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Sample records for phocomelia spectrum-a case

  1. Phocomelia: Report of Three Cases

    PubMed Central

    Coodin, Fischel J.; Uchida, Irene A.; Murphy, Claude H.

    1962-01-01

    Three infants were born with phocomelia in Winnipeg during the period from May 1961 to May 1962. In one case thalidomide had been administered to the mother early in the pregnancy. No etiological agent was discovered in the other two, both of whom died. Known teratogenic agents capable of causing phocomelia are reviewed, but no clear association with the two cases described in this report is evident. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5 PMID:14022756

  2. The Roberts syndrome/SC phocomelia spectrum--a case report of an adult with review of the literature.

    PubMed

    Goh, Elaine Suk-Ying; Li, Chumei; Horsburgh, Sheri; Kasai, Yumi; Kolomietz, Elena; Morel, Chantal France

    2010-02-01

    Roberts syndrome (RBS) (OMIM #268300) is a rare autosomal recessive disorder characterized by tetraphocomelia (symmetrical limb reduction), craniofacial anomalies, growth retardation, mental retardation, cardiac and renal abnormalities. The syndrome is caused by mutations in the ESCO2 (establishment of cohesion 1 homolog 2) (Entrez 609353) gene, which is located at 8p21.1, and encodes a protein essential in establishing sister chromatid cohesion during S phase. SC phocomelia (SC) (OMIM #269000), has less severe symmetric limb reduction, flexion contractures of various joints, minor facial anomalies, growth retardation and occasionally, mental retardation. These two syndromes can be considered part of a spectrum, with RBS at the most severe range in which severely affected infants may be stillborn or die in the post-natal period, while individuals with SC phocomelia represent the milder end of the spectrum and typically survive to adulthood. In both presentations, karyotype investigations characteristically reveal premature centromere separation (PCS), otherwise known as heterochromatin repulsion or puffing. There is little literature about the follow-up of adults with the spectrum of RBS/SC phocomelia or their recommended management. We report on an adult presentation of RBS/SC phocomelia spectrum disorder with a history of major cardiac malformation in childhood, normal limbs on physical examination, mild facial anomalies, mild learning difficulties, and PCS. Molecular studies of ESCO2 have confirmed the diagnosis. A literature review, focussing on adult manifestations of this condition and a discussion of follow-up guidelines are presented. Copyright 2010 Wiley-Liss, Inc.

  3. Phocomelia: Case report and differential diagnosis.

    PubMed

    Osadsky, Captain Rasto

    2011-01-01

    While rarely seen in the present-day Western world, phocomelia is not uncommon in underdeveloped countries. Phocomelia is an abnormality in which the limbs are not fully formed. It may be inherited as an autosomal recessive or dominant disorder. This case concerns a 12-year-old Afghan boy with multiple skeletal anomalies, most prominently of his right arm, including aplasia of the entire proximal humerus, hypoplasia of the clavicle and scapula, and absence of the radial ray and thumb. A hypoplastic left thumb was also present. Other anomalies included thoracic scoliosis, upper thoracic hemivertebrae, and mild cardiomegaly. The differential diagnosis and likely diagnosis are discussed.

  4. Tetra-phocomelia: a rarest of rare case.

    PubMed

    Shukla, Anil Kumar; Sanjay, S C; Krishna, L; Krishnappa, N

    2015-03-01

    We present a rarest of rare case of Tetra-Phocomelia evaluated by antenatal Ultrasonography. It is a condition seen in 0.62 per 100,000 live births. An ultrasonogram was done at 18 wk of pregnancy to assess the fetus and after termination gross specimen was evaluated and X-ray infantograms were done to confirm the findings. The case showed classic Tetra-Phocomelia with limbs like flippers of a seal. Our findings make it rarest of rare as only few cases have been so far reported.

  5. Tetra-Phocomelia: A Rarest of Rare Case

    PubMed Central

    Sanjay, S.C.; Krishna, L.; Krishnappa, N.

    2015-01-01

    We present a rarest of rare case of Tetra-Phocomelia evaluated by antenatal Ultrasonography. It is a condition seen in 0.62 per 100,000 live births. An ultrasonogram was done at 18 wk of pregnancy to assess the fetus and after termination gross specimen was evaluated and X-ray infantograms were done to confirm the findings. The case showed classic Tetra-Phocomelia with limbs like flippers of a seal. Our findings make it rarest of rare as only few cases have been so far reported. PMID:25954680

  6. [Newborn with phocomelia and thrombocytopenia. Case report].

    PubMed

    Maas, C; Arand, J; Orlikowsky, Th; Goelz, R

    2002-01-01

    Associated malformations and symptoms may be decisive in the differential diagnosis of neonatal phocomelia. We report on a neonate with phocomelia, petechiae and thrombocytopenia. This constellation is typical for the phocomelia-thrombocytopenia-syndrome, a variant of the thrombocytopenia-absent radius-(TAR) syndrome. During the neonatal period platelet transfusions were necessary. Relevant bleeding and development delays were not evident until the age of seven months. Cardinal symptoms of the TAR syndrome are bilaterally absent radius and neonatal thrombocytopenia. The patient presented with phocomelia of the upper extremities which occurs in only 5 - 10 % of the patients with TAR syndrome. Further abnormalities include additional bone and joint disorders and haematopoietic problems, such as thrombocytopenia. Bleeding episodes mainly occur in the first year of life, hence platelet transfusions may be necessary during this period. A new experimental approach is the Interleukin-6-mediated stimulation of thrombopoiesis. Usually platelet counts reach normal values in adults. The main problem remains a satisfactory management of various limb defects.

  7. Tetra-phocomelia: the seal limb deformity - a case report.

    PubMed

    Samal, Sunil Kumar; Rathod, Setu; Ghose, Seetesh

    2015-02-01

    We report a case of term live baby with tetra-phocomelia born to a 35-year-old G3P2L2A0 with history of consanguineous marriage. She was an unbooked case from a tribal community with no previous antenatal visits. At 39 wk of gestation, she was admitted to our hospital with complaint of pain abdomen and on examination was found to be in second stage of labour. She delivered vaginally a term live 2.5 kg female baby with multiple anomalies. There was no history of drug intake, radiation exposure, maternal diabetes or family history of congenital anomalies to support the occurrence of tetra-phocomelia in this baby. The neonate also had multiple facial abnormalities like hypertelorism, microretrognathia and partial cleft palate. Further investigations revealed no abnormalities of internal organs. At present the baby is being followed up at our paediatric department. The case is reported owing to its rarity and term live birth.

  8. [Phocomelia in Africa: thoughts about a case report].

    PubMed

    Mouafo Tambo, Faustin Félicien; Andze, Ondobo Gervais

    2010-01-01

    Phocomelia is a developmental abnormality which occurs during pregnancy and results in congenital ectromelia (developmental arrest of one or more limbs), with characteristically atrophied limbs that look as if they were directly implanted on the trunk, that is, like seal (phocid) flippers. The authors report the case of a Cameroonian neonate. Abnormalities were limited to the upper limbs. The lack of useful causal information and especially the difficulties in therapeutic management in this context are highlighted.

  9. A report of two cases of Al-Awadi Raas-Rothschild syndrome (AARRS) supporting that "apparent" Phocomelia differentiates AARRS from Schinzel Phocomelia syndrome (SPS).

    PubMed

    AlQattan, Mohammad M; AlAbdulkareem, Ibrahim; Ballow, Mariam; Al Balwi, Mohammed

    2013-09-15

    Although there is a long list of syndromes with phocomelia, there are only two syndromes in which there is concurrent pelvic dysplasia and phocomelia: Al-Awadi-Raas-Rothschild syndrome (AARRS) and Schinzel phocomelia syndrome (SPS). Currently, there is a diagnostic confusion between the two syndromes and both have the same MIM entry (MIM 276820). We believe that the two syndromes are different entities and we also believe that the limb defect in SPS is a "true" phocomelia while the limb defect in AARRS is an "apparent" phocomelia. "Apparent" phocomelia describes the most severe form of ulnar ray deficiency in which there is absent ulna with radio-humeral synostosis. "Apparent" phocomelia is diagnosed radiologically by three radiological features: the apparently single bone occupying the arm/forearm appears relatively long, the area of radio-humeral synostosis will have thicker cortex with or without slight angulation, and the lower end of the bone resembles the lower end of a radius and not a humerus. In this paper, we present two new cases of AARRS from two different Saudi Arabian tribes: one case with R292C mutation of WNT7A with bilateral "apparent" phocomelia and a second case with a novel c.814G>T mutation of the WNT7A gene (resulting in wnt7a protein truncation at position 272) with unilateral "apparent" phocomelia. We reviewed previously reported cases of AARRS and SPS to further delineate the differences between these two syndromes. We make the argument that these two syndromes are two different entities and hence require two different MIM entries. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Tetra-Phocomelia: The Seal Limb Deformity - A Case Report

    PubMed Central

    Rathod, Setu; Ghose, Seetesh

    2015-01-01

    We report a case of term live baby with tetra-phocomelia born to a 35-year-old G3P2L2A0 with history of consanguineous marriage. She was an unbooked case from a tribal community with no previous antenatal visits. At 39 wk of gestation, she was admitted to our hospital with complaint of pain abdomen and on examination was found to be in second stage of labour. She delivered vaginally a term live 2.5 kg female baby with multiple anomalies. There was no history of drug intake, radiation exposure, maternal diabetes or family history of congenital anomalies to support the occurrence of tetra-phocomelia in this baby. The neonate also had multiple facial abnormalities like hypertelorism, microretrognathia and partial cleft palate. Further investigations revealed no abnormalities of internal organs. At present the baby is being followed up at our paediatric department. The case is reported owing to its rarity and term live birth. PMID:25859493

  11. Roberts-SC Phocomelia Syndrome (Pseudothalidomide Syndrome): A Case Report.

    PubMed

    Keypour, Farideh; Naghi, Ilana; Behnam, Babak

    2013-03-01

    A 39-year-old pregnant woman at 38 weeks of gestation was referred with labor pain to a hospital. She had consanguinity with her husband. A female newborn had multiple craniofacial anomalies and phocomelia in right upper limb. The disease locus was assigned to chromosome17q21. Four days later, infant died of cardiopulmonary arrest.

  12. Roberts-SC Phocomelia Syndrome (Pseudothalidomide Syndrome): A Case Report

    PubMed Central

    Naghi, Ilana; Behnam, Babak

    2013-01-01

    A 39-year-old pregnant woman at 38 weeks of gestation was referred with labor pain to a hospital. She had consanguinity with her husband. A female newborn had multiple craniofacial anomalies and phocomelia in right upper limb. The disease locus was assigned to chromosome17q21. Four days later, infant died of cardiopulmonary arrest. PMID:24971102

  13. Al-Awadi/Raas-Rothschild/Schinzel (AARRS) phocomelia syndrome: case report and developmental field analysis.

    PubMed

    Subhani, Muhammad; Akangire, Gangaram; Kulkarni, Archana; Wilson, Golder N

    2009-07-01

    We describe a girl infant with anomalies of the left pelvis and lower limb (pelvic, femoral, and tibial hypogenesis with absent fibula), subtle facial changes, patent foraman ovale, single umbilical artery, single kidney, and imperforate anus. The external genitalia were asymmetric and ambiguous with normal uterus and ovaries visualized by ultrasound. The anomalies are compatible with previously reported cases of Al-Awadi/Raas-Rothschild/Schinzel (AARRS) phocomelia, an autosomal recessive disorder with WNT7 gene mutations documented in one family. We suggest that AARRS phocomelia, Fuhrmann syndrome, and similar conditions comprise a spectrum, and that the anomaly pattern derives from serial action of the same signal pathways within primary (e.g., the major axes), secondary (e.g., heart or limb primordia), and/or local (e.g., tibial-fibular differentiation) developmental fields.

  14. Phocomelia: a worldwide descriptive epidemiologic study in a large series of cases from the International Clearinghouse for Birth Defects Surveillance and Research, and overview of the literature.

    PubMed

    Bermejo-Sánchez, Eva; Cuevas, Lourdes; Amar, Emmanuelle; Bianca, Sebastiano; Bianchi, Fabrizio; Botto, Lorenzo D; Canfield, Mark A; Castilla, Eduardo E; Clementi, Maurizio; Cocchi, Guido; Landau, Danielle; Leoncini, Emanuele; Li, Zhu; Lowry, R Brian; Mastroiacovo, Pierpaolo; Mutchinick, Osvaldo M; Rissmann, Anke; Ritvanen, Annukka; Scarano, Gioacchino; Siffel, Csaba; Szabova, Elena; Martínez-Frías, María-Luisa

    2011-11-15

    Epidemiologic data on phocomelia are scarce. This study presents an epidemiologic analysis of the largest series of phocomelia cases known to date. Data were provided by 19 birth defect surveillance programs, all members of the International Clearinghouse for Birth Defects Surveillance and Research. Depending on the program, data corresponded to a period from 1968 through 2006. A total of 22,740,933 live births, stillbirths and, for some programs, elective terminations of pregnancy for fetal anomaly (ETOPFA) were monitored. After a detailed review of clinical data, only true phocomelia cases were included. Descriptive data are presented and additional analyses compared isolated cases with those with multiple congenital anomalies (MCA), excluding syndromes. We also briefly compared congenital anomalies associated with nonsyndromic phocomelia with those presented with amelia, another rare severe congenital limb defect. A total of 141 phocomelia cases registered gave an overall total prevalence of 0.62 per 100,000 births (95% confidence interval: 0.52-0.73). Three programs (Australia Victoria, South America ECLAMC, Italy North East) had significantly different prevalence estimates. Most cases (53.2%) had isolated phocomelia, while 9.9% had syndromes. Most nonsyndromic cases were monomelic (55.9%), with an excess of left (64.9%) and upper limb (64.9%) involvement. Most nonsyndromic cases (66.9%) were live births; most isolated cases (57.9%) weighed more than 2,499 g; most MCA (60.7%) weighed less than 2,500 g, and were more likely stillbirths (30.8%) or ETOPFA (15.4%) than isolated cases. The most common associated defects were musculoskeletal, cardiac, and intestinal. Epidemiological differences between phocomelia and amelia highlighted possible differences in their causes. Copyright © 2011 Wiley Periodicals, Inc.

  15. Phocomelia: A Worldwide Descriptive Epidemiologic Study in a Large Series of Cases From the International Clearinghouse for Birth Defects Surveillance and Research, and Overview of the Literature

    PubMed Central

    Bermejo-Sánchez, Eva; Cuevas, Lourdes; Amar, Emmanuelle; Bianca, Sebastiano; Bianchi, Fabrizio; Botto, Lorenzo D.; Canfield, Mark A.; Castilla, Eduardo E.; Clementi, Maurizio; Cocchi, Guido; Landau, Danielle; Leoncini, Emanuele; Li, Zhu; Lowry, R. Brian; Mastroiacovo, Pierpaolo; Mutchinick, Osvaldo M.; Rissmann, Anke; Ritvanen, Annukka; Scarano, Gioacchino; Siffel, Csaba; Szabova, Elena; Martínez-Frías, María-Luisa

    2015-01-01

    Epidemiologic data on phocomelia are scarce. This study presents an epidemiologic analysis of the largest series of phocomelia cases known to date. Data were provided by 19 birth defect surveillance programs, all members of the International Clearinghouse for Birth Defects Surveillance and Research. Depending on the program, data corresponded to a period from 1968 through 2006. A total of 22,740,933 live births, stillbirths and, for some programs, elective terminations of pregnancy for fetal anomaly (ETOPFA) were monitored. After a detailed review of clinical data, only true phocomelia cases were included. Descriptive data are presented and additional analyses compared isolated cases with those with multiple congenital anomalies (MCA), excluding syndromes. We also briefly compared congenital anomalies associated with nonsyndromic phocomelia with those presented with amelia, another rare severe congenital limb defect. A total of 141 phocomelia cases registered gave an overall total prevalence of 0.62 per 100,000 births (95% confidence interval: 0.52–0.73). Three programs (Australia Victoria, South America ECLAMC, Italy North East) had significantly different prevalence estimates. Most cases (53.2%) had isolated phocomelia, while 9.9% had syndromes. Most nonsyndromic cases were monomelic (55.9%), with an excess of left (64.9%) and upper limb (64.9%) involvement. Most nonsyndromic cases (66.9%) were live births; most isolated cases (57.9%) weighed more than 2,499 g; most MCA (60.7%) weighed less than 2,500 g, and were more likely stillbirths (30.8%) or ETOPFA (15.4%) than isolated cases. The most common associated defects were musculoskeletal, cardiac, and intestinal. Epidemiological differences between phocomelia and amelia highlighted possible differences in their causes. PMID:22002800

  16. A rare case of suprahepatic gall bladder with phocomelia and pancytopenia: detected by tc-99m mebrofenin scintigraphy.

    PubMed

    Rather, Tanveeer Ah; Khan, Shoukat H; Singh, Manjeet; Choh, Naseer A

    2013-01-01

    The possibility of an ectopic gallbladder should always be considered whenever there is a failure to localize it in its normal anatomical position on routine imaging. Although a very rare entity, the anomalous position of gallbladder can result in misinterpretation of imaging findings and create clinical confusion. Awareness of such an anomaly facilitates proper diagnosis and subsequent management. The authors report a very rare case of suprahepatic gallbladder associated with phocomelia, pancytopenia, and splenomegaly in a young 25-year-old female. The suprahepatic gallbladder was initially visualized on Technetium-99m (Tc-99m) Mebrofenin radionuclide hepatobiliary scintigraphy. Subsequent magnetic resonance cholecystopancreatography (MRCP) was also done to confirm the diagnosis.

  17. A Rare Case of Suprahepatic Gall Bladder with Phocomelia and Pancytopenia: Detected by Tc-99m Mebrofenin Scintigraphy

    PubMed Central

    Rather, Tanveeer Ah; Khan, Shoukat H.; Singh, Manjeet; Choh, Naseer A.

    2013-01-01

    The possibility of an ectopic gallbladder should always be considered whenever there is a failure to localize it in its normal anatomical position on routine imaging. Although a very rare entity, the anomalous position of gallbladder can result in misinterpretation of imaging findings and create clinical confusion. Awareness of such an anomaly facilitates proper diagnosis and subsequent management. The authors report a very rare case of suprahepatic gallbladder associated with phocomelia, pancytopenia, and splenomegaly in a young 25-year-old female. The suprahepatic gallbladder was initially visualized on Technetium-99m (Tc-99m) Mebrofenin radionuclide hepatobiliary scintigraphy. Subsequent magnetic resonance cholecystopancreatography (MRCP) was also done to confirm the diagnosis. PMID:23961256

  18. Complex Anatomic Abnormalities of the Lower Leg Muscles and Tendons Associated With Phocomelia: A Case Report.

    PubMed

    Hodo, Thomas; Hamrick, Mark; Melenevsky, Yulia

    Musculoskeletal anatomy is widely known to have components that stray from the norm in the form of variant muscle and tendon presence, absence, origin, insertion, and bifurcation. Although these variant muscles and tendons might be deemed incidental and insignificant findings by most, they can be important contributors to pathologic physiology or, more importantly, an option for effective treatment. In the present case report, we describe a patient with phocomelia and Müllerian abnormalities secondary to in utero thalidomide exposure. The patient had experienced recurrent bilateral foot pain accompanied by numbness, stiffness, swelling, and longstanding pes planus. These symptoms persisted despite conservative treatment with orthotics, steroids, and nonsteroidal anti-inflammatory drugs. Radiographic imaging showed dysmorphic and degenerative changes of the ankle and foot joints. Further investigation with magnetic resonance imaging revealed complex anatomic abnormalities, including the absence of the posterior tibialis and peroneus brevis, lateralization of the peroneus longus, and the presence of a variant anterior compartment muscle. The variant structure was likely a previously described anterior compartment variant, anterior fibulocalcaneus, and might have been a source of the recurrent pain. Also, the absence of the posterior tibialis might have caused the pes planus in the present patient, considering that posterior tibialis tendon dysfunction is the most common cause of acquired pes planus. Although thalidomide infrequently affects the lower extremities, its effects on growth and development were likely the cause of this rare array of anatomic abnormalities and resulting ankle and foot pathologic features. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Association of ectrodactyly and distal phocomelia.

    PubMed

    Delrue, M A; Lacombe, D

    2002-01-01

    Ectrodactyly and phocomelia are well known limbs malformations. They can be a part of various syndromes, and are more often transmitted with dominant autosomal Inheritance with variable expression and Incomplete penetrance. Different loci have been Identified for ectrodactyly (SHFM1 at 7q21.3q22.1, SHFM2 at Xq26, SHFM3 at 10q24q25, SHFM4 at 3q27), and two genes are known (DSS1 for SHFM1, p63 for SHFM4). We report the case of a 33 year-old female affected with the association of ectrodactyly and phocomelia. It could be a "new" association, or a mild or partial expression of the syndrome Including ectrodactyly, phocomelia, deafness and sinusal arythmia.

  20. The classification of phocomelia.

    PubMed

    Tytherleigh-Strong, G; Hooper, G

    2003-06-01

    We studied 24 patients with 44 phocomelic upper limbs. Only 11 limbs could be grouped in the classification system of Frantz and O' Rahilly. The non-classifiable limbs were further studied and their characteristics identified. It is confirmed that phocomelia is not an intercalary defect.

  1. DK phocomelia phenotype (von Voss-Cherstvoy syndrome) caused by somatic mosaicism for del(13q).

    PubMed

    Bamforth, J S; Lin, C C

    1997-12-31

    DK phocomelia (von Voss-Cherstvoy syndrome) is a rare condition characterized by radial ray defects, occipital encephalocoele, and urogenital abnormalities. Lubinsky et al. [1994: Am J Med Genet 52:272-278] pointed out similarities between this and the del(13q) syndrome. To date, all reported cases of DK phocomelia have been apparently normal chromosomally. We report on a case of DK phocomelia in which the proposita had normal lymphocyte chromosomes, but was mosaic in fibroblasts for del(13)(q12). Fibroblast chromosomes studies on other cases of DK phocomelia have not been reported: this raises the possibility that some cases of DK phocomelia may be somatic mosaics for del(13)(q12).

  2. Roberts-SC phocomelia syndrome.

    PubMed

    Maheshwari, A; Kumar, P; Dutta, S; Narang, A

    2001-06-01

    A severely growth retarded baby was born at 38 weeks gestation. He had multiple craniofacial anomalies, microbrachycephaly, phocomelia in the upper limbs and renal cysts visible on ultrasound. He died of recurrent apneas. The autopsy showed left sided multicystic dysplastic kidney and absence of one testis. Cytogenetic studies did not reveal any abnormality. The phenotypic features match those described in the Roberts-SC phocomelia syndrome. A literature review revealed that 50% of these patients have chromosomal defects and antenatal detection is possible on ultrasound and by chromosome analysis of the amniocytes.

  3. [Roberts-SC phocomelia syndrome].

    PubMed

    Musfeld, D A; Bühler, E M; Heinzl, S

    2001-01-01

    The Roberts-SC phocomelia syndrome is a rare autosomal recessive inherited disorder clinically manifested by tetraphocomelia, pre- and postnatal growth retardation, and craniofacial abnormalities (skull, eyes, lip, and palate), accompanied at times by centromer puffing and splitting, renal abnormalities, heart defect, clitoral or penile enlargement, and bilateral corneal opacities. Mental retardation is common in surviving patients.

  4. Neurocognitive profile of a young adolescent with DK phocomelia/von Voss phocomelia/von Voss Cherstvoy syndrome.

    PubMed

    Antonini, Tanya N; Van Horn Kerne, Valerie; Axelrad, Marni E; Karaviti, Lefkothea P; Schwartz, David D

    2015-07-01

    DK phocomelia/von Voss Cherstvoy syndrome is a rare condition characterized by upper limb and urogenital abnormalities and various brain anomalies. Previously reported cases have noted significant developmental delays, although no formal testing of cognitive abilities has been reported. In this paper we describe results from a comprehensive neuropsychological evaluation of a 12-year-old male with DK phocomelia syndrome. Test findings indicated mild impairment in intellectual functioning, with more significant impairment in adaptive skills and academic achievement. The neuropsychological profile converged with neurological findings, showing a distinct pattern of strengths and weaknesses that suggests functional compromise of posterior brain regions with relatively well-preserved functioning of more anterior regions. Specifically, impairments were evident in perceptual reasoning, visual perception, and visuomotor integration, whereas normal or near normal functioning was evident in memory, receptive language, social cognition, attention, and most aspects of executive functioning. To our knowledge this is the first report to describe the neurocognitive profile of an individual with DK phocomelia syndrome. © 2015 Wiley Periodicals, Inc.

  5. Limb/pelvis hypoplasia/aplasia with skull defect (Schinzel phocomelia): distinctive features and prenatal detection.

    PubMed

    Olney, R S; Hoyme, H E; Roche, F; Ferguson, K; Hintz, S; Madan, A

    2001-11-01

    Schinzel phocomelia syndrome is characterized by limb/pelvis hypoplasia/aplasia: specifically, intercalary limb deficiencies and absent or hypoplastic pelvic bones. The phenotype is similar to that described in a related multiple malformation syndrome known as Al-Awadi/Raas-Rothschild syndrome. The additional important feature of large parietooccipital skull defects without meningocele, encephalocele, or other brain malformation has thus far been reported only in children with Schinzel phocomelia syndrome. We recently evaluated a boy affected with Schinzel phocomelia born to nonconsanguineous healthy parents of Mexican origin. A third-trimester fetal ultrasound scan showed severe limb deficiencies and an absent pelvis. The infant died shortly after birth. Dysmorphology examination, radiographs, and autopsy revealed quadrilateral intercalary limb deficiencies with preaxial toe polydactyly; an absent pelvis and a 7 x 3-cm skull defect; and extraskeletal anomalies including microtia, telecanthus, micropenis with cryptorchidism, renal cysts, stenosis of the colon, and a cleft alveolar ridge. A normal 46,XY karyotype was demonstrated, and autosomal recessive inheritance was presumed on the basis of previously reported families. This case report emphasizes the importance of recognizing severe pelvic and skull deficiencies (either post- or prenatally) in differentiating infants with Schinzel phocomelia from other multiple malformation syndromes that feature intercalary limb defects, including thalidomide embryopathy and Roberts-SC phocomelia. Copyright 2001 Wiley-Liss, Inc.

  6. Upper-extremity phocomelia reexamined: a longitudinal dysplasia.

    PubMed

    Goldfarb, Charles A; Manske, Paul R; Busa, Riccardo; Mills, Janith; Carter, Peter; Ezaki, Marybeth

    2005-12-01

    focal deficiency, were common in those patients. Eleven limbs in ten patients were identified as having severe combined dysplasia, which was type A in seven of them and type B in four. Four patients with severe combined dysplasia had congenital cardiac anomalies, and four had associated musculoskeletal abnormalities. Three of the four patients with the type-B disorder had a contralateral ulnar longitudinal dysplasia. We propose that cases previously classified as upper-extremity phocomelia represent a spectrum of severe longitudinal dysplasia, as none of the sixty extremities that we studied demonstrated a true intercalary deficiency. These findings have both developmental and genetic implications.

  7. A Reevaluation of X-Irradiation Induced Phocomelia and Proximodistal Limb Patterning

    PubMed Central

    Galloway, Jenna L.; Delgado, Irene; Ros, Maria A.; Tabin, Clifford J.

    2009-01-01

    Phocomelia is a devastating, rare congenital limb malformation in which the long bones are shorter than normal, with the upper portion of the limb being most severely affected. In extreme cases, the hands or fingers are attached directly to the shoulder and the most proximal elements (those closest to the shoulder) are entirely missing. This disorder, previously known in both autosomal recessive and sporadic forms, showed a dramatic increase in incidence in the early 1960’s due to the tragic toxicological effects of the drug thalidomide, which had been prescribed as a mild sedative1, 2. This human birth defect is mimicked in developing chick limb buds exposed to X-irradiation3-5. Both X-irradiation5 and thalidomide-induced phocomelia5, 6 have been interpreted as patterning defects in the context of the Progress Zone Model, which states that a cell’s proximodistal (PD) identity is determined by the length of time spent in a distal limb region termed the “Progress Zone” 7. Indeed, studies of X-irradiation induced phocomelia have served as one of the two major experimental lines of evidence supporting the validity of the Progress Zone Model. Here, using a combination of molecular analysis and lineage tracing, we show that X-irradiation-induced phocomelia is fundamentally not a patterning defect, but rather results from a time-dependent loss of skeletal progenitors. As skeletal condensation proceeds from the shoulder to fingers (in a proximal to distal direction), the proximal elements are differentially affected in limb buds exposed to radiation at early stages. This conclusion changes the framework for considering the effect of thalidomide and other forms of phocomelia, suggesting the possibility that the etiology lies not in a defect in the patterning process, but rather in progenitor cell survival and differentiation. Moreover, molecular evidence that PD patterning is unaffected following X-irradiation does not support the predictions of the Progress Zone

  8. A reevaluation of X-irradiation-induced phocomelia and proximodistal limb patterning.

    PubMed

    Galloway, Jenna L; Delgado, Irene; Ros, Maria A; Tabin, Clifford J

    2009-07-16

    Phocomelia is a devastating, rare congenital limb malformation in which the long bones are shorter than normal, with the upper portion of the limb being most severely affected. In extreme cases, the hands or fingers are attached directly to the shoulder and the most proximal elements (those closest to the shoulder) are entirely missing. This disorder, previously known in both autosomal recessive and sporadic forms, showed a marked increase in incidence in the early 1960s due to the tragic toxicological effects of the drug thalidomide, which had been prescribed as a mild sedative. This human birth defect is mimicked in developing chick limb buds exposed to X-irradiation. Both X-irradiation and thalidomide-induced phocomelia have been interpreted as patterning defects in the context of the progress zone model, which states that a cell's proximodistal identity is determined by the length of time spent in a distal limb region termed the 'progress zone'. Indeed, studies of X-irradiation-induced phocomelia have served as one of the two major experimental lines of evidence supporting the validity of the progress zone model. Here, using a combination of molecular analysis and lineage tracing in chick, we show that X-irradiation-induced phocomelia is fundamentally not a patterning defect, but rather results from a time-dependent loss of skeletal progenitors. Because skeletal condensation proceeds from the shoulder to fingers (in a proximal to distal direction), the proximal elements are differentially affected in limb buds exposed to radiation at early stages. This conclusion changes the framework for considering the effect of thalidomide and other forms of phocomelia, suggesting the possibility that the aetiology lies not in a defect in the patterning process, but rather in progenitor cell survival and differentiation. Moreover, molecular evidence that proximodistal patterning is unaffected after X-irradiation does not support the predictions of the progress zone model.

  9. Complete Pentalogy of Cantrell (POC) with Phocomelia and Other Associated Rare Anomalies

    PubMed Central

    Shukla, Dhirajkumar B; Jain, Akash; Jagtap, Swati S

    2014-01-01

    We are reporting a rare case of Complete Pentalogy of Cantrell (CPOC) with phocomelia and other associated anomalies such as encephalocoele, craniofacial defects, limb defects and a flexion deformity, with club foot in right lower limb. Antenatal ultrasonography done in a 20 year old primigravida revealed multiple thoraco-abdominal and CNS anomalies in a foetus with an average gestational age of 18.2 weeks. Foetal autopsy done following termination of the pregnancy revealed a combination of defects, based on which the diagnosis of Complete Pentalogy of Cantrell with associated anomalies was given. To the best of our knowledge, this is the first case of Complete Pentalogy of Cantrell with phocomelia which has been seen in the world. PMID:24995190

  10. The importance of chromosome studies in Roberts syndrome/SC phocomelia and other cohesinopathies.

    PubMed

    Gerkes, Erica H; van der Kevie-Kersemaekers, Anne-Marie F; Yakin, Mariam; Smeets, Dominique F C M; van Ravenswaaij-Arts, Conny M A

    2010-01-01

    Roberts syndrome/SC phocomelia is a rare, autosomal recessive syndrome characterised by pre- and postnatal growth retardation, microcephaly, craniofacial anomalies, mental retardation, and tetraphocomelia in varying degrees of severity. The clinical diagnosis can be challenging in phenotypically mild cases. In the extremely mild case presented here, specific mitotic abnormalities were detected and proved to be very helpful, since Roberts syndrome/SC phocomelia could be diagnosed after finding premature centromere separation and somatic aneuploidy at routine karyotyping. We discuss these and other mitotic cytogenetic abnormalities that can be of significant diagnostic importance, but which will be missed if only array studies are performed. We also discuss the difference between premature centromere separation and premature (sister) chromatid separation. Copyright (c) 2009 Elsevier Masson SAS. All rights reserved.

  11. Complete Pentalogy of Cantrell (POC) with Phocomelia and Other Associated Rare Anomalies.

    PubMed

    Jagtap, Sunil V; Shukla, Dhirajkumar B; Jain, Akash; Jagtap, Swati S

    2014-05-01

    We are reporting a rare case of Complete Pentalogy of Cantrell (CPOC) with phocomelia and other associated anomalies such as encephalocoele, craniofacial defects, limb defects and a flexion deformity, with club foot in right lower limb. Antenatal ultrasonography done in a 20 year old primigravida revealed multiple thoraco-abdominal and CNS anomalies in a foetus with an average gestational age of 18.2 weeks. Foetal autopsy done following termination of the pregnancy revealed a combination of defects, based on which the diagnosis of Complete Pentalogy of Cantrell with associated anomalies was given. To the best of our knowledge, this is the first case of Complete Pentalogy of Cantrell with phocomelia which has been seen in the world.

  12. Management of an infant with cleft lip and palate with phocomelia in dental practice.

    PubMed

    Muthu, M S

    2000-12-01

    Cleft lip and palate is a severe birth defect occurring approximately one in 800-1000 newborn infants. The incidence varies widely among races. Cleft lip and palate together account for approximately 50% of all cases whereas isolated cleft lip and isolated cleft palate occur in about 25% of cases. Many of these congenital anomalies appear to be genetically determined though the majority are of unknown causes or teratogenic influences. Presented here is a 3 day old infant with bilateral cleft lip and palate and phocomelia for whom a feeding obturator was made and delivered to facilitate feeding.

  13. Spontaneous intracranial hemorrhage and multiple intracranial aneurysms in a patient with Roberts/SC phocomelia syndrome.

    PubMed

    Wang, Anthony C; Gemmete, Joseph J; Keegan, Catherine E; Witt, Cordelie E; Muraszko, Karin M; Than, Khoi D; Maher, Cormac O

    2011-11-01

    Roberts/SC phocomelia syndrome (RBS) is a rare but distinct genetic disorder with an autosomal recessive inheritance pattern. It has been associated with microcephaly, craniofacial malformation, cavernous hemangioma, encephalocele, and hydrocephalus. There are no previously reported cases of RBS with intracranial aneurysms. The authors report on a patient with a history of RBS who presented with a spontaneous posterior fossa hemorrhage. Multiple small intracranial aneurysms were noted on a preoperative CT angiogram. The patient underwent emergency craniotomy for evacuation of the hemorrhage. A postoperative angiogram confirmed the presence of multiple, distal small intracranial aneurysms.

  14. Cellular anomalies underlying retinoid-induced phocomelia.

    PubMed

    Zhou, Jian; Kochhar, Devendra M

    2004-11-01

    The question of how alterations in cell behavior produced by retinoic acid (RA) influenced the development of skeletogenic mesenchyme of the limb bud was examined in this study. Our established model was employed, which involves treatment of pregnant mice with a teratogenic dose of RA (100 mg/kg) on 11 days postcoitum (dpc) resulting in a severe truncation of all long bones of the forelimbs in virtually every exposed fetus. It is shown that RA, administered at a stage to induce phocomelia in virtually all exposed embryos, resulted in immediate appearance of enhanced cell death within the mesenchyme in the central core of the limb bud, an area destined for chondrogenesis. The central core mesenchyme, which in the untreated limb buds experiences a sharp decline in cell proliferation heralding the onset of chondrogenesis, demonstrated a reversal of the process; this mesenchyme maintained a higher rate of cell proliferation upon RA exposure. These events resulted in a truncation and disorganization of the chondrogenic anlage, more pronounced in zeugopodal mesenchyme than in the autopod. We conclude that an inhibition of chondrogenesis was secondary to a disruption in cellular behavior caused by RA, a likely consequence of misregulation in the growth factor signaling cascade.

  15. Symmetrical upper limb peromelia and lower limb phocomelia associated with a de novo apparently balanced reciprocal translocation: 46,XX,t(2; 12)(p25.1;q24.1).

    PubMed

    Murray, R S; Keeling, J W; Ellis, P M; FitzPatrick, D R

    2002-04-01

    We report a female fetus of 20 weeks gestation with severe symmetrical deformity affecting all four limbs. These deformities were unusual in that there was upper limb peromelia and lower limb phocomelia. No additional major malformations were identified on postmortem examination. In particular there was no evidence of splenogonadal fusion or micrognathia and hypoglossia. The limb malformations in this case are associated with a de novo apparently balanced reciprocal translocation 46,XX,t(2;12)(p25.1;q24.1). The cytogenetic features of Roberts-SC phocomelia syndrome were not detected. Unfortunately, the fibroblast line died and no FISH or DNA analysis could be carried out. In spite of this, the case is presented as it may be useful to other researchers in the selection of candidate genes for mendelian forms of peromelia and phocomelia.

  16. Inactivating mutations in ESCO2 cause SC phocomelia and Roberts syndrome: no phenotype-genotype correlation.

    PubMed

    Schüle, Birgitt; Oviedo, Angelica; Johnston, Kathreen; Pai, Shashidhar; Francke, Uta

    2005-12-01

    The rare, autosomal recessive Roberts syndrome (RBS) is characterized by tetraphocomelia, profound growth deficiency of prenatal onset, craniofacial anomalies, microcephaly, and mental deficiency. SC phocomelia (SC) has a milder phenotype, with a lesser degree of limb reduction and with survival to adulthood. Since heterochromatin repulsion (HR) is characteristic for both disorders and is not complemented in somatic-cell hybrids, it has been hypothesized that the disorders are allelic. Recently, mutations in ESCO2 (establishment of cohesion 1 homolog 2) on 8p21.1 have been reported in RBS. To determine whether ESCO2 mutations are also responsible for SC, we studied three families with SC and two families in which variable degrees of limb and craniofacial abnormalities, detected by fetal ultrasound, led to pregnancy terminations. All cases were positive for HR. We identified seven novel mutations in exons 3-8 of ESCO2. In two families, affected individuals were homozygous--for a 5-nucleotide deletion in one family and a splice-site mutation in the other. In three nonconsanguineous families, probands were compound heterozygous for a single-nucleotide insertion or deletion, a nonsense mutation, or a splice-site mutation. Abnormal splice products were characterized at the RNA level. Since only protein-truncating mutations were identified, regardless of clinical severity, we conclude that genotype does not predict phenotype. Having established that RBS and SC are caused by mutations in the same gene, we delineated the clinical phenotype of the tetraphocomelia spectrum that is associated with HR and ESCO2 mutations and differentiated it from other types of phocomelia that are negative for HR.

  17. Inactivating Mutations in ESCO2 Cause SC Phocomelia and Roberts Syndrome: No Phenotype-Genotype Correlation

    PubMed Central

    Schüle, Birgitt; Oviedo, Angelica; Johnston, Kathreen; Pai, Shashidhar; Francke, Uta

    2005-01-01

    The rare, autosomal recessive Roberts syndrome (RBS) is characterized by tetraphocomelia, profound growth deficiency of prenatal onset, craniofacial anomalies, microcephaly, and mental deficiency. SC phocomelia (SC) has a milder phenotype, with a lesser degree of limb reduction and with survival to adulthood. Since heterochromatin repulsion (HR) is characteristic for both disorders and is not complemented in somatic-cell hybrids, it has been hypothesized that the disorders are allelic. Recently, mutations in ESCO2 (establishment of cohesion 1 homolog 2) on 8p21.1 have been reported in RBS. To determine whether ESCO2 mutations are also responsible for SC, we studied three families with SC and two families in which variable degrees of limb and craniofacial abnormalities, detected by fetal ultrasound, led to pregnancy terminations. All cases were positive for HR. We identified seven novel mutations in exons 3–8 of ESCO2. In two families, affected individuals were homozygous—for a 5-nucleotide deletion in one family and a splice-site mutation in the other. In three nonconsanguineous families, probands were compound heterozygous for a single-nucleotide insertion or deletion, a nonsense mutation, or a splice-site mutation. Abnormal splice products were characterized at the RNA level. Since only protein-truncating mutations were identified, regardless of clinical severity, we conclude that genotype does not predict phenotype. Having established that RBS and SC are caused by mutations in the same gene, we delineated the clinical phenotype of the tetraphocomelia spectrum that is associated with HR and ESCO2 mutations and differentiated it from other types of phocomelia that are negative for HR. PMID:16380922

  18. Establishment and characterization of Roberts syndrome and SC phocomelia model medaka (Oryzias latipes).

    PubMed

    Morita, Akihiro; Nakahira, Kumiko; Hasegawa, Taeko; Uchida, Kaoru; Taniguchi, Yoshihito; Takeda, Shunichi; Toyoda, Atsushi; Sakaki, Yoshiyuki; Shimada, Atsuko; Takeda, Hiroyuki; Yanagihara, Itaru

    2012-06-01

    Roberts syndrome and SC phocomelia (RBS/SC) are genetic autosomal recessive syndromes caused by establishment of cohesion 1 homolog 2 ( ESCO 2) mutation. RBS/SC appear to have a variety of clinical features, even with the same mutation of the ESCO2 gene. Here, we established and genetically characterized a medaka model of RBS/SC by reverse genetics. The RBS/SC model was screened from a mutant medaka library produced by the Targeting Induced Local Lesions in Genomes method. The medaka mutant carrying the homozygous mutation at R80S in the conserved region of ESCO2 exhibited clinical variety (i.e. developmental arrest with craniofacial and chromosomal abnormalities and embryonic lethality) as characterized in RBS/SC. Moreover, widespread apoptosis and downregulation of some gene expression, including notch1a, were detected in the R80S mutant. The R80S mutant is the animal model for RBS/SC and a valuable resource that provides the opportunity to extend knowledge of ESCO2. Downregulation of some gene expression in the R80S mutant is an important clue explaining non-correlation between genotype and phenotype in RBS/SC. © 2012 The Authors Development, Growth & Differentiation © 2012 Japanese Society of Developmental Biologists.

  19. Real-time measurement of blood pressure with Nexfin in a patient with thalidomide-related phocomelia.

    PubMed

    Earle, Rosie; Vaghadia, Himat; Shanahan, Enda; Tang, Raymond; Sawka, Andrew

    2016-11-01

    We report the novel application of photoplethysmographic technology with the Nexfin HD monitor for real-time measurement of blood pressure (BP) in a patient with tetraamelia. The patient was a 58-year-old man with tetraamelia secondary to thalidomide exposure in utero, who presented for surgical excision of a maxillary schwannoma. Because difficulty of cuff use on rudimentary limbs and failure to gain invasive arterial access due to abnormalities of limb vasculature, this population is known to pose some unique challenges for BP measurement. Nexfin may offer an alternative noninvasive method to detect BP in patients with phocomelia during the perioperative period. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Mutations in WNT7A cause a range of limb malformations, including Fuhrmann syndrome and Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome.

