over 1 month was almost stable across all age groups. The proportion of cases with far-advanced cavities in the lungs of pulmonary TB patients increased from 1.5% in 1975, remained stable at approximately 2% from 1985-2007, and decreased slightly thereafter until 2011 to 1.8%. From 2007-2011, there were 304 newly notified TB cases with HIV infection, 263 (86.5%) and 41 (13.5%) of which were men and

  10. Roberts syndrome: study of 4 new Rgyptian cases with comparison of clinical and cytogenetic findings.

    PubMed

    Temtamy, S A; Ismail, S; Helmy, N A

    2006-01-01

    Roberts syndrome is a rare autosomal recessive genetic disorder (MIM 268300). It is characterized by pre and postnatal growth retardation, severe shortening of limbs with radial defects, oligodactyly and characteristic facial features. The present study reports 4 new cases of Roberts syndrome from 3 families presenting variable phenotypes. Patients were thoroughly investigated clinically and cytogenetically. By reviewing literature, we compared our cases to those previously reported. The rating severity system proposed by Van den Berg and Francke (30) was applied to correlate the phenotypic and cytogenetics changes. We observed more severe reduction defects in the upper limbs than in the lower limbs. While the main reduction defects in the upper limbs involved the thumb and radius ranging to phocomelia, absent or severely hypoplastic fibula was the main lower limb involvement. We emphasize this finding in the present investigation. Heterochromatin repulsion of chromosomes derived from Roberts syndrome patients is a characteristic cytogenetic abnormality. It was a constant finding in our studied patients demonstrated by DABI stain which supports the possibility that mutations in Roberts syndrome lie in centromere related proteins which may also play a role in body patterning. This was proved recently by Vega et al. (31). Application of the clinical rating score and its correlation with cytogenetic changes showed negative results. Cytogenetic studies in normal obligatory heterozygotes parents showed no changes. Phenotypic variability within the same family as well as between different families was observed. The ascertainment of 4 cases with Roberts syndrome from 3 Egyptian consanguineous families during one year in our department may indicate a high frequency of the Roberts syndrome allele among Egyptians. This confirms the need for molecular studies for early and accurate prenatal diagnosis to prevent such dramatic malformation syndrome.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. Agriculture intensifies soil moisture decline in Northern China

    DOE PAGES

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; ...

    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

  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. Chronic pancreatitis in dogs: a retrospective study of clinical, clinicopathological, and histopathological findings in 61 cases.

    PubMed

    Bostrom, Brier M; Xenoulis, Panagiotis G; Newman, Shelley J; Pool, Roy R; Fosgate, Geoffrey T; Steiner, Jörg M

    2013-01-01

    The objective of this study was to characterize the clinical, clinicopathological, and histopathological findings of dogs with chronic pancreatitis. The necropsy database at Texas A&M University was searched for reports of dogs with histological evidence of chronic pancreatitis defined as irreversible histologic changes of the pancreas (i.e. fibrosis or atrophy). A reference necropsy population of 100 randomly selected dogs was used for signalment and concurrent disease comparisons. Cases were categorized as clinical or incidental chronic pancreatitis based on the presence of vomiting, decreased appetite, or both vs. neither of these signs. All archived pancreas samples were scored histologically using a published scoring system. Sixty-one dogs with chronic pancreatitis were included. The most frequent clinical signs were lethargy, decreased appetite, vomiting, and diarrhea. Compared to the reference necropsy population, chronic pancreatitis cases were more likely to be older, neutered, of the non-sporting/toy breed group, and to have concurrent endocrine, hepatobiliary, or neurological disease. Clinical cases had significantly higher histological scores for pancreatic necrosis and peripancreatic fat necrosis, and were significantly more likely to have hepatobiliary or endocrine disease as well as increased liver enzyme activities, or elevated cholesterol and bilirubin concentrations. In conclusion, clinical disease resulting from chronic pancreatitis might be related to the presence of pancreatic necrosis and pancreatic fat necrosis. The signalment, presentation, and concurrent diseases of dogs with chronic pancreatitis are similar to those previously reported for dogs with acute pancreatitis.

  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. PMID:27672661

  19. Mobilising elementary and secondary school students for tuberculosis case finding in Anhui, China

    PubMed Central

    Kan, X. H.; Zhang, L. X.; Yang, J. A.; Zhang, J.

    2012-01-01

    Objectives: To evaluate the implementation of a FIDELIS (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) project in Anhui Province, China. Design: A survey card was designed for students to identify individuals who might have tuberculosis (TB) in their family. Teachers provided health education on TB before distributing the survey cards. Survey cards identifying individuals with respiratory symptoms for ≥3 weeks were sent by the teachers to village doctors who were trained to visit symptomatic individuals and advise them to undergo sputum examination. Data were routinely collected in the implementation of the FIDELIS project, and quarterly reports from the National Tuberculosis Programme were analysed. The detection of new smear-positive TB cases before and after FIDELIS, as well as with and without FIDELIS, were compared. Results: In the first year, a total of 2 387 405 students were involved and 23 079 symptomatic individuals were examined, among whom 2307 (10.3%) were diagnosed with smear-positive TB. Case detection in FIDELIS counties increased by a factor of 3.5 during the FIDELIS period compared with before FIDELIS, and that in non-FIDELIS counties by a factor of 3.1 (P = 0.001). Conclusion: It was feasible to massively mobilise students for TB case finding through collaboration between the health care and education systems. PMID:26392976

  20. (Manufacturing of the 40/30 mm gated image intensifier tube)

    SciTech Connect

    Vine, B.H.

    1990-04-27

    One of EG G's customers is attempting to find a manufacturer to make the 40/30 mm gated image intensifier tube. A request for quotation had been sent out to a number of manufacturers. The tube performance required was not fully defined and the replies, as expected, came back with caveats to cover the areas of uncertainty. The trip was undertaken to discuss the project, to more clearly define the areas of uncertainty and to evaluate the capabilities of the manufacturers.

  1. A survived case of diabetic nonclostridial gas gangrene and the review of the literatures on microbiological findings.

    PubMed

    Yasuda, K; Hayashi, M; Takeda, N; Goshima, E; Miura, K

    1986-05-01

    Nonclostridial gas gangrene in diabetics results in poor prognosis. In this paper, a survived case of diabetic nonclostridial gas gangrene caused by Proteus vulgaris and Streptococcus faecalis is described and microbiological findings of 31 cases of the literatures including our own case were reviewed. Twenty of 31 cases died (64.5%). The microbiological findings in 30 cases revealed an average of 1.8 organism per case. Predominant aerobes were E. Coli (56.7%), Streptococcus faecalis (16.7%), aerobic Streptococcus and Proteus (both 13.3%) in that order. Anaerobes were found in 12 of 20 cases and isolated anaerobes were Bacteroides (8 cases) and Peptococcus (4 cases). The role of specific bacteria in causing severe form of nonclostridial gas gangrene in diabetics was suggested.

  2. Two novel cases of compound heterozygous mutations in mitofusin2: Finding out the inheritance.

    PubMed

    Geroldi, Alessandro; Lastella, Patrizia; Patruno, Margherita; Gotta, Fabio; Resta, Nicoletta; Devigili, Grazia; Sabbà, Carlo; Gulli, Rossella; Lamp, Merit; Origone, Paola; Mandich, Paola; Bellone, Emilia

    2017-01-17

    MFN2 is the major gene involved in the axonal form of Charcot-Marie-Tooth disease. It usually has an autosomal dominant pattern of inheritance, but a few cases of homozygous or compound heterozygous mutations have been described. These patients usually present an earlier onset, more severe phenotype and their inheritance pattern can span from autosomal recessive to semidominant. Here we report two unrelated patients carrying two compound heterozygous MFN2 mutations. Both present a pure axonal neuropathy without any additional features. The first patient presents a mild clinical phenotype with onset in the 2nd decade, while the second patient shows a severe, early onset phenotype with loss of independent ambulation. Only a careful clinical examination as well as neurophysiological and genetic studies allowed us to establish the role and the transmission pattern of the identified variants. We discuss practical consequences of this finding in genetic counseling.

  3. A Case of Metastatic Esophageal Carcinoma in a Pregnant Woman with Radiologic Findings

    PubMed Central

    Akdemir, Zülküf; Arslan, Harun; Çalli, Iskan; Akdeniz, Hüseyin

    2016-01-01

    The incidence of all malignant tumours during pregnancy is extremely rare and esophageal carcinoma ranges from 0.07 to 0.1% of all malignant neoplasms. The physiological changes during pregnancy frequently mask the complaints and symptoms related to the disease. The physical and physiological clinical conditions limit the diagnostic approaches. Therefore, the stage of cancer at the time of diagnosis is usually advanced. The management with cancer surgery and chemotherapy regimens must be modified in pregnant women in order to minimize fetal and maternal risks. Here, we report a very rare case of metastatic esophagus cancer in a 39-year-old woman with 28 weeks of pregnancy and aim to show the ultrasound (USG) and magnetic resonance imaging (MRI) findings with treatment and follow up management. PMID:26894146

  4. Computer Tomography Imaging Findings of Abdominal Follicular Dendritic Cell Sarcoma: A Report of 5 Cases.

    PubMed

    Li, Jing; Geng, Zhi-Jun; Xie, Chuan-Miao; Zhang, Xin-Ke; Chen, Rui-Ying; Cai, Pei-Qiang; Lv, Xiao-Fei

    2016-01-01

    Follicular dendritic cell sarcoma (FDCS) is a neoplasm that arises from follicular dendritic cells. FDCSs originating in the abdomen are extremely rare. Clinically, they often mimic a wide variety of other abdominal tumors, and correct preoperative diagnosis is often a challenging task. To date, only scattered cases of abdominal FDCS have been reported and few data are available on their radiological features. Here we present the computer tomography imaging findings of 5 patients with surgically and pathologically demonstrated abdominal FDCS. An abdominal FDCS should be included in the differential diagnosis when single or multiple masses with relatively large size, well- or ill-defined borders, complex internal architecture with marked internal necrosis and/or focal calcification, and heterogeneous enhancement with "rapid wash-in and slow wash-out" or "progressive enhancement" enhancement patterns in the solid component are seen.

  5. Renal medullary carcinoma as an incidental finding in a horseshoe kidney: case report and literature review.

    PubMed

    Molgat, Gilles; Afrouzian, Marjan; Trpkov, Kiril

    2005-10-01

    Renal medullary carcinoma is rare and extremely aggressive neoplasm that typically affects young patients of African decent who demonstrate sickle cell trait or disease. Since the original description in 1995, only few cases have been reported outside the United States. A 29 year-old Canadian male of Afro-Caribbean decent with sickle cell trait developed right-sided hemiparesis due to brain infarct. During the clinical work-up, a 3 cm renal tumor was detected in a horseshoe kidney. The patient died suddenly 2 weeks after the presentation of massive non-neoplastic pulmonary thromboembolism, confirmed at autopsy. The final diagnosis of renal medullary carcinoma was established after the autopsy. Due to the small size of the tumor and the limited metastatic spread only to the regional lymph nodes, the tumor was considered an incidental finding, and not the primary cause of patient's death.

  6. [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

  7. Integrating clinical trial findings into practice through risk stratification: the case of heart failure management.

    PubMed

    Smith, David H; Johnson, Eric S; Thorp, Micah L; Crispell, Kathy A; Yang, Xiuhai; Petrik, Amanda F

    2010-06-01

    Heart failure case management programs have been shown in clinical trials to be highly effective at preventing future hospitalizations. But the absolute benefits of these programs depend on the baseline risk of outcome in the treated population. Because baseline risks of hospitalization in trials are often higher than community-based samples, translating trial results to the community setting may be misleading. One solution is to identify subgroups for intervention that have sufficiently high baseline risk. Using estimates of hospitalizations averted from a previously published systematic review of heart failure management, we estimated a program's efficiency based on level of predicted risk. Medical history and demographic data on heart failure patients from a large integrated US health plan were used to build a logistic regression-based prognostic risk score for cardiovascular-related hospitalization over 1 year. We calculated the crude rate of hospitalizations for comparison with trial data. We also calculated the program's potential dollar savings from averting hospitalizations. The average risk of hospitalization in the systematic review's trials was 45%; our population's average observed risk was 18% and the risk among the highest risk patients was 33%. After accounting for the assumed annual intervention cost of $700, the base-case analysis (at $6000 per hospitalization) shows a savings of $122/patient at highest risk; failing to intervene according to predicted risk (no targeting) would actually cost $211/patient. Our findings illustrate how clinical trial findings can be efficiently integrated into community settings by using a prognostic risk score to focus attention on high-risk subgroups.

  8. When You Can't Find the Perfect Match: Using the Accumulated Most Similar Design in Case Studies

    ERIC Educational Resources Information Center

    Quinn, John James

    2009-01-01

    What happens when you want to use a most similar case study design for a small-N study, but you cannot find a particular pair of cases where all of the relevant, competing explanations are held constant? It is proposed here that scholars and teachers could employ or teach the "accumulated most-similar/crucial case design." This design…

  9. Ophthalmic findings in acute mercury poisoning in adults: A case series study.

    PubMed

    Aslan, Lokman; Aslankurt, Murat; Bozkurt, Selim; Aksoy, Adnan; Ozdemir, Murat; Gizir, Harun; Yasar, Ibrahim

    2015-08-01

    The aim of this study is to report ophthalmic findings of acute mercury poisoning in 48 adults referred to emergency department. Full ophthalmologic examination including the best corrected visual acuity, external eye examination, reaction to light, a slit-lamp examination, funduscopy, intraocular pressure measurements, and visual field (VF) and color vision (CV) tests were performed at the presentation and repeated after 6 months. The parametric values of VF test, the mean deviation (MD), and pattern standard deviation (PSD) were recorded in order to compare patients and the 30 healthy controls. The mean parameter of color confusion index in patients was found to be statistically different than controls (p < 0.01). The MD and PSD in patients were different from controls statistically significant (p < 0.01 and p < 0.01, respectively). There was no correlation between the ocular findings and the urine and blood mercury levels. Methyl mercury, held in the school laboratory for experimental purpose, may be a source of poisoning. In this case series, we showed that acute exposure to mercury had hazardous effect on the visual system, especially CV and VF. We propose that emphasizing the public education on the potential hazards of mercury is crucial for preventive community health.

  10. 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.

  11. 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.

  12. A case of pigmentary orthochromatic leukodystrophy with findings of proton MR spectroscopy and serial brain MRIs.

    PubMed

    Sohn, Sung-Yeon; Ko, Young-Jin; Hong, Ji Man; Kim, Se-Hyuk; Kim, Ho-Sung; Kim, Jang-Hee; Chi, Je-Geun; Moon, So Young

    2010-08-15

    Despite a few case reports over the last 60 years, little progress has been made in defining the phenotype, genotype and pathophysiological mechanisms involved in pigmentary orthochromatic leukodystrophy (POLD). Furthermore, there is currently no data available regarding MRI in patients in the relatively early stages of POLD. Here, we present a 37 year old male patient with brain biopsy-proven POLD who had brain MRIs three times during the first year of his clinical course and proton MR spectroscopy (MRS) throughout his diagnostic evaluation. This patient with POLD was clinically characterized by seizures, rapidly progressive frontally predominant dementia and gait disturbance. The brain MRIs taken serially over the first year revealed progressive development of frontal-predominant white matter changes in the periventricular areas during the earlier periods, which later spread into the deep white matter. His MRS was helpful in the diagnostic approach because the results enabled demyelinating changes to be distinguished from other disease processes such as ischemia, gliosis or tumors. The MRS findings also reflected the disease dynamics because metabolic derangement was observed, even in the white matter that appeared normal. The findings presented here provide insight into the dynamics of POLD.

  13. Proximal ureteral atresia, a rare congenital anomaly-incidental finding: a case report.

    PubMed

    Bleve, Cosimo; Conighi, Maria Luisa; Fasoli, Lorella; Bucci, Valeria; Battaglino, Francesco; Chiarenza, Salvatore Fabio

    2017-01-01

    Ureteral atresia is a rare disease usually associated with a non-functioning dysplastic kidney. The condition may be unilateral or bilateral; focal, short or long and may involve any part of the ureter. Association with other urinary anomalies is rare. We report the case of a 10-month-old boy with prenatal diagnosis of multicystic right kidney. This suspicion was confirmed after birth by ultrasound and static scintigraphy; a right vesicoureteral reflux (VUR) was recorded at cystography. The boy presented a regular renal function but was hospitalized twice for suspected pyelonephritis between the 8th and the 10th month of life and were recorded occasional mild changes in blood pressure. Antibiotic prophylaxis was administered until surgery. When he was 10-month underwent retroperitoneoscopy to perform a nephroureterectomy finding a complete atresia of the upper third of the ureter with the blind end at the level of the uretero-pelvic-junction. The programmed surgery was performed. By a revision of literature, only few cases of imperforate distal ureter have been described. This condition is associated with a kidney dysplasia. The atresia of the ureter with no signs of infection in the dysplastic kidney may be unknown up to adulthood or throughout one's life. Prognosis usually depends on the severity of the obstruction.

  14. Clinical features and imaging findings in a case of Capgras syndrome

    PubMed Central

    Luca, Maria; Bordone, Andrea; Luca, Antonina; Patti, Andrea; Sortino, Giuseppe; Calandra, Carmela

    2013-01-01

    Capgras syndrome consists of the delusional belief that a person or persons have been replaced by doubles or impostors. It can occur in the context of both psychiatric and organic illness, and seems to be related to lesions of the bifrontal and right limbic and temporal regions. Indeed, magnetic resonance imaging has revealed brain lesions in patients suffering from Capgras syndrome. This case study reports the findings of a thorough diagnostic evaluation in a woman suffering from Capgras syndrome and presenting with the following clinical peculiarities: obsessive modality of presentation of the delusional ideation, intrusiveness of such ideation (that even disturbed her sleep), as well as a sense of alienation and utter disgust towards the double. These characteristics bring to mind the typical aspects of obsessive-compulsive disorder. Neuroanatomic investigation, through magnetic resonance imaging, performed on this patient showed alteration of the bilateral semioval centers, which are brain regions associated with the emotion of disgust and often show alterations in subjects suffering from obsessive-compulsive disorder. Hence, neuroimaging allows researchers to put forward the hypothesis of a common neuroanatomic basis for Capgras syndrome and obsessive-compulsive disorder, at least for cases in which the delusional ideation is associated with deep feelings of disgust and presents with a certain pervasiveness. PMID:23950650

  15. Proximal ureteral atresia, a rare congenital anomaly—incidental finding: a case report

    PubMed Central

    Conighi, Maria Luisa; Fasoli, Lorella; Bucci, Valeria; Battaglino, Francesco; Chiarenza, Salvatore Fabio

    2017-01-01

    Ureteral atresia is a rare disease usually associated with a non-functioning dysplastic kidney. The condition may be unilateral or bilateral; focal, short or long and may involve any part of the ureter. Association with other urinary anomalies is rare. We report the case of a 10-month-old boy with prenatal diagnosis of multicystic right kidney. This suspicion was confirmed after birth by ultrasound and static scintigraphy; a right vesicoureteral reflux (VUR) was recorded at cystography. The boy presented a regular renal function but was hospitalized twice for suspected pyelonephritis between the 8th and the 10th month of life and were recorded occasional mild changes in blood pressure. Antibiotic prophylaxis was administered until surgery. When he was 10-month underwent retroperitoneoscopy to perform a nephroureterectomy finding a complete atresia of the upper third of the ureter with the blind end at the level of the uretero-pelvic-junction. The programmed surgery was performed. By a revision of literature, only few cases of imperforate distal ureter have been described. This condition is associated with a kidney dysplasia. The atresia of the ureter with no signs of infection in the dysplastic kidney may be unknown up to adulthood or throughout one’s life. Prognosis usually depends on the severity of the obstruction. PMID:28164035

  16. Meconium pseudocyst with particular pathologic findings: a case report and review of the literature.

    PubMed

    Minato, Masashi; Okada, Tadao; Miyagi, Hisayuki; Honda, Shohei; Takazawa, Kei; Kubota, Kanako C; Todo, Satoru

    2012-04-01

    Meconium peritonitis is a sterile chemical peritonitis caused by bowel perforation with intraperitoneal extravasation of the meconium in utero. When the inflamed intestinal loops become fixed, meconium peritonitis leads to a cystic cavity with a fibrous wall, and the result is termed cystic-type meconium peritonitis. On the contrary, a meconium pseudocyst has a muscle layer continuous with the normal intestine and is distinguished from cystic-type meconium peritonitis based on the histopathologic findings. This report describes the rare case of a neonate complicated by a meconium pseudocyst, which was successfully treated with 1-stage resection and primary anastomosis. There have been few cases of meconium pseudocysts reported in the literature. Meconium peritonitis should be considered in the differential diagnosis in patients who develop large abdominal cysts with air and fluid content. Cystic-type meconium peritonitis is usually treated using drainage with subsequent elective surgery. However, for a meconium pseudocyst, 1-stage intestinal resection with primary anastomosis may be recommended. A meconium pseudocyst may be treatable using 1-stage resection based on histopathologic features.

  17. Clinical and laboratory findings in chronic conjunctivitis in cats: 91 cases (1983-1991).

    PubMed

    Nasisse, M P; Guy, J S; Stevens, J B; English, R V; Davidson, M G

    1993-09-15

    Clinical findings and laboratory test results from 91 cats with chronic conjunctivitis were studied to determine the causes of the disease and the sensitivity of diagnostic procedures used, and to identify correlations between results of various diagnostic procedures and clinical or signalment variations. Mean age of affected cats was 2.9 +/- 2.7 years (+/- SD), with a range from 1 month to 11 years. Conjunctivitis was more likely to be bilateral (56 cats) than unilateral (35 cats). In cats tested for FeLV or feline immunodeficiency virus infection, 15 and 8.5%, respectively, of the results were positive, compared with 4 and 2.6% for the general hospital population. Culturing or immunofluorescent assay (IFA) for feline herpesvirus 1 (FHV-1) and Chlamydia psittaci IFA resulted in identification of pathogens (positive test results) in 19% (FHV-1) and 18% (C psittaci) of tested cats. For FHV-1, culturing was more sensitive than was IFA, yielding positive results in 19 vs 8.8% of cases. In only 1 cat were FHV-1 and chlamydiae recovered. The probability of positive test results for FHV-1 or chlamydiae was unrelated to concurrent corneal disease, unilateral vs bilateral involvement, or age. Cause of conjunctivitis could not be definitively determined in the remaining 35 cases tested for both agents. Bacterial species considered to be potentially pathogenic were isolated from conjunctival sac specimens in only 1 of 38 attempts. Cytologic changes considered compatible with chlamydial or FHV-1 infection (intracytoplasmic inclusions or multinucleated epithelial cells, respectively) were found in 8 and 5 cases, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. 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

  19. [Case of spontaneous ventriculocisternostomy: with special reference to a CT finding].

    PubMed

    Yamane, K; Yoshimoto, H; Harada, K; Uozumi, T; Kuwabara, S

    1983-05-01

    Spontaneous ventriculocisternostomy rarely occurs in obstructive hydrocephalus. The authors experienced a case of spontaneous ventriculocisternostomy diagnosed by CT scan with metrizamide and Conray. Patient was 23-year-old male who had been in good health until one month before admission, when he began to have headache and tinnitus. He noticed bilateral visual acuity was decreased about one week before admission and vomiting appeared two days before admission. He was admitted to our hospital because of bilateral papilledema and remarkable hydrocephalus diagnosed by CT scan. On admission, no abnormal neurological signs except for bilateral papilledema were noted. Immediately, right ventricular drainage was performed. Pressure of the ventricle was over 300 mmH2O and CSF was clear. PVG and PEG disclosed an another cavity behind the third ventricle, which was communicated with the third ventricle, and occlusion of aqueduct of Sylvius. Metrizamide CT scan and Conray CT scan showed a communication between this cavity and quadrigeminal and supracerebellar cisterns. On these neuroradiological findings, the diagnosis of obstructive hydrocephalus due to benign aqueduct stenosis accompanied with spontaneous ventriculocisternostomy was obtained. Spontaneous ventriculocisternostomy was noticed to produce arrest of hydrocephalus, but with our case, spontaneous regression of such symptoms did not appeared. In the literature, arrest of hydrocephalus was noted in 50 per cent of 14 cases of obstructive hydrocephalus with spontaneous ventriculocisternostomy. By surgical ventriculocisternostomy (method by Torkildsen, Dandy, or Scarff), arrest of hydrocephalus was seen in about 50 to 70 per cent, which was the same results as those of spontaneous ventriculocisternostomy. It is concluded that VP shunt or VA shunt is thought to be better treatment of obstructive hydrocephalus than the various kinds of surgical ventriculocisternostomy.

  20. [TUBERCULOSIS ANNUAL REPORT 2013--(3) Case Finding and Condition of Tuberculosis on Diagnosis].

    PubMed

    2015-06-01

    In 2013, tuberculosis (TB) case findings from the nationwide TB surveillance data in Japan were reviewed with regard to the mode of detection, symptom at diagnosis, diagnostic delay, proportion of far-advanced cavitary lesions, co-existence of human immunodeficiency virus (HIV) infection and diabetes mellitus (DM), and drug susceptibility testing (DST). Among the 20,495 new TB cases in 2013, 83.1% were diagnosed when the patients sought medical attention for TB symptoms or attended medical facilities because of other chief complaints. Among the 15,972 patients with pulmonary TB, 26.4% had only respiratory symptoms, 30.5% had respiratory and non-respiratory symptoms, 17.8% had only non-respiratory symptoms, and 24.5% were asymptomatic. The proportion of patient and doctor delays among the 11,933 symptomatic pulmonary TB cases was analyzed. A large proportion--around 30%--of patients aged 45-54 years with symptomatic pulmonary TB exhibited a patient delay of ≥ 2 months. The proportion of patients with a total delay (i.e., the sum of patient and doctor delays) of ≥ 3 months exhibited a similar tendency to that of those with a patient delay. The proportion of patients aged ≥ 65 years with a doctor delay of ≥ 1 month surpassed that of age-matched patients with a patient delay. Among symptomatic smear-positive TB, a patient delay of ≥ 2 months exhibited a bimodal distribution, and its peak was > 35%. The proportion of patient delay in those aged 30-39 years decreased compared to that of recent years. Meanwhile, the proportion of patients--approximately 15%--with a doctor delay of ≥ 1 month was relatively stable across all the age groups. The proportion of patients with pulmonary TB who had far-advanced cavities in the lungs increased from 1.5% in 1975 to approximately 2% and then remained stable from 1985 to 2013. Among the 50 new TB cases with HIV in 2013, 5 occurred in women and 10 in foreigners. From 2007 to 2013, there were 416 patients with newly

  1. Active case finding strategy for chronic obstructive pulmonary disease with handheld spirometry.

    PubMed

    Kim, Joo Kyung; Lee, Chang Min; Park, Ji Young; Kim, Joo Hee; Park, Sung-Hoon; Jang, Seung Hun; Jung, Ki-Suck; Yoo, Kwang Ha; Park, Yong Bum; Rhee, Chin Kook; Kim, Deog Kyeom; Hwang, Yong Il

    2016-12-01

    The early detection and diagnosis of chronic obstructive pulmonary disease (COPD) is critical to providing appropriate and timely treatment. We explored a new active case-finding strategy for COPD using handheld spirometry.We recruited subjects over 40 years of age with a smoking history of more than 10 pack-years who visited a primary clinic complaining of respiratory symptoms. A total of 190 of subjects were enrolled. Medical information was obtained from historical records and physical examination by general practitioners. All subjects had their pulmonary function evaluated using handheld spirometry with a COPD-6 device. Because forced expiratory volume in 6 seconds (FEV6) has been suggested as an alternative to FVC, we measured forced expiratory volume in 1 second (FEV1)/FEV6 for diagnosis of airflow limitation. All subjects were then referred to tertiary referral hospitals to complete a "Could it be COPD?" questionnaire, handheld spiromtery, and conventional spirometry. The results of each instrument were compared to evaluate the efficacy of both handheld spirometry and the questionnaire.COPD was newly diagnosed in 45 (23.7%) patients. According to our receiver-operating characteristic (ROC) curve analysis, sensitivity and specificity were maximal when the FEV1/FEV6 ratio was less than 77%. The area under the ROC curve was 0.759. The sensitivity, specificity, positive predictive value, and negative predictive value were 72.7%, 77.1%, 50%, and 90%, respectively. The area under the ROC curve of respiratory symptoms listed on the questionnaire ranged from 0.5 to 0.65, which indicates that there is almost no difference compared with the results of handheld spirometry.The present study demonstrated the efficacy of handheld spirometry as an active case-finding tool for COPD in a primary clinical setting. This study suggested that physicians should recommend handheld spirometry for people over the age of 40, who have a smoking history of more than 10 pack

  2. The Cluster-Randomized BRIGHT Trial: Proactive Case Finding for Community-Dwelling Older Adults

    PubMed Central

    Kerse, Ngaire; McLean, Chris; Moyes, Simon A.; Peri, Kathy; Ng, Terence; Wilkinson-Meyers, Laura; Brown, Paul; Latham, Nancy; Connolly, Martin

    2014-01-01

    PURPOSE People are now living longer, but disability may affect the quality of those additional years of life. We undertook a trial to assess whether case finding reduces disability among older primary care patients. METHODS We conducted a cluster-randomized trial of the Brief Risk Identification Geriatric Health Tool (BRIGHT) among 60 primary care practices in New Zealand, assigning them to an intervention or control group. Intervention practices sent a BRIGHT screening tool to older adults every birthday; those with a score of 3 or higher were referred to regional geriatric services for assessment and, if needed, service provision. Control practices provided usual care. Main outcomes, assessed in blinded fashion, were residential care placement and hospitalization, and secondary outcomes were disability, assessed with Nottingham Extended Activities of Daily Living Scale (NEADL), and quality of life, assessed with the World Health Organization Quality of Life scale, abbreviated version (WHOQOL-BREF). RESULTS All 8,308 community-dwelling patients aged 75 years and older were approached; 3,893 (47%) participated, of whom 3,010 (77%) completed the trial. Their mean age was 80.3 (SD 4.5) years, and 55% were women. Overall, 88% of the intervention group returned a BRIGHT tool; 549 patients were referred. After 36 months, patients in the intervention group were more likely than those in the control group to have been placed in residential care: 8.4% vs 6.2% (hazard ratio = 1.32; 95% CI, 1.04–1.68; P = .02). Intervention patients had smaller declines in mean scores for physical health-related quality of life (1.6 vs 2.9 points, P = .007) and psychological health-related quality of life (1.1 vs 2.4 points, P = .005). Hospitalization, disability, and use of services did not differ between groups, however. CONCLUSIONS Our case-finding strategy was effective in increasing identification of older adults with disability, but there was little evidence of improved outcomes

  3. 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

  4. Methamphetamine in hair and interpretation of forensic findings in a fatal case.

    PubMed

    Beránková, Katerina; Habrdová, Vilma; Balíková, Marie; Strejc, Premysl

    2005-10-04

    Hair analysis for drugs has been developing and is considered a significant tool for distinguishing between recent and long-term drug abuse in forensic and clinical toxicology. Chronic consumption of drugs can gradually induce certain harmful effects on the human organism and can exacerbate some pre-existing diseases. Analysis for drugs in blood or urine in isolation does not provide sufficient information about the history of drug-use by a person and their results cannot be correlated directly with the toxic effects displayed. The chronic abuse of methamphetamine is known to be associated with cardiovascular diseases. During or after autopsy certain types of morphologic alterations are found in the hearts of stimulant addicts. The rapid increase in blood pressure after an intravenous methamphetamine dose can be risky for addicts with arteriosclerosis. However, the anamnestic data about a deceased person may not always be available to explain the pathological findings and to classify the cause of death correctly. The aim of this study was to demonstrate the value of hair analysis for drugs in the context of explaining pathological cardiovascular alterations observed during the autopsy in a case where methamphetamine consumption was involved. In this case, only methamphetamine and metabolites were detected with traces of ephedrine. Ephedrine is the precursor chemical in the illicit synthesis of methamphetamine (known in the Czech Republic as "Pervitin"). The femoral blood level of methamphetamine was 1500 ng/ml. It was documented by a witness that the 31-year-old man died within 1h after an intravenous injection of the drug. The cause of death was established as cerebral edema due to cerebellar bleeding shortly after an intravenous dose of methamphetamine. Findings of methamphetamine in the first three 2-cm hair segments (numbered from the roots) were nearly equal (132+/-9 ng/mg). In the fourth 2-cm segment, it was approximately one-half of previous values. In the

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

    PubMed Central

    Kallumpuram, Sen; Sudhir Kumar, CT; 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

  6. Active case finding strategy for chronic obstructive pulmonary disease with handheld spirometry

    PubMed Central

    Kim, Joo Kyung; Lee, Chang Min; Park, Ji Young; Kim, Joo Hee; Park, Sung-hoon; Jang, Seung Hun; Jung, Ki-Suck; Yoo, Kwang Ha; Park, Yong Bum; Rhee, Chin Kook; Kim, Deog Kyeom; Hwang, Yong Il

    2016-01-01

    Abstract The early detection and diagnosis of chronic obstructive pulmonary disease (COPD) is critical to providing appropriate and timely treatment. We explored a new active case-finding strategy for COPD using handheld spirometry. We recruited subjects over 40 years of age with a smoking history of more than 10 pack-years who visited a primary clinic complaining of respiratory symptoms. A total of 190 of subjects were enrolled. Medical information was obtained from historical records and physical examination by general practitioners. All subjects had their pulmonary function evaluated using handheld spirometry with a COPD-6 device. Because forced expiratory volume in 6 seconds (FEV6) has been suggested as an alternative to FVC, we measured forced expiratory volume in 1 second (FEV1)/FEV6 for diagnosis of airflow limitation. All subjects were then referred to tertiary referral hospitals to complete a “Could it be COPD?” questionnaire, handheld spiromtery, and conventional spirometry. The results of each instrument were compared to evaluate the efficacy of both handheld spirometry and the questionnaire. COPD was newly diagnosed in 45 (23.7%) patients. According to our receiver-operating characteristic (ROC) curve analysis, sensitivity and specificity were maximal when the FEV1/FEV6 ratio was less than 77%. The area under the ROC curve was 0.759. The sensitivity, specificity, positive predictive value, and negative predictive value were 72.7%, 77.1%, 50%, and 90%, respectively. The area under the ROC curve of respiratory symptoms listed on the questionnaire ranged from 0.5 to 0.65, which indicates that there is almost no difference compared with the results of handheld spirometry. The present study demonstrated the efficacy of handheld spirometry as an active case-finding tool for COPD in a primary clinical setting. This study suggested that physicians should recommend handheld spirometry for people over the age of 40, who have a smoking history of more than

  7. Retrospective case series of the imaging findings of facial nerve hemangioma.

    PubMed

    Yue, Yunlong; Jin, Yanfang; Yang, Bentao; Yuan, Hui; Li, Jiandong; Wang, Zhenchang

    2015-09-01

    The aim was to compare high-resolution computed tomography (HRCT) and thin-section magnetic resonance imaging (MRI) findings of facial nerve hemangioma. The HRCT and MRI characteristics of 17 facial nerve hemangiomas diagnosed between 2006 and 2013 were retrospectively analyzed. All patients included in the study suffered from a space-occupying lesion of soft tissues at the geniculate ganglion fossa. Affected nerve was compared for size and shape with the contralateral unaffected nerve. HRCT showed irregular expansion and broadening of the facial nerve canal, damage of the bone wall and destruction of adjacent bone, with "point"-like or "needle"-like calcifications in 14 cases. The average CT value was 320.9 ± 141.8 Hu. Fourteen patients had a widened labyrinthine segment; 6/17 had a tympanic segment widening; 2/17 had a greater superficial petrosal nerve canal involvement, and 2/17 had an affected internal auditory canal (IAC) segment. On MRI, all lesions were significantly enhanced due to high blood supply. Using 2D FSE T2WI, the lesion detection rate was 82.4 % (14/17). 3D fast imaging employing steady-state acquisition (3D FIESTA) revealed the lesions in all patients. HRCT showed that the average number of involved segments in the facial nerve canal was 2.41, while MRI revealed an average of 2.70 segments (P < 0.05). HRCT and MR findings of facial nerve hemangioma were typical, revealing irregular masses growing along the facial nerve canal, with calcifications and rich blood supply. Thin-section enhanced MRI was more accurate in lesion detection and assessment compared with HRCT.