    PubMed

    Woods, C G; Stricker, S; Seemann, P; Stern, R; Cox, J; Sherridan, E; Roberts, E; Springell, K; Scott, S; Karbani, G; Sharif, S M; Toomes, C; Bond, J; Kumar, D; Al-Gazali, L; Mundlos, S

    2006-08-01

    Fuhrmann syndrome and the Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome are considered to be distinct limb-malformation disorders characterized by various degrees of limb aplasia/hypoplasia and joint dysplasia in humans. In families with these syndromes, we found homozygous missense mutations in the dorsoventral-patterning gene WNT7A and confirmed their functional significance in retroviral-mediated transfection of chicken mesenchyme cell cultures and developing limbs. The results suggest that a partial loss of WNT7A function causes Fuhrmann syndrome (and a phenotype similar to mouse Wnt7a knockout), whereas the more-severe limb truncation phenotypes observed in Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome result from null mutations (and cause a phenotype similar to mouse Shh knockout). These findings illustrate the specific and conserved importance of WNT7A in multiple aspects of vertebrate limb development.

  1. Mutations in WNT7A Cause a Range of Limb Malformations, Including Fuhrmann Syndrome and Al-Awadi/Raas-Rothschild/Schinzel Phocomelia Syndrome

    PubMed Central

    Woods, C. G.; Stricker, S.; Seemann, P.; Stern, R.; Cox, J.; Sherridan, E.; Roberts, E.; Springell, K.; Scott, S.; Karbani, G.; Sharif, S. M.; Toomes, C.; Bond, J.; Kumar, D.; Al-Gazali, L.; Mundlos, S.

    2006-01-01

    Fuhrmann syndrome and the Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome are considered to be distinct limb-malformation disorders characterized by various degrees of limb aplasia/hypoplasia and joint dysplasia in humans. In families with these syndromes, we found homozygous missense mutations in the dorsoventral-patterning gene WNT7A and confirmed their functional significance in retroviral-mediated transfection of chicken mesenchyme cell cultures and developing limbs. The results suggest that a partial loss of WNT7A function causes Fuhrmann syndrome (and a phenotype similar to mouse Wnt7a knockout), whereas the more-severe limb truncation phenotypes observed in Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome result from null mutations (and cause a phenotype similar to mouse Shh knockout). These findings illustrate the specific and conserved importance of WNT7A in multiple aspects of vertebrate limb development. PMID:16826533

  2. Chromatid repulsion associated with Roberts/SC phocomelia syndrome is reduced in malignant cells and not expressed in interspecies somatic-cell hybrids.

    PubMed Central

    Krassikoff, N E; Cowan, J M; Parry, D M; Francke, U

    1986-01-01

    Different cell types from a female patient with Roberts/SC phocomelia syndrome were evaluated quantitatively for the presence of repulsion of heterochromatin and satellite regions of mitotic chromosomes. Whereas EBV-transformed lymphoblasts from an established cell line revealed these phenomena at frequencies equal to those in PHA-stimulated lymphocytes and cultured skin fibroblasts, aneuploid cells from a metastatic melanoma displayed them at 50% lower frequency. Cocultivation of the patient's fibroblasts with either an immortal Chinese hamster cell line or with a human male fibroblast strain carrying a t(4;6)(p14;q21) translocation showed that the phenomenon was not corrected or induced by a diffusible factor or by cell-to-cell contact. In each experiment, only the patient's metaphase spreads revealed chromatid repulsion. In fusion hybrids between the patient's fibroblasts and an established Chinese hamster cell line, the human chromosomes behaved perfectly normally, suggesting that the gene product which is missing or mutant in Roberts/SC phocomelia syndrome is supplied by the Chinese hamster genome. Images Fig. 1 Fig. 2 Fig. 3 PMID:3788975

  3. A novel homozygous Arg222Trp missense mutation in WNT7A in two sisters with severe Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndrome.

    PubMed

    Kantaputra, Piranit N; Mundlos, Stefan; Sripathomsawat, Warissara

    2010-11-01

    Al-Awadi/Raas-Rothschild/Schinzel phocomelia (AARRS) syndrome, a rare autosomal recessive disorder, comprises malformations of upper and lower limbs with severely hypoplastic pelvis and abnormal genitalia. Mutations in WNT7A have been reported as cause of the syndrome. We report on two sisters in a Thai family with short and malformed long bones, absent fibulae, flexion contracture of digits, and a/hypoplastic nails. Fusion between severely malformed femora and slender tibiae has never been reported in patients with WNT7A mutations. Lower limbs were more severely malformed than the upper ones and the pelvis was also severely affected. Multiple fusions of long bones and of the femoral heads to the acetabula were evident. A novel homozygous missense mutation in coding exon 4 of the WNT7A was detected in both affected daughters (c.664C > T) leading to an amino acid exchange from arginine to tryptophan (p.Arg222Trp; R222W). The phenotype is likely to result from an abnormality of all three signaling centers in the developing limb resulting in ventralization with a loss of dorsal structures (aplasia/hypoplasia of nails) a loss of anterior-posterior identity (single distal bones in lower limb without polarity) and an outgrowth defect resulting in distal truncations. © 2010 Wiley-Liss, Inc.

  4. Intrapartum diagnostic of Roberts syndrome - case presentation.

    PubMed

    Socolov, Răzvan Vladimir; Andreescu, Nicoleta Ioana; Haliciu, Ana Maria; Gorduza, Eusebiu Vlad; Dumitrache, Florentin; Balan, Raluca Anca; Puiu, Maria; Dobrescu, Mihaela Amelia; Socolov, Demetra Gabriela

    2015-01-01

    Roberts syndrome is a rare disease, with multiple limb and skeletal abnormalities (called "pseudothalidomide disease"). There are only around 150 cases described in literature. We present a case of Roberts syndrome, diagnosed in moment of delivery, after a pregnancy without prenatal follow-up. The stillborn baby was naturally delivered by a 17-year-old primiparous woman at 38 weeks of amenorrhea. The pregnancy was not followed due to socioeconomic and family situation, and no prenatal ultrasound was performed. The male baby has 2650 g and presented several morphological abnormalities and tight double umbilical abdominal loop. The macroscopic evaluation showed: dolichocephaly, hypoplastic inferior maxilla with micrognathia, antimongoloid palpebral slant, pterygium colli, abnormal and lower implanted ears, superior limbs phocomelia, syndactyly at lower left limb and tetradactyly in all limbs, bilateral cryptorchidism, pancreatic aplasia. Roberts syndrome is a rare genetic disease with recessive autosomal transmission generated by mutations in ESCO2 gene, located on chromosome 8. The disease should be easy to diagnose by antenatal ultrasound examination, but in our case, the lack of prenatal follow-up determined the diagnostic at term. We believe consider this case is an argument towards introducing ultrasound-screening compulsory to all pregnancies. To identify a possible genetic mutation, further investigations of the parents are in progress, but classically the disease has a recessive autosomal transmission.

  5. Facebook Advertising Across an Engagement Spectrum: A Case Example for Public Health Communication.

    PubMed

    Platt, Tevah; Platt, Jodyn; Thiel, Daniel B; Kardia, Sharon L R

    2016-05-30

    The interpersonal, dialogic features of social networking sites have untapped potential for public health communication. We ran a Facebook advertising campaign to raise statewide awareness of Michigan's newborn screening and biobanking programs. We ran a Facebook advertising campaign to stimulate public engagement on the complex and sensitive issue of Michigan's newborn screening and biobank programs. We ran an 11-week, US $15,000 Facebook advertising campaign engaging Michigan Facebook users aged 18-64 years about the state's newborn screening and population biobank programs, and we used a novel "engagement spectrum" framework to contextualize and evaluate engagement outcomes ranging from observation to multi-way conversation. The campaign reached 1.88 million Facebook users, yielding a range of engagement outcomes across ad sets that varied by objective, content, budget, duration, and bid type. Ad sets yielded 9009 page likes (US $4125), 15,958 website clicks (US $5578), and 12,909 complete video views to 100% (US $3750). "Boosted posts" yielded 528 comments and 35,966 page post engagements (US $1500). Overall, the campaign led to 452 shares and 642 comments, including 176 discussing newborn screening and biobanking. Facebook advertising campaigns can efficiently reach large populations and achieve a range of engagement outcomes by diversifying ad types, bid types, and content. This campaign provided a population-based approach to communication that also increased transparency on a sensitive and complex topic by creating a forum for multi-way interaction.

  6. Facebook Advertising Across an Engagement Spectrum: A Case Example for Public Health Communication

    PubMed Central

    Platt, Jodyn; Thiel, Daniel B; Kardia, Sharon L. R

    2016-01-01

    Background The interpersonal, dialogic features of social networking sites have untapped potential for public health communication. We ran a Facebook advertising campaign to raise statewide awareness of Michigan’s newborn screening and biobanking programs. Objective We ran a Facebook advertising campaign to stimulate public engagement on the complex and sensitive issue of Michigan’s newborn screening and biobank programs. Methods We ran an 11-week, US $15,000 Facebook advertising campaign engaging Michigan Facebook users aged 18-64 years about the state’s newborn screening and population biobank programs, and we used a novel “engagement spectrum” framework to contextualize and evaluate engagement outcomes ranging from observation to multi-way conversation. Results The campaign reached 1.88 million Facebook users, yielding a range of engagement outcomes across ad sets that varied by objective, content, budget, duration, and bid type. Ad sets yielded 9009 page likes (US $4125), 15,958 website clicks (US $5578), and 12,909 complete video views to 100% (US $3750). “Boosted posts” yielded 528 comments and 35,966 page post engagements (US $1500). Overall, the campaign led to 452 shares and 642 comments, including 176 discussing newborn screening and biobanking. Conclusions Facebook advertising campaigns can efficiently reach large populations and achieve a range of engagement outcomes by diversifying ad types, bid types, and content. This campaign provided a population-based approach to communication that also increased transparency on a sensitive and complex topic by creating a forum for multi-way interaction. PMID:27244774

  7. The TRAP (twin reversed arterial perfusion) sequence - case presentation.

    PubMed

    Mărginean, Claudiu; Mărginean, Maria Oana; Mureşan, Daniel; Zahiu, LuminiŢa; Horváth, Emőke

    2016-01-01

    We present a particular case of TRAP (twin reversed arterial perfusion) syndrome, which has a very rarely association of the simultaneous existence of a rudimentary malformed heart and brain, and also other malformations like abdominal wall abnormality, absent bladder with present kidneys, and absence of the lungs, which appear only in a few cases on the receptor twin from this sequence, malformations incompatible with life. A Caucasian 26-year-old pregnant woman, at the first pregnancy, with a monochorionic-diamniotic pregnancy, 26 weeks of gestation was referred to our hospital, for polyhydramnios. The patient delivered a living female newborn, weighing 950 g, with an Apgar score of 2 at one minute - the donor fetus and a second female newborn with multiple malformations, no signs of life and who weighed 2300 g - the receptor fetus. The anatomopathological examination confirmed the TRAP sequence associated with severe facial dysmorphism, bilateral phocomelia and cardiac malformations (rudimentary hypoplastic, univentricular) and a vascular anastomosis between the two umbilical cords. Anemia and cardiac complications which can lead to cardiac failure, appear early during pregnancy and caused the death of the pumping twin. We emphasize that in our case of TRAP sequence, the ultrasound examination established the diagnosis of the syndrome with high accuracy. Therefore, we can conclude that the existence of a rudimentary heart and a vascular anastomosis between the two umbilical cords supports the apparition of TRAP sequence. The early diagnosis of this pathology, the observation of the pregnancy with the help of weekly ultrasounds and the intrauterine interventions can increase the survival chances of the donor fetus from the TRAP sequence.

  8. Adaptively synchronous scalable spread spectrum (A4S) data-hiding strategy for three-dimensional visualization

    NASA Astrophysics Data System (ADS)

    Hayat, Khizar; Puech, William; Gesquière, Gilles

    2010-04-01

    We propose an adaptively synchronous scalable spread spectrum (A4S) data-hiding strategy to integrate disparate data, needed for a typical 3-D visualization, into a single JPEG2000 format file. JPEG2000 encoding provides a standard format on one hand and the needed multiresolution for scalability on the other. The method has the potential of being imperceptible and robust at the same time. While the spread spectrum (SS) methods are known for the high robustness they offer, our data-hiding strategy is removable at the same time, which ensures highest possible visualization quality. The SS embedding of the discrete wavelet transform (DWT)-domain depth map is carried out in transform domain YCrCb components from the JPEG2000 coding stream just after the DWT stage. To maintain synchronization, the embedding is carried out while taking into account the correspondence of subbands. Since security is not the immediate concern, we are at liberty with the strength of embedding. This permits us to increase the robustness and bring the reversibility of our method. To estimate the maximum tolerable error in the depth map according to a given viewpoint, a human visual system (HVS)-based psychovisual analysis is also presented.

  9. Incidence of Traumatic Brain Injury Across the Full Disease Spectrum: A Population-Based Medical Record Review Study

    PubMed Central

    Leibson, Cynthia L.; Brown, Allen W.; Ransom, Jeanine E.; Diehl, Nancy N.; Perkins, Patricia K.; Mandrekar, Jay; Malec, James F.

    2012-01-01

    Background Extremely few objective estimates of traumatic brain injury incidence include all ages, both sexes, all injury mechanisms, and the full spectrum from very mild to fatal events. Methods We used unique Rochester Epidemiology Project medical records-linkage resources, including highly sensitive and specific diagnostic coding, to identify all Olmsted County, MN, residents with diagnoses suggestive of traumatic brain injury regardless of age, setting, insurance, or injury mechanism. Provider-linked medical records for a 16% random sample were reviewed for confirmation as definite, probable, possible (symptomatic), or no traumatic brain injury. We estimated incidence per 100,000 person-years for 1987–2000 and compared these record-review rates with rates obtained using Centers for Disease Control and Prevention (CDC) data-systems approach. For the latter, we identified all Olmsted County residents with any CDC-specified diagnosis codes recorded on hospital/emergency department administrative claims or death certificates 1987–2000. Results Of sampled individuals, 1257 met record-review criteria for incident traumatic brain injury; 56% were ages 16–64 years, 56% were male, 53% were symptomatic. Mechanism, sex, and diagnostic certainty differed by age. The incidence rate per 100,000 person-years was 558 (95% confidence interval = 528–590) versus 341 (331–350) using the CDC data system approach. The CDC approach captured only 40% of record-review cases. Seventy-four percent of missing cases presented to hospital/emergency department; none had CDC-specified codes assigned on hospital/emergency department administrative claims or death certificates; 66% were symptomatic. Conclusions Capture of symptomatic traumatic brain injuries requires a wider range of diagnosis codes, plus sampling strategies to avoid high rates of false-positive events. PMID:21968774

  10. The Case for CASES

    ERIC Educational Resources Information Center

    Powell, W. R.

    1978-01-01

    In this article the Community Annual Energy Storage System ( CASES), a "thermal utility" plan for heating and cooling communities by storing summer heat and winter cold for use in the opposite season, is described. (MDR)

  11. Fetal bilateral renal agenesis, phocomelia, and single umbilical artery associated with cocaine abuse in early pregnancy.

    PubMed

    Kashiwagi, Maki; Chaoui, Rabih; Stallmach, Thomas; Hürlimann, Sandra; Lauper, Urs; Hebisch, Gundula

    2003-11-01

    Maternal cocaine abuse in pregnancy is associated with complications such as intrauterine growth retardation, abruptio placentae, and preterm delivery. We report what is, to our knowledge, the first published observation of fetal bilateral renal agenesis associated with a vascular disruption syndrome comprising upper limb reduction defect and a single umbilical artery following maternal cocaine abuse in early pregnancy. This constellation in a fetus aborted at 18 weeks extends the spectrum of complications possibly associated with cocaine abuse in pregnancy. Copyright 2003 Wiley-Liss, Inc.

  12. Case management.

    PubMed

    Woodward, Judy; Rice, Eve

    2015-03-01

    Health care in the United States is changing rapidly under pressure from both political and professional stakeholders, and one area on the front line of required change is the discipline of case management. Historically, case management has worked to defragment the health care delivery system for clients and increase access to health care. Case management will have an expanded role resulting from Affordable Care Act initiatives to improve health care. This article includes definitions of case management, current issues related to case management, case management standards of practice, and a case study of the management of pediatric chronic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Case management: a case study.

    PubMed

    Stanton, M P; Walizer, E M; Graham, J I; Keppel, L

    2000-01-01

    This article describes the implementation of a pilot case management program at Walter Reed Army Medical Center. I, it we discuss obvious pitfalls and problems implementing case management in a large multiservice center and the steps and processes implemented to expedite and move case management forward in its early stages. The insights shared may be useful for those implementing case management in a complex medical center situation. Other models used in similar situations are also reviewed.

  14. Case Studies.

    ERIC Educational Resources Information Center

    Emerson, Allen; And Others

    1994-01-01

    Three cases of use of collaborative learning techniques in the college classroom are described: a developmental mathematics course, a graduate-level writing project, and college science instruction. Each case includes description of specific class activities and assignments, results, and teacher concerns and comments. (MSE)

  15. Making a Case for Cases.

    ERIC Educational Resources Information Center

    Richmond, Gail; Neureither, Barbara

    1998-01-01

    Summarizes the process of a reform effort in biology instruction. Describes the use of a case study about cholera epidemics and explains how it enables critical objectives in the science curriculum to be addressed. (DDR)

  16. The case for case reports.

    PubMed

    Bhattacharrya, Shamik; Miller, Julie; Ropper, Allan H

    2014-10-01

    Case reports have seemingly fallen upon hard times. Once esteemed by William Osler and C. Miller Fisher, these reports are now considered anachronistic. Nonetheless, case reports remain valuable and formed the largest proportion of publications written last year by residents in our training program (the Partners Neurology Residency). Although they are easy to produce, it is reasonable to ask if these modern exercises are of equal significance to the narratives of migraine by John Graham in the 1950s or descriptions of Parkinson disease by James Parkinson in 1817. Even a brief reading of currently published case reports raises doubts about the value of many of them but also emphasizes their utility. We argue here that the case report format remains of considerable merit, especially to the aspiring academic clinician. © 2014 American Neurological Association.

  17. Case Studies

    ERIC Educational Resources Information Center

    Ritter, Lois A., Ed.; Sue, Valerie M., Ed.

    2007-01-01

    This article presents two case studies using online surveys for evaluation. The authors begin with an example of a needs assessment survey designed to measure the amount of help new students at a university require in their first year. They then discuss the follow-up survey conducted by the same university to measure the effectiveness of the…

  18. [Variants of radial hemimelia with and without vitium cordis (Holt-Oram syndrome) in 2 families].

    PubMed

    Pfeiffer, R A; Böwing, B; Deeg, K H

    1989-05-01

    In two families radial hemimelia is inherited as a dominant trait. The first proposita suffered from bilateral radial aplasia, the 2nd propositus exhibited (pseudo)phocomelia. In this case the diagnosis was Holt-Oram-syndrome. The affected mothers showed unilateral hypoplasia of the thumb only. Cases like these ones are likely to be overlooked or misinterpreted. The recurrence risk is 50%. Similar observations are quoted. The cause of "variable expressivity" is unknown.

  19. Corruption case.

    PubMed

    1999-07-23

    A Federal jury in Puerto Rico found three defendants guilty of participating in the theft of $2.2 million in Federal funds from the San Juan AIDS Institute. The key figure in the case is [name removed], a consultant to the institute. He was convicted of 12 counts of money laundering and faces up to 25 years in prison. Two other administrative officials were also convicted in the case. Four others have pleaded guilty, and three more await trial. Rep. Jose Granados Navado was among those implicated; he received $100,000 for his campaign for mayor of San Juan in 1988 from the institute=s medical director. U.S. Rep. Tom Coburn (R-Okla.) has called for an audit of all Ryan White CARE Act funds since this scandal was uncovered.

  20. Case Report

    PubMed Central

    Naran, Sanjay; Imbriglia, Joseph E.

    2016-01-01

    Background: A case is discussed in which a young girl was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits at the age of four. At 39 years of age, she presented incidentally to our clinic and was observed to have a very functional hand with mobile metacarpophalangeal joints in all reconstructed digits. Methods: We present a case report which is discussed in the context of long-term follow-up, and phalangeal growth in the absence of distraction, and a review of the current literature in regards to outcomes for this modality of treatment. Results: We document growth of the transplanted phalanges, despite surgery occurring after the reported optimum age of before 18 months, and the patient not undergoing distraction. The patient reported no donor site morbidity in regards to function or psychosocial impact. Furthermore, we observed active function at the metacarpophalangeal joints of all operated digits. Conclusions: We report the longest follow-up (35 years) following nonvascularized proximal toe phalangeal transfer for short finger type symbrachydactyly. We highlight the long-term functional outcome of nonvascularized toe phalangeal transfers, and present an overview of the current outcome literature for this type of procedure, advocating that nonvascularized toe phalangeal transfers remain a viable treatment option for select cases of symbrachydactyly. PMID:28149225

  1. Congenital unilateral absence of the upper extremity may give rise to a specific kind of thoracolumbar curve.

    PubMed

    Olgun, Z Deniz; Demirkiran, Gokhan; Polly, David; Yazici, Muharrem

    2018-03-01

    There is an increased incidence of scoliosis in patients with congenital malformations of the upper extremity even in the absence of overt vertebral abnormalities. In this case series, we summarize the curve characteristics of four patients presenting to two spine surgery clinics with unilateral amelia or phocomelia and a progressive scoliotic curve with the apex on the side of deficiency. All patients required orthopedic intervention for their curves. Amelia and phocomelia are severe congenital malformations of the upper limb affecting trunk balance and, conceivably, causing scoliosis with the absence of counterbalancing weight on the affected side. The combination of upper limb absence and same-sided scoliosis in these patients may provide a clue of the mechanical factors causing scoliosis in other disorders. In this article, we attempt to define this exceptional deformity, theorize on its etiology, and draw attention to this particular combination of problems. Case series; Level IV.

  2. Case Master

    DTIC Science & Technology

    2009-04-01

    information on  user’s interests. In that case, the polarity takes the value of zero.  Positive polarity examples: Query, Question/Assertion, cut/paste,  chat ...Polarity Query (Keywords/Question/Assertion) 1  +1 cut/paste 0.9  +1 Selection from list 0.8  +1 Saving/printing 0.7  +1 Chat 0.6  +1 Reading doc/Web...3. logging all VIGEstimates (from UMS and IMS separately) and user  snap  shots as xml files for post‐process  analysis  As new InfoPacks come into the

  3. Case Series.

    PubMed

    Vetrayan, Jayachandran; Othman, Suhana; Victor Paulraj, Smily Jesu Priya

    2017-01-01

    To assess the effectiveness and feasibility of behavioral sleep intervention for medicated children with ADHD. Six medicated children (five boys, one girl; aged 6-12 years) with ADHD participated in a 4-week sleep intervention program. The main behavioral strategies used were Faded Bedtime With Response Cost (FBRC) and positive reinforcement. Within a case-series design, objective measure (Sleep Disturbance Scale for Children [SDSC]) and subjective measure (sleep diaries) were used to record changes in children's sleep. For all six children, significant decrease was found in the severity of children's sleep problems (based on SDSC data). Bedtime resistance and mean sleep onset latency were reduced following the 4-week intervention program according to sleep diaries data. Gains were generally maintained at the follow-up. Parents perceived the intervention as being helpful. Based on the initial data, this intervention shows promise as an effective and feasible treatment.

  4. Case Study: Testing with Case Studies

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman

    2015-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

  5. Abnormal centromere-chromatid apposition (ACCA) and Peters' anomaly.

    PubMed

    Wertelecki, W; Dev, V G; Superneau, D W

    1985-08-01

    Abnormal centromere-chromatid apposition (ACCA) was noted in a patient with Peters' anomaly. Previous reports of ACCA emphasized its association with tetraphocomelia and other congenital malformations (Roberts, SC Phocomelia, Pseudothalidomide Syndromes). This report expands the array of congenital malformations associated with ACCA and emphasizes the diagnostic importance of ocular defects for the ascertainment of additional cases of ACCA and its possible relationship with abnormal cell division.

  6. CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

    EPA Science Inventory

    Case study critique: Upper Clinch case study (from Research on Methods for Integrating Ecological Economics and Ecological Risk Assessment: A Trade-off Weighted Index Approach to Integrating Economics and Ecological Risk Assessment). This critique answers the questions: 1) does ...

  7. Case Study: Writing a Journal Case Study

    ERIC Educational Resources Information Center

    Prud'homme-Genereux, Annie

    2016-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue describes incorporating a journal article into the classroom by first converting it into a case study.

  8. Case Resolution Manual

    EPA Pesticide Factsheets

    This Case Resolution Manual (CRM) is intended to provide procedural guidance to ECRCO case managers to ensure EPA’s prompt, effective, and efficient resolution of civil rights cases consistent with science and the civil rights laws.

  9. Case Study Teaching

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman

    2011-01-01

    This chapter describes the history of case study teaching, types of cases, and experimental data supporting their effectiveness. It also describes a model for comparing the efficacy of the various case study methods. (Contains 1 figure.)

  10. Case Studies Behavior Modification.

    ERIC Educational Resources Information Center

    Wark, David M.

    The case histories of five students enrolled in a university course in how to study are reported. The students ranged in age from 18 to 35, included two males and three females, and varied in school experience from no college in one case and some college in two cases to college degrees in two cases. Students were initially taught to chart their…

  11. [Bone hydatidosis. 12 cases].

    PubMed

    Jlidi, R; Yaakoubi, M T; Ladeb, M F; Ben Ayeche, M L; Ghannouchi, G; Moula, T

    1992-01-01

    The hydatic cyst is a parasitic disease caused by the development in man of the larval form of echinococcus granulosus. All parts of the body may be involved, but the liver and lungs are the main locations of the disease. The bone site is rare, accounting for 0.9 to 2% of all hydatic lesions. Between 1982 and 1988, we have compiled 12 cases of hydatic disease of bone. They were located in the skull (4 cases), the iliac bone (4 cases), the omoplate (1 case), the ribs (1 case), the femur (1 case) and the fibula (1 case). These lesions are generally considered as primary, but association with visceral locations was noted in 3 cases in our series.

  12. The State's Case

    ERIC Educational Resources Information Center

    Calhoun, John W.

    1972-01-01

    Author is Assistant Attorney General in Wisconsin and represented the state in the Wisconsin vs. Yoder case. Cites other cases and decisions handed down by the United States Supreme Court in relation to compulsory education. (RB)

  13. Mining with Rare Cases

    NASA Astrophysics Data System (ADS)

    Weiss, Gary M.

    Rare cases are often the most interesting cases. For example, in medical diagnosis one is typically interested in identifying relatively rare diseases, such as cancer, rather than more frequently occurring ones, such as the common cold. In this chapter we discuss the role of rare cases in Data Mining. Specific problems associated with mining rare cases are discussed, followed by a description of methods for addressing these problems.

  14. Case Selection via Matching

    ERIC Educational Resources Information Center

    Nielsen, Richard A.

    2016-01-01

    This article shows how statistical matching methods can be used to select "most similar" cases for qualitative analysis. I first offer a methodological justification for research designs based on selecting most similar cases. I then discuss the applicability of existing matching methods to the task of selecting most similar cases and…

  15. Case Report: Protothecal Tenosynovitis

    PubMed Central

    Lee, Jin Seo; Moon, Goo Hyun; Lee, Nam Yong

    2008-01-01

    Protothecosis is a rare infection caused by achlorophyllic algae called Prototheca. Approximately 117 cases have been described in the literature world wide, the majority caused by the species P. wickerhamii. Cutaneous infection is the most common and cases of tenosynovitis are very rare. A local or systemic immunosuppressive factor is seen in half of the cases of protothecosis. We report a case of protothecal tenosynovitis in a middle-aged, immunocompetent woman that developed after she received sclerosing therapy of varicose veins. Administration of itraconazole with surgical débridement produced a good response. We also review the published cases of protothecal tenosynovitis. PMID:18791778

  16. Case report: protothecal tenosynovitis.

    PubMed

    Lee, Jin Seo; Moon, Goo Hyun; Lee, Nam Yong; Peck, Kyong Ran

    2008-12-01

    Protothecosis is a rare infection caused by achlorophyllic algae called Prototheca. Approximately 117 cases have been described in the literature world wide, the majority caused by the species P. wickerhamii. Cutaneous infection is the most common and cases of tenosynovitis are very rare. A local or systemic immunosuppressive factor is seen in half of the cases of protothecosis. We report a case of protothecal tenosynovitis in a middle-aged, immunocompetent woman that developed after she received sclerosing therapy of varicose veins. Administration of itraconazole with surgical débridement produced a good response. We also review the published cases of protothecal tenosynovitis.

  17. A C9orf72 promoter repeat expansion in a Flanders-Belgian cohort with disorders of the frontotemporal lobar degeneration-amyotrophic lateral sclerosis spectrum: a gene identification study.

    PubMed

    Gijselinck, Ilse; Van Langenhove, Tim; van der Zee, Julie; Sleegers, Kristel; Philtjens, Stéphanie; Kleinberger, Gernot; Janssens, Jonathan; Bettens, Karolien; Van Cauwenberghe, Caroline; Pereson, Sandra; Engelborghs, Sebastiaan; Sieben, Anne; De Jonghe, Peter; Vandenberghe, Rik; Santens, Patrick; De Bleecker, Jan; Maes, Githa; Bäumer, Veerle; Dillen, Lubina; Joris, Geert; Cuijt, Ivy; Corsmit, Ellen; Elinck, Ellen; Van Dongen, Jasper; Vermeulen, Steven; Van den Broeck, Marleen; Vaerenberg, Carolien; Mattheijssens, Maria; Peeters, Karin; Robberecht, Wim; Cras, Patrick; Martin, Jean-Jacques; De Deyn, Peter P; Cruts, Marc; Van Broeckhoven, Christine

    2012-01-01

    Amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD) are extremes of a clinically, pathologically, and genetically overlapping disease spectrum. A locus on chromosome 9p21 has been associated with both disorders, and we aimed to identify the causal gene within this region. We studied 305 patients with FTLD, 137 with ALS, and 23 with concomitant FTLD and ALS (FTLD-ALS) and 856 controls from Flanders (Belgium); patients were identified from a hospital-based cohort and were negative for mutations in known FTLD and ALS genes. We also examined the family of one patient with FTLD-ALS previously linked to 9p21 (family DR14). We analysed 130 kbp at 9p21 in association and segregation studies, genomic sequencing, repeat genotyping, and expression studies to identify the causal mutation. We compared genotype-phenotype correlations between mutation carriers and non-carriers. In the patient-control cohort, the single-nucleotide polymorphism rs28140707 within the 130 kbp region of 9p21 was associated with disease (odds ratio [OR] 2·6, 95% CI 1·5-4·7; p=0·001). A GGGGCC repeat expansion in C9orf72 completely co-segregated with disease in family DR14. The association of rs28140707 with disease in the patient-control cohort was abolished when we excluded GGGGCC repeat expansion carriers. In patients with familial disease, six (86%) of seven with FTLD-ALS, seven (47%) of 15 with ALS, and 12 (16%) of 75 with FTLD had the repeat expansion. In patients without known familial disease, one (6%) of 16 with FTLD-ALS, six (5%) of 122 with ALS, and nine (4%) of 230 with FTLD had the repeat expansion. Mutation carriers primarily presented with classic ALS (10 of 11 individuals) or behavioural variant FTLD (14 of 15 individuals). Mean age at onset of FTLD was 55·3 years (SD 8·4) in 21 mutation carriers and 63·2 years (9·6) in 284 non-carriers (p=0·001); mean age at onset of ALS was 54·5 years (9·9) in 13 carriers and 60·4 years (11·4) in 124 non

  18. Teaching Case: Enterprise Architecture Specification Case Study

    ERIC Educational Resources Information Center

    Steenkamp, Annette Lerine; Alawdah, Amal; Almasri, Osama; Gai, Keke; Khattab, Nidal; Swaby, Carval; Abaas, Ramy

    2013-01-01

    A graduate course in enterprise architecture had a team project component in which a real-world business case, provided by an industry sponsor, formed the basis of the project charter and the architecture statement of work. The paper aims to share the team project experience on developing the architecture specifications based on the business case…

  19. Building the Business Case

    DTIC Science & Technology

    2001-05-15

    Building the Business Case Dr Robin Miller Centre for Defence Analysis Report Documentation Page Report Date 15052001 Report Type N/A Dates Covered...from... to) - Title and Subtitle Building the Business Case Contract Number Grant Number Program Element Number Author(s) Miller, Robin...Trade-offs between men/materiel/process can be made coherent – auditable links to operational risk can be maintained Business Case Challenge for SBA

  20. [Costal chondrosarcoma. 4 cases].

    PubMed

    Ben M'rad, S; el Hammami, S; Merai, S; Kamoun, N; Horchani, H; Ben Miled, K; Kilani, T; Djenayah, F

    1999-09-04

    Tumors of the rib cage are uncommon and malignant in 29% of the cases. Chondrosarcoma predominates, accounting for 40% of all cases of malignant costal tumors. Four patients (3 women, 1 man, mean age 28.2 years) were hospitalized for costal chondrosarcoma. Pain and tumefaction dominated the clinical presentation. Calcifications suggested the diagnosis in 3 cases. Curative surgery was performed in all cases. Postoperative radiotherapy was unable to improve prognosis in 2 patients. Chondrosarcoma of the ribs is characterized by a strong potential for invasive extension. Diagnosis is suspected on the basis of imaging findings and confirmed at pathology. Surgery is required. Chemotherapy and radiotherapy do not improve prognosis significantly.

  1. Hierarchical Safety Cases

    NASA Technical Reports Server (NTRS)

    Denney, Ewen W.; Whiteside, Iain J.

    2012-01-01

    We introduce hierarchical safety cases (or hicases) as a technique to overcome some of the difficulties that arise creating and maintaining industrial-size safety cases. Our approach extends the existing Goal Structuring Notation with abstraction structures, which allow the safety case to be viewed at different levels of detail. We motivate hicases and give a mathematical account of them as well as an intuition, relating them to other related concepts. We give a second definition which corresponds closely to our implementation of hicases in the AdvoCATE Assurance Case Editor and prove the correspondence between the two. Finally, we suggest areas of future enhancement, both theoretically and practically.

  2. [Case and studies].

    PubMed

    Schubert, András

    2015-11-15

    Case studies and case reports form an important and ever growing part of scientific and scholarly literature. The paper deals with the share and citation rate of these publication types on different fields of research. In general, evidence seems to support the opinion that an excessive number of such publications may negatively influence the impact factor of the journal. In the literature of scientometrics, case studies (at least the presence of the term "case study" in the titles of the papers) have a moderate share, but their citation rate is practically equal to that of other publication types.

  3. Work Sharing Case Studies.

    ERIC Educational Resources Information Center

    McCarthy, Maureen E.; And Others

    Designed to provide private sector employers with the practical information necessary to select and then to design and implement work sharing arrangements, this book presents case studies of some 36 work sharing programs. Topics covered in the case studies include the circumstances leading to adoption of the program, details of compensation and…

  4. "Tuberculosis Case Management" Training.

    ERIC Educational Resources Information Center

    Knebel, Elisa; Kolodner, Jennifer

    2001-01-01

    The need to isolated health providers with critical knowledge in tuberculosis (TB) case management prompted the development of "Tuberculosis Case Management" CD-ROM. Features include "Learning Center,""Examination Room," and "Library." The combination of audio, video, and graphics allows participants to…

  5. SETDA Case Studies 2012

    ERIC Educational Resources Information Center

    State Educational Technology Directors Association, 2012

    2012-01-01

    The State Educational Technology Directors Association (SETDA) published a series of case studies from 28 states to showcase examples of how ARRA EETT ("American Recovery and Reinvestment Act of 2009 Enhancing Education Through Technology") grant funds have impacted teaching and learning. SETDA collected data for the case studies through…

  6. HYDROGEOLOGIC CASE STUDIES

    EPA Science Inventory

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  7. Moral case deliberation.

    PubMed

    Tan, Daniel Y B; Ter Meulen, Bastiaan C; Molewijk, Albert; Widdershoven, Guy

    2018-06-01

    Ethical dilemmas in general are characterised by a choice between two mutually excluding options neither of which is satisfactory, because there always will be a form of moral damage. Within the context of medicine several ethics support services have been developed to support healthcare professionals in dealing with ethical dilemmas, including moral case deliberation. In this article, we describe how moral case deliberation works in daily practice, illustrated with a case example from the neurology ward. The article is meant as an introduction to moral case deliberation according to the dilemma method. We show its relevance to the clinic and the context needed to put it into practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Septic Systems Case Studies

    EPA Pesticide Factsheets

    A collection of septic systems case studies to help community planners, elected officials, health department staff, state officials, and interested citizens explore alternatives for managing their decentralized wastewater treatment systems.

  9. MULTIPLE CONTAMINANTS CASE STUDIES

    EPA Science Inventory

    The presentation provides information taken from the arsenic demonstration program projects that have treatment systems removing multiply contaminants from drinking water. The case studies sited in the presentation consist of projects that have arsenic along with either nitrate, ...

  10. 511 case studies : Kentucky

    DOT National Transportation Integrated Search

    2000-11-01

    This document is the first of five case studies planned on the implementation of statewide 511 transportation information abbreviated telephone dialing codes. It provides a current snapshot of the progress being made in Kentucky

  11. CASE Recognition Awards.

    ERIC Educational Resources Information Center

    Currents, 1985

    1985-01-01

    A total of 294 schools, colleges, and universities received prizes in this year's CASE Recognition program. Awards were given in: public relations programs, student recruitment, marketing, program pulications, news writing, fund raising, radio programming, school periodicals, etc. (MLW)

  12. 511 Case Studies : Arizona

    DOT National Transportation Integrated Search

    2001-01-01

    This document is one of five case studies planned on the implementation of statewide 511 transportation information abbreviated telephone dialing codes. It provides a current snapshot of the progress being made in Arizona.

  13. Autoerotic deaths: four cases.

    PubMed

    Cooke, C T; Cadden, G A; Margolius, K A

    1994-07-01

    We describe the circumstances and post mortem medical findings of 4 unusual fatalities where death occurred during autoerotic practice. Three cases occurred in young to middle-aged men--hanging, electrocution and inhalation of a zucchini. The manner of death in each was accidental. The fourth case was an elderly man who died of ischemic heart disease, apparently whilst masturbating with a vacuum cleaner and a hair dryer.

  14. Qualitative Case Study Guidelines

    DTIC Science & Technology

    2013-11-01

    Introduction to Sociological Methods. 2nd ed. New York, McGraw-Hill 14. Denzin , N. K. and Lincoln , Y. S. (2011) The SAGE Handbook of Qualitative...The Art of Science. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage 19. GAO (1990) Case Study...Rinehart & Winston 39. Stake, R. E. (1994) Case Studies. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage

  15. Case Management Directors

    PubMed Central

    Bankston White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. This is Part 2 of a two-part article written for case management directors, particularly new ones. Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes. This article attempts to answer the following questions: Are case management directors prepared for an expanded role that affects departments and organizations outside of their own?How does a case management director manage the transition of care of patients while managing required relationships outside the department?How does the director manage program outcomes in such a complex department? Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Findings/Conclusions: Part 1 found that case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations

  16. Case Management Directors

    PubMed Central

    Bankston-White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care for patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. The purpose of this two-part article is to provide case management directors, particularly new ones, with a framework for understanding and fulfilling their role. We have divided the guide into seven tracks of responsibility. Part 1 discusses the first four tracks: (1) staffing and human resources, (2) compliance and accreditation, (3) discharge planning, and (4) utilization review and revenue cycle. Part 2 addresses (5) internal departmental relationships (organizational), (6) external relationships (Community agency), and (7) quality and program outcomes. Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems, and have frontline case managers reporting to them. Findings/Conclusions: Case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. New directors would benefit from mentoring and networking with one another. Implications for Case Management: As new regulations and models of care bring increased emphasis and focus to transitions of care, the role of the case management director continues to evolve, growing in importance and complexity. The growing financial impact of readmissions also brings added scrutiny and increased pressure to get the transitions of care right the first time. To operate most effectively, case management directors must understand the full range of their

  17. ASRM Case Insulation development

    NASA Technical Reports Server (NTRS)

    Tam, W. F. S.; Bell, M.

    1993-01-01

    The ASRM Case Insulation Program used design of experiments to develop a high performance case insulation. The program traded-off more than thirty properties in areas of ablation performance, material properties, processibility, bonding/aging. Kevlar pulp was found to be the most significant factor. The low-molecular weight ethylene propylene diene monomer, EPDM was the second most significant factor. The curative was the third most significant factor. The tackifier was the fourth most significant factor. The stripwinding process for applying the insulation onto the case inner surfaces was also studied. The parameters selected for experiment were extruder speed, upper roller temperature and extruder nozzle temperature. The extrudability results showed that non-Kevlar filled formulations displayed optimum edges but poor thickness continuity. High Kevlar filled formulations displayed optimum thickness continuity but poor strip edge ratings.

  18. ASRM Case Insulation development

    NASA Astrophysics Data System (ADS)

    Tam, W. F. S.; Bell, M.

    1993-06-01

    The ASRM Case Insulation Program used design of experiments to develop a high performance case insulation. The program traded-off more than thirty properties in areas of ablation performance, material properties, processibility, bonding/aging. Kevlar pulp was found to be the most significant factor. The low-molecular weight ethylene propylene diene monomer, EPDM was the second most significant factor. The curative was the third most significant factor. The tackifier was the fourth most significant factor. The stripwinding process for applying the insulation onto the case inner surfaces was also studied. The parameters selected for experiment were extruder speed, upper roller temperature and extruder nozzle temperature. The extrudability results showed that non-Kevlar filled formulations displayed optimum edges but poor thickness continuity. High Kevlar filled formulations displayed optimum thickness continuity but poor strip edge ratings.

  19. Uniform research case definition criteria differentiate tuberculous and bacterial meningitis in children.

    PubMed

    Solomons, Regan S; Wessels, Marie; Visser, Douwe H; Donald, Peter R; Marais, Ben J; Schoeman, Johan F; van Furth, Anne M

    2014-12-01

    Tuberculous meningitis (TBM) research is hampered by low numbers of microbiologically confirmed TBM cases and the fact that they may represent a select part of the disease spectrum. A uniform TBM research case definition was developed to address these limitations, but its ability to differentiate TBM from bacterial meningitis has not been evaluated. We assessed all children treated for TBM from 1985 to 2005 at Tygerberg Children's Hospital, Cape Town, South Africa. For comparative purposes, a group of children with culture-confirmed bacterial meningitis, diagnosed between 2003 and 2009, was identified from the National Health Laboratory Service database. The performance of the proposed case definition was evaluated in culture-confirmed TBM and bacterial meningitis cases. Of 554 children treated for TBM, 66 (11.9%) were classified as "definite TBM," 408 (73.6%) as "probable TBM," and 72 (13.0%) as "possible TBM." "Probable TBM" criteria identified culture-confirmed TBM with a sensitivity of 86% and specificity of 100%; sensitivity was increased but specificity reduced when using "possible TBM" criteria (sensitivity 100%, specificity 56%). "Probable TBM" criteria accurately differentiated TBM from bacterial meningitis and could be considered for use in clinical trials; reduced sensitivity in children with early TBM (stage 1 disease) remains a concern. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. Melorheostosis: Two atypical cases

    PubMed Central

    Sureka, Binit; Mittal, Mahesh Kumar; Udhaya, KK; Sinha, Mukul; Mittal, Aliza; Thukral, Brij Bhushan

    2014-01-01

    Melorheostosis is an uncommon mesenchymal dysplasia that rarely affects the axial skeleton. We describe two atypical cases of melorheostosis with classical imaging findings – the first one involving the cervico-dorsal spine with encroachment of left vertebral artery canal causing attenuation of the left vertebral artery and the second one of mixed sclerosing bony dysplasia (monomelic involvement coexisting with osteopoikilosis). PMID:25024532

  1. Melorheostosis: Two atypical cases.

    PubMed

    Sureka, Binit; Mittal, Mahesh Kumar; Udhaya, Kk; Sinha, Mukul; Mittal, Aliza; Thukral, Brij Bhushan

    2014-04-01

    Melorheostosis is an uncommon mesenchymal dysplasia that rarely affects the axial skeleton. We describe two atypical cases of melorheostosis with classical imaging findings - the first one involving the cervico-dorsal spine with encroachment of left vertebral artery canal causing attenuation of the left vertebral artery and the second one of mixed sclerosing bony dysplasia (monomelic involvement coexisting with osteopoikilosis).

  2. Morrie: A Case Study.

    ERIC Educational Resources Information Center

    Wheeler, Eugenie G.; Knight, Bob

    1981-01-01

    Presents a case study demonstrating successful behavioral treatment of a depressed older man using group and conjoint therapy. Two major issues in dealing with the aged are addressed: dealing with resistance to therapy, and distinguishing between disability due to organic brain syndrome and that due to depression. (Author/RC)

  3. Five Data Validation Cases

    ERIC Educational Resources Information Center

    Simkin, Mark G.

    2008-01-01

    Data-validation routines enable computer applications to test data to ensure their accuracy, completeness, and conformance to industry or proprietary standards. This paper presents five programming cases that require students to validate five different types of data: (1) simple user data entries, (2) UPC codes, (3) passwords, (4) ISBN numbers, and…

  4. Geothermal Case Studies

    DOE Data Explorer

    Young, Katherine

    2014-09-30

    database.) In fiscal year 2015, NREL is working with universities to populate additional case studies on OpenEI. The goal is to provide a large enough dataset to start conducting analyses of exploration programs to identify correlations between successful exploration plans for areas with similar geologic occurrence models.

  5. The Directed Case Method.

    ERIC Educational Resources Information Center

    Cliff, William H.; Curtin, Leslie Nesbitt

    2000-01-01

    Provides an example of a directed case on human anatomy and physiology. Uses brief real life newspaper articles and clinical descriptions of medical reference texts to describe an actual, fictitious, or composite event. Includes interrelated human anatomy and physiology topics in the scenario. (YDS)

  6. Querying Safety Cases

    NASA Technical Reports Server (NTRS)

    Denney, Ewen W.; Naylor, Dwight; Pai, Ganesh

    2014-01-01

    Querying a safety case to show how the various stakeholders' concerns about system safety are addressed has been put forth as one of the benefits of argument-based assurance (in a recent study by the Health Foundation, UK, which reviewed the use of safety cases in safety-critical industries). However, neither the literature nor current practice offer much guidance on querying mechanisms appropriate for, or available within, a safety case paradigm. This paper presents a preliminary approach that uses a formal basis for querying safety cases, specifically Goal Structuring Notation (GSN) argument structures. Our approach semantically enriches GSN arguments with domain-specific metadata that the query language leverages, along with its inherent structure, to produce views. We have implemented the approach in our toolset AdvoCATE, and illustrate it by application to a fragment of the safety argument for an Unmanned Aircraft System (UAS) being developed at NASA Ames. We also discuss the potential practical utility of our query mechanism within the context of the existing framework for UAS safety assurance.

  7. Nesidioblastosis: a case study.

    PubMed

    Starbuck, A L

    1997-09-01

    Hypoglycemia is a common problem among neonates. Transient in nature, it usually resolves with an increase in glucose intake. However, as clinicians, we must recognize that prolonged hypoglycemia may be caused by increased insulin production. Nesidioblastosis is one cause of persistent hyperinsulinism of the newborn. This case study reviews fetal physiology, neonatal presentation, and treatment.

  8. Introducing Students to Cases

    ERIC Educational Resources Information Center

    Brickman, Peggy; Glynn, Shawn; Graybeal, Geoffrey

    2008-01-01

    Strategically introducing students to a controversial science case--before they read it, watch it, or listen to it--motivates them to learn from it and paves the way for successful discussion and debate. A strategic introduction also provides an opportunity for the instructor to demonstrate scientific reasoning and share guidelines for the…

  9. [The stamina case].

    PubMed

    2013-01-01

    The Stamina method is proposed by the non-profit Stamina Foundation and envisages the conversion of mesenchymal stem cells, which normally generate bone, cartilage and adipose tissue, into neurons after brief exposure to ethanol and retinoic acid. The reactions of the scientific community and the implications of the case are briefly explored.

  10. Creating Caddisfly Cases

    ERIC Educational Resources Information Center

    Gates, Donna M.

    2005-01-01

    The larval stage of a northern casemaker caddisfly provides a creative hands-on activity for students while also introducing them to aquatic insect development and adaptations to stream life. This project is an opportunity to study the role of this invertebrate in the food web of a stream. Using cardboard tubes to fashion a case for a generic…

  11. An unexpected tetanus case.

    PubMed

    Ergonul, Onder; Egeli, Demet; Kahyaoglu, Bulent; Bahar, Mois; Etienne, Mill; Bleck, Thomas

    2016-06-01

    1 million cases of tetanus are estimated to occur worldwide each year, with more than 200 000 deaths. Tetanus is a life-threatening but preventable disease caused by a toxin produced by Clostridium tetani-a Gram-positive bacillus found in high concentrations in soil and animal excrement. Tetanus is almost completely preventable by active immunisation, but very rarely unexpected cases can occur in individuals who have been previously vaccinated. We report a case of generalised tetanus in a 22-year-old woman that arose despite the protective antitoxin antibody in her serum. The patient received all her vaccinations in the USA; her last vaccination was 6 years ago. The case was unusual because the patient had received all standard vaccinations, had no defined port of entry at disease onset, and had symptoms lasting for 6 months. Tetanus can present with unusual clinical forms; therefore, the diagnosis and management of this rare but difficult disease should be updated. In this Grand Round, we review the clinical features, epidemiology, treatment, and prognosis of C tetani infections. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Distance Learning Case Studies.

    ERIC Educational Resources Information Center

    Barker, Bruce O.

    The Office of Technology Assessment authorized a series of case studies in 1989 to investigate how technologies, services, and programs are implemented in distance education projects. The studies were also intended to look at the role of local, state, and federal agencies, and other public and private entities in providing educational services to…

  13. Structural Case Assignment in Korean

    ERIC Educational Resources Information Center

    Koak, Heeshin

    2012-01-01

    In this dissertation, I aim to provide a theory on the distribution of structural Case in Korean. I propose the following Structural Case Assignment Hypothesis (SCAH) regarding the assignment of structural Case: "Structural Case is assigned by phase heads (C: nominative; v: accusative) to every argument in the c-command domain of the phase…

  14. Case Studies in Wilderness Medicine.

    ERIC Educational Resources Information Center

    Gray, Melissa; Tarter, Shana Lee

    Five case studies explore issues in wilderness medicine, with emphasis on evacuation decision making. The cases describe medical problems encountered during wilderness trips involving college or high school students. In each case, the situation and facts of the case are outlined, including the patient's medical history and vital signs, and at…

  15. How to use case studies: continuity cases vs. one-shot cases.

    PubMed

    Reeves, P N

    1992-01-01

    Cases are a widely used instructional technique in health services administration education. This article discusses the merits of using cases in graduate education and identifies two types of cases, one-shot cases and continuity cases. The continuity case has many advantages for professional education. In particular it requires the students to recognize and cope with the interactions among decisions. Continuity cases are good vehicles both for instruction and for evaluation of students' competence. The supply of good continuity cases, however, is very limited. Consequently, despite the advantages of this type of case, instructors must consider using a blend of continuity and one-shot cases. Suggestions for the mix of cases within a curriculum are presented.

  16. Case vignettes of movement disorders.

    PubMed

    Yung, C Y

    1983-08-01

    This paper reports five movement disorders cases to serve as a basis for discussion of the problems encountered in the clinical management of these cases, and the pathophysiological mechanisms involved in these disorders as presented. Case 1 is a description of the subjective experience of a patient with acute orofacial dystonia from promethazine. Case 2 is the use of clonazepam is post-head injury tics. Case 3 is the complication from discontinuation of haloperidol and benztropine mesylate treatment. Case 4 is myoclonus in subacute sclerosing Panencephalitis, and Case 5 is rebound tremor from withdrawal of a beta-adrenergic blocker.

  17. Pleural mesothelioma - case report.

    PubMed

    Klawiter, Anna; Damaszke, Tomasz

    2010-10-01

    Pleural mesothelioma is a very rare neoplasm; especially the local form. The diagnostics is difficult and the prognosis unfavourable. We presented a case of a man with dyspnoea and cough. His chest radiogram showed hydrothorax on the left side. Neither the examinations of the pleural liquid, nor the CT-guided fine needle biopsy established the diagnosis. CT showed features suggestive of pleural mesothelioma. The diagnosis was confirmed by thoracoscopy. Although no neoplastic cells were found in the thoracoscopic specimen from the supradiaphragmatic tumor, we assumed that to be a case of a diffuse, primarily local form of mesothelioma. Diagnostics of pleural mesothelioma is very difficult. CT and thoracoscopy seem to be very valuable diagnostic methods. It is worth remembering that pleural mesothelioma can have a local form which may transform into a diffuse one.

  18. Kleptomania: a case series

    PubMed Central

    Saluja, Bharat; Chan, Lai Gwen; Dhaval, Dani

    2014-01-01

    Kleptomania is an enigmatic condition and is among the very few psychiatric disorders in which crime is medicalised and used as a legal defence. The scientific literature on kleptomania is scarce. Early literature and recent studies have shown a female preponderance, with an early age of onset of stealing in people with comorbid personality disorder(s). In a retrospective review of the case notes of theft offenders who had forensic psychiatric evaluations performed in a one-year period in 2010 at the Institute of Mental Health, Singapore, we found three patients who were diagnosed with kleptomania. In this report, we describe the pertinent clinical and sociodemographic characteristics, as well as the diagnostic issues of kleptomania in relation to the three cases. PMID:25630329

  19. Abdominal pregnancy - Case presentation.

    PubMed

    Bohiltea, R; Radoi, V; Tufan, C; Horhoianu, I A; Bohiltea, C

    2015-01-01

    Abdominal pregnancy, a rare diagnosis, belongs to the ectopic pregnancy group, the leading cause of pregnancy related exitus. The positive diagnosis is very difficult to establish most often in an acute setting, leading to a staggering percent of feto-maternal morbidity and mortality. We present the case of 26-weeks-old abdominal pregnancy with partial feto-placental detachment in a patient, after hysteroscopy and in vitro fertilization, which until the acute symptoms that led to emergency laparotomy went unrecognized. The patient recovered completely and satisfactorily after surgery and, due to the high risk of uterine rupture with regard to a second pregnancy, opted for a surrogate mother. Abdominal pregnancy can be regarded as a difficult to establish diagnosis, with a greater chance in case of increased awareness. It is compulsory to be well informed in order not to be surprised by the diagnosis and to apply the correct treatment immediately as the morbidity and mortality rate is elevated.

  20. OMC Compressor Case

    NASA Technical Reports Server (NTRS)

    Humphrey, W. Donald

    1997-01-01

    This report summarizes efforts expended in the development of an all-composite compressor case. Two pre-production units have been built, one utilizing V-CAP and one utilizing AFR-700B resin systems. Both units have been rig tested at elevated temperatures well above design limit loads. This report discusses the manufacturing processes, test results, and Finite Element Analysis performed. The V-CAP unit was funded by NASA-Lewis Research Center in 1994 under contract number NAS3- 27442 for Development of an All-Composite OMC Compressor Case. This contract was followed by an Air Force study in 1996 to build and identical unit using the AFR-700B resin system in place of the V-CAP system. The second compressor case was funded under U.S. Air Force contract F33615-93-D-5326, Advanced Materials for Aerospace Structures Special Studies (AMAS3), Delivery Order 0021 entitled "Advanced Polymeric Composite Materials and Structures Technology for Advanced High Temperature Gas Turbine Engines.' Initial studies using the V-CAP resin system were undertaken in 1993 under a NASA Lewis contract (NAS3-26829). A first prototype unit was developed in a joint program between Textron-Lycoming (now Allied Signal) and Brunswick (now Lincoln Composites). This unit included composite end closures using low density, high temperature molded end closures. The units was similar in size and shape to a titanium case currently used on the PT-21 0 engine and was funded as part of the integrated High Performance Turbine Engine Technology (EHPTET) initiative of DOD and NASA.

  1. [Penile torsion. Case report].

    PubMed

    Arch Canas, Albert; Gutiérfz del Pozo, Rafael

    2006-01-01

    To report the clinical characteristics and therapeutic options of penile torsion. We report the case of a male with asymptomatic penile torsion as an incidental finding after consultation for other reasons. The patient was treated conservatively because it was not an important aesthetic trouble and it was asymptomatic. Penile torsion is rare. Surgical treatment is reserved for very important degrees of torsion, symptomatic patients or, when patient feels discomfort with the aesthetic alteration.

  2. Lupus myocarditis: case report

    SciTech Connect

    LaManna, M.M.; Lumia, F.J.; Gordon, C.I.

    1988-03-01

    Although gallium-67 (/sup 67/Ga) accumulates in both neoplastic and inflammatory tissues, indium-111 (/sup 111/In) labeled leukocytes are seen only in inflammatory cells. Indium-111-labeled leukocytes therefore are a useful agent in the noninvasive differentiation of inflammatory tissue from neoplastic tissue. This case is an interesting example of the use of /sup 111/In-labeled leukocytes to make that differentiation.

  3. Fishing and casing repairs

    SciTech Connect

    Short, J.A.

    1982-01-01

    Up to 1/4 of a total drilling budget can be spent on fishing failures and downhole remedial operations. The book presented is aimed at cutting these costs. Specific examples of operations are included throughout the book to illustrate conditions in field situations. The author also discusses background conditions causing the problems and possible solutions, along with preventive measures. Also included are chapters on types of fishing tools, fishing procedures and operations, casing failures and repairs. (JMT)

  4. Extended Policies case

    EIA Publications

    2016-01-01

    The Annual Energy Outlook 2016 (AEO2016) Extended Policies case includes selected policies that go beyond current laws and regulations. Existing tax credits that have scheduled reductions and sunset dates are assumed to remain unchanged through 2040. Other efficiency policies, including corporate average fuel economy standards, appliance standards, and building codes, are expanded beyond current provisions; and the U.S. Environmental Protection Agency (EPA) Clean Power Plan (CPP) regulations that reduce carbon dioxide emissions from electric power generation are tightened after 2030.

  5. Alkaptonuria: A case report.

    PubMed

    Damarla, Nirupama; Linga, Prathima; Goyal, Mallika; Tadisina, Sanjay Reddy; Reddy, G Satyanarayana; Bommisetti, Hymavathi

    2017-06-01

    Alkaptonuria is a rare inborn error of metabolism with autosomal recessive inheritance with a mutation in homogentisate 1,2-dioxygenase. It results in accumulation of homogentisic acid in connective tissues (ochronosis). Most common ocular manifestations are bluish-black discoloration of the conjunctiva, cornea, and sclera. In this case report, a 39-year-old Indian male patient with additional ocular features in the retina is described.

  6. Alkaptonuria: A case report

    PubMed Central

    Damarla, Nirupama; Linga, Prathima; Goyal, Mallika; Tadisina, Sanjay Reddy; Reddy, G Satyanarayana; Bommisetti, Hymavathi

    2017-01-01

    Alkaptonuria is a rare inborn error of metabolism with autosomal recessive inheritance with a mutation in homogentisate 1,2-dioxygenase. It results in accumulation of homogentisic acid in connective tissues (ochronosis). Most common ocular manifestations are bluish-black discoloration of the conjunctiva, cornea, and sclera. In this case report, a 39-year-old Indian male patient with additional ocular features in the retina is described. PMID:28643719

  7. Case for diagnosis*

    PubMed Central

    Fernandes, Iolanda Conde; Sanches, Madalena; Alves, Rosário; Selores, Manuela

    2012-01-01

    We report a clinical case of a rare variant of pemphigus - pemphigus herpetiformis - which combines the clinical features of dermatitis herpetiformis with the immunological findings of pemphigus. Due to its atypical presentation, it is frequently misdiagnosed as dermatitis herpetiformis. It is basically characterized by the herpetiform pattern of skin lesions, severe pruritus and by the presence of eosinophilic spongiosis confirmed on histopathology. We call attention to the excellent response to dapsone. PMID:23197221

  8. Psoriasiform Keratosis - Case report*

    PubMed Central

    Pires, Carla Andréa Avelar; de Sousa, Brena Andrade; do Nascimento, Carla do Socorro Silva; Moutinho, Ana Thais Machado; de Miranda, Mario Fernando Ribeiro; Carneiro, Francisca Regina Oliveira

    2014-01-01

    Psoriasiform Keratosis is a rare clinic entity. The etiopathogenesis remains unknown and the disease is characterized by a solitary, scaly or keratotic papule, or plaque mainly located on the extremities. Histopathological features closely resemble those of psoriasis. We report the case of a 70-year-old woman presenting a solitary and asymptomatic keratotic plaque, located on the back of the left leg, unresponsive to topical corticosteroids. We performed an excisional biopsy and histopathology was consistent with psoriasiform keratosis. PMID:24770510

  9. Psoriasiform keratosis - case report.

    PubMed

    Pires, Carla Andréa Avelar; Sousa, Brena Andrade de; Nascimento, Carla do Socorro Silva do; Moutinho, Ana Thais Machado; Miranda, Mario Fernando Ribeiro de; Carneiro, Francisca Regina Oliveira

    2014-01-01

    Psoriasiform Keratosis is a rare clinic entity. The etiopathogenesis remains unknown and the disease is characterized by a solitary, scaly or keratotic papule, or plaque mainly located on the extremities. Histopathological features closely resemble those of psoriasis. We report the case of a 70-year-old woman presenting a solitary and asymptomatic keratotic plaque, located on the back of the left leg, unresponsive to topical corticosteroids. We performed an excisional biopsy and histopathology was consistent with psoriasiform keratosis.

  10. Combustible Cartridge Case Characterization

    DTIC Science & Technology

    1984-02-01

    Latex 241 * Nitrocellulose and Kraft /fibers National Starch Resin 78-3730 The beater additive process for manufacturing combustible cartridge cases *is... Kraft Fibers The Kraft fibers were received as sheets weighing approximately 1.3 lb each. The moisture content of the sheets varied from 6 to 7-1/2... Kraft fibers was incorporated into each batch. Resins The resins were supplied as a water emulsion with nominally 50 percent solids. Samples of each

  11. [Brucella endocarditis: case report].

    PubMed

    Dragosavac, Desanka; Tasso, Ana Paula; Catalan, Miguel; Leme Junior, Cid de Abreu

    2007-09-01

    Endocarditis is a rare and serious complication of human brucellosis. The diagnosis is suspected in cases of endocarditis without response to conservative antibiotic treatment and it is confirmed with enzyme-linked immunosorbent assay (ELISA) test, titers being higher than 1:160. The treatment is usually a surgery, followed with antibiotics for long period of time. Some cases can be cured with antibiotic treatment only, with antibiotics such as doxiciclin, rifampicin, ciprofloxacin, gentamicin and tetracycline. We present a case report of a patient with brucellose endocarditis. Fifty one year old male patient, a farmer, was admitted with clinical history of fever and weight loss. Echocardiography showed thickening and vegetation on the aortic valve and blood culture was positive for Staphylococcus epidermidis. The treatment with crystal penicillin and garamycin was initiated with no improval during three weeks. Endocarditis caused by human brucellosis was suspected and a new treatment with rifampicin and ciprofloxacin, associated with vancomycin because of the first blood culture, was initiated. Agglutination sorology was positive for brucellosis, with titers of 1:360. The patient got better with new treatment and was dismissed from the intensive care unit clinically stable, taking ciprofloxacin and gentamicin. Endocarditis caused by human brucellosis is rare; however it should always be considered when conservative antibiotic treatment fails, especially in patients that have contact with animals and dairy products.

  12. Exploration case studies

    NASA Astrophysics Data System (ADS)

    Underwood, Jimmy M.

    1989-04-01

    NASA's Office of Exploration has undertaken four case studies for prospective expansion of manned space activities beyond earth orbit. The subjects of these studies are (1) an expedition to the Martian moon Phobos; (2) a three-mission expedition to Mars; (3) the construction of a man-tended lunar observatory; and (4) the construction of a lunar outpost to serve as the basis for construction of a Martian outpost. The fourth alternative would follow the recommendation of the National Commission on Space for the creation of a 'bridge between worlds' in which explorers would develop ways in which to 'live off the land' in a space environment.

  13. Myxofibrosarcoma - Case report*

    PubMed Central

    de Castro, Breno Augusto Campos; Piancastelli, André Costa Cruz; Meyer, Renata Leal Bregunci; Piancastelli, Patricia Mourthe; Ribeiro, Carlos Alberto; Miranda, Rubem Mateus Campos

    2016-01-01

    Myxofibrosarcoma is recognized as a malignant neoplasm of fibroblastic origin with increased prevalence in the elderly, presenting as nodules or tumors that may extend to the dermis and skeletal muscle, preferably in the lower limbs. Histologically it is characterized by a proliferation of spindle cells in a myxoid stroma. Myxofibrosarcoma has a high potential for local recurrence and metastasis, mainly when it presents a high or intermediate histological grade. We report the case of an eighty-four year old patient with a difficult diagnosis of a highly aggressive tumor. PMID:26982788

  14. [A case report: elephantiasis].

    PubMed

    Karagöz, Ergenekon; Karaahmetoğlu, Gökhan; Acar, Ali; Turhan, Vedat; Oncül, Oral; Görenek, Levent

    2012-01-01

    Klippel-Trenaunay syndrome (KTS) is a rare disease and a syndrome that is characterized by the triad of congenital port wine stains,venous malformations with or without varicose veins, bone or soft tissue hypertrophy. Lymphatic filariasis is a filarial disease which usually occurs with genital anomalies, pathologies associated with lymphedema or elephantiasis caused by a filarial infectious agent. In this case report, a 20-year-old male patient admitted to our clinic for diagnosis and treatment with right leg edema and lesions compatible with dermatological manifestations. In the list of differential diagnosis, filarial elephantiasis was also thought, consequently KTS was diagnosed. (Turkiye Parazitol Derg 2012; 36: 188-90).

  15. [Pearson syndrome. Case report].

    PubMed

    Cammarata-Scalisi, Francisco; López-Gallardo, Ester; Emperador, Sonia; Ruiz-Pesini, Eduardo; Da Silva, Gloria; Camacho, Nolis; Montoya, Julio

    2011-09-01

    Among the etiologies of anemia in the infancy, the mitochondrial cytopathies are infrequent. Pearson syndrome is diagnosed principally during the initial stages of life and it is characterized by refractory sideroblastic anemia with vacuolization of marrow progenitor cells, exocrine pancreatic dysfunction and variable neurologic, hepatic, renal and endocrine failures. We report the case of a 14 month-old girl evaluated by a multicentric study, with clinic and molecular diagnosis of Pearson syndrome, with the 4,977-base pair common deletion of mitochondrial DNA. This entity has been associated to diverse phenotypes within the broad clinical spectrum of mitochondrial disease.

  16. [Dichotic digit test. Case].

    PubMed

    Zenker Castro, Franz; Fernández Belda, Rafael; Barajas de Prat, José Juan

    2008-12-01

    In this study we present a case of a 71-year-old female patient with sensorineural hearing loss and fitted with bilateral hearing aids. The patient complained of scant benefit from the hearing aid fitting with difficulties in understanding speech with background noise. The otolaryngology examination was normal. Audiological tests revealed bilateral sensorineural hearing loss with threshold values of 51 and 50 dB HL in the right and left ear. The Dichotic Digit Test was administered in a divided attention mode and focalizing the attention to each ear. Results in this test are consistent with a Central Auditory Processing Disorder.

  17. Convoy Ambush Case Studies

    DTIC Science & Technology

    2006-01-01

    battalions were garrisoned in the vicinity of Qui Nhon and marshaled at Cha Rang Valley every morning for the long haul to Pleiku, 110 miles to the west ...C. Brown and J.D. Calhoun by Richard Killblane, 13 June 2003 . 2 Bellino, “8th Transportation” and Wolfe Interview. 5 Killblane, Convoy Ambush...Case Studies him and came to a halt. He thought, “ Oh crap. I can’t sit in a truck. I’ve got to get out and get behind something.” The drivers

  18. Case reports and case series in prehospital emergency care research.

    PubMed

    Patterson, P Daniel; Weaver, Matthew; Clark, Sunday; Yealy, Donald M

    2010-11-01

    Research begins with a clearly stated question, problem or hypothesis. The selection of a study design appropriate to the task is the next key step. This paper provides guidance for the use of case report and case series designs by describing the 'what', 'when' and 'how' of both designs. Also described is the use of case reports and case series study designs in prehospital emergency research and the quality of published literature from 2000 to mid-2008.

  19. [The case-case-time-control study design].

    PubMed

    Wang, Jing; Zhuo, Lin; Zhan, Siyan

    2014-12-01

    Although the 'self-matched case-only studies' (such as the case-cross-over or self-controlled case-series method) can control the time-invariant confounders (measured or unmeasured) through design of the study, however, they can not control those confounders that vary with time. A bidirectional case-crossover design can be used to adjust the exposure-time trends. In the areas of pharmaco-epidemiology, illness often influence the future use of medications, making a bidirectional study design problematic. Suissa's case-time-control design combines the case-crossover and the case-control design which could adjust for exposure-trend bias, but the control group may reintroduce selection bias, if the matching does not go well. We propose a "case-case-time-control" design which is an extension of the case-time-control design. However, rather than using a sample of external controls, we choose those future cases as controls for current cases to counter the bias that arising from temporal trends caused by exposure to the target of interest. In the end of this article we will discuss the strength and limitations of this design based on an applied example.

  20. Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

    ERIC Educational Resources Information Center

    Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

    2017-01-01

    Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

  1. [Neuroretinitis. Clinical cases].

    PubMed

    Valverde-Gubianas, M; Ramos-López, J F; López-Torres, J A; Toribio-García, M; Milla-Peñalver, C; Gálvez Torres-Puchol, J; Medialdea-Marcos, S

    2009-08-01

    Evaluate the etiology and the most frequent funduscopic alterations of the neuroretinitis. We present the case of a woman 24 years old with a bilateral decrease of visual sharpness (AV), painless and progressive, the funduscopic examination of which reveals a bilateral optical disc edema, with no hemorrhages or exudates, retina edema of the posterior pole and phlebitic areas. The systematic study was normal except for the hemogram (18,000/mm(3) leucocytes with 79% neutrophils) and the positive serology next to a Chlamydia. We also present the case of a 64 years old woman with a decrease of AV at the right eye of one week duration. At the back of the eye a macular star can be seen, and papilla edema. A systematic study gave normal results and positive serology at Bartonella henselae. The illness produced by a cat scratch is the most common cause of neuroretinitis. The customary findings are a loss of AV, discromatopsia, afferent papillary defects and abnormality on the visual field. Other frequent findings at the back of the eye are hemorrhagic nerve fibers, cotton-like exudates, papilla edema, macular star and glassy inflammation. The roll of antibiotic therapy is questionable. Oral ciprofloxacine seems to give good results.

  2. [Gallbladder agenesis. Case report].

    PubMed

    Cavazos-García, Ricardo; Díaz-Elizondo, José Antonio; Flores-Villalba, Eduardo; Rodríguez-García, Héctor Alejandro

    2015-01-01

    Gallbladder agenesis is a very rare congenital abnormality of the biliary tract. The diagnosis is made during surgery, because all preoperative studies have failed to identify this malformation. The purpose of this article is to present a case of gallbladder agenesis diagnosed during surgery, its management, and a review of the literature. The case involves a sixty-two year- old female, referring to repeated biliary colic symptoms. The abdominal ultrasound diagnosed cholelithiasis. It was impossible to identify the gallbladder during surgery. Diagnosis was confirmed by intra-operative cholangiography. Preoperative diagnostic workup has failed to recognise patients with gallbladder agenesis. It is currently recommended to abandon the surgery once this diagnosis is suspected and confirm it by a cholangio-magnetic resonance scan in order to avoid a bile duct injury. Agenesis of the gallbladder is a rare congenital abnormality of the biliary tree. Every surgeon must keep this rare entity in mind when a "difficult dissection" or an anatomic variant is identified during surgery, and make use of an intra-operative cholangiography, mainly to prevent a bile duct injury. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  3. Case Citations 1991. Eleventh Series.

    ERIC Educational Resources Information Center

    Sharp, Linda A., Ed.

    Case citations from five legal areas--college students, liability on campus, sport law, employment, and employment discrimination--are presented in this document. Each section offers brief summaries of cases and concludes with a table of cases. The first section on college students examines litigation involving student finances, disciplinary…

  4. Emotion, Engagement, and Case Studies

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

    2014-01-01

    Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

  5. Teaching Cases on Family Involvement

    ERIC Educational Resources Information Center

    Harvard Family Research Project, 2010

    2010-01-01

    Teaching cases are a valuable tool in preparing teachers and school administrators to engage effectively with families. Because the case method presents a story in practice, it offers students an active learning opportunity. Teaching cases involve real world situations and consider the perspectives of various stakeholders, including teachers,…

  6. Natural Learning Case Study Archives

    ERIC Educational Resources Information Center

    Lawler, Robert W.

    2015-01-01

    Natural Learning Case Study Archives (NLCSA) is a research facility for those interested in using case study analysis to deepen their understanding of common sense knowledge and natural learning (how the mind interacts with everyday experiences to develop common sense knowledge). The database comprises three case study corpora based on experiences…

  7. [Metachromatic Leukodystrophy. Case Presentation].

    PubMed

    Espejo, Lina María; de la Espriella, Ricardo; Hernández, José Fernando

    Metachromatic leukodystrophy (MLD) is a rare demyelinating disease (prevalence 1:40 000), also called arylsulfatase A deficiency (ARS-A), which may present with neurological and psychiatric symptoms. Clinical assessment may be difficult, due to unspecific signs and symptoms. A case is presented of a 16 year-old female patient seen in psychiatry due to behavioural changes, psychosis, and with impaired overall performance. She was initially diagnosed with schizophrenia, but the Nuclear Magnetic Resonance (NMR) scan and laboratory tests lead to the diagnosis of MLD. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  8. Cutaneous protothecosis - Case report*

    PubMed Central

    da Silva, Pâmela Craveiro Gomes; Silva, Sabrina Beirão da Costa e; Lima, Ricardo Barbosa; D'Acri, Antonio Macedo; Lupi, Omar; Martins, Carlos José

    2013-01-01

    Cutaneous protothecosis is a rare infection caused by achlorophyllic algae of the genus Prototheca. The lesions usually occur on exposed areas, related with trauma, in immunocompromised patients. The most common clinical presentation is a vesicobullous and ulcerative lesion with pustules and scabs, simulating bacterial, fungal or herpetic infections or eczema. The diagnosis is determined by agent identification through histopathology, culture and the carbohydrates assimilation test. The finding of morula-like spherules is characteristic of Prototheca sp. Its rarity and non-specific clinical aspect may difficult the disease diagnosis. We report a case of a diabetic patient, in chronic use of systemic corticosteroids, that developed a skin lesion after trauma to the right leg. PMID:24346914

  9. Case for diagnosis*

    PubMed Central

    Fabre, Andréa Buosi; Passos, Paola C. Vieira da Rosa; de Lima, Brunno Zeni; Fabricio, Lincoln; Fillus, José; Bonalumi, Aguinaldo

    2014-01-01

    Intravascular papillary endothelial hyperplasia is a benign vascular lesion caused by proliferation of endothelium. It is reactive to thrombotic or inflammatory stimuli in the vessel wall.We report the case of a 14-yearold male patient with a violet-colored erythematous tumoral lesion of progressive growth in the occipital region. The diagnosis of intravascular papillary endothelial hyperplasia (IPEH) was confirmed by clinical and histopathological findings. Total lesion exeresis was performed with no recurrence up to date. IPEH presents clinical importance due to its clinical and histological resemblance to angiosarcoma. In order to differentiate it from angiosarcoma, distinguishing features of the benign disease should be considered, such as lack of cellular atypia and rare mitotic activity.Prognosis is good. PMID:25054765

  10. [Leigh syndrome: case report].

    PubMed

    Roma, Adriano de Carvalho; Pereira, Paula Resende Aquino de Assis; Dantas, Adalmir Morterá

    2008-01-01

    The authors describe for the first time in the Country a case of a 10-year-old female child, assisted at the Ophthalmology Clinic of the Hospital Universitário Clementino Fraga Filho UFRJ, with Leigh's syndrome that is part of a metabolic disease group known as mitochondrial encephalomyopathies. It is an hereditary disease transmitted by a different mode of inheritance: mitochondrial, X-linked recessive and autosomal recessive. The beginning of clinical manifestations is varied and occurs usually in the first two years of life, with progressive and insidious evolution and exacerbation periods. Diagnosis is difficult because pleomorphic presentation, based on clinical findings and complementary study related to mitochondrial production of ATP and cytochrome c oxidase deficiencies. Considering that there is no specific treatment, this is based on a palliative procedure. So, the identification of this syndrome is very important to keep it under control, since its evolution is progressive.

  11. Case report: waardenburg syndrome.

    PubMed

    Dumayas, Grace Lea; Capó-Aponte, José E

    2015-03-01

    A case of Waardenburg syndrome type 1 is described and relevant literature is reviewed to raise awareness about this rare syndrome, including the classification of each subtype and the differentiating clinical manifestations. A 44-year-old African-American female presented for a routine evaluation with hearing loss, dystopia canthorum (W index = 2.74), and almost complete gray hair. In addition, she presented with heterochromia irides, different fundus pigmentation between eyes. The patient did not have any upper limbs defect, cranial skeletal abnormalities, or intestinal disorders. Facial abnormalities and a white forelock are prominent features difficult to overlook during a routine ophthalmological examination. A careful medical history in patients with suspected Waardenburg syndrome is important to accurately classify this rare condition and to identify potential systemic implications associated to each subtype. The associated systemic complications can be addressed and managed through referral to the appropriate subspecialties. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  12. Reasoning on the Autism Spectrum: A Dual Process Theory Account.

    PubMed

    Brosnan, Mark; Lewton, Marcus; Ashwin, Chris

    2016-06-01

    Dual process theory proposes two distinct reasoning processes in humans, an intuitive style that is rapid and automatic and a deliberative style that is more effortful. However, no study to date has specifically examined these reasoning styles in relation to the autism spectrum. The present studies investigated deliberative and intuitive reasoning profiles in: (1) a non-clinical sample from the general population with varying degrees of autism traits (n = 95), and (2) males diagnosed with ASD (n = 17) versus comparisons (n = 18). Taken together, the results suggest reasoning on the autism spectrum is compatible with the processes proposed by Dual Process Theory and that higher autism traits and ASD are characterised by a consistent bias towards deliberative reasoning (and potentially away from intuition).

  13. The Iodine Spectrum: A New Look at an Old Topic

    NASA Astrophysics Data System (ADS)

    Long, George; Sauder, Deborah; Shalhoub, George M.; Stout, Roland; Hamby Towns, Marcy; Zielinski, Theresa Julia

    1999-06-01

    This paper describes a new approach to the traditional iodine gas absorption spectrum experiment often performed in undergraduate physical chemistry labs. The approach is student centered and designed to emphasize the conceptual richness in this classic experiment. It gives students the opportunity to examine the conceptual and mathematical connections between spectroscopic data and quantum models by organizing the material in conceptual chunks, which they work through sequentially. Students use symbolic mathematics software, Mathcad, to expedite the sophisticated numerical calculations required. The curricular chunks were specifically constructed to make the sophisticated concepts embedded in the project accessible. The focus activities remind the students of information they already know and require them to employ both paper and pencil and computer worksheets to complete calculations. Five Mathcad templates provide a rich mathematical treatment of the topics in this experiment. This paper describes how the documents MorsePotential.mcd, BirgeSponer.mcd, IodineSpectrum.mcd, FranckCondonBackground.mcd, and FranckCondonComputation.mcd are used during the three weeks in which this experiment can be performed by a typical physical chemistry student. Although originally designed to use the WWW to disseminate information and promote interaction among physical chemistry students at geographically dispersed institutions, this segmented focus-question approach to the iodine experiment has also been used by a physical chemistry class at a single campus. In both formats, faculty noticed decreased anxiety of the students towards the experiment and an increase in the quality of laboratory reports that indicated better understanding of the chemical concepts.

  14. Reasoning on the Autism Spectrum: A Dual Process Theory Account

    ERIC Educational Resources Information Center

    Brosnan, Mark; Lewton, Marcus; Ashwin, Chris

    2016-01-01

    Dual process theory proposes two distinct reasoning processes in humans, an intuitive style that is rapid and automatic and a deliberative style that is more effortful. However, no study to date has specifically examined these reasoning styles in relation to the autism spectrum. The present studies investigated deliberative and intuitive reasoning…

  15. Participative Case Studies: Integrating Case Writing and a Traditional Case Study Approach in a Marketing Context

    ERIC Educational Resources Information Center

    Forman, Howard

    2006-01-01

    Case-based pedagogy is a valuable tool for applying business concepts and theories to organizational contexts. Traditional case-based pedagogy offers such learning opportunities. What this pedagogy lacks, however, is an element of real-time experiential learning opportunities. This research focuses on the advantages of incorporating a case-writing…

  16. [Methodology of psychiatric case histories].

    PubMed

    Scherbaum, N; Mirzaian, E

    1999-05-01

    This paper deals with the methodology of psychiatric case histories. Three types of case histories are differentiated. The didactic case history teaches about the typical aspects of a psychiatric disorder or treatment by using an individual patient as an example. In the heuristic case history the individual case gives rise to challenging established concepts or to generate new hypotheses. Such hypotheses drawn from inductive reasoning have then to be tested using representative samples. The focus of hermeneutic case histories is the significance of pathological behaviour and experience in the context of the biography of an individual patient. So-called psychopathographies of important historical figures can also be differentiated according to these types. Based on these methodological considerations, quality standards for the named types of case histories are stated.

  17. Scleroderma: a case report

    NASA Astrophysics Data System (ADS)

    Harahap, T. A.; Marpaung, B.

    2018-03-01

    Scleroderma is a complex disease in which extensive fibrosis, vascular alterations, and autoantibodies against various cellular antigens are among the principal features.[1,2] The prevalenceranging from 50 to 300 cases per 1 million persons with women are at much higher risk. The average age of diagnosis is the fifth decades of life.[2] There is no cure for scleroderma, but many of its problems and complications can be treated.[3-7]A 54-year-old female patient with main complains limitation of motion and mouth, stiffness and painful joints in the hands and feet, thickening on the skin in the chest and trunk for eight years, purplish red spots on arms and legs intermittent for tenyears. On physical examination found sclerosis lesions, sclerodactyly on fingers and toes, telangiectasias in the antebrachii and cruris region. On laboratory, examination showed ANA test 10.7 and Anti DS DNA 123. The histopathological of the skin result is scleroderma. The patient was diagnosed with scleroderma and treated with methotrexate 7.5 mg/weeks, ciclosporin 2×100 mg/day, omeprazole 2×20 mg. After seven days of therapy, there is aclinical improvement, and the patient becomes anoutpatient treatment.

  18. Childhood obesity case statement.

    PubMed

    Esposito, Paul W; Caskey, Paul; Heaton, Lisa E; Otsuka, Norman

    2013-04-01

    The goal of this publication is to raise awareness of the impact of childhood obesity on the musculoskeletal health of children and its potential long-term implications. Relevant articles dealing with musculoskeletal disorders either caused by or worsened by childhood obesity were reviewed through a Pub Med search. Efforts to recognize and combat the childhood obesity epidemic were also identified through Internet search engines. This case statement was then reviewed by the members of the pediatric specialty group of the US Bone and Joint Initiative, which represents an extensive number of organizations dealing with musculoskeletal health. Multiple musculoskeletal disorders are clearly caused by or worsened by childhood obesity. The review of the literature clearly demonstrates the increased frequency and severity of many childhood musculoskeletal disorders. Concerns about the long-term implications of these childhood onset disorders such as pain and degenerative changes into adulthood are clearly recognized by all the member organizations of the US Bone and Joint Initiative. It is imperative to recognize the long-term implications of musculoskeletal disorders caused by or worsened by childhood obesity. It is also important to recognize that the ability to exercise comfortably is a key factor to developing a healthy lifestyle and maintaining a healthy body weight. Efforts to develop reasonable and acceptable programs to increase physical activity by all facets of society should be supported. Further research into the long-term implications of childhood musculoskeletal disorders related to childhood obesity is necessary. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Case consultation: ablatio penis.

    PubMed

    Money, J

    1998-01-01

    In male infants, traumatic ablation of the penis, with or without loss of the testicles may occur as a sequel to mutilatory violence, accidental injury, or circumcision error. Post-traumatically, one program of case management is surgical sex reassignment to live as a girl, with female hormonal therapy at the age of puberty. The other program is genital reconstructive surgery to live as a boy, with male hormonal therapy at puberty if the testicles are missing. In both programs, the long term outcome is less than perfect and is contingent on intervening variables that include societal ideology; surgical technology; juvenile and adolescent timing and frequency of hospital admissions construed by the child as nosocomial abuse; development of body image; health and sex education; fertility versus sterility; coitus and orgasm; possible lesbian orientation if living as a girl; and long-term cost accounting, including the psychic cost of being a pawn in possible malpractice litigation on whose disability a very large fortune in compensation may devolve. There is, as yet, no unanimously endorsed set of guidelines for the treatment of genital trauma and mutilation in infancy, and no provision for a statistical depository for outcome data.

  20. Explosively separable casing

    DOEpatents

    Jacobson, A.K.; Rychnovsky, R.E.; Visbeck, C.N.

    An explosively separable casing including a cylindrical afterbody and a circular cover for one end of the afterbody is disclosed. The afterbody has a cylindrical tongue extending longitudinally from one end which is matingly received in a corresponding groove in the cover. The groove is sized to provide a picket between the end of the tongue and the remainder of the groove so that an explosive can be located therein. A seal is also provided between the tongue and the groove for sealing the pocket from the atmosphere. A frangible holding device is utilized to hold the cover to the afterbody. When the explosive is ignited, the increase in pressure in the pocket causes the cover to be accelerated away from the afterbody. Preferably, the inner wall of the afterbody is in the same plane as the inner wall of the tongue to provide a maximum space for storage in the afterbody and the side wall of the cover is thicker than the side wall of the afterbody so as to provide a sufficiently strong surrounding portion for the pocket in which the explosion takes place. The detonator for the explosive is also located on the cover and is carried away with the cover during separation. The seal is preferably located at the longitudinal end of the tongue and has a chevron cross section.

  1. Explosively separable casing

    DOEpatents

    Jacobson, Albin K.; Rychnovsky, Raymond E.; Visbeck, Cornelius N.