  8. 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

  9. Malabsorption syndrome with cow's milk intolerance. Clinical findings and course in 54 cases.

    PubMed Central

    Kuitunen, P; Visakorpi, J K; Savilahti, E; Pelkonen, P

    1975-01-01

    Fifty-four infants with the malabsorption syndrome and cow's milk intolerence seen during 1962-1971 were investigated. All had diarrhoea and failed to thrive. Most had vomiting and about 20% had atopic eczema and recurrent respiratory infections. Laboratory investigations revealed malabsorption, raised serum IgA, and precipitins to cow's milk. Biopsies showed that the jejunal mucosa was damaged, and in about half the cases was flat. The patient did well on human milk but reacted clinically to cow's milk challenge, either in a few hours or gradually during 3-4 weeks. Some patients showed first a quick, but later a slow, reaction. Clinical symptoms of cow's milk intolerance disappeared at the age of about one year. At that time 81% had normal faecal fat, but only 29% had a normal proximal jejunal mucosa. Many of the patients developed intolerances to other food proteins, such as soya and wheat, if these were given during the sensitive period. Forty-two patients have been followed up for 2 years on a normal gluten-containing diet. Of these, 37 have a normal or nearly normal jejunal mucosa and 5 (12%) have subtotal villous atrophy indicative of coeliac disease. It is concluded that the malabsorption syndrome with cow's milk intolerance is a clear-cut clinical entity. However, the symptomatology, results of laboratory tests, and jejunal biopsy findings closely resemble those of other entities where damage to the intestinal mucosa causes a malabsorption snydrome. Follow-up studies showed that the disease is transient, but about 10% of the patients have coeliac disease, regarded in such cases as the primary disorder. PMID:1242623

  10. Malabsorption syndrome with cow's milk intolerance. Clinical findings and course in 54 cases.

    PubMed

    Kuitunen, P; Visakorpi, J K; Savilahti, E; Pelkonen, P

    1975-05-01

    Fifty-four infants with the malabsorption syndrome and cow's milk intolerence seen during 1962-1971 were investigated. All had diarrhoea and failed to thrive. Most had vomiting and about 20% had atopic eczema and recurrent respiratory infections. Laboratory investigations revealed malabsorption, raised serum IgA, and precipitins to cow's milk. Biopsies showed that the jejunal mucosa was damaged, and in about half the cases was flat. The patient did well on human milk but reacted clinically to cow's milk challenge, either in a few hours or gradually during 3-4 weeks. Some patients showed first a quick, but later a slow, reaction. Clinical symptoms of cow's milk intolerance disappeared at the age of about one year. At that time 81% had normal faecal fat, but only 29% had a normal proximal jejunal mucosa. Many of the patients developed intolerances to other food proteins, such as soya and wheat, if these were given during the sensitive period. Forty-two patients have been followed up for 2 years on a normal gluten-containing diet. Of these, 37 have a normal or nearly normal jejunal mucosa and 5 (12%) have subtotal villous atrophy indicative of coeliac disease. It is concluded that the malabsorption syndrome with cow's milk intolerance is a clear-cut clinical entity. However, the symptomatology, results of laboratory tests, and jejunal biopsy findings closely resemble those of other entities where damage to the intestinal mucosa causes a malabsorption snydrome. Follow-up studies showed that the disease is transient, but about 10% of the patients have coeliac disease, regarded in such cases as the primary disorder.

  11. Measured responsivities of generation II and hybrid image intensifiers

    SciTech Connect

    Yates, G.J.; King, N.S.P.; Thomas, M.C.

    1995-07-01

    We have measured the absolute and coupled system responsivities of several image intensifier types at several wavelengths in the visible spectrum. Intensifiers characterized include microchannel plate (MCP) generation II proximity-focused and hybrid generation I/generation II electrostatic-focused designs. Configurations including single plate, double plate, nominal and high strip current MCPs, and standard S20 and super generation II enhanced S-20 photocathodes were evaluated. Absolute responsivity measurements were performed using NIST-traceable radiometry instrumentation. The normalized relative sensitivities and overall optical luminous gain performance provided by individual intensifiers when similarly coupled to either high resolution 10-bit RS-170 CCD or FPS cameras are presented along with their radiometric data.

  12. 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

  13. Medical Image Intensifier In 1980 (What Really Happened)

    NASA Astrophysics Data System (ADS)

    Baiter, Stephen; Kuhl, Walter

    1980-08-01

    In 1972, at the first SPIE seminar covering the application of optical instrumentation in medicine, Balter and Stanton presented a paper forecasting the status of x-ray image intensifiers in the year 1980. Now, eight years later, it is 1980, and it seems a good idea to evaluate these forecasts in the light of what has actually happened. The x-ray sensitive image intensifier tube (with cesium iodide as an input phosphor) is used nearly universally. Input screen sizes range from 15 cm to 36 cm in diameter. Real time monitoring of both fluoroscopic and fluorographic examinations is generally performed via closed circuit television. Archival recording of images is carried out using cameras with film formats of approximately 100 mm for single exposure or serial fluorography and 35 mm for cine fluorography. With the detective quantum efficiency of image intensifier tubes remaining near 50% throughout the decade, the noise content of most fluorographic and fluoroscopic images is still determined by the input exposure. Consequently, patient doses today, in 1980, have not substantially changed in the last ten years. There is, however, interest in uncoupling the x-ray dose and the image brightness by providing a variable optical diaphragm between the output of the image intensifier tube and the recording devices. During the past eight years, there has been a major philosophical change in the approach to imaging systems. It is now realized that medical image quality is much more dependent on the reduction of large area contrast losses than on the limiting resolution of the imaging system. It has also been clear that much diagnostic information is carried by spatial frequencies in the neighborhood of one line pair per millimeter (referred to the patient). The design of modern image intensifiers has been directed toward improvement in the large area contrast by minimizing x-ray and optical scatter in both the image intensifier tube and its associated components.

  14. Analog signal processing for a spaceborne Digicon image intensifier

    NASA Astrophysics Data System (ADS)

    Oberlack, N.; Klein, J. W.; Tueg, H.

    The paper presents the Digicon image intensifier, which uses a multidetector arrangement. The general instrument movement and electronic requirements are reviewed. A circuit diagram is used to illustrate circuit arrangement, and the technological state-of-the-art of multiple-thickness-configurations is discussed. Possible modifications in the image intensifier are considered, and technical parameters of the analog electronics (one channel) include a conversion factor of 1.9 microA/keV, a power requirement of 4.1 mW, a working temperature range of -55 to +125 C, and a dimension of 25.4 x 4.5 sq mm.

  15. Effects of Cumulus Convection on Rapidly Intensifying Cyclones

    DTIC Science & Technology

    2016-06-07

    Effects Of Cumulus Convection On Rapidly Intensifying Cyclones M.K. Yau and R. R. Rogers Department of Atmospheric and Oceanic Sciences McGill...N00014-96-1-0746 LONG-TERM GOAL Our long term goal is to contribute to our understanding of the physics and dynamics of marine convection and mesoscale...00-00-1999 to 00-00-1999 4. TITLE AND SUBTITLE Effects Of Cumulus Convection On Rapidly Intensifying Cyclones 5a. CONTRACT NUMBER 5b. GRANT NUMBER

  16. Dental findings and rehabilitation in familial osteodysplasia (Anderson type): a case report.

    PubMed

    Deger, S; Tabar, G; Sermet, B; Tanyeri, H; Kurklu, E

    2006-03-01

    Familial osteodysplasia is a disorder of osteogenesis with an autosomal recessive pattern of inheritance which predominantly affects facial bones. No recent case had been reported, particularly from a dental point of view since the syndrome was first described by Anderson et al (JAMA 1972;220:1687-93). A 23-year-old male with familial osteodysplasia was presented in maxillofacial and dental aspects with clinical and radiological manifestations including malocclusion, abnormal teeth alignment, impacted teeth, shape disturbances including uncompleted coronal formation, root shortening with bulbous form, high angled mandible and elongation of the corpus of mandible. Recognition of the syndromal features prior to any dental intervention is of paramount importance because of increased inclination to spontaneous mandibular fractures. Hence, no surgical intervention was performed for impacted teeth. Following the extractions of severely mobile teeth, a definitive restoration was fabricated as distal-extension removable partial dentures with conus crown telescopic system. The aesthetic and functional outcome was satisfactory for the patient. In conclusion, dentists appear to play an important role in the recognition of familial osteodysplasia, based on maxillofacial and dentoalveolar findings. Awareness of the syndromal features, especially of spontaneous fractures, would detect the limitations for dental interventions and treatment planning.

  17. 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

  18. Mammary analogue secretory carcinoma: the first submandibular case reported including findings on fine needle aspiration cytology.

    PubMed

    Petersson, Fredrik; Lian, Derrick; Chau, Yuk Ping; Yan, Benedict

    2012-03-01

    We present the first case (male, 35 years old) of a mammary analogue secretory carcinoma occurring in a submandibular gland and document findings on fine needle aspiration cytology. On histology, the tumor displayed characteristic features: circumscribed nodules composed of bland, pink to light red neoplastic cells with low proliferative/mitotic activity arranged in tubular, vaguely cribriform, and microcystic structures containing Periodic acid Schiff-positive, diastase-resistant secretory material. Immunohistochemistry showed strong and diffuse positivity for cytokeratin 7, S100 protein, and vimentin, as well as moderate to strong immunoreactivity for c-kit in the majority of tumor cells. A rearrangement of the ETV6 gene on fluorescence in situ hybridization was documented. The patient underwent an ipsilateral selective (levels I-IV) neck dissection which showed metastasis in 3 out of 36 lymph nodes (levels 1-3). Adjuvant radiotherapy was administered. No local recurrence or metastatic disease has been detected during a follow up period of 28 months.

  19. Epidermoid cyst in Meckel's cave with unusual computed tomography and magnetic resonance imaging findings. Case report.

    PubMed

    Arai, Atsushi; Sasayama, Takashi; Koyama, Junji; Fujita, Atsushi; Hosoda, Kohkichi; Kohmura, Eiji

    2010-01-01

    A 27-year-old woman presented with headache and occasional numbness over her right face. Computed tomography revealed a hypodense mass in the middle cranial fossa and another adjacent hyperdense mass in the posterior fossa with erosion of the right petrous apex. Magnetic resonance imaging revealed the lesion in the middle cranial fossa as iso- to hypointense on T(1)-weighted and hyperintense on T(2)-weighted imaging, with peripheral enhancement after gadolinium administration, and the adjacent lesion in the posterior fossa as hyperintense on T(1)-weighted and hypointense on T(2)-weighted imaging. During surgery, these lesions mimicking two adjacent distinct tumors were revealed to connect through Meckel's cave. The hypodense lesion in the middle cranial fossa consisted of pearly-like solid contents, and the hyperdense lesion in the posterior cranial fossa consisted of viscid dark-green materials. The tumors were gross totally resected with endoscopic assistance. Histological examination confirmed that the tumor was an epidermoid cyst. The present case cyst indicates that although the diffusion-weighted imaging sequence is useful for detection of intracranial epidermoid cysts, epidermoid cysts including viscous materials with unusual radiological findings could complicate the preoperative diagnosis.

  20. 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…

  1. 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…

  2. 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…

  3. 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…

  4. 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

  5. Physician perspectives on de-intensifying diabetes medications

    PubMed Central

    Genere, Natalia; Sargis, Robert M.; Masi, Christopher M.; Nathan, Aviva G.; Quinn, Michael T.; Huang, Elbert S.; Laiteerapong, Neda

    2016-01-01

    Abstract Guidelines for diabetes care recommend that physicians select individualized glycemic goals based on life expectancy, diabetes duration, comorbidity, and resources/support. When patients have stable hemoglobin A1C (HbA1C) levels, guidelines lack recommendations on when diabetes medications should be de-intensified. To understand physicians’ perspectives on de-intensifying diabetes medications in patients with type 2 diabetes. Cross-sectional survey, (February–June, 2015). Academic medical center and suburban integrated health system. Primary care and endocrinology physicians. Physicians’ self-reported: awareness, agreement, and frequency of individualizing HbA1C goals; practice of de-intensifying diabetes medications; HbA1C values at which physicians de-intensify diabetes medications; and other patient factors physicians consider when de-intensifying diabetes medications. Response rate was 73% (156/213). Most physicians (78%) responded they were familiar with recommendations to individualize HbA1C goals. For patients with stable HbA1C levels, 80% of physicians reported they had initiated conversations about stopping medications; however, physicians differed in predefined HbA1C levels used to initiate conversations (HbA1C < 5.7%: 14%; HbA1C < 6.0%: 31%; HbA1C < 6.5%: 22%; individualized level: 21%). In multiple logistic regression, women physicians (odds ratio [OR] 3.0; confidence interval [CI] 1.1–8.2; P = 0.03) and physicians practicing fewer than 20 years (OR 2.8; CI 1.01–7.7; P = 0.048) were more likely to report de-intensifying diabetes medications. Individualizing glycemic goals and de-intensifying treatments are concepts well accepted by physicians in our sample. However, physicians vary considerably in reporting how they carry out recommendations to individualize and may be missing opportunities to stop or taper diabetes medications based on patients’ individualized glycemic goals. PMID:27861373

  6. 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

  7. Prenatal findings in a case of massive fetomaternal hemorrhage associated with intraplacental choriocarcinoma.

    PubMed

    Aso, Kaai; Tsukimori, Kiyomi; Yumoto, Yasuo; Hojo, Satoshi; Fukushima, Kotaro; Koga, Takaomi; Sueishi, Katsuo; Takahata, Yasushi; Hara, Toshiro; Wake, Norio

    2009-01-01

    We describe biochemical assessment of maternal circulation in a case of massive fetomaternal hemorrhage at term associated with intraplacental choriocarcinoma. Markedly elevated maternal serum hCG level at 37 weeks of gestation suggested choriocarcinoma as a cause of fetomaternal hemorrhage in this case. Measurement of maternal hCG may be a useful parameter when intraplacental choriocarcinoma is in the differential diagnosis. In addition, the placenta should be examined in all cases of fetomaternal hemorrhage.

  8. 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

  9. 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

  10. 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…

  11. How did soil dryness intensify recent European heatwaves?

    NASA Astrophysics Data System (ADS)

    Miralles, Diego; Teuling, Ryan; van Heerwaarden, Chiel; Vilá-Guerau de Arellano, Jordi

    2014-05-01

    In August 2010 a mega-heatwave hit large parts of Eastern Europe and Russia, breaking the historical records from the 2003 event in Western Europe. While such heatwaves are predicted to become common by the end of this century, our understanding of the physics behind these phenomena is still imperfect, and so is their representation in climate models. In this presentation we will provide new evidence of how land-atmosphere feedbacks contribute to the development of the extreme temperatures based on satellite observations, climate model reanalyses data (ERA Interim), balloon sounding measurements, soil moisture-temperature coupling diagnostics and mechanistic modelling of the lower atmosphere. Results of our analyses show that in both European mega-heatwaves, persistent synoptic conditions favored evaporation and intensified soil desiccation. As a consequence of soil dryness, a deep residual atmospheric boundary layer (ABL) developed, which allowed the multi-day storage of heat coming from: (a) large-scale horizontal advection, (b) intense warming from the land surface associated to the increasingly dry soils, and (c) enhanced warm air entrainment from the top of the ABL (which counteracted the dilution effect of the gradually deeper layer). This progressive storage of heat in the residual ABL played a crucial role in the escalation of temperatures, and therefore in the regulation and intensification of land feedbacks. Soil moisture deficits have both direct and indirect effects in all these processes, effects that have not been scrutinized separately in previous model studies. This suggests the need of revisiting the traditional view of the soil moisture-temperature coupling during mega-heatwaves, in which only the direct impact of dry soils on the surface energy balance is explicitly considered. Reinforced by our findings, a more complete conceptualization can be provided, with dry soils enhancing diurnal warm air entrainment and leading to the formation of

  12. [Radiographic diagnosis of abdominal diseases in foals and ponys. II. Pathologic findings in 60 cases].

    PubMed

    Gerhards, H; Klein, H J; Offeney, F

    1990-08-01

    A diagnostic approach based on clinical and radiographic examinations for evaluation of young foals and small ponies with acute abdominal discomfort is presented. Standing right to left lateral abdominal radiographs were taken of 54 foals and 6 ponies using a previously described technique. Interpretation of the radiographs was in conjunction with all clinical and laboratory findings and patient management. Using this approach, the site and cause of acute abdominal discomfort could be diagnosed accurately in 55 of 60 (91%) patients as confirmed by clinical, surgical or necropsy findings. Typical radiographs and photographs taken at surgery or at necropsy are presented. Typical radiographic findings, their interpretation and possible underlying gastrointestinal diseases are listed. The incorporation of standing lateral abdominal radiography in the clinical evaluation of foals and ponies with acute abdominal diseases gives findings of high diagnostic significance and should contribute to clinical decision-making. Abdominal radiography can replace data from rectal palpation in foals and ponies.

  13. 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

  14. Development of seals for a geothermal downhole intensifier. Progress report

    SciTech Connect

    Captain, K.M.; Harvey, A.C.; Caskey, B.C.

    1985-08-01

    A system using high-velocity fluid jets in conjunction with a rotary diamond bit is currently considered as the best candidate for reducing the cost of drilling geothermal wells. Technical, safety and cost considerations indicate that the required jet supply pressure can best be established by a downhole pressure intensifier. Key intensifier components are the check valve and plunger seals, which must prevent leakage of the high-pressure, high-temperature abrasive fluid (drilling mud). To achieve the required performance, novel ceramic seals are currently being developed. The check valve seal includes a tapered polymeric plug and ceramic stop acting against a ceramic seat. The ceramic plunger seal is a variant of the ''stepped-joint'' piston ring and is designed to minimize contact pressure and abrasive wear. Initial testing of these seals in the laboratory shows encouraging results; design refinement and further testing is in progress. 2 refs., 6 figs., 3 tabs.

  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. 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.

  18. Multiexposure imaging and parameter optimization for intensified star trackers.

    PubMed

    Yu, Wenbo; Jiang, Jie; Zhang, Guangjun

    2016-12-20

    Due to the introduction of the intensified image detector, the dynamic performance of the intensified star tracker is effectively improved. However, its attitude update rate is still seriously restricted by the transmission and processing of pixel data. In order to break through the above limitation, a multiexposure imaging approach for intensified star trackers is proposed in this paper. One star image formed by this approach actually records N different groups of star positions, and then N corresponding groups of attitude information can be acquired. Compared with the existing exposure imaging approach, the proposed approach improves the attitude update rate by N times. Furthermore, for a dim star, the proposed approach can also accumulate the energy of its N positions and then effectively improve its signal-to-noise ratio. Subsequently, in order to obtain the optimal performance of the proposed approach, parameter optimization is carried out. First, the motion model of the star spot in the image plane is established, and then based on it, all the key parameters are optimized. Simulations and experiments demonstrate the feasibility and effectiveness of the proposed approach and parameter optimization.

  19. Characterization of domestic and foreign image intensifier tubes

    NASA Astrophysics Data System (ADS)

    Bender, Edward J.; Wood, Michael V.; Hosek, Daniel J.; Hart, Steve D.

    2013-06-01

    The market for military-use Generation 2 and Generation 3 image intensifier (I2) tubes has become truly global, with major manufacturers and customers spanning five continents. This worldwide market is becoming increasingly important to U.S. manufacturers, with the majority of U.S. Army intensifier fielding having been completed in 2012. Given this keen global competition, it is not surprising that the advertised tube performance of a given source is often discounted by competitors, and the customers have no objective "honest broker" to determine the relative accuracy of these claims. To help fill this void, the U.S. Army RDECOM CERDEC NVESD recently measured a number of domestic and foreign image intensifier tubes, using consistent test equipment/procedures with which the U.S. industry must correlate for Army tube deliveries. Data and analysis will be presented for the major tube parameters of luminance gain, equivalent background input (EBI), signal-to-noise ratio (SNR), limiting resolution, halo, and modulation transfer function (MTF). The bright-light resolution provided by various auto-gated and non-gated tubes will also be addressed, since this area has been an important factor in the international market. RDECOM CERDEC NVESD measurement data will be compared to the corresponding manufacturer specifications whenever possible.

  20. 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

  1. Laboratory findings in four cases of adult botulism suggest colonization of the intestinal tract.

    PubMed Central

    McCroskey, L M; Hatheway, C L

    1988-01-01

    There was laboratory evidence of intestinal colonization in four cases of adult botulism confirmed by the Centers for Disease Control. No performed toxin was detected in available foods, but Clostridium botulinum was isolated from foods in two instances. Botulinal toxin was detected in the sera of all four patients, in one case at 47 days after ingestion of suspected food. C. botulinum was demonstrated in the stool of all four patients and persisted for 119 days after the onset of illness in one patient. Two patients had surgical alterations of the gastrointestinal tract, which may have promoted the colonization. The apparent lack of ingestion of performed toxin in these cases and the persistence of botulinal toxin or C. botulinum, or both, for long periods in three of the patients suggest that colonization of the intestinal tract occurred. PMID:3290234

  2. Enigmatic Inv(9): A Case Report on Rare Findings in Hematological Malignancies

    PubMed Central

    Vijay, Sangeetha; Narayanan, Geetha; Sarojam, Santhi; Raveendran, Suresh Kumar; Hariharan, Sreedharan

    2016-01-01

    Introduction Inversion of chromosome 9 had been widely discussed among geneticists and evolutionary biologists because of its significant impact on various hereditary disorders and in the evolution of man. The role of such inversions in human disease evolution is an area hitherto unclear. Case Presentation We present the case of a chronic myeloid leukemia (CML) patient who showed intermittent relapse on treatment, with a rare appearance of clones with dual inversion (9) breakpoints [inv(9)(p22q34); inv(9)(p11q21)]. We also present the first report of inv(9)(p11,q13) as the sole abnormality in a patient with chronic myeloproliferative disorder(CMPD). Both the patients registered in 2012 and were from Kerala, India. Conclusions Both the cases discussed in our study have inv(9) as the sole abnormality and are found to confer a relatively poor prognosis. PMID:27280043

  3. 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

  4. Autopsy findings in AIDS--a histopathological analysis of fifty cases.

    PubMed

    Falk, S; Schmidts, H L; Müller, H; Berger, K; Schneider, M; Schlote, W; Helm, E B; Stille, W; Hübner, K; Stutte, H J

    1987-07-15

    Fifty consecutive AIDS autopsy cases were evaluated. All subjects showed one or more opportunistic infections and malignancies included in the AIDS case definition with cytomegalovirus and Kaposi's sarcoma being most prevalent. Mycobacterial and cryptococcal infections occurred only infrequently. Most patients of our series after successful treatment of Pneumocystis carinii pneumonia or cerebral toxoplasmosis later succumbed to less treatable conditions like disseminated cytomegalovirus or fungal infections or malignant lymphoma. In the absence of specific treatment for the HIV infection leading to these lethal complications special emphasis must be put on the prevention of HIV transmission and spread.

  5. 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.

  6. Analysis of 756 cases of sexual assault in Tours (France): medico-legal findings and judicial outcomes.

    PubMed

    Saint-Martin, Pauline; Bouyssy, Marie; O'Byrne, Patrick

    2007-10-01

    We describe the medico-legal findings in a population of sexual assault cases assessed in an urban French referral centre, analyse the subsequent legal dispositions in each case and determine whether the characteristics of the assault and the medico-legal findings were associated with conviction of the assailant. We performed a retrospective study of medicolegal reports in all the sexual assault cases reported in Tours (France) during a seven-year period. We defined two groups of victims: children under 15 years old and victims aged 15 years or more. Legal outcomes were obtained from courtroom proceedings. The relationship between the outcomes and the circumstances of the case was analyzed by logistic regression. We enrolled a total of 756 cases during the study period. The mean age of the study population was 16.5 years and 68.3% of the cases involved children under 15 years old. In 57% of these cases, the assailant was a family member. 31.7% of all the victims were aged 15 years or more. The assailant was an acquaintance of the victim in 62.2% of the cases. Drug-facilitated assault was suspected in 2.9% of the cases. In 46.2% of the cases, formal criminal charges were not filed due to insufficient evidence; 36.3% of the assailants were convicted. Examination at the request of the police authorities and previous acquaintance of the assailant by the victim were significantly associated with conviction. Allegations of penetration, the presence of general body trauma and the presence of genital trauma were not necessarily associated with conviction. Medical examiners need to be circumspect when they record non-medical variables. Physical evidence of trauma was neither predictive nor essential for conviction. Successful prosecution depends on the quality of the testimony provided by the victim.

  7. 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.…

  8. Finding a (W)hole in the Text: A Case Study of Four Readers Reading.

    ERIC Educational Resources Information Center

    Nance, Mary Moore

    The purpose of the study was to examine: (1) which perspectives of Reader Response Theory were most applicable in this study; (2) which factors influenced reader responses; and (3) how readers' responses changed over time. The four participants for this case study were chosen from a subject pool of 10 initiate adult full-time divinity students in…

  9. 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…

  10. Finding the Keys to Educational Progress in Urban Youth: Three Case Studies.

    ERIC Educational Resources Information Center

    Babbitt, Susan; Byrne, Maureen

    2000-01-01

    Presents case studies of three 13-year-olds receiving individual after-school instruction from a certified reading specialist in a reading program that is part of an urban multidisciplinary mental health agency. Describes students' level of academic functioning and emotional situation and how their needs were met. Shows successes and failures over…

  11. Brief communication: unusual finding at Pueblo Bonito: multiple cases of hyperostosis frontalis interna.

    PubMed

    Mulhern, Dawn M; Wilczak, Cynthia A; Dudar, J Christopher

    2006-08-01

    Hyperostosis frontalis interna (HFI) is a disease characterized by excess bone growth on the internal lamina of the frontal bone and, occasionally, other cranial bones. Although the disease is fairly common in modern populations, its etiology is poorly understood. Hyperostosis frontalis interna has been identified in antiquity, primarily in the Old World, but with a much lower frequency than in modern groups. The purpose of the present study is to report multiple cases of HFI at Pueblo Bonito (Chaco Canyon, New Mexico). Twelve out of 37 adults with observable frontal bones exhibited HFI, ranging from mild to severe, including 11 females and one male. This is the first published case report of HFI in archaeological remains from the New World having a frequency comparable with modern groups. Most archaeological cases of HFI are isolated, so comparative data for multiple cases at one site are rare. The results of this study emphasize the importance of looking for HFI in archaeological remains, although it is rarely observed. Possible genetic and environmental factors for the high frequency of HFI at Chaco Canyon are considered, but additional research is needed to discover the etiology and to better understand why HFI sometimes occurs at modern frequencies in ancient populations.

  12. 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…

  13. Case report: Portal and systemic venous gas in a patient with perforated duodenal ulcer: CT findings

    PubMed Central

    Fam, Maged Nassef Abdalla; Attia, Khaled Mostafa Elgharib; Khalil, Safaa Maged Fathelbab

    2014-01-01

    Gas within the portal circulation has been known to be associated with a number of conditions most commonly mesenteric ischemia and necrosis. Systemic venous gas is described with few conditions and is mostly iatrogenic in nature. We describe a case of combined portal and systemic venous gas detected by computed tomography in a patient with perforated duodenal ulcer. PMID:25426236

  14. Anatomic findings in revision endoscopic sinus surgery: Case series and review of contributory factors

    PubMed Central

    Bewick, Jessica; Egro, Francesco M.; Masterson, Liam; Javer, Amin R.

    2016-01-01

    Background: It is recognized that patients who undergo endoscopic sinus surgery (ESS) do not always achieve control of their disease. The causes are multifactorial; variations in surgical practice have been identified as possible factors in refractory disease. Objective: To reflect on the frequent anatomic findings of patients with chronic rhinosinusitis (CRS) who require revision ESS. Methods: A retrospective review of patients who required revision ESS at a tertiary institution over a 3-year period. Patients for whom maximal medical therapy failed for CRS underwent computed tomography of the paranasal sinuses and image-guided surgery. Surgical records of anatomic findings were reviewed and analyzed. Results: Over 3 years, a total of 75 patients underwent revision procedures, 28% of all ESS performed in the unit. The most frequent finding was a residual uncinate process in 64% of the patients (n = 48); other findings included a maxillary antrostomy not based on the natural ostium of the maxillary sinus in 47% (n = 35), an oversized antrostomy in 29% (n = 22), resected middle turbinates in 35% (n = 26), middle meatal stenosis in 15% (n = 11), synechiae in 29% (n = 22), and osteitic bone that required drilling in 13% (n = 10). Conclusion: Surgical technique can give rise to anatomic variations that may prevent adequate mucociliary clearance and medication delivery, which leads to failure in ESS in patients with CRS. This study demonstrated the surgical findings encountered in revision ESS that should be highlighted in the training of Ear, Nose and Throat surgeons to help prevent primary failure and reduce health care costs. PMID:28107148

  15. Thrombotic Thrombocytopenic Purpura with Reversible Neurological Features: Brain Diffusion MRI with ADC Map, Spect and EEG Findings. A Case Report.

    PubMed

    Yerdelen, D; Göksel, B K; Yıldırım, T; Karataş, M; Karaca, S; Reyhan, M; Ozdoğu, H

    2006-11-30

    Although nervous system involvement is common in thrombotic thrombocytopenic purpura (TTP), abnormalities on computerized tomography, magnetic resonance imaging and electroencephalography are not encountered so frequently and if present, these abnormalities are often reversible. We describe a 39-year-old woman with recurring transient focal neurological findings found to have laboratory findings consistent with TTP. In cerebral diffusion weighted images (DWI), diffuse cortical hyperintensity was noted in right frontal lobe, but the ADC (apparent diffusion coefficient) map was normal. Electroencephalography demonstrated lateralized slowing and repeated DWI showed diffuse cortical hyperintensity in the right hemisphere. SPECT showed luxury perfusion in the right hemisphere areas. The patient's condition resolved with plasmapheresis. Our patient illustrates that diffuse hemispheric involvement can be seen in DWI and EEG, and SPECT may show luxury perfusion after resolution of neurological findings in TTP cases. To our knowledge, this is the first TTP case in which the ADC map was normal.

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

    PubMed

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

    2016-09-01

    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.

  17. 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

  18. 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

  19. 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

  20. Institutional Capacity for Natural Disasters: Findings from Case Studies in Africa

    DTIC Science & Technology

    2013-03-01

    project: Ethiopia, Kenya, Gambia, Senegal, Ghana, Togo, Zambia , Zimbabwe, Malawi, and Mozambique. The ten case study countries face varied...will continue in the future with the national government’s efforts to invest in its preparedness and response capacity. In Zambia , the regular threat... Zambia , Zimbabwe, and especially Togo have invested relatively low levels of their own capital in preparedness activities. This does not imply that all

  1. Advanced MRI applications and findings of malignant phyllodes tumour: review of two cases.

    PubMed

    Alhabshi, Sharifah Majedah Idrus; Rahmat, Kartini; Abu Hassan, Hasyma; Westerhout, Caroline Judy; Chandran, Patricia Ann

    2013-05-01

    Phyllodes tumour or cystosarcoma phyllodes is a rare stromal breast tumour that is usually benign but on rare occasions can turn malignant. Non-specificity of the imaging features on sonography and mammography makes it difficult to distinguish malignant from benign counterparts solely based on imaging. The final diagnosis is still highly dependent on histopathological assessment. Herein, we describe two cases of malignant phyllodes tumour with emphasis on magnetic resonance (MR) imaging features using advanced MR applications.

  2. Spontaneous intracranial hypotension: clinical and neuroimaging findings in six cases with literature review.

    PubMed

    Haritanti, A; Karacostas, D; Drevelengas, A; Kanellopoulos, V; Paraskevopoulou, E; Lefkopoulos, A; Economou, I; Dimitriadis, A S

    2009-02-01

    Spontaneous intracranial hypotension (SIH) is an uncommon but increasingly recognized syndrome. Orthostatic headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Delayed diagnosis of this condition may subject patients to unnecessary procedures and prolong morbidity. We describe six patients with SIH and outline the important clinical and neuroimaging findings. They were all relatively young, 20-54 years old, with clearly orthostatic headache, minimal neurological signs (only abducent nerve paresis in two) and diffuse pachymeningeal gadolinium enhancement on brain MRI, while two of them presented subdural hygromas. Spinal MRI was helpful in detecting a cervical cerebrospinal fluid leak in three patients and dilatation of the vertebral venous plexus with extradural fluid collection in another. Conservative management resulted in rapid resolution of symptoms in five patients (10 days-3 weeks) and in one who developed cerebral venous sinus thrombosis, the condition resolved in 2 months. However, this rapid clinical improvement was not accompanied by an analogous regression of the brain MR findings that persisted on a longer follow-up. Along with recent literature data, our patients further point out that SIH, to be correctly diagnosed, necessitates increased alertness by the attending physician, in the evaluation of headaches.

  3. A Recurrent Case of Pentalogy of Cantrell: A Rare Case with Sonological Findings and Review of Literature

    PubMed Central

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

    2017-01-01

    Summary Background Pentalogy of Cantrell (POC) is an extremely rare and complex congenital anomaly. Ultrasound is a valuable, safe, nonionizing, cost effective, widely available, and easily reproducible imaging tool and is indispensible in the diagnosis of POC. Despite the rarity of POC, it is imperative for a radiologist to be aware of its wide spectrum of presentation on ultrasound in first trimester of gestation. Most reported cases in literature till now have been sporadic. In this paper, we aimed to report for the first time in literature, a recurrent case of POC detected in the first trimester in a mother whose previous pregnancy also was terminated in the second trimester medically due to the ultrasound diagnosis of POC. We also discuss the role of ultrasound and other imaging modalities in a case of POC as well as the differential diagnoses which can mimic POC. Case Report A 23-year-old G2P0A1 (Gravida2, para0, abortion1) woman with a gestational age of around 12 weeks was referred for a routine first trimester ultrasound scan. The antenatal ultrasound scan showed a single, live, intrauterine gestation corresponding to a gestational age of 11 weeks and 5 days. The fetal heart was visualized outside the chest through a defect in the lower sternum in association with anterior diaphragmatic and ventral abdominal wall defects suggestive of thoraco-abdominal variety of ectopia cardis. There was a membrane covered, midline, abdominal wall defect at the base of the umbilical cord insertion containing the herniated abdominal organs including the liver, bowel loops and the ectopic cardia. There was a breach in the normal outline of the lower sternum indicating a sternal deficiency. The fetal pericardium was absent. The nuchal translucency was grossly increased. Pentalogy of Cantrell was diagnosed on ultrasound and the patient was explained about the poor prognosis of this condition. An informed consent was obtained after she opted for medical termination of

  4. Acute calcific tendinitis of the rectus femoris associated with intraosseous involvement: a case report with serial CT and MRI findings.

    PubMed

    Kim, Young Sung; Lee, Ho Min; Kim, Jong Pil

    2013-11-01

    Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the rectus femoris origin. Mostly reported cases were occurred in the reflected head of the rectus femoris, and only few cases were in the direct head of the rectus femoris. Intraosseous marrow involvement of calcific tendinitis is a more rare condition; it often goes misdiagnosed as an infection or a neoplasm. We report a rare, unusual case of acute calcific tendinitis of the direct head of the rectus femoris associated with intraosseous marrow involvement of calcification in anterior inferior iliac spine with serial CT and MRI findings. Aggressive osseous change may occur in acute calcific tendinitis of the rectus femoris as in this case which should be made an appropriate diagnosis to avoid unnecessary investigation and overtreatment like a surgery.

  5. 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.