    1985-01-01

    An explosively separable casing including a cylindrical afterbody and a circular cover for one end of the afterbody is disclosed. The afterbody has a cylindrical tongue extending longitudinally from one end which is matingly received in a corresponding groove in the cover. The groove is sized to provide a pocket between the end of the tongue and the remainder of the groove so that an explosive can be located therein. A seal is also provided between the tongue and the groove for sealing the pocket from the atmosphere. A frangible holding device is utilized to hold the cover to the afterbody. When the explosive is ignited, the increase in pressure in the pocket causes the cover to be accelerated away from the afterbody. Preferably, the inner wall of the afterbody is in the same plane as the inner wall of the tongue to provide a maximum space for storage in the afterbody and the side wall of the cover is thicker than the side wall of the afterbody so as to provide a sufficiently strong surrounding portion for the pocket in which the explosion takes place. The detonator for the explosive is also located on the cover and is carried away with the cover during separation. The seal is preferably located at the longitudinal end of the tongue and has a chevron cross section.

  2. Unusual case of anorexia.

    PubMed

    Darmaun, Laura; Aubry, Estelle; Lejeune, Sophie; Sudour-Bonnange, Helene

    2018-06-04

    We report the case of a 15-year-old female patient suffering from progressive anorexia, weight loss and recurrent abdominal pain, initially diagnosed as anorexia nervosa. She eventually presented with severe malnutrition and acute bowel obstruction, revealing a mass of the transverse colon. A well-differentiated Lieberkühn adenocarcinoma was established by histology. The patient underwent transverse and right colectomy and was treated with adjuvant chemotherapy. Colorectal cancer (CRC) is predominantly a disease of older adults and is extremely rare in children and adolescents. Seldom suspected, it is more likely to be diagnosed at an advanced stage, with unfavourable tumour histology and poor outcome. Young patients diagnosed with CRC should receive genetic counselling regardless of their family history or tumour type. This reports' take-home message is that recurrent and persistent digestive symptoms in the young should alert physicians and lead to further investigations. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. [Case-non case studies: Principles, methods, bias and interpretation].

    PubMed

    Faillie, Jean-Luc

    2017-10-31

    Case-non case studies belongs to the methods assessing drug safety by analyzing the disproportionality of notifications of adverse drug reactions in pharmacovigilance databases. Used for the first time in the 1980s, the last few decades have seen a significant increase in the use of this design. The principle of the case-non case study is to compare drug exposure in cases of a studied adverse reaction with that of cases of other reported adverse reactions and called "non cases". Results are presented in the form of a reporting odds ratio (ROR), the interpretation of which makes it possible to identify drug safety signals. This article describes the principle of the case-non case study, the method of calculating the ROR and its confidence interval, the different modalities of analysis and how to interpret its results with regard to the advantages and limitations of this design. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  4. Membranous Dysmenorrhea: A Case Series

    PubMed Central

    Omar, Hatim A.; Smith, Shawn J.

    2007-01-01

    The purpose was to illustrate the variability of hormonal contraception of patients that presented with membranous dysmenorrheal. A case analysis chart review was completed on six patients referred to a Pediatric Gynecologist in an academic setting. In each case the patient underwent a thorough pelvic and bimanual exam. Following the initial presentation, each patient continued to be followed on a regular visits. Cases: Two were using the transdermal contraceptive patch and oral contraceptive, but following the expulsion of decidual cast, they were both placed on depot medroxyprogesterone acetate (DMPA) without further complications. Three of the six cases were on DMPA prior to the similar occurrence of membranous dysmenorrheal and following this incident, continued on DMPA without further problems. The final case was on the transdermal patch prior to decidual cast expulsion and remained on this form of hormonal contraception without further complications. These cases indicate that membranous dysmenorrheal is not limited to the use of DMPA. PMID:18060329

  5. A report on case reports

    PubMed Central

    Gopikrishna, Velayutham

    2010-01-01

    Case reports are defined as the scientific documentation of a single clinical observation and have a time-honored and rich tradition in medicine and scientific publication. This article discusses the role and relevance of case reports in the current evidence-based medical literature. It also seeks to help and guide authors to understand how to prepare a reasonable and well-written case report and how they may anticipate concerns that peer reviewers may express when scrutinizing their manuscript. An overview of the Journal of Conservative Dentistry’s review process of a manuscript submission is provided for the benefit of future authors. It is important to be able to read a case report critically and to use the information they contain appropriately. This article also discusses the factors to consider in evaluating individual case reports, and discusses a practical conceptual scheme for evaluating the potential value and educational content of a case report. PMID:21217956

  6. Trichotillomania in a dementia case

    PubMed Central

    Caixeta, Leonardo; Lopes, Danielly Bandeira

    2011-01-01

    We report an 87-year-old male case of hair pulling associated with a white-matter vascular dementia (Binswanger’s disease). Trichotillomania in our case did not resolve using mirtazapine or anticholinesterasic medication. Trichotillomania seems to be related to a form of perseveration associated with dementia. The findings in this case suggest the abnormality involving white matter in the pathogenesis of trichotillomania, may constitute a defect in connectivity in the right frontal-subcortical circuit. PMID:29213722

  7. Non-ferromagnetic overburden casing

    DOEpatents

    Vinegar, Harold J.; Harris, Christopher Kelvin; Mason, Stanley Leroy

    2010-09-14

    Systems, methods, and heaters for treating a subsurface formation are described herein. At least one system for electrically insulating an overburden portion of a heater wellbore is described. The system may include a heater wellbore located in a subsurface formation and an electrically insulating casing located in the overburden portion of the heater wellbore. The casing may include at least one non-ferromagnetic material such that ferromagnetic effects are inhibited in the casing.

  8. [Tuberculous pyopneumothorax: about 18 cases].

    PubMed

    Hicham, Souhi; Hanane, El Ouazzani; Hicham, Janah; Ismaïl, Rhorfi; Ahmed, Abid

    2016-01-01

    Tuberculous pyopneumothorax is a rare but serious complication of evolutive pulmonary tuberculosis. We report a series of 18 cases with tuberculous pyopneumothorax admitted to the Pneumo-Phthisiology Department of the Mohammed V Military Teaching Hospital in Rabat between January 2005 and December 2009. Our study included 15 men and 3 women, the average age was 35 ± 7 years. 4 patients were diabetic. Smoking was found in 9 cases. Right-sided pneumothorax was found in 13 cases. Chest radiograph showed cavitary lesions in 15 patients and extensive bilateral lesions in 8 cases. The search for Mycobacterium tuberculosis in the fluid from the gastric tube was positive in 16 cases. Chest drainage associated with antituberculosis treatment according to the 2SRHZ/7RH regimen and respiratory kinesitherapy were performed in all cases. The average duration of pleural drainage was 4 weeks. In 3 cases we noted persistent pleural suppuration requiring pleural toilet using thoracoscopy with pleurectomy and limited pulmonary resection to eliminate tuberculous parenchymal lesions and the persistence of a large pleural pocket with restrictive ventilatory defect that required surgery for pleural decortication in two cases. The outcome was favorable with minimal pachypleuritis as sequelae in the remaining cases. Tuberculous pyopneumothorax is a severe form, which is often associated with active cavitary tuberculosis. Evolution is generally progressive despite antituberculosis treatment and thoracic drainage, hence the need for early diagnosis and treatment of all forms of tuberculosis.

  9. BOS MOrth cases prize 2011.

    PubMed

    Patel, Jigar Vipinchandra

    2013-12-01

    This paper describes the orthodontic treatment of two cases awarded the prize by the British Orthodontic Society for best treated cases submitted for the Membership in Orthodontics. The first case reports on the treatment of a class III malocclusion with increased vertical lower anterior facial proportions and dentoalveolar compensation that was treated with orthodontic camouflage. The second case reports on the treatment of a class II division II malocclusion with reduced vertical lower anterior facial proportions and an overbite complete to the palate, which was treated with orthodontic camouflage.

  10. Dioctophymiasis: A Rare Case Report

    PubMed Central

    Kaval, Sunil; Tewari, Swati

    2016-01-01

    Dioctophyma renale commonly known as “giant kidney worm’ is found in the kidney of carnivorous mammals. Human infestation is rare, but results in destruction of the kidneys. Very few cases have been reported worldwide. We are here reporting a case of Dioctophymiasis in a 35-year-old male patient who presented with retention of urine and subsequent passage of worm and blood in urine. The worm was confirmed as Dioctophyma renale based on its morphology and clinical presentation. This is a very rare case report and to best of our knowledge only two cases have been reported from India. PMID:27042466

  11. Dioctophymiasis: A Rare Case Report.

    PubMed

    Chauhan, Sapna; Kaval, Sunil; Tewari, Swati

    2016-02-01

    Dioctophyma renale commonly known as "giant kidney worm' is found in the kidney of carnivorous mammals. Human infestation is rare, but results in destruction of the kidneys. Very few cases have been reported worldwide. We are here reporting a case of Dioctophymiasis in a 35-year-old male patient who presented with retention of urine and subsequent passage of worm and blood in urine. The worm was confirmed as Dioctophyma renale based on its morphology and clinical presentation. This is a very rare case report and to best of our knowledge only two cases have been reported from India.

  12. Using existing case-mix methods to fund trauma cases.

    PubMed

    Monakova, Julia; Blais, Irene; Botz, Charles; Chechulin, Yuriy; Picciano, Gino; Basinski, Antoni

    2010-01-01

    Policymakers frequently face the need to increase funding in isolated and frequently heterogeneous (clinically and in terms of resource consumption) patient subpopulations. This article presents a methodologic solution for testing the appropriateness of using existing grouping and weighting methodologies for funding subsets of patients in the scenario where a case-mix approach is preferable to a flat-rate based payment system. Using as an example the subpopulation of trauma cases of Ontario lead trauma hospitals, the statistical techniques of linear and nonlinear regression models, regression trees, and spline models were applied to examine the fit of the existing case-mix groups and reference weights for the trauma cases. The analyses demonstrated that for funding Ontario trauma cases, the existing case-mix systems can form the basis for rational and equitable hospital funding, decreasing the need to develop a different grouper for this subset of patients. This study confirmed that Injury Severity Score is a poor predictor of costs for trauma patients. Although our analysis used the Canadian case-mix classification system and cost weights, the demonstrated concept of using existing case-mix systems to develop funding rates for specific subsets of patient populations may be applicable internationally.

  13. Teaching Case: MiHotel--Applicant Processing System Design Case

    ERIC Educational Resources Information Center

    Miller, Robert E.; Dunn, Paul

    2018-01-01

    This teaching case describes the functionality of an applicant processing system designed for a fictitious hotel chain. The system detailed in the case includes a webform where applicants complete and submit job applications. The system also includes a desktop application used by hotel managers and Human Resources to track applications and process…

  14. Federal Protection for Human Research Subjects: An Analysis of the Common Rule and Its Interactions with FDA Regulations and the HIPAA Privacy Rule

    DTIC Science & Technology

    2005-06-02

    the interaction of the Privacy Rule and FDA regulations with the Common Rule. Appendix B CRS-12 20 Phocomelia Syndrome is a birth defect that may...linked to the birth defect phocomelia .20 ! Congress enacts the Drug Amendments of 1962 (P.L. 87-781), requiring researchers to obtain subjects...information about Phocomelia Syndrome, see [http://my.webmd.com/hw/health_guide_atoz/nord780.asp], visited Apr. 11, 2005. 178 Section 505(i) of the Food

  15. The Economic Case for Education

    ERIC Educational Resources Information Center

    Woessmann, Ludger

    2016-01-01

    The case for education can be made from many perspectives. This paper makes the case for education based on economic outcomes. Surveying the most recent empirical evidence, it shows the crucial role of education for individual and societal prosperity. Education is a leading determinant of economic growth, employment, and earnings in modern…

  16. A case of triple volvulus

    PubMed Central

    Basu, I; Phillips, D

    2012-01-01

    Situs inversus is a rare congenital anomaly that has reportedly been associated with caecal volvulus. We describe a case of partial situs inversus complicated by intestinal obstruction secondary to three simultaneously occurring volvuli of the stomach, caecum and sigmoid colon. To our knowledge, this is the first documented case in the literature of multiple, simultaneously occurring volvuli. PMID:22391352

  17. A case of triple volvulus.

    PubMed

    Elsharif, M; Basu, I; Phillips, D

    2012-03-01

    Situs inversus is a rare congenital anomaly that has reportedly been associated with caecal volvulus. We describe a case of partial situs inversus complicated by intestinal obstruction secondary to three simultaneously occurring volvuli of the stomach, caecum and sigmoid colon. To our knowledge, this is the first documented case in the literature of multiple, simultaneously occurring volvuli.

  18. Fuzzy-Set Case Studies

    ERIC Educational Resources Information Center

    Mikkelsen, Kim Sass

    2017-01-01

    Contemporary case studies rely on verbal arguments and set theory to build or evaluate theoretical claims. While existing procedures excel in the use of qualitative information (information about kind), they ignore quantitative information (information about degree) at central points of the analysis. Effectively, contemporary case studies rely on…

  19. [A case of lingual agenesis].

    PubMed

    Carinci, F; Felisatti, P; Curioni, C

    1996-01-01

    Lingual agenesis is a rare anomaly caused by failed morphogenesis of the lateral lingual swellings during embriogenesis. Most reported cases have been part of oromandibular limb hypogenesis syndrome (OLHS). A case of lingual agenesis associated with micrognathia and alteration of the hands is reported.

  20. Case Management: Service or Symptom?

    ERIC Educational Resources Information Center

    Netting, F. Ellen

    1992-01-01

    Provides overview of case management, its history, and contemporary models. Examines challenges that case management poses for social work profession: covering up issue that health and human services delivery system is nonsystem; maintaining client-centered perspective in cost-obsessed environment; dealing with quality control; coping with…

  1. Teaching Diversity through Case Competition

    ERIC Educational Resources Information Center

    Phillips, T. Nichole; Wood, Lynette I.

    2017-01-01

    This paper shares the process and outcomes of utilizing case competitions as an approach to diversity education. A university-wide case competition was held for two consecutive years. We detail the procedure for facilitating the competition, the role of internal and external stakeholders, and student performance and feedback. It is our position…

  2. The Big Read: Case Studies

    ERIC Educational Resources Information Center

    National Endowment for the Arts, 2009

    2009-01-01

    The Big Read evaluation included a series of 35 case studies designed to gather more in-depth information on the program's implementation and impact. The case studies gave readers a valuable first-hand look at The Big Read in context. Both formal and informal interviews, focus groups, attendance at a wide range of events--all showed how…

  3. CaseWorld™: Interactive, media rich, multidisciplinary case based learning.

    PubMed

    Gillham, David; Tucker, Katie; Parker, Steve; Wright, Victoria; Kargillis, Christina

    2015-11-01

    Nurse educators are challenged to keep up with highly specialised clinical practice, emerging research evidence, regulation requirements and rapidly changing information technology while teaching very large numbers of diverse students in a resource constrained environment. This complex setting provides the context for the CaseWorld project, which aims to simulate those aspects of clinical practice that can be represented by e-learning. This paper describes the development, implementation and evaluation of CaseWorld, a simulated learning environment that supports case based learning. CaseWorld provides nursing students with the opportunity to view unfolding authentic cases presented in a rich multimedia context. The first round of comprehensive summative evaluation of CaseWorld is discussed in the context of earlier formative evaluation, reference group input and strategies for integration of CaseWorld with subject content. This discussion highlights the unique approach taken in this project that involved simultaneous prototype development and large scale implementation, thereby necessitating strong emphasis on staff development, uptake and engagement. The lessons learned provide an interesting basis for further discussion of broad content sharing across disciplines and universities, and the contribution that local innovations can make to global education advancement. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  4. Case and Administrative Support Tools

    EPA Pesticide Factsheets

    Case and Administrative Support Tools (CAST) is the secure portion of the Office of General Counsel (OGC) Dashboard business process automation tool used to help reduce office administrative labor costs while increasing employee effectiveness. CAST supports business functions which rely on and store Privacy Act sensitive data (PII). Specific business processes included in CAST (and respective PII) are: -Civil Rights Cast Tracking (name, partial medical history, summary of case, and case correspondance). -Employment Law Case Tracking (name, summary of case). -Federal Tort Claims Act Incident Tracking (name, summary of incidents). -Ethics Program Support Tools and Tracking (name, partial financial history). -Summer Honors Application Tracking (name, home address, telephone number, employment history). -Workforce Flexibility Initiative Support Tools (name, alternative workplace phone number). -Resource and Personnel Management Support Tools (name, partial employment and financial history).

  5. Case Studies in Science Ethics

    NASA Astrophysics Data System (ADS)

    Williams, Karen

    2010-03-01

    Everyone in science should have ethics education training. I have seen graduate students taken advantage of by their mentors. Many of us have seen misconduct...but what should we do about it? Young scientists are often unaware of the rules in science and make mistakes because of their ignorance of the rules in that particular field of study. Then there are an increasing number of cases in the news of overt cases of misrepresentation in science. All are welcome to attend this discussion of case studies. A case study on topics such as: how to treat data properly, how our values in science affect our work, who gets authorship on scientific papers, who is first author on a paper, what you should do if you uncover misconduct or plagiarism in your university, and we will discuss the scientist's role in society. This will be a painless, non-confrontational small group, then large group discussion of each case

  6. [Cases of strangulated obturator hernia].

    PubMed

    Chakhvadze, B; Nakashidze, D; Kashibadze, K; Beridze, A

    2010-02-01

    Obturator hernias are extremely rare in surgical practice. Only about 600 cases are described in the world medical literature. To diagnose obturator hernia is very complicated. Hernial protrusion is not often observed. The strangulation of obturator hernia is accompanied by rapidly developing symptoms of intestinal obstruction, which is usually an indication for emergency surgery. The article analyzes two clinical cases of strangulated obturator hernia and one traumatic eventration and strangulation of small intestine in the obturator ring ruined by trauma. In all cases the indication of surgery was clinical picture of a growing intestinal obstruction or acute abdomen. Only in one case, despite the prevailing clinical picture of acute intestinal obstruction in the light of anamnesis and the accompanying neurological symptoms before the operation could be suspected strangulated obturator hernia, which was confirmed during surgery. As it was mentioned above, in doubtful cases to clarify the diagnosis should be applied other methods of examination of patients, including computed tomography.

  7. Habilitation of Patients with Congenital Malformations Associated with Thalidomide: Surgery of Limb Defects

    PubMed Central

    Hall, John E.

    1963-01-01

    The deformities commonly seen in “thalidomide babies” are described. These vary from relatively uncomplicated radial-ray defects to complete phocomelia of all four extremities. It is suggested that the care of these children is best carried out in a clinic accustomed to dealing with juvenile amputee problems. A plea is made for very early fitting of upper-extremity prostheses (at approximately three months of age) in cases of unilateral upper-limb deficiencies. A “bucket” for sitting should be supplied for children with quadrilateral phocomelia to sit in when they reach seven or eight months of age. Children with severe upper-limb malformations will be candidates for some form of externally powered prostheses. ImagesFig. 1a and 1bFig. 2a and 2bFig. 3a and 3bFig. 4a and 4bFig. 5a, b and cFig. 6a and 6bFig. 7Fig. 8Fig. 9a and 9bFig. 10a,bFig. 10c and d PMID:13952105

  8. Analysis of Restricted Natural Gas Supply Cases

    EIA Publications

    2004-01-01

    The four cases examined in this study have progressively greater impacts on overall natural gas consumption, prices, and supply. Compared to the Annual Energy Outlook 2004 reference case, the no Alaska pipeline case has the least impact; the low liquefied natural gas case has more impact; the low unconventional gas recovery case has even more impact; and the combined case has the most impact.

  9. Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies

    ERIC Educational Resources Information Center

    Pai, Aditi

    2014-01-01

    A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

  10. IVHS institutional issues and case studies : ADVANCE case study

    DOT National Transportation Integrated Search

    1994-04-01

    This operational test case study is one of six performed in response to a Volpe National Transportation Systems Center technical task directive (TTD) to Science Applications International Corporation (SAIC) entitled, IVHS Institutional Issues and ...

  11. [Ectopic breast fibroadenoma. Case report].

    PubMed

    Senatore, G; Zanotti, S; Cambrini, P; Montroni, I; Pellegrini, A; Montanari, E; Santini, D; Taffurelli, M

    2010-03-01

    Among the rare anomalies of the breast development, polythelia is the most common, between 1% and 5% of women and men present supernumerary nipples. Polymastia, usually presenting as ectopic breast tissue without areola-nipple complex, is seen mostly along the milk line, extending from the axilla to the pubic region. Ectopic breast tissue is functionally analogous to mammary gland and it is subjected to the same alterations and diseases, whether benign or malignant, that affect normal breast tissue. We report the case of a 21 years-old female evaluated by the medical staff after founding a solid nodular mass by suspect axillary lymphadenopathy. Differential diagnosis with lymphoma is the major problem in these cases. The mass was removed and the intraoperative histological examination showed fibroadenoma in axillary supernumerary breast. Presence of ectopic breast tissue is a rare condition; development of benign mass or malignant degeneration is possible, but it is very unusual. In case of polymastia diagnosis is simple; in case of isolated nodule, without local inflammation or infection, there are greater difficulties. Ultrasonography is diagnostic in case of breast fibroadenoma, but it might be inadequate in ectopic localizations owing to the shortage of mammary tissue around the mass. Preoperative diagnosis is important to plan an adequate surgical treatment; lumpectomy is indicated in case of benign tissue; in case of malignancy, therapy is based on the standard treatment used for breast cancer (surgery, chemotherapy and radiation therapy).

  12. Lunar drill footplate and casing

    NASA Technical Reports Server (NTRS)

    Maassen, Erik C.; Hendrix, Thomas H.; Morrison, Eddie W.; Phillips, Rodrick B.; Le, Vu Quang; Works, Bruce A.

    1989-01-01

    To prevent hole collapse during lunar drilling operations, a casing has been devised of a graphite reinforced polyimide composite which will be able to withstand the lunar environment. Additionally, this casing will be inserted into the ground in segments two meters long which will penetrate the regolith simultaneously with the auger. The vertical action of the mobile platform will provide a downward force to the casing string through a special adaptor, giving the casing the needed impetus to sink the anticipated depth of ten meters. Casing segments will be connected with a simple snap arrangement. Excess casing will be cut off by a cylindrical cutting tool which will also transport the excess casing away from the hole. A footplate will be incorporated to grasp the auger rod string during rod segment additions or removals. The footplate grasping mechanism will consist of a set of vice-like arms, one end of each bearing threaded to a common power screw. The power screw will be threaded such that one end's thread pitch opposes that of the other end. The weight of the auger and rod string will be transmitted through the arms to the power screw and absorbed by a set of three ball bearing assemblies. The power screw will be driven by a one-half horsepower brushless motor actuated by radio control. The footplate will rest on four short legs and be anchored with pins that are an integral part of each leg.

  13. Understanding and Evaluating Assurance Cases

    NASA Technical Reports Server (NTRS)

    Rushby, John; Xu, Xidong; Rangarajan, Murali; Weaver, Thomas L.

    2015-01-01

    Assurance cases are a method for providing assurance for a system by giving an argument to justify a claim about the system, based on evidence about its design, development, and tested behavior. In comparison with assurance based on guidelines or standards (which essentially specify only the evidence to be produced), the chief novelty in assurance cases is provision of an explicit argument. In principle, this can allow assurance cases to be more finely tuned to the specific circumstances of the system, and more agile than guidelines in adapting to new techniques and applications. The first part of this report (Sections 1-4) provides an introduction to assurance cases. Although this material should be accessible to all those with an interest in these topics, the examples focus on software for airborne systems, traditionally assured using the DO-178C guidelines and its predecessors. A brief survey of some existing assurance cases is provided in Section 5. The second part (Section 6) considers the criteria, methods, and tools that may be used to evaluate whether an assurance case provides sufficient confidence that a particular system or service is fit for its intended use. An assurance case cannot provide unequivocal "proof" for its claim, so much of the discussion focuses on the interpretation of such less-than-definitive arguments, and on methods to counteract confirmation bias and other fallibilities in human reasoning.

  14. Rhabdomyolysis case based on hypothyroidism

    PubMed Central

    Katipoglu, Bilal; Acehan, Fatih; Meteris, Ayşenur; Yılmaz, Nisbet

    2016-01-01

    Summary Hypothyroidism is a wide clinical spectrum disorder and only a few cases in literature show this. Rhabdomyolysis and acute renal impairment can be seen concurrently in a hypothyroid state. We report a case of severe hypothyroidism with poor drug compliance leading to rhabdomyolysis and acute kidney injury. Learning points: Hypothyroidism is a rare cause of acute kidney injury. In this case report, we studied a rare occurrence of acute renal impairment due to hypothyroidism with poor drug compliance, which induced rhabdomyolysis. Our report emphasized that thyroid status should be evaluated in patients with unexplained acute renal impairment or presenting with the symptoms of muscle involvement. PMID:27855234

  15. An unusual case of priapism.

    PubMed Central

    Jam, M.; Datta, N. S.; Askari, A.

    1993-01-01

    A case of sickle cell disease with 63 documented episodes of priapism that were managed medically is presented. The case is very unusual because of the fact that despite so many episodes of priapism, he did not lose sexual potency. On the contrary, over a period of time, his penis hypertrophied. To the best of our knowledge, this is the first such case with so many episodes of priapism reported in the English literature. We present a hypothesis for such unusual occurrence. PMID:8366540

  16. Two cases of scimitar variant.

    PubMed

    Takeda, S; Imachi, T; Arimitsu, K; Minami, M; Hayakawa, M

    1994-01-01

    The scimitar sign is characteristic of partial anomalous pulmonary venous drainage into the inferior vena cava (IVC). We encountered two variant cases of scimitar sign. In one case, the scimitar vein entered both the IVC and the left atrium (LA) without any intracardiac shunts. Surgical repair was made by simple ligation of the scimitar vein to correct the left to right shunt. Retrograde balloon occlusion angiography of the scimitar vein was diagnostic. In the other case, the scimitar vein showed a meandering course, and then drained into the LA without any connection with the IVC, and surgical intervention was not required.

  17. HYDROGEOLOGIC CASE STUDIES (DENVER PRESENTATION)

    EPA Science Inventory

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  18. Hydrogeologic Case Studies (Seattle, WA)

    EPA Science Inventory

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  19. HYDROGEOLOGIC CASE STUDIES (CHICAGO, IL)

    EPA Science Inventory

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  20. [A case of true hermaphroditism].

    PubMed

    Warenik-Szymankiewicz, A; Grotowski, W; Jaruzelska, J; Halerz-Nowakowska, B; Wiza, M

    1997-09-01

    In the paper we present the case of true hermaphroditism in young girl. The examinations revealed the presence of an ovary with left corn of the uterus at the left side and immature testis with seminal duct the right side.

  1. Teaching astronomy with case studies

    NASA Astrophysics Data System (ADS)

    Slater, Timothy F.

    2015-11-01

    Breaking the students into small, collaborative learning groups to solve a meaningful task together is one of the most successful and fully evaluated teaching techniques implemented over the last century. Although there are many ways to accomplish small group learning, a long-standing and consistently successful collaborative class activity is to use the case study teaching strategy. The use of case studies is common in medical schools and law schools, but not so common in the teaching of astronomy. Case studies create meaningful conversations among students and with the professor by focusing on life-like dilemmas to be solved. Case study tasks ask audience members to synthesize several ideas or evaluate scenarios that have not been explicitly presented to them in the lecture or in available readings.

  2. Case Study: del Amo Bioventing

    EPA Science Inventory

    The attached presentation discusses the fundamentals of bioventing in the vadose zone. The basics of bioventing are presented. The experience to date with the del Amo Superfund Site is presented as a case study.

  3. Nasopharyngeal Case-Control Study

    Cancer.gov

    A case-control study conducted in Taiwan between 1991-1994 among approximately 1,000 individuals to examine the role of viral, environmental, and genetic factors associated with the development of nasopharyngeal carcinoma

  4. Asperger's syndrome: a case report

    PubMed Central

    Goodman, Carol M.

    1987-01-01

    A case report is presented of an 11-year-old boy who has been diagnosed as having Asperger's syndrome. There follows a review of the clinical features, course, prognosis and management of this condition. PMID:2453672

  5. Mesothelioma in Mongolia: case report

    PubMed Central

    Damiran, Naransukh; Davaajav, Khishigtogtokh; Erdenebayar, Erdenechimeg; Gomboloi, Burmaa; Frank, Arthur L

    2015-01-01

    Background: More than 80% of cases of mesothelioma worldwide have a history of asbestos exposure. In Mongolia, workers in coal burning thermal power plants (TPP) have widely utilized asbestos as an insulation material. Methods: We describe the case of a 47-year-old woman diagnosed with a malignant pleural mesothelioma. She worked in a TPP in Ulaanbaatar, Mongolia for 28 years. Results: A computer tomography (CT) scan showed a circumferential ring around her left lung, and tissues’ samples had a biphasic variant of mesothelioma with epithelioid and sarcomatoid components. Discussion: This is the first reported case of mesothelioma in Mongolia. We expect additional cases of mesothelioma, as well as other asbestos related diseases, will be identified in the future. In order to properly track asbestos related diseases in the country, we recommend the creation of an asbestos related disease registry. PMID:25582747

  6. Measles (Rubeola) Cases and Outbreaks

    MedlinePlus

    ... and Mortality Weekly Report (MMWR), Notifiable Diseases and Mortality Tables Measles Cases From January 1 to April 21, 2018, 63 people from 16 states (Arkansas, California, Connecticut, Illinois, Indiana, Kansas, Louisiana, Michigan, Missouri, Nevada, New Jersey, New York, Oklahoma, Pennsylvania, ...

  7. Case studies of uncommon headaches.

    PubMed

    Evans, Randolph W

    2006-05-01

    The following interesting and uncommon headache disorders are presented through case studies: exploding head syndrome, hypnic headache, neck-tongue syndrome, "Alice in Wonderland" syndrome, nummular headache, red ear syndrome, burning mouth syndrome, spontaneous intracranial hypotension syndrome, and cardiac cephalalgia.

  8. Pediatric cannabinoid hyperemesis: two cases.

    PubMed

    Miller, Joseph B; Walsh, Mark; Patel, Pankaj A; Rogan, Michael; Arnold, Cliff; Maloney, Megan; Donnino, Michael

    2010-12-01

    Cannabinoid hyperemesis has recently been described in the literature. It is a syndrome characterized by severe nausea and hyperemesis in the setting of chronic marijuana abuse and, to date, has been described only in adults. We describe the syndrome in 2 pediatric patients, for whom extensive gastrointestinal workups failed to identify a clear cause and cessation of marijuana use resulted in the alleviation of their symptoms. As in most published adult cases, compulsive bathing was present in both of these cases.

  9. [Two cases of Costello syndrome].

    PubMed

    Masuyama, Tatsuo; Matsuo, Muneaki; Kuno, Tateo; Kitsuki, Kyoko; Kan, Yuka; Ishii, Kiyohisa; Ohtani, Yoshinobu

    2003-01-01

    We report two unrelated cases of Costello syndrome, presenting with poor postnatal growth, mild mental retardation, poor feeding, curly hair, coarse characteristic face, loose skin, hypotonia, and cardiac involvement. Nasal papilloma and acanthosis nigricans were the most characteristic features of this syndrome. Both cases had atrial fibrilation from infancy to early childhood. One patient had hypertonia in the lower extremities and pes equinovarus, while the other had hypotonia and pes planovalgus.

  10. Organizational Effectiveness Case Development Manual

    DTIC Science & Technology

    1980-10-01

    Target audience Legal issues UAmographic information Sanctions Write-up format L eaching case Pay-off s The manual is a guide for developing...most efficient and effective way. The manual is divided into three main sections: (1) on the issues of client system sanction, confidentiality, and...CASE DEVELOPMENT MANUAL James Bedoian, Larry E. Greiner, Charles P. Schaefer, Warren H. Schmidt, Stanley R. Weingart System Development Corporation

  11. Construction of integrated case environments.

    PubMed

    Losavio, Francisca; Matteo, Alfredo; Pérez, María

    2003-01-01

    The main goal of Computer-Aided Software Engineering (CASE) technology is to improve the entire software system development process. The CASE approach is not merely a technology; it involves a fundamental change in the process of software development. The tendency of the CASE approach, technically speaking, is the integration of tools that assist in the application of specific methods. In this sense, the environment architecture, which includes the platform and the system's hardware and software, constitutes the base of the CASE environment. The problem of tools integration has been proposed for two decades. Current integration efforts emphasize the interoperability of tools, especially in distributed environments. In this work we use the Brown approach. The environment resulting from the application of this model is called a federative environment, focusing on the fact that this architecture pays special attention to the connections among the components of the environment. This approach is now being used in component-based design. This paper describes a concrete experience in civil engineering and architecture fields, for the construction of an integrated CASE environment. A generic architectural framework based on an intermediary architectural pattern is applied to achieve the integration of the different tools. This intermediary represents the control perspective of the PAC (Presentation-Abstraction-Control) style, which has been implemented as a Mediator pattern and it has been used in the interactive systems domain. In addition, a process is given to construct the integrated CASE.

  12. Teaching with Cases: Learning to Question.

    ERIC Educational Resources Information Center

    Boehrer, John; Linsky, Marty

    1990-01-01

    This chapter discusses the origins of the case method, looks at the question of what is a case, gives ideas about learning in case teaching, the purposes it can serve in the classroom, the ground rules for case discussion, including the role of questions, and new directions for case teaching. (MLW)

  13. Four cases of vertebrobasilar insufficiency.

    PubMed

    Inui, H; Yoneyama, K; Kitaoku, Y; Nakane, M; Ohue, S; Yamanaka, T; Ueda, T; Fujita, N; Miyahara, H; Matsunaga, T

    1998-01-01

    Four cases of vertebrobasilar insufficiency are reported. Case 1 was a 38-year-old man who felt a sudden onset of dizziness when he turned his head to the back. An abnormal positional nystagmus was observed when he rotated his head to the left. A magnetic resonance angiogram (MRA) demonstrated total occlusion of the left vertebral artery (VA). Case 2 was a 31-year-old woman who had a total occlusion of her left VA as observed in the MRA. Case 3 was a 68-year-old man who noted dizziness. The systolic blood pressure change on his Schellong test was 28 mmHg. On his MRA, severe displacement of the basilar and the vertebral arteries was visible. Case 4 was a 76-year-old woman who noted a blackout-like sensation. Optokinetic nystagmus was noted with a hyponystagmus pattern, and an eye tracking test showed a saccadic pattern. On her MRA, the vertebrobasilar system was narrowed. The arterial architecture and any stenosis of the blood vessels could be detected non-invasively by MRA.

  14. Crouzon's Syndrome: A Case Report

    PubMed Central

    Jyothsna, M; Ahmed, Syed Basheer; Lakshmi, K Sree

    2013-01-01

    ABSTRACT Crouzon's syndrome (CS) is a rare autosomal dominant condition with multiple mutations of the fibroblast growth factor receptor (FGFR2) gene, which accounts for 4.8% of all cases of craniosynostosis. It is characterized by premature closure of cranial sutures, cranial deformities, midface hypoplasia, relative mandibular prognathism, hypertelorism, proptosis, strabismus and short upper lip, crowding of teeth, pseudocleft or sometimes cleft palate and other associated abnormalities. The CS can vary in severity from mild presentation to severe forms involving multiple cranial sutures. We report a case of CS in 11-year-old boy. How to cite this article: Kumar GR, Jyothsna M, Ahmed SB, Lakshmi KS, Crouzon's Syndrome: A Case Report. Int J Clin Pediatr Dent 2013;6(1):33-37. PMID:25206185

  15. Crouzon's Syndrome: A Case Report.

    PubMed

    Kumar, G Ravi; Jyothsna, M; Ahmed, Syed Basheer; Lakshmi, K Sree

    2013-01-01

    Crouzon's syndrome (CS) is a rare autosomal dominant condition with multiple mutations of the fibroblast growth factor receptor (FGFR2) gene, which accounts for 4.8% of all cases of craniosynostosis. It is characterized by premature closure of cranial sutures, cranial deformities, midface hypoplasia, relative mandibular prognathism, hypertelorism, proptosis, strabismus and short upper lip, crowding of teeth, pseudocleft or sometimes cleft palate and other associated abnormalities. The CS can vary in severity from mild presentation to severe forms involving multiple cranial sutures. We report a case of CS in 11-year-old boy. How to cite this article: Kumar GR, Jyothsna M, Ahmed SB, Lakshmi KS, Crouzon's Syndrome: A Case Report. Int J Clin Pediatr Dent 2013;6(1):33-37.

  16. Menstruation angina: a case report

    PubMed Central

    2009-01-01

    Introduction Menstruation is commonly associated with migraine and irritable bowel but is rarely correlated with angina or myocardial ischaemia. Only a small number of cases have been reported suggesting a link between menstruation and myocardial ischaemic events. Case presentation A case of menstruation angina is reported in order to raise awareness of this association. A 47-year-old South Asian woman presented with recurrent chest pains in a monthly fashion coinciding with her menstruations. Each presentation was associated with troponin elevation. Angioplasty failed to resolve her symptoms but she eventually responded to hormonal therapy. Conclusions The possibility of menstruation angina should always be taken into account in any female patients from puberty to menopause presenting with recurrent chest pains. This can allow an earlier introduction of hormonal therapy to arrest further myocardial damage. PMID:19830114

  17. Brain Tuberculomas: A Case Report

    PubMed Central

    Saleh, Maryam; Saeedi, Ali Asghar; Ali Pooran, Ali

    2014-01-01

    Introduction: An unusual incidence of tuberculosis in different parts of the body is called tuberculomas. The rate of brain tuberculosis is rare. Case Presentation: The following case of tuberculamas of the brain, presented by enhancing rings of meninges, is reported because of its rarity. It was a case of brain tuberculomas in a 15-year-old girl with primary symptoms of headache and general weakness, and no signs of primary pulmonary infection. Discussion: The subject underwent computerized tomography (CT) and magnetic resonance imaging (MRI) of the brain. Microbiological tests (acid fast bacilli smear-AFB, and culture of biopsy specimen) were applied subsequently. According to the results, the problem was diagnosed as brain tuberculomas. After operation she was completely treated with anti-TB drugs. Although brain tuberculosis is rare, it was diagnosed on the basis of histopathology and the patient's successful response to anti-tuberculous drug treatment. PMID:25368795

  18. Testicular calculus: A rare case.

    PubMed

    Sen, Volkan; Bozkurt, Ozan; Demır, Omer; Tuna, Burcin; Yorukoglu, Kutsal; Esen, Adil

    2015-01-01

    Testicular calculus is an extremely rare case with unknown etiology and pathogenesis. To our knowledge, here we report the third case of testicular calculus. A 31-year-old man was admitted to our clinic with painful solid mass in left testis. After diagnostic work-up for a possible testicular tumour, he underwent inguinal orchiectomy and histopathologic examination showed a testicular calculus. Case hypothesis: Solid testicular lesions in young adults generally correspond to testicular cancer. Differential diagnosis should be done carefully. Future implications: In young adults with painful and solid testicular mass with hyperechogenic appearance on scrotal ultrasonography, testicular calculus must be kept in mind in differential diagnosis. Further reports on this topic may let us do more clear recommendations about the etiology and treatment of this rare disease.

  19. A Case of Lymphomatoid Keratosis

    PubMed Central

    Choi, Min Jee; Kim, Hei Sung; Kim, Hyung Ok; Song, Kye Yong

    2010-01-01

    Lymphomatoid keratosis (LK) is considered to be a rare variant of cutaneous lymphoid hyperplasia, with epidermotropism. We herein report a case of LK which developed on the abdomen of an elderly Korean woman. A 60-year-old woman presented with a 10-year history of a pruritic, solitary, brown to black plaque on the abdomen. Histopathologically, the specimen showed hyperkeratosis, parakeratosis, acanthosis and Pautrier's micro-abscess in the epidermis, and a lichenoid infiltration of lymphocytes in the dermis, which expressed both B cell and T cell lineage on the immune-histochemical staining. Based on these clinical and histopathological findings, our case was diagnosed as LK. To our knowledge, this is the first case report of LK in the Korean dermatologic literature. PMID:20548920

  20. Pleural mesothelioma – case report

    PubMed Central

    Klawiter, Anna; Damaszke, Tomasz

    2010-01-01

    Summary Background: Pleural mesothelioma is a very rare neoplasm; especially the local form. The diagnostics is difficult and the prognosis unfavourable. Case Report: We presented a case of a man with dyspnoea and cough. His chest radiogram showed hydrothorax on the left side. Neither the examinations of the pleural liquid, nor the CT-guided fine needle biopsy established the diagnosis. CT showed features suggestive of pleural mesothelioma. The diagnosis was confirmed by thoracoscopy. Although no neoplastic cells were found in the thoracoscopic specimen from the supradiaphragmatic tumor, we assumed that to be a case of a diffuse, primarily local form of mesothelioma. Conclusions: Diagnostics of pleural mesothelioma is very difficult. CT and thoracoscopy seem to be very valuable diagnostic methods. It is worth remembering that pleural mesothelioma can have a local form which may transform into a diffuse one. PMID:22802809

  1. [Case management process identified from experience of nurse case managers].

    PubMed

    Park, Eun-Jun; Kim, Chunmi

    2008-12-01

    The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

  2. CASE Annual Fund Ideas. The Best of CASE Currents.

    ERIC Educational Resources Information Center

    Carter, Virginia L., Ed.

    Fund raising ideas for colleges and universities are compiled in a handbook of articles from "CASE Currents." The first section discusses the annual fund drive in such articles as: "Start that Habit Early--Senior Giving '5X'" (Lynn Segall); "Join Hands with Lost Friends" (Jeanne Knoerle); "Match Those…

  3. Approximation of Engine Casing Temperature Constraints for Casing Mounted Electronics

    NASA Technical Reports Server (NTRS)

    Kratz, Jonathan L.; Culley, Dennis E.; Chapman, Jeffryes W.

    2017-01-01

    The performance of propulsion engine systems is sensitive to weight and volume considerations. This can severely constrain the configuration and complexity of the control system hardware. Distributed Engine Control technology is a response to these concerns by providing more flexibility in designing the control system, and by extension, more functionality leading to higher performing engine systems. Consequently, there can be a weight benefit to mounting modular electronic hardware on the engine core casing in a high temperature environment. This paper attempts to quantify the in-flight temperature constraints for engine casing mounted electronics. In addition, an attempt is made at studying heat soak back effects. The Commercial Modular Aero Propulsion System Simulation 40k (C-MAPSS40k) software is leveraged with real flight data as the inputs to the simulation. A two-dimensional (2-D) heat transfer model is integrated with the engine simulation to approximate the temperature along the length of the engine casing. This modification to the existing C-MAPSS40k software will provide tools and methodologies to develop a better understanding of the requirements for the embedded electronics hardware in future engine systems. Results of the simulations are presented and their implications on temperature constraints for engine casing mounted electronics is discussed.

  4. Approximation of Engine Casing Temperature Constraints for Casing Mounted Electronics

    NASA Technical Reports Server (NTRS)

    Kratz, Jonathan; Culley, Dennis; Chapman, Jeffryes

    2016-01-01

    The performance of propulsion engine systems is sensitive to weight and volume considerations. This can severely constrain the configuration and complexity of the control system hardware. Distributed Engine Control technology is a response to these concerns by providing more flexibility in designing the control system, and by extension, more functionality leading to higher performing engine systems. Consequently, there can be a weight benefit to mounting modular electronic hardware on the engine core casing in a high temperature environment. This paper attempts to quantify the in-flight temperature constraints for engine casing mounted electronics. In addition, an attempt is made at studying heat soak back effects. The Commercial Modular Aero Propulsion System Simulation 40k (C-MAPSS40k) software is leveraged with real flight data as the inputs to the simulation. A two-dimensional (2-D) heat transfer model is integrated with the engine simulation to approximate the temperature along the length of the engine casing. This modification to the existing C-MAPSS40k software will provide tools and methodologies to develop a better understanding of the requirements for the embedded electronics hardware in future engine systems. Results of the simulations are presented and their implications on temperature constraints for engine casing mounted electronics is discussed.

  5. Bakke's Case vs. the Case for Affirmative Action

    ERIC Educational Resources Information Center

    Smith, Ralph R.

    1978-01-01

    Before the Supreme Court is Allan Bakke's claim that he was denied medical school admission because 16 reserved places were granted to minority applicants. Professor Smith believes the case is weak, that admissions are best left to university discretion, and that whatever the Court renders, the questions raised by Bakke will not be put to rest.…

  6. Literary Precocity: An Exceptional Case among Exceptional Cases.

    ERIC Educational Resources Information Center

    Edmunds, Alan L.; Noel, Kathryn A.

    2003-01-01

    This article presents the case of Geoffrey, a prolific 5-year-old writer. It examines his writing and how his intrapersonal factors and propitious environment contribute to his prodigious output. Childhood precocity is presented as an age-based comparable rather than as an adult-based predictor. A developmental theory of precocity is considered.…

  7. Dissecting malpractice in pancreaticoduodenectomy cases.

    PubMed

    Anandalwar, Seema P; Scholer, Anthony J; Ninan, Gigio; Oliver, Joseph B; Christian, Derick; Eloy, Jean Anderson; Chokshi, Ravi J

    2017-05-15

    Medical malpractice is a growing concern for physicians in all fields. Surgical fields have some of the highest malpractice premiums and litigation rates. Pancreaticoduodenectomy (PD) has become a popular procedure; however, it is still associated with significant morbidity and mortality. This study is the first to analyze factors involved in litigation regarding PD cases. The Westlaw database was searched for jury verdicts and settlements using the terms "medical malpractice" and "pancreaticoduodenectomy". Twenty-nine cases from 1991 to 2012 were initially collected. Seven entries not involving PD and three duplicate cases were excluded. Nineteen cases were included for analysis. Of the 19 cases included in the analysis, three (15.8%) reached a settlement, three (15.8%) were ruled in favor of the plaintiff, and 13 (68.4%) were ruled in favor of the physician. The average settlement award was $398,333 (range, $195,000-500,000), and the average plaintiff award was $4,288,869 (range, $1,066,608-10,300,000). The most common factors raised in litigation included PD being allegedly unnecessary (47.4%), followed by postoperative negligence and misdiagnosis (36.8% each). The most common factors present in litigation included the allegation that PD was unnecessarily performed. The cases that are awarded large monetary sums are those that involve continued medical care. Ways to improve patient safety and limit litigation include increasing transparency and communication with a thorough discussion between surgeon and patient of the most common topics of litigation discussed. Published by Elsevier Inc.

  8. Case-based medical informatics

    PubMed Central

    Pantazi, Stefan V; Arocha, José F; Moehr, Jochen R

    2004-01-01

    Background The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning) and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. Discussion We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences of problem-solving and

  9. Informed Consent for Case Reports

    PubMed Central

    Levine, Stephen B.; Stagno, Susan J.

    2001-01-01

    A new international standard of editorial policy calls for written informed consent by the subject of every case report. Although this appears to be ethically appealing, the authors posit that in some situations, requesting informed consent may be unethical, can harm patients, and may erode the use of case reports as a valuable teaching method in psychiatry and psychotherapy. The authors discuss concerns regarding this new policy for mental health publication based on issues of transference, countertransference, best interest of the patient, and practicality. PMID:11402083

  10. Bertolotti's syndrome: a case report.

    PubMed

    Mitra, Raj; Carlisle, Mark

    2009-01-01

    A case report and literature review is presented. To review relevant data for the management of Bertolotti's syndrome and to determine whether the transverse process-ilium articulation may be a pain generator. Bertolotti's syndrome is associated with axial low back pain secondary to arthritic changes; the pain generator in the disorder is unclear. We present a case report of symptomatic Bertolotti's syndrome managed with intra-articular steroid injections. A patient with Bertolotti's syndrome had significant relief of axial pain after steroid injection of the ilium-transverse process articulation. Steroid therapy may be a non-surgical alternative for the treatment of symptomatic Bertolotti's syndrome.

  11. Case studies in medical futility.

    PubMed

    Mains, Douglas A; Coustasse, Alberto; Lurie, Sue G

    2007-01-01

    Technology has provided means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient. This study presents two case histories, compiled from historical patient charts, staff notes and observations, that illustrate the variety of ethical issues involved and the role culture plays in the decision making process related to possible futile medical treatment. Ethical and cultural issues related to the cases are discussed and processes are presented that can help hospitals to avoid, or decrease the level of, medically futile care, and improve the cultural appropriateness of medical care and relationships with patients.

  12. [Unusual cases of non-Hodgkin's lymphomas--case reports].

    PubMed

    Wach, M; Dmoszyńska, A; Wasik-Szczepanek, E; Skomra, D

    2000-01-01

    We describe 4 cases of non-Hodkin's lymphomas that were interesting because of their curiosal clinical courses and spontaneous complete remissions during the course of high malignancy lymphoma. We present three of them for the first time in Poland. Case 1: a 61-year old woman was admitted to the hospital because of the headache, lasting for 4 months before hospitalization and right hemiparesis. CT scans revealed the presence of tumor in the temporo-occipital region. The diagnosis of B-cell lymphoma was established at histopathological examination of the postoperative material. Co60--therapy of these region was applied after the operation with good response. Case 2: a 38-year woman was admitted to the hospital because of L5-S1 spondylolisthesis to operate it. During the hospitalization haemolytic anaemia of unknown origin, thrombocytopoenia, splenomegaly, fever and rising acute insufficiency of kidneys, heart, liver and CNS were occurred. The patient died, despite applying corticosteroidotherapy. The diagnosis of intravascular lymphoma was established at postmortem examination. Case 3: a 51-year old woman was admitted to the hospital with diagnosis: anaplastic non-Hodgkin lymphoma B-cell type high malignancy established after the double histopathological examination of lymph nodes and biopsy of the lung. At the admission to the Department of Haematology we stated absolute regression of these changes. The patient had been only observed in the Outpatient Department over 1 year. She died after 6 months since the beginning of the relapse despite intensive chemotherapy. Case 4: a 43-year old man was admitted to the hospital because of great hyperleukocytosis, hepatosplenomegaly and neurological symptoms. The diagnosis: chronic prolymphocytic leukaemia was established. The cerebrospinal fluid examination showed presence of mononuclears which infiltrated CNS. CT scans of the brain revealed leucaemic infiltrations of the hemispheres and cerebellum. The patient died despite

  13. The Case for Nudge Analytics

    ERIC Educational Resources Information Center

    Carmean, Colleen; Mizzi, Philip

    2010-01-01

    Developed as a concept in the science of choice, subtle interactions--or "nudges"--can influence people's actions without infringing on their freedom of choice. This article makes the case that not only can the wealth of digital data in higher education nudge students to better achievement and persistence but also that the knowledge embedded in…

  14. Rhino facial zygomycosis: case report

    PubMed Central

    Souza, Juliana Miguita e; Sproesser, Antonio José; Felippu, Alexandre; Fuks, Florencia Barbero; de Oliveira, Carlos Augusto Cardim

    2014-01-01

    Zygomycosis is an invasive disease that affects both immunocompetent and immunocompromised, depending on the type of strain. This disease diagnosis is clinical and histopathological, and its treatment is based on antifungal therapy and surgical cleaning. This paper reports a case of a boy with invasive zygomycosis rinofacial who final treatment was successful after underwent antifungal and surgical therapies. PMID:25167339

  15. Case Studies in Broadcast Management.

    ERIC Educational Resources Information Center

    Coleman, Howard W.

    This collection of case studies, based on factual situations which have challenged broadcast managers in recent years, is designed to stimulate thinking about and solving of "real world" problems in commercial radio and television operations. Topics of a serious, long-run nature include enlarging the radio audience; station revenue and economy;…

  16. Case Studies in Applied Mathematics.

    ERIC Educational Resources Information Center

    Mathematical Association of America, Washington, DC.

    This collection of nine case studies in applied mathematics was written primarily for the use of the instructor by a Conference sponsored by the Committee on the Undergraduate Program in Mathematics (CUPM). Each chapter contains exercises of varying degrees of difficulty and several include student projects. The materials were used on a trial…

  17. A case of feverish neutropenia

    PubMed Central

    Invernizzi, Rosangela; Ambaglio, Chiara; Quaglia, Federica

    2014-01-01

    Key Clinical Message A case of feverish benign neutropenia occurring in a diabetic patient receiving pregabalin for peripheral neuropathy is reported. Although pregabalin-induced neutropenia is very rare, it is important to keep in mind that this drug like other anticonvulsants used for neuropathic pain, can cause severe neutropenia. PMID:25548642

  18. Vibrio parahemolyticus bacteremia: case report.

    PubMed

    Ng, T C; Chiang, P C; Wu, T L; Leu, H S

    1999-09-01

    Vibrio parahemolyticus (V. parahemolyticus) is a halophilic gram-negative bacillus that lives in the ocean. It is the leading cause of infectious diarrhea in Taiwan and sometimes produces soft tissue infections, but it is rarely a cause of bacteremia. There have been only 11 cases reported in the literature. Most of the cases involved a history of ingestion of seafood or exposure to seawater. In addition, those patients were all immunosuppressed, especially with leukemia and cirrhosis. We report a 60-year-old male patient with chronic hepatitis C and adrenal insufficiency. He developed V. parahemolyticus bacteremia following ingestion of seafood one week prior to admission. His condition was complicated with neck and right lower leg soft tissue infection, as well as multiple organ failure. The patient survived after intravenous ceftazidime, oral doxycycline, and surgical debridement. To our knowledge, this is the 12th reported cases on Medline, and the second bacteremic case in Taiwan. After reviewing the literature, we suggest that all patients with immunosuppressed conditions or adrenal insufficiency should eat foods that are well cooked and avoid raw seafood. Moreover, when patients who are at risk to develop fever, diarrhea, and soft tissue infection after ingestion of seafood, V. parahemolyticus infection should be suspected. All culture specimens should be inoculated on Vibrios selective media.

  19. The 'Amistad' Case. Lesson Plan.

    ERIC Educational Resources Information Center

    National Archives and Records Administration, Washington, DC.

    Teaching about the Amistad case provides correlations to the National Standards for History, and Civics and Government. An overview of the events of 1839 is given in this lesson plan. Seven student activities include reading and using primary source documents, writing journal articles, viewing the movie "Amistad," and giving…

  20. Macrodystrophia lipomatosa. A case report.

    PubMed

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

    1995-07-01

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

  1. Due Process Hearing Case Study

    ERIC Educational Resources Information Center

    Bateman, David F.; Jones, Marni Gail

    2010-01-01

    This article presents a due process hearing case study of a mother who contended that his son, D.J., has been denied of a free and appropriate public education (FAPE) of his School District after being suspended from school. D.J., an elementary student, had been described as hyperactive, inattentive, defiant, and often volatile. He was identified…

  2. Current Cases on Academic Freedom.

    ERIC Educational Resources Information Center

    Sandmann, Warren

    This paper discusses current court rulings on academic freedom at the college and university level. The paper focuses on three cases: "Hall v. Kutztown," in which the U.S. District Court for the Eastern District of Pennsylvania ruled that Kutztown University violated the free speech rights of a philosophy professor when it rejected him…

  3. Rett'S syndrome : a case report.

    PubMed

    Gupta, V

    2001-01-01

    Rett's syndrome is a rare condition affecting only the girl child. It presents as a pervasive developmental disorder with a remarkable behavioural phenotype. The cause for this remains unknown but genetic factors and brain dysfunction have been implicated. This case report emphasises the importance of being aware of rare yet significant disorders of interest to neuro-developmental psychiatrists.

  4. RETT'S SYNDROME : A CASE REPORT

    PubMed Central

    Gupta, Vinay

    2001-01-01

    Rett's syndrome is a rare condition affecting only the girl child. It presents as a pervasive developmental disorder with a remarkable behavioural phenotype. The cause for this remains unknown but genetic factors and brain dysfunction have been implicated. This case report emphasises the importance of being aware of rare yet significant disorders of interest to neuro-developmental psychiatrists. PMID:21407847

  5. [A case of cutaneous protothecosis].

    PubMed

    Kazantseva, I A; Molochkov, A V; Sukhov, A V; Bondarenko, E V

    The paper describes a case of a rare opportunistic infection, such as skin lesion caused by achlorophyllic unicellular algae of the genus Prototheca. It provides a detailed pathologic description of the foci of cutaneous protothecosis, such as pandermal inflammatory infiltrate, granulomas, pseudoepitheliomatous hyperplasia, and intraepidermal abscesses. Criteria for pathogen detection in histological sections are given.

  6. Abusive Administration: A Case Study

    ERIC Educational Resources Information Center

    Jefferson, Anne L.

    2006-01-01

    In the academic world, there is an assumption of reasonable administrative conduct. In fact, to ensure such conduct, universities, like other public institutions, may have collective agreements to reinforce this assumption. However, in some cases, the university as employer can very quick off the mark should any faculty member wander into what it…

  7. Gestational diabetes insipidus. Case Report.

    PubMed

    Ejmocka-Ambroziak, Anna; Grzechocińska, Barbara; Jastrzebska, Helena; Kochman, Magdalena; Cyganek, Anna; Wielgoś, Mirosław; Zgliczyński, Wojciech

    2015-01-01

    Gestational diabetes insipidus is a very rare complication. However, undiagnosed and untreated may lead to serious complications in both mother and fetus. In this study, a case of 34-year-old female patient with diabetes insipidus associated with pregnancy was reported. We discussed process of diagnosis and treatment with particular emphasis on the monitoring of water-electrolyte imbalance during labor.

  8. The Case for Forensic Toxicology

    ERIC Educational Resources Information Center

    Baker, William P.; DeBeus, Elizabeth; Jones, Carleton

    2006-01-01

    Understanding natural and human-induced hazards is an important part of the standards-based science curriculum. Experience, however, indicates that the topic is a difficult one for many students. We have developed an exciting investigative laboratory exercise that uses simulated food-based case studies to promote critical thinking and improve…

  9. Benign squamous papillomatosis: case report.

    PubMed Central

    Manoharan, V; Sommerville, J M

    1987-01-01

    Squamous papillae in the vestibule are common. They were once considered to be normal variants of female anatomy, but reports of the viral aetiology of such lesions are emerging. When they are symptomatic, squamous papillae can lead to problems in sexual relationships between healthy partners. Here we report a case that responded well to treatment. Images PMID:3428897

  10. Case Studies in School Communication.

    ERIC Educational Resources Information Center

    Texas School Public Relations Association.

    This two-part source book offers administrators both general information for effective communications in public education and case studies describing methods used by individual Texas school districts to solve communications problems. General articles include guidelines for working with the news media, producing school newsletters, developing a…

  11. Case Formulation in TADS CBT

    ERIC Educational Resources Information Center

    Rogers, Gregory M.; Reinecke, Mark A.; Curry, John F.

    2005-01-01

    For the Treatment for Adolescents With Depression Study (TADS), a cognitive-behavioral therapy (CBT) manual was developed with the aim of balancing standardization and flexibility. In this article, we describe the manual's case formulation procedures, which served as one major mechanism of flexibility in TADS CBT. We first describe the essential…

  12. Video Cases. [SITE 2002 Section].

    ERIC Educational Resources Information Center

    Talley, Sue, Ed.

    This document contains the following papers on video case studies from the SITE (Society for Information Technology & Teacher Education) 2002 conference: (1) "Developing Digital Video Resources To Improve Teaching with Technology: The PT3--'Best Practices' Project"; (2) "Portraits of Three Schools from the U.S.A. Exemplary Technology-Supported…

  13. Employee Participation: Some Australian Cases.

    ERIC Educational Resources Information Center

    Lansbury, Russell D.; Davis, Edward M.

    1992-01-01

    The Australian Workplace Industrial Relations Survey of 2,353 companies showed sporadic employee participation in decision making. Although case studies of Ford Motor, Australia Post, Lend Lease, Telecom Australia, and Woodlawn Mining illustrate successful programs, most managers appear cautious about industrial democracy. (SK)

  14. True hermaphrodite: a case report.

    PubMed

    Iqbal, Muhammad Zafar; Jam, Mazhar Rafee; Saleem, Muhammad; Ahmad, Mushtaq

    2011-05-01

    True hermaphrodite is one of the rarest variety of disorders of sexual differentiation (DSD) and represents only 5% cases of all. A 3-year-old child presented with left sided undescended testis and penoscrotal hypospadias. Chordee correction was performed 18 months back, elsewhere. At laparotomy Mullerian structures were present on left side. On right side testis was normally descended into the scrotum.

  15. Student-generated case reports.

    PubMed

    Good, Christopher J

    2009-01-01

    When students create teaching materials, learning can be enhanced. Therefore, a project was designed based on the traditional clinical case report and the chiropractic technique and principles curriculum at the University of Bridgeport College of Chiropractic. The objectives were to increase mastery in a clinical topic, increase awareness of different patient presentations and management options, and enhance information technology skills. Following lectures about the components of a case report and neurological reflexes related to visceral comorbidities and subluxation and joint dysfunction, students created a case report based on a template provided by the instructor. A survey gathered student perspectives on the exercise. More than 70% of the surveyed students felt the project was at least moderately helpful in improving understanding of a case report, the condition investigated, their clinical reasoning, and the ability to integrate information. Most felt that they improved their understanding of neurological reflexes, use of the literature, and the practice of evidence-based care. The majority believed that they identified weakness in knowledge, improved self-learning skills, and increased confidence in managing patients. Most enjoyed it at least somewhat and 70% agreed that the project should be continued. Many believed that they were better prepared for national boards and had improved their writing skills.

  16. Graphite oral tattoo: case report.

    PubMed

    Moraes, Renata Mendonça; Gouvêa Lima, Gabriela de Morais; Guilhermino, Marinaldo; Vieira, Mayana Soares; Carvalho, Yasmin Rodarte; Anbinder, Ana Lia

    2015-10-16

    Pigmented oral lesions compose a large number of pathological entities, including exogenous pigmentat oral tattoos, such as amalgam and graphite tattoos. We report a rare case of a graphite tattoo on the palate of a 62-year-old patient with a history of pencil injury, compare it with amalgam tattoos, and determine the prevalence of oral tattoos in our Oral Pathology Service. We also compare the clinical and histological findings of grafite and amalgam tattoos. Oral tattoos affect women more frequently in the region of the alveolar ridge. Graphite tattoos occur in younger patients when compared with the amalgam type. Histologically, amalgam lesions represent impregnation of the reticular fibers of vessels and nerves with silver, whereas in cases of graphite tattoos, this impregnation is not observed, but it is common to observe a granulomatous inflammatory response, less evident in cases of amalgam tattoos. Both types of lesions require no treatment, but in some cases a biopsy may be done to rule out melanocytic lesions.

  17. Case mix management in context.

    PubMed

    King, H

    1988-02-01

    The advent of DRGs has demanded that hospitals account for all costs and resources. A case mix management system must take into consideration every component of a total managerial accounting strategy. This article discusses the factors healthcare institutions need to address to achieve a completely interfaced accounting system.

  18. The Case of Jessica Chang.

    ERIC Educational Resources Information Center

    Chen, Stephen; Leong, Frederick T. L.

    1997-01-01

    Reports on a case study that explores the culture-related issues of Asian Americans in the workplace. Focuses on a young, second-generation, Chinese-American woman, Jessica Chang, and the employment challenges that Dr. Chang encountered. Discusses her job strategies and some of the ethical dilemmas that she faced. (RJM)

  19. [Sexual offences--selected cases].

    PubMed

    Łabecka, Marzena; Jarzabek-Bielecka, Grazyna; Lorkiewicz-Muszyńska, Dorota

    2013-04-01

    Expert testimony on violence victims also includes victims of sexual assault. The role of an expert is to classify the injuries by their severity as defined in art. 157 156 or 217 of the Criminal Code pertaining to crimes against health and life. Also, the role of an expert opinion is to determine whether the injuries identified during the exam occurred at the time and under the circumstances stated in medical history. The examination of sexual assault victims is conducted by two experts: a gynecologist and a forensic physician. Most examinations are performed at different times and various medical centers. The conclusions are presented in an official report. Regardless of victim age, all sexual crimes are investigated ex officio by the Police Department and the Prosecutor's Office. Further legal classification of criminal offenses is the task of an appropriate legal body and the offenses are codified in accordance with the provisions of chapter XXV of the Criminal Code, articles 197 - 205. In controversial cases, i.e. when two different expert opinions appear on the same case, or if, according to the law enforcement, a medical opinion is insufficient for some reason, an appropriate expert or team of experts is appointed to resolve the problem. To present selected cases of sexual violence victims treated at the Department of Gynecology and assessed at the Department of Forensic Medicine with reference to the challenges regarding qualification of the sustained injuries and clinical diagnoses. Research material included selected forensic opinions developed for law enforcement offices that involved victims of sexual violence. The expert opinions were prepared either on the basis of submitted evidence, or both, submitted evidence and examination of the victim at the Department of Forensic Medicine. Moreover the article presents a case of a patient examined and treated at the Department of Gynecology in Poznan. Based on the selected cases, the authors conclude that a

  20. Compatible poliomyelitis cases in India during 2000.

    PubMed Central

    Kohler, Kathryn A.; Hlady, W. Gary; Banerjee, Kaushik; Gupta, Dhananjoy; Francis, Paul; Durrani, Sunita; Zuber, Patrick L. F.; Sutter, Roland W.

    2003-01-01

    OBJECTIVE: To describe the characteristics of compatible poliomyelitis cases and to assess the programmatic implications of clusters of such cases in India. METHODS: We described the characteristics of compatible poliomyelitis cases, identified clusters of compatible cases (two or more in the same district or neighbouring districts within two months), and examined their relationship to wild poliovirus cases. FINDINGS: There were 362 compatible cases in 2000. The incidence of compatible cases was higher in districts with laboratory-confirmed poliomyelitis cases than in districts without laboratory-confirmed cases. Of 580 districts, 96 reported one compatible case and 72 reported two or more compatible cases. Among these 168 districts with at least one compatible case, 123 had internal or cross- border clusters of compatible cases. In 27 districts with clusters of compatible cases, no wild poliovirus was isolated either in the same district or in neighbouring districts. Three of these 27 districts presented laboratory-confirmed poliomyelitis cases during 2001. CONCLUSION: Most clusters of compatible cases occurred in districts identified as areas with continuing wild poliovirus transmission and where mopping-up vaccination campaigns were carried out. As certification nears, areas with compatible poliomyelitis cases should be investigated and deficiencies in surveillance should be corrected in order to ensure that certification is justified. PMID:12640469

  1. Brief: Field measurements of casing tension forces

    SciTech Connect

    Quigley, M.S.; Lewis, D.B.; Boswell, R.S.

    1995-02-01

    Tension forces acting on individual casing joints were accurately measured during installation of 10,158 ft of 9 5/8-in. {times} 47-lbm/ft casing and 11,960 ft of 11 7/8-in. {times} 71.8-lbm/ft casing. A unique casing load table (CLT) weighed the casing string after the addition of each casing joint. Strain gauges attached inside the pin ends of instrumented casing joints (ICJ`s) directly measured tension force on those joints. A high-speed computer data-acquisition system (DAS) automatically recorded data from all the sensors. Several casing joints were intentionally subjected to extreme deceleration to determine upper limits for dynamic tension forces. Data from these testsmore » clearly show effects of wellbore friction and casing handling conditions. In every case, tension forces in the casing during maximum deceleration were considerably less than expected. In some cases, the highest tension forces occurred when the casing lifted out of the slips. Peak tension forces caused by setting the casing slips were typically no more than 5% greater than tension forces in the casing at rest. This dynamic amplification was far less than the 60% value used in the previous casing design method. Reducing the safety factor for installation loads has permitted use of lighter, less-expensive casing than dictated by older design criteria.« less

  2. Statin-Associated Polymyalgia Rheumatica. An Analysis Using WHO Global Individual Case Safety Database: A Case/Non-Case Approach

    PubMed Central

    de Jong, Hilda J. I.; Saldi, Siti R. F.; Klungel, Olaf H.; Vandebriel, Rob J.; Souverein, Patrick C.; Meyboom, Ronald H. B.; Passier, J. L. M. (Anneke); van Loveren, Henk; Tervaert, Jan Willem Cohen

    2012-01-01

    Objective To assess whether there is an association between statin use and the occurrence of polymyalgia rheumatic (PMR) in the spontaneous reporting database of the World Health Organisation (WHO). Methods We conducted a case/non-case study based on individual case safety reports (ICSR) in the WHO global ICSR database (VigiBase). Case reports containing the adverse event term polymyalgia rheumatica (WHOART or MedDRA Preferred Term) were defined as cases. Non-cases were all case reports containing other adverse event terms. Each case was matched to five non-cases by age, gender, and time of reporting. Case reports regarding a statin as suspected or concomitant drug were identified using the Anatomical Therapeutic Chemical (ATC) classification. Multivariate logistic regression was used to calculate reporting odds ratios (RORs) with 95% confidence intervals (CI). Results We identified 327 reports of PMR as cases and 1635 reports of other ADRs as non-cases. Among cases, statins were more frequently reported as suspected agent (29.4%) compared to non-cases (2.9%). After adjustment for several covariates, statins were significantly associated with reports of PMR (ROR 14.21; 95% CI 9.89–20.85). Conclusion The results of this study lends support to previous anecdotal case reports in the literature suggesting that the use of a statin may be associated with the occurrence of PMR. Further studies are needed to study the strength of the association in more detail and to elucidate the underlying mechanism. PMID:22844450

  3. The Elements of a Good Case

    ERIC Educational Resources Information Center

    Fossey, Richard; Crow, Gary M.

    2011-01-01

    In the broad sense, case teaching is an ancient pedagogy. Since time began, teachers have taught other people by drawing on stories from real-life experiences. In a way, then, telling stories taken from real life can be seen as case teaching. Case writing and case teaching in a college or university setting, however, require specific research and…

  4. Qualitative Case Study Research as Empirical Inquiry

    ERIC Educational Resources Information Center

    Ellinger, Andrea D.; McWhorter, Rochell

    2016-01-01

    This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…

  5. [Four cases of penile fracture].

    PubMed

    Ohtake, Shinji; Nakaigawa, Noboru; Kubota, Yoshinobu

    2013-04-01

    Penile fracture is not common but is an emergency disease. We report 4 cases of penile fracture treated at the Department of Urology, Yokohama City University between 2005 and 2012. The age of the patients ranged between 26 and 67 years (mean age, 41.5 years). Of the patients in our series, 3 sustained injury during sexual intercourse, and 1 while rolling over in bed. All patients were treated surgically and cured without any functional disturbance after treatment. Reports before 2002 and 99 cases after 2002 were also reviewed. The number of patients between 40 and 60 years was increasing. Magnetic resonance imaging was useful to detect the site of penile fracture and immediate surgical treatment was important.

  6. Perianal nodular hidradenocarcinoma. Case report.

    PubMed

    Sierra Montenegro, Ernesto; Sierra Luzuriaga, Gastón; Leone Stay, Gaetano; Salazar Menéndez, Vilma; Quiñonez Auria, Carlos

    2010-01-01

    Eccrine glands (sweat glands) appear in all sites of the skin and are more abundant in hands and feet. Nodular hidradenocarcinoma (NH) is a rare malignant and aggressive tumor of the eccrine glands. The objective of this study is to report a case of perianal hidradenocarcinoma. We present the case of a 75-year-old female with diabetes, hypertension, and hypothyroidism. Physical examination revealed a small perianal tumor that was palpated near the anal canal. Biopsy was done. Pathology report revealed perianal hidradenoma. Rectosigmoidoscopy was normal. Computed tomography showed 1-cm adenopathies in inguinal and right iliac regions. Extensive resection of the tumor was done. Definitive pathology report was malignant eccrine acrospiroma. The patient underwent adjuvant chemotherapy in the Oncology Service and died 1 month later. In patients with a first symptom of metastases in the inguinal region, suspicion must be directed to the anal canal.

  7. Case four. Synergistic strategy development.

    PubMed

    Taylor, J D

    1990-01-01

    Mercy Medical Center is a 467 bed, not-for-profit teaching hospital affiliated with a multispecialty group practice and health maintenance organization through contractual arrangements. Historically, strategy development was not helping the hospital remain viable while accomplishing its mission. Strategic planning was fragmented, not focused toward concern for balance of the overall product line, total growth of the organization or the best use of resources. The hospital did not involve the affiliated group practice or HMO in its planning. This last case in Chapter One describes the pursuit of synergy through strategy formulation. The case provides a good example of what Kanter describes as a post-entrepreneurial organization, striving for advantage through collaboration and linkage with "PALs."

  8. A case of female epispadias.

    PubMed

    Tantibhedhyangkul, Julierut; Copland, Susannah D; Haqq, Andrea M; Price, Thomas M

    2008-11-01

    To present a case of unrecognized female epispadias. Case report. University-based reproductive endocrinology and fertility clinic. A 16-year-old girl with epispadias, history of mild urinary incontinence, auditory neuropathy, and functional hyperandrogenism. None. Peripheral blood array-based comparative genomic hybridization. The patient was referred for evaluation of excessive weight gain, secondary amenorrhea, and abnormal external genitalia. Examination under anesthesia revealed bilateral labia minora hypertrophy, bifid clitoris, and a patulous urethra, consistent with female epispadias. Hormonal evaluation showed functional hyperandrogenism, and peripheral blood array-based comparative genomic hybridization showed no chromosomal deletions or duplications. Female epispadias is a rare abnormality, not commonly recognized by most practitioners. The diagnosis is supported by a history of urinary incontinence and physical findings of bifid clitoris and patulous urethra. The condition can have serious physical and psychological consequences leading to a gross disruption of social function.

  9. [3M syndrome: case history].

    PubMed

    Fehlow, P

    2006-01-01

    This case report shall draw attention to a still little known syndrome of primordial nanism. It is important for the differential diagnosis on the genetic counselling, specially with regard to the Silver-Russell syndrome. A striking mentally retarded (I. Q. 54) 9-year-old boy with primordial proportionate short stature exhibited characteristic features of the 3M syndrome (MMM): pseudohydrocephalic dolichocephalia, short neck with protruding muscles, transversal furrow in the lower thorax, muscular hypotonia with joint laxity - "falling hands", radiographic manifestations included the tall vertebral bodies and gracile long bones. Furthermore there was a dent temporal at the left. But this feature is found on many other syndromes with nanosomia frontotemporal, less frequent the low position of the navel on these patients. The karyotype was normal, the case apparently sporadic. MMM can be differentiated from other types of nanosomia by clinical criterias; a molecular genetic proof is not yet possible.

  10. Brain tuberculomas: a case report.

    PubMed

    Saleh, Maryam; Saeedi, Ali Asghar; Ali Pooran, Ali

    2014-07-01

    An unusual incidence of tuberculosis in different parts of the body is called tuberculomas. The rate of brain tuberculosis is rare. The following case of tuberculamas of the brain, presented by enhancing rings of meninges, is reported because of its rarity. It was a case of brain tuberculomas in a 15-year-old girl with primary symptoms of headache and general weakness, and no signs of primary pulmonary infection. The subject underwent computerized tomography (CT) and magnetic resonance imaging (MRI) of the brain. Microbiological tests (acid fast bacilli smear-AFB, and culture of biopsy specimen) were applied subsequently. According to the results, the problem was diagnosed as brain tuberculomas. After operation she was completely treated with anti-TB drugs. Although brain tuberculosis is rare, it was diagnosed on the basis of histopathology and the patient's successful response to anti-tuberculous drug treatment.

  11. A case of factitious pedophilia.

    PubMed

    Porter, Theresa M; Feldman, Marc D

    2011-09-01

    Factitious disorder involves feigning, exaggerating, or self-inducing physical and/or psychological ailments with the goal of assuming the "sick" or "patient" role. In turn, the sick role entitles the factitious disorder patient to care, nurturance, and protection; it also exempts one from usual responsibilities. In this paper, we present the first reported case of factitious pedophilia. Although it seems counterintuitive, this middle-aged man has falsely claimed or exaggerated sexual desire for minors ostensibly to remain in a state hospital; indeed, he has remained in the same inpatient facility for more than 20 years as a result of his deceptions. At times, his reports have included disconfirmed claims of bizarre accidents and other physical travails. This case enlarges the literature on factitious psychological disorders and shows that some individuals may falsify paraphilic behaviors, although clearly minimization of these behaviors remains more common. © 2011 American Academy of Forensic Sciences.

  12. [A case of parental alienation].

    PubMed

    Menz, Wolfgang

    2014-01-01

    The clinical term "Parental Alienation Syndrome" (PAS) was introduced in 1984 by Richard Gardner, an American psychiatrist. Gardner described PAS and its symptoms, as a personality disorder, which appears chiefly in connection to child custody disputes wherein a child turns suddenly and massively against the non-custodial parent without reasonable grounds for doing so. This action by the child is a result of the custodial parent's emotionally abusive attempts to incite the child against the non-custodial parent.Where the child's rejection is based on some real past experience, there is not PAS. PAS only occurs as a result of the custodial parent's actions. Despite intensive effort, PAS was not included in the new DSM-V. In this case, a particularly impressive case history of parental alienation is described and discussed.

  13. [Multiorgan autoimmune syndrome: case report].

    PubMed

    Ghiringhelli, Paolo; Chelazzi, Paolo; Chelazzi, Giovanni; Bellintani, Claudio; Rania, Simone

    2003-01-01

    The present case report refers to a multiorgan autoimmune disease manifesting following thymectomy performed for a benign thymoma. This disease is characterized by hypothyroidism, severe myasthenia, polymyositis and alopecia which are organ-specific diseases probably with a different time of onset but which are all an expression of the same immunopathologic process occurring in individuals who have a genetic predisposition. Characteristic of the present case is not only the association of the different immunopathologic clinical pictures but also the rather difficult differential diagnosis between a hypothyroidism-related myopathy and polymyositis. It was possible to formulate the diagnosis by integrating the results of clinical and laboratory evaluation with the therapeutic outcome. The onset of the syndrome was attributed to the withdrawal, following surgery, of the inhibitory effects of the thymoma on some clones of autoreactive lymphocytes.

  14. Case of coccidioidomycosis in Ireland.

    PubMed

    Duggan, Patrick Thomas; Deegan, Alexander P; McDonnell, Timothy J

    2016-08-11

    Coccidioidal infection is a well-recognised cause of pulmonary disease in certain parts of the south-western USA, Central and South America; however, it is rarely encountered elsewhere in the world. We describe the case of a previously healthy man presenting to a Dublin hospital with fever, dry cough and chest pain, following a visit to the western USA. Despite treatment with broad-spectrum antimicrobials, the patient developed progressive bilateral pulmonary infiltrates and a large pleural effusion. After extensive investigations including CT, bronchoscopy and pleural fluid analysis, a diagnosis of pulmonary coccidioidomycosis was made. Following the initiation of appropriate antifungal therapy, the patient made a full recovery. This case was of interest due to the rarity of the disease outside its areas of endemicity and the unusual findings associated with its diagnosis. 2016 BMJ Publishing Group Ltd.

  15. Hyperthyroidism: an unusual case presentation.

    PubMed

    Scripture, D L

    1998-02-01

    Hyperthyroidism is the most common disorder of the thyroid. Patients typically present with complaints consistent with a hypermetabolic state, including nervousness, weight loss, heat intolerance, palpitations, irritability, and tremor. This case report reviews a 34-year-old woman who presented with unilateral upper extremity weakness, weight gain, and an episode of atrial fibrillation, the latter coinciding with a 36-hour lack of sleep and excess alcohol and caffeine intake. Although an extensive neurologic evaluation failed to identify any abnormality, the patient's laboratory analysis revealed elevations in thyroxine (T4) and triiodothyronine (T3) levels with unsuppressed thyroid-stimulating hormone levels. Subsequent treatment with the antithyroid drug methimazole (Tapazole) provided complete relief of symptoms. This case report illustrates how health care providers can be diverted to pursue a neurologic etiology when muscle weakness presents as a unilateral symptom. Plausible alternative causes for muscle weakness and other symptoms are presented.

  16. PROGRESSIVE OSSIFYING FIBRODYSPLASIA: CASE REPORT

    PubMed Central

    Romani, Fabiana; de Menezes Karam, Simone

    2015-01-01

    Progressive ossifying fibrodysplasia is a rare genetic disease that affects one individual in every two million births. Its main consequence is heterotopic ossification, i.e. formation of additional bone in abnormal locations. It is an autosomal dominant disease, usually caused by a new mutation in the ACVR1 receptor gene, which is in the signaling pathway for bone morphogenic protein. This abnormality is not related to gender, ethnicity or consanguinity. The present study reports the case of A.C., a 17-year-old girl. Her clinical investigation began at the age of four years, but she was only diagnosed with FOP at the age of 15 years, after being evaluated by several specialists in different centers. The patient has two siblings, but her family history did not reveal any similar cases. PMID:27047836

  17. The Case for Personalized Medicine

    PubMed Central

    Abrahams, Edward; Silver, Mike

    2009-01-01

    Personalized medicine may be considered an extension of traditional approaches to understanding and treating disease, but with greater precision. Physicians may now use a patient's genetic variation or expression profile as well as protein and metabolic markers to guide the selection of certain drugs or treatments. In many cases, the information provided by molecular markers predicts susceptibility to conditions. The added precision introduces the possibility of a more preventive, effective approach to clinical care and reductions in the duration and cost of clinical trials. Here, we make the case, through real-world examples, that personalized medicine is delivering significant value to individuals, to industry, and to the health care system overall and that it will continue to grow in importance if we can lift the barriers that impede its adoption and build incentives to encourage its practice. PMID:20144313

  18. Ainhum - A Rare Case Report.

    PubMed

    Prabhu, Ravi; Kannan, Narayanasamy Subbaraju; Vinoth, Sundaresan; Praveen, Chinnappan Balasubramanian

    2016-04-01

    The term 'AINHUM' is derived from the African word meaning 'to saw or cut'. True ainhum otherwise called dactylolysis spontanea is a condition involving soft tissue or digits with constricting rings commonly presenting in fifth toes, usually bilateral. It is to be differentiated from Pseudo-ainhum that occurs secondary to some hereditary and nonhereditary diseases that lead to annular constriction of digits. We report a rare case of true ainhum involving the left fourth toe only. It is a very rare case and a very few were reported worldwide. The highest incidence of ainhum has been reported in South Africa and South America. It is rarely reported in India. Ainhum when diagnosed and treated in early stages can be prevented from progressing to mutilating deformities.

  19. [Bladder carcinosarcoma. A clinical case].

    PubMed

    Pena Outeiriño, J M; León Dueñas, E; Romero Gil, J R; Leal López, A

    1995-03-01

    Presentation of a new case of vesical carcinosarcoma in a 49 year-old male patient. The tumour's pathoanatomical study showed an epithelial pattern of transitional and squamous cells and a sarcomatous pattern composed of rabdomiosarcoma, osteochondrosarcoma and pleomorphous indifferentiated sarcoma with giant multinuclear cells. Histogenesis, signs and symptoms, and treatment, as well as the need of performing an immunohistochemical study for its diagnosis are discussed.

  20. [Usher syndrome: about a case].

    PubMed

    Daoudi, Chama; Boutimzine, Noureddine; Haouzi, Samia El; Lezrek, Omar; Tachfouti, Samira; Lezrek, Mounir; Laghmari, Mina; Daoudi, Rajae

    2017-01-01

    Usher syndrome is a genetic disease resulting in double sensory deprivation (auditory and visual) called deafblindness. We report the case of a 50-year old patient, born to consanguineous parents, presenting with congenital deafness associated with normal vestibular function and pigmentary retinopathy responsible for decreased bilateral visual acuity occurred at the age of 16 years. This association composes Usher syndrome type 2, a rare autosomal recessive disorder. Cataract surgery allowed visual acuity improvement in this patient.

  1. The business case for quality.

    PubMed

    Boehler, Richard; Hardesty, Daniel; Gonzales, Eva; Kasnetz, Karen

    2009-10-01

    Among the lessons St. Joseph Medical Center learned in implementing a diabetes care management program were that: There is a sound business case for quality with such a program. A sound business plan based on a track record of accomplishments by other organizations is key to gaining clinician buy-in. Deploying dwindling resources to simultaneously improve care and the organization's bottom line requires collaboration between clinicians and finance.

  2. Crohns disease: a case report.

    PubMed

    Adi, Ashindoitiang John; Lloyd, Geoffrey J

    2010-01-01

    Inflammatory bowel disease (IBD) was previously regarded as a disease of the Western Countries. A number of studies showed a high incidence and prevalence of inflammatory bowel disease in United States, United Kingdom and Northern Europe, whereas it was considered uncommon in Asians population and rare in Africa. To report case of crohns disease that is rare in the tropic like Nigeria so as to create a high index of awareness that inflammatory bowel disease may be present but not correctly diagnosed

  3. Macrodystrophia lipomatosa: four case reports

    PubMed Central

    2010-01-01

    Aim Macrodystrophia lipomatosa is a rare cause of gigantism of limb which can be confused with other common causes like congenital lymphedema. It presents usually with loss of function and cosmetic problems. Four cases are described with emphasis on clinical presentation, differential diagnoses, imaging and treatment options. Methods & Results Four patients of macrodystrophia lipomatosa were thoroughly examined and subjected to investigations. Conclusion Besides diligent clinical examination, imaging and histopathology are crucial in clinching the diagnosis. PMID:20969776

  4. Ectodermal Dysplasia: A Case Report

    PubMed Central

    2011-01-01

    Ectodermal dysplasia is a hereditary disease characterized by dysplasia of tissues of ectodermal origin. The incidence of ectodermal dysplasia is rare (1 in 100,000 birth). This case report discusses the features, classification and prosthetic treatment plan (upper partial denture and lower complete denture for upper partial and lower complete edentulous arches respectively). This treatment plan would be able to provide psychological and functional boost to the sufferer. PMID:27678241

  5. Vitamin D intoxication: case report

    PubMed Central

    Marins, Tatiana Aporta; Galvão, Tatiana de Fátima Gonçalves; Korkes, Fernando; Malerbi, Domingos Augusto Cherino; Ganc, Arnaldo José; Korn, Davi; Wagner, Jairo; Guerra, João Carlos de Campos; Borges, Wladimir Mendes; Ferracini, Fábio Teixeira; Korkes, Hélio

    2014-01-01

    ABSTRACT Hypervitaminosis D is a rarely reported condition. In general it is only perceived when hypercalcemia is not resolved. The use of vitamin D has increased in recent years because of its benefits, but as a result, intoxication cases have occurred more frequently. This report describes a patient who presented worsening of renal function and hypercalcemia. After investigation, vitamin D intoxication was confirmed and it was due to an error in compounding. PMID:25003934

  6. True Hermaphrodite: A Case Report

    PubMed Central

    Jam, Mazhar Rafee; Saleem, Muhammad; Ahmad, Mushtaq

    2011-01-01

    True hermaphrodite is one of the rarest variety of disorders of sexual differentiation (DSD) and represents only 5% cases of all. A 3-year-old child presented with left sided undescended testis and penoscrotal hypospadias. Chordee correction was performed 18 months back, elsewhere. At laparotomy Mullerian structures were present on left side. On right side testis was normally descended into the scrotum. PMID:22953283

  7. Aerodynamic instability: A case history

    NASA Technical Reports Server (NTRS)

    Eisenmann, R. C.