  6. Histopathologic findings of spontaneous osteonecrosis of the knee at an early stage: a case report.

    PubMed

    Hatanaka, Hiroyuki; Yamamoto, Takuaki; Motomura, Goro; Sonoda, Kazuhiko; Iwamoto, Yukihide

    2016-05-01

    We histopathologically examined a surgically resected full specimen obtained from an early-stage spontaneous osteonecrosis of the knee (SPONK). On a mid-coronal cut section of the resected medial femoral condyle, a linear fracture line paralleling the subchondral bone endplate was found. Histopathologically, prominent callus formation was seen comprising of reactive woven bone and granulation tissue on both sides of the fracture. Fracture-related bone debris was focally observed at the osteochondral side of the fracture. Definitive features of antecedent bone infarction such as creeping substitution and bone marrow necrosis were not detected. These findings suggested that SPONK was the result of a subchondral fracture rather than primary osteonecrosis.

  7. Headache secondary to sleep-related bruxism: A case with polysomnographic findings

    PubMed Central

    Das, Sourav; Gupta, Ravi; Dhyani, Mohan; Goel, Deepak

    2015-01-01

    Sleep-related bruxism may present with headache. However, in clinical practice it may be difficult to differentiate from other causes of headache, especially in subjects with substance abuse. We are presenting a case of sleep-related bruxism that presented with headache and sleep-related symptoms in the presence of substance abuse. Polysomnography was used to ascertain cause of headache. How the other possible causes of headache ruled out is also discussed in report. In short, Sleep-related bruxism can cause headache that is worse in the morning. It is associated with poor quality sleep. PMID:25883492

  8. Intraosseous pneumatocyst of the ilium: CT findings in two cases and literature review.

    PubMed

    Catalano, O; De Rosa, F; Muto, M

    1997-01-01

    Intraosseous pneumatocyst of the ilium is a rare lesion of uncertain origin. It predilects male subjects and may be associated or not with sacroiliac joint degenerative disease, intra-articular gas, sacral pneumatocyst, and communication with the articular space. To our knowledge, only 16 observations have been reported in the literature. We have evaluated with plain radiographs and CT two additional cases. Plain films frequently identify these lesions, but CT is the method of choice in demonstrating their air density and assessing the possible abnormalities of the surrounding bone and sacroiliac joints.

  9. 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.

  10. Pulmonary Alveolar Microlithiasis: A Case Report with Emphasis on Imaging Findings

    PubMed Central

    Abdalla, Guilherme; Marchiori, Edson; Zanetti, Gláucia; Mucillo, Antonio; Pereira, Mariana Leite; Ventura, Nina; Martins, Pedro; Constantino, Carolina Pesce Lamas; Canellas, Rodrigo; Brandão, Viviane; Varella de Oliveira, Romulo

    2010-01-01

    Pulmonary alveolar microlithiasis (PAM) is a rare disease characterized by the presence of small calculi in the alveolar space. The authors report a case of a 21-year-old man with a 2-year history of shortness of breath on exertion and dry cough. Physical examination was altered only for crackles at auscultation. Pulmonary function revealed a mild restrictive ventilatory defect and the chest radiograph demonstrated paracardiac confluence of dense micronodular infiltrate. High-resolution CT scan revealed diffuse ground glass attenuation and septal thickening, more pronounced in lower pulmonary regions, with calcifications along the interlobar septa and subpleural regions. A transbronchial lung biopsy confirmed the diagnosis of PAM. PMID:20671919

  11. Mucinous Cystadenoma of the Testis: A Case Report with Immunohistochemical Findings

    PubMed Central

    Kim, Gilhyang; Kwon, Dohee; Na, Hee Young; Kim, Sehui; Moon, Kyung Chul

    2017-01-01

    Mucinous cystadenoma of the testis is a very rare tumor. Herein, we report a case of mucinous cystadenoma arising in the testis of a 61-year-old man, along with a literature review. Computed tomography showed a 2.5-cm-sized poorly enhancing cystic mass. Grossly, the tumor was a unilocular cystic mass filled with mucinous material and confined to the testicular parenchyma. Histologically, the cyst had a fibrotic wall lined by mucinous columnar epithelium without atypia. Immunohistochemical staining was positive for cytokeratin 20 and CDX2, as well as focally positive for cytokeratin 7. The pathologic diagnosis was mucinous cystadenoma. PMID:28189139

  12. 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

  13. Contrast-associated transient cortical blindness: three cases with MRI and electrophysiology findings.

    PubMed

    Baguma, Marius; Younan, Nadia; London, Frédéric; Ossemann, Michel; Vandermeeren, Yves

    2016-09-26

    Transient cortical blindness (TCB) is a rare but striking complication following contrast agent injection. TCB might be secondary to a direct toxicity of the contrast agent, leading to an osmotic disruption of the blood-brain barrier (BBB), with a preferential involvement of the posterior circulation and occipital cortex. We report a series of three patients with contrast medium-associated TCB (intra-arterial injection of non-ionic contrast agent during diagnostic cerebral angiography for two of them and coronary angioplasty for the other one). In two patients, the magnetic resonance imaging (MRI) was unremarkable; in the other patient, typical MRI findings were observed, with FLAIR hyperintensities in the right occipital cortex and decreased apparent diffusions coefficient (ADC). Interestingly, this patient also presented posterior rhythmic epileptiform activities on electroencephalogram during the first 36 h. Visual evoked potentials (VEPs) showed normal retinal potential, but a massive destructuration of the later potentials of the cortical origin. To our knowledge, this is the first time that VEPs acquired during TCB are reported. We discuss these findings with respect to the pathophysiology of TCB.

  14. Merosin-deficient congenital muscular dystrophy (MDCMD): a case report with MRI, MRS and DTI findings.

    PubMed

    Ip, Janice J K; Hui, Peter K T; Chau, M T; Lam, Wendy W M

    2012-08-01

    Congenital muscular dystrophy (CMD) comprises a heterogeneous group of disorders present at birth with muscle weakness, hypotonia and contractures. Congenital muscular dystrophy (CMD) comprises a heterogeneous group of disorders with muscle weakness, hypotonia and contractures present at birth. A particular subset of classic CMD is characterized by a complete absence of merosin. Merosin-deficient congenital muscular dystrophy (MDCMD) is a rare genetic disease involving the central and peripheral nervous system in the childhood. High signal intensities are often observed throughout the centrum semiovale, periventricular, and sub-cortical white matters on T2-weighted images in MRI brain in children with MDCMD. Apparent diffusion coefficient (ADC) map may reveal increased signal intensity and apparent diffusion coefficient values in the periventricular and deep white matters. These white matter findings, observed in late infancy, decrease in severity with age. The pathogenesis of these changes remains uncertain at present. In this article, we outline the specific MR imaging findings seen in a patient with documented MDCMD and also suggest the causes.

  15. A case of bilateral patellar osteochondrosis and fracture in a cat. Clinical and histological findings.

    PubMed

    Palierne, S; Palissier, F; Raymond-Letron, I; Autefage, A

    2010-01-01

    Fracture of the patella associated with bilateral osteochondrosis of the superior pole of the patella in a 14-week-old cat is reported with histological findings. Patellar osteochondrosis has been described in humans, horses, pigs, and dogs and is characterised by incomplete union of the ossification centres related to an abnormal process of endochondral ossification. However this disease has not yet been described in cats. Macroscopically, two main fragments separated by interposed tissue were identified on the left patella. In contrast, no fracture but only a fissuration of the articular cartilage was observed on the right patella. Bilateral partial patellectomy was performed. Histological examination of the excised fragments from the left patella revealed two main areas of trabecular bone separated by a wide irregular band of hyaline cartilage. The microscopic aspect of the right patella was similar to that of the left. Serial sections showed the initial appearance of an area of necrosis in the central band of hyaline cartilage, and that this hyaline cartilage was subsequently replaced by fibrovascular connective tissue. These findings indicate that some patellar fractures may be due to patellar osteochondrosis.

  16. Equine phacoclastic uveitis: the clinical manifestations, light microscopic findings, and therapy of 7 cases.

    PubMed Central

    Grahn, B H; Cullen, C L

    2000-01-01

    This retrospective clinical study describes the clinical manifestations, light microscopic findings, and diagnosis and treatment of acute and chronic lens rupture in the horse. Rupture of the lens capsule in the horse usually results in a chronic, blinding inflammation (phacoclastic uveitis) unless prompt surgical and medical therapies are implemented. The clinical manifestations of acute lens capsule rupture included: cataract; intralenticular displacement of iridal pigment; lens cortical fragments attached to the perforated lens capsule, iris, and corneal endothelium; miosis; aqueous flare; and usually a corneal or scleral perforation with ulceration or focal full thickness corneal edema and scarring. The clinical signs of chronic phacoclastic uveitis include blindness, phthisis bulbi, and generalized corneal opacification related to scarring, vascularization, pigmentation, and edema. In one horse, acute phacoclastic uveitis was successfully treated with phacoemulsification to remove the ruptured lens and medical therapy to control the accompanying inflammation. The affected eyes of the horses with chronic phacoclastic uveitis were enucleated because of persistent clinical signs of nonulcerative keratitis and uveitis, despite long-term medical management. The clinical manifestations and lack of improvement with medical therapy are similar in the horse, dog, cat, and rabbit. However, the histologic findings in equine phacoclastic uveitis differ significantly from those in the dog, and rabbit. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Figure 7. Figure 8. PMID:10816830

  17. Case finding with incomplete administrative data: observations on playing with less than a full deck.

    PubMed

    Holmes, Ann M; Ackermann, Ronald T; Katz, Barry P; Downs, Stephen M; Inui, Thomas S

    2010-12-01

    Capacity constraints and efficiency considerations require that disease management programs identify patients most likely to benefit from intervention. Predictive modeling with available administrative data has been used as a strategy to match patients with appropriate interventions. Administrative data, however, can be plagued by problems of incompleteness and delays in processing. In this article, we examine the effects of these problems on the effectiveness of using administrative data to identify suitable candidates for disease management, and we evaluate various proposed solutions. We build prospective models using regression analysis and evaluate the resulting stratification algorithms using R² statistics, areas under receiver operator characteristic curves, and cost concentration ratios. We find delays in receipt of data reduce the effectiveness of the stratification algorithm, but the degree of compromise depends on what proportion of the population is targeted for intervention. Surprisingly, we find that supplementing partial data with a longer panel of more outdated data produces algorithms that are inferior to algorithms based on a shorter window of more recent data. Demographic data add little to algorithms that include prior claims data, and are an inadequate substitute when claims data are unavailable. Supplementing demographic data with additional information on self-reported health status improves the stratification performance only slightly and only when disease management is targeted to the highest risk patients. We conclude that the extra costs associated with surveying patients for health status information or retrieving older claims data cannot be justified given the lack of evidence that either improves the effectiveness of the stratification algorithm.

  18. 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.

  19. Incidental finding of a true human tail in an adult: a case report.

    PubMed

    Robinson, Caitlin G; Duke, Taylor C; Allison, Ashley W

    2017-01-01

    True human tails are rare vestigial structures that are typically removed in childhood. Here a case is presented in which an inconspicuous sacrococcygeal tail was incidentally discovered in late adulthood. A 56-year-old man with no significant past medical history presented to a dermatology clinic with a chief complaint of a hyperpigmented lesion on his central back. However, on full body skin exam, a separate flesh-colored 0.7 cm × 0.5 cm appendage was discovered in the midline sacrococcygeal region. This lesion had been present and unchanged since childhood. This particular lesion was removed via shave biopsy. Microscopic exam found it to be consistent with a diagnosis of a true human tail. There were no apparent involved spinal cord structures, and no further treatment was thought to be necessary. Human tails are congenital anomalies associated with occult spinal lesions in about 50% of cases. Therefore, it is in these patients' best interest to thoroughly evaluate for spinal cord involvement prior to biopsy. There is a relative lack of literature published on the topic, and a greater awareness of human tails would be helpful to ensure their inclusion in a differential diagnosis for persistent sacrococcygeal lesions in patients of any age.

  20. Canine immune-mediated polyarthritis: Clinical and laboratory findings in 83 cases in western Canada (1991–2001)

    PubMed Central

    Stull, Jason W.; Evason, Michelle; Carr, Anthony P.; Waldner, Cheryl

    2008-01-01

    A hospital-based, case-control study was used to describe clinical and laboratory findings in 83 dogs diagnosed with noninfectious, nonerosive, immune-mediated polyarthritis (IMPA) in western Canada. Case medical records were reviewed. Cases were analyzed as total IMPA cases and as subgroups [breed, systemic lupus erythematosus (SLE), reactive, and idiopathic] and compared with the general canine hospital population. Dogs with IMPA differed in age (P = 0.004) and weight (P = 0.01) from other hospital admissions. Idiopathic IMPA cases were older (4–10 y; P < 0.05), compared with the general canine hospital population, and their common laboratory abnormalities included the following: leukocytosis, nonregenerative anemia, increased alkaline phosphatase, and hypoalbuminemia. The SLE cases were seen more often in summer and fall (P = 0.04), raising concern of an undiagnosed etiologic agent. The hock joint appeared to be the most reliable for diagnosis of IMPA, and arthrocentesis of both hock joints may aid in case identification. PMID:19252711

  1. Multichannel intensified photodiode for near infrared single photon detection

    NASA Astrophysics Data System (ADS)

    Aebi, Verle W.; Sykora, Derek F.; Jurkovic, Michael J.; Costello, Kenneth A.

    2011-05-01

    An overview of the Intensified Photodiode (IPD) is presented with an emphasis on IPDs optimized for use in the 950nm to 1350nm spectral range for single photon detection applications. The theory of operation of the IPD, two different electron optics designs, and device performance for a multichannel, 4x4 pixel array, low jitter IPD optimized for operation at 1060nm are presented in this paper. Key results include greater than 15% quantum efficiency, large active area, and less than 550ps impulse response.

  2. Dosimetry of portable image intensifiers in pacemaker insertions.

    PubMed

    Hayt, D B; Malsky, S J; Blatt, C J; Greenberg, E I; Pochaczevsky, R; Simon, D F; Perez, L A

    1975-01-01

    With the increased utilization of portable image intensifiers for pacemaker insertions, an investigation of the radiation hazards to operative personnel was undertaken. The personnel were tested first utilizing a Rando phantom and later during actual pacemaker insertions. Studies of medical personnel show the critical organs to be the thyroid (approximately 15mR per procedure) and the lens of the eye (approximately 13mR per procedure). While the MPD/week was not exceeded, the radiation dosage was substantial and could increase under operating conditions other than those measured. Recommendations to insure safer operation of this equipment are presented.

  3. A case of Mikulicz's disease complicated by malignant lymphoma: a postmortem histopathological finding.

    PubMed

    Uehara, Takeshi; Ikeda, Shu-ichi; Hamano, Hideaki; Kawa, Shigeyuki; Moteki, Hideaki; Matsuda, Kazuyuki; Kaneko, Yasunori; Hara, Eiji

    2012-01-01

    A 66-year-old Japanese man with an 11-year history of Mikulicz's disease (MD) received continuous corticosteroid administration. At age 58, a left renal pelvic mass was identified and diagnosed as an IgG4-related inflammatory pseudotumor. The patient underwent an operation to remove the tumor. Subsequently, he contracted repeated pulmonary infections and eventually died of severe gastrointestinal bleeding. Autopsy revealed systemic lymph node swelling and infiltration in some organs, and diffuse large B-cell lymphoma (DLBCL) was diagnosed. These findings suggest that an IgG4-related disease can be causally related to the development of malignant lymphoma through the occurrence of mucosa-associated lymphoid tissue lymphoma.

  4. Acrodermatitis chronica atrophicans: histopathologic findings and clinical correlations in 111 cases.

    PubMed

    Brehmer-Andersson, E; Hovmark, A; Asbrink, E

    1998-05-01

    We studied 111 consecutive, untreated and serologically confirmed patients with acrodermatitis chronica atrophicans. Emphasis was on the histopathologic patterns of erythematous and fibrous lesions, and on an assay used to correlate histopathologic findings with such clinical features as fibrous nodules, ulnar bands and the pain reaction allodynia. There was a significant correlation between allodynia and signs of marked inflammation, but not between allodynia and neural and perineural cell infiltrates or fibrosis. Moreover, there was no significant correlation between serum IgG titers to Borrelia and the density of inflammatory cell infiltrates or the proportion of plasma cells in tissue. Histopathologic examination did not reveal any important differences between fibrous nodules, ulnar bands and sclerodermatous lesions. The histopathologic pattern is not diagnostic per se, but characteristic enough to alert the experienced pathologist.

  5. [A case of lichenoid sarcoidosis with characteristic clinical and histopathological findings].

    PubMed

    Sanchez-Lopez, Josefa; Porriño-Bustamante, Ma Librada; Aneiros-Fernández, Jose; Naranjo-Sintes, Ramon; Fernández-Pugnaire, Ma Antonia

    2014-04-16

    Sarcoidosis is a multisystem inflammatory disease characterized by the formation of noncaseating granulomas in various organs and tissues. The majority of patients with systemic sarcoidosis will present with lung and lymph node involvement. In addition, 20% have skin involvement that may be the only manifestation of the disease or may be an important prognostic marker for involvement of other organs. There are multiple forms of presentation of cutaneous sarcoidosis, which may be a true challenge.We report a patient with a one month history of an eruption of skin colored papules. Some were grouped in a symmetrical distribution on the trunk, inner arms, and lumbar region. Pathologic examination revealed an infiltrate in the papillary dermis showing a band of noncaseating granulomas along with disruption of the basal lamina and lichenoid changes. The clinicopathological correlation confirmed the diagnosis of lichenoid sarcoidosis. We consider our case interesting owing to the clinical presentation and the lichenoid distribution of granulomas.

  6. Grammatical constructions in Cri du chat syndrome--findings from a case study.

    PubMed

    Kristoffersen, Kristian Emil

    2009-12-01

    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. The theoretical framework is construction grammar. Data for the study were collected in a diary by the author over a period of 4 months and make up a corpus of 552 utterances. These utterances are described in terms of MLU, diversity of argument structure constructions, proportion and types of complex utterances, use of auxiliaries, as well as deviant word order patterns, types of omissions, and use of prefabricated units. The primary aim of the study is to identify strengths and weaknesses in syntactic skills, which provide the basis for future research on grammatical skills in persons with CCS.

  7. Perinatal autopsy findings in three cases of jugular lymphatic obstruction sequence and cardiac polyvalvular dysplasia.

    PubMed

    Bendon, Robert; Asamoah, Alexander

    2008-01-01

    Three infants with a prenatal diagnosis of Noonan's syndrome suffered fetal hydrops and immediate neonatal death. The infants all had the external appearance of jugular lymphatic obstruction sequence with wide-spaced nipples, redundant posterior nuchal skin, and edema of the dorsa of the feet and hands. All 3 demonstrated thick, redundant leaflets of all 4 cardiac valves, and 2 had a membranous ventricular septal defect. One female infant had a mutation of the PTPN11 gene. Two males had no common mutation of PTPN11. The males demonstrated other abnormalities in common, including small penis, testicular malformation, rosette-like appearance of the pituicytes, and an eosinophil infiltration of the pancreatic islets with islet cell hypertrophy. Detailed anatomy of cases of lymphatic obstruction sequence fetuses can be correlated with an increasing number of genetic mutations associated with Noonan's syndrome and related syndromes in mice and humans.

  8. Coma blisters after poisoning caused by central nervous system depressants: case report including histopathological findings.

    PubMed

    Branco, Maira Migliari; Capitani, Eduardo Mello De; Cintra, Maria Letícia; Hyslop, Stephen; Carvalho, Adriana Camargo; Bucaretchi, Fabio

    2012-01-01

    Blister formation and eccrine sweat gland necrosis is a cutaneous manifestation associated with states of impaired consciousness, most frequently reported after overdoses of central nervous system depressants, particularly phenobarbital. The case of a 45-year-old woman who developed "coma blisters" at six distinct anatomic sites after confirmed (laboratory) phenobarbital poisoning, associated with other central nervous system depressants (clonazepam, promethazine, oxcarbazepine and quetiapine), is presented. A biopsy from the left thumb blister taken on day 4 revealed focal necrosis of the epidermis and necrosis of sweat gland epithelial cells; direct immunofluorescence was strongly positive for IgG in superficial blood vessel walls but negative for IgM, IgA, C3 and C1q. The patient was discharged on day 21 with no sequelae.

  9. Evidence of disturbed sleep and mood state in well-trained athletes during short-term intensified training with and without a high carbohydrate nutritional intervention.

    PubMed

    Killer, S C; Svendsen, I S; Jeukendrup, A E; Gleeson, M

    2015-09-25

    Few studies have investigated the effects of exercise training on sleep physiology in well-trained athletes. We investigated changes in sleep markers, mood state and exercise performance in well-trained cyclists undergoing short-term intensified training and carbohydrate nutritional intervention. Thirteen highly-trained male cyclists (age: 25 ± 6y, [Formula: see text]O2max: 72 ± 5 ml/kg/min) participated in two 9-day periods of intensified training while undergoing a high (HCHO) or moderate (CON) carbohydrate nutritional intervention before, during and after training sessions. Sleep was measured each night via wristwatch actigraphy. Mood state questionnaires were completed daily. Performance was assessed with maximal oxygen uptake ([Formula: see text]. Percentage sleep time fell during intensified training (87.9 ± 1.5 to 82.5 ± 2.3%; p < 0.05) despite an increase in time in bed (456 ± 50 to 509 ± 48 min; p = 0.02). Sleep efficiency decreased during intensified training (83.1 ± 5.3 to 77.8 ± 8.6%; p < 0.05). Actual sleep time was significantly higher in CON than HCHO throughout intensified training. Mood disturbance increased during intensified training and was higher in CON than HCHO (p < 0.05). Performance in the [Formula: see text] exercise protocol fell significantly with intensified training. The main findings of this study were that 9-days of intensified training in highly-trained cyclists resulted in significant and progressive declines in sleep quality, mood state and maximal exercise performance.

  10. Arthroscopic grafting of scaphoid nonunion - surgical technique and preliminary findings from 23 cases.

    PubMed

    Cognet, J-M; Louis, P; Martinache, X; Schernberg, F

    2017-02-01

    We report our experience with the arthroscopic treatment of 23 cases of scaphoid nonunion. We explain the surgical technique and describe the different steps needed to achieve bone union. We report our initial clinical and radiological results. This was a prospective non-randomized study. Inclusion criteria were a scaphoid nonunion without radiocarpal arthritis, without any time limit and without any selection as to nonunion location. Before the operation, patients underwent an X-Ray and CT scan or MRI. Schernberg's classification was used to evaluate the location of the nonunion. Internal fixation was performed with a screw or K-wires. Bone grafts were taken from the dorsal side of the distal radius using a T-Lok™ bone marrow biopsy needle (Argon Medical Devices, Plano, TX, USA). A CT scan was performed 3 months after the operation to determine whether union was achieved. Pain, strength and range of motion were evaluated before and after the operation. The patients' smoking habits were also documented. The average follow-up was 17.3 months (4-41). There were 20 men and 3 women with an average age of 26 years (17-63). The average duration of nonunion before the operation was 17 months (6-60). Based on Schernberg's classification, there was one type I, 12 type II and 10 type III nonunions. Wrist strength increased from 32 to 41kg. Union was obtained in all patients after an average of 4 months (3-12). Numerous treatments have been described for treating scaphoid nonunion: Matti-Russe, Fisk-Fernadez bone graft, vascularized bone graft, bone substitutes, etc. The success rate varies depending on the technique and study design. We have described an arthroscopic technique for treating scaphoid nonunion with very promising preliminary results. Arthroscopic debridement is needed to ensure good quality bone at the graft site, while preserving extrinsic vascularization. Traction is used during the operation to restore the scaphoid height, once debridement has been

  11. 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

  12. Amplitude-integrated electroencephalography and MRI findings in a case of severe neonatal methicillin-resistant Staphylococcus aureus meningitis

    PubMed Central

    Olischar, Monika; Hunt, Rod W; Daley, Andrew J; Clifford, Vanessa; Tingay, David G

    2010-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) can cause serious infection among hospitalised patients. The emergence of community acquired strains of MRSA (CA-MRSA) increases the potential exposure of newborns. The high incidence of reported meningitis in neonates in large CA-MRSA outbreaks suggests increased virulence in the neonatal population. The authors describe a case of severe meningitis due to MRSA in a previously healthy neonate and include findings from amplitude-integrated electroencephalography (aEEG) and MRI. PMID:22802366

  13. 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.

  14. From struggles to resource gains in interprofessional service networks: Key findings from a multiple case study.

    PubMed

    Toiviainen, Hanna; Kira, Mari

    2017-04-07

    In interprofessional service networks, employees cross professional boundaries to collaborate with colleagues and clients with expertise and values different from their own. It can be a struggle to adopt shared work practices and deal with "multivoicedness." At the same time, networks allow members to engage in meaningful service provision, gain a broader understanding of the service provided, and obtain social support. Intertwined network struggles and resource gains have received limited attention in the interprofessional care literature to date. The aim of the study was to investigate the learning potential of the co-existing struggles and resource gains. This article reports findings from two interprofessional networks. Interviews were conducted with 19 employees and thematically analysed. Three types of struggles and six types of resource gains of networking were identified. The struggles relate, first, to the assumptions of networking following similar practices to those in a home organisation; second, to the challenges of dealing with the multivoicedness of networking; and, third, to the experienced gap between the networking ideals and the reality of cooperation. At the same time, the network members experience gains in emotional resources (e.g., stronger sense of meaningfulness at work), cognitive resources (e.g., understanding the customer needs from alternative perspectives), and social resources (e.g., being able to rely on other professionals' competence). Learning potential emerged from the dynamics between coexisting struggles and resource gains.

  15. A Case of ADEM Mimicking Cerebral Adrenoleukodystrophy Based on Supratentorial MRI Findings

    PubMed Central

    BEYAZAL, Mehmet; ÜNAL, Özkan; YILMAZ, Sanem; BORA, Aydın

    2014-01-01

    A 9-year-old male admitted for syncope also had the complains of pain and numbness in his legs and frequent falling down. There was a history of upper respiratory tract infection 10 days before. On neurologic examination, paraparesia and fall a sleep were identified. On magnetic resonance imaging, the symetric signal increases were seen in biparieto-occipital white matter intented to corpus callosum at T2-weighted sequences and cytotoxic edema was seen at diffusion-weighted images. Heterogeneous contrast enhancement was seen on these areas. In addition, at the C7-Th5 vertebrae levels, spinal cord had diffuse increased signal intensity and contrast enhancement. Acute disseminated encephalomyelitis was thought based on clinical and radiological findings. Steroid therapy was started. Significant improvement was shown after treatment. On 2-year follow-up, there was no recurrence. In conclusion, it must be kept in mind that acute disseminated encephalomyelitis can rarely present with biparieto-occipital involvement which extends to corpus callosum and can mimic adrenoleukodystrophy. For the differential diagnosis butterfly glioma, tumefactive demyelinating lesions or multiple sclerosis should be considered.

  16. Clinical and Laboratory Findings in Patients with δ-Storage Pool Disease: A Case Series.

    PubMed

    Selle, Fabien; James, Chloé; Tuffigo, Marie; Pillois, Xavier; Viallard, Jean-François; Alessi, Marie-Christine; Fiore, Mathieu

    2017-02-01

    Platelet δ-storage pool disease (δ-SPD) is a platelet function disorder characterized by a reduction in the number or content of dense granules. Reports on δ-SPD are mostly limited to case presentations. We aimed to retrospectively describe a series of patients with δ-SPD to better characterize the disease. We studied 16 patients with congenital or acquired δ-SPD. Lumiaggregometry, α- and δ-granules content, platelet ultrastructure, αIIbβ3 integrin, and glycoprotein Ib (GPIb) activation were assessed. Most of the patients generally demonstrate mild to moderate bleeding diathesis. Platelet aggregation studies showed moderate abnormalities with variable profiles, while all the individuals had almost complete absence of adenosine triphosphate release. Mepacrine capture, CD63 expression, and study of dense granules by electron microscopy enabled to distinguish different subtypes of δ-SPD with quantitative or qualitative defect. Surprisingly, significantly decreased GPIb expression levels after platelet activation with thrombin receptor activating peptide 50 μM were found, suggesting that GPIb-impaired mobilization may represent an additional feature of the disorder. In conclusion, δ-SPD represents a complex disorder with various clinical and biological aspects, requiring a great deal of expertise to be properly diagnosed.

  17. Posterior cortical atrophy: variant of Alzheimer's disease? A case series with PET findings.

    PubMed

    Schmidtke, Klaus; Hüll, Michael; Talazko, Jochen

    2005-01-01

    Nine patients with posterior cortical atrophy (PCA), a rare degenerative brain disease of unclear etiology and nosology, were followed over a mean time of 7.4 years. The mean age at onset was low (56.2 years). At onset, eight patients had visuo-spatial and eight had memory impairment. A minority showed early signs of occipital lobe involvement with visual agnosia or hemianopia. Eight patients developed dementia after a mean course of five years. 18F-FDG-PET data of six patients were analysed with statistical parametric mapping. They showed hypometabolism centred on the lateral and medial parietal associative cortex, with variable involvement of the adjacent temporal and occipital associative cortex. A minority showed involvement of the frontal lobes, possibly related to deafferenting of areas related to the control of eye movements. Atrophy and hypometabolism were markedly asymmetric in a subset of cases. Autopsy was performed in one patient. Presenile onset, location, and asymmetry of atrophy suggest that PCA represents a biologically separable variant of Alzheimer's disease.

  18. Intravascular papillary endothelial hyperplasia: report of 4 cases with immunohistochemical findings.

    PubMed

    Campos, Marcia-Sampaio; Garcia-Rejas, Roberto-A; Pinto, Décio-Santos; de Sousa, Suzana-C O M; Nunes, Fabio-Daumas

    2009-10-01

    Intravascular papillary endothelial hyperplasia (IPEH) is a benign endothelial proliferation, usually intravascular, that may mimic angiosarcoma. In this report, four new cases of IPEH involving the oral region are described. The affected sites were the lower lip, labial comissure and the submandibular region. After clinical evaluation, the complete removal of the lesions showed a circumscribed and soft mass. Histologically, the major feature was a reactive proliferation of endothelial cells composed of small papillary structures with hypocellular and hyalinized cores arising in an organized thrombus. Immunohistochemical staining for CD34 was strongly positive in endothelial cells. Vimentin and laminin immunolabelling were also consistent with a vascular origin. In order to verify the proliferative potential of the lesions, the Ki-67 antibody was used, revealing low percentage of labeled cells (<20%). No immunoreactivity for GLUT-1 was observed. Since the complete removal is curative, no additional treatment was necessary, and no signs of recurrence had been observed until now. Due to the particular features of IPEH, it is important for pathologists and clinicians to become familiar with this lesion. Additionally, the specific histological arrangement, including the absence of cellular pleomorphism, mitotic activity and necrosis, represents a guide to help in the differential diagnosis. Moreover, the vascular origin and the proliferative index should be assessed by immunohistochemistry in order to provide an accurate diagnosis.

  19. 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.

  20. Feline lungworm Oslerus rostratus (Strongylida: Filaridae) in Italy: first case report and histopathological findings.

    PubMed

    Brianti, Emanuele; Gaglio, Gabriella; Napoli, Ettore; Falsone, Luigi; Giannelli, Alessio; Annoscia, Giada; Varcasia, Antonio; Giannetto, Salvatore; Mazzullo, Giuseppe; Otranto, Domenico

    2014-10-01

    Oslerus rostratus syn. Anafilaroides rostratus (Strongylida: Filaroididae) is a metastrongyloid transmitted by snails, which localizes in peri-bronchial tissues and in the lung parenchyma of wild as well as domestic cats. In Europe, this nematode has been reported only on two occasions, being diagnosed in cats from Majorca Island and in northern Spain. Here, we describe a case of O. rostratus infection in a necropsied 4-year-old cat in Sicily (southern Italy). At the inspection of lungs, slender and greyish nematodes (four females and two males) were found embedded in the peri-bronchial tissues and in the bronchial walls. Parasites were morphological and molecularly identified as O. rostratus, with their 18S sequences being identical among them and showing a high homology (99%) with those available in public databases. At the histology, nematodes were encapsulated in a pseudo-cystic formation surrounded by an interstitial inflammatory process and fibrous tissue. Lung lesions were mainly represented by peri-luminal fibrosis, hyperplasia and hypertrophy of the bronchial mucosa and glands, respectively. This first record of O. rostratus infection from Italy indicates that this parasite should be included in the differential diagnosis of feline of lungworm infection.

  1. 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

  2. Incidental finding of carcinoid tumor on Meckel's diverticulum: case report and literature review, should prophylactic resection be recommended?

    PubMed

    Caracappa, Daniela; Gullà, Nino; Lombardo, Francesco; Burini, Gloria; Castellani, Elisa; Boselli, Carlo; Gemini, Alessandro; Burattini, Maria Federica; Covarelli, Piero; Noya, Giuseppe

    2014-05-08

    Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and is caused by incomplete obliteration of the vitelline duct during intrauterine life. MD affects less than 2% of the population. In most cases, MD is asymptomatic and the estimated average complication risk of MD carriers, which is inversely proportional to age, ranges between 2% and 4%. The most common MD-related complications are gastrointestinal bleeding, intestinal obstruction and acute phlogosis. Excision is mandatory in the case of symptomatic diverticula regardless of age, while surgical treatment for asymptomatic diverticula remains controversial. According to the majority of studies, the incidental finding of MD in children is an indication for surgical resection, while the management of adults is not yet unanimous. In this case report, we describe the prophylactic resection of an incidentally detected MD, which led to the removal of an occult mucosal carcinoid tumor. In literature, the association of MD and carcinoid tumor is reported as a rare finding. Even though the strategy for adult patients of an incidental finding of MD during surgery performed for other reasons divides the experts, we recommend prophylactic excision in order to avoid any further risk.

  3. Neurobehavioural dysfunction following mild traumatic brain injury in childhood: a case report with positive findings on positron emission tomography (PET).

    PubMed

    Roberts, M A; Manshadi, F F; Bushnell, D L; Hines, M E

    1995-07-01

    The present case study describes the neurobehavioural, neurodiagnostic, and positron emission tomography (PET) scan findings in a child who sustained a whiplash-type injury in a motor vehicle accident. Although neck and back pain were reported immediately, neurobehavioural symptoms, such as staring spells, gradually increased in frequency over a 2-year period following the accident. At 4 years after the accident the patient's symptoms persisted, as reported by teachers and parents, and more extensive diagnostic work-up was initiated. Standard EEG was normal while two ambulatory EEGs were abnormal and interpreted as epileptiform. A PET scan showed evidence of marked hypometabolism in both temporal lobes. Neuropsychological findings were consistent with PET findings and reflected verbal and visual memory deficits in the context of high average intelligence. Treatment with carbamazepine, verapamil, and fluoxetine greatly improved the patient's symptoms. The present case illustrates an example of a poor outcome in a paediatric case of mild traumatic brain injury, the importance of PET in demonstrating definitive evidence of brain dysfunction, and the child's positive response to anticonvulsant medication.

  4. [Intracranial chondroma arising from the skull base: two case reports featuring the image findings for differential diagnosis].

    PubMed

    Higashida, Tetsuhiro; Sakata, Katsumi; Kanno, Hiroshi; Tanabe, Yutaka; Kawasaki, Takashi; Yamamoto, Isao

    2007-05-01

    We reported two cases of intracranial skull base chondroma and discussed the differential diagnosis and the treatment strategies. The first case was a 39-year-old male who presented with left exophtalmos, visual loss and oculomotor disturbance. MRI showed a huge tumor occupying the bilateral cavernous sinus. Partial removal of the tumor was performed through the left orbitozygomatic subtemporal approach. The second case was a 54-year-old male who presented with left hemiparesis. MRI showed a brain stem infarction with a huge tumor located at the right middle fossa. Partial removal was performed through the right orbitozygomatic subtemporal approach. In these two cases, the histopathological diagnosis of the tumors was benign chondroma and the size of residual tumors have not changed for one year without any additional therapy. Although preoperative definite diagnosis for skull base chondromas is difficult, strategies for diagnosis and treatment without any complication are essential. In our cases, chondromas showed low uptake in PET images, which might be useful for differentiation between chondromas and chordomas. The current popular surgical approach for parasellar tumors is transcranial such as the orbitozygomatic subtemporal approach. In surgical removal of skull base chondromas, it is advisable to try to confirm the diagnosis preoperatively with characteristic image findings and to consider the best approach in each case to decompress the involved nerves without any complications.