    1985-01-01

    The identification, diagnosis, and final correction of complex machinery malfunctions typically require the correlation of many parameters such as mechanical construction, process influence, maintenance history, and vibration response characteristics. The progression is reviewed of field testing, diagnosis, and final correction of a specific machinery instability problem. The case history presented addresses a unique low frequency instability problem on a high pressure barrel compressor. The malfunction was eventually diagnosed as a fluidic mechanism that manifested as an aerodynamic disturbance to the rotor assembly.

  8. ["Addiction" to phenelzine - case report].

    PubMed

    Antosik-Wójcińska, Anna Z; Bzinkowska, Dorota; Chojnacka, Magdalena; Swiecicki, Łukasz; Torbiński, Jarosław

    2013-01-01

    The use of non-selective monoamine oxidase inhibitors (IMAO) may be associated with the risk of addiction, which is confirmed by case studies published so far. Harmful use of antidepressants in patients with affective disorders and anxiety is not frequent, but due to the fact that in clinical practice can meet with this phenomenon, we present the case of a 30-year-old patient with a history of using phenelzine who presented a combination of symptoms that meet criteria for addiction. The current classification of ICD- 10 does not consist the diagnosis of dependence on antidepressants. In this case, the category F55.0: abuse of a substance which does not cause addiction, should be used. In the literature most often mentioned as a possible substances with addictive potential is a group of non-selective MAO, particularly tranylcypromine. The mechanism of non-selective MAO dependence may be associated with the similarity of their chemical structure to amphetamine (both amphetamine and IMAO are derivatives of phenylethylamine), although the mechanism of action is different. Furthermore, it was noted that there is a group of patients in whom treatment with IMAO is associated with greater risk of abuse of these substances. The study contains the characteristics of this group of patients.

  9. Abdominal elephantiasis: a case report.

    PubMed

    Hanna, Dominique; Cloutier, Richard; Lapointe, Roch; Desgagné, Antoine

    2004-01-01

    Elephantiasis is a well-known condition in dermatology usually affecting the legs and external genitalia. It is characterized by chronic inflammation and obstruction of the lymphatic channels and by hypertrophy of the skin and subcutaneous tissues. The etiology is either idiopathic or caused by a variety of conditions such as chronic filarial disease, leprosy, leishmaniasis, and chronic recurrent cellulites. Elephantiasis of the abdominal wall is very rare. A complete review of the English and French literature showed only two cases reported in 1966 and 1973, respectively. We report a third case of abdominal elephantiasis and we briefly review this entity. We present the case of a 51-year-old woman who had progressively developed an enormous pediculated abdominal mass hanging down her knees. The skin was thickened, hyperpigmented, and fissured. She had a history of multiple abdominal cellulites. She underwent an abdominal lipectomy. Histopathology of the specimen confirmed the diagnosis of abdominal elephantiasis. Abdominal elephantiasis is a rare disease that represents end-stage failure of lymph drainage. Lipectomy should be considered in the management of this condition.

  10. Permanent global amnesia: case report.

    PubMed

    Bertolucci, Paulo H F; Siviero, Marilena O; Bueno, Orlando F A; Okamoto, Ivan H; Camargo, Candida H P; Santos, Ruth F

    2004-04-01

    To present a case of permanent global amnesia related to hippocampal damage. Permanent global amnesia is a very rare condition of unknown etiology; lesions restricted to the hippocampus are uncommon, which hinders investigations of this pattern of memory loss. This case is unusually well documented, as the patient underwent extensive neuropsychological evaluations. A cheerful right-handed, 83-year-old retired electrician was first evaluated in 1990 for progressive difficulty in learning new information and in recalling events over the preceding 3-4 years. Tests over the next 5 years showed that the impairment was confined to episodic declarative memory. New verbal information could be stored only in episodic memory in a restricted manner, limited by short-term memory capacity. A relatively mild retrograde amnesia was detected. Semantic and implicit memory was spared, as were other functions evaluated. The patient's language and executive function were strikingly efficient. Magnetic resonance imaging of the brain showed bilateral atrophy of the hippocampi and amygdalae, ruling out conditions such as tumour growth. A diagnosis of permanent global amnesia was made. In the ensuing years, the retrograde amnesia worsened, but no new deficits were identified. This case, the first with a detailed cognitive examination, is evidence of a relatively pure hippocampal pattern for memory loss in permanent global amnesia.

  11. [Jerusalem syndrome - a case report].

    PubMed

    Poleszczyk, Anna; Swiecicki, Łukasz

    2013-01-01

    The aim of the paper was to present the case of a patient who developed acute psychotic symptoms on her visit to Jerusalem. The analysis of the clinical case and medical history. The presented 62-year-old women with a history of previous psychiatric disorder arrived with her husband to Jerusalem as a part of organised touristic group. She developed acute psychotic reaction through some stages characteristic for the third type of Jerusalem syndrome. Symptoms resolved completely soon after returning to Poland and admission to the hospital where an antipsychotic treatment was performed. Despite the rare occurrence of this phenomenon, it is worth noting that we can divide Jerusalem syndrome into three types depending on its clinical course, patient's history of previous psychiatric disorders and this division has some clinical implications. This syndrome can be also considered in the context of some factors connected with travelling in general which may be responsible for psychiatric disturbances occurring among travelers. The course of psychiatric disturbances in the presented patient resembled the third type of Jerusalem syndrome despite her past psychiatric history and probably travelling caused her decompensations. In clinical practice we have to remember that in case of the patients with a known psychiatric history, clinical evaluation may be useful before travelling. In previously healthy patients developing the third type of the Jerusalem syndrome early intervention and separation from Jerusalem and its holy places and their contact with family are crucial for soon recovery.

  12. [Duodeno-pancreatic trauma. About 14 cases].

    PubMed

    Beyrouti, Mohamed Issam; Beyrouti, Ramez; Kchaou, Issam; Gharbi, Walid; Elleuch, Slim; Tafech, Issam; Frikha, Foued; Ben Amar, Mohamed; Ghorbel, Ali; Bouaziz, Mounir; Karoui, Abdelhamid; Sellami, Abdelhafidh

    2005-02-01

    Through a series of 14 cases brought over a period of 12 years, we realized a retrospective, analytical and descriptive study of these traumatisms. We aimed to release recommendations to improve their management. It was 2 women and 12 men, whom mean age was 24.4 years (extremes: 50 and 60 years), divided into 10 pancreatic injuries, 2 duodenal injuries and 2 duodeno-pancreatic injuries. Etiology was dominated by traffic accidents 7 cases (50%). Trauma was closed in 13 cases (92%). Associated lesions were present among 13 patients (92%). The traumatism appeared by an urgent surgical abdomen among 9 patients, secondarily in 3 cases, tardily in 2 cases: a case of deep suppuration 3 months after a traumatism treated into ambulatory and a case of persistent ascites after a past unperceived traumatism. Abdominal ultrasonography was made among 4 patients. It allowed diagnosing only a case. Scanner was made among 4 patients. It allowed diagnosing all the cases. Only a patient was treated medically, it was a post-traumatic acute pancreatitis. Surgical treatment was made in 13 cases: conservative in 7 cases and radical in 6 cases. Follow-up was complicated in 11 cases (78%) and non-complicated in 3 cases. Mortality rate was 7.1%.

  13. The First Case(s) of Botulism in Vienna in 21 Years: A Case Report.

    PubMed

    Vossen, Matthias Gerhard; Gattringer, Klaus-Bernhard; Wenisch, Judith; Khalifeh, Neda; Koreny, Maria; Spertini, Verena; Allerberger, Franz; Graninger, Wolfgang; Kornschober, Christian; Lagler, Heimo; Reitner, Andreas; Sycha, Thomas; Thalhammer, Florian

    2012-01-01

    We describe two linked cases of botulinum toxin intoxication to provide the clinician with a better idea about how botulism cases may present since early diagnosis and treatment are crucial in botulism. Botulinum toxin is the strongest neurotoxin known. We review the available literature, the compiled clinical data, and observations. After a slow onset of clinical signs a married couple living in Vienna presented with dysphagia, difficulties in accommodation, inability to sweat, urinary and stool retention, dizziness, and nausea. They suffered intoxication with botulinum toxin type B. Botulism is a rarely occurring disease in Austria. In the last 21 years there were only twelve reported cases. Both patients went to a general practitioner as well as several specialists before they were sent to and correctly diagnosed at our outpatient department. To avoid long delays between intoxication and diagnosis we think it is crucial to advert to the complex symptoms a nonsevere intoxication with botulinum toxin can produce, especially since intoxications have become rare occurrences in the industrialized societies due to the high quality of industrial food production.

  14. The First Case(s) of Botulism in Vienna in 21 Years: A Case Report

    PubMed Central

    Vossen, Matthias Gerhard; Gattringer, Klaus-Bernhard; Wenisch, Judith; Khalifeh, Neda; Koreny, Maria; Spertini, Verena; Allerberger, Franz; Graninger, Wolfgang; Kornschober, Christian; Lagler, Heimo; Reitner, Andreas; Sycha, Thomas; Thalhammer, Florian

    2012-01-01

    We describe two linked cases of botulinum toxin intoxication to provide the clinician with a better idea about how botulism cases may present since early diagnosis and treatment are crucial in botulism. Botulinum toxin is the strongest neurotoxin known. Methods: We review the available literature, the compiled clinical data, and observations. Results: After a slow onset of clinical signs a married couple living in Vienna presented with dysphagia, difficulties in accommodation, inability to sweat, urinary and stool retention, dizziness, and nausea. They suffered intoxication with botulinum toxin type B. Botulism is a rarely occurring disease in Austria. In the last 21 years there were only twelve reported cases. Conclusion: Both patients went to a general practitioner as well as several specialists before they were sent to and correctly diagnosed at our outpatient department. To avoid long delays between intoxication and diagnosis we think it is crucial to advert to the complex symptoms a nonsevere intoxication with botulinum toxin can produce, especially since intoxications have become rare occurrences in the industrialized societies due to the high quality of industrial food production. PMID:22779015

  15. Stiff person case misdiagnosed as conversion disorder: A case report

    PubMed Central

    Razmeh, Saeed; Habibi, Amir Hasan; Sina, Farzad; Alizadeh, Elham; Eslami, Monireh

    2017-01-01

    Background: Stiff person syndrome (SPS) is a rare neurological disease resulting in stiffness and spasm of muscles. It initially affects the axial muscles and then spread to limb muscles. Emotional stress exacerbated the symptoms and signs of the disease. The pathophysiology of the disease is caused by the decreased level of the glutamic acid decarboxylase (GAD) activity due to an autoantibody against GAD that decreases the level of gamma-aminobutyric acid (GABA). In this paper, we present a case of atypical presentation of SPS with lower limb stiffness misdiagnosed as conversion disorder. Case presentation: We report a patient with atypical presentation of SPS with lower limb stiffness and gait disorder misdiagnosed as conversion disorder for a year. Her antithyroid peroxidase antibody (anti-TPO Ab) level was 75 IU (normal value: 0–34 IU). Intravenous immunoglobulin (IVIG) was administered (2gr/kg, 5 days) for the patient that showed significant improvement in the follow-up visit. Conclusion: It is essential that in any patient with bizarre gait disorder and suspicious to conversion disorder due to the reversibility of symptoms, SPS and other movement disorder should be considered. PMID:29201327

  16. The Barnes case: taking difficult futility cases public.

    PubMed

    Mickelsen, Ruth A; Bernstein, Daniel S; Marshall, Mary Faith; Miles, Steven H

    2013-01-01

    Futility disputes are increasing and courts are slowly abandoning their historical reluctance to engage these contentious issues, particularly when confronted with inappropriate surrogate demands for aggressive treatment. Use of the judicial system to resolve futility disputes inevitably brings media attention and requires clinicians, hospitals, and families to debate these deep moral conflicts in the public eye. A recent case in Minnesota, In re Emergency Guardianship of Albert Barnes, explores this emerging trend and the complex responsibilities of clinicians and hospital administrators seeking to replace an unfaithful surrogate demanding aggressive therapy. Use of the courts requires the coordinated commitment of significant institutional resources, management of intense media scrutiny and individual and organizational courage to enter the unpredictable world of litigation. Given the dearth of legislative guidance on medical futility, individual clinicians and institutions will continue to bear the difficult responsibility for resolution of individual futility disputes. The Barnes case illustrates how one institution successfully used the judicial system to replace an unfaithful surrogate, cease the provision of inappropriate aggressive care, and stimulate a community dialogue about appropriate care at the end of life. © 2013 American Society of Law, Medicine & Ethics, Inc.

  17. Cast abscess: a case report.

    PubMed

    Carmichael, Kelly D; Goucher, Nicholas R

    2006-01-01

    This report describes a case in which a pediatric patient wounded his ankle when he stuck an object inside the cast while trying to scratch himself. The wound became infected and resulted in a limb-threatening abscess. Although most patients treated with casts do not have any significant problems, it is important to emphasize cast care instructions to young patients and their parents. In addition, it may be equally important to advise patients about safe methods to alleviate itching, such as blowing cool air under the cast. In this way, the risk of serious infectious complications can be minimized.

  18. Traumatic asphyxia: An autopsy case.

    PubMed

    Türkmen, Nursel; Eren, Bülent; Erkol, Zerrin

    2015-01-01

    Traumatic asphyxia is a form of asphyxia where respiration is prevented by external pressure on the body. A 19-year-old man was found by relatives compressed by motorboat in the garage. The death was investigated by the prosecutor; body was taken to the Morgue Department for performing autopsy. On gross physical examination; the face, neck and upper part of the chest were congested and many petechiae were observed on the conjunctivae, but not in low extremities. Autopsy macroscopic examination of lungs revealed congestion, sub pleural superficial bleeding areas. In the presented case death was reported as traumatic asphyxia by thorax compression without other lethal factors.

  19. [Dyssegmental dwarfism. A new case].

    PubMed

    Maisonneuve, J; Armand, J P; Louis, J J; Guibaud, P

    1984-06-01

    In a 3 1/2 month old child with micromelic dwarfism, a case of dyssegmental dwarfism is reported. This affection is characterized, on one hand, by a shortening and a squat aspect of long bones with diaphyseal curve, and on the other hand, by a trouble of vertebral segmentation associated to a variability in the size of vertebral bodies. The differential diagnosis appears adequate to differentiate the dyssegmental dwarfism from other types of neonatal chondrodysplasia, in particular from Kniest syndrome and micrognathia dwarfism.

  20. Azadirachtin poisoning: a case report.

    PubMed

    Iyyadurai, Ramya; Surekha, V; Sathyendra, Sowmya; Paul Wilson, Benny; Gopinath, K G

    2010-10-01

    The use of neem-based products is widespread in the Indian Subcontinent. Neem-based pesticides obtained from neem kernels are considered natural and safe. The toxic effects of ingestion and overdose of this pesticide in adults have not been described in this literature. We report the case of a 35-year-old lady who had consumed Azadirachtin in an attempt of deliberate self-harm. The patient had features of neurotoxicity because of Azadirachtin requiring intensive medical care with mechanical ventilation. The patient survived the overdose with no long-lasting side effects of the toxin.

  1. Craniofacial Duplication: A Case Report

    PubMed Central

    Suryawanshi, Pradeep; Deshpande, Mandar; Verma, Nitin; Mahendrakar, Vivek; Mahendrakar, Sandhya

    2013-01-01

    A craniofacial duplication or diprosopus is an unusual variant of conjoined twinning. The reported incidence is one in 180,000-15 million births and 35 cases have been reported till date. The phenotype is wide, with the partial duplication of a few facial structures to complete dicephalus. A complete duplication is associated with a high incidence of anomalies in the central nervous system, cardiovascular system, gastrointestinal system and the respiratory system, whereas no major anomalies are found in the infants with a partial duplication. A term baby with the features of a craniofacial duplication has been described, with the proposed theories on embryogenesis and a brief review of the literature. PMID:24179933

  2. Craniofacial duplication: a case report.

    PubMed

    Suryawanshi, Pradeep; Deshpande, Mandar; Verma, Nitin; Mahendrakar, Vivek; Mahendrakar, Sandhya

    2013-09-01

    A craniofacial duplication or diprosopus is an unusual variant of conjoined twinning. The reported incidence is one in 180,000-15 million births and 35 cases have been reported till date. The phenotype is wide, with the partial duplication of a few facial structures to complete dicephalus. A complete duplication is associated with a high incidence of anomalies in the central nervous system, cardiovascular system, gastrointestinal system and the respiratory system, whereas no major anomalies are found in the infants with a partial duplication. A term baby with the features of a craniofacial duplication has been described, with the proposed theories on embryogenesis and a brief review of the literature.

  3. [Congenital syphilis: a case report].

    PubMed

    Lasfargue, M; Thümmler, S; Perelman, S; de Ricaud, D

    2009-10-01

    Syphilis is a re-emerging infectious disease in Western Europe. Congenital syphilis is a potentially serious pathology affecting newborns of infected mothers. This disease is easily curable by a simple antibiotic treatment. Because of systematic antenatal screening it should no longer exist in industrialized countries. Nevertheless, we report a case of a six-week-old infant with a delayed diagnosis of congenital syphilis. Physicians, especially gynaecologists, obstetricians and paediatricians, have to be vigilant in order to allow for early diagnosis and appropriate treatment of congenital syphilis.

  4. [Sellar hemangiopericytoma. A case report].

    PubMed

    Ksira, I; Berhouma, M; Jemel, H; Khouja, N; Khaldi, M

    2006-06-01

    Primary central nervous system hemangiopericytoma is rare, accounting for less than 1% of primary central nervous system tumors. Diagnosis is histological. Treatment is surgical excision, followed by radiotherapy. Long-term follow-up is mandatory for these tumors with a high potential for recurrence and metastasis. The sellar location is very rare, and can be confused with pituitary adenoma. We report the case of a patient presenting a sellar hemangiopericytoma, who underwent surgery via a transsphenoidal approach, then right frontal craniotomy followed by radiotherapy. There was no recurrence at one year follow-up.

  5. Ocular Dirofilariasis, a Case Report

    PubMed Central

    Tafti, MR Fallah; Hajilary, A; Siatiri, H; Rokni, MB; Mobedi, I; Mowlavi, Gh

    2010-01-01

    Accidental infection with animal filarial worms in humans is a dilemma for clinicians and parasitologists throughout the world. To date a variety of such rare parasitoses have been reported mostly in tropics and subtropics. Human dirofilariasis is among those unusual zoonotic infections that occasionally have been observed in the eye and in subcutaneous areas exhibiting with nodule formation. Filarial worms are transmitted to humans through invertebrate biological vectors such as certain species of mosquitoes. The present report describes a peculiar case of ocular dirofilariasis in a 49-year-old man resident in Iran. PMID:22347257

  6. The case for Mars concept

    NASA Technical Reports Server (NTRS)

    French, J. R.

    1986-01-01

    The Case for Mars workshops conducted in 1984 dealt with a program to establish a permanent scientific research base at Mars. The participants, viewed a Mars base as the much needed long-term focus for the space program. A permanent base was chosen rather than the more conventional concept of a series of individual missions to different sites became the permanent base offers much greater scientific return plus greater crew safety and the potential for growth into a true colony. The results of the workshops are summarized.

  7. A case of multisystem endometriosis.

    PubMed

    Athwal, Pardeep; Patel, Krishna; Hassani, Cameron; Bahadori, Shapour; Nardi, Peter

    2013-10-01

    Catamenial pneumothorax is a rare complication secondary to pleural endometriosis. We present a case of a 37-year-old-female with a history of recurrent pneumothoraces with an associated temporal relationship to the onset of her menses. In addition to her recurrent pneumothoraces, on further evaluation, she was found to have multiple nodular masses within the omentum. A thoracoscopic biopsy was subsequently performed, which showed endometrial implants within the pleural space and within the omental cavity. The radiological features and pathogenesis of this rare disease are reviewed and discussed with reference to relevant literature.

  8. The impact of staff case manager-case management supervisor relationship on job satisfaction and retention of RN case managers.

    PubMed

    Hogan, Tierney D

    2005-01-01

    A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff.

  9. Tragedy in moral case deliberation.

    PubMed

    Spronk, Benita; Stolper, Margreet; Widdershoven, Guy

    2017-09-01

    In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation (MCD) in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on the views and experiences of the participants. A case study design is used by conducting semi-structured interviews (N = 10) with health care professionals who both played a role in the treatment of the patient and attended the MCD. The results show that MCD helps people to deal with tragic situations. An important element of MCD in this respect is making explicit the dilemma and the damage, demonstrating that there is no simple solution. MCD prompts participants to formulate and share personal experiences with one another and thus helps to create a shared perception of the situation as tragic. The article concludes that MCD contributes to the sharing of tragic experiences, and fosters mutual interaction during a tragedy. Its value could be increased through explicit reflection on the aspect of contingency that characterises tragedy.

  10. Maxillary haemangiopericytoma: a case report.

    PubMed

    Fatusi, O A; Owotade, F J; Ojo, O S

    2004-01-01

    Haemangiopericytoma is a very rare slow-growing vascular tumour with a variable malignant potential, constituting less than 1% of all neoplasms. It may arise from any blood vessel and in any organ of the body. Primary haemangiopericytoma of bone is even rarer, constituting about 0.1% of bone tumours. The tumour is extremely rare in Africans and particularly in the head and neck region. We describe the case of a 66-year old Nigerian with haemangiopericytoma of the maxilla, who presented with a recurrent but painless jaw mass. Surgical resection of this tumour is potentially bedevilled with the risk of torrential haemorrhage and high rate of recurrence. This risk may be substantially reduced by wide surgical resection with a careful microscopical examination of the resection margins and the institution of adjuvant radiotherapy in incompletely resected tumours. Chemotherapy has no known role in the management of haemangiopericytoma. Postoperative radiation therapy appears to be effective against tumour recurrence. Even then, long-term follow-up is essential in all cases. To our knowledge, this is the first report of this entity in an African.

  11. [Wilkie Syndrome. A case report].

    PubMed

    González Hermosillo-Cornejo, Daniel; Díaz Girón-Gidi, Alejandro; Vélez-Pérez, Francisco Manuel; Lemus-Ramírez, Ramón Ignacio; Andrade Martínez-Garza, Pablo

    Wilkie syndrome, also referred as superior mesenteric artery syndrome, is an unusual cause of a proximal small bowel obstruction. It is characterised by the compression of the duodenum in its third portion due to a narrowing of the space between the superior mesenteric artery and the aorta. Its presentation symptoms are consistent and include the obstruction of the proximal small bowel. However, the physical and laboratory findings are non-specific. Nevertheless, many imaging methods are useful for its diagnosis. The management of this condition varies between observation and surgery, depending on each particular case. The case is presented of a 19 year-old male who began with acute, intense abdominal pain, nausea, vomiting, and diarrhoea. On examination, he had abdominal wall rigidity and hyperesthesia. Imaging studies were requested, revealing a decreased superior mesenteric artery angle, a shortening of the aortic mesenteric distance, and a decrease in the calibre of the third duodenal portion, all findings concomitant with Wilkie syndrome. Conservative treatment was applied and the patient was discharged without complications. Wilkie syndrome continues to be an unknown condition to the general practitioner, and the underdiagnosis of this condition may put a patient at risk of serious complications. A high index of suspicion is required to reach a diagnosis. Early treatment should give a good outcome most of the time. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  12. A case of instantaneous rigor?

    PubMed

    Pirch, J; Schulz, Y; Klintschar, M

    2013-09-01

    The question of whether instantaneous rigor mortis (IR), the hypothetic sudden occurrence of stiffening of the muscles upon death, actually exists has been controversially debated over the last 150 years. While modern German forensic literature rejects this concept, the contemporary British literature is more willing to embrace it. We present the case of a young woman who suffered from diabetes and who was found dead in an upright standing position with back and shoulders leaned against a punchbag and a cupboard. Rigor mortis was fully established, livor mortis was strong and according to the position the body was found in. After autopsy and toxicological analysis, it was stated that death most probably occurred due to a ketoacidotic coma with markedly increased values of glucose and lactate in the cerebrospinal fluid as well as acetone in blood and urine. Whereas the position of the body is most unusual, a detailed analysis revealed that it is a stable position even without rigor mortis. Therefore, this case does not further support the controversial concept of IR.

  13. Abernethy malformation: a case report

    PubMed Central

    2012-01-01

    Background Abernethy malformation is a very rare congenital vascular malformation defined by diversion of portal blood away from liver. It is commonly associated with multiple congenital anomalies. We present a case of Abernethy malformation, without associated congenital anomalies from India. Case presentation A 5-year-old female child presented with short history of jaundice. A provisional diagnosis of acute viral hepatitis was made in view of clinical presentation and local endemicity of viral hepatitis A. Persistence of jaundice on follow up after 4 weeks led to detailed investigations. Ultrasound and doppler study of abdomen revealed drainage of portal vein into inferior vena cava. CT angiography was performed which confirmed the diagnosis of Type 1 b Abernethy malformation without associated major anomalies. We discuss the common clinical presentations, associated anomalies, diagnostic workup and treatment options of this disorder. Conclusion The treatment of the patients with congenital porto-systemic shunts depends on the site of the shunt, associated congenital anomalies and the extent of liver damage but the prognosis depends on the complications irrespective of anatomical type. However, the extent of associated abnormalities should not deter paediatricians to refer patients for treatment. Whenever possible closure of the shunt should be advised for cure or to prevent complications. Only symptomatic type I patients with absence of possibility to close the shunt may require liver transplant. Long-term follow-up is indicated for all patients. PMID:22642663

  14. Multicystic mesothelioma--a rare case of ascites: case report.

    PubMed

    Manuc, M; Lamatic, C; Pop, C; Dobrea, C; Becheanu, G; Grasu, M; Iosif, D; Diculescu, M

    2007-01-01

    We present the case of a 37-year-old male, admitted to our clinic with abdominal tenderness, right supraclavicular tumour, and ascites. The presence of ascites was incidentally reported 6 years before, but no other evaluation was done at that moment or during this period. Abdominal ultrasound and CT scan revealed moderate ascites, perivascular adenopathies, and multiple abdominal cystic lesions, while thoracic CT scan revealed the same lesions in mediastinum. Laboratory data were within normal limits, including the tumoral markers, and the tests for hydatid cysts. A biopsy from the right supraclavicular nodule was performed, and based on usual and immunohistochemical stains (calretinin, mesotheline, CK 5/6, CK 7, CK18 diffusely positive in mesothelial cells, and CEA -M, bcl-2 and vimentin negative), suggested the diagnosis of mesothelioma. Based on these results, the diagnosis of "multicystic mesothelioma" was made. The patient was referred for surgery.

  15. Writing a case report: polishing a gem?

    PubMed

    Papanas, N; Lazarides, M K

    2008-08-01

    Case reports describe patient cases which are of particular interest due to their novelty and their potential message for clinical practice. While there are several types of case reports, originality and clinical implications constitute the main virtues by which case reports are judged. Defining the educational message and choosing the right audience are vital steps in the process of writing. Generally, a case report is structured, its main components being the abstract, the introduction, the case description and the discussion. Guidelines and tips for writing case reports are not enough for making a successful author, but they help, especially less experienced doctors, to exercise and improve their writing. If properly prepared, case reports can still communicate new observations in an interesting and pleasant way, thereby enriching our knowledge, even in the era of evidence-based medicine.

  16. A Compliant Casing for Transonic Axial Compressors

    NASA Technical Reports Server (NTRS)

    Bloch, Gregory S.; Hah, Chunill

    2003-01-01

    A viewgraph presentation on the concept of compliant casing for transonic axial compressors is shown. The topics include: 1) Concept for compliant casing; 2) Rig and facility details; 3) Experimental results; and 4) Numerical results.

  17. Teaching cases on transportation and global warming.

    DOT National Transportation Integrated Search

    2013-03-01

    This project developed a series of three teaching cases that explore the implications of global : warming for transportation policy in the United States. The cases are intended to be used in : graduate and undergraduate courses on transportation poli...

  18. Transportation planning effectiveness: twenty case studies

    DOT National Transportation Integrated Search

    1977-12-31

    This document consists of 20 site-specific case studies of urban area experience with the Technical Study Grant Program of the Urban Mass Transportation Administration (UMTA). The objective of the case studies is to determine how the Technical Study ...

  19. Case acceptance: no random acts allowed.

    PubMed

    McAnally, James

    2009-12-01

    Consider implementing a case acceptance system in your office to fully utilize your hard-earned clinical skills, and to experience the professional rewards that come with serving more patients at a higher level. Doctors who are willing to commit the time and resources necessary to improving case acceptance will increase the number of implant cases entering the treatment phase--cases that run the gamut of complexity and support fees commensurate with their skills!

  20. Education for Effective Case Management Practice.

    ERIC Educational Resources Information Center

    Dickerson, Pamela S.; Mansfield, Jerry A.

    2003-01-01

    Managed care organization employees (n=115) attended case management training that included case studies, problem solving and communication skills, and focus on internal capability. Three-month follow-up showed that case managers now ask more questions, have more confidence, mentor new employees, and work with greater accuracy. (SK)

  1. Temporal Visualization for Legal Case Histories.

    ERIC Educational Resources Information Center

    Harris, Chanda; Allen, Robert B.; Plaisant, Catherine; Shneiderman, Ben

    1999-01-01

    Discusses visualization of legal information using a tool for temporal information called "LifeLines." Explores ways "LifeLines" could aid in viewing the links between original case and direct and indirect case histories. Uses the case of Apple Computer, Inc. versus Microsoft Corporation and Hewlett Packard Company to…

  2. Using Case Studies to Enrich Field Experience.

    ERIC Educational Resources Information Center

    Florio-Ruane, Susan; Clark, Christopher M.

    1990-01-01

    This paper discusses the use of field experience in teacher education and how it can be augmented by phenomenological case studies. It summarizes a particular case study involving three teacher education classes, noting that reflective analysis of cases can prepare students to observe in the field. (SM)

  3. Case Citations 1996. Eighteenth Series (School Administrators).

    ERIC Educational Resources Information Center

    Evans, William J., Jr., Ed.

    This document contains case citations for 1996 in areas pertaining to school administration. The cases are categorized according to the topics of negligence, workers' compensation, administrator due process, discrimination against school administrators, and discrimination in hiring teachers for administrative positions. Negligence cases cover…

  4. Case Study: The Chemistry of Cocaine

    ERIC Educational Resources Information Center

    Dewprashad, Brahmadeo

    2011-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

  5. Discursive Hierarchical Patterning in Economics Cases

    ERIC Educational Resources Information Center

    Lung, Jane

    2011-01-01

    This paper attempts to apply Lung's (2008) model of the discursive hierarchical patterning of cases to a closer and more specific study of Economics cases and proposes a model of the distinct discursive hierarchical patterning of the same. It examines a corpus of 150 Economics cases with a view to uncovering the patterns of discourse construction.…

  6. Building Physics Test Cases | Buildings | NREL

    Science.gov Websites

    building physics test cases in BESTEST-EX. In these cases, the model inputs that describe the house are programs. This diagram provides an overview of the BESTEST-EX physics case process. On the left side of the diagram is a box labeled "BESTEST-EX Document" with a list that contains two bulleted items. The

  7. Utility Bill Calibration Test Cases | Buildings | NREL

    Science.gov Websites

    illustrates the utility bill calibration test cases in BESTEST-EX. In these cases, participants are given software results have been generated. This diagram provides an overview of the BESTEST-EX utility bill calibration case process. On the left side of the diagram is a box labeled "BESTEST-EX Document"

  8. An Arizona Border Wall Case Study

    DTIC Science & Technology

    2017-12-01

    WALL CASE STUDY by Justin Alexander Bristow December 2017 Thesis Advisor: Erik Dahl Second Reader: Jorge Gonzalez THIS PAGE...4. TITLE AND SUBTITLE AN ARIZONA BORDER WALL CASE STUDY 5. FUNDING NUMBERS 6. AUTHOR(S) Justin Alexander Bristow 7. PERFORMING ORGANIZATION...PAGE INTENTIONALLY LEFT BLANK iii Approved for public release. Distribution is unlimited. AN ARIZONA BORDER WALL CASE STUDY Justin Alexander

  9. 49 CFR 192.323 - Casing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... loads. (b) If there is a possibility of water entering the casing, the ends must be sealed. (c) If the... operating pressure of the pipe, the casing must be designed to hold this pressure at a stress level of not... the weather to prevent water from entering the casing. ...

  10. 49 CFR 192.323 - Casing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... loads. (b) If there is a possibility of water entering the casing, the ends must be sealed. (c) If the... operating pressure of the pipe, the casing must be designed to hold this pressure at a stress level of not... the weather to prevent water from entering the casing. ...

  11. The Self-Actualizing Case Method.

    ERIC Educational Resources Information Center

    Gunn, Bruce

    1980-01-01

    Presents a case procedure designed to assist trainees in perfecting their problem-solving skills. Elements of that procedure are the rationale behind this "self-actualizing" case method; the role that the instructor, case leaders, and participants play in its execution; and the closed-loop grading system used for peer evaluation. (CT)

  12. Study on Case Teaching of Financial Management

    ERIC Educational Resources Information Center

    Che, Zhenghong; Che, Zhengmei

    2011-01-01

    Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

  13. Real-Life Case Studies for Teachers.

    ERIC Educational Resources Information Center

    Hayes, William

    Case studies described in this book reflect conditions present in today's public schools. Situations described in these case studies are intended to introduce education students to the variety of problems existing in today's schools. The 38 case studies highlight: student cheating; teacher's observation by administrator; inclusion; contract…

  14. Case Studies for Effective Business Instruction.

    ERIC Educational Resources Information Center

    McAlister-Kizzier, Donna

    This book is designed as a resource for educators who teach business content in a variety of instructional settings. It contains case studies representing all functional areas of business, including corporate training, for grades 7 through graduate education. Chapter 1 provides an overview of the case study method. The history of the case method,…

  15. Avoidable costs of comprehensive case management.

    PubMed

    Issel, L M; Anderson, R A

    1999-01-01

    Comprehensive case management has become an industry standard and its pervasiveness raises questions about the ubiquitous need for this service. Analyzed from the perspective of transaction cost analysis and access, we argue that in some cases comprehensive case management is an avoidable cost incurred because of system problems that limit access to otherwise eligible clients. Implications are discussed.

  16. Associative visual agnosia: a case study.

    PubMed

    Charnallet, A; Carbonnel, S; David, D; Moreaud, O

    2008-01-01

    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study, an alternative account in the framework of (non abstractive) episodic models of memory.

  17. Teaching Agricultural Policy with the Case Method.

    ERIC Educational Resources Information Center

    Stuhler, E. A.

    1994-01-01

    Two groups of agriculture students were taught with case studies and one group without (about 30 students in each group). Case-method groups had greater gains in cognitive performance and changed motivation and attitudes. Case studies had a positive effect on the development of problem-solving skills. (SK)

  18. Case Management: Let Us Count the Ways.

    ERIC Educational Resources Information Center

    Austin, Carol D.

    Case management as implemented in programs for the elderly, has focused on interactions between the client and case manager in the areas of assessment, care planning, service plan implementation, and follow-up. Variation in these case management tasks suggests that no single model can be implemented in all local delivery systems. This emphasis on…

  19. Case Studies for Management Development in Bangladesh.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    Eight case studies appropriate for use in a course in management development were prepared and are provided in this document. The typical case describes a real business situation in which a real manager had to reach a decision. The case gives quantitative and qualitative information that is, or may be, relevant to that decision. Questions for…

  20. Obsessional Slowness in College Students: Case Studies

    ERIC Educational Resources Information Center

    Johnson, Aleta

    2014-01-01

    Cases of obsessional slowness, a variant of obsessive compulsive disorder, have been documented in case literature regarding relatively low functioning populations. However, obsessional slowness can also present in higher functioning populations, including college and graduate students, as illustrated here by three case examples from a competitive…

  1. Business and Consumer Education Case Studies.

    ERIC Educational Resources Information Center

    Delta Pi Epsilon, Minneapolis, Minn. Phi Chapter.

    This publication contains 58 case studies for classroom use in teaching various business and consumer education subjects at the high school level. A supplement to a previous Phi Chapter publication, "Office Education Case Studies" (1973), the case studies are intended to create class discussions and help students acquire the ability to analyze…

  2. 49 CFR 192.323 - Casing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS General Construction Requirements for Transmission Lines and Mains § 192.323 Casing. Each casing used on a transmission line or main under a railroad or highway must comply with the following: (a) The casing must be designed to withstand the superimposed...

  3. 49 CFR 192.323 - Casing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS General Construction Requirements for Transmission Lines and Mains § 192.323 Casing. Each casing used on a transmission line or main under a railroad or highway must comply with the following: (a) The casing must be designed to withstand the superimposed...

  4. 49 CFR 192.323 - Casing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS General Construction Requirements for Transmission Lines and Mains § 192.323 Casing. Each casing used on a transmission line or main under a railroad or highway must comply with the following: (a) The casing must be designed to withstand the superimposed...

  5. CASE Thriving on the Sunshine Coast

    ERIC Educational Resources Information Center

    Gordon, Neil

    2016-01-01

    Cognitive Acceleration through Science Education (CASE) on the Sunshine Coast is growing rapidly. It has expanded from one inaugural Year 8 class in 2012 to the current state of play with the involvement of over 3,000 CASE students from eleven Sunshine Coast State High Schools. It is being taught by more than seventy CASE teachers with…

  6. Osseous genioplasty: A case series

    PubMed Central

    Deshpande, Sanjeev N.; Munoli, Amarnath V.

    2011-01-01

    Introduction: The chin (mentum) is vital to the human facial morphology as it contributes to the facial aesthetics and harmony both on frontal and lateral views. Osseous genioplasty, the alteration of the chin through skeletal modification, can lead to significant enhancement of the overall facial profile. Aim and Study Design: A case series was designed to study the long-term results of osseous genioplasty in Indian patients with regard to patient satisfaction, complications, and long-term stability. Materials and Methods: All subjects who underwent osseous genioplasty either alone or as a component of orthognathic surgery between January 1992 and December 2010, with a minimum follow-up of 2 years, were included. The genioplasty was performed using standard protocols of assessment and execution. Post-operative evaluation included patient satisfaction, complications and radiological evidence of long-term stability. A comprehensive score was formulated for the purpose of the study. Results: Thirty-seven subjects underwent osseous genioplasty with at least 2 years of follow-up in the study period. This included 17 male and 20 female subjects, with a mean age of 22.8 years (15-52 years) and a mean follow-up of 3 years 4 months (2 years to 4 years and 11 months). Nineteen subjects underwent isolated genioplasty while 18 underwent genioplasty as a part of orthognathic surgery. The procedures included advancement (22), pushback (9), side-to-side (4) and vertical reduction (2) genioplasty. Thirty-six subjects (97.3%) were extremely pleased with the results with only one subject expressing reservations, without, however, demanding any further procedure. There were no significant complications. The osteotomised segment was well maintained in its new position with good bony union and minimal resorption. Overall, 35 (94.6%) cases had excellent results and 2 (4.4%) cases had good results, according to the comprehensive score. Conclusions: Osseous genioplasty is a safe and

  7. Citalopram Overdose: a Fatal Case.

    PubMed

    Kraai, Erik P; Seifert, Steven A

    2015-06-01

    Citalopram is a selective serotonin reuptake inhibitor (SSRI) with cardiac and neurologic toxicities as well as the potential for serotonin syndrome. In most instances, patients recover fully from toxic ingestions of SSRIs. We describe a fatal case of a citalopram overdose. A 35-year-old woman presented to the emergency department after having witnessed seizures at home. An empty citalopram prescription bottle was located, and an intentional overdose was suspected. At the scene, she was found to be in cardiac arrest with pulseless electrical activity and underwent cardiopulmonary resuscitation, including intravenous epinephrine and bicarbonate. In the emergency department, her physical exam was notable for cough and gag reflexes and movement in all extremities with increased muscle tone and tachycardia. Her initial postresuscitation ECG showed sinus rhythm with QRS 92 ms and QTc 502 ms. Her temperature was initially normal, but she rapidly became febrile to 41.8 °C shortly after admission. She was treated symptomatically and with cyproheptadine for suspected serotonin syndrome (SS) but became increasingly hemodynamically unstable over the next 6 h and then developed torsades des pointes (TdP) progressing to pulseless, wide complex tachycardia. She underwent cardiopulmonary resuscitation (CPR) for approximately 50 min but ultimately expired. Postmortem serum analysis revealed a citalopram concentration of 7300 ng/mL (therapeutic range 9-200 ng/mL) and THC, but no other non-resuscitation drugs or substances. Citalopram overdoses often have only mild to moderate symptoms, particularly with ingestions under 600 mg in adults. However, with higher doses, severe manifestations have been described, including QTc prolongation, TdP, and seizures. Serotonin syndrome has also been described in SSRI overdose, and our patient exhibited signs consistent with SS, including increased muscle tone and autonomic dysregulation. Our patient's serum concentration suggests a massive

  8. Sinonasal haemangiopericytoma: a case report.

    PubMed

    Stomeo, Francesco; Fois, Valeria; Cossu, Antonio; Meloni, Francesco; Pastore, Antonio; Bozzo, Corrado

    2004-11-01

    Haemangiopericytoma (HPC) is a rare vascular tumour that is thought to originate from the vascular pericytes of Zimmerman. HPC may arise in any part of the body, and from 15 to 30% of these tumours are found in the head and neck, with a rare involvement of the sinonasal region The main symptoms of nasal HPC, epistaxis and nasal obstruction, are not typical. The final diagnosis is based on the histopathology and immunochemistry, and whether the tumour is benign or malignant is defined on the basis of the clinical history. HPC located in the sinonasal area is generally benign. We report the case of a young woman with a sinonasal mass histologically proven to be haemangiopericytoma. The patient underwent surgical treatment by means of mid-facial degloving after embolisation of the maxillary artery. After a careful 3-year follow-up, the patient is disease free and healthy.

  9. [Adult hepatoblastoma. A case report].

    PubMed

    Goikoetxea Urdiain, A; Sánchez Acedo, P; Mateo Retuerta, J; Tarifa Castilla, A; Zazpe Ripa, C; Herrera Cabezón, J

    2016-01-01

    Adult hepatoblastoma is a rare pathology. Its pathogeny is not well understood and prognosis is very bad. We pre-sent a case of adult hepatoblastoma treated in our centre. A 65 year-old male, without previous hepatopathy, who consulted due to right hypochondrial pain with a subacute evolution. The pathological diagnosis was adult epithelial hepatoblastoma, with free surgical margins. The patient recei-ved a second surgical intervention 5 months later due to early recurrence and died 10 months after the diagnosis due to a new massive recurrence. His definitive diagnosis is histological. Radical surgery is the only treatment that increases survival, but recurrence is frequent. There are no well-defined patterns of adjuvant chemotherapy nor is there any trans-plant experience.