  5. Intensified Fischer-Tropsch Synthesis Process with Microchannel Catalytic Reactors

    SciTech Connect

    Cao, Chunshe; Hu, Jianli; Li, Shari; Wilcox, Wayne A.; Wang, Yong

    2009-02-28

    A microchannel catalytic reactor with improved heat and mass transport has been used for Fischer-Tropsch synthesis to produce fuels and chemicals. This type of novel reactor takes advantages of highly active and selective catalysts with increased site density so that the FT synthesis process can be intensified. It was demonstrated that this microchannel reactor based process can be carried out at gas hourly space velocity (GHSV) as high as 60,000 hr-1 to achieve greater than 60% of one-pass CO conversion while maintaining low methane selectivity (<10%) and high chain growth probability(>0.9). Such superior FT synthesis performance has not ever been reported in the prior open literatures. The overall productivity to heavy hydrocarbons has been significantly improved over the conventional reactor technology. In this study, performance data were obtained in a wide range of pressure (10atm-35atm) and hydrogen to carbon monoxide ratio (1-2.5). The catalytic system was characterized by BET, scanning electron microcopy (SEM), transmission electron microcopy(TEM), and H2 chemisorption. A three dimensional pseudo-homogeneous model were used to simulate temperature profiles in the exothermic reaction system in order to optimize the reactor design and intensify the synthesis process. Intraparticle non-isothermal characteristics are also analyzed for the FT synthesis catalyst.

  6. [Intensified smoking cessation for diabetic patients--preliminary results].

    PubMed

    Brath, H; Lasar, D; Buchhäusl, I; Kästenbauer, T; Binter, E

    1999-01-01

    Cigarette smoking is the most prominent yet avoidable cause of illness in the general population as well as in patients with diabetes. The danger of developing late complications is much higher for smoking than for non-smoking diabetic patients. The aim of this study was to determine whether an intensified smoking cessation program for patients with diabetes, including an initial 3 week-period of inpatient cessation, is effective and more successful than a mere outpatient program. The outpatient program consisted of at least 7 consultations within 2 years, and included nicotine replacement therapy, steps for modifying the smokers' behavioural patterns, advice in dietary and exercise as well as measurements of amounts of exhaled carbonmonoxide and lung function. In the inpatient program the patients passed the first 3 cessation weeks in a specialised clinic providing a similar, but intensified program, aside from daily life and professional routine. The following consultations corresponded to those of the outpatient program. Altogether we analysed 89 patients (64 in the outpatient and 25 in the inpatient program).

  7. Imaging astrocytosis with PET in Creutzfeldt-Jakob disease: case report with histopathological findings

    PubMed Central

    Engler, Henry; Nennesmo, Inger; Kumlien, Eva; Gambini, Juan Pablo; Lundberg, PO; Savitcheva, Irina; Långström, Bengt

    2012-01-01

    In a previous study, patients with suspect Creutzfeldt-Jakob’s disease (CJD) have been examined with Positron Emission Tomography (PET) combining N-[11C-methyl]-L-deuterodeprenyl (DED) and [18F] 2- fluorodeoxyglucose (FDG) in an attempt to detect astrocytosis and neuronal dysfunction, two of the hallmarks in CJD. Increased DED uptake with pronounced hypometabolism matching the areas with high DED retention was found in the fronto-parieto-occipital areas and cerebellum of patients with confirmed CJD. However, the temporal lobes did not present such a pattern. In 6 of the 15 examined patients the autopsy was performed, but a strict comparison between the PET results and the histopathology could not be done. Recently, one patient with suspect CJD was examined with PET using DED and FDG. The results of the examinations in this patient showed a pattern similar to that found in the brain of the CJD patients from the first study. The patient died shortly after the examination and an autopsy could be performed. The autopsy showed neuronal death, astrocytosis and spongiform changes in the brain. The diagnosis of definite sporadic CJD was established by the Western blot analysis, confirming the presence of the prion resistant protein (PrPres). The PET data demonstrated high DED uptake and extreme low glucose uptake in the left brain hemisphere whereas the right side was less affected. The autopsy was performed allowing the comparison between high DED uptake and the histopathological findings of reactive astrocytosis revealed by immunostaining with antibodies against glial fibrillary acid protein (GFAP). The results confirmed the presence of a pattern with high ratio DED/FDG, similar to that found in the previous study and revealing for the first time, a good correlation between high DED uptake and high density of reactive astrocytes as demonstrated by immunostaining. PMID:22567182

  8. False Positive Findings on I-131 WBS and SPECT/CT in Patients with History of Thyroid Cancer: Case Series

    PubMed Central

    Hannoush, Zeina C.; Palacios, Juan D.; Kuker, Russ A.

    2017-01-01

    Introduction. Although whole body scan (WBS) with I-131 is a highly sensitive tool for detecting normal thyroid tissue and metastasis of differentiated thyroid cancer (DTC), it is not specific. Additional information, provided by single photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) and by the serum thyroglobulin level, is extremely useful for the interpretation of findings. Case Presentation. We report four cases of false positive WBS in patients with DTC: ovarian uptake corresponding to an endometrioma, scrotal uptake due to a spermatocele, rib-cage uptake due to an old fracture, and hepatic and renal uptake secondary to a granuloma and simple cyst, respectively. Conclusions. Trapping, organification, and storage of iodine are more prominent in thyroid tissue but not specific. Physiologic sodium-iodine symporter expression in other tissues explains some, but not all, of the WBS false positive cases. Other proposed etiologies are accumulation of radioiodine in inflamed organs, metabolism of radiodinated thyroid hormone, presence of radioiodine in body fluids, and contamination. In our cases nonthyroidal pathologies were suspected since the imaging findings were not corroborated by an elevated thyroglobulin level, which is considered a reliable tumor marker for most well-differentiated thyroid cancers. Clinicians should be aware of the potential pitfalls of WBS in DTC to avoid incorrect management. PMID:28246564

  9. 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.

  10. Yield of pulmonary tuberculosis cases by symptoms: Findings from a community survey in Madhya Pradesh, central India.

    PubMed

    Rao, V G; Bhat, J; Yadav, R; Muniyandi, M; Bhondeley, M K; Wares, D F

    2015-04-01

    A cross-sectional tuberculosis prevalence survey was undertaken in Jabalpur district, Madhya Pradesh, central India. All individuals were questioned for chest symptoms. Sputum samples were collected and examined for microscopy and culture. Overall prevalence of sputum positive pulmonary tuberculosis was found to be 255.3 per 100,000 population. Cough, with or without other symptoms, was present in 75.5% individuals and yielded 88.2% of the detected pulmonary tuberculosis cases. Elicitation of a previous history of treatment yielded 5.9%, and chest pain 4.5% cases. History of fever alone yielded no cases. The findings suggest that a history of fever alone may be safely excluded from the list of symptoms to be elicited in future TB prevalence surveys in India.

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. Recurrent odontogenic ghost cell carcinoma (OGCC) at a reconstructed fibular flap: a case report with immunohistochemical findings.

    PubMed

    Li, B-H; Cho, Y-A; Kim, S-M; Kim, M-J; Hong, S-P; Lee, J-H

    2011-08-01

    Odontogenic ghost cell carcinoma (OGCC), a malignant counterpart of the odontogenic ghost cell tumor (OGCT), with aggressive growth characteristics, is exceedingly rare. A painful swelling in the jaw with local paresthesia is the most common symptom. We described a case of 47-year Korean woman who had a rare central epithelial odontogenic ghost cell carcinoma which recurred at reconstructed fibular flap. Immunohistochemical differences between OGCT and OGCC analyzed using primary and recurred surgical specimen. On the basis of this case, the tumor started as an OGCT and transformed into OGCC with highly aggressive, rapidly growing, infiltrative tumors. Our findings suggest that some of the cytokines produced by ghost cells may play important roles in causing extensive bone resorption in the odontogenic ghost cell carcinoma. Wide local excision with histologically clean margins is the treatment mode of selection. Also, we recommend close long-term surveillance of OGCT because of high recurrence and potential for malignancy transformation.

  17. [Teniasis in a child with finding of Taenia saginata proglottids in the school environment: a case report].

    PubMed

    Dutto, M; Giovanetti, F; Pellegrino, A

    2009-01-01

    We describe a case of teniasis in a child, associated to the finding of Taenia proglottids in a classroom of a primary school in the area of Cuneo (Local Health Unit Cn-1, Piedmont Region, Italy). Several proglottids had been repeatedly found by cleaners on the bookbox of several schooldesks in the same classroom. Laboratory investigation was able to identify Taenia saginata proglottids and cooperation of the local Public Health Unit with the school management allowed to identify and treat the affected child. Laboratory investigation was crucial to exclude a Taenia solium infection, which should have had important public health implications. In fact, infection among humans can follow the ingestion of Taenia solium eggs and in this case larval forms in several tissues can occur (cysticercosis). Moreover the disease can be particularly severe when cysticerci invade the brain, causing seizures and hydrocephalia.

  18. 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.

  19. 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.

  20. Effect of Active Case Finding on Prevalence and Transmission of Pulmonary Tuberculosis in Dhaka Central Jail, Bangladesh

    PubMed Central

    Banu, Sayera; Rahman, Md. Toufiq; Uddin, Mohammad Khaja Mafij; Khatun, Razia; Khan, Md. Siddiqur Rahman; Rahman, Md. Mojibur; Uddin, Syed Iftekhar; Ahmed, Tahmeed; Heffelfinger, James D.

    2015-01-01

    Background Understanding tuberculosis (TB) transmission dynamics is essential for establishing effective TB control strategies in settings where the burden and risk of transmission are high. The objectives of this study were to evaluate the effect of active screening on controlling TB transmission and also to characterize Mycobacterium tuberculosis strains for investigating transmission dynamics in a correctional setting. Methods The study was carried out in Dhaka Central Jail (DCJ), from October 2005 to February 2010. An active case finding strategy for pulmonary TB was established both at the entry point to the prison and inside the prison. Three sputum specimens were collected from all pulmonary TB suspects and subjected to smear microscopy, culture, and drug susceptibility testing as well as genotyping which included deletion analysis, spoligotyping and analysis of mycobacterial interspersed repetitive units (MIRU). Results A total of 60,585 inmates were screened during the study period. We found 466 inmates with pulmonary TB of whom 357 (77%) had positive smear microscopy results and 109 (23%) had negative smear microscopy results but had positive results on culture. The number of pulmonary TB cases declined significantly, from 49 cases during the first quarter to 8 cases in the final quarter of the study period (p=0.001). Deletion analysis identified all isolates as M. tuberculosis and further identified 229 (70%) strains as ‘modern’ and 100 (30%) strains as ‘ancestral’. Analysis of MIRU showed that 347 strains (85%) exhibited unique patterns, whereas 61 strains (15%) clustered into 22 groups. The largest cluster comprised eight strains of the Beijing M. tuberculosis type. The rate of recent transmission was estimated to be 9.6%. Conclusions Implementation of active screening for TB was associated with a decline in TB cases in DCJ. Implementation of active screening in prison settings might substantially reduce the national burden of TB in Bangladesh

  1. Magnetic resonance imaging findings of remnants of an intradural oil-based contrast agent: report of a case

    PubMed Central

    Oo, Myint; Wang, Zhuo; Sakakibara, Toshihiko; Kasai, Yuichi

    2012-01-01

    Background Myodil (iophendylate), an oil-based positive contrast media, now discontinued, was widely used for performing myelography 30–70 years ago. We identified this agent as the explanation for uncommon magnetic resonance imaging (MRI) findings in a patient with thoracic spinal fracture. Design Case report and literature review. Findings An 81-year-old man complained of back pain after falling down stairs. Anamnesis revealed that he had undergone myelography with an oil-based contrast agent about 60 years previously as a part of the diagnostic workup for back pain and sudden onset of gait difficulty. Plain radiography of the thoraco-lumbar spine showed a fracture of the eleventh thoracic vertebra and a radio-opaque, oval shadow at the level of the T9–T10 vertebrae. Many small radio-opaque dots with the appearance of a string of pearls were seen from T8 to L3 vertebrae. MRI revealed a sharply demarcated intradural extramedullary mass, of approximately 5 mm in diameter on the left side of the dura in the region of the T9–T10. The mass showed high signal intensity on T1-weighted MRI, and low signal intensity on T2-weighted MRI. Conclusions Increased awareness of this rare presentation of procedures performed in the past is essential when atypical radiographic images are encountered. This case illustrates rare sequelae of Myodil use manifesting decades after administration. PMID:22333888

  2. Bamboo Leaf Sign as a Sensitive Magnetic Resonance Imaging Finding in Spinal Subependymoma: Case Report and Literature Review

    PubMed Central

    Ogawa, Yukari; Kinoshita, Keita; Hirai, Satoshi; Takai, Hiroki; Hara, Keijiro; Matsushita, Nobuhisa; Matsubara, Shunji; Uno, Masaaki

    2016-01-01

    Background and Importance. Subependymoma occurs very rarely in the spinal cord. We report another case of spinal subependymoma along with a review of the literature and discussion of a radiological finding that is useful for preoperative diagnosis of this tumor. Clinical Presentation. A 51-year-old man presented with a 2-year history of progressive muscle weakness in the right lower extremity. Sagittal magnetic resonance imaging (MRI) showed spinal cord expansion at the Th7–12 vertebral level. Surgical resection was performed and the tumor was found to involve predominantly subpial growth. Histological diagnosis was subependymoma, classified as Grade I according to criteria of World Health Organization. We made an important discovery of what seems to be a characteristic appearance for spinal subependymoma on sagittal MRI. Swelling of the spinal cord is extremely steep, providing unusually large fusiform dilatation resembling a bamboo leaf. We have termed this characteristic MRI appearance as the “bamboo leaf sign.” This characteristic was apparent in 76.2% of cases of spinal subependymoma for which MRI findings were reported. Conclusion. The bamboo leaf sign on spinal MRI is useful for differentiating between subependymoma and other intramedullary tumors. Neurosurgeons encountering the bamboo leaf sign on spinal MRI should consider the possibility of subependymoma. PMID:28074165

  3. Case Finding and Medical Treatment of Type 2 Diabetes among Different Ethnic Minority Groups: The HELIUS Study

    PubMed Central

    Agyemang, Charles; Peters, Ron J.; Stronks, Karien; Ujcic-Voortman, Joanna K.; van Valkengoed, Irene G. M.

    2017-01-01

    Aims. Prevention of diabetes complications depends on the level of case finding and successful treatment of diabetes, which may differ between ethnicities. Therefore, we studied the prevalence by age, awareness, treatment, and control of type 2 diabetes, among a multiethnic population. Methods. We included 4,541 Dutch, 3,032 South-Asian Surinamese, 4,109 African Surinamese, 2,323 Ghanaian, 3,591 Turkish, and 3,887 Moroccan participants (aged 18–70 y) from the HELIUS study. The prevalence of diabetes was analysed by sex, ethnicity, and 10-year age groups. Ethnic differences in the prevalence, awareness, treatment, and control of diabetes were studied by logistic regression. Results. From the age of 31–40 years and older, the prevalence of diabetes was 3 to 12 times higher among ethnic minority groups than that among the Dutch host population. Awareness and medical treatment of diabetes were 2 to 5 times higher among ethnic minorities than that among Dutch. Among those medically treated, only 37–53% had HbA1c levels on target (≤7.0%); only Dutch men had HbA1c levels on target more often (67%). Conclusions. Our results suggest that the age limit for case finding among ethnic minority groups should be lower than that for the general population. Importantly, despite higher awareness and treatment among ethnic minorities, glycemic control was low, suggesting a need for increased efforts to improve the effectiveness of treatment in these groups. PMID:28154830

  4. Case Finding and Medical Treatment of Type 2 Diabetes among Different Ethnic Minority Groups: The HELIUS Study.

    PubMed

    Snijder, Marieke B; Agyemang, Charles; Peters, Ron J; Stronks, Karien; Ujcic-Voortman, Joanna K; van Valkengoed, Irene G M

    2017-01-01

    Aims. Prevention of diabetes complications depends on the level of case finding and successful treatment of diabetes, which may differ between ethnicities. Therefore, we studied the prevalence by age, awareness, treatment, and control of type 2 diabetes, among a multiethnic population. Methods. We included 4,541 Dutch, 3,032 South-Asian Surinamese, 4,109 African Surinamese, 2,323 Ghanaian, 3,591 Turkish, and 3,887 Moroccan participants (aged 18-70 y) from the HELIUS study. The prevalence of diabetes was analysed by sex, ethnicity, and 10-year age groups. Ethnic differences in the prevalence, awareness, treatment, and control of diabetes were studied by logistic regression. Results. From the age of 31-40 years and older, the prevalence of diabetes was 3 to 12 times higher among ethnic minority groups than that among the Dutch host population. Awareness and medical treatment of diabetes were 2 to 5 times higher among ethnic minorities than that among Dutch. Among those medically treated, only 37-53% had HbA1c levels on target (≤7.0%); only Dutch men had HbA1c levels on target more often (67%). Conclusions. Our results suggest that the age limit for case finding among ethnic minority groups should be lower than that for the general population. Importantly, despite higher awareness and treatment among ethnic minorities, glycemic control was low, suggesting a need for increased efforts to improve the effectiveness of treatment in these groups.

  5. Pre-Liver Transplant Transthoracic Echocardiogram Findings and 6-Month Post-Transplant Outcomes: A Case-Control Analysis.

    PubMed

    Konerman, Monica A; Price, Jennifer C; Campbell, Catherine Y; Eluri, Swathi; Gurakar, Ahmet; Hamilton, James; Li, Zhiping

    2016-07-05

    BACKGROUND Cardiopulmonary (CP) outcomes remain a leading cause of morbidity and mortality following liver transplantation (LT). The optimal CP risk stratification of LT candidates remains unclear. The aim of this study was to evaluate the association of pre-LT transthoracic echocardiogram (TTE) findings and 6-month post-LT outcomes. MATERIAL AND METHODS This retrospective review analyzed adults who underwent LT, comparing those who died within 6 months of LT (cases; n=38) with age- and sex-matched patients who survived >6 months (controls; n=38). Cases were categorized by cause of death (COD) defined as either a primary CP process (n=20) or a non-CP process (n=18). Data were analyzed using logistic regression and survival analysis was performed using Kaplan-Meier curves. RESULTS There was a higher odds of death within 6 months of LT with ≥ mild mitral regurgitation (OR 3.44, p=0.03) or an incomplete assessment of right ventricular systolic function (RVSF) (OR 24, p=0.004). On subgroup analysis, these findings only persisted in patients with a CP COD. Patients with CP COD were older (61 vs. 54.5, p=0.04), had longer intervals between TTE and LT (122 vs. 29 days, p=0.05), less complete assessments of RVSF (p=0.009), and lower RV fractional area change (p=0.04) compared to patients with non-CP COD. CONCLUSIONS Multiple TTE parameters were associated with patients who died within 6 months of LT, and in particular patients with a CP COD. Our findings suggest that pre-LT TTEs can convey useful CP risk stratification information and emphasizes the importance of adequately assessing these parameters prior to LT.

  6. 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.

  7. Estimating the joint disease outbreak-detection time when an automated biosurveillance system is augmenting traditional clinical case finding.

    PubMed

    Shen, Yanna; Adamou, Christina; Dowling, John N; Cooper, Gregory F

    2008-04-01

    The goals of automated biosurveillance systems are to detect disease outbreaks early, while exhibiting few false positives. Evaluation measures currently exist to estimate the expected detection time of biosurveillance systems. Researchers also have developed models that estimate clinician detection of cases of outbreak diseases, which is a process known as clinical case finding. However, little research has been done on estimating how well biosurveillance systems augment traditional outbreak detection that is carried out by clinicians. In this paper, we introduce a general approach for doing so for non-endemic disease outbreaks, which are characteristic of bioterrorist induced diseases, such as respiratory anthrax. We first layout the basic framework, which makes minimal assumptions, and then we specialize it in several ways. We illustrate the method using a Bayesian outbreak detection algorithm called PANDA, a model of clinician outbreak detection, and simulated cases of a windborne anthrax release. This analysis derives a bound on how well we would expect PANDA to augment clinician detection of an anthrax outbreak. The results support that such analyses are useful in assessing the extent to which computer-based outbreak detection systems are expected to augment traditional clinician outbreak detection.

  8. Ocular findings in raised intracranial pressure: a case of Terson syndrome in a 7-month-old infant.

    PubMed

    Mena, Othon J; Paul, Ian; Reichard, R Ross

    2011-03-01

    We present the case of a 7-month-old female infant who was found crying and limp. She was transported to a hospital where a possible subarachnoid hemorrhage was diagnosed radiologically. Before further studies could be pursued, her condition worsened and she died. The autopsy demonstrated diffuse subarachnoid hemorrhage of the brain and along the spinal cord. The brain, spinal cord, and eyes were retained and examined postfixation. An aneurysm of the middle cerebral artery was identified. Examination of the eyes demonstrated bilateral optic nerve sheath hemorrhage and extensive retinal hemorrhages extending to the ora serrata. A rapid increase in intracranial pressure secondary to subarachnoid hemorrhage following rupture of an aneurysm can result in sequelae similar to those found in inflicted traumatic brain injury. In this case, the rise in intracranial pressure resulted in marked hemorrhage within the optic nerve sheaths as well as intra- and preretinal hemorrhages. Patients with subarachnoid hemorrhage, or other causes of rapidly increased intracranial pressure, may develop ocular hemorrhage (Terson syndrome). This case illustrates the importance of ruling out natural disease before attributing the autopsy findings to trauma, as well as the importance of postmortem fixation of pediatric brains and eyes prior to examination.

  9. 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

  10. 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,…

  11. Effects of image intensifier halo on perceived layout

    NASA Astrophysics Data System (ADS)

    Zacher, James E.; Brandwood, Tracey; Thomas, Paul; Vinnikov, Margarita; Xu, Gancun; Jennings, Sion; Macuda, Todd; Palmisano, Stephan A.; Craig, Greg; Wilcox, Laurie; Allison, Robert S.

    2007-04-01

    Night vision devices (NVDs) or night-vision goggles (NVGs) based on image intensifiers improve nighttime visibility and extend night operations for military and increasingly civil aviation. However, NVG imagery is not equivalent to daytime vision and impaired depth and motion perception has been noted. One potential cause of impaired perceptions of space and environmental layout is NVG halo, where bright light sources appear to be surrounded by a disc-like halo. In this study we measured the characteristics of NVG halo psychophysically and objectively and then evaluated the influence of halo on perceived environmental layout in a simulation experiment. Halos are generated in the device and are not directly related to the spatial layout of the scene. We found that, when visible, halo image (i.e. angular) size was only weakly dependent on both source intensity and distance although halo intensity did vary with effective source intensity. The size of halo images surrounding lights sources are independent of the source distance and thus do not obey the normal laws of perspective. In simulation experiments we investigated the effect of NVG halo on judgements of observer attitude with respect to the ground during simulated flight. We discuss the results in terms of NVG design and of the ability of human operators to compensate for perceptual distortions.

  12. 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.

  13. Emulsification in novel ultrasonic cavitation intensifying bag reactors.

    PubMed

    van Zwieten, Ralph; Verhaagen, Bram; Schroën, Karin; Fernández Rivas, David

    2017-05-01

    Cavitation Intensifying Bags (CIBs), a novel reactor type for use with ultrasound, have been recently proposed as a scaled-up microreactor with increased energy efficiencies. We now report on the use of the CIBs for the preparation of emulsions out of hexadecane and an SDS aqueous solution. The CIBs have been designed in such a way that cavitation effects created by the ultrasound are increased. It was found that the CIBs were 60 times more effective in breaking up droplets than conventional bags, therewith showing a proof of principle for the CIBs for the preparation of emulsions. Droplets of 0.2μm could easily be obtained. To our knowledge, no other technology results in the same droplet size more easily in terms of energy usage. Without depending on the wettability changes of the membrane, the CIBs score similarly as membrane emulsification, which is the most energy friendly emulsification method known in literature. Out of the frequencies used, 37kHz was found to require the lowest treatment time. The treatment time decreased at higher temperatures. While the energy usage in the current non-optimised experiments was on the order of 10(7)-10(9)J/m(3), which is comparable to that of a high-pressure homogenizer, we expect that the use of CIBs for the preparation of fine emulsions can still be improved considerably. The process presented can be applied for other uses such as water treatment, synthesis of nanomaterials and food processing.

  14. Elite synchronized swimmers display decreased energy availability during intensified training.

    PubMed

    Schaal, K; Tiollier, E; Le Meur, Y; Casazza, G; Hausswirth, C

    2016-07-01

    Elite synchronized swimmers follow high-volume training regimen that result in elevated rates of exercise energy expenditure (ExEE). While adequate energy intake (EI) is important to optimize recovery, a number of sport-specific constraints may lead to chronically low energy availability (EA = EI-ExEE). This study aimed to quantify changes in EA, endocrine markers of energy conservation, and perceived fatigue in synchronized swimmers, during a week of baseline training followed by 4 weeks of intensified training (IT). EI, ExEE, and body composition were measured in nine swimmers at Baseline, midpoint (ITWK2 ), and end of IT (ITWK4 ). Waking saliva samples were obtained to measure [leptin]s , [ghrelin]s , and [cortisol]s . Fatigue ratings were provided daily. ExEE increased by 27% during IT. Swimmers increased EI from Baseline to ITWK2 , but decreased it significantly from ITWK2 to ITWK4 . EA, fat mass, and [leptin]s decreased from Baseline to ITWK4 , while [ghrelin]s increased significantly. Fatigue at ITWK4 was inversely correlated with Baseline EI and EA. The significant decrease in EA was accompanied by endocrine signs of energy conservation in elite swimmers. As perceived fatigue was associated with low EA, particular attention should be paid to these athletes' energy intake during phases of heavy training.

  15. Professional commitment: Does it buffer or intensify job demands?

    PubMed

    Nesje, Kjersti

    2017-04-01

    The purpose of this study is to investigate whether professional commitment can be seen as a moderator in the relationship between job demands and emotional exhaustion among Norwegian nurses. Inspired by the job demands-resources model, this study explores whether having a strong commitment to the nursing profession can be seen as a resource that buffers the effect of job demands on emotional exhaustion or, conversely, intensifies the impact of job demands. A survey that comprised Norwegian nurses who had graduated three years previously (N = 388) was conducted. Multiple regression was performed to test the hypothesis. The results provide support to a buffering effect; thus, individuals with a higher degree of professional commitment conveyed a weaker association between job demands and emotional exhaustion compared with nurses with a lower degree of commitment. Developing a better understanding of the potential buffering effect of professional commitment is of great interest. The present study is the first to utilize professional commitment as a resource within the job demands-resources framework.

  16. [A case of intractable epilepsy: diagnosis of tuberous sclerosis based on histopathological findings and immunohistochemical expression of hamartin and tuberin].

    PubMed

    Takaishi, Yasuko; Hashimoto, Kiyoshi; Fujino, Osamu; Arai, Nobutaka; Mizuguchi, Masashi; Maehara, Taketoshi; Shimizu, Hiroyuki

    2002-01-01

    We report here a 14-year-old boy suffering from intractable epilepsy since the age of 2. Neuroimaging showed a lesion in the left temporal lobe. He underwent resection of the left temporal lobe and multiple subpial transection of the left frontal lobe at the age of 8. Histopathological findings of surgical specimens were similar to those of tubers of tuberous sclerosis (TSC), although he had no other TSC stigmata. To discriminate from cortical dysplasia grade III, we examined the immunohistochemical expression of hamartin and tuberin, the TSC1 and TSC2 gene products. Based on results, we diagnosed this case as having TSC. He has been seizure free since the operation. Although lower than preoperatively, his intelligence quotient has not been declining progressively.

  17. Incidental finding of an extensive oropharyngeal mass in magnetic resonance imaging of a patient with temporomandibular disorder: A case report

    PubMed Central

    Omolehinwa, Temitope T.; Mupparapu, Mel

    2016-01-01

    In this report, we describe the incidental finding of an oropharyngeal mass in a patient who presented with a chief complaint of temporomandibular pain. The patient was initially evaluated by an otorhinolaryngologist for complaints of headaches, earache, and sinus congestion. Due to worsening headaches and trismus, he was further referred for the management of temporomandibular disorder. The clinical evaluation was uneventful except for limited mouth opening (trismus). An advanced radiological evaluation using magnetic resonance imaging revealed a mass in the nasopharyngeal/oropharyngeal region. The mass occupied the masticatory space and extended superioinferiorly from the skull base to the mandible. A diagnostic biopsy of the lesion revealed a long-standing human papilloma virus (HPV-16)-positive squamous cell carcinoma of the oropharynx. This case illustrates the need for the timely radiological evaluation of seemingly innocuous orofacial pain. PMID:28035308

  18. A case of monomelic amyotrophy of the upper limb: MRI findings and the implication on its pathogenesis.

    PubMed

    Li, Yuebing; Remmel, Krista

    2012-06-01

    Monomelic amyotrophy of the upper limb or Hirayama disease is mostly considered as an anterior horn disorder resulting from local ischemia, triggered by arterial compression from an anterior shifting of the posterior cervical dura upon neck flexion. However, such a dural shifting is not universally seen. We report on a Caucasian male patient who developed a slowly progressive unilateral distal hand weakness in his teens. His clinical and electromyographic findings were consistent with Hirayama disease. Local anterior cervical cord atrophy was observed without dural shifting on the dynamic magnetic resonance imaging. Axial magnetic resonance imaging demonstrated signal changes of "snake-eye" appearance in the cervical anterior horn region, similar to ischemic myelopathies caused by various etiologies. This case illustrated that even without dural shifting, a mechanism of anterior spinal cord ischemia could still be responsible for the pathogenesis of Hirayama disease.

  19. Benign incidental findings of osteopoikilosis on Tc-99m MDP bone SPECT/CT: A case report and literature review.

    PubMed

    Tsai, Szu-Ying; Wang, Shan-Ying; Shiau, Yu-Chien; Wu, Yen-Wen

    2016-06-01

    Osteopoikilosis is a benign but rare condition characterized by bone islands throughout the osseous tissue, which could be easily confused with bone metastasis. We present a case of a 37-year-old man presented to orthopedic outpatient clinic with right hip pain for 2 weeks. There were multiple, small punctate lesions scattered throughout the skeleton on radiograph. Subsequent Tc-99m methylene diphosphonate (MDP) bone scan with pelvic single-photon emission computed tomography (SPECT)/computed tomography (CT) showed multiple enostoses without abnormal focal MDP uptake. Therefore, clinical diagnosis was compatible with osteopoikilosis while bone metastasis was unlikely. The symptoms then improved by conservative treatments. Osteopoikilosis is usually an incidental finding on radiograph or CT, and a normal MDP confirmed the diagnosis by excluding bone metastasis. It is important for clinicians to recognize the specific image features to prevent further unnecessary interventions. In addition, bone SPECT/CT could also make the diagnosis in one step.

  20. Necrobiosis lipoidica: a case with histopathological findings revealed asteroid bodies and was successfully treated with dipyridamole plus intralesional triamcinolone.

    PubMed

    Jiquan, Song; Khalaf, Ahmad T; Jinquan, Tan; Xiaoming, Liu

    2008-01-01

    The significance of necrobiosis lipoidica (NL) includes its relationship with insulin-dependent diabetes mellitus, its tendency to break down into painful ulcers, an albeit tenuous association with squamous cell carcinoma and, by no means least, its cosmetic impact, occurring as it does on the shins of young and middle-aged women. Necrobiosis (degeneration of collagen) and granulomous inflammation are well-documented histological findings in NL; however, to see an asteroid body in an area of NL is rare. To the best of our knowledge, there is only one such report of NL described so far. We report the case of a NL patient whose histopathological examination revealed asteroid bodies. The patient had suffered persistent NL for a period of more than 2 years. She was successfully treated with dipyridamole plus intralesional triamcinolone and the lesions healed completely after 2 months of therapy. The patient has remained free of lesions since discontinuing therapy.

  1. 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.

  2. Spectrum of clinicoradiological findings in spinal cord infarction: Report of three cases and review of the literature

    PubMed Central

    Sivadasan, Ajith; Alexander, Mathew; Patil, Anil K.; Mani, Sunithi

    2013-01-01

    Spinal cord infarction (SCI) often remains undiagnosed due to infrequent occurrence and lack of established diagnostic procedures. The unique pattern of blood supply explains the heterogeneity of clinical presentation. We present three cases of SCI to highlight the varied spectrum of clinicoradiological findings. The first patient had posterior spinal artery infarction, and spine imaging showed infarction of adjacent vertebral body, which is usually rare. The second patient had anterior spinal artery infarction and the cANCA titers were elevated. The third patient had a pure motor quadriparesis. Initial imaging did not show any cord infarction, but signal changes were noted on serial imaging. Fibrocartilagenous embolism (FCE) seems the most likely etiology in the first and third cases. A high index of clinical suspicion is necessary for prompt diagnosis. Sensitivity of the initial magnetic resonance imaging remains limited, necessitating serial follow-up scans. Infarction of the adjacent vertebral body is a useful confirmatory sign. Fat suppression images can delineate the marrow signal changes better. Elderly patients with vascular risk factors and degenerative discs need to avoid mechanical triggers that predispose to FCE. Younger patients with SCI will need evaluation for cardioembolic source and vasculitis. PMID:23956562

  3. Range-gated intensified spectrographic imager: an instrument for active hyperspectral imaging

    NASA Astrophysics Data System (ADS)

    Simard, Jean-Robert; Mathieu, Pierre; Fournier, Georges R.; Larochelle, Vincent; Babey, Stephen K.

    2000-09-01

    Hyperspectral imaging has demonstrated impressive capabilities in airborne surveys, particularly for mineral and biomass characterizations. Based on this success, it is believed that other applications like search and rescue operations, and detection/identification of various ground military targets could greatly benefit from this technology. The strength of hyperspectral imaging comes from the access to another dimension of information: the spectral content of the detected return signal for each spatial pixel. In the case of conventional hyperspectral imaging, the return signal depicts the spectral reflectance of the day irradiance from the scene within the field of view of each pixel. However, by inserting a range-gated intensifier into a hyperspectral camera and by combining the camera with selected pulsed lasers, it becomes possible to relate the returned spectral information to specific light/matter interactions like induced fluorescence. This new technique may be referred to as 'active hyperspectral imaging.' Among its advantages, this approach is independent of the ambient lighting conditions and can be customized in excitation wavelengths. Moreover, by using a range-gated intensified camera, it is possible to survey limited area with a significant increase in signal-to-noise ratio. A camera of this type has been built by our group in collaboration with private industry and is described in this paper. The internal design of the camera is discussed, new issues concerning the calibration of the camera are depicted and a model based on signal-to-noise ratio analysis is presented. From the fluorescent characteristics of surrogate land mines measured in the laboratory, this model is used to predict the capabilities of detecting surface-laid mines from an aerial platform based scenario.

  4. Epidemiologic Correlates of Mortality among Symptomatic Visceral Leishmaniasis Cases: Findings from Situation Assessment in High Endemic Foci in India

    PubMed Central

    Karthick, Morchan; Dwivedi, Shweta; Banerjee, Indranath; Mahapatra, Tanmay; Srikantiah, Sridhar; Chaudhuri, Indrajit

    2016-01-01

    Background Visceral leishmaniasis (VL) is highly prevalent in the Indian state of Bihar and, without proper diagnosis and treatment, is associated with high fatality. However, lack of efficient reporting mechanism had been an impediment in estimating the burden of mortality and its antecedents among symptomatic VL cases. The objectives of the current study were to generate a reliable estimate of symptomatic VL caseload and mortality in Bihar, as well as to identify the epidemiologic and health infrastructure-related predictors of VL mortality. Methodology and Principal Findings Using an elaborate index case tracing method, we attempted to locate all symptomatic VL patients in eight districts of Bihar. Interviews and medical-record-reviews were conducted with cases (or next-of-kin for the dead) meeting the eligibility criteria. The information collected during the interviews included socio-demographic characteristics, onset of disease symptoms, place of diagnosis, pre- and post-diagnosis treatment history, type and duration of drugs received. In total, we analyzed data on 4925 VL patients—59% were male and 68% were less than 30 years old. There were 158 (3.2%) deaths and the incidence rate of mortality was 3.2/100 person-years. In the adjusted Cox-proportional-hazards analysis, treatment at public facility [Adjusted Hazard Ratio (AHR) = 0.61; 95% CI = 0.43–0.86], shorter (≤30 days) diagnostic delay [AHR = 0.62, 95% CI = 0.43–0.92], and treatment completion [AHR = 0.03, 95% CI = 0.02–0.05] emerged as significant negative predictors of mortality. Conclusion Mortality reduction efforts in Bihar should focus on improving access to early diagnosis, quality treatment and treatment-adherence measures, with special emphasis on marginalized communities. PMID:27870870

  5. 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

  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. 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

  8. 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.

  9. 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.

  10. Pure neuritic leprosy presenting as ulnar nerve neuropathy: a case report of electrodiagnostic, radiographic, and histopathological findings.

    PubMed

    Payne, Russell; Baccon, Jennifer; Dossett, John; Scollard, David; Byler, Debra; Patel, Akshal; Harbaugh, Kimberly

    2015-11-01

    Hansen's disease, or leprosy, is a chronic infectious disease with many manifestations. Though still a major health concern and leading cause of peripheral neuropathy in the developing world, it is rare in the United States, with only about 150 cases reported each year. Nevertheless, it is imperative that neurosurgeons consider it in the differential diagnosis of neuropathy. The causative organism is Mycobacterium leprae, which infects and damages Schwann cells in the peripheral nervous system, leading first to sensory and then to motor deficits. A rare presentation of Hansen's disease is pure neuritic leprosy. It is characterized by nerve involvement without the characteristic cutaneous stigmata. The authors of this report describe a case of pure neuritic leprosy presenting as ulnar nerve neuropathy with corresponding radiographic, electrodiagnostic, and histopathological data. This 11-year-old, otherwise healthy male presented with progressive right-hand weakness and numbness with no cutaneous abnormalities. Physical examination and electrodiagnostic testing revealed findings consistent with a severe ulnar neuropathy at the elbow. Magnetic resonance imaging revealed diffuse thickening and enhancement of the ulnar nerve and narrowing at the cubital tunnel. The patient underwent ulnar nerve decompression with biopsy. Pathology revealed acid-fast organisms within the nerve, which was pathognomonic for Hansen's disease. He was started on antibiotic therapy, and on follow-up he had improved strength and sensation in the ulnar nerve distribution. Pure neuritic leprosy, though rare in the United States, should be considered in the differential diagnosis of those presenting with peripheral neuropathy and a history of travel to leprosy-endemic areas. The long incubation period of M. leprae, the ability of leprosy to mimic other conditions, and the low sensitivity of serological tests make clinical, electrodiagnostic, and radiographic evaluation necessary for diagnosis

  11. Autopsy findings in the acquired immunodeficiency syndrome (AIDS). A report of 395 cases from the south of France.

    PubMed

    Hofman, P; Saint-Paul, M C; Battaglione, V; Michiels, J F; Loubière, R

    1999-01-01

    Necropsy findings in 395 adult patients with the acquired immunodeficiency syndrome (AIDS) who died in Nice, France, between March 1983 and May 1996 were compared retrospectively with antemortem diagnoses, risk factors and number of positive T CD4 lymphocytes at the time of death. Special emphasis on bacterial infections was made in this study. Lesions observed from 1983 through 1989 and from 1990 through 1996 were compared. We assessed the role of organ lesions in the immediate cause of death. The organ system distribution of major opportunistic infections and neoplasms was similar throughout the years of the study. The most common diagnostic disease entities in all organ sites were cytomegalovirus infection, toxoplasmosis and candidiasis. Toxoplasmosis was more common in the intravenous drug abuser group. Bacterial infections were frequent and contributed to the mortality and morbidity of all risk factor groups. Kaposi' sarcoma continued to occur more frequently in the homosexual population. Cytomegalovirus infection remained one of the most common causes of death from 1983 to 1996. Mortality from fungal and bacterial infections, and mycobacteriosis increased in frequency during the course of this study whereas deaths from pneumocystosis declined. The death rate from malignant lymphoma and carcinoma increased after 1989. The clinical cause of death concurred with the pathological cause in 55% of the cases. Lung was the most frequent organ involved followed by the central nervous system the gastrointestinal tract and the heart.

  12. 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.

  13. 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.

  14. Interstitial pneumonia with autoimmune features (IPAF) and radiological findings suggestive of lymphocytic interstitial pneumonia (LIP) - case report.

    PubMed

    Płóciniczak, Alicja; Goździk-Spychalska, Joanna; Batura-Gabryel, Halina Batura-Gabryel

    2017-01-01

    Interstitial pneumonia with autoimmune features (IPAF) is a term to describe individuals with both interstitial lung disease (ILD) and combinations of other clinical, serologic, and/or pulmonary morphologic features, which presumably originate from an underlying systemic autoimmune condition, but do not meet current rheumatologic criteria for a defined connective tissue disease (CTD). Predominantly, interstitial pneumonia arises in the course of an established CTD, but it is not so rare for the ILD to be the first, and possibly the one and only manifestation of a latent CTD. Lymphocytic Interstitial Pneumonia (LIP) is an uncommon disease, characterized by infiltration of the interstitium and alveolar spaces of the lung by lymphocytes, plasma cells and other lymphoreticular elements. The cause of LIP is still unknown but it could be also a manifestation of CTD. Clinically, it is highly variable, from spontaneous resolution to progressive respiratory failure and death despite glucocorticoid treatment. Since there are no recent standards for the management of LIP, the disease is treated empirically. We report a case of a HIV-negative 54-year-old woman, who was suspected of LIP according to clinical features and radiological findings. Positive laboratory results were highly suggestive of underlying autoimmune process, but did not fulfil the criteria of any particular CTD. Because of severe general condition of the patient, immunosuppressive treatment was started immediately, without further invasive diagnostics including lung biopsy, which is required for a definitive diagnosis. We present two-year observation of the patient with all our doubts concerning clinical proceedings.

  15. Canine prostatic disease--comparison of ultrasonographic appearance with morphologic and microbiologic findings: 30 cases (1981-1985).

    PubMed

    Feeney, D A; Johnston, G R; Klausner, J S; Perman, V; Leininger, J R; Tomlinson, M J

    1987-04-15

    A retrospective analysis was made of 30 cases of canine prostatic disease, with the objective of identifying (via a prepubic approach) the 2-dimensional, gray-scale ultrasonographic appearance most often associated with the various spontaneous prostatic diseases. Ultrasonography was of value in characterizing the parenchymal architecture as normal vs focally hyperechoic and diffusely hyperechoic (associated with chronic inflammation and neoplasia) or focally hypoechoic or anechoic (either accompanied by distant enhancement), which was associated with retention cyst or abscess. Further specificity based only on abnormal echotexture was not possible. Ultrasonography facilitated the differentiation of radiographically identifiable prostatomegaly attributable to abscess or neoplasia from apparent prostatomegaly attributable to paraprostatic cyst. An imaging protocol consisting of distention retrograde urethrocystography and prepubic ultrasonography was recommended, as a distended bladder aided ultrasonographic identification of the prostate gland. In addition, the combination of urethral morphologic features and urethroprostatic reflux appearance complemented the ultrasonographic appearance for differentiation of prostatic abscess from prostatic carcinoma. A classification scheme for spontaneous canine prostatic disease combining germane imaging morphologic features with microscopic and microbiologic findings was proposed.

  16. 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.

  17. 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.

  18. Diffuse Infantile Hepatic Hemangioendothelioma With Early Central Enhancement in an Adult: A Case Report of CT and MRI Findings.

    PubMed

    Dong, Aisheng; Dong, Hui; Zuo, Changjing; He, Tianlin

    2015-12-01

    Infantile hepatic hemangioendothelioma (IHH) is the most common vascular tumor of the liver in infancy. Adult with IHH is extremely rare. We presented a diffuse IHH in an adult patient with computed tomography (CT) and magnetic resonance image (MRI) findings.A 39-year-old man was admitted to our hospital because of a 2-year history of abnormal liver function tests and a 7-day history of jaundice. Physical examination revealed enlarged liver. Unenhanced abdominal CT showed enlargement of the liver with diffuse hypodensity. Enhanced CT on the arterial phase revealed multiple centrally enhanced lesions diffusely involved the enlarged liver. The enhanced areas of the lesions became larger on the portal phase and all the lesions became homogeneous enhanced on the delayed phase. These lesions showed heterogeneously hyperintense on T2-weighted image, hypointense on T1-weighted image, and early centrally enhanced on dynamic gadolinium-enhanced MRI, with complete tumor enhancement after 180 s. The patient underwent orthotopic liver transplantation. IHH type 2 was confirmed by pathology. The patient died of tumor recurrence in the liver 4 months after transplantation.Unlike the previously described imaging appearances of IHH, this case showed diffuse nodules with early central enhancement on CT and MRI. Considering the importance of the ability to differentiate IHH from other hepatic tumors, radiologists should be aware of these imaging appearances to establish knowledge of the entire spectrum of IHH.

  19. [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.

  20. 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

  1. 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

  2. 2-D fluorescence lifetime imaging using a time-gated image intensifier

    NASA Astrophysics Data System (ADS)

    Dowling, K.; Hyde, S. C. W.; Dainty, J. C.; French, P. M. W.; Hares, J. D.

    1997-02-01

    We report a 2-D fluorescence lifetime imaging system based on a time-gated image intensifier and a Cr:LiSAF regenerative amplifier. We have demonstrated 185 ps temporal resolution. The deleterious effects of optical scattering are demonstrated.

  3. 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.

  4. 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.

  5. 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.

  6. 42 CFR 431.822 - Resolution of differences in State and Federal case eligibility or payment findings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... described above), the Federal findings will be sustained. (c) If the Regional Office disagrees with the... difference. Medicaid Quality Control (MQC) Claims Processing Assessment System Source: Sections...

  7. 42 CFR 431.822 - Resolution of differences in State and Federal case eligibility or payment findings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... described above), the Federal findings will be sustained. (c) If the Regional Office disagrees with the... difference. Medicaid Quality Control (MQC) Claims Processing Assessment System Source: Sections...

  8. 42 CFR 431.822 - Resolution of differences in State and Federal case eligibility or payment findings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... described above), the Federal findings will be sustained. (c) If the Regional Office disagrees with the... difference. Medicaid Quality Control (MQC) Claims Processing Assessment System Source: Sections...

  9. 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

  10. Excess “read-through” acetylcholinesterase attenuates but the “synaptic” variant intensifies neurodeterioration correlates

    PubMed Central

    Sternfeld, Meira; Shoham, Shai; Klein, Omer; Flores-Flores, Cesar; Evron, Tamah; Idelson, Gregory H.; Kitsberg, Dani; Patrick, James W.; Soreq, Hermona

    2000-01-01

    Acute stress increases the risk for neurodegeneration, but the molecular signals regulating the shift from transient stress responses to progressive disease are not yet known. The “read-through” variant of acetylcholinesterase (AChE-R) accumulates in the mammalian brain under acute stress. Therefore, markers of neurodeterioration were examined in transgenic mice overexpressing either AChE-R or the “synaptic” AChE variant, AChE-S. Several observations demonstrate that excess AChE-R attenuates, whereas AChE-S intensifies, neurodeterioration. In the somatosensory cortex, AChE-S transgenics, but not AChE-R or control FVB/N mice, displayed a high density of curled neuronal processes indicative of hyperexcitation. In the hippocampus, AChE-S and control mice, but not AChE-R transgenics, presented progressive accumulation of clustered, heat shock protein 70–immunopositive neuronal fragments and displayed a high incidence of reactive astrocytes. Our findings suggest that AChE-R serves as a modulator that may play a role in preventing the shift from transient, acute stress to progressive neurological disease. PMID:10890884

  11. 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. PMID:27660372

  12. 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.

  13. Intensified glucose self-monitoring with education in Saudi DM patients.

    PubMed

    Ba-Essa, Ebtesam M; Mobarak, Eman I; Alghamdi, Abdulaziz; Al-Daghri, Nasser M

    2015-01-01

    The purpose of this study is to assess the impact of intensified SMBG with patient education on DM patients at the Eastern province of Saudi Arabia. 60 poorly controlled adult type 1 and 2 DM patients (30 intervention; 30 control) were included in this 4-month case-control study. All patients were subjected to the same educational program at baseline. Controls were followed up after 3 months. The intervention group was followed monthly. Fasting blood glucose, HbA1c and lipid profile levels were the main outcome measures. The intervention arm showed significant reduction in the post-fasting glucose (P<0.001) and HbA1c (P<0.001) levels as well as a significant increase in glucose testing (P<0.001) than pre-levels. Both post-fasting glucose and HbA1c levels were significantly lower in the intervention arm than the control arm (P<0.001 and P=0.001, respectively). The intervention group also showed higher improvement in knowledge, attitude and behavior than the controls (P<0.001). Short duration of structured periodic SMBG with patient education significantly improved glycemic control in all DM patients, regardless of the type or mode of treatment. It facilitated timely and aggressive treatment modification and encouraged patient self-care behavior.

  14. Intensified glucose self-monitoring with education in Saudi DM patients

    PubMed Central

    Ba-Essa, Ebtesam M; Mobarak, Eman I; Alghamdi, Abdulaziz; Al-Daghri, Nasser M

    2015-01-01

    The purpose of this study is to assess the impact of intensified SMBG with patient education on DM patients at the Eastern province of Saudi Arabia. 60 poorly controlled adult type 1 and 2 DM patients (30 intervention; 30 control) were included in this 4-month case-control study. All patients were subjected to the same educational program at baseline. Controls were followed up after 3 months. The intervention group was followed monthly. Fasting blood glucose, HbA1c and lipid profile levels were the main outcome measures. The intervention arm showed significant reduction in the post-fasting glucose (P<0.001) and HbA1c (P<0.001) levels as well as a significant increase in glucose testing (P<0.001) than pre-levels. Both post-fasting glucose and HbA1c levels were significantly lower in the intervention arm than the control arm (P<0.001 and P=0.001, respectively). The intervention group also showed higher improvement in knowledge, attitude and behavior than the controls (P<0.001). Short duration of structured periodic SMBG with patient education significantly improved glycemic control in all DM patients, regardless of the type or mode of treatment. It facilitated timely and aggressive treatment modification and encouraged patient self-care behavior. PMID:26770578

  15. Research on testing field flaws of image intensifier based on spatio-temporal SNR

    NASA Astrophysics Data System (ADS)

    Zhou, Bin; Liu, Bingqi; Wu, Dongsheng

    2010-10-01

    Image intensifier is the kernel of low-light-level device. The field flaw is one of the important index parameters of the image intensifier. Traditionally the statistic number of the image intensifier's field flaws is calculated through the people's eyes by the aid of an optical microscope, which main limitation is subjective and inefficient. With the broad application of the high-powered CCD and digital imaging processing method in testing performance of image intensifier, the method of appraising SNR based on spatio-temporal noise theory can accurately reflect the spatio-temporal heterogeneous of fluorescence's output image and fulfill the requirements of digital and automatic test. The limitation of the flaws' shape and position can be disregard and the accurate flaws' inspection can be realized rapidly by this method. In this paper, the main factors of forming the field flaws are analyzed and the mathematic model of spatio-temporal SNR is deduced. The hardware devices of the test system for image intensifier's spatio-temporal SNR are discussed. The spatio-temporal SNR of Gen image intensifier is tested by this test system and the test software based on Visual C++ and Matlab. The digital and automatic test of a factitious field flaw is realized by the theory of spatio-temporal SNR. The test precision can achieve pixel level. The experimental results show that this new method is rational, reliable and visualized.

  16. The evaluation of the clinical, laboratory and the radiological findings of the fifty-five cases diagnosed with tuberculous, Brucellar and pyogenic spondylodiscitis

    PubMed Central

    Yasar, Kadriye; Pehlivanoglu, Filiz; Cicek, Gulten; Sengoz, Gonul

    2012-01-01

    Objective: In this study, the evaluation of the clinical, laboratory and radiological findings belonging to 55 cases that were hospitalized in our clinic to be followed-up and were diagnosed with tuberculous, brucellar and pyogenic spondylodiscitis (SD) was aimed. Materials and Methods: The cases with SD were evaluated retrospectively. Hematological, serological, biochemical laboratory tests and imaging technics were used for diagnosis. Results: Of 55 cases aged ranging between 25 to 79, 33 (59%) were female. The cases with tuberculous SD (TBSD), brucellar SD (BSD) and pyogenic SD (PSD) were found in 24 (43%), 12 (21%) and in 19 (34%) patients. Erytrocyte sedimentation rate, increased C-reactive protein, and leucocytosis were present in 51 (91%), 22 (39%) and 8 (14%) cases. The number of the cases with history of previous surgery or trauma was 14 (25%). Diagnosis of TBSD was established by acid fast bacilli positiveness and Löwenstein Jensen culture positiveness, in two and seven patients, respectively. While all 12 cases with BSD had positive standard tube aglutination test, only 3 (25%) had hemoculture positivity. In PSDs, diagnosis was confirmed with culture positivity in 9 of 19 cases.Of the cases in our study, 89% responded to medical treatment while three required surgery and three died (5.5% and 5.5%, respectively). Conclusion: SD may develop secondary to infections or following spinal surgical procedures and traumas. Also, the importance of endemicity should be kept in mind, beside the helpful diagnostic findings while treatment regulation. PMID:22346185

  17. 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…

  18. The "Geography" of Child Maltreatment in Israel: Findings from a National Data Set of Cases Reported to the Social Services

    ERIC Educational Resources Information Center

    Ben-Arieh, Asher; Haj-Yahia, Muhammad M.

    2006-01-01

    Objectives: This article examines the "geography" of reported cases of child maltreatment in Israel by determining its frequency and rates according to nationality, area of residence, and size and type of locality. Method: The study collected data at the local level in Israel based on reports to social services of cases of child…

  19. Comparison of epileptic and nonepileptic cases with centrotemporal spikes in view of clinical findings and electroencephalographic characteristics.

    PubMed

    Tombul, Temel; Anlar, Omer; Caksen, Hüseyin

    2006-03-01

    The morphological features of centrotemporal spike discharges (CTSD) and relationship of them with clinical diagnosis in cases with benign epilepsy of childhood with centrotemporal spikes (BECTS) and the other epileptic syndromes of childhood as well as some nonconvulsive neurological disorders were detected in the routine patient population who referred to the authors' EEG laboratory. Thirty-six cases (21 males, 15 females; 8 months-14 years old), in which awake and/or sleep EEGs revealed CTSD were included in this study. The cases were divided into two groups as epileptic and nonepileptic. The cases with seizure were divided into BECTS and the other epilepsies. Of the epileptic cases, 14 (38.8%) patients had typical rolandic seizures. In five cases, there were partial or secondary generalized seizures. Two cases had myoclonic seizures. In the nonepileptic group, there was mental retardation/behavioral disturbances in five cases; there were periodic syndromes of childhood such as migraine and equivalents of migraine in three cases; febrile convulsion in three cases, breath-holding spells in two cases, and primary enuresis nocturna in two cases. In the nonepileptic group, the discharges were significantly fewer than the other groups (p = .014). More frequent discharges occuring for shorter periods were more significantly observed in BECTS group (64%). Typically isolated spike and slow-waves in T3/T4 and C3/C4 location were significantly more common (86%) in rolandic epilepsy group (p = .01). The EEGs of cases with BECTS had more frequency in the cluster of discharges than the other groups (p = .018). Multifocal discharges were observed in 28.5% of cases with BECTS, in 20% of nonepileptic group, and in 71.4% of other epileptics in the trial. Although these epileptic and nonepileptic conditions have some differences in view of frequency and morphology and location, CTSDs could be manifested in the group without seizure. It was concluded that the similar focal

  20. 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

  1. Toxicological findings in cases of alleged drug-facilitated sexual assault in the United Kingdom over a 3-year period.

    PubMed

    Scott-Ham, Michael; Burton, Fiona C

    2005-08-01

    This paper outlines the toxicology results from 1014 cases of claimed drug-facilitated sexual assault (DFSA) analysed at the Forensic Science Service, London Laboratory between January 2000 and December 2002. Where appropriate, either a whole blood sample and/or a urine sample was analysed for alcohol, common drugs of abuse and potentially stupefying drugs. The results were interpreted with respect to the number of drugs detected and an attempt was made to distinguish between voluntary and involuntary ingestion from information supplied. Alcohol (either alone or with an illicit and/or medicinal drug) was detected in 470 of all cases (46%). Illicit drugs were detected in 344 cases (34%), with cannabis being the most commonly detected (26% of cases), followed by cocaine (11%). In 21 cases (2%), a sedative or disinhibiting drug was detected which had not been admitted and could therefore be an instance of deliberate spiking. This included three cases in which complainants were allegedly given Ecstasy (MDMA) without their knowledge. Other drugs detected included gammahydroxybutyrate (GHB) and the benzodiazepine drugs diazepam and temazepam. Another nine cases (1%) involved the complainant being either given or forced to ingest pharmaceutical tablets or an illicit drug.

  2. 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

  3. Fibroma with minor sex cord elements--an incidental finding in a normal sized ovary. A case report with literature review.

    PubMed

    Mandal, Shramana; Mahajan, Dipti; Roy, Somak; Singh, Meeta; Khurana, Nita

    2007-12-04

    Ovarian fibroma with minor sex cord element is a rare neoplasm. Microscopically it is composed of predominantly fibromatous or a thecomatous tumor containing scattered minor sex cord elements in less than 10% of the tumor area.A case of fibroma with minor sex cord elements discovered incidentally in a normal sized ovary in a patient who presented with dysfunctional uterine bleeding is being presented. This is the first case report describing this entity in a normal sized ovary as an incidental finding.

  4. Multimodal imaging findings of SAPHO syndrome with no skin lesions: A report of three cases and review of the literature.

    PubMed

    Duan, Na; Chen, Xiao; Liu, Yongkang; Wang, Jianhua; Wang, Zhongqiu

    2016-10-01

    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.

  5. 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

  6. Effect of process intensifying parameters on the hydrodynamic cavitation based degradation of commercial pesticide (methomyl) in the aqueous solution.

    PubMed

    Raut-Jadhav, Sunita; Saini, Daulat; Sonawane, Shirish; Pandit, Aniruddha

    2016-01-01

    Methomyl, a carbamate pesticide, is classified as a pesticide of category-1 toxicity and hence shows harmful effects on both human and aquatic life. In the present work, the degradation of methomyl has been studied by using hydrodynamic cavitation reactor (HC) and its combination with intensifying agents such as H2O2, fenton reagent and ozone (hybrid processes). Initially, the optimization of operating parameters such pH and inlet pressure to the cavitating device (circular venturi) has been carried out for maximizing the efficacy of hydrodynamic cavitation. Further degradation study of methomyl by the application of hybrid processes was carried out at an optimal pH of 2.5 and the optimal inlet pressure of 5 bar. Significant synergetic effect has been observed in case of all the hybrid processes studied. Synergetic coefficient of 5.8, 13.41 and 47.6 has been obtained by combining hydrodynamic cavitation with H2O2, fenton process and ozone respectively. Efficacy of individual and hybrid processes has also been obtained in terms of energy efficiency and extent of mineralization. HC+Ozone process has proved to be the most effective process having highest synergetic coefficient, energy efficiency and the extent of mineralization. The study has also encompassed the identification of intermediate by-products generated during the degradation and has proposed the probable degradation pathway. It has been conclusively established that hydrodynamic cavitation in the presence of intensifying agents can effectively be used for complete degradation of methomyl.

  7. 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.

  8. Odontogenic Sinusitis Caused by an Inflammation of a Dentigerous Cyst and Subsequent Finding of a Fibrous Dysplasia. A Case Report

    PubMed Central

    López-Carriches, Carmen; López-Carriches, Inmaculada; Bryan, Rafael Baca-Perez

    2016-01-01

    We report the case of a 38-year old male patient with sinusitis caused by an infected follicular cyst due to an ectopic impacted third molar in the right maxillary sinus. A 10-day antibiotherapy regimen was administered; subsequently, the cyst and the third molar were removed achieving complete recovery. Fibrous dysplasia was diagnosed at follow-up examination (occupation of the maxillary sinus by bone tissue was observed in a radiographic examination) and confirmed by biopsy. In cases of odontogenic sinusitis, thorough examination is crucial, as evidenced by the case reported in this study. A Literature review was performed in order to identify the diagnostic methods currently available and the clinical features, complications and treatment for both, odontogenic maxillary sinusitis and fibrous dysplasia. PMID:28077969

  9. 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

  10. 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…

  11. The Case for Pre-K in Education Reform: A Summary of Program Evaluation Findings. Research Series

    ERIC Educational Resources Information Center

    Wat, Albert

    2010-01-01

    For state and federal officials seeking to improve school performance, 50 years of evidence shows that high-quality, voluntary pre-kindergarten is among the best strategies for education reform. This brief from Pew's Pre-K Now initiative highlighted findings from evaluations of state-funded Pre-K programs that continue to document gains in key…

  12. CASE Fundraising in International Schools Report 2016. Findings from Data Collected for the Academic Year 2014-15

    ERIC Educational Resources Information Center

    Council for Advancement and Support of Education, 2016

    2016-01-01

    The CASE Fundraising in International Schools Survey (FRIS) provides a set of measurement standards for advancement programmes at international schools around the world. The survey was first conducted in 2009 among practitioners to trace the expansion and innovation of development and external relations initiatives in international schools. Given…

  13. 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"…

  14. 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

  15. 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.

  16. 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.

  17. Magnetic Resonance Imaging Findings of Mumps Meningoencephalitis with Bilateral Hippocampal Lesions without Preceding Acute Parotitis: A Case Report

    PubMed Central

    Woo, Ah Reum; Lim, Myung Kwan; Kang, Young Hye; Cho, Soon Gu; Choi, Seong Hye; Baek, Ji Hyeon

    2017-01-01

    Meningitis is a common central nervous system (CNS) complication of the mumps, a viral infection, but encephalitis and meningoencephalitis are less common in mumps. We describe magnetic resonance imaging findings of acute mumps meningoencephalitis in a 32-year-old male who showed bilateral hippocampal lesions without preceding parotitis. Although it is rare, hippocampal involvement should be considered a CNS complication of mumps infection. PMID:28246518

  18. Canine prostatic disease--comparison of radiographic appearance with morphologic and microbiologic findings: 30 cases (1981-1985).

    PubMed

    Feeney, D A; Johnston, G R; Klausner, J S; Perman, V; Leininger, J R; Tomlinson, M J

    1987-04-15

    A retrospective analysis was made of radiographs from 24 clinically normal young adult male Beagles used in previously reported base-line research on the distal male urinary tract. The ventrodorsal and craniocaudal prostate gland dimensions were measured, as visualized on the lateral radiographic view, and expressed as a ratio of the distance between the cranial aspect of the public bone and the sacral promontory. In 17 of these 24 dogs, there was sufficient image clarity to permit confident measurement of prostatic dimensions. From these data, the largest acceptable prostatic dimension, as visualized on the lateral radiographic view, was 70% of the public-promontory distance. A retrospective analysis was made of 30 cases of canine prostatic disease, with the objective of identifying the radiographic (survey and distention retrograde urethrocystogram) appearance most often associated with the various spontaneous prostatic diseases. Prostatomegaly was not specific for the cause of prostatic disease, except if the apparent parenchymal dimensions were greater than or equal to 90% of the public-promontory distance wherein neoplasia, abscess, and paraprostatic cysts (readily differentiated from diffuse intraparenchymal disease by ultrasonography) were the principle considerations. Multifocal, irregularly shaped, parenchymal mineral densities were observed only in dogs with prostatic carcinoma (4/7 cases) or prostatitis (1 case of chronic prostatitis). Narrowing of the prostatic portion of the urethra was observed only in association with abscess, neoplasm, or noninflammatory nonneoplastic disease (possibly benign hypertrophy/hyperplasia), whereas widening of this part of the urethra was not observed.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. 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.

  20. Intensified Diapycnal Mixing in the Midlatitude Western Boundary Currents

    PubMed Central

    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 m2s−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

  1. A long-term study of 277 cases of equine sinonasal disease. Part 1: details of horses, historical, clinical and ancillary diagnostic findings.

    PubMed

    Tremaine, W H; Dixon, P M

    2001-05-01

    The clinical and ancillary diagnostic findings in equine sinnasal disease were studied. The diagnoses in 277 referred (1984-1996) cases of equine sinonasal disease included the following (% all cases): 67 cases (24.2%) primary sinusitis, 61 (22.0%) dental sinusitis, 37 (13.4%) sinus cysts, 22 (7.9%) sinonasal neoplasia, 21 (7.6%) progressive ethmoid haematoma, 17 (6.1%) sinonasal trauma, 13 (4.7%) sinonasal mycosis, 11 (4.0%) rostral maxillary cheek tooth infection, 7 (2.5%) sinonasal polyps, 7 (2.5%) cases of nasal epidermal inclusion cysts and 14 (5.1%) miscellaneous sinonasal disorders. Many disorders showed similar clinical signs including nasal discharge (present in 88% of all cases) and facial swelling (46%). Most disorders were chronic, with a median duration of signs of 12 weeks (range 3 days- 6 years) prior to referral. Sinus cysts and sinonasal neoplasia were significantly (P<0.05) more frequently associated with gross distortion of the nasal passages and facial bones than the other sinonasal disorders. Endoscopic changes were detected per nasum in 91% of cases, but contributed to the exact diagnosis in only 20%. Radiography revealed abnormalities in 81% of cases but was diagnostically useful in only 36%. Sinoscopy was diagnostically useful in 70% of the 61 cases where used.

  2. The Threat Among Us: Insiders Intensify Aviation Terrorism

    SciTech Connect

    Krull, Katie E.

    2016-08-19

    Aviation terrorism is powerful and symbolic, and will likely remain a staple target for terrorists aiming to inflict chaos and cause mass casualties similar to the 9/11 attacks on the U.S. The majority of international and domestic aviation terrorist attacks involves outsiders, or people who do not have direct access to or affiliation with a target through employment. However, several significant attacks and plots against the industry involved malicious employees motivated by suicide or devotion to a terrorist organization. Malicious insiders’ access and knowledge of aviation security, systems, networks, and infrastructure is valuable to terrorists, providing a different pathway for attacking the industry through the insider threat. Indicators and warnings of insider threats in these cases exist, providing insight into how security agencies, such as the Transportation Security Administration, can better predict and identify insider involvement. Understanding previous aviation insider threat events will likely aid in stimulating proactive security measures, rather than reactive responses. However, similar to traditional airport security measures, there are social, political, and economic challenges in protecting against the insider threat, including privacy concerns and cost-benefit analysis.

  3. Use of Dual-Pulse Lithotripter to Generate a Localized Intensified Cavitation Field

    SciTech Connect

    Sokolov, Dihlia L.; Bailey, Michael R.; Crum, Lawrence A.

    2001-09-01

    Localizing cavitation to the kidney stone in extracorporeal shock wave lithotripsy may be desirable since cavitation appears to play a major role in both stone comminution and renal tissue damage. A method has been developed to localize and intensify cavitation damage in vitro. Cavitation fields in water were filmed with a high-speed digital video camera. In a conventional lithotripter (CL), the shock wave produced by a single source creates a 2 x 10 cm cylindrical cloud of bubbles in water. Bubbles in the CL field collapse simultaneously along the focal axis to produce a nearly uniform 1-mm x 8-cm line of pits in 25- mm-thick aluminum foil. Our dual-pulse lithotripter (DPL) uses two shock wave sources, facing each other, confocal, and triggered simultaneously to create a 4 x 5 cm cylindrical cloud of bubbles that collapse over a range of times and strengths such that the greatest pit damage on foils is contained within a few square millimeters of the focus. The time for bubbles to grow and collapse was measured with a focused hydrophone and compared with calculations based on the Gilmore equation. Pressure doubling due to synchronous arrival of the two pulses at the focus created increased bubble growth and increased foil pit depth. Asynchronous timing between the two pulses elsewhere in the DPL field resulted in disruption of radial dynamics and negligible pitting to foils. Translation of bubbles was also investigated, both numerically and experimentally. While net translation was calculated to be ,0.3 mm in all cases, the rapid

  4. 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.

  5. Magnetic resonance imaging findings in patients with delusional disorder due to diffuse cerebrovascular disease: a report of seven cases.

    PubMed

    Su, K P; Hsu, C Y; Hsieh, S C; Shen, W W

    2001-04-01

    Delusions associated with cerebrovascular diseases have been sporadically reported. Although both psychiatrists and neurologists attempted to link delusions with anatomical locations of the brain lesion, comorbid psychiatric and neurological disorders make the interpretation of delusions difficult. The purpose of the present paper is to report the clinical features and magnetic resonance imaging (MRI) characteristics in patients with delusional disorder due to diffuse cerebrovascular diseases, and to redefine the concept of 'vascular delusion'. The clinical features and MRI findings were reviewed retrospectively in a series of seven patients with 'delusional disorder due to cerebrovascular disease' as defined in Diagnostic and Statistical Manual of Mental Disorders (DSMIV). The average age of onset is 64. No patient had a prior personal or family history of major psychiatric illness. The illness is presented as acute, subacute or stepwise course. Hypertension was present in all patients. Two had diabetes mellitus, and one had atrial fibrillation. Three had clinical evidence of previous cerebrovascular attacks, only one showed minor neurological deficits. Three had diffuse cortical slow wave in electroencephalogram. No patient had significant cognitive impairment but had multiple cortical and subcortical cerebrovascular lesions in MRI, with white-matter lesions (WML) in bilateral frontal areas. Delusional disorder due to diffuse cerebrovascular change is characterized by late-onset, stepwise course, and comorbid medical and neurological diseases. The results of vascular changes in the present study did not establish a cause-effect relationship and should be considered as multifactorial in pathogenesis. The findings suggested the hypothesis of neural circuit theory. Further studies in larger numbers of patients and newer neuroimaging techniques are needed to expand the knowledge learned from these findings.

  6. A case of Robin sequence, microgastria, radiohumeral synostosis, femoral deficiency, and other unusual findings: a newly recognized syndrome?

    PubMed

    Roberts, Jessica; Torres-Martinez, Wilfredo; Farrow, Emily; Stevens, Abby; Delk, Paula; White, Kenneth E; Weaver, David D

    2014-02-01

    In this report, we describe an 8-year-old male with Robin sequence, bilateral radiohumeral synostosis, microgastria, cryptorchidism, dislocated hips, proximal femoral deficiency, and an autism spectrum disorder. This combination of findings has not been previously reported. Features of particular interest are the radiohumeral synostosis and microgastria, both of which are rare defects, and to our knowledge, have not been reported to occur together. We propose that the patient has a newly recognized syndrome consisting of the aforementioned features, the etiology of which is unknown.

  7. Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases.