  10. A case of tinea incognito.

    PubMed

    Segal, Dan; Wells, Malcolm M; Rahalkar, Amit; Joseph, Mariamma; Mrkobrada, Marko

    2013-05-15

    Tinea incognito is a dermatophyte infection of the skin that presents atypically because it has previously been treated with imunnosuppresive medication. Herein we present a case of a middle-aged man who was initially clinically diagnosed to have plaque-type psoriasis on his arms. Over the course of two months of topical hydrocortisone and calciptriol treatment as well as phototherapy, the rash worsened. At the time of presentation to hospital the patient had a pruritic, widespread, sloughing, erythematous rash with areas of eschar. A punch biopsy skin confirmed dermatophyte fungal infection of the skin. Fungal culture was positive for Trichophyton Rubrum and the eruption resolved with systemic anti-fungal therapy. Patient specific risk factors for atypical presentation included poor hygiene and hepatatic disease.

  11. [A case of Kartagener's syndrome].

    PubMed

    Ishiga, Takeshi; Tanigawa, Motoaki; Ichioka, Maresuke; Saito, Kimimasa

    2005-03-01

    This case describes a 57-year-old woman in whom situs inversus had been noted at her birth. She had bronchial asthma and bilateral sinusitis during her childhood. She married and experienced childbirth. In December 2003, she was admitted to our Division complaining of wheezing, expectoration and dyspnea on effort. Bronciectasis was visualized on chest X-ray and CT. Electron microscopic examination of the nasal cavity epithelium and bronchial epithelial cilia revealed a deficit of bilateral dynein arms. These findings, helped establish a diagnosis of Kartagener's syndrome, which is characterized by primary ciliary dyskinesia. The restrictive and obstructive pulmonary dysfunction with increase of residual volume in the lung function tests and diffuse centrilobular small nodules with hyperinflation on chest CT were consistent with the findings of diffuse panbronchilitis (DPB) and suggested extended obliterative peripheral airway disease. Clarithromycin which is highly effective for DPB failed to prevent the aggravation of airway infection, arousing the concern about the progression into chronic respiratory failure.

  12. Giant gallstone: A case report

    PubMed Central

    Becerra, Pablo; Becerra, Valentina; Aguilar, Christian; Modragon, Itziar; Cooper, David K.C.

    2011-01-01

    Introduction There is a high incidence of gallstones in the Chilean population. Presentation of case We report on a 57-year-old man who complained of abdominal pain in the right upper quadrant. Abdominal ultrasound indicated acute cholecystitis and a single, extremely large pear-shaped gallstone (16.8 cm long, and 7.8 cm at its widest point and 4.1 cm at its narrowest point). Its fresh weight (at operation) was 278.0 g and, after 4 years, its dry weight was 259.5 g. Emergency classical cholecystectomy was carried out successfully. Discussion and Conclusion We have been unable to find a report of a larger gallstone in the English or Spanish language medical literature. PMID:22096735

  13. Unique Case of Imperforate Hymen.

    PubMed

    Coppola, Lynn

    2016-02-01

    Imperforate hymen typically presents in adolescence with pain, hematocolpometra and primary amenorrhea. This case documents a previously unreported etiology for an atypical presentation with a history of recent menstruation. A female adolescent presented with symptoms of urinary retention and leg pain. She reported a history of irregular, painful menses. Clinical examination revealed a pelvic mass and imperforate hymen. Sonography was consistent with hematocolpometra. Before a planned hymenectomy, the patient began to pass dark blood through a fistulous opening in her vulva. Hymenectomy resulted in complete resolution of the pain and hematocolpometra. Identification of the fistulous tract explained the patient's history of menstrual bleeding despite an imperforate hymen. Spontaneous rupture of hematocolpometra through a fistulous tract to the vulva is a previously unreported atypical presentation of imperforate hymen in a "menstruating" adolescent with pain and a pelvic mass. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  14. The business case for connectivity

    NASA Technical Reports Server (NTRS)

    Adams, Dennis; Hirschheim, Rudy

    1991-01-01

    Information systems that provide competitive advantages to organizations can be broadly classified into those that improve the effectiveness of a business function and those that improve the reach of information in the organization. The latter, organizational connectivity systems, can be categorized as intraorganizational and interorganizational systems. Intraorganization systems provide connectivity to function areas within the business, while interorganizational systems support the exchange of business data between independent business units. These system are not confined to a single entity but span organizational boundaries which can be national or international in scope. A series of case studies was undertaken in an effort to better understand the issues and problems associated with providing an increased flow of information within and outside of an organization. Ten issues emerged from this study. In summary, it is necessary for firms to first consider how effective their internal communications systems are before launching projects that tie the organization to external systems.

  15. Vertebral pneumatocyst. A case report.

    PubMed

    Laufer, L; Schulman, H; Hertzanu, Y

    1996-02-01

    This study illustrates intraosseous pneumatocyst of the vertebral body, a benign lesion. To review the incidence and location of this benign lesion during a 1-year period. Intraosseous pneumatocyst is a rare benign condition, commonly seen in iliac bone or sacrum. The etiology of this entity is unclear. Other locations of these lesions are very rare, and only a few isolated cases are reported in the literature. In the last year (1994-1995), vertebral pneumatocyst was incidentally found in four patients who underwent computed tomography examination for presumptive discal lesion. Axial computed tomography with 2- and 4-mm slice thickness was performed. The typical computed tomography patterns of intraosseous pneumatocyst involving the cervical, dorsal, or lumbar spine were found. The bony structure and joints were normal. To the best of our knowledge, intraosseous pneumatocyst located in the spinal process has not been reported. Intraosseous pneumatocyst is a benign lesion. Biopsy and follow-up are unnecessary.

  16. [Ocular toxocariasis--case report].

    PubMed

    Moraru, Andreea; Panfil, Madălina; Totolici, Geanina; Brănişteanu, Daniel; Costin, Dănut; Schmitzer, Speranţa

    2014-01-01

    Ocular Toxocariasis is a parasitosis caused by Toxocara catis/canis larvae localized in the eye. The most frequent clinical manifestations are the central retinal granuloma, peripheral retinal granuloma and chronic endophthalmitis. Secondary complications due to the presence of parasite in the posterior segment of the eye may have significant consequences on visual function. We present the case of a 23 years old patient, admitted for progressive decrease of the right eye BCVA during the last 6 months. After performing clinical examination and serological tests we established the diagnosis of ocular Toxocariasis. The patient presented a particular form of the disease consisting in the presence of both a central retinal granuloma and a peripheral one. We performed 23G pars plana vitrectomy and membrane peeling. VA improved as soon as the first month after surgery.

  17. A case of ovarian enterobiasis

    PubMed Central

    Hong, Sung-Tae; Chai, Jong-Yil; Kim, Young Tak; Kim, Mi Kyung; Kim, Kyu Rae

    2002-01-01

    A 36-year old Korean woman consulted a clinic for a regular gynecological examination, and a mass was noticed in her pelvis. She was referred to the Asan Medical Center, Seoul where transvaginal ultrasonography confirmed a pelvic mass exceeding 10 cm in diameter. She received total abdominal hysterectomy and bilateral salpingoophorectomy, and a borderline serous neoplasm with micropapillary features involving the left ovary and right ovarian serosa was histopathologically confirmed. In addition, a section of a nematode with numerous eggs was found in the parenchyma of the left ovary. The worm had degenerated but the eggs were well-preserved and were identified as those of Enterobius vermicularis. She is an incidentally recognized case of ovarian enterobiasis. PMID:12325444

  18. A Case of Unusual Clitoromegaly.

    PubMed

    Wooi Ch'ng, Tong; Umpaichitra, Vatcharapan

    2018-05-03

    Mild degree of clitoromegaly can be associated with patient with polycystic ovarian syndrome (PCOS). We describe an unusually significant clitoromegaly in a patient with PCOS. An 18-year old non-obese female referred for clitoromegaly. Her genitalia exam showed significant clitoral enlargement with a well-formed glans, clitoris measured at 35 mm for length and 10 mm for width. Pelvic ultrasound showed left ovarian cyst. Testosterone level ranged from 28.8 to 64.1 ng/dl (normal: 8.4-48.1 ng/dl) with normal sex hormone binding globulin. Other ovarian hormones were in acceptable ranges. This case demonstrates the coexistence of significant clitoromegaly, PCOS, and non-functioning ovarian cyst. Copyright © 2018. Published by Elsevier Inc.

  19. [Plant poisoning cases in Turkey].

    PubMed

    Oztekin-Mat, A

    1994-01-01

    In Turkey, the majority of the population live in rural areas where they use wild plants as food and medicine. The confusion of an edible plant with a poisonous one give rise to serious poisoning which may even result in death. The incidence of plant poisoning in Turkey is about 6% and especially high among children between ages of 2 and 11 living in rural areas. The number of species that cause poisoning is around twenty and Hyoscyamus niger (Solanaceae), Colchicum species (Liliaceae), Conium maculatum (Umbelliferae) and Prunus species (Rosaceae) are the most important. Mushroom poisoning is more frequent in spring and fall. The main reasons are their widespread usage as food and the inexperience of the gatherers in distinguishing the edibles from the poisonous. Amanita phalloides, A. verna, A. muscaria, A. pantherina are responsible for severe cases of poisoning.

  20. A case of proctalgia fugax.

    PubMed

    Higgins, G L

    1984-05-01

    The syndrome called proctalgia fugax may be a repository of various conditions, because there are no distinctive signs or supporting tests. Usually, the pain of this condition is described as cramping, gnawing or tight, and lasts about ten to 15 minutes. It occurs most frequently at night and is localized to the rectal region above the anus. One subgroup may be diagnosed by the existence of a `shelf sign' in the rectum. This shelf is probably caused by pubococcygeus spasm. Patients suffering from proctalgia fugax tend to be perfectionists and above average in intelligence. A literature review and the case history of one patient illustrate the difficulties, frustrations and pitfalls associated with this incurable condition.

  1. A Case of Proctalgia Fugax

    PubMed Central

    Higgins, G. L.

    1984-01-01

    The syndrome called proctalgia fugax may be a repository of various conditions, because there are no distinctive signs or supporting tests. Usually, the pain of this condition is described as cramping, gnawing or tight, and lasts about ten to 15 minutes. It occurs most frequently at night and is localized to the rectal region above the anus. One subgroup may be diagnosed by the existence of a `shelf sign' in the rectum. This shelf is probably caused by pubococcygeus spasm. Patients suffering from proctalgia fugax tend to be perfectionists and above average in intelligence. A literature review and the case history of one patient illustrate the difficulties, frustrations and pitfalls associated with this incurable condition. PMID:21279002

  2. Cutaneous protothecosis--case report.

    PubMed

    Silva, Pâmela Craveiro Gomes da; Costa e Silva, Sabrina Beirão da; Lima, Ricardo Barbosa; D'Acri, Antonio Macedo; Lupi, Omar; Martins, Carlos José

    2013-01-01

    Cutaneous protothecosis is a rare infection caused by achlorophyllic algae of the genus Prototheca. The lesions usually occur on exposed areas, related with trauma, in immunocompromised patients. The most common clinical presentation is a vesicobullous and ulcerative lesion with pustules and scabs, simulating bacterial, fungal or herpetic infections or eczema. The diagnosis is determined by agent identification through histopathology, culture and the carbohydrates assimilation test. The finding of morula-like spherules is characteristic of Prototheca sp. Its rarity and non-specific clinical aspect may difficult the disease diagnosis. We report a case of a diabetic patient, in chronic use of systemic corticosteroids, that developed a skin lesion after trauma to the right leg.

  3. STS Case Study Development Support

    NASA Technical Reports Server (NTRS)

    Rosa de Jesus, Dan A.; Johnson, Grace K.

    2013-01-01

    The Shuttle Case Study Collection (SCSC) has been developed using lessons learned documented by NASA engineers, analysts, and contractors. The SCSC provides educators with a new tool to teach real-world engineering processes with the goal of providing unique educational materials that enhance critical thinking, decision-making and problem-solving skills. During this third phase of the project, responsibilities included: the revision of the Hyper Text Markup Language (HTML) source code to ensure all pages follow World Wide Web Consortium (W3C) standards, and the addition and edition of website content, including text, documents, and images. Basic HTML knowledge was required, as was basic knowledge of photo editing software, and training to learn how to use NASA's Content Management System for website design. The outcome of this project was its release to the public.

  4. A case of hypertensive urgency.

    PubMed

    Baum, Laurence

    2016-08-01

    A 41-year-old male Nepalese soldier presented to the primary care medical centre with a 1-week history of fatigue and muscle aches following a trip to Nepal. His BP was 164/98 but was otherwise normal. Four days later he presented with new symptoms of sweating and palpitations and a BP of 200/127 whereupon he was admitted to hospital with the diagnosis of hypertensive crisis. Appropriate investigation and initial management were undertaken, and he was discharged after 12 h on antihypertensive treatment. This case highlights the risk of hypertensive crisis in both diagnosed and silent hypertensive disease, and the review highlights the presentations, initial investigation and different management of hypertensive crisis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Sinonasal fibrosarcoma: a case report.

    PubMed

    Plaza, G; Ferrando, J; Pinedo, F

    2006-07-01

    Sinonasal fibrosarcoma (SFS) is an infrequent malignant neoplasm. It usually presents as other sarcomas in this region, with nasal obstruction and epistaxis. The final diagnosis is based on the histopathology and immunohistochemistry. We report the case of a 58-year-old man with an 8-month history of left proptosis, recurrent epistaxis and nasal obstruction. Nasal endoscopy confirmed a left nasal neoplasia. CT and MRI showed the extension of the neoplasia, occupying the left nasal fossa and ethmoid sinuses, and eroding the medial wall of the orbit. Complete removal was achieved through endoscopic sinus surgery, preserving the orbit. SFS was found on histopathologic examination. After 4 years of follow-up, nasal endoscopy, CT and MRI imaging show no sign of recurrence.

  6. [Myxedema coma. A case reported].

    PubMed

    Rebollo-Gómez, Héctor

    2010-01-01

    Myxedema coma is a life-threatening condition; it is a complication of untreated hypothyroidism and an endocrine emergency. Most patients are elderly women with a previous history of long-standing hypothyroidism which presents during the winter. The myxedema coma has an insidious onset and it is very rare; its recognition can be quite difficult. Once suspected, treatment can be lifesaving and should be start promptly in anticipation of confirmation of the diagnosis by laboratory test. The mortality rate is high. I presented a case of an old woman with myxedema coma with an undiagnosed hypothyroidism, with altered mental status, normal temperature, pneumonia, hyponatremia and high level of creatine phosphokinase, who presented in the emergency room.

  7. A brush fire forensic case.

    PubMed

    Rella, R; Sturaro, A; Parvoli, G; Ferrara, D; Casellato, U; Vadalà, G

    2005-01-01

    In Italy, every summer forest fires attract public attention due to the number of victims, the intensity of the fires, the areas devastated, the environmental damage and the loss of property. Excluding some fires by natural causes, other causes are related to the social, economic, and productive profile of the territory. The erroneous expectation is that wooded areas destroyed by fire can then be used for private interests. Often, a fire, started to clear a small area, can completely change the expected result, producing disaster, loss of property, destruction of entire forests and resident fauna, and kill innocent people. In this case report, the reconstruction of an arson scene, the analytical techniques and the results obtained are illustrated in this paper, with the aim of sharing with other research laboratories the current knowledge on forest fire.

  8. [Herpetic encephalitis: a clinical case].

    PubMed

    Dryhant, L P; Sereda, V H; Kushpiĭ, O V; Tkachenko, V V; Kravchuk, N A; Inhula, N I; Sizina, A V; Sachko, Iu Iu; Andrusenko, A S; Tytenko, Iu I; Babirad, A M

    2012-01-01

    An example of diagnostics and treatment of patient is in-process made with herpetic encephalitis. It is well-proven in researches, that a herpetic encephalitis is 11.5% among sharp encephalitises. Morbidity is sporadic, some researchers specify on an increase its spring. An infection can be passed tiny and pin a way. Seasonal vibrations are not incident to the herpetic encephalitis. Two peaks of morbidity are on 5-30 years and age more senior 50 years. More than in 95% cases the virus of simple herpes of type serves as an exciter of herpetic encephalitis 1. A characteristic triad of herpetic encephalitis is the sharp feverish beginning, development of cramps of dzheksonovskogo type and violation of consciousness, developing usually after a brief respirator infection. Sometimes sudden development of cramps and loss of consciousness is preceded a fever. Example of such development of disease is made an in our work.

  9. A Case of Cutis Pleonasmus

    PubMed Central

    Ko, Hyun Chang; Jwa, Seung Wook; Song, Margaret; Kwon, Kyung Sool

    2008-01-01

    In 2005, Kreidstein first proposed the term "Cutis pleonasmus," a Greek term meaning "redundancy," which refers to the excessive skin that remains after massive weight loss. Cutis pleonasmus is clearly distinguishable from other diseases showing increased laxity of the skin, such as pseudoxanthoma elasticum, congenital and acquired generalized cutis laxa. Although individuals who are severely overweight are few and bariatric surgeries are less common in Korea than in the West, the number of these patients is increasing due to changes to Western life styles. We report a case for a 24-year-old man who presented with generalized lax and loose skin after massive weight loss. He was diagnosed with cutis pleonasmus based on the history of great weight loss, characteristic clinical features and normal histological findings. To the best of our knowledge, this is the first report of cutis pleonasmus in Korea. PMID:27303198

  10. Factitious cheilitis: a case report

    PubMed Central

    Aydin, Erdinc; Gokoglu, Ozgur; Ozcurumez, Gamze; Aydin, Hakan

    2008-01-01

    Introduction Factitious cheilitis is a chronic condition characterized by crusting and ulceration that is probably secondary to chewing and sucking of the lips. Atopy, actinic damage, exfoliative cheilitis, cheilitis granulomatosa or glandularis, contact dermatitis, photosensitivity reactions and neoplasia should be considered in the differential diagnosis of crusted and ulcerated lesions of the lip. Case presentation We present a 56 year-old female with an ulcerated and crusted lesion on her lower lip. The biopsy showed granulation tissue and associated inflammation but no malignancy. Based on the tissue examination and through clinical evaluation the diagnosis of factitious cheilitis was rendered. Conclusion Thorough clinical history, utilization of basic laboratory tests and histopathologic evaluation are required to exclude other diseases and a thoruough psychiatric evaluation and treatment is vital for successful management of these patients. PMID:18226274

  11. Periodontal microsurgery: A case report

    PubMed Central

    Kapadia, Janak Anil; Bhedasgoankar, Surekha Y.; Bhandari, Saurabh Dilip

    2013-01-01

    The purpose of this article is to limelight the benefit of periodontal microsurgery in the surgical disciplines. It reviews the benefits and potential applications of magnification and microsurgery in the specialty of periodontics and a case report on microsurgical approach for free gingival graft surgery in the treatment of gingival recession. The increased demand for mucogingival esthetics has required the optimization of periodontal procedures. Microsurgery is a minimally invasive technique that is performed with the surgical microscope and adapted instruments and suture materials. Although this hardware and knowledge of various operations are necessary to achieve patient esthetic expectations, clinicians must be willing to undergo an extended period of systematic training to become familiar with novel operating procedures and instruments. This article describes the application of the surgical microscope to provide enhanced perioplastic treatment. PMID:24554892

  12. [Ocular dirofilariasis: a case report].

    PubMed

    Janjetović, Zeljka; Arar, Zeljka Vuković; Paradzik, Maja Tomić; Sapina, Lidija; Bitunjac, Milan; Lojen, Gordana; Marinculić, Albert

    2010-03-01

    A case of ocular dirofilariasis in a female patient is presented. The zoonosis caused by parasites of the genus Dirofilaria is relatively rare in humans, with a higher incidence in south and central Europe, Asia and Africa. In Europe, dirofilariasis is mostly caused by the species Dirofilaria repens. In the past 50 years, the number of individuals involved has been on an increase, with about 780 cases reported in the literature to date. Dirofilaria is a parasite found in the dog, cat, racoon and bear. The parasite replicates in the animal's body and enters circulation in the form of microfilariae. These microfilariae reach the insect's digestive tract and are transmitted to another animal or human with subsequent mosquito bites. When transmitted to humans, the parasite is found in the skin and subcutaneous tissue, mucous membranes, and less frequently visceral organs. Concerning ocular involvement, infections of the eye and adnexa oculi and tumorous noninfectious growth of eyelid or orbit have been described to date. The symptoms of the disease vary and include local pain, proptosis, diplopia, palpebral and conjunctival edema, redness, feeling of foreign body, and impaired vision. The diagnosis is generally made by histologic identification of the parasite micro- and macroscopic characteristics, Dirofilaria DNA analysis by the method of polymerase chain reaction, and serology (ELISA) demonstrating the presence of Dirofilaria antibodies in serum. Treatment includes surgical excision of the parasite as an appropriate and efficient therapeutic procedure. A 76-old-female patient presented to outpatient ophthalmology clinic for occasional sensation of pain, rubbing and redness in her right eye. Initial therapy was introduced, resulting in short-lasting improvement. In two weeks, the patient was re-examined for recurrence of discomforts. Slit lamp examination performed temporally revealed a whitish motile, live parasite under the injected and chemotic bulbar conjunctiva

  13. Pituitary Gigantism: A Case Report

    PubMed Central

    Bhattacharjee, Rana; Roy, Ajitesh; Goswami, Soumik; Selvan, Chitra; Chakraborty, Partha P.; Ghosh, Sujoy; Biswas, Dibakar; Dasgupta, Ranen; Mukhopadhyay, Satinath; Chowdhury, Subhankar

    2012-01-01

    Objective: To present a rare case of gigantism. Case Report: A 25-year-old lady presented with increased statural growth and enlarged body parts noticed since the age of 14 years, primary amenorrhea, and frontal headache for the last 2 years. She has also been suffering from non-inflammatory low back pain with progressive kyphosis and pain in the knees, ankles, and elbows for the last 5 years. There was no history of visual disturbance, vomiting, galactorrhoea, cold intolerance. She had no siblings. Family history was non-contributory. Blood pressure was normal. Height 221 cm, weight 138 kg, body mass index (BMI)28. There was coarsening of facial features along with frontal bossing and prognathism, large hands and feet, and small goitre. Patient had severe kyphosis and osteoarthritis of knees. Confrontation perimetry suggested bitemporal hemianopia. Breast and pubic hair were of Tanner stage 1. Serum insulin like growth factor-1 (IGF1) was 703 ng/ml with all glucose suppressedgrowth hormone (GH)values of >40 ng/ml. Prolactin was 174 ng/ml. Basal serum Lutenising Hormone (LH), follicle stimulating Hormone (FSH) was low. Oral glucose tolerance test (OGTT), liver and renal function tests, basal cortisol and thyroid profile, Calcium, phosphorus and Intact Parathyroid hormone (iPTH) were normal. Computed tomographyscan of brain showed large pituitary macroadenoma. Automated perimetry confirmed bitemporal hemianopia. A diagnosis of gigantism due to GH secreting pituitary macroadenoma with hypogonadotrophichypogonadism was made. Debulking pituitary surgery followed by somatostatin analogue therapy with gonadal steroid replacement had been planned, but the patient refused further treatment. PMID:23565401

  14. Aldicarb poisoning: one case report.

    PubMed

    Proença, Paula; Teixeira, Helena; de Mendonça, M C; Castanheira, Fernando; Marques, Estela P; Corte-Real, Francisco; Nuno Vieira, Duarte

    2004-12-02

    The carbamate aldicarb (Temik) is a highly toxic (LD50 = 0.9 mg/kg oral in rats) insecticide often used in agriculture. The authors present a fatal intoxication case with aldicarb, in a 24-year-old male, under police custody in the island of S. Tome and Prince (STP), in Africa. He was found 3 h after his arrest, lying on the floor of his cell, unconscious, frothing at the mouth, and entered into the hospital already dead. Aldicarb analysis was carried out by high-performance liquid chromatography, with a post-column derivatization system (with o-phthaldialdehyde and 2-mercaptoethanol, under alkaline conditions at 80 degrees C) with fluorescence detection at lambda(ex)= 339 nm and lambda(em) = 445 nm. The toxicological analysis revealed toxic concentrations of aldicarb in the post-mortem samples: blood (6.2 microg/ml), stomach (48.9 microg/g), liver (0.80 microg/g), kidney (8.10 microg/g), heart (6.70 microg/g) and urine (17.50 microg/ml). It was also detected to be the same substance in a grey granulate powder supplied by criminal authorities of that country, as a probable substance ingested by the victim. The toxicological analysis results, the autopsy findings and the information given, allowed us to conclude that death occurred due to an aldicarb acute intoxication. Although the case suggested a suicide, particularly based on the known information and on the high aldicarb concentration found in the stomach, it was not possible to indicate precisely its etiology (suicide or homicide).

  15. Stiff person case misdiagnosed as conversion disorder: A case report.

    PubMed

    Razmeh, Saeed; Habibi, Amir Hasan; Sina, Farzad; Alizadeh, Elham; Eslami, Monireh

    2017-01-01

    Stiff person syndrome (SPS) is a rare neurological disease resulting in stiffness and spasm of muscles. It initially affects the axial muscles and then spread to limb muscles. Emotional stress exacerbated the symptoms and signs of the disease. The pathophysiology of the disease is caused by the decreased level of the glutamic acid decarboxylase (GAD) activity due to an autoantibody against GAD that decreases the level of gamma-aminobutyric acid (GABA). In this paper, we present a case of atypical presentation of SPS with lower limb stiffness misdiagnosed as conversion disorder. We report a patient with atypical presentation of SPS with lower limb stiffness and gait disorder misdiagnosed as conversion disorder for a year. Her antithyroid peroxidase antibody (anti-TPO Ab) level was 75 IU (normal value: 0-34 IU). Intravenous immunoglobulin (IVIG) was administered (2gr/kg, 5 days) for the patient that showed significant improvement in the follow-up visit. It is essential that in any patient with bizarre gait disorder and suspicious to conversion disorder due to the reversibility of symptoms, SPS and other movement disorder should be considered.

  16. A rare case of generalized pyogenic granuloma: a case report.

    PubMed

    Shivaswamy, Sumanth; Siddiqui, Nazia; Jain, Sanjay A; Koshy, Ajit; Tambwekar, Sonal; Shankar, Akhil

    2011-06-01

    Gingival enlargement is defined as an overgrowth or increase in size of the gingiva. Enlargement can be of many types depending on etiologic factors like inflammation, drug-induced effects, neoplasm, hormonal imbalance, and systemic involvement (leukemia, etc). Drugs and hormonal imbalance are the most common causes of gingival enlargement. Nonspecific conditioned enlargement, or pyogenic granuloma, is considered an exaggerated conditioned response to minor trauma or chronic irritation. Pyogenic granuloma occurring in the oral cavity is a common phenomenon. However, simultaneously occurring generalized pyogenic granuloma in the oral cavity is a rare entity. Generalized pyogenic granuloma on the back and skin have been reported. This is the first case report of generalized pyogenic granuloma in the oral cavity. A 19-year-old male patient reported with a complaint of difficulty in mastication and generalized swelling of the gingiva that developed within a span of 15 days. Family and systemic history were noncontributory. Based on the clinical findings, histopathology report, and immunohistochemistry result, the patient was diagnosed with generalized pyogenic granuloma. Scaling and root planing were performed as the first phase of therapy followed by external bevel gingivectomy. The patient was followed for 3 months. The patient was advised to visit the clinic for regular maintenance visits for 1 year, as pyogenic granuloma has a tendency to recur. © 2011 By Quintessence Publishing Co, Inc.

  17. [Retrospective Analysis of 17 Family Homicide Cases].

    PubMed

    Xu, W J; Ji, P

    2016-12-01

    To summarize the characteristics of family homicide cases and to provide reference for the analysis and prevention of such cases. Seventeen solved family homicide cases in Liyang from 2004 to 2014 were investigated. The original registration information, record of scene investigation, corpse inspection report and case situation were analyzed statistically. The characteristics of the 17 family homicides cases showed that most victims were female and most suspects were male, and spouse infidelity and suspected spouse infidelity have higher proportion in the motives for the killings. Murders by patients with psychosis, camouflage murders and murder-suicides occupied a certain proportion in the family homicide cases. The family homicide cases are correlated with the family factors such as extramarital sexual intercourse and murder by patients with psychosis. Some suspects suicided after murder. The tools for committing crimes have the features of simplicity, randomness and easy source availability. Copyright© by the Editorial Department of Journal of Forensic Medicine

  18. Exchangeability in the case-crossover design

    PubMed Central

    Mittleman, Murray A; Mostofsky, Elizabeth

    2014-01-01

    In cohort and case-control studies, confounding that arises as a result of differences in the distribution of determinants of the outcome between exposure groups leading to non-exchangeability are addressed by restriction, matching or with statistical models. In case-only studies, this issue is addressed by comparing each individual with his/herself. Although case-only designs use self-matching and only include individuals who develop the outcome of interest, issues of non-exchangeability are identical to those that arise in traditional case-control and cohort studies. In this review, we describe one type of case-only design, the case-crossover design, and discuss how the concept of exchangeability can be used to understand issues of confounding, carryover effects, period effects and selection bias in case-crossover studies. PMID:24756878

  19. 24 CFR 252.3 - Case-by-case conversion to full insurance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Case-by-case conversion to full insurance. 252.3 Section 252.3 Housing and Urban Development Regulations Relating to Housing and Urban... HOMES § 252.3 Case-by-case conversion to full insurance. Cross Reference: The provisions of 24 CFR 251.3...

  20. 24 CFR 251.3 - Case-by-case conversion to full insurance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Case-by-case conversion to full... § 251.3 Case-by-case conversion to full insurance. Upon the request of a coinsuring lender, the... conversion would be less costly to HUD than if the Mortgage remained coinsured; (d) The lender has paid HUD...

  1. Case Study: Puttin' on the Ritz: How to Put Science into Cases

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman

    2017-01-01

    There are multiple ways to put science into a case. This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses different ways of presenting science in case studies.

  2. In Case You Teach English: Case Studies in the English Classroom.

    ERIC Educational Resources Information Center

    Johannessen, Larry R.

    Case studies can be a powerful strategy to use for helping students learn critical thinking processes that are key to interpreting and responding to literature and writing. Some of the major benefits of applying case methods are: cases provide an environment for active learning; they encourage the creation of a community of learners; cases help…

  3. Unexpected findings at diagnostic laparoscopy: caecal incarceration with concurrent appendicitis in a patient with bilateral broad ligament defects

    PubMed Central

    Onida, S; Lynes, K; Whitehouse, PA

    2010-01-01

    Internal herniations through broad ligament defects are very rare. We present the first report of the triad of broad ligament defect, internal herniation of the caecum and appendicitis. A 36-year-old woman with phocomelia presented with right iliac fossa pain and vomiting. The patient had no previous history of trauma or surgery. Abdominal ultrasound showed a small amount of free fluid. At laparoscopy, bilateral broad ligament defects were found, with herniation of the caecum and an inflamed appendix through the right-sided defect. A laparoscopic salpingo-oophorectomy was required for reduction of the herniated bowel, and an appendicectomy was performed. Broad ligament defects may be congenital or acquired. In this case, in light of the limb abnormality and absence of previous surgery, a congenital aetiology is more likely. Ultrasound scan is not reliable and, although computed tomography may be of help, a diagnostic laparoscopy is the best investigation. PMID:20566032

  4. Bilaterally cleft lip, limb defects, and haematological manifestations: Roberts syndrome versus TAR syndrome.

    PubMed

    Urban, M; Opitz, C; Bommer, C; Enders, H; Tinschert, S; Witkowski, R

    1998-09-23

    We report on a 13-year-old patient followed since birth. He is the only offspring of young, non-consanguineous German parents. His mother has an isolated left cleft of lip and a cleft palate. At birth, our patient presented with bilaterally cleft lip/cleft palate, phocomelia of upper limbs with normal hands, and mild symmetrical deficiencies of the long bones of the lower limbs. Haematological evaluation demonstrated a leukaemoid reaction during a urinary tract infection as well as intermittent thrombocytopenia and episodes of marked eosinophilia during the first two years of life. Intellectual development has been normal. Comparison with two similar cases from the literature suggests a non-random phenotypic overlap of Roberts syndrome (MIM 268300) and TAR syndrome (MIM 274000). Such clinical constellations may be key observations to understand the genetic relationship of Roberts syndrome and TAR syndrome in future phenotype-genotype correlations.

  5. Acrofacial dysostosis syndrome type Rodriguez: prenatal diagnosis and autopsy findings.

    PubMed

    Sermer, David; Quercia, Nada; Chong, Karen; Chitayat, David

    2007-12-15

    A new lethal form of acrofacial dysostosis (AFD) syndrome was delineated by Rodriguez et al. [Rodriguez et al. (1990); Am J Med Genet 35:484-489]. We report on a male fetus with mandibulofacial dysostosis, including phocomelia-like upper limb deficiencies and lower limb anomalies which are characteristic of AFD Rodriguez type. The diagnosis was made on prenatal sonogram at 20 and at 24.1 weeks gestation. The severity of the upper limb defects, the involvement of lower limbs, and the absence of eyelid coloboma and polythelia excluded the possibility of other conditions associated with acrofacial dysostosis (AFD) including Nager acrofacial dysostosis syndrome (NADS) and postaxial acrofacial dysostosis syndrome (POADS). This case further delineates the AFD syndrome type Rodriguez. (c) 2007 Wiley-Liss, Inc.

  6. Working smarter on cold cases: identifying factors associated with successful cold case investigations.

    PubMed

    Davis, Robert C; Jensen, Carl J; Burgette, Lane; Burnett, Kathryn

    2014-03-01

    Cold case squads have garnered much attention; however, they have yet to undergo significant empirical scrutiny. In the present study, the authors interviewed investigators and reviewed 189 solved and unsolved cold cases in Washington, D.C., to determine whether there are factors that can predict cold case solvability. In the interviews, new information from witnesses or information from new witnesses was cited as the most prevalent reason for case clearance. The case reviews determined that there were factors in each of the following domains that predicted whether cases would be solved during cold case investigations: Crime Context, Initial Investigation Results, Basis for Opening Cold Case, and Cold Case Investigator Actions. The results suggest that it is possible to prioritize cold case work based on the likelihood of investigations leading to clearances. © 2014 American Academy of Forensic Sciences.

  7. Aims and harvest of moral case deliberation.

    PubMed

    Weidema, Froukje C; Molewijk, Bert A C; Kamsteeg, Frans; Widdershoven, Guy A M

    2013-09-01

    Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (N = 78) and harvest (N = 255). A naturalistic data collection included interviews with managers and evaluation questionnaires of moral case deliberation participants (nurses). From the analysis, moral case deliberation appeals for cooperation, team bonding, critical attitude towards routines and nurses' empowerment. Differences are that managers aim to foster identity of the nursing profession, whereas nurses emphasize learning processes and understanding perspectives. We conclude that moral case deliberation influences team cooperation that cannot be controlled with traditional management tools, but requires time and dialogue. Exchanging aims and harvest between manager and team could result in co-creating (moral) practice in which improvements for daily cooperation result from bringing together perspectives of managers and team members.

  8. CABINS: Case-based interactive scheduler

    NASA Technical Reports Server (NTRS)

    Miyashita, Kazuo; Sycara, Katia

    1992-01-01

    In this paper we discuss the need for interactive factory schedule repair and improvement, and we identify case-based reasoning (CBR) as an appropriate methodology. Case-based reasoning is the problem solving paradigm that relies on a memory for past problem solving experiences (cases) to guide current problem solving. Cases similar to the current case are retrieved from the case memory, and similarities and differences of the current case to past cases are identified. Then a best case is selected, and its repair plan is adapted to fit the current problem description. If a repair solution fails, an explanation for the failure is stored along with the case in memory, so that the user can avoid repeating similar failures in the future. So far we have identified a number of repair strategies and tactics for factory scheduling and have implemented a part of our approach in a prototype system, called CABINS. As a future work, we are going to scale up CABINS to evaluate its usefulness in a real manufacturing environment.

  9. Scholarship improved by case report curriculum.

    PubMed

    Stephens, John; Wardrop, Richard

    2016-12-01

    The Accreditation Council for Graduate Medical Education (ACGME) requires that residents participate in scholarly activity. Case reports are an accessible form of resident scholarship, given the time required relative to other forms of research. Our paediatric residency lacked a curriculum for writing and presenting case reports. We created and implemented a brief curriculum for writing case reports and scientific posters. The curriculum consisted of two 1-hour didactic sessions, followed by mentoring during the writing process. The impact of the curriculum was measured via resident surveys about the material presented and by the rate of presentations of case reports made by residents at our departmental research day, before and after implementation. In the year of curriculum implementation, there were 15 case reports presented at the departmental research day, compared with an average of 4.7 per year in the three prior years. The resident (n = 85) participation rate increased from an average of 0.06 case reports per resident per year before implementation to 0.18 case reports per resident per year after implementation (p = 0.0023). Implementation of a case report curriculum with subsequent mentoring was associated with a marked increase in resident case report presentations at the departmental research day. These results suggest that even brief instruction and subsequent faculty mentorship in preparation of case reports can significantly improve resident participation in scholarly activity. © 2016 John Wiley & Sons Ltd.

  10. [Cutaneous mastocytosis: A case report].

    PubMed

    Zegpi-Trueba, María Soledad; Hasbún-Acuña, Paula; Berroeta-Mauriziano, Daniela

    2016-01-01

    Mastocytosis represents a group of diseases characterised by an excesive accumulation of mastocytes in one or multiple tissues. It can affect only the skin, or have a systemic involvement. It has a low prevalence, and the prognosis is benign in children. To report a case of urticaria pigmentosa as a subtype of cutaneous mastocytosis, and present a literature review focused on clinical findings, diagnosis and initial basic management. A child of six months of age presenting with multiple blemishes and light brown papules located on the trunk, arms and legs. The symptoms were compatible with urticaria pigmentosa, and was confirmed by biopsy. Tests to rule out systemic involvement were requested. The patient was treated with general measures, education, and antihistamines, with favourable results. Cutaneous mastocytosis is a rare disease with a good prognosis. In childhood general measures and education are usually enough to obtain favourable results. Histamine H1 antagonists are the first line drug treatment. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. A case discussion on presbyacusis.

    PubMed

    Angadi, Savita S; Kotrannavar, Vijaykumar S

    2013-01-01

    Presbyacusis is one among the many socio-medical problems, which is considered as a hidden disability. The hearing impairment in elderly people is described as presbyacusis. Hearing problem among elderly people is a major issue and a person with hearing loss may be unable to hear doorbells and alarms, to respond while talking with anyone, etc. All this can make them feel frustrated, lonely, and depressed. It is the third most common chronic condition after arthritis and hypertensive diseases among elders. Hearing loss can be improved by using the hearing aids. Hearing aids work well for some while for others; it may not be a perfect solution due to many reasons such as some people do not buy aids that meet their needs, incorrect amplification adjustments, low custom design, etc. In classics of Ayurveda this ailment has been described as karnabaadhirya under the heading of ear diseases. Karnapurana (Instillation of medicated oil into the external auditory canal) is one of the major treatments for ear diseases explained in classics. Clinical observation has shown its effectiveness in the management of presbyacusis. A case report of 75-year-old male who presented with complaints of reduced hearing and tinnitus in both ears has been presented here.

  12. [Hemorrhagic adrenal pseudocyst: case report].

    PubMed

    Basile, G; Buffone, A; Cicciarella, G; di Mari, P; Cirino, E

    2004-01-01

    Adrenal cysts are usually asymptomatic; they are usually identified occasionally during ultrasound or C.T. scans (incidentaloma). Among adrenal cysts the most common types are epithelial cysts and pseudocysts. Intracystic haemorrhage is one of the possible complications of adrenal pseudocysts. We report a case of a young woman with right superior abdominal pain, fever and acute anemia. A C.T. scan showed a 10 cm. mass between the liver and the right kidney. To be sure of the nature of this mass also M.R., urography and C.T.-guided biopsy were carried out. This latter only let us make the final diagnosis of hemorrhagic adrenal pseudocyst. Thereafter, a laparotomic right adrenalectomy was performed, with full recovery of the patient. Adrenal cysts may cause differential diagnostic problems with masses of contiguous organs like kidney, liver and gallbladder. For this reason, ultrasound and C.T. scans may not be sufficient and must be completed by M.R., urography and/or C.T.-guided biopsy. Intracystic hamorrhage, spontaneous or post-traumatic, may cause to the patient acute anemia which, as soon as the diagnosis is confirmed, indicates surgery. The operation usually is a laparotomic adrenalectomy, since the laparoscopic approach is not sufficient to control large masses with active bleeding inside.

  13. [Scimitar syndrome: a case series].

    PubMed

    Jaramillo González, Carlos; Karam Bechara, José; Sáenz Gómez, Jessica; Siegert Olivares, Augusto; Jamaica Balderas, Lourdes

    Scimitar syndrome is a rare and complex congenital anomaly of the lung with multiple variables and is named for its resemblance to the classical radiological crooked sword. Its defining feature is the anomalous pulmonary drainage. It is associated with various cardiothoracic malformations and a wide spectrum of clinical manifestations. Nine patients diagnosed with scimitar syndrome found in the database of Hospital Infantil de México between 2009 and 2013 were reviewed. Demographic records, clinical status and hemodynamic parameters reported were collected. This case series called attention to certain differences between our group of patients and those reported in the international literature. Patients were predominantly female and were diagnosed between 1 and 20 months of life. All were asymptomatic at the time of the study. Half of the patients had a history of respiratory disease and all patients had with pulmonary hypertension. Surgical management was required in on-third of the patient group. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  14. Vulval Elephantiasis: A Case Report

    PubMed Central

    Mohan, Harsh; Bisht, Bhumika; Goel, Poonam; Garg, Geeta

    2012-01-01

    Introduction. Elephantiasis is a chronic manifestation of filariasis; it commonly affects limbs, scrotum, and trunk. Females have lower incidence of filarial infection. Vulval elephantiasis due to filariasis is still rarer. It is difficult to make the diagnosis on histopathology alone, more so in view of the fact that the parasite is usually not identified in tissue sections. Identification of microfilariae in night samples of peripheral blood or seropositivity for filarial antigen is requisite for the correct diagnosis. Case Presentation. A young female presented with progressively increasing vulval swelling over a period of two years. The swelling was soft and measured 5 × 6 cm. Other possible differential diagnoses were excluded, and ancillary tests were performed to reach a conclusive diagnosis of vulval elephantiasis on histopathology. Conclusion. Vulval elephantiasis due to filariasis is rare. Its diagnosis on histopathology is more often by exclusion. High index of suspicion on microscopic findings and corelation with relevant diagnostic tests are required to reach the correct diagnosis. PMID:23198192

  15. Telescopic Overdenture: A Case Report

    PubMed Central

    Shruthi, C. S.; Poojya, R.; Ram, Swati; Anupama

    2017-01-01

    Patient: This report describes the case of a 68 year old female patient who presented with the chief complaint of difficulty in chewing and poor aesthetics due to missing teeth. The patient was interested in saving the remaining natural teeth and desired minimal tissue coverage from the prosthesis. After consideration of all the factors involved, it was deemed advisable to resort to a palate free maxillary telescopic complete denture and a mandibular removable partial denture. Discussion: Considering the age of the patient and the cost involved, implant supported prosthesis was ruled out as a treatment option for the patient. A telescopic denture was chosen as a favourable treatment option since it overcomes many of the problems posed by conventional complete dentures like progressive bone loss, lower stability and retention, loss of periodontal proprioception and low masticatory efficiency. It also provides minimal tissue coverage and better distribution of forces. Evaluation of occlusion, esthetics, phonetics and comfort after 24 hours, 1 week and 1 month of treatment showed that the patient was happy with the prosthesis and was able to speak and chew well. Conclusion: Telescopic overdentures have better retention and stability as compared to conventional complete dentures. They improve the chewing efficiency, patient comfort and also decrease the alveolar bone resorption. As such they are an excellent alternative to conventional complete denture treatment. PMID:28533736

  16. Telescopic Overdenture: A Case Report.

    PubMed

    Shruthi, C S; Poojya, R; Ram, Swati; Anupama

    2017-03-01

    This report describes the case of a 68 year old female patient who presented with the chief complaint of difficulty in chewing and poor aesthetics due to missing teeth. The patient was interested in saving the remaining natural teeth and desired minimal tissue coverage from the prosthesis. After consideration of all the factors involved, it was deemed advisable to resort to a palate free maxillary telescopic complete denture and a mandibular removable partial denture. Considering the age of the patient and the cost involved, implant supported prosthesis was ruled out as a treatment option for the patient. A telescopic denture was chosen as a favourable treatment option since it overcomes many of the problems posed by conventional complete dentures like progressive bone loss, lower stability and retention, loss of periodontal proprioception and low masticatory efficiency. It also provides minimal tissue coverage and better distribution of forces. Evaluation of occlusion, esthetics, phonetics and comfort after 24 hours, 1 week and 1 month of treatment showed that the patient was happy with the prosthesis and was able to speak and chew well. Telescopic overdentures have better retention and stability as compared to conventional complete dentures. They improve the chewing efficiency, patient comfort and also decrease the alveolar bone resorption. As such they are an excellent alternative to conventional complete denture treatment.