    PubMed

    D'Elia, F; Zingarelli, A; Palli, D; Grani, M

    2000-01-01

    The aim of this study was to evaluate the accuracy of dynamic CT in the preoperative staging of gastric cancer. One hundred seven patients affected by gastric cancer diagnosed by endoscopic biopsy were prospectively staged by dynamic CT prior to tumor resection. After an oral intake of 400-600 ml of tap water and an intravenous infusion of a hypotonic agent, 200 ml of non-ionic contrast agent were administered by power injector using a biphasic technique. The CT findings were prospectively analyzed and correlated with the pathological findings at surgery. The accuracy of dynamic CT for tumor detection was 80 and 99% in early and advanced gastric cancer, respectively, with overall detection rate of 96% (103 of 107). Three early (pT1) and one advanced (pT2) cancers were undetected. Tumor stage as determined by dynamic CT agreed with pathological findings in 83 of 107 patients with an overall accuracy of 78%. The accuracy of CT in detecting increasing degrees of depth of tumor invasion when compared with pathological TNM staging was 20% (3 of 15) and 87% (80 of 92) in early and advanced cancer, respectively. The sensitivity, specificity, and accuracy of CT in the preoperative staging (pT3-pT4 vs pT1-pT2) was 93, 90, and 91.6%, respectively. The sensitivity, specificity, and accuracy of CT in assessing metastasis to regional lymph nodes was 97.2, 65.7, and 87%, respectively. Computed tomography correctly staged liver metastases in 105 of 107 patients with an overall sensitivity of 87.5% and specificity of 99 %. The sensitivity of peritoneal involvement was 30% when ascites or peritoneal nodules were absent. Our findings show that dynamic CTcan play a role in the preoperative definition of gastric cancer stage. The results can be used to optimize the therapeutic strategy for each individual patient prior to surgery, thus avoiding unnecessary intervention and allowing careful planning of extended surgery in eligible patients.

  8. Incidental Finding of Ebstein’s Anomaly in an Adolescent with an Upper Respiratory Infection: A Case Report

    PubMed Central

    Kapoor, Rohit; Paul, Premila

    2016-01-01

    Ebstein’s anomaly is a rare congenital heart disorder and has a varied clinical course, with detection as late as the seventh decade. We hereby describe an 11-year-old child in whom Ebstein’s anomaly was diagnosed. The most common presentation in early second decade is due to an arrhythmia; however, the present case report is about a patient who presented with acute congestive heart failure due to decompensation from an acute upper respiratory tract infection, which is a rather uncommon presentation. PMID:27134958

  9. 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.

  10. Epidermoid Cyst in an Intrapancreatic Accessory Spleen: Case Report and Literature Review of the Preoperative Imaging Findings

    PubMed Central

    Kato, Shin; Mori, Hideki; Zakimi, Moriya; Yamada, Koki; Chinen, Kenji; Arashiro, Masayuki; Shinoura, Susumu; Kikuchi, Kaoru; Murakami, Takahiro; Kunishima, Fumihito

    2016-01-01

    An epidermoid cyst arising within an intrapancreatic accessory spleen (ECIAS) is rare, and also difficult to correctly diagnose before surgery. It is mostly misdiagnosed as a cystic tumor, such as a mucinous cystic neoplasm or as a solid tumor with cystic degeneration, such as a neuro endocrine tumor. We herein report a case of ECIAS and also perform a literature review of 35 reports of ECIAS. Although the preoperative diagnosis of ECIAS using conventional imaging is relatively difficult to make, careful preoperative examinations of the features on computed tomography and magnetic resonance imaging could lead to a correct preoperative diagnosis of ECIAS which might thereby reduce the number of unnecessary resections. PMID:27904107

  11. Asperger Syndrome in India: Findings from a Case-Series with Respect to Clinical Profile and Comorbidity

    PubMed Central

    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

  12. Remarkable Diagnostic Magnetic Resonance Imaging Findings in Sellar Xanthogranuloma: Report of Three First Cases in Latin America

    PubMed Central

    Céspedes, Mario Tapia; Vargas, Jaime Pinto; Yañez, Fernando Andrade; León, Loreto Spencer; Arancibia, Pablo Álvarez; Putz, Thomas Schmidt

    2017-01-01

    The sellar xanthogranuloma is a rare lesion of the sellar–parasellar region difficult to differentiate from other tumors such as craniopharyngiomas or Rathke's cleft cyst in the preoperative evaluation. As they are recently recognized as a separate entity and the few number of reports in the literature, its etiology is unknown and its impact remains uncertain. This article will describe the first three cases reported in Latin America, identified in one of them an imaging feature that may be helpful to elucidate an imaging growth pattern. Current evidence will be described regarding to the clinicopathological features, imaging diagnosis, and etiology origin theories. PMID:28286725

  13. A Rare Case of Congenital Heart Disease with Bifid Cardiac Apex: A Unique Finding in Left Ventricle

    PubMed Central

    Maleki, Majid; Esmaeilzadeh, Maryam; Alizadeasl, Azin; Hashemi, Arash

    2013-01-01

    Bifid cardiac apex is a rare anomaly of human hearts. We report of the case of a 34-year-old man with a previous history of ventricular septal defect (VSD) and subvalvular pulmonary stenosis. He had undergone pulmonary commissurotomy and VSD closure 22 years before he was referred to our center for evaluation of progressive dyspnea. Transthoracic echocardiography revealed atrial septal defect (ASD), multiple VSDs, severe pulmonary regurgitation, and a bifid cardiac apex. The patient was referred for re-do surgery for ASD and VSD closure along with pulmonary valve replacement, but he refused the surgery. PMID:24396366

  14. Measurements of an intensified CCD detector for the Solar and Heliospheric Observatory

    NASA Technical Reports Server (NTRS)

    Thompson, William T.; Poland, Arthur I.; Siegmund, Oswald H.; Swartz, Marvin; Leviton, Douglas B.; Payne, Leslie J.

    1992-01-01

    An engineering model intensified CCD detector for the SOHO Coronal Diagnostics Spectrometer has been built and tested at the NASA Goddard Space Flight Center. A windowless MCP intensifier tube converts EUV radiation (30-65 nm) into visible light, which is focused via a lens system onto a Tektronix 1024 x 1024 CCD. Tests have been made of this engineering model to determine the following characteristics: quantum efficiency, resolution, throughput, linearity, statistical variation, readout noise, scattering, and flat-field response. In almost all respects, the detector performed as expected. This detector has been delivered, and work is underway on the flight detector.

  15. Assessing the relationship between farming practices, laboratory analyses and post-mortem findings: a case study in pig fattening.

    PubMed

    Langkabel, N; Fries, R

    2013-12-01

    European Union legislation on animal production associated with food safety requires the collection and management of information and data about the farm, the herd and the individual animal. This paper describes the technical steps of the generation, collection and interpretation of data from 296 pig-fattening farms, belonging to two farming associations and using indoor production systems (56 management parameters). The paper also describes post-mortem findings and the results of enzyme-linked immunosorbent assays (ELISA) for antibodies to salmonellae, Trichinella spp. and Yersinia spp. A total of nearly 30 million data points were collected and analysed for this study. The results of the ELISA were negative for Trichinella spp.; for salmonellae and Yersinia spp., both negative and positive results were obtained. Analysis of the farm management parameters showed no significant differences; therefore, the cut-off levels for salmonellae and Yersinia spp. were increased, in order to identify farms with a greater hygiene burden. Post-mortem findings, possibly related to 'farm hygiene', were used in the analysis. As a result, three farms with particular management decisions were identified as potentially having contributed to the high burden of pathogens detected using ELISA. A relationship between laboratory results and farm management parameters assessed from yes/no answers could not be established in this study without further work on the available data set.

  16. 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.

  17. Image intensifier-guided injection of corticosteroid and local anesthetic agent for the treatment of recalcitrant plantar fasciitis.

    PubMed

    Atkins, Kate L; Chin, Kuen Foo; Noorani, Ali M; Nairn, David S

    2010-08-01

    Plantar fasciitis is the most common cause of plantar heel pain. The condition is potentially self-limiting and can respond to conservative treatment, but patients may opt for surgery if the treatments fail. Surgical intervention is associated with potential complications. This study set out to explore the efficacy of the specific nonsurgical intervention offered to treatment-resistant cases in a local clinical setting. The technique involves image intensifier-guided injection of corticosteroid and local anesthetic agents under general anesthesia. Nineteen patients with recalcitrant plantar fasciitis of over 12 months' duration received injections. A simple follow-up questionnaire was given to patients after the procedure that focused on their subjective opinion of any change in their pain. They were also asked if the injection had solved their problems with heel pain. The improvements that the patients reported were found to be statistically significant (P = .012).

  18. Changes in conceptions and attitudes during five years of intensified conventional insulin treatment in the Stockholm Diabetes Intervention Study (SDIS).

    PubMed

    Reichard, P; Toomingas, B; Rosenqvist, U

    1994-01-01

    Previous studies have demonstrated that intensified treatment can result in lower blood glucose concentrations and retard microvascular complications. In the Stockholm Diabetes Intervention Study, 96 patients were followed for 5 years; 44 patients received intensified, conventional treatment and 52 patients received regular treatment. Changes in conceptions and attitudes that accompanied intensified treatment were evaluated with questionnaires and semistructured interviews. After education and personal tutoring, HbAlc was significantly lower in patients in the intensified treatment group compared with patients in the regular treatment group. Self-rated well-being and perceived ability to control the diabetes increased more in the patients in the intensified treatment group. Blood glucose testing became more important to the patients in the intensified treatment group, who used the blood glucose tests more frequently whenever necessary, and who acted on the test results. Microvascular complications were retarded or halted.

  19. Cost-effectiveness of active case-finding of household contacts of pulmonary tuberculosis patients in a low HIV, tuberculosis-endemic urban area of Lima, Peru.

    PubMed

    Shah, L; Rojas, M; Mori, O; Zamudio, C; Kaufman, J S; Otero, L; Gotuzzo, E; Seas, C; Brewer, T F

    2017-04-01

    We compared the cost-effectiveness (CE) of an active case-finding (ACF) programme for household contacts of tuberculosis (TB) cases enrolled in first-line treatment to routine passive case-finding (PCF) within an established national TB programme in Peru. Decision analysis was used to model detection of TB in household contacts through: (1) self-report of symptomatic cases for evaluation (PCF), (2) a provider-initiated ACF programme, (3) addition of an Xpert MTB/RIF diagnostic test for a single sputum sample from household contacts, and (4) all strategies combined. CE was calculated as the incremental cost-effectiveness ratio (ICER) in terms of US dollars per disability-adjusted life years (DALYs) averted. Compared to PCF alone, ACF for household contacts resulted in an ICER of $2155 per DALY averted. The addition of the Xpert MTB/RIF diagnostic test resulted in an ICER of $3275 per DALY averted within a PCF programme and $3399 per DALY averted when an ACF programme was included. Provider-initiated ACF of household contacts in an urban setting of Lima, Peru can be highly cost-effective, even including costs to seek out contacts and perform an Xpert/MTB RIF test. ACF including Xpert MTB/RIF was not cost-effective if TB cases detected had high rates of default from treatment or poor outcomes.

  20. Risk factors for central nervous system tumors in children: New findings from a case-control study

    PubMed Central

    Tamayo-Uria, Ibon; Gómez-Barroso, Diana; López-Abente, Gonzalo; Morales-Piga, Antonio; Pardo Romaguera, Elena; Aragonés, Nuria; García-Pérez, Javier

    2017-01-01

    Background Central nervous system tumors (CNS) are the most frequent solid tumor in children. Causes of CNS tumors are mainly unknown and only 5% of the cases can be explained by genetic predisposition. We studied the effects of environmental exposure on the incidence of CNS tumors in children by subtype, according to exposure to industrial and/or urban environment, exposure to crops and according to socio-economic status of the child. Methods We carried out a population-based case-control study of CNS tumors in Spain, covering 714 incident cases collected from the Spanish Registry of Childhood Tumors (period 1996–2011) and 4284 controls, individually matched by year of birth, sex, and autonomous region of residence. We built a covariate to approximate the exposure to industrial and/or urban environment and a covariate for the exposure to crops (GCI) using the coordinates of the home addresses of the children. We used the 2001 Census to obtain information about socio-economic status (SES). We fitted logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs). Results The results for all CNS tumors showed an excess risk (OR = 1.37; 95%CI = 1.09–1.73) for SES, i.e., children living in the least deprived areas had 37% more risk of CNS tumor than children living in the most deprived areas. For GCI, an increase of 10% in crop surface in the 1-km buffer around the residence implied an increase of 22% in the OR (OR = 1.22; 95%CI = 1.15–1.29). Children living in the intersection of industrial and urban areas could have a greater risk of CNS tumors than children who live outside these areas (OR = 1.20; 95%CI = 0.82–1.77). Living in urban areas (OR = 0.90; 95%CI = 0.65–1.24) or industrial areas (OR = 0.96; 95%CI = 0.81–1.77) did not seem to increase the risk for all CNS tumors together. By subtype, Astrocytomas, Intracranial and intraspinal embryonal tumors, and other gliomas showed similar results. Conclusion Our results

  1. Hepatopulmonary fusion in a newborn. An uncommon intraoperatory finding during right congenital diaphragmatic hernia surgery: case description and review of literature.

    PubMed

    Olenik, D; Codrich, D; Gobbo, F; Travan, L; Zennaro, F; Dell'Oste, C; Bussani, R; Schleef, J

    2014-06-01

    Hepatic pulmonary fusion is a rare malformation associated with right congenital diaphragmatic hernia (CDH), often only discovered during surgical repair of the defect. Fourteen previous cases have been reported in the literature. We describe a case of a full term male newborn with prenatal ultrasound diagnosis of right CDH who underwent a thoracoscopy converted to a thoracotomy, due to this rare aforementioned intraoperative incidental finding. We reviewed the previous reported literature, especially focusing on the chosen surgical approach, concluding that an early and appropriate preoperative imaging investigation may be crucial for the best management of these kinds of patients.

  2. Finding clusters of similar events within clinical incident reports: a novel methodology combining case based reasoning and information retrieval

    PubMed Central

    Tsatsoulis, C; Amthauer, H

    2003-01-01

    A novel methodological approach for identifying clusters of similar medical incidents by analyzing large databases of incident reports is described. The discovery of similar events allows the identification of patterns and trends, and makes possible the prediction of future events and the establishment of barriers and best practices. Two techniques from the fields of information science and artificial intelligence have been integrated—namely, case based reasoning and information retrieval—and very good clustering accuracies have been achieved on a test data set of incident reports from transfusion medicine. This work suggests that clustering should integrate the features of an incident captured in traditional form based records together with the detailed information found in the narrative included in event reports. PMID:14645892

  3. Sarcomatoid carcinoma of the renal pelvis with giant cell tumor-like features: case report with immunohistochemical findings.

    PubMed

    Acikalin, Mustafa Fuat; Kabukcuoglu, Sare; Can, Cavit

    2005-02-01

    Sarcomatoid transitional cell carcinoma is a rare entity, in which a malignant, overtly epithelial component coexists with areas having a sarcoma-like appearance. Histological distinction of sarcomatoid carcinomas from carcinosarcomas is often difficult and immunohistochemistry is a helpful diagnostic adjunct in the correct diagnosis. In the present report, we describe an uncommon case of sarcomatoid transitional cell carcinoma of the renal pelvis, associated with giant cell tumor-like features. Immunoperoxidase staining for cytokeratin was positive in spindle cell component, indicating an epithelial origin. The carcinomatous component showed a diffuse membranous reactivity for E-cadherin, whereas the reactivity was sporadic and weaker in the sarcomatoid component, suggesting that the decrease of E-cadherin expression might be associated with the acquisition of sarcomatous morphology. Osteoclast-like multinucleated giant cells were positive for CD68 and negative for p53 oncoprotein, suggesting that they represent a non-neoplastic component that is reactively induced in the tumor stroma.

  4. A case of mass-forming splenic tuberculosis: MRI findings with emphasis of diffusion-weighted imaging characteristics.

    PubMed

    Lim, Jihe; Yu, Jeong-Sik; Hong, Soon Won; Chung, Jae-Joon; Kim, Joo Hee; Kim, Ki Whang

    2011-03-01

    Tuberculosis remains one of the most prevalent and fatal infectious diseases in spite of considerable improvements in medical science. The diagnosis and treatment of extrapulmonary tuberculosis involving the abdomen is still complicated owing to vague or non-specific clinical features. Although rare, isolated splenic involvement is one of the important manifestations of extrapulmonary tuberculosis, and imaging suspicion of the disease is essential. We report a case of surgically confirmed mass-forming splenic tuberculosis showing a layered pattern consisting of caseous necrosis with profound restriction of water molecules surrounded by an irregular rind of granulation tissue with less diffusion restriction on diffusion-weighted magnetic resonance imaging (DWI). In the differential diagnosis of neoplastic or non-neoplastic mass-forming lesions involving the spleen, this unique DWI feature could be helpful in characterizing splenic tuberculosis. The patient has been in clinically disease free status for nearly 20 months after splenectomy.

  5. [Oncoplastic versus conventional breast conserving surgery. A comparison of clinicopathological findings, cosmetic results and quality of life in 60 cases].

    PubMed

    Mátrai, Zoltán; Gulyás, Gusztáv; Kovács, Eszter; Sándor, Zsuzsanna; Polgár, Csaba; Bartal, Alexandra; Kásler, Miklós

    2014-06-01

    Oncoplastic surgical techniques seem to be suitable for realizing the goal of retaining cosmesis following radical removal of breast tumors. The purpose of the present study is to provide a clinical and pathological comparison of conventional (BCS) and oncoplastic (OPS) breast-conserving surgeries, supplemented by a subjective assessment of cosmesis and quality of life of patients, the first time on a Hungarian sample. The authors performed a retrospective assessment of clinicopathological data of 60 advanced oncoplastic and 60 conventional breast-conserving surgery cases, and following adjuvant radiotherapy, the authors also surveyed patients for cosmetic results and quality of life (EORTC BR23). Comparison of the results was performed by statistical methods. The two groups did not differ substantially in age, tumor location, breast size, type of axillary surgery (sentinel node biopsy vs. axillary lymphadenectomy), tumor grade and receptor status. Tumor size was significantly greater (p=0.0009), the rate of quadranectomies was higher (p=0.0032), metastases in the regional lymph nodes (p=0.0043) and the administration of adjuvant chemotherapy (p=0.0122) were more frequent in the OPS group. The duration of surgeries was longer (p<0.001), the weight of the specimens was greater (p=0.0308), the rate of completion surgeries due to microscopically positive surgical margins was significantly smaller (p=0.0306) in the OPS than in the BCS group. There was no difference between the two groups in the rate of complications and the time elapsed to the start of adjuvant treatment. The cosmetic outcome was clearly superior in the OPS group (p<0.001), and OPS patients had fewer arm, shoulder (p=0.0399), and chest pain (of the affected side) (p=0.0304), upper limb movements of the operated side were also better (p=0.006). The short follow-up period of the OPS group (mean 32.2 vs. 8.7 months in BCS and OPS, respectively) did not allow a meaningful assessment of oncologic endpoints

  6. Clinicopathological findings and disease staging of feline infectious peritonitis: 51 cases from 2003 to 2009 in Taiwan.

    PubMed

    Tsai, Hsien-Ying; Chueh, Ling-Ling; Lin, Chao-Nan; Su, Bi-Ling

    2011-02-01

    Fifty-one cats histopathologically confirmed to have been naturally infected by feline infectious peritonitis (FIP), were collected to analyse the clinical and laboratory findings and to characterise disease staging. Effusive FIP was found in 33 cats, non-effusive FIP in 12 cats, and mixed-type in six cats. Highly significant decreases in haematocrit and albumin levels and an increase in total bilirubin level were noted in both effusive and non-effusive FIP, at first presentation and before death. In serial blood examinations of the effusive group, anaemia and increases in bilirubin and aspartate aminotransferase (AST) were observed from 2 weeks to 0-3 days before death. The packed cell volume, bilirubin, AST, potassium, and sodium levels were established to predict disease staging and survival time. Cumulative points ranging from 0 to 4, 5 to 11 and excess of 12, indicate that the cat can survive for at least 2 weeks, less than 2 weeks and less than 3 days, respectively.

  7. 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.

  8. Congenital insensitivity to pain and anhidrosis: Case report and review of findings along neuro-immune axis in the disorder.

    PubMed

    Varma, Aditi Vian; McBride, Lori; Marble, Michael; Tilton, Ann

    2016-11-15

    Congenital insensitivity to pain and anhidrosis (CIPA) is one of the hereditary autonomic and sensory neuropathies. Typically presenting in infancy, it manifests as hyperpyrexia from defects in sweating (autonomic) and self-mutilating injuries from pain insensitivity (sensory). CIPA being rare in North America, diagnosis is often missed due to variable presentation. Subsequent management of its complications is therefore delayed. We report an unusual presentation in a 2-year-old girl with preexisting diagnosis of CIPA who was evaluated for bilateral upper extremity paresis of insidious onset. MRI revealed a mass compressing her cervical spine as the cause, and work up suggested immune dysfunction as possible etiology. To our knowledge, this complication has not been reported before in association with the disease. We introduce the disease by explaining the molecular pathology behind its presenting features. The neurological findings, documented in association with CIPA, are summarized and serve as a reference for the various presentations of this rare disorder. Since this disease is known to affect the immune system, immune defects in CIPA are discussed with recommendations for surveillance of patient's immune status.

  9. 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

  10. 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.

  11. [Interesting radiological and pathological findings of the internal carotid artery observed in a case of cavernous sinusitis (author's transl)].

    PubMed

    Moriyama, T; Fujita, Y; Ono, H; Mori, K

    1977-06-01

    A 47-year-old man was admitted to the neurosurgical department of Nagasaki University Hospital with complaints of high fever, deteriorated conciousness and nonpulsating exophthalmus on the left side. The first carotid angiography which had been done 2 days prior to admission, showed only an irregular narrowing in the cavernous portion of the left carotid artery. The right carotid angiogram did not show any recognizable abnormality. The second angiography which was performed 4 days after the admission, revealed an cylindrical aneurysmal opacification about 0.8 cm in diameter in the left intracavernous portion. The right angiography could not be done at that time. On the 47th hospital day, the third angiogram was performed. There noted again, the aneurysmal opacification in the left carotid artery and furthermore, the right carotid artery was occluded completely at its entrance into the cavernous sinus. On post-mortem examination, the cavernous sinus was filled with coagulated blood which drived from the ruptured left internal carotid artery. Microscopic examination revealed marked invasion of leucocytes to the wall of the internal carotid artery at the cavernous portion in both sides. These findings suggested that a mycotic aneurysm which resulted from the cavernous sinusitis ruptured into the left cavernous sinus and spelled blood compressed the opposite (right) carotid artery within the carvernous sinus which resulted in occlusion of the artery.

  12. Smith-Magenis syndrome deletion: A case with equivocal cytogenetic findings resolved by fluorescence in situ hybridization

    SciTech Connect

    Juyal, R.C.; Patel, P.I.; Greenberg, F.

    1995-09-11

    The availability of markers for the 17p11.2 region has enabled the diagnosis of Smith-Magenis syndrome (SMS) by fluorescence in situ hybridization (FISH). SMS is typically associated with a discernible deletion of band 17p11.2 upon cytogenetic analysis at a resolution of 400-550 bands. We present a case that illustrates the importance of using FISH to confirm a cytogenetic diagnosis of del(17)(p11.2). Four independent cytogenetic analyses were performed with different conclusions. Results of low resolution analyses of amniocytes and peripheral blood lymphocytes were apparently normal, while high resolution analyses of peripheral blood samples in two laboratories indicated mosaicism for del(17)(p11.2). FISH clearly demonstrated a 17p deletion on one chromosome of all peripheral blood cells analyzed and ruled out mosaicism unambiguously. The deletion was undetectable by flow cytometric quantitation of chromosomal DNA content, suggesting that it is less than 2 Mb. We conclude that FISH should be used to detect the SMS deletion when routine chromosome analysis fails to detect it and to verify mosaicism. 23 refs., 3 figs., 1 tab.

  13. 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.

  14. Epidemiological findings and laboratory evaluation of sporotrichosis: a description of 103 cases in cats and dogs in southern Brazil.

    PubMed

    Madrid, Isabel Martins; Mattei, Antonella Souza; Fernandes, Cristina Gevehr; Nobre, Márcia de Oliveira; Meireles, Mário Carlos Araújo

    2012-04-01

    Sporotrichosis is a subcutaneous mycosis, which affects mainly small animals, and is considered an important public health disease. This paper describes the epidemiological and laboratory characteristics of 103 clinical cases of sporotrichosis diagnosed over a 10-year period in southern Brazil. The 92 cats and 11 dogs from eight municipalities in Rio Grande do Sul State developed especially the disseminated cutaneous and fixed cutaneous forms of the disease. Respiratory signs such as sneezing, serous nasal discharge and dyspnea were found in about 57% of the animals. The detection of Sporothrix schenckii in different clinical samples showed highest isolation in testicles (46.6%), oral cavity (45.2%) and conjunctival mucosa (38.1%). A differentiated histological pattern was found between the fixed cutaneous and disseminated cutaneous (DC) manifestations of the disease; well-organized granulomas of nodular distribution and various fungal structures prevailed in the DC form in cats. Melanin detection in S. schenckii cells by the Fontana-Masson technique was positive in 45.4% of the samples. The study revealed that the State of Rio Grande do Sul is an endemic sporotrichosis area and demonstrated the possibility of involvement of other pathways in the infection and spread of the disease. In addition, it emphasized the importance of laboratory tests for mycosis confirmation, especially in dogs that develop clinical manifestations without the presence of cutaneous lesions.

  15. 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

  16. 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…

  17. 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

  18. 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. 892.1650 Section 892.1650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1650...

  19. 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. 892.1650 Section 892.1650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1650...

  20. 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. 892.1660 Section 892.1660 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1660...

  1. 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. 892.1650 Section 892.1650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1650...

  2. 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. 892.1650 Section 892.1650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1650...

  3. 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. 892.1650 Section 892.1650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1650...

  4. 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. 892.1660 Section 892.1660 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1660...

  5. 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. 892.1660 Section 892.1660 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1660...

  6. 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. 892.1660 Section 892.1660 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1660...

  7. 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. 892.1660 Section 892.1660 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1660...

  8. 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.

  9. 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

  10. TGR5 expression in benign, preneoplastic and neoplastic lesions of Barrett’s esophagus: Case series and findings

    PubMed Central

    Marketkar, Shivali; Li, Dan; Yang, Dongfang; Cao, Weibiao

    2017-01-01

    AIM To examined the bile acid receptor TGR5 expression in squamous mucosa, Barrett’s mucosa, dysplasia and esophageal adenocarcinoma (EA). METHODS Slides were stained with TGR5 antibody. The staining intensity was scored as 1+, 2+ and 3+. The extent of staining (percentage of cells staining) was scored as follows: 1+, 1%-10%, 2+, 11%-50%, 3+, 51%-100%. A combined score of intensity and extent was calculated and categorized as negative, weak, moderate and strong staining. TGR5 mRNA was measured by real time PCR. RESULTS We found that levels of TGR5 mRNA were significantly increased in Barrett’s dysplastic cell line CP-D and EA cell line SK-GT-4, when compared with Barrett’s cell line CP-A. Moderate to strong TGR5 staining was significantly higher in high-grade dysplasia and EA cases than in Barrett’s esophagus (BE) or in low-grade dysplasia. Moderate to strong staining was slightly higher in low-grade dysplasia than in BE mucosa, but there is no statistical significance. TGR5 staining had no significant difference between high-grade dysplasia and EA. In addition, TGR5 staining intensity was not associated with the clinical stage, the pathological stage and the status of lymph node metastasis. CONCLUSION We conclude that TGR5 immunostaining was much stronger in high-grade dysplasia and EA than in BE mucosa or low-grade dysplasia and that its staining intensity was not associated with the clinical stage, the pathological stage and the status of lymph node metastasis. TGR5 might be a potential marker for the progression from BE to high-grade dysplasia and EA. PMID:28293080

  11. 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

  12. 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

  13. 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

  14. [Preoperative magnetic resonance angiography findings and postoperative neurological complications in 93 cases of CABG with cardiopulmonary bypass].

    PubMed

    Koyama, T; Mochizuki, T; Mitsui, N; Marui, A

    1998-12-01

    Between February 1994 and January 1997, 102 of the 146 patients treated by coronary artery bypass grafting (CABG) had undergone magnetic resonance angiography (MRA) of the brain and neck before the operation, and arterial stenosis or occlusion had been detected in 38 (36.9%) of them. Two of these patients had complicating severe calcification of the ascending aorta, and CABG was performed without cardiopulmonary bypass (CPB). Seven patients without stenotic lesions on MRA were also treated by CABG without CPB for other complications. In addition to the 102 patients one patient had been found to have occlusion of the left common carotid artery and poor enhancement of the distal portion, and as a result we switched from CABG to percutaneous transluminal angioplasty (PTCA). We enrolled 93 patients in this study excluding these 10 patients. The patients were distributed into the three groups according to the MRA findings. Group C = no stenotic lesions (58 patients). Group S = stenosis of < 70% (26 patients), Group SS = stenosis of > or = 70% (9 patients). Enhancement distal to the stenotic or occlusive lesions was good in all patients in group S and SS. We then examined them for the incidence of postoperative neurological complications. There were no significant differences among the three groups in regard to age, male/female ratio, or incidence of hypertension and hyperlipidemia. In Group S, the incidence of diabetes was significantly higher than in the other Groups. The incidence of prior stroke was significantly higher and the number of coronary arteries affected was significantly larger in group SS than the other groups. There were no significant differences among the three groups with regard to intraoperative variables. The lowest mean arterial pressure on CPB was 44.3 +/- 7.4 mmHg, 48.0 +/- 8.8 mmHg, 46.3 +/- 7.8 mmHg in Group C, S, and SS, respectively, In all groups the lowest mean arterial pressure on CPB was below 50 mmHg. There were no significant

  15. 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

  16. Seizures and EEG findings in an adult patient with DiGeorge syndrome: a case report and review of the literature.

    PubMed

    González, Walter; Bautista, Ramon Edmundo D

    2009-11-01

    This is the first case report to describe the EEG findings in a patient with DiGeorge syndrome who survived into adulthood. The patient developed generalized tonic-clonic seizures when she was 9 years old and these were associated with hypocalcemia. Despite treatment with calcium, seizures persisted and the patient required antiepileptic medications. She was eventually controlled with oxcarbazepine. An MRI of the head was normal. An EEG showed independent spike and wave discharges emanating from the left temporal and right frontal region. The presence of focal findings on EEG, the lack of complete response to calcium therapy, and the need for antiepileptic drug therapy indicate that some of these patients may be inherently predisposed to developing epilepsy.

  17. Unusually severe limitation of the jaw attributable to fibrodysplasia ossificans progressiva: a case report with cone-beam computed tomography findings.

    PubMed

    Orhan, Kaan; Uyanik, Lokman Onur; Erkmen, Erkan; Kilinc, Yeliz

    2012-03-01

    Fibrodysplasia ossificans progressiva (FOP) is a rare hereditary connective tissue disease characterized by the progressive ectopic ossification of ligaments, tendons, and facial and skeletal muscles throughout life. Symptoms begin in childhood as localized soft tissue swellings. Immobility and articular dysfunction appear with involvement of the spine and proximal extremities. The temporomandibular joint (TMJ) is a critical component involved in the maxillofacial region, resulting in severe limitation of masticatory function, although TMJ involvement is rare. We report a case of FOP presenting as severely limited TMJ movements owing to ectopic calcification of the left coronoid process. In addition to the clinical examination, panoramic radiography and cone-beam computed tomography images were obtained. The case is presented and the clinical and imaging findings, differential diagnosis, and treatment modalities are discussed.

  18. The use of Geographical Information System (GIS) to improve active leprosy case finding campaigns in the municipality of Mossoró, Rio Grande do Norte State, Brazil.

    PubMed

    De Souza Dias, Márcia Célia Freitas; Dias, Gutemberg Henrique; Nobre, Maurício Lisboa

    2007-09-01

    There is a high incidence of leprosy in the municipality of Mossor6, Rio Grande do Norte state, where the detection coefficient has risen from 2.78/10,000 population in 1998 to 5.14 in 2004. While cases have been registered throughout the urban area, the disease is concentrated in select neighbourhoods. This study was undertaken using Geographical Information System (GIS) with the objective of defining low-cost, effective strategies to control leprosy. The land registry map of the city, Ikonos satellite images and the SINAN (National Morbidity Notification Information System) database were used as the cartographical basis for the study. The sample for the leprosy mapping was drawn from the 358 new cases of the disease diagnosed in the municipality between 1998 and 2002. The houses of 281 patients were located (78.5% of the total) and their addresses geo-referenced using a GPS handheld device. Subsequently, geographical analysis was carried out using ArcView 9.0 software showing predominant concentration of cases in the neighbourhoods of Barrocas, Santo Antônio, Bom Jardim and Paredões. This mapping served as the basis for four active case finding campaigns conducted in the most highly concentrated areas between March and September of 2005. Campaigns guided by spatial analysis led to the diagnosis of 104 new cases of the disease (50% of the total number of new cases detected in the municipality in 2005). The use of GIS in leprosy diagnosis has shown to be extremely effective, providing a clear visual understanding of the distribution of the disease in the municipality, which results in targeted interventions and important cost reductions in leprosy control activities.

  19. 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

  20. Color duplex ultrasonography findings of temporal arteries in a case of giant cell arteritis: role in diagnosis and follow-up

    PubMed Central

    Laria, Antonella; Lurati, Alfredo; Scarpellini, Magda

    2017-01-01

    Giant cell arteritis (GCA) is a systemic autoimmune disease that affects medium- and large-sized arteries. The diagnostic gold standard is the temporal artery biopsy, but it has limited sensitivity and some difficulties in reproducibility. Color duplex ultrasonography is a noninvasive, reproducible, and inexpensive method for diagnosis of temporal arteries involvement (temporal arteritis [TA]) in GCA with high sensitivity and specificity. We present the ultrasound findings at baseline and during follow-up in a case of TA in a patient with GCA. PMID:28352206

  1. Image intensifier gain uniformity improvements in sealed tubes by selective scrubbing

    DOEpatents

    Thomas, Stanley W.

    1995-01-01

    The gain uniformity of sealed microchannel plate image intensifiers (MCPIs) is improved by selectively scrubbing the high gain sections with a controlled bright light source. Using the premise that ions returning to the cathode from the microchannel plate (MCP) damage the cathode and reduce its sensitivity, a HeNe laser beam light source is raster scanned across the cathode of a microchannel plate image intensifier (MCPI) tube. Cathode current is monitored and when it exceeds a preset threshold, the sweep rate is decreased 1000 times, giving 1000 times the exposure to cathode areas with sensitivity greater than the threshold. The threshold is set at the cathode current corresponding to the lowest sensitivity in the active cathode area so that sensitivity of the entire cathode is reduced to this level. This process reduces tube gain by between 10% and 30% in the high gain areas while gain reduction in low gain areas is negligible.

  2. Image intensifier gain uniformity improvements in sealed tubes by selective scrubbing

    DOEpatents

    Thomas, S.W.

    1995-04-18

    The gain uniformity of sealed microchannel plate image intensifiers (MCPIs) is improved by selectively scrubbing the high gain sections with a controlled bright light source. Using the premise that ions returning to the cathode from the microchannel plate (MCP) damage the cathode and reduce its sensitivity, a HeNe laser beam light source is raster scanned across the cathode of a microchannel plate image intensifier (MCPI) tube. Cathode current is monitored and when it exceeds a preset threshold, the sweep rate is decreased 1000 times, giving 1000 times the exposure to cathode areas with sensitivity greater than the threshold. The threshold is set at the cathode current corresponding to the lowest sensitivity in the active cathode area so that sensitivity of the entire cathode is reduced to this level. This process reduces tube gain by between 10% and 30% in the high gain areas while gain reduction in low gain areas is negligible. 4 figs.

  3. Deformation-intensified atomic separation in bcc Fe-Mn alloys

    NASA Astrophysics Data System (ADS)

    Shabashov, V. A.; Kozlov, K. A.; Lyashkov, K. A.; Zamatovskii, A. E.; Titova, S. G.

    2016-12-01

    The deformation-intensified atomic Mn-related separation of the bcc solid solution has been found in Fe100-xMnx alloys ( x = 4.5-9.9) subjected to ball milling using Mössbauer spectroscopy. In the near surrounding of iron atoms, the atomic separation is similar to that observed upon the annealing of the alloys in a temperature range of 400-500°C. It has been found that the deformation-intensified atomic separation leads to the stabilization of the bcc phase with regard to the α → γ transformation, as well as to the expansion of the field of the existence of the bcc phase during heating.

  4. Assessment of an optically stimulated infrared emission from image intensifier tube photocathodes

    NASA Astrophysics Data System (ADS)

    Wales, Jesse G.; Marasco, Peter L.

    2005-05-01

    Anecdotal evidence suggested that bright, night-vision imaging system (NVIS) compatible, green cockpit displays could cause a veiling luminance in night-vision goggles (NVGs) and degrade visual performance. The mechanism suspected of causing this veiling luminance was an infrared emission from the image intensifier tube photocathode stimulated by visible, NVIS compatible light. This paper describes an effort to measure this stimulated infrared emission from three different image intensifier tubes. Measurements of the emission were analyzed with respect to tube age, the wavelength of incident illumination, and illumination angle of incidence. The emission was found during certain combinations of light wavelengths, angles, and intensities. However, results suggest that this phenomenon is not sufficiently strong to cause observable veiling luminance in NVGs.

  5. Nanosecond-gating properties of proximity-focused microchannel-plate image intensifiers

    NASA Astrophysics Data System (ADS)

    King, N. S. P.; Yates, G. J.; Jaramillo, S. A.; Ogle, J. W.

    Some fundamental properties of 18 mm-diam gated proximity focussed microchannel plate (MCP) image intensifiers used as fast image shutters in the 1 to 10 ns range were identified and studied. Light pulses from a modelocked dye laser optically sample the gated MCP. Shuttering is achieved by applying a forward biasing electrical gate pulse to the quiescently reverse-biased photocathode MCP interface. Variable delay between the gate pulse and the laser pulse permits tracing the MCP's optical response. Gating speeds, turn-on and turn-off patterns, the asymmetric spatial depedence of the MCP optical response, and resolution effects as functions of gate pulse width and photocathode-MCP bias were characterized. Variations in the intensity profiles of the phosphor's spatial response for uniform photocathode illumination are measured with a calibrated silicon intensified target focus projection, scan television camera and a high speed video digitizer while photomultipliers monitor the laser pulse and the phosphor's spatially integrated output intensities.

  6. Efficacy and tolerability of 5-day azacytidine dose-intensified regimen in higher-risk MDS.

    PubMed

    Pierdomenico, Francesca; Esteves, Susana; Almeida, Antonio

    2013-09-01

    Higher-risk myelodysplastic syndromes (MDS) are aggressive disorders with rapid progression to AML and short survival. Azacitidine has shown unprecedented survival advantage in these patients but its treatment schedule involves daily hospital administrations for 7 days every 4 weeks. Due to patient and staffing constraints, we have treated 50 patients with a 5-day dose-intensified (500 mg/m(2) total monthly dose divided in 5 days) azacitidine schedule in our center. The regimen was well tolerated, with Grade 3/4 adverse events seen in 24 % patients and only two discontinuations due to toxicity. The response rate was similar to that reported with the 7-day schedule: 16 % complete remissions, 32 % partial remissions, and 62 % transfusion independence. The median survival was 19.2 months from diagnosis. In addition, this regimen reduced hospital visits by 28 % and drug use by 30 %. Our results demonstrate the safety and efficacy of a dose-intensified 5-day regimen.

  7. 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…

  8. Relationship between fatigue of generation II image intensifier and input illumination

    NASA Astrophysics Data System (ADS)

    Chen, Qingyou

    1995-09-01

    If there is fatigue for an image intesifier, then it has an effect on the imaging property of the night vision system. In this paper, using the principle of Joule Heat, we derive a mathematical formula for the generated heat of semiconductor photocathode. We describe the relationship among the various parameters in the formula. We also discuss reasons for the fatigue of Generation II image intensifier caused by bigger input illumination.

  9. An Intensified Vibratory Milling Process for Enhancing the Breakage Kinetics during the Preparation of Drug Nanosuspensions.

    PubMed

    Li, Meng; Zhang, Lu; Davé, Rajesh N; Bilgili, Ecevit

    2016-04-01

    As a drug-sparing approach in early development, vibratory milling has been used for the preparation of nanosuspensions of poorly water-soluble drugs. The aim of this study was to intensify this process through a systematic increase in vibration intensity and bead loading with the optimal bead size for faster production. Griseofulvin, a poorly water-soluble drug, was wet-milled using yttrium-stabilized zirconia beads with sizes ranging from 50 to 1500 μm at low power density (0.87 W/g). Then, this process was intensified with the optimal bead size by sequentially increasing vibration intensity and bead loading. Additional experiments with several bead sizes were performed at high power density (16 W/g), and the results were compared to those from wet stirred media milling. Laser diffraction, scanning electron microscopy, X-ray diffraction, differential scanning calorimetry, and dissolution tests were used for characterization. Results for the low power density indicated 800 μm as the optimal bead size which led to a median size of 545 nm with more than 10% of the drug particles greater than 1.8 μm albeit the fastest breakage. An increase in either vibration intensity or bead loading resulted in faster breakage. The most intensified process led to 90% of the particles being smaller than 300 nm. At the high power intensity, 400 μm beads were optimal, which enhanced griseofulvin dissolution significantly and signified the importance of bead size in view of the power density. Only the optimally intensified vibratory milling led to a comparable nanosuspension to that prepared by the stirred media milling.

  10. Late Quaternary intensified monsoon phases control landscape evolution in the northwest Himalaya

    NASA Astrophysics Data System (ADS)

    Bookhagen, Bodo; Thiede, Rasmus C.; Strecker, Manfred R.

    2005-02-01

    The intensity of the Asian summer-monsoon circulation varies over decadal to millennial time scales and is reflected in changes in surface processes, terrestrial environments, and marine sediment records. However, the mechanisms of long-lived (2 5 k.y.) intensified monsoon phases, the related changes in precipitation distribution, and their effect on landscape evolution and sedimentation rates are not yet well understood. The arid high-elevation sectors of the orogen correspond to a climatically sensitive zone that currently receives rain only during abnormal (i.e., strengthened) monsoon seasons. Analogous to present-day rainfall anomalies, enhanced precipitation during an intensified monsoon phase is expected to have penetrated far into these geomorphic threshold regions where hillslopes are close to the angle of failure. We associate landslide triggering during intensified monsoon phases with enhanced precipitation, discharge, and sediment flux leading to an increase in pore-water pressure, lateral scouring of rivers, and oversteepening of hillslopes, eventually resulting in failure of slopes and exceptionally large mass movements. Here we use lacustrine deposits related to spatially and temporally clustered large landslides (>0.5 km3) in the Sutlej Valley region of the northwest Himalaya to calculate sedimentation rates and to infer rainfall patterns during late Pleistocene (29 24 ka) and Holocene (10 4 ka) intensified monsoon phases. Compared to present-day sediment-flux measurements, a fivefold increase in sediment-transport rates recorded by sediments in landslide-dammed lakes characterized these episodes of high climatic variability. These changes thus emphasize the pronounced imprint of millennial-scale climate change on surface processes and landscape evolution.

  11. Prototypical near-infrared projection system - A potential training system for image intensifier devices

    NASA Astrophysics Data System (ADS)

    Intano, Gabriel P.; Pedroni, Gena M.; Rusche, Gerald

    1989-03-01

    A prototype near-IR projection system has been developed for possible use as a supplemental night vision goggle training aid. The system uses a near-IR cathode ray tube, projection lens, and an optical cut-off filter to project daytime video in the 830-1000 nm range. The prototype system and its image intensifier devices are described. Results from training effectiveness research are presented and used to proposed possible modifications to the system.

  12. Real time pulse width monitor for Intensified Charge Coupled Device (ICCD) electro-optic shutters

    SciTech Connect

    Yates, G.J.

    1996-12-01

    A method is described or controlling and measuring the pulse width of electrical gate pulses used for optical shuttering of image intensifier. The intensifiers are coupled to high frame rate Charge-Coupled-Devices (CCD) or Focus-Projection Scan (FPS) vidicon TV cameras for readout and telemetry of time resolved image sequences. The shutter duration or gate width of individual shutters is measured in real time and encoded in the video frame corresponding to a given shutter interval. The shutter information is updated once catch video frame by strobing new data with each TV camera vertical sync pulse. This circuitry is used in conjunction with commercial video insertion/annotation equipment to provide die shutter width information in alpha numeric text form along with the time resolved video image on a frame-by-frame basis. The measurement technique and circuitry involving a combination of high speed digital counters and analog integrators for measurements in the Ins to 1024 ns range are described. The accuracy obtained is compared with measurements obtained using batch speed DSOs. The measured data are provided in 10-bit Binary (Bi) and four decades of Binary Coded Decimal (BCD) and also displayed on four digit seven segment displays. The control circuitry including digital and analog input means for gate width selection are described. The implementation of both measurement and control circuitry into an Intensified Shuttered CCD (ISCCD) radiometric system for recording fast shuttered images at RS-170 to 4 KHz frame rates is presented.

  13. 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

  14. Thyroid abnormality trend over time in northeastern regions of Kazakstan, adjacent to the Semipalatinsk nuclear test site: a case review of pathological findings for 7271 patients.

    PubMed

    Zhumadilov, Z; Gusev, B I; Takada, J; Hoshi, M; Kimura, A; Hayakawa, N; Takeichi, N

    2000-03-01

    From 1949 through 1989 nuclear weapons testing carried out by the former Soviet Union at the Semipalatinsk Nuclear Test Site (SNTS) resulted in local fallout affecting the residents of Semipalatinsk, Ust-Kamenogorsk and Pavlodar regions of Kazakstan. To investigate the possible relationship between radiation exposure and thyroid gland abnormalities, we conducted a case review of pathological findings of 7271 urban and rural patients who underwent surgery from 1966-96. Of the 7271 patients, 761 (10.5%) were men, and 6510 (89.5%) were women. The age of the patients varied from 15 to 90 years. Overall, a diagnosis of adenomatous goiter (most frequently multinodular) was found in 1683 patients (63.4%) of Semipalatinsk region, in 2032 patients (68.6%) of Ust-Kamenogorsk region and in 1142 patients (69.0%) of Pavlodar region. In the period 1982-96, as compared before, there was a noticeable increase in the number of cases of Hashimoto's thyroiditis and thyroid cancer. Among histological forms of thyroid cancer, papillary (48.1%) and follicular (33.1%) predominated in the Semipalatinsk region. In later periods (1987-96), an increased frequency of abnormal cases occurred among patients less than 40 years of age, with the highest proportion among patients below 20 in Semipalatinsk and Ust-Kamenogorsk regions of Kazakstan. Given the positive findings of a significant cancer-period interaction, and a significant trend for the proportion of cancer to increase over time, we recommend more detailed and etiologic studies of thyroid disease among populations exposed to radiation fallout from the SNTS in comparison to non-exposed population.

  15. A Study of Naturally Acquired Canine Babesiosis Caused by Single and Mixed Babesia Species in Zambia: Clinicopathological Findings and Case Management

    PubMed Central

    Nalubamba, King Shimumbo; Mudenda, Ntombi Basimbi; Namwila, Mwaka Mwangala; Mulenga, Chilufya Susan; Bwalya, Eugene Chisela; M'kandawire, Ethel; Saasa, Ngonda; Hankanga, Careen; Oparaocha, Elizabeth; Simuunza, Martin

    2015-01-01

    A retrospective and prospective analysis of clinical records of dogs diagnosed with Babesia infections was carried out for the years 2000 to 2013 from practices in Lusaka, Zambia. Records of 363 dogs with confirmed Babesia infections were analysed using demographic factors including sex, breed, age, and clinical signs in relation to haematological findings and Babesia species. The clinical and laboratory findings observed are described as well as Babesia species identification. The study included 18 breeds and the highest proportion were mongrels (32.2%), males representing 64.5% of the population. The most common presenting problems were anorexia (65.3%) and lethargy/weakness (65.3%). The most common clinical signs were fever (87.3%), pallor (52.3%), lymphadenopathy (47.4%), and presence of ticks (44.9%). Anaemia (96.4%) and nucleated erythrocytes (42.2%) were the most common laboratory findings. A mixed infection of Babesia rossi and Babesia gibsoni was present in 59.7% of dogs, whilst 8% and 32.2% had B. rossi and B. gibsoni as a single infection, respectively. Case management mainly involved therapy with tetracyclines and imidocarb and was usually accompanied by clinical improvement. This study highlights, for the first time, the presence of B. gibsoni in natural dog populations in Zambia, where previously only B. rossi was reported. PMID:26682062

  16. A practical method of active case finding and epidemiological assessment: its origin and application in the leprosy control project in Indonesia.

    PubMed

    Louhenapessy, A A; Zuiderhoek, B

    1997-12-01

    Random sample surveys in the past have revealed high estimated against low registered prevalences for leprosy in several parts of Indonesia. A pilot project showed that the problem of cases that had not yet been detected could not be solved without the active participation of the local authorities, who proved able to overcome the stigma and to convince potential patients to go for examination and treatment. The pilot project was based on the principle of what are called exploration surveys, which were introduced by Sitanala in Indonesia in 1931. The Indonesian government decided to reintroduce these surveys in 1977 under the name of chase or trace surveys. They are carried out within the framework of the leprosy workers' routine duties and no additional expenses are incurred. Since then, thousands of patients of all types and with long case histories have been detected and brought under treatment. Without this "push" it is fair to assume that many would never have sought treatment voluntarily. In view of the experience in Indonesia, one wonders whether leprosy can be eliminated without emphasizing the importance of active case finding, especially in areas in which the disease is still highly endemic. Chase surveys also provide rough information about the local leprosy situation. Although of great value, they are not, in high-endemic regions, an alternative to random sample surveys which reveal, besides a wealth of additional information, the possible unknown sources of infection.

  17. 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

  18. 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

  19. Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study

    PubMed Central

    van der Linden, Vanessa; Brainer-Lima, Alessandra Mertens; Coeli, Regina Ramos; Rocha, Maria Angela; Sobral da Silva, Paula; Durce Costa Gomes de Carvalho, Maria; van der Linden, Ana; Cesario de Holanda, Arthur; Valenca, Marcelo Moraes

    2016-01-01

    Objective To report radiological findings observed in computed tomography (CT) and magnetic resonance imaging (MRI) scans of the first cases of congenital infection and microcephaly presumably associated with the Zika virus in the current Brazilian epidemic. Design Retrospective study with a case series. Setting Association for Assistance of Disabled Children (AACD), Pernambuco state, Brazil. Participants 23 children with a diagnosis of congenital infection presumably associated with the Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Types of abnormalities and the radiological pattern of lesions identified on CT and MRI brain scans. Results Six of the 23 children tested positive for IgM antibodies to Zika virus in cerebrospinal fluid. The other 17 children met the protocol criteria for congenital infection presumably associated with the Zika virus, even without being tested for IgM antibodies to the virus—the test was not yet available on a routine basis. Of the 23 children, 15 underwent CT, seven underwent both CT and MRI, and one underwent MRI. Of the 22 children who underwent CT, all had calcifications in the junction between cortical and subcortical white matter, 21 (95%) had malformations of cortical development, 20 (91%) had a decreased brain volume, 19 (86%) had ventriculomegaly, and 11 (50%) had hypoplasia of the cerebellum or brainstem. Of the eight children who underwent MRI, all had calcifications in the junction between cortical and subcortical white matter, malformations of cortical development occurring predominantly in the frontal lobes, and ventriculomegaly. Seven of the eight (88%) children had enlarged cisterna magna, seven (88%) delayed myelination, and six each (75%) a moderate to severe decrease in brain volume, simplified gyral pattern, and abnormalities of the corpus callosum (38% hypogenesis and 38% hypoplasia). Malformations were symmetrical in 75% of the cases. Conclusion Severe cerebral damage was

  20. Histopathologic findings and diagnostic difficulties posed with use of escharotic agents for treatment of skin lesions: a case report and review of the literature.

    PubMed

    Moran, Anna M; Helm, Klaus F

    2008-04-01

    Escharotic agents have been used as alternative therapy for treatment of skin cancer and skin problems for centuries. Internet web sites such as online health product stores and eBay have made them widely available to the general public. The use of these agents carries risk of incomplete removal of tumor, damage of surrounding healthy tissues and marked scarring with poor cosmetic outcome. We report the case of a 27-year-old man who presented with history of moles and self-treatment with an escharotic agent containing bloodroot in order to document the histopathologic findings of topical bloodroot treatment and to show the clinical consequences that may occur in the unsuspecting public. To the best of our knowledge, the histological features following use of bloodroot (Sanguinaria canadensis) have not yet been documented.

  1. Brain MRI, Tc-99m HMPAO SPECT and F-18 FP-CIT PET/CT Findings in a Patient with Wilson Disease: A Case Report.

    PubMed

    Kim, Seungyoo; Song, In Uk; Chung, Yong An; Choi, Eun Kyung; Oh, Jin Kyoung

    2014-12-01

    A 34-year-old female had experienced head and hand tremors with a dystonic component for 8 months. Brain MRI showed T2 high signal intensity in the periaqueductal region, dorsal midbrain and dorsal upper pons. No abnormal uptake was noted on Tc-99m HMPAO SPECT or F-18 FP-CIT PET/CT. Wilson disease was diagnosed according to the 2008 consensus guideline from the American Association for the Study of Liver Disease and 2012 guideline from the European Association for the Study of the Liver. This case demonstrates T2 signal change in the basal ganglia, excluding the putamen, in a Wilson disease patient with relatively severe clinical findings, but normal Tc-99m HMPAO SPECT and F-18 FP-CIT PET/CT.

  2. An audit of the safe use of the mini c-arm image intensifier in the out-patient setting.

    PubMed

    Hasham, S; Burke, F D; Evans, S J; Arundell, M K; Quinton, D N

    2007-10-01

    Mini C-arm image intensifiers are used commonly in surgery of the upper limb. With relatively low doses of emitted ionising radiation, portability and superior quality of image, they are a useful aid to the operating surgeon. However, these benefits are not so often used outside the theatre setting. This paper examines the use of a mini C-arm image intensifier in the out-patient clinic and presents an audit of 100 consecutive out-patients. We reviewed the potential benefits and effects on their care pathway. We also look at the specific radiation protection issues of the mini C-arm image intensifier in the out-patients clinic. We believe use of the mini C-arm image intensifier in the out-patient setting may speed treatment and reduce the cost of treatment.

  3. Advanced Image Intensifier: a 60°field-of-view night vision system with integral electroluminescent display

    NASA Astrophysics Data System (ADS)

    Crenshaw, David A.; Branigan, Robert G.

    1996-06-01

    The Advanced Image Intensifier Advanced Technology Demonstrator is an Army program to develop and demonstrate the next generation of night vision goggle using revolutionary new technologies to improve system performance and expand the capability of currently fielded image intensifier devices. The Advanced Image Intensifier is a helmet mounted imaging and display system that exploits recent advances in diffractive optics, miniature flat panel displays, image intensifier tube technology and manufacturing processes. The system will demonstrate significantly enhanced operational performance by increasing low-light resolution by greater than 25 percent; increasing field of view from 40 degrees to 60 degrees; improving high light performance; and integrating a display for viewing thermal imagery, computer graphics, and symbology. The results of these improvements will increase the night fighting capability, operational effectiveness, mobilty, versatility, and survivability of the dismounted soldier and aviator.

  4. Bringing state-of-the-art diagnostics to vulnerable populations: The use of a mobile screening unit in active case finding for tuberculosis in Palawan, the Philippines

    PubMed Central

    Morishita, Fukushi; Garfin, Anna Marie Celina Gonzales; Lew, Woojin; Oh, Kyung Hyun; Yadav, Rajendra-Prasad; Reston, Janeth Cuencaho; Infante, Lenie Lucio; Acala, Maria Rebethia Crueldad; Palanca, Dean Lim; Kim, Hee Jin; Nishikiori, Nobuyuki

    2017-01-01

    Background Globally, case detection of tuberculosis (TB) has stabilized in recent years. Active case finding (ACF) has regained an increased attention as a complementary strategy to fill the case detection gap. In the Philippines, the DetecTB project implemented an innovative ACF strategy that offered a one-stop diagnostic service with a mobile unit equipped with enhanced diagnostic tools including chest X-ray (CXR) and Xpert®MTB/RIF (Xpert). The project targeted the rural poor, the urban poor, prison inmates, indigenous population and high school students. Methods This is a retrospective review of TB screening data from 25,103 individuals. A descriptive analysis was carried out to compare screening and treatment outcomes across target populations. Univariate and multivariate analyses were performed to identify predictors of TB for each population. The composition of bacteriologically-confirmed cases by smear and symptom status was further investigated. Results The highest yield with lowest number needed to screen (NNS) was found in prison (6.2%, NNS: 16), followed by indigenous population (2.9%, NNS: 34), the rural poor (2.2%, NNS: 45), the urban poor (2.1%, NNS: 48), and high school (0.2%, NNS: 495). The treatment success rate for all populations was high with 89.5% in rifampicin-susceptible patients and 83.3% in rifampicin-resistant patients. A relatively higher loss to follow-up rate was observed in indigenous population (7.5%) and the rural poor (6.4%). Only cough more than two weeks showed a significant association with TB diagnosis in all target populations (Adjusted Odds Ratio ranging from 1.71 to 6.73) while other symptoms and demographic factors varied in their strength of association. The urban poor had the highest proportion of smear-positive patients with cough more than two weeks (72.0%). The proportion of smear-negative (Xpert-positive) patients without cough more than two weeks was the highest in indigenous population (39.3%), followed by prison

  5. [Abnormal MR findings in the temporal lobe and basal ganglia along with vasospasm in a case of hemiballism associated with diabetes mellitus].

    PubMed

    Uchibori, Ayumi; Kobayashi, Yasuhiro; Chiba, Atsuro; Tsuchiya, Kazuhiro; Sakuta, Manabu

    2003-06-01

    A 46-year-old woman with a nine-year history of diabetes mellitus (DM) without treatment had an acute onset of right hemiballism. For the treatment of hyperglycemia (random blood sugar 588 mg/dl) conventional insulin therapy was started, and HbA1c rapidly decreased from 16.3% to 8.8% over the first two months. During this period, there were no hypoglycemic symptoms or episodes, though amnesia appeared just after the insulin therapy was started. T1-weighted MRI showed hyperintensity in the left basal ganglia, which has been reported in many cases of chorea or ballism associated with DM. In addition, there were unique changes in the left temporal lobe, including transient contrast enhancement along the cortex followed by transient hyperintensity in the cortical-subcortical area on T2 weighted and FLAIR images, and then hyperintensity along the cortex on T1 weighted images and atrophy. These findings were thought to indicate a consecutive process, i.e., capillary hyperlucency followed mainly by vasogenic edema and then laminar necrosis. Similar MR findings were reported in hypoglycemic coma. MRA also revealed a transient vasospasm in the left MCA M1-M2 portions in this patient. These signal changes may have been related to the prolonged hyperglycemic state as well as blood sugar control that was too rapid.

  6. Divergent cell signaling after short-term intensified endurance training in human skeletal muscle.

    PubMed

    Benziane, Boubacar; Burton, Timothy J; Scanlan, Brendan; Galuska, Dana; Canny, Benedict J; Chibalin, Alexander V; Zierath, Juleen R; Stepto, Nigel K

    2008-12-01

    Endurance training represents one extreme in the continuum of skeletal muscle plasticity. The molecular signals elicited in response to acute and chronic exercise and the integration of multiple intracellular pathways are incompletely understood. We determined the effect of 10 days of intensified cycle training on signal transduction in nine inactive males in response to a 1-h acute bout of cycling at the same absolute workload (164 +/- 9 W). Muscle biopsies were taken at rest and immediately and 3 h after the acute exercise. The metabolic signaling pathways, including AMP-activated protein kinase (AMPK) and mammalian target of rapamycin (mTOR), demonstrated divergent regulation by exercise after training. AMPK phosphorylation increased in response to exercise ( approximately 16-fold; P < 0.05), which was abrogated posttraining (P < 0.01). In contrast, mTOR phosphorylation increased in response to exercise ( approximately 2-fold; P < 0.01), which was augmented posttraining (P < 0.01) in the presence of increased mTOR expression (P < 0.05). Exercise elicited divergent effects on mitogen-activated protein kinase (MAPK) pathways after training, with exercise-induced extracellular signal-regulated kinase (ERK) 1/2 phosphorylation being abolished (P < 0.01) and p38 MAPK maintained. Finally, calmodulin kinase II (CaMKII) exercise-induced phosphorylation and activity were maintained (P < 0.01), despite increased expression ( approximately 2-fold; P < 0.05). In conclusion, 10 days of intensified endurance training attenuated AMPK, ERK1/2, and mTOR, but not CaMKII and p38 MAPK signaling, highlighting molecular pathways important for rapid functional adaptations and maintenance in response to intensified endurance exercise and training.

  7. Dispersal limitation drives successional pathways in Central Siberian forests under current and intensified fire regimes.

    PubMed

    Tautenhahn, Susanne; Lichstein, Jeremy W; Jung, Martin; Kattge, Jens; Bohlman, Stephanie A; Heilmeier, Hermann; Prokushkin, Anatoly; Kahl, Anja; Wirth, Christian

    2016-06-01

    Fire is a primary driver of boreal forest dynamics. Intensifying fire regimes due to climate change may cause a shift in boreal forest composition toward reduced dominance of conifers and greater abundance of deciduous hardwoods, with potential biogeochemical and biophysical feedbacks to regional and global climate. This shift has already been observed in some North American boreal forests and has been attributed to changes in site conditions. However, it is unknown if the mechanisms controlling fire-induced changes in deciduous hardwood cover are similar among different boreal forests, which differ in the ecological traits of the dominant tree species. To better understand the consequences of intensifying fire regimes in boreal forests, we studied postfire regeneration in five burns in the Central Siberian dark taiga, a vast but poorly studied boreal region. We combined field measurements, dendrochronological analysis, and seed-source maps derived from high-resolution satellite images to quantify the importance of site conditions (e.g., organic layer depth) vs. seed availability in shaping postfire regeneration. We show that dispersal limitation of evergreen conifers was the main factor determining postfire regeneration composition and density. Site conditions had significant but weaker effects. We used information on postfire regeneration to develop a classification scheme for successional pathways, representing the dominance of deciduous hardwoods vs. evergreen conifers at different successional stages. We estimated the spatial distribution of different successional pathways under alternative fire regime scenarios. Under intensified fire regimes, dispersal limitation of evergreen conifers is predicted to become more severe, primarily due to reduced abundance of surviving seed sources within burned areas. Increased dispersal limitation of evergreen conifers, in turn, is predicted to increase the prevalence of successional pathways dominated by deciduous hardwoods

  8. Diels–Alder reactions of myrcene using intensified continuous-flow reactors

    PubMed Central

    Álvarez-Diéguez, Miguel Á; Kohl, Thomas M; Tsanaktsidis, John

    2017-01-01

    This work describes the Diels–Alder reaction of the naturally occurring substituted butadiene, myrcene, with a range of different naturally occurring and synthetic dienophiles. The synthesis of the Diels–Alder adduct from myrcene and acrylic acid, containing surfactant properties, was scaled-up in a plate-type continuous-flow reactor with a volume of 105 mL to a throughput of 2.79 kg of the final product per day. This continuous-flow approach provides a facile alternative scale-up route to conventional batch processing, and it helps to intensify the synthesis protocol by applying higher reaction temperatures and shorter reaction times. PMID:28228853

  9. Characterisation of new gated optical image intensifiers for fluorescence lifetime imaging

    NASA Astrophysics Data System (ADS)

    Sparks, H.; Görlitz, F.; Kelly, D. J.; Warren, S. C.; Kellett, P. A.; Garcia, E.; Dymoke-Bradshaw, A. K. L.; Hares, J. D.; Neil, M. A. A.; Dunsby, C.; French, P. M. W.

    2017-01-01

    We report the characterisation of gated optical image intensifiers for fluorescence lifetime imaging, evaluating the performance of several different prototypes that culminate in a new design that provides improved spatial resolution conferred by the addition of a magnetic field to reduce the lateral spread of photoelectrons on their path between the photocathode and microchannel plate, and higher signal to noise ratio conferred by longer time gates. We also present a methodology to compare these systems and their capabilities, including the quantitative readouts of Förster resonant energy transfer.

  10. Low temperature multi-alkali photocathode processing technique for sealed intensified CCD tubes

    NASA Technical Reports Server (NTRS)

    Doliber, D. L.; Dozier, E. E.; Wenzel, H.; Beaver, E. A.; Hier, R. G.

    1989-01-01

    A low temperature photocathode process has been used to fabricate an intensified CCD visual photocathode image tube, by incorporating a thinned, backside-illumined CCD as the target anode of a digicon tube of Hubble Space Telescope (HST) design. The CCD digicon tube employs the HST's sodium bialkali photocathode and MgF2 substrate, thereby allowing a direct photocathode quantum efficiency comparison between photocathodes produced by the presently employed low temperature process and those of the conventional high temperature process. Attention is given to the processing chamber used, as well as the details of gas desorption and photocathode processing.

  11. The Response of the South Asian Summer Monsoon Circulation to Intensified Irrigation in Global Climate Model Simulations

    NASA Technical Reports Server (NTRS)

    Shukla, Sonali P.; Puma, Michael J.; Cook, Benjamin I.

    2013-01-01

    Agricultural intensification in South Asia has resulted in the expansion and intensification of surface irrigation over the twentieth century. The resulting changes to the surface energy balance could affect the temperature contrasts between the South Asian land surface and the equatorial Indian Ocean, potentially altering the South Asian Summer Monsoon (SASM) circulation. Prior studies have noted apparent declines in the monsoon intensity over the twentieth century and have focused on how altered surface energy balances impact the SASM rainfall distribution. Here, we use the coupled Goddard Institute for Space Studies ModelE-R general circulation model to investigate the impact of intensifying irrigation on the large-scale SASM circulation over the twentieth century, including how the effect of irrigation compares to the impact of increasing greenhouse gas (GHG) forcing. We force our simulations with time-varying, historical estimates of irrigation, both alone and with twentieth century GHGs and other forcings. In the irrigation only experiment, irrigation rates correlate strongly with lower and upper level temperature contrasts between the Indian sub-continent and the Indian Ocean (Pearson's r = -0.66 and r = -0.46, respectively), important quantities that control the strength of the SASM circulation. When GHG forcing is included, these correlations strengthen: r = -0.72 and r = -0.47 for lower and upper level temperature contrasts, respectively. Under irrigated conditions, the mean SASM intensity in the model decreases only slightly and insignificantly. However, in the simulation with irrigation and GHG forcing, inter-annual variability of the SASM circulation decreases by *40 %, consistent with trends in the reanalysis products. This suggests that the inclusion of irrigation may be necessary to accurately simulate the historical trends and variability of the SASM system over the last 50 years. These findings suggest that intensifying irrigation, in concert with

  12. Cognitive Difficulty Intensifies Age-related Changes in Anterior Frontal Hemodynamics: Novel Evidence from Near-infrared Spectroscopy.

    PubMed

    Bierre, Kirstin L; Lucas, Samuel J E; Guiney, Hayley; Cotter, James D; Machado, Liana

    2017-02-01

    Alongside age-related brain deterioration, cognitive functioning declines, particularly for more demanding tasks. Past research indicates that, to offset this decline, older adults exhibit hemodynamic changes consistent with recruitment of more anterior brain regions. However, the nature of the hemodynamic changes remains unclear. To address this knowledge gap, we used near-infrared spectroscopy in 36 young adults (aged 18-30 years) and 36 older adults (aged 60-72 years) to assess anterior frontal hemodynamic responses to engagement in three cognitive tasks of increasing difficulty. Behavioral results for all three tasks confirmed aging deficits (evidenced by slower reaction times and reduced accuracy rates) that progressively increased with task difficulty. Hemodynamic results showed opposing effects in young versus older adults, with oxygenated and total hemoglobin decreasing in young but increasing in older adults, particularly during the harder tasks. Also, tissue oxygenation increased only in older adults during the harder tasks. Among the older adults only, anterior frontal hemodynamic changes correlated with better cognitive performance, indicating that they were compensatory in nature. These findings provide novel evidence of age-related anterior frontal hemodynamic changes that intensify with cognitive demands and compensate for performance deficits.

  13. Episodes of intensified biological productivity in the subtropical Atlantic Ocean during the termination of the Middle Eocene Climatic Optimum (MECO)

    NASA Astrophysics Data System (ADS)

    Moebius, Iris; Friedrich, Oliver; Edgar, Kirsty M.; Sexton, Philip F.

    2015-08-01

    The Middle Eocene Climatic Optimum (MECO) is an ~500 kyr interval of pronounced global warming from which the climate system recovered in <50 kyr. The deep-sea sedimentary record can provide valuable insight on the marine ecosystem response to this protracted global warming event and consequently on the ecological changes during this time. Here we present new benthic foraminiferal assemblage data from Ocean Drilling Program Site 1051 in the subtropical North Atlantic, spanning the MECO and post-MECO interval (41.1 to 39.5 Ma). We find little change in the species composition of benthic foraminiferal assemblages during the studied interval, suggesting that the rate of environmental change was gradual enough that these organisms were able to adapt. However, we identify two transient intervals associated with peak warming (higher-productivity interval (HPI)-1; 40.07-39.96 Ma) and shortly after the MECO (HPI-2; 39.68-39.55 Ma), where benthic foraminiferal accumulation rates increase by an order of magnitude. These HPIs at Site 1051 appear to coincide with intervals of strengthened productivity in the Tethys, Southern Ocean, and South Atlantic, and we suggest that an intensified hydrological cycle during the climatic warmth of the MECO was responsible for eutrophication of marine shelf and slope environments.

  14. Intensified impact of tropical Atlantic SST on the western North Pacific summer climate under a weakened Atlantic thermohaline circulation

    NASA Astrophysics Data System (ADS)

    Chen, Wei; Lee, June-Yi; Lu, Riyu; Dong, Buwen; Ha, Kyung-Ja

    2015-10-01

    The tropical North Atlantic (TNA) sea surface temperature (SST) has been identified as one of regulators on the boreal summer climate over the western North Pacific (WNP), in addition to SSTs in the tropical Pacific and Indian Oceans. The major physical process proposed is that the TNA warming induces a pair of cyclonic circulation anomaly over the eastern Pacific and negative precipitation anomalies over the eastern to central tropical Pacific, which in turn lead to an anticyclonic circulation anomaly over the western to central North Pacific. This study further demonstrates that the modulation of the TNA warming to the WNP summer climate anomaly tends to be intensified under background of the weakened Atlantic thermohaline circulation (THC) by using a water-hosing experiment. The results suggest that the weakened THC induces a decrease in thermocline depth over the TNA region, resulting in the enhanced sensitivity of SST variability to wind anomalies and thus intensification of the interannual variation of TNA SST. Under the weakened THC, the atmospheric responses to the TNA warming are westward shifted, enhancing the anticyclonic circulation and negative precipitation anomaly over the WNP. This study supports the recent finding that the negative phase of the Atlantic multidecadal oscillation after the late 1960s has been favourable for the strengthening of the connection between TNA SST variability and WNP summer climate and has important implications for seasonal prediction and future projection of the WNP summer climate.