  17. [Maxillary cementoblastoma. A case report].

    PubMed

    Slimani, F; Elbouihi, M; Oukerroum, A; Lazreqh, H; Mahtar, M; Karkouri, M; Abdelouafi, A; Benjelloun, A; Chekkoury-Idrissi, A

    2009-01-01

    Cementoblastoma is a rare benign odontogenic neoplasm. Its cause is unknown. It represents less 6 % of all odontogenic tumors. The aim of our work is to present a rare case of maxillary cementoblastoma involving an included central incisor. A 32-year old man consulted for a left maxillary swelling to projection under nostril. A panoramic radiographic examination revealed an included tooth 21 with a radiopaque lesion around its root. The computed tomography revealed the included tooth 21 with a process around its root. This process is well-defined, high-dense and is surrounded by a radiolucent halo. The treatment should consist of complete removal of the lesion with the tooth 21. Histological examination concluded to the diagnosis of a cementoblastoma. The cementoblastoma occurs most frequently in young persons and predominantly among men. The mandibular premolar and molar are the more frequently reached. The maxillary localization remains rare. This tumor occurs around the roots of the posterior and lower teeth. Radiographically, the lesion is well-defined and attached to the root of the tooth, radiopaque dense and surrounded by a radiolucent halo. The cementoblastoma evolves slowly and has the tendency to blow the cortical. The prognosis is good.

  18. Nebivolol Induced Hyperkalemia: Case Report

    PubMed

    Altabas, Karmela; Altabas, Velimir; Gulin, Tonko

    2016-12-01

    In this article, we document a conclusive case of nebivolol-induced hyperkalemia for the first time in the known medical literature. Hyperkalemia is associated with serious conditions such as cardiac arrhythmias and sudden cardiac death. Nebivolol was not known to cause hyperkalemia, and this event is not listed in its summary of product characteristics (SmPC). For older beta blockers, hyperkalemia is recognized as a rare adverse event linked to cytochrome P450 2D6 (CYP2D6) polymorphism and poor drug degradation. Our patient, a 47-year-old woman taking nebivolol for hypertension developed persistent hyperkalemia, with serum potassium levels up to 6.4 mmol/L. After extensive diagnostic evaluation and exclusion of other known conditions leading to hyperkalemia, its cause remained occult. Since hyperkalemia coincided with increased doses of nebivolol, dose reduction and discontinuation were attempted, resulting in normalized serum potassium. Poor drug metabolism could not explain this adverse effect, since pharmacogenetic testing showed no relevant aberrations. In conclusion, hyperkalemia is a harmful adverse event with possible lethal outcome, and it may be caused by nebivolol. Therefore, medical professionals have to be aware of this side effect and hyperkalemia should be listed as an adverse event in nebivolol SmPC.

  19. [Three cases of scombroid poisoning].

    PubMed

    Harmelin, Y; Hubiche, T; Pharaon, M; Del Giudice, P

    2018-01-01

    Scombroid poisoning is a poorly known type of food poisoning due to the presence of histamine in spoiled fish of the Scombridae family. We report 3 cases of scombroid poisoning seen at the Fréjus-Saint-Raphaël hospital in the Var region. Within around thirty minutes of eating a meal containing tuna, three patients presented varied symptoms: malaise, itchy rash, headache, and for two of them, nausea. The diagnosis of scombroid poisoning was based on the circumstances in which the clinical signs appeared and on the signs themselves. The patients were given antihistamines and one injection of intravenous corticosteroids, and symptoms regressed rapidly within a few hours. The symptoms of scombroid poisoning appear within a few minutes after eating fish of the Scombridae family and related species. The first symptoms are cutaneous, with flush, pruritus, and erythema of the face and trunk having an urticarial appearance, together with faintness. Gastrointestinal symptoms include nausea, vomiting, abdominal cramps and occasionally diarrhea. Symptoms subside within a few hours. Histamine is present in the flesh of these fish due to decarboxylation of histidine through the action of Gram-negative bacteria whose development is enhanced by heat and sun. Scombroid poisoning is one of the most common types of poisoning caused by eating fish but it is underdiagnosed by dermatologists. The diagnosis is made by measuring histamine levels in the incriminated fish or in the patient's plasma. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. Usher's syndrome--case report.

    PubMed

    Kwiecień, Sława; Sulak, Robert; Szaflik, Jerzy

    2008-01-01

    The aim of this study is to present a case of coincidence of sensorineural hearing loss with chronic recurrent bilateral cystoid macular oedema in a 32-year-old woman, who was admitted to the clinic for deterioration of visual acuity of four months' duration. The patient gave a history of hearing loss for 29 years. Visual field examination disclosed peripheral ring scotoma. Electrophysiological examination was performed: pattern visual evoked response was within normal limits and electroretinogram displayed diminished both photopic and scotopic response. As ophthalmoscopy demonstrated no pigment in the fundus of the eye, the findings were consisted with diagnosis of retinitis pigmentosis sine pigmento. The presence of loss of hearing indicated the necessity of performing the genetic examination for Usher's syndrome. In order to establish a final diagnosis of Usher's syndrome genetic examination must be performed, but family history is relevant. Early investigation for Usher's syndrome in children with sensorineural hearing impairment is of a great significance. The patient may develop symptoms of retinitis pigmentosa in second or even third decade of his life. The necessity of thorough investigation for detecting other systemic abnormalities should be emphasized. There is no effective treatment of this syndrome. A child with Usher's syndrome requires a comprehensive care of different medical specialties. Psychological, educational and sociological attitude is also of a great importance in the child development.

  1. A case discussion on presbyacusis

    PubMed Central

    Angadi, Savita S.; Kotrannavar, Vijaykumar S.

    2013-01-01

    Presbyacusis is one among the many socio-medical problems, which is considered as a hidden disability. The hearing impairment in elderly people is described as presbyacusis. Hearing problem among elderly people is a major issue and a person with hearing loss may be unable to hear doorbells and alarms, to respond while talking with anyone, etc. All this can make them feel frustrated, lonely, and depressed. It is the third most common chronic condition after arthritis and hypertensive diseases among elders. Hearing loss can be improved by using the hearing aids. Hearing aids work well for some while for others; it may not be a perfect solution due to many reasons such as some people do not buy aids that meet their needs, incorrect amplification adjustments, low custom design, etc. In classics of Ayurveda this ailment has been described as karnabaadhirya under the heading of ear diseases. Karnapurana (Instillation of medicated oil into the external auditory canal) is one of the major treatments for ear diseases explained in classics. Clinical observation has shown its effectiveness in the management of presbyacusis. A case report of 75-year-old male who presented with complaints of reduced hearing and tinnitus in both ears has been presented here. PMID:23741163

  2. ASRM case insulation design and development

    NASA Technical Reports Server (NTRS)

    Bell, Matthew S.; Tam, William F. S.

    1992-01-01

    This paper describes the achievements made on the Advanced Solid Rocket Motor (ASRM) case insulation design and development program. The ASRM case insulation system described herein protects the metal case and joints from direct radiation and hot gas impingement. Critical failure of solid rocket systems is often traceable to failure of the insulation design. The wide ranging accomplishments included the development of a nonasbestos insulation material for ASRM that replaced the existing Redesigned Solid Rocket Motor (RSRM) asbestos-filled nitrile butadiene rubber (NBR) along with a performance gain of 300 pounds, and improved reliability of all the insulation joint designs, i.e., segmented case joint, case-to-nozzle and case-to-igniter joint. The insulation process development program included the internal stripwinding process. This process advancement allowed Aerojet to match to exceed the capability of other propulsion companies.

  3. Multiple orthokeratinized odontogenic cysts: a case report.

    PubMed

    Cheng, Yi-Shing Lisa; Liang, Hui; Wright, John; Teenier, Tom

    2015-03-01

    The purpose of this report is to document the clinical, radiographic, pathological and molecular findings of the first case of multiple orthokeratinized odontogenic cysts (OOCs). Multiple odontogenic keratocysts are one of the major features of nevoid basal cell carcinoma syndrome (NBCCS), and loss of heterozygosity in the PTCH gene, the culprit gene for NBCCS, has recently been found in sporadic OOC cases. Therefore, in this presenting case, we also investigated the possibility that this patient might also have NBCCS, by comparing the available clinical information and the molecular findings of this case to the diagnostic criteria for NBCCS (as proposed by the First International Colloquium on NBCCS in 2011). However, this patient with multiple OOCs showed no evidence of having NBCCS. This conclusion supports the findings from previous case series based on sporadic cases that OOC does not appear to be associated with NBCCS.

  4. ASRM case insulation design and development

    NASA Astrophysics Data System (ADS)

    Bell, Matthew S.; Tam, William F. S.

    1992-10-01

    This paper describes the achievements made on the Advanced Solid Rocket Motor (ASRM) case insulation design and development program. The ASRM case insulation system described herein protects the metal case and joints from direct radiation and hot gas impingement. Critical failure of solid rocket systems is often traceable to failure of the insulation design. The wide ranging accomplishments included the development of a nonasbestos insulation material for ASRM that replaced the existing Redesigned Solid Rocket Motor (RSRM) asbestos-filled nitrile butadiene rubber (NBR) along with a performance gain of 300 pounds, and improved reliability of all the insulation joint designs, i.e., segmented case joint, case-to-nozzle and case-to-igniter joint. The insulation process development program included the internal stripwinding process. This process advancement allowed Aerojet to match to exceed the capability of other propulsion companies.

  5. Reusable experiment controllers, case studies

    NASA Astrophysics Data System (ADS)

    Buckley, Brian A.; Gaasbeck, Jim Van

    1996-03-01

    Congress has given NASA and the science community a reality check. The tight and ever shrinking budgets are trimming the fat from many space science programs. No longer can a Principal Investigator (PI) afford to waste development dollars on re-inventing spacecraft controllers, experiment/payload controllers, ground control systems, or test sets. Inheritance of the Ground Support Equipment (GSE) from one program to another is not a significant re-use of technology to develop a science mission in these times. Reduction of operational staff and highly autonomous experiments are needed to reduce the sustaining cost of a mission. The re-use of an infrastructure from one program to another is needed to truly attain the cost and time savings required. Interface and Control Systems, Inc. (ICS) has a long history of re-usable software. Navy, Air Force, and NASA programs have benefited from the re-use of a common control system from program to program. Several standardization efforts in the AIAA have adopted the Spacecraft Command Language (SCL) architecture as a point solution to satisfy requirements for re-use and autonomy. The Environmental Research Institute of Michigan (ERIM) has been a long-standing customer of ICS and are working on their 4th generation system using SCL. Much of the hardware and software infrastructure has been re-used from mission to mission with little cost for re-hosting a new experiment. The same software infrastructure has successfully been used on Clementine, and an end-to-end system is being deployed for the Far Ultraviolet Spectroscopic Explorer (FUSE) for Johns Hopkins University. A case study of the ERIM programs, Clementine and FUSE will be detailed in this paper.

  6. Pituitary gigantism: a case report.

    PubMed

    Bhattacharjee, Rana; Roy, Ajitesh; Goswami, Soumik; Selvan, Chitra; Chakraborty, Partha P; Ghosh, Sujoy; Biswas, Dibakar; Dasgupta, Ranen; Mukhopadhyay, Satinath; Chowdhury, Subhankar

    2012-12-01

    To present a rare case of gigantism. A 25-year-old lady presented with increased statural growth and enlarged body parts noticed since the age of 14 years, primary amenorrhea, and frontal headache for the last 2 years. She has also been suffering from non-inflammatory low back pain with progressive kyphosis and pain in the knees, ankles, and elbows for the last 5 years. There was no history of visual disturbance, vomiting, galactorrhoea, cold intolerance. She had no siblings. Family history was non-contributory. Blood pressure was normal. Height 221 cm, weight 138 kg, body mass index (BMI)28. There was coarsening of facial features along with frontal bossing and prognathism, large hands and feet, and small goitre. Patient had severe kyphosis and osteoarthritis of knees. Confrontation perimetry suggested bitemporal hemianopia. Breast and pubic hair were of Tanner stage 1. Serum insulin like growth factor-1 (IGF1) was 703 ng/ml with all glucose suppressedgrowth hormone (GH)values of >40 ng/ml. Prolactin was 174 ng/ml. Basal serum Lutenising Hormone (LH), follicle stimulating Hormone (FSH) was low. Oral glucose tolerance test (OGTT), liver and renal function tests, basal cortisol and thyroid profile, Calcium, phosphorus and Intact Parathyroid hormone (iPTH) were normal. Computed tomographyscan of brain showed large pituitary macroadenoma. Automated perimetry confirmed bitemporal hemianopia. A diagnosis of gigantism due to GH secreting pituitary macroadenoma with hypogonadotrophichypogonadism was made. Debulking pituitary surgery followed by somatostatin analogue therapy with gonadal steroid replacement had been planned, but the patient refused further treatment.

  7. Profilin desensitization: A case series

    PubMed Central

    Nucera, Eleonora; Aruanno, Arianna; Rizzi, Angela; Pecora, Valentina; Patriarca, Giampiero; Buonomo, Alessandro; Mezzacappa, Simona; Schiavino, Domenico

    2016-01-01

    The role of profilin as an allergen has long been questioned. The capacity of profilin to induce respiratory symptoms has recently been demonstrated; moreover, over 50% of patients sensitized to profilin experienced symptoms after the ingestion of plant-derived foods, suggesting that profilin should be considered as a clinically relevant food allergen. We describe the cases of seven allergic patients with oral allergy syndrome and other adverse reactions after eating plant-derived food, that have been undergone to profilin desensitization treatment. The protocol started with a drop of profilin solution (50 µg/mL) diluted 1:1018 in water until the highest dose of 10 drops of undiluted solution three times a week. At the end of the treatment we observed a decreased mean diameter of profilin wheal in skin prick test (SPT) in five of the seven participants and in profilin specific IgE values in six patients that repeated the test. Regarding basophil activation test (BAT) and the detection of IgG4, we do not have significant results because the tests have to be repeated in some patients. Regarding the double-blind placebo-controlled challenges, after about 10 months of induction phase all the patients showed tolerance to several foods that they previously did not tolerate. Moreover, the immunotherapy with profilin has proved to be safe because no serious adverse events have been reported in our patients. In summary, the results of this exploratory study of sublingual immunotherapy (SLIT) for profilin allergy show that it can be a promising therapeutic option that could modify the clinical reactivity of the patients to the intake of plant-derived food. PMID:26684620

  8. The business case for telemedicine.

    PubMed

    Henny, Chris; Hartington, Katharine; Scott, Stuart; Tveiten, Agnar; Canals, Luisa

    2013-01-01

    Following the coming into force of the International Labour Organisation Maritime Labour Convention (ILO/MLC) and International Maritime Organisation Standards for Training, Certification and Watchkeeping, Manila 2010 (IMO/STCW) amendments, the objective of this article is to provide the shipping community with an initial assessment of the economic reasons and business case, in support of both publicly financed and private telemedicine being implemented on board commercial vessels. It provides the global scale of the requirement, the number of Telemedicine Assistance Services (TMAS) calls handled by participating TMAS, the average direct and indirect costs incurred by both TMAS and ship operators, responding to medical emergencies, and also provides a calculation of the market size of about 760 million Euro/year. It estimates a return on investment per ship, of implementing telemedicine on board to meet the MLC and STCW requirements at less than 1 year. 1. There are both financial and soft benefits, such as crew retention and being perceived as a quality employer offering a telemedicine service on board. 2. It is quite possible to obtain a 20% savings to the industry of perhaps 152 million Euro/year from the deployment of telemedicine on board. 3. The deployment of a telemedical service on ships is an opportunity to encourage further cooperation between TMAS and also with the private TMAS sector. 4. There is clearly a great need, on a global basis, for more cooperation, particularly in standardisation of pre-boarding medical files available, the equipmentrequired on board at a minimum, and level of service quality provided. 5. A collection of a common TMAS annual set of normalised statistics from the stakeholders in the maritime industry is needed. Should someone not be tasked with collecting this? 6. Open registries and countries where the private sector only providestele medicine, should be encouraged to work with the global public TMAS system and contribute to

  9. A Case Study of Engineering Ethics

    NASA Astrophysics Data System (ADS)

    Shimizu, Kazuo

    In Engineering Ethics Class at Shizuoka University, the Code of Ethics and Cases for Electrical Engineers by IEEJ Ethics committee is used to promote for high education effect to correspond large number of students (140students). In this paper, a case study in the class, and survey results for ethics value of students are presented. In addition, some comments for role playing act on the case of virtual experiences by students are described.

  10. The Strange Case of Emil Rupp

    NASA Astrophysics Data System (ADS)

    French, A. P.

    1999-03-01

    Physics has seldom had to deal with claims of alteration or fabrication of data, such as have troubled biological and medical research in recent years. The case of Emil Rupp in the 1930s was, however, a notable exception. The present paper revisits this case, adding in certain areas to earlier accounts of Rupp and his work. The case is not without significance, because Rupp's publications carried considerable weight during a historically important era of 20th-century physics.

  11. [Aspergillus spondylodiscitis. Apropos of 5 cases].

    PubMed

    Cortet, B; Deprez, X; Triki, R; Savage, C; Flipo, R M; Duquesnoy, B; Delcambre, B

    1993-01-01

    Five cases of Aspergillus discitis in male patients are reported. Three patients had impaired immune responses as a result of immunosuppressive therapy following a heart transplant (two cases) or hairy cell leukemia (one case). Two patients had a recent history of mycobacterial infection. All five patients were hospitalized for severe spinal pain suggestive of an inflammatory disease with no neurological abnormalities. Erythrocyte sedimentation rate was elevated in every case. The diagnosis of discitis was suspected on spinal roentgenograms and established by computed tomography and/or magnetic resonance imaging. In three patients the spine was the only site of Aspergillus infection (lumbar discitis in two cases and thoracic discitis in one case). One patient developed Aspergillus infection of several disks (L1-L2, L2-L3, and L4-L5) after Aspergillus endocarditis with embolization to the left lower limb. Another patient developed discitis after an Aspergillus lung infection. In every case, Aspergillus fumigatus was recovered in cultures of specimens harvested by a percutaneous needle biopsy of the intervertebral disk. All five patients were treated by itraconazole which was given as single drug therapy in one case and in combination with 5-flucytosine and amphotericin B in four cases. Recovery was achieved in every case after four to six months of this drug therapy. In contrast to most previously reported cases, none of the five patients reported herein required surgical treatment. Efficacy of conservative treatment in this study may be related to the use of itraconazole in every case.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Recurrent rhabdomyolysis in a child. Case presentation.

    PubMed

    Ertuğrul, Sabahattin; Yolbaş, İlyas; Aktar, Fesih; Yılmaz, Kamil; Tekin, Recep

    2016-06-01

    Viral myositis associated with infections rarely may cause rhabdomyolysis. There is no any pediatric case with severe recurrent rhabdomyolysis triggered by infections in the literature. We reported a two-year-old boy who was hospitalized three times due to severe rhabdomyolysis associated with viral myositis in the winter months. This is the first child case presentation with severe rhabdomyolysis triggered by infections. Prednisolone and intravenous immunoglobulin treatments were ineffective in this case. Sociedad Argentina de Pediatría.

  13. Corporate Information Management: A Case Study

    DTIC Science & Technology

    1991-03-01

    SUBJECT TERMS ( FIELD GROUP SUB-GROUP ICorporate Information Management (CIM), Case study, Strategic level decision making, Department Of Defense. 19...ABSTRACT ( This thesis documents in a case format the events, environment and decisions in the genesis and evolution of the Department of Defense’s...case format the events, environment and decisions in the genesis and evolution of the Department of Defense’s Corporate Information Management

  14. The tantalum-cased tantalum capacitor

    NASA Technical Reports Server (NTRS)

    Moynihan, J. D.

    1977-01-01

    Tantalum-cased tantalum capacitors were tested with regard to temperature stability, capacitance ratio, surge current capabilities, shock, vibration, and thermal shock. They were found to be superior to the conventional wet slug tantalum capacitor cased in silver, since they are more resistant to sulfuric acid. The tantalum-cased tantalum capacitors are widely accepted for use in critical electronic equipment because of their excellent performance and reliability.

  15. Associative Visual Agnosia: A Case Study

    PubMed Central

    Charnallet, A.; Carbonnel, S.; David, D.; Moreaud, O.

    2008-01-01

    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive) episodic models of memory [4]. PMID:18413915

  16. Research misconduct oversight: defining case costs.

    PubMed

    Gammon, Elizabeth; Franzini, Luisa

    2013-01-01

    This study uses a sequential mixed method study design to define cost elements of research misconduct among faculty at academic medical centers. Using time driven activity based costing, the model estimates a per case cost for 17 cases of research misconduct reported by the Office of Research Integrity for the period of 2000-2005. Per case cost of research misconduct was found to range from $116,160 to $2,192,620. Research misconduct cost drivers are identified.

  17. Colombia - A Case Study in Smart Power

    DTIC Science & Technology

    2014-05-22

    COLOMBIA–A CASE STUDY IN SMART POWER A Monograph by John P. Brady Foreign Service Officer United States Agency for...Colombia–A Case Study in Smart Power 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) John P. Brady...of Candidate: John P. Brady Monograph Title: Colombia–A Case Study in Smart Power Approved by: , Monograph Director Robert W

  18. Impact of the Dayton Tire case.

    PubMed

    Hart, D L; Isernhagen, S J; Matheson, L N

    1998-01-01

    Three of the more pertinent legal cases in the United States concerning the performance of ergonomists are summarized. The results of the cited cases have impact on the validity of the NIOSH lifting formulae, the lack of scientific evidence relating performance of jobs with alleged ergonomic stressors with specific medical pathology, and the gold standard for expert witness testimony. The cases, taken together, should act as a catalyst for ergonomists to improve their level of scientific justification for their work and conclusions.

  19. High laboratory cost predicted per tuberculosis case diagnosed with increased case finding without a triage strategy.

    PubMed

    Dunbar, R; Naidoo, P; Beyers, N; Langley, I

    2017-09-01

    Cape Town, South Africa. To model the effects of increased case finding and triage strategies on laboratory costs per tuberculosis (TB) case diagnosed. We used a validated operational model and published laboratory cost data. We modelled the effect of varying the proportion with TB among presumptive cases and Xpert cartridge price reductions on cost per TB case and per additional TB case diagnosed in the Xpert-based vs. smear/culture-based algorithms. In our current scenario (18.3% with TB among presumptive cases), the proportion of cases diagnosed increased by 8.7% (16.7% vs. 15.0%), and the cost per case diagnosed increased by 142% (US$121 vs. US$50). The cost per additional case diagnosed was US$986. This would increase to US$1619 if the proportion with TB among presumptive cases was 10.6%. At 25.9-30.8% of TB prevalence among presumptive cases and a 50% reduction in Xpert cartridge price, the cost per TB case diagnosed would range from US$50 to US$59 (comparable to the US$48.77 found in routine practice with smear/culture). The operational model illustrates the effect of increased case finding on laboratory costs per TB case diagnosed. Unless triage strategies are identified, the approach will not be sustainable, even if Xpert cartridge prices are reduced.

  20. [Surrogacy, yes or no? Case report].

    PubMed

    Pektorová, M; Ventruba, P

    2015-08-01

    Case study of surrogacy which did not come up to client-couple´s expectation. Case report. Department of Gynaecology and Obstetrics, Uherske Hradiste Hospital a. s., Uherske Hradiste. Description of the case, case study. In the Czech Republic, missing legislation when subject matter is surrogacy does not allow to make a complex legal contract. This fact causes legal uncertainty to all participants. Irresponsible approach of doctors, surrogate mother, client-couple, and in the upshot care of disabled child at government expense can be results.

  1. A Rare Case of Periampullary Tumor

    DTIC Science & Technology

    2017-10-13

    portion of the duodenum. They commonly present with abdominal pain, gastrointestinal bleeding, or rarely with obstructive jaundice. This is a case of an asymptomatic periampullary gangliocytic paraganglioma.

  2. Northeastern Pennsylvania Retrospective Case Study Fact Sheet

    EPA Pesticide Factsheets

    EPA conducted a retrospective case study in northeastern Pennsylvania to investigate reported instances of contaminated drinking water resources in areas where hydraulic fracturing activities occurred

  3. Transvestism as a Symptom: A Case Series.

    PubMed

    Anupama, M; Gangadhar, K H; Shetty, Vandana B; Dip, P Bhadja

    2016-01-01

    Transvestism, commonly termed as cross-dressing, means to dress in the clothing of opposite sex. We describe a series of three cases with transvestism as one of their primary complaints. The discussion sheds light on the various ways in which transvestism as a symptom can present in Psychiatry. In the first two cases, there was lower intelligence. In first and third case, there were other paraphilia along with transvestism. Second case had co-morbid obsessive-compulsive disorder (OCD) and had good response to selective serotonin reuptake inhibitor (SSRI).

  4. Transvestism as a Symptom: A Case Series

    PubMed Central

    Anupama, M.; Gangadhar, K. H.; Shetty, Vandana B.; Dip, P. Bhadja

    2016-01-01

    Transvestism, commonly termed as cross-dressing, means to dress in the clothing of opposite sex. We describe a series of three cases with transvestism as one of their primary complaints. The discussion sheds light on the various ways in which transvestism as a symptom can present in Psychiatry. In the first two cases, there was lower intelligence. In first and third case, there were other paraphilia along with transvestism. Second case had co-morbid obsessive-compulsive disorder (OCD) and had good response to selective serotonin reuptake inhibitor (SSRI). PMID:27011411

  5. How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

    ERIC Educational Resources Information Center

    Fallek, Max

    This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

  6. Case Study: A Step-by-Step Guide to Students Writing Case Studies (and Tools for Novice Case Authors)

    ERIC Educational Resources Information Center

    Prud'homme-Genereux, Annie

    2015-01-01

    In experimenting with ways of structuring the assignment and providing guidance to students, the author developed a series of tools that may be of interest to instructors wishing to implement a case-writing assignment in their course. This assignment is more suited for instructors experienced in case writing, as their knowledge of how to design a…

  7. [Research and control of relapse tuberculosis cases].

    PubMed

    Yamagishi, Fumio; Toyota, Makoto

    2009-12-01

    With this symposium, we focused on the relapse of tuberculosis in Japan. Out of 19,893 tuberculosis patients registered in 2007 in Japan, 7.48% were classified as relapse cases. Relapse cases have the risk of acquired drug resistance. But we have few analyses of the proportion of relapse tuberculosis cases with standard short course regimens for six months, factors contributing to tuberculosis relapse and the proportion of drug resistance among relapse TB cases in Japan. Therefore we analyzed the relapse tuberculosis cases in two rural areas and three urban areas. We also analyzed the proportion of drug resistance among relapse cases with the data of drug susceptibility survey of Ryoken. 1. Research of relapse tuberculosis cases: Makoto TOYOTA (Kochi City Public Health Center). To clarify the relapse rate and factors contributing to tuberculosis relapse, we investigated the relapse tuberculosis cases in the municipality where the proportion of elderly tuberculosis patients was high. Out of 902 tuberculosis patients registered in Kochi City Public Health Center during 10 years, 20 pulmonary tuberculosis patients were confirmed relapse cases with initial registered records. Pretreatment cavitations, sputum culture positivity at 2 months, medical miss-management (e.g. number of doses, duration of therapy) and poor adherence were considered to be factors contributing to tuberculosis relapse. Out of 20 relapse cases, 12 cases were detected with symptoms, while only 3 cases were detected by examination in law. 2. A clinical study on relapse cases of pulmonary tuberculosis: Shuichi TAKIKAWA (National Hospital Organization Nishibeppu National Hospital). The relapse of pulmonary tuberculosis was investigated. In the cases with a treatment history before short course chemotherapy, drug resistance rate was high, and thus it needs to be cautious of drug resistance at the time of the retreatment. In the cases with a treatment history of short course chemotherapy, relapse cases

  8. [Arthroscopic knee arthrodesis: 4 cases].

    PubMed

    Acquitter, Y; Hulet, C; Souquet, D; Pierre, A; Locker, B; Vielpeau, C

    2004-02-01

    Arthroscopic arthrodesis of the knee joint is an alternative to classical surgery, which retains a few exceptional indications. We report the first four cases of our experience, describing the technical modalities and indications. The four patients had undergone multiple operations for severe trauma. All four had persistent severe pain with a very limited walking distance. Before the procedure, the IKS score ranged from 11 to 44 and the mean function score was 20 to 45 points. Arthroscopic arthrodesis was proposed after several consultations and took into account the young age of the patient and a positive brace test. The successive arthroscopic times were: exploration and adherence release, complete extramural meniscectomy, joint surface avivement. Traction was not necessary. Careful avivement spared the anatomic curvatures of the condyles and slightly scraped out the plateaus. Finally, the arthrodesis was fixed in correct position under fluoroscopy using a single tube external fixator. The fixation was maintained until fusion (satisfactory x-ray and no pain). A drain was inserted only for the first patient. There were no cutaneous complications. Patients were discharged after 3 days on the average with immediate simulated weight bearing using two crutches. The external fixator was dynamized at two months (mean) and removed at five months. The functional gain was considerable in four patients, assessed at two years, with a mean IKS score of 75 and a mean function score of 80. The four patients walked without crutches and without pain. Single leg stance was stable. Final leg shortening was 1 to 2 cm. The arthroscopic approach provides several benefits: uneventful postoperative period, little bleeding, no cutaneous complications, shorter hospital stay. The time to fusion appears to be shorter than with classical techniques, but cannot be demonstrated clearly because of the diversity of the series reported in the literature. Arthroscopic arthrodesis does not require

  9. Drive Electric Vermont Case Study

    SciTech Connect

    Wagner, Fred; Roberts, Dave; Francfort, Jim

    Currently in the United States, the heavy majority of plug-in electric vehicle (PEV) sales have been in highly conducive, selected, metropolitan areas; opposed to more broad distribution across the country. The U.S. Department of Energy’s EV Everywhere Grand Challenge is looking carefully at the barriers and opportunities that exist to enable small and midsize communities to partake in the PEV market and benefit from the economic and environmental advantages of PEVs. In order to gain insight into these challenges and barriers, DOE selected a success story (i.e., Drive Electric Vermont) as the subject of this case study, as the statemore » of Vermont is tied with Detroit, Michigan in having the highest percentage of 2014 (most recent complete data) PEV registrations for cold weather U.S. cities and has seen more than a sixfold increase in charging stations over the last three years. The overall objective of this case study was to use the lessons learned from Drive Electric Vermont to determine what activities are most effective at encouraging acquisitions of PEVs and deployment of charging infrastructure in small to midsize communities, prioritizing and sequencing their implementation, identifying robust means for extrapolation, and applying this understanding to other small to midsize communities across the nation. The Drive Electric Vermont Program was formed in 2012 with a goal of increasing the use of electrified transportation in Vermont through policy development, education and outreach, and infrastructure development. The Drive Electric Vermont Program can be broadly broken into four components: (1) strategic planning/leadership, (2) stakeholder/partnership development, (3) education and outreach, and (4) incentives. The early phases of the program focused heavily on strategic planning, and stakeholder and partnership development, followed by a transition to education and outreach activities, charging infrastructure development, and grant and incentive

  10. Case-Control Study of Writer's Cramp

    ERIC Educational Resources Information Center

    Roze, E.; Soumare, A.; Pironneau, I.; Sangla, S.; de Cock, V. Cochen; Teixeira, A.; Astorquiza, A.; Bonnet, C.; Bleton, J. P.; Vidailhet, M.; Elbaz, A.

    2009-01-01

    Task-specific focal dystonias are thought to be due to a combination of individual vulnerability and environmental factors. There are no case-control studies of risk factors for writer's cramp. We undertook a case-control study of 104 consecutive patients and matched controls to identify risk factors for the condition. We collected detailed data…

  11. 76 FR 6381 - Fee-Generating Cases

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-04

    ... LEGAL SERVICES CORPORATION 45 CFR Part 1609 Fee-Generating Cases AGENCY: Legal Services...) proposes to amend the Legal Services Corporation's regulation on fee-generating cases to clarify that it... Counsel, Office of Legal Affairs, Legal Services Corporation, 3333 K Street, NW., Washington, DC 20007...

  12. The Black Press and the Bakke Case.

    ERIC Educational Resources Information Center

    Poindexter, Paula M.; Stroman, Carolyn A.

    1980-01-01

    Content analyses of four Black newspapers during 1977 indicate that only one newspaper gave the Regents of the University of California v Bakke case substantial front-page coverage and suggest that most items provided only superficial facts about the case rather than interpretative information. (GT)

  13. Selected Regional Judicial Officer Cases, 2005 - Present

    EPA Pesticide Factsheets

    This dataset contains selected cases involving EPA's Regional Judicial Officers (RJOs) from 2005 to present. EPA's Regional Judicial Officers (RJOs) perform adjudicatory functions and act as Agency neutrals in administrative cases. EPA's RJOs are senior attorneys with backgrounds in EPA enforcement, general law, or both.

  14. 27 CFR 25.143 - Cases.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Cases. 25.143 Section 25.143 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS BEER Marks, Brands, and Labels § 25.143 Cases. (a) Brewer's name. The brewer's name or...

  15. Case Study: A Separation of Powers Lesson.

    ERIC Educational Resources Information Center

    Jenkins, Steve

    1986-01-01

    Presents a case study involving students in the issue of separation of powers as applied to the 1952 Immigration and Nationality Act. Students examine the case of Jagdish Rai Chadha, an immigrant threatened with deportation whose problems resulted in 1983 U.S. Supreme Court decision declaring legislative veto provision of Immigration and…

  16. Case-Based Policy and Goal Recognition

    DTIC Science & Technology

    2015-09-30

    or noisy. Ontanón et al. [8] use case-based reasoning (CBR) to model human driving vehicle control behaviors and skill level to reduce teen crash...Snodgrass, S., Bonfiglio, D., Winston, F.K., McDonald, C., Gonzalez, A.J.: Case-based prediction of teen driver behavior and skill. In: Pro- ceedings

  17. 75 FR 27375 - Postal Rate Case Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... POSTAL REGULATORY COMMISSION [Docket No. PI2010-3; Order No. 456] Postal Rate Case Management AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is seeking comments relevant to management of an anticipated exigent postal rate case. It has scheduled a technical conference...

  18. Iowa Case Management for Rural Drug Abuse

    ERIC Educational Resources Information Center

    Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

    2009-01-01

    Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

  19. Case Marking Uniformity in Developmental Pronoun Errors

    ERIC Educational Resources Information Center

    Fitzgerald, Colleen E.; Rispoli, Matthew; Hadley, Pamela A.

    2017-01-01

    The purpose of this study was to determine if children acquire grammatical case as a unified system or in a piecemeal fashion. In English language acquisition, many children make developmental errors in marking case on subject position pronouns (e.g., "Me" do it, "Him" like it). It is unknown whether children who produce…

  20. Verbal Artistry: A Case for Education

    ERIC Educational Resources Information Center

    Henne, Richard B.

    2009-01-01

    This article expands our understanding of how language-minoritized children's communicative competence interrelates with schooling. It features a verbal performance by a young Native American girl. A case is made for greater empirical specification of the real extent of children's non-school-sanctioned communicative competence. The case disrupts…

  1. Court Cases Involving Contracts for School Districts

    ERIC Educational Resources Information Center

    Allen, L. Hank

    2011-01-01

    The purpose of this research was to analyze trends in the United States regarding contract disputes that exist in school districts. Court cases were identified at the state and federal level to determine the outcomes and the fact patterns of contract disputes. To gain the knowledge of how courts handle cases of contractual breach, contracts…

  2. Educator Sexual Abuse: Two Case Reports

    ERIC Educational Resources Information Center

    Burgess, Ann Wolbert; Welner, Michael; Willis, Danny G.

    2010-01-01

    Sexual abuse by educators has become an increasingly noted type of sexual abuse, especially among adolescents, for two reasons. First, there is a potential for these cases to be silent and prolonged and second, when disclosed, the forensic implications usually include both criminal and/or civil sanctions. For forensic case evaluations,…

  3. 7 CFR 29.2287 - Order (case).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

  4. 7 CFR 29.3536 - Order (case).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Order (case). 29.3536 Section 29.3536 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 95) § 29.3536 Order (case). The state of tobacco with respect to its moisture content. [30 FR 9207...

  5. 7 CFR 29.2287 - Order (case).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

  6. 7 CFR 29.1045 - Order (case).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Order (case). 29.1045 Section 29.1045 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1045 Order (case). The state of tobacco with respect to its moisture content. [42 FR...

  7. 7 CFR 29.3045 - Order (case).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Order (case). 29.3045 Section 29.3045 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Order (case). The state of tobacco with respect to its moisture content. [24 FR 8771, Oct. 29, 1959...

  8. 7 CFR 29.3045 - Order (case).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Order (case). 29.3045 Section 29.3045 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Order (case). The state of tobacco with respect to its moisture content. [24 FR 8771, Oct. 29, 1959...

  9. 7 CFR 29.1045 - Order (case).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Order (case). 29.1045 Section 29.1045 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1045 Order (case). The state of tobacco with respect to its moisture content. [42 FR...

  10. 7 CFR 29.2287 - Order (case).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

  11. 7 CFR 29.3536 - Order (case).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Order (case). 29.3536 Section 29.3536 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 95) § 29.3536 Order (case). The state of tobacco with respect to its moisture content. [30 FR 9207...

  12. 7 CFR 29.3536 - Order (case).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Order (case). 29.3536 Section 29.3536 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 95) § 29.3536 Order (case). The state of tobacco with respect to its moisture content. [30 FR 9207...

  13. 7 CFR 29.1045 - Order (case).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Order (case). 29.1045 Section 29.1045 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1045 Order (case). The state of tobacco with respect to its moisture content. [42 FR...

  14. 7 CFR 29.2287 - Order (case).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

  15. 7 CFR 29.3045 - Order (case).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Order (case). 29.3045 Section 29.3045 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Order (case). The state of tobacco with respect to its moisture content. [24 FR 8771, Oct. 29, 1959...

  16. 7 CFR 29.3045 - Order (case).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Order (case). 29.3045 Section 29.3045 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Order (case). The state of tobacco with respect to its moisture content. [24 FR 8771, Oct. 29, 1959...

  17. 7 CFR 29.3536 - Order (case).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Order (case). 29.3536 Section 29.3536 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 95) § 29.3536 Order (case). The state of tobacco with respect to its moisture content. [30 FR 9207...

  18. 7 CFR 29.1045 - Order (case).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Order (case). 29.1045 Section 29.1045 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1045 Order (case). The state of tobacco with respect to its moisture content. [42 FR...

  19. Case Studies in Elementary and Secondary Curriculum

    ERIC Educational Resources Information Center

    Boboc, Marius; Nordgren, R. D.

    2010-01-01

    Practical and engaging, this book contains 21 case studies that help students apply curriculum theory to classroom reality. Each case is authored by an in-service teacher, reflecting on ways to improve instruction by making changes to various aspects of the curriculum. These real-life examples investigate up-to-date curricular issues ranging from…

  20. Case Studies on Educational Administration. Third Edition.

    ERIC Educational Resources Information Center

    Kowalski, Theodore J.

    This book contains 24 case studies selected to demonstrate the different types of challenges in contemporary educational leadership. It is intended to help prospective administrators develop decision-making skills. The cases are quite complex with multiple viewpoints and aspects. They represent a range of problems encountered by practitioners in…

  1. A Case Study of "Empathetic Teaching Artistry"

    ERIC Educational Resources Information Center

    Risner, Doug

    2014-01-01

    This case study is one of twenty cases derived from Anderson and Risner's international study of teaching artists in dance, and theatre, which investigated participants' (n=172) artistic and academic preparation in dance, and theatre, initial entry into the teaching artist field, rewards, challenges, and obstacles in participants' work, artists'…

  2. 37 CFR 251.43 - Written cases.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... and redirect) must be referenced. (d) In the case of a royalty fee distribution proceeding, each party... ROYALTY PANEL RULES AND PROCEDURES COPYRIGHT ARBITRATION ROYALTY PANEL RULES OF PROCEDURE Procedures of Copyright Arbitration Royalty Panels § 251.43 Written cases. (a) All parties who have filed a notice of...

  3. Library-ABE Projects. Case Studies.

    ERIC Educational Resources Information Center

    MacVicar, Phyllis

    This document contains 41 case studies submitted to the Appalachian Adult Education Center by the staffs of four projects demonstrating library services to disadvantaged adults, in cooperation with adult basic education programs. Included in each case study is the coping skill area in which an individual need was recognized and met through the…

  4. Consumerism--Student: Legal Issues and Cases.

    ERIC Educational Resources Information Center

    Zabetakis, Steve

    The facts, issues, and final judgements of 53 court cases are presented in this compilation focusing on the legal aspects of the student consumerism movement. The first 18 cases cited deal with issues related to admissions, such as reverse discrimination, admission fees, residency, fraudulent misrepresentation, employment promise, contractual…

  5. A Constructive Controversy Approach to "Case Studies"

    ERIC Educational Resources Information Center

    Bird, Sharon R.; Erickson, Karla A.

    2010-01-01

    On the basis of analysis of student responses to a case study titled "Drinks and Dinner," the authors evaluate the pedagogical potential of using constructive controversy case studies to teach about inequality. "Drinks and Dinner" is designed to capture the complexity of social interactions that defy simple solutions to engage students in…

  6. Speak up! Mini Cases in Language

    ERIC Educational Resources Information Center

    Miller, Antoinette R.

    2010-01-01

    This is a series of short cases useful for a variety of courses, including physiological psychology, neuroscience, cognitive psychology, cognitive science, and cognitive neuropsychology/neuroscience. Each of these cases depicts a breakdown in language that may be traced to damage in an area or areas that are related to language processing, and…

  7. 76 FR 11267 - Cased Pencils From China

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-01

    ... China AGENCY: United States International Trade Commission. ACTION: Scheduling of an expedited five-year review concerning the antidumping duty order on cased pencils from China. SUMMARY: The Commission hereby... cased pencils