  15. BUTIMBA: Intensifying the Hunt for Child TB in Swaziland through Household Contact Tracing

    PubMed Central

    Alonso Ustero, Pilar; Golin, Rachel; Anabwani, Florence; Mzileni, Bulisile; Sikhondze, Welile; Stevens, Robert

    2017-01-01

    Background Limited data exists to inform contact tracing guidelines in children and HIV-affected populations. We evaluated the yield and additionality of household contact and source case investigations in Swaziland, a TB/HIV high-burden setting, while prioritizing identification of childhood TB. Methods In partnership with 7 local TB clinics, we implemented standardized contact tracing of index cases (IC) receiving TB treatment. Prioritizing child contacts and HIV-affected households, screening officers screened contacts for TB symptoms and to identify risk factors associated with TB. We ascertained factors moderating the yield of contact tracing and measured the impact of our program by additional notifications. Results From March 2013 to November 2015, 3,258 ICs (54% bacteriologically confirmed; 70% HIV-infected; 85% adults) were enrolled leading to evaluation of 12,175 contacts (median age 18 years, IQR 24–42; 45% children; 9% HIV-infected). Among contacts, 196 TB cases (56% bacteriologically confirmed) were diagnosed resulting in a program yield of 1.6% for all forms of TB. The number needed to screen (NNS) to identify a bacteriologically confirmed TB case or all forms TB case traced from a child IC <5 years was respectively 62% and 40% greater than the NNS for tracing from an adult IC. In year one, we demonstrated a 32% increase in detection of bacteriologically confirmed child TB. Contacts were more likely to have TB if <5 years (OR = 2.0), HIV-infected (OR = 4.9), reporting ≥1 TB symptoms (OR = 7.7), and sharing a bed (OR = 1.7) or home (OR = 1.4) with the IC. There was a 1.4 fold increased chance of detecting a TB case in households known to be HIV-affected. Conclusion Contact tracing prioritizing children is not only feasible in a TB/HIV high-burden setting but contributes to overall case detection. Our findings support WHO guidelines prioritizing contact tracing among children and HIV-infected populations while highlighting potential to integrate TB

  16. High-frame-rate intensified fast optically shuttered TV cameras with selected imaging applications

    SciTech Connect

    Yates, G.J.; King, N.S.P.

    1994-08-01

    This invited paper focuses on high speed electronic/electro-optic camera development by the Applied Physics Experiments and Imaging Measurements Group (P-15) of Los Alamos National Laboratory`s Physics Division over the last two decades. The evolution of TV and image intensifier sensors and fast readout fast shuttered cameras are discussed. Their use in nuclear, military, and medical imaging applications are presented. Several salient characteristics and anomalies associated with single-pulse and high repetition rate performance of the cameras/sensors are included from earlier studies to emphasize their effects on radiometric accuracy of electronic framing cameras. The Group`s test and evaluation capabilities for characterization of imaging type electro-optic sensors and sensor components including Focal Plane Arrays, gated Image Intensifiers, microchannel plates, and phosphors are discussed. Two new unique facilities, the High Speed Solid State Imager Test Station (HSTS) and the Electron Gun Vacuum Test Chamber (EGTC) arc described. A summary of the Group`s current and developmental camera designs and R&D initiatives are included.

  17. Development of ultra-fast 2D ion Doppler tomography using image intensified CMOS fast camera

    NASA Astrophysics Data System (ADS)

    Tanabe, Hiroshi; Kuwahata, Akihiro; Yamanaka, Haruki; Inomoto, Michiaki; Ono, Yasushi; TS-group Team

    2015-11-01

    The world fastest novel time-resolved 2D ion Doppler tomography diagnostics has been developed using fast camera with high-speed gated image intensifier (frame rate: 200kfps. phosphor decay time: ~ 1 μ s). Time evolution of line-integrated spectra are diffracted from a f=1m, F/8.3 and g=2400L/mm Czerny-Turner polychromator, whose output is intensified and recorded to a high-speed camera with spectral resolution of ~0.005nm/pixel. The system can accommodate up to 36 (9 ×4) spatial points recorded at 5 μs time resolution, tomographic reconstruction is applied for the line-integrated spectra, time-resolved (5 μs/frame) local 2D ion temperature measurement has been achieved without any assumption of shot repeatability. Ion heating during intermittent reconnection event which tends to happen during high guide field merging tokamak was measured around diffusion region in UTST. The measured 2D profile shows ion heating inside the acceleration channel of reconnection outflow jet, stagnation point and downstream region where reconnected field forms thick closed flux surface as in MAST. Achieved maximum ion temperature increases as a function of Brec2 and shows good fit with MAST experiment, demonstrating promising CS-less startup scenario for spherical tokamak. This work is supported by JSPS KAKENHI Grant Number 15H05750 and 15K20921.

  18. Hyperlipidemia intensifies cerulein-induced acute pancreatitis associated with activation of protein kinase C in rats

    PubMed Central

    Wang, Ya-Jun; Sun, Jia-Bang; Li, Fei; Zhang, Shu-Wen

    2006-01-01

    AIM: To investigate the effects of hyperlipidemia on acute pancreatitis (AP) and the possible mechanisms. METHODS: Rat models of hyperlipidemia and AP were established by Triton WR1339 and cerulein respectively. Human albumin was used to treat AP complicated by hyperlipidemia. In each group, we compared the histological score, volume of ascites, ratio of pancreatic wet/dry weight, serum amylase (AMY) and pancreatic acinar cell apoptosis. The level of protein kinase C (PKC) membrane translocation in pancreatic tissue was detected by Western blot. RESULTS: In the hyperlipidemia model established by Triton WR1339, triglyceride (TG) increased remarkably and reached its peak 6 h after injection, and most rats developed mild acute pancreatitis. Histological score, volume of ascites, ratio of wet/dry weight and serum AMY in AP animals with hyperlipidemia were obviously higher than those in AP animals (P < 0.05) and decreased after albumin therapy but not significantly (P > 0.05). Apoptotic cells detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) increased in AP animals with hyperlipidemia and did not change distinctly after albumin therapy. PKC membrane translocation level increased in AP animals with hyperlipidemia and decreased remarkably after albumin therapy (P < 0.05). CONCLUSION: Hyperlipidemia may induce AP or intensify pancreatic injury. Albumin therapy can not alleviate pancreatic lesion effectively. PKC activation may be one mechanism by which AP is intensified by hyperlipidemia. PMID:16718817

  19. Intensified climate-driven exhumation along the South Himalayan Front since one million years ago

    NASA Astrophysics Data System (ADS)

    Yu, Xiangjiang; Ji, Jianqing; Wang, Fengyi; Zhong, Dalai

    2017-04-01

    This paper builds a database of apatite fission track (AFT) ages and thermal-modeling results covering the whole southern Tibetan Plateau, providing detailed information on the cooling and erosion process of the modern landscape evolution and comparing with the distribution of climatic factors. Large-scale AFT age distribution and thermal-history modeling results indicate extraordinarily intense erosion along the South Himalayan Front and relatively weak erosion in the interior of the plateau. AFT samples from different regions plot into different partitions on the elevation vs AFT age diagram, and there is an excellent coupling between AFT ages and climatic factors. Based on AFT thermal-history modeling results, an intensified erosion event since ∼1 Myr ago has been identified along the South Himalayan Front. The varied AFT ages along the South Himalayan Front are probably induced by differential intensity of erosion in the same cooling event rather than the time when the rapid cooling event began. Meanwhile, the spatiotemporal coupling of climatic factors and the intensified erosion belt suggests that climatic transition is the key factor dominating the rapid exhumation event since ∼1 Myr.

  20. Performance in sports--With specific emphasis on the effect of intensified training.

    PubMed

    Bangsbo, J

    2015-12-01

    Performance in most sports is determined by the athlete's technical, tactical, physiological and psychological/social characteristics. In the present article, the physical aspect will be evaluated with a focus on what limits performance, and how training can be conducted to improve performance. Specifically how intensified training, i.e., increasing the amount of aerobic high-intensity and speed endurance training, affects physiological adaptations and performance of trained subjects. Periods of speed endurance training do improve performance in events lasting 30 s-4 min, and when combined with aerobic high-intensity sessions, also performance during longer events. Athletes in team sports involving intense exercise actions and endurance aspects, such as soccer and basketball, can also benefit from intensified training. Speed endurance training does reduce energy expenditure and increase expression of muscle Na(+), K(+) pump α subunits, which may preserve muscle cell excitability and delay fatigue development during intense exercise. When various types of training are conducted in the same period (concurrent training), as done in a number of sports, one type of training may blunt the effect of other types of training. It is not, however, clear how various training modalities are affecting each other, and this issue should be addressed in future studies.

  1. Effect of Intensified Decellularization of Equine Carotid Arteries on Scaffold Biomechanics and Cytotoxicity.

    PubMed

    Böer, Ulrike; Hurtado-Aguilar, Luis G; Klingenberg, Melanie; Lau, Skadi; Jockenhoevel, Stefan; Haverich, Axel; Wilhelmi, Mathias

    2015-11-01

    Decellularized equine carotid arteries (dEAC) are suggested to represent an alternative for alloplastic vascular grafts in haemodialysis patients to achieve vascular access. Recently it was shown that intensified detergent treatment completely removed cellular components from dEAC and thereby significantly reduced matrix immunogenicity. However, detergents may also affect matrix composition and stability and render scaffolds cytotoxic. Therefore, intensively decellularized carotids (int-dEAC) were now evaluated for their biomechanical characteristics (suture retention strength, burst pressure and circumferential compliance at arterial and venous systolic and diastolic pressure), matrix components (collagen and glycosaminoglycan content) and indirect and direct cytotoxicity (WST-8 assay and endothelial cell seeding) and compared with native (n-EAC) and conventionally decellularized carotids (con-dEAC). Both decellularization protocols comparably reduced matrix compliance (venous pressure compliance: 32.2 and 27.4% of n-EAC; p < 0.01 and arterial pressure compliance: 26.8 and 23.7% of n-EAC, p < 0.01) but had no effect on suture retention strength and burst pressure. Matrix characterization revealed unchanged collagen contents but a 39.0% (con-dEAC) and 26.4% (int-dEAC, p < 0.01) reduction of glycosaminoglycans, respectively. Cytotoxicity was not observed in either dEAC matrix which was also displayed by an intact endothelial lining after seeding. Thus, even intensified decellularization generates matrix scaffolds highly suitable for vascular tissue engineering purposes, e.g., the generation of haemodialysis shunts.

  2. Nanosecond Gating Properties Of Proximity-Focused Microchannel-Plate Image Intensifiers

    NASA Astrophysics Data System (ADS)

    King, N. S.; Yates, G. J.; Jaramillo, S. A.; Ogle, J. W.; Detch, J. L.

    1981-12-01

    Some fundamental properties of 18-mm-diam gated proximity-focussed microchannel-plate (MCP) image intensifiers used as fast image shutters in the 1 to 10 ns range have been identified and studied. Light pulses (≍ 5-ps-wide) from a modelocked dye laser optically sample the gated MCP. Shuttering is achieved by applying a forward-biasing electrical gate pulse to the quiescently reverse-biased photocathode-MCP interface. Variable delay (≍ 30-ps jitter) between the gate pulse and the laser pulse permit tracing the MCP's optical response. Gating speeds, turn-on and turn-off patterns, the asymmetric spatial dependence of the MCP optical response, and resolution effects as functions of gate pulse width and photocathode-MCP bias have been characterized. Shutter times of >= 750 ps and <= 5 1p/mm resolution with the MCP fully on were observed. Variations in the intensity profiles of the phosphorl.s spatial response for uniform photocathode illumination are measured with a calibrated silicon-intensified-target (SIT) focus projection, scan (FPS) television camera and a high-speed video digitizer while photomultipliers (PMTs) monitor the laser pulse and the phosphor's spatially integrated output intensities. The characterization system, gating and biasing circuits, and experimental results will be presented.

  3. Intensified Adjuvant Treatment of Prostate Carcinoma: Feasibility Analysis of a Phase I/II Trial

    PubMed Central

    Mantini, Giovanna; Fersino, Sergio; Frascino, Vincenzo; Massaccesi, Mariangela; Fionda, Bruno; Luzi, Stefano; Balducci, Mario; De Belvis, Antonio; Morganti, Alessio Giuseppe; Valentini, Vincenzo

    2014-01-01

    Purpose. To perform a preliminary feasibility acute and late toxicity evaluation of an intensified and modulated adjuvant treatment in prostate cancer (PCa) patients after radical prostatectomy. Material and Methods. A phase I/II has been designed. Eligible patients were 79 years old or younger, with an ECOG of 0–2, previously untreated, histologically proven prostate adenocarcinoma with no distant metastases, pT2–4 N0-1, and with at least one of the following risk factors: capsular perforation, positive surgical margins, and seminal vesicle invasion. All patients received a minimum dose on tumor bed of 64.8 Gy, or higher dose (70.2 Gy; 85.4%), according to the pathological stage, pelvic lymph nodes irradiation (57.7%), and/or hormonal therapy (69.1%). Results. 123 patients were enrolled and completed the planned treatment, with good tolerance. Median follow-up was 50.6 months. Grade 3 acute toxicity was only 2.4% and 3.3% for genitourinary (GU) and gastrointestinal (GI) tract, respectively. No patient had late grade 3 GI toxicity, and the GU grade 3 toxicity incidence was 5.8% at 5 years. 5-year BDSF was 90.2%. Conclusions. A modulated and intensified adjuvant treatment in PCa was feasible in this trial. A further period of observation can provide a complete assessment of late toxicity and confirm the BDSF positive results. PMID:25093169

  4. Finding food

    PubMed Central

    Forsyth, Ann; Lytle, Leslie; Riper, David Van

    2011-01-01

    A significant amount of travel is undertaken to find food. This paper examines challenges in measuring access to food using Geographic Information Systems (GIS), important in studies of both travel and eating behavior. It compares different sources of data available including fieldwork, land use and parcel data, licensing information, commercial listings, taxation data, and online street-level photographs. It proposes methods to classify different kinds of food sales places in a way that says something about their potential for delivering healthy food options. In assessing the relationship between food access and travel behavior, analysts must clearly conceptualize key variables, document measurement processes, and be clear about the strengths and weaknesses of data. PMID:21837264

  5. Real-Time Web-Based Assessment of Total Population Risk of Future Emergency Department Utilization: Statewide Prospective Active Case Finding Study

    PubMed Central

    Zhu, Chunqing; Zhao, Yifan; Hao, Shiying; Zheng, Le; Fu, Changlin; Wen, Qiaojun; Ji, Jun; Li, Zhen; Wang, Yong; Zheng, Xiaolin; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric

    2015-01-01

    Background An easily accessible real-time Web-based utility to assess patient risks of future emergency department (ED) visits can help the health care provider guide the allocation of resources to better manage higher-risk patient populations and thereby reduce unnecessary use of EDs. Objective Our main objective was to develop a Health Information Exchange-based, next 6-month ED risk surveillance system in the state of Maine. Methods Data on electronic medical record (EMR) encounters integrated by HealthInfoNet (HIN), Maine’s Health Information Exchange, were used to develop the Web-based surveillance system for a population ED future 6-month risk prediction. To model, a retrospective cohort of 829,641 patients with comprehensive clinical histories from January 1 to December 31, 2012 was used for training and then tested with a prospective cohort of 875,979 patients from July 1, 2012, to June 30, 2013. Results The multivariate statistical analysis identified 101 variables predictive of future defined 6-month risk of ED visit: 4 age groups, history of 8 different encounter types, history of 17 primary and 8 secondary diagnoses, 8 specific chronic diseases, 28 laboratory test results, history of 3 radiographic tests, and history of 25 outpatient prescription medications. The c-statistics for the retrospective and prospective cohorts were 0.739 and 0.732 respectively. Integration of our method into the HIN secure statewide data system in real time prospectively validated its performance. Cluster analysis in both the retrospective and prospective analyses revealed discrete subpopulations of high-risk patients, grouped around multiple “anchoring” demographics and chronic conditions. With the Web-based population risk-monitoring enterprise dashboards, the effectiveness of the active case finding algorithm has been validated by clinicians and caregivers in Maine. Conclusions The active case finding model and associated real-time Web-based app were designed to

  6. Challenges from Tuberculosis Diagnosis to Care in Community-Based Active Case Finding among the Urban Poor in Cambodia: A Mixed-Methods Study

    PubMed Central

    Malhotra, Shelly; Koeut, Pichenda; Thai, Sopheak; Khun, Kim Eam; Colebunders, Robert; Lynen, Lut

    2015-01-01

    Background While community-based active case finding (ACF) for tuberculosis (TB) holds promise for increasing early case detection among hard-to-reach populations, limited data exist on the acceptability of active screening. We aimed to identify barriers and explore facilitators on the pathway from diagnosis to care among TB patients and health providers. Methods Mixed-methods study. We administered a survey questionnaire to, and performed in-depth interviews with, TB patients identified through ACF from poor urban settlements in Phnom Penh, Cambodia. Additionally, we conducted focus group discussions and in-depth interviews with community and public health providers involved in ACF, respectively. Results Acceptance of home TB screening was strong among key stakeholders due to perceived reductions in access barriers and in direct and indirect patient costs. Privacy and stigma were not an issue. To build trust and facilitate communication, the participation of community representatives alongside health workers was preferred. Most health providers saw ACF as complementary to existing TB services; however, additional workload as a result of ACF was perceived as straining operating capacity at public sector sites. Proximity to a health facility and disease severity were the strongest determinants of prompt care-seeking. The main reasons reported for delays in treatment-seeking were non-acceptance of diagnosis, high indirect costs related to lost income/productivity and transportation expenses, and anticipated side-effects from TB drugs. Conclusions TB patients and health providers considered home-based ACF complementary to facility-based TB screening. Strong engagement with community representatives was believed critical in gaining access to high risk communities. The main barriers to prompt treatment uptake in ACF were refusal of diagnosis, high indirect costs, and anticipated treatment side-effects. A patient-centred approach and community involvement were essential

  7. Psychiatric diagnoses in patients who screen positive on the Mood Disorder Questionnaire: Implications for using the scale as a case-finding instrument for bipolar disorder.

    PubMed

    Zimmerman, Mark; Galione, Janine N; Chelminski, Iwona; Young, Diane; Dalrymple, Kristy

    2011-02-28

    Bipolar disorder is prone to being overlooked because its diagnosis is more often based on retrospective report than cross-sectional assessment. Recommendations for improving the detection of bipolar disorder include the use of screening questionnaires. The Mood Disorder Questionnaire (MDQ) is the most widely studied self-report screening scale that has been developed to improve the detection of bipolar disorder. Although developed as a screening scale, the MDQ has also been used as a case-finding measure. However, studies of the MDQ in psychiatric patients have found high false positive rates, though no study has determined the psychiatric diagnoses associated with false positive results on the MDQ. The goal of the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project was to identify the psychiatric disorders associated with increased false positive rates on the MDQ. Four hundred eighty psychiatric outpatients were interviewed with the Structured Clinical Interview for DSM-IV (SCID) and completed the MDQ. After excluding the 52 patients diagnosed with a lifetime history of bipolar disorder we compared diagnostic frequencies in patients who did and did not screen positive on the MDQ. Based on the Hirschfeld et al. scoring guidelines of the MDQ, 15.2% (n=65) of the 428 nonbipolar patients screened positive on MDQ. Compared to patients who screened negative, the patients who screened positive were significantly more likely have a current and lifetime diagnosis of specific phobia, posttraumatic stress disorder, alcohol and drug use disorders, any eating disorder, any impulse control disorder, and attention deficit disorder. Results were similar using a less restrictive threshold to identify MDQ cases. That is, MDQ caseness was associated with significantly elevated rates of anxiety, impulse control, substance use, and attention deficit disorders. Studies using the MDQ as a stand-alone proxy for the diagnosis of

  8. Exploring classical conditioning for strengthening the links between semantic and lexical representations in pure anomia: Preliminary findings from a single case study.

    PubMed

    Zannino, Gian Daniele; Barban, Francesco; Caltagirone, Carlo; Carlesimo, Giovanni A

    2017-03-01

    The same language symptom might arise at different functional loci in people with aphasia. Therefore, it is plausible that different therapeutic interventions should be adopted to approach the same difficulties in different patients. Although this point of view is still widely accepted, recently the focus has shifted from the functional locus of a rehabilitative intervention to the mechanisms of action underlying the relearning process. We maintain that both aspects should be taken into account when programming a rehabilitative intervention; furthermore, investigating relearning mechanisms might shed new light on the functional architecture of the disrupted processes. Here, we investigated, in a single case study, whether classical conditioning was a suitable relearning paradigm for targeting word-finding difficulties in pure anomia, that is in a patient with an impairment in accessing intact output lexical representations from a spared semantic system. Using a word-repetition task on picture presentation, we contrasted a condition in which the stimulus onset asynchrony between word and picture stimuli was well suited to produce classical conditioning with a condition in which repetition training could not benefit from this learning mechanism. Only classical conditioning training exerted a significant, long-lasting effect on our patient's naming skill. Tentative implications of our results for the functional architecture of single-word processing are discussed.

  9. Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET/CT) Findings in an Unusual Case of Multiple Myeloma Presenting with a Large Extra-Axial Intracranial Mass

    PubMed Central

    Ayaz, Sevin; Ayaz, Ümit Yaşar

    2016-01-01

    Summary Background We aimed to present unusual cranial FDG PET/CT findings of a 56-year-old female with multiple myeloma (MM). Case Report Plain CT images revealed a lytic lesion in the right parietal bone, filled with an oval-shaped, large, extra-axial, extradural, intracranial mass which measured 75×75×40 mm and had smooth borders. The right parietal lobe was compressed by the mass. The maximum standardized uptake value (SUVmax) of the mass lesion was 8.94 on FDG PET/CT images. Multiple lytic lesions with an increased uptake were also detected in other calvarial bones, in several vertebras and in the proximal left femur. After seven months, a control FDG PET/CT following radiotherapy and chemotherapy revealed almost complete regression of the right parietal extra-axial mass lesion. The number, size and metabolism of lytic lesions in other bones also decreased. Conclusions FDG PET/CT was useful for an initial evaluation of MM lesions and was effective in monitoring the response of these lesions to therapy. PMID:28058074

  10. The role of gestures in making connections between space and shape aspects and their verbal representations in the early years: findings from a case study

    NASA Astrophysics Data System (ADS)

    Elia, Iliada; Gagatsis, Athanasios; van den Heuvel-Panhuizen, Marja

    2014-12-01

    In recent educational research, it is well acknowledged that gestures are an important source of developing abstract thinking in early childhood and can serve as an additional window to the mind of the developing child. The present paper reports on a case study which explores the function of gestures in a geometrical activity at kindergarten level. In the study, the spontaneous gestures of the child are investigated, as well as the influence of the teacher's gestures on the child's gestures. In the first part of the activity, the child under study transforms a spatial array of blocks she has constructed by herself into a verbal description, so that another person, i.e., the teacher, who cannot see what the child has built, makes the same construction. Next, the teacher builds a new construction and describes it so that the child can build it. Hereafter, it is again the turn of the child to build another construction and describe it to the teacher. The child was found to spontaneously use iconic and deictic gestures throughout the whole activity. These gestures, and primarily the iconic ones, helped her make apparent different space and shape aspects of the constructions. Along with her speech, gestures acted as semiotic means of objectification to successfully accomplish the task. The teacher's gestures were found to influence the child's gestures when describing aspects of shapes and spatial relationships between shapes. This influence results in either mimicking or extending the teacher's gestures. These findings are discussed and implications for further research are drawn.

  11. Ellis-van Creveld syndrome in a fetus with rhizomelia and polydactyly. Report of a case diagnosed by genetic analysis, and correlation with pathological andradiologic findings.

    PubMed

    Peraita-Ezcurra, Milena; Martínez-García, Mónica; Ruiz-Pérez, Víctor L; Sánchez-Gutiérrez, María Eugenia; Fenollar-Cortés, María; Vélez-Monsalve, Camilo; Ramos-Corrales, Carmen; Pastor, Ignacio; Santonja, Carlos; Trujillo-Tiebas, María José

    2012-05-10

    Ellis-van Creveld syndrome is an autosomal recessive disorder mainly characterized by a disproportionate limb dwarfism, chondroectodermal dysplasia, congenital heart disease, postaxial polydactyly, and dysplastic fingernails and teeth. Only 300 cases have been published worldwide. We report a 21-week fetus with rhizomelia and polydactyly detected. Gross photographs, radiologic studies and pathological study were performed leading to the clinico-pathological suspicion of EvC. DNA from fresh fetal tissue was extracted for sequencing the EVC and EVC2 genes. p.W215X and p.R677X mutations were identified in the EVC2 gene in the fetal sample. Parental sample analysis showed the p.W215X mutation to be inherited from the mother and the p.R677X mutation from the father. The clinical information is essential not only to arrive at a correct diagnosis in fetuses with pathologic ultrasound findings, but also to offer a proper genetic counseling to the parents and their relatives.

  12. Pathological findings in homocystinuria

    PubMed Central

    Gibson, J. B.; Carson, Nina A. J.; Neill, D. W.

    1964-01-01

    Pathological findings are described in four cases of a new aminoaciduria in which homocystine is excreted in the urine. All the patients were mentally retarded children. Three of them presented diagnostic features of Marfan's syndrome. Necropsy on one case and biopsy findings in the others are described. Fatty change occurs in the liver. The most striking lesions are vascular. Metachromatic medial degeneration of the aorta and of the elastic arteries in the necropsied case are considered in relation to Marfan's syndrome. Other changes, particularly thrombosis which is prevalent in homocystinuria, suggest the possibility of a platelet defect. The findings are discussed in respect of an upset in the metabolism of sulphur-containing amino-acids and with particular reference to Marfan's syndrome. Images PMID:14195630

  13. Towards improved biomonitoring tools for an intensified sustainable multi-use environment.

    PubMed

    van der Meer, Jan Roelof

    2016-09-01

    The increasing use of our environment for multiple contrasting activities (e.g. fisheries, tourism) will have to be accompanied by improved monitoring of environmental quality, to avoid transboundary conflicts and ensure long-term sustainable intensified usage. Biomonitoring approaches are appropriate for this, since they can integrate biological effects of environmental exposure rather than measure individual compound concentrations. Recent advances in biomonitoring concepts and tools focus on single-cell assays and purified biological components that can be miniaturized and integrated in automated systems. Despite these advances, we are still very far from being able to deploy bioassays routinely in environmental monitoring, mostly because of lack of experience in interpreting responses and insufficient robustness of the biosensors for their environmental application. Further future challenges include broadening the spectrum of detectable compounds by biosensors, accelerate response times and combining sample pretreatment strategies with bioassays.

  14. Intensified nitrogen removal of constructed wetland by novel integration of high rate algal pond biotechnology.

    PubMed

    Ding, Yi; Wang, Wei; Liu, Xingpo; Song, Xinshan; Wang, Yuhui; Ullman, Jeffrey L

    2016-11-01

    High rate algal pond (HRAP) was combined with constructed wetland (CW) to intensify nitrogen removal through optimizing nitrification and denitrification. Nitrification and denitrification process mainly depends on the oxygen content and carbon source level in CWs. Algal biomass was enriched in HRAP, and dissolved oxygen (DO) concentration was increased via photosynthesis. Algal debris increased COD as degradable bioresource. The results showed that HRAP-CW hybrid systems effectively promoted the nitrogen removal performance due to rich DO and COD. The extension of hydraulic retention time in HRAP significantly improved NH4-N and TN removals by 10.9% and 11.1% in hybrid systems, respectively. The highest NH4-N and TN removals in hybrid systems respectively reached 67.2% and 63.5%, which were significantly higher than those in single CW. The study suggested that the hybrid system had the application potentials in nitrogen removal from wastewater.

  15. Botryococcus braunii cells: ultrasound-intensified outdoor cultivation integrated with in situ magnetic separation.

    PubMed

    Wang, Shi-Kai; Wang, Feng; Stiles, Amanda R; Guo, Chen; Liu, Chun-Zhao

    2014-09-01

    An integrated system combining ultrasound-intensified outdoor cultivation of Botryococcus braunii with in situ magnetic harvesting of the algal cells was developed. The algal cells were cultivated in 200 L plastic bag reactors, and seven five-minute ultrasonic treatments at a four-day interval using a fixed frequency of 40 kHz and a total power of 300 W improved algal cell biomass and hydrocarbon productivity. The algal cells were harvested using functional magnetic particles and a magnetic separator, and a recovery efficiency of 90% was obtained under continuous operation at a flow rate of 100mL/min using the in situ magnetic separation system. The overall production cost using the integrated system was US$ 25.14 per kilogram of B. braunii dry biomass. The system developed in this study provides a base for the industrial production of B. braunii.

  16. Lead foil in dental X-ray film: Backscattering rejection or image intensifier?

    NASA Astrophysics Data System (ADS)

    Hönnicke, M. G.; Delben, G. J.; Godoi, W. C.; Swinka-Filho, V.

    2014-11-01

    Dental X-ray films are still largely used due to sterilization issues, simplicity and, mainly, economic reasons. These films almost always are double coated (double emulsion) and have a lead foil in contact with the film for X-ray backscattering rejection. Herein we explore the use of the lead foil as an image intensifier. In these studies, spatial resolution was investigated when images were acquired on the dental X-ray films with and without the lead foil. Also, the lead foil was subjected to atomic analysis (fluorescent measurements) and structure analysis (X-ray diffraction). We determined that the use of the lead foil reduces the exposure time, however, does not affect the spatial resolution on the acquired images. This suggests that the fluorescent radiation spread is smaller than the grain sizes of the dental X-ray films.

  17. Intensifying of the processes of mechanical separation of oil products from industrial waste water

    SciTech Connect

    Kostova, I.

    1995-11-01

    The raised requirements for discharge of industrial effluents in the Black Sea and in the rivers lead to the development of more efficient technologies for additional treatment and improving the existing facilities. Pollutants with concentrations which are several times higher than the admissible rates according to the Bulgarian Standards, are found at many places along the Black Sea Coast. This is due to the imperfect construction of the water treatment facilities and their improper maintenance. Oil products are one of the main pollutants in water basins. The negative influence which they have on the ecological balance comes from the fact that they are among the most difficulty and slowly dissociating organic substances. They have negative impact on the physical and chemical qualities of water and obstruct the self-purification process disrupting its biological life. In this paper the opportunity to intensify the processes of mechanical separation of oil products from industrial waste water is discussed.

  18. H2O2 intensifies CN(-)-induced apoptosis in pea leaves.

    PubMed

    Samuilov, V D; Kiselevsky, D B; Sinitsyn, S V; Shestak, A A; Lagunova, E M; Nesov, A V

    2006-04-01

    H2O2 intensifies CN(-)-induced apoptosis in stoma guard cells and to lesser degree in basic epidermal cells in peels of the lower epidermis isolated from pea leaves. The maximum effect of H2O2 on guard cells was observed at 10(-4) M. By switching on non-cyclic electron transfer in chloroplasts menadione and methyl viologen intensified H2O2 generation in the light, but prevented the CN--induced apoptosis in guard cells. The light stimulation of CN- effect on guard cell apoptosis cannot be caused by disturbance of the ribulose-1,5-bisphosphate carboxylase function and associated OH* generation in chloroplasts with participation of free transition metals in the Fenton or Haber-Weiss type reactions as well as with participation of the FeS clusters of the electron acceptor side of Photosystem I. Menadione and methyl viologen did not suppress the CN(-)-induced apoptosis in epidermal cells that, unlike guard cells, contain mitochondria only, but not chloroplasts. Quinacrine and diphenylene iodonium, inhibitors of NAD(P)H oxidase of cell plasma membrane, had no effect on the respiration and photosynthetic O2 evolution by leaf slices, but prevented the CN(-)-induced guard cell death. The data suggest that NAD(P)H oxidase of guard cell plasma membrane is a source of reactive oxygen species (ROS) needed for execution of CN(-)-induced programmed cell death. Chloroplasts and mitochondria were inefficient as ROS sources in the programmed death of guard cells. When ROS generation is insufficient, exogenous H2O2 exhibits a stimulating effect on programmed cell death. H2O2 decreased the inhibitory effects of DCMU and DNP-INT on the CN(-)-induced apoptosis of guard cells. Quinacrine, DCMU, and DNP-INT had no effect on CN(-)-induced death of epidermal cells.

  19. Web-based Real-Time Case Finding for the Population Health Management of Patients With Diabetes Mellitus: A Prospective Validation of the Natural Language Processing–Based Algorithm With Statewide Electronic Medical Records

    PubMed Central

    Jin, Bo; Ngo, Anh D; Jackson-Browne, Medina S; Feller, Daniel J; Fu, Tianyun; Zhang, Karena; Zhou, Xin; Zhu, Chunqing; Dai, Dorothy; Yu, Yunxian; Zheng, Gang; Li, Yu-Ming; McElhinney, Doff B; Culver, Devore S; Alfreds, Shaun T; Stearns, Frank; Sylvester, Karl G; Widen, Eric

    2016-01-01

    Background Diabetes case finding based on structured medical records does not fully identify diabetic patients whose medical histories related to diabetes are available in the form of free text. Manual chart reviews have been used but involve high labor costs and long latency. Objective This study developed and tested a Web-based diabetes case finding algorithm using both structured and unstructured electronic medical records (EMRs). Methods This study was based on the health information exchange (HIE) EMR database that covers almost all health facilities in the state of Maine, United States. Using narrative clinical notes, a Web-based natural language processing (NLP) case finding algorithm was retrospectively (July 1, 2012, to June 30, 2013) developed with a random subset of HIE-associated facilities, which was then blind tested with the remaining facilities. The NLP-based algorithm was subsequently integrated into the HIE database and validated prospectively (July 1, 2013, to June 30, 2014). Results Of the 935,891 patients in the prospective cohort, 64,168 diabetes cases were identified using diagnosis codes alone. Our NLP-based case finding algorithm prospectively found an additional 5756 uncodified cases (5756/64,168, 8.97% increase) with a positive predictive value of .90. Of the 21,720 diabetic patients identified by both methods, 6616 patients (6616/21,720, 30.46%) were identified by the NLP-based algorithm before a diabetes diagnosis was noted in the structured EMR (mean time difference = 48 days). Conclusions The online NLP algorithm was effective in identifying uncodified diabetes cases in real time, leading to a significant improvement in diabetes case finding. The successful integration of the NLP-based case finding algorithm into the Maine HIE database indicates a strong potential for application of this novel method to achieve a more complete ascertainment of diagnoses of diabetes mellitus. PMID:27836816

  20. Intensified vmPFC surveillance over PTSS under perturbed microRNA-608/AChE interaction.

    PubMed

    Lin, T; Simchovitz, A; Shenhar-Tsarfaty, S; Vaisvaser, S; Admon, R; Hanin, G; Hanan, M; Kliper, E; Bar-Haim, Y; Shomron, N; Fernandez, G; Lubin, G; Fruchter, E; Hendler, T; Soreq, H

    2016-05-03

    Trauma causes variable risk of posttraumatic stress symptoms (PTSS) owing to yet-unknown genome-neuronal interactions. Here, we report co-intensified amygdala and ventromedial prefrontal cortex (vmPFC) emotional responses that may overcome PTSS in individuals with the single-nucleotide polymorphism (SNP) rs17228616 in the acetylcholinesterase (AChE) gene. We have recently shown that in individuals with the minor rs17228616 allele, this SNP interrupts AChE suppression by microRNA (miRNA)-608, leading to cortical elevation of brain AChE and reduced cortisol and the miRNA-608 target GABAergic modulator CDC42, all stress-associated. To examine whether this SNP has effects on PTSS and threat-related brain circuits, we exposed 76 healthy Israel Defense Forces soldiers who experienced chronic military stress to a functional magnetic resonance imaging task of emotional and neutral visual stimuli. Minor allele individuals predictably reacted to emotional stimuli by hyperactivated amygdala, a hallmark of PTSS and a predisposing factor of posttraumatic stress disorder (PTSD). Despite this, minor allele individuals showed no difference in PTSS levels. Mediation analyses indicated that the potentiated amygdala reactivity in minor allele soldiers promoted enhanced vmPFC recruitment that was associated with their limited PTSS. Furthermore, we found interrelated expression levels of several miRNA-608 targets including CD44, CDC42 and interleukin 6 in human amygdala samples (N=7). Our findings suggest that miRNA-608/AChE interaction is involved in the threat circuitry and PTSS and support a model where greater vmPFC regulatory activity compensates for amygdala hyperactivation in minor allele individuals to neutralize their PTSS susceptibility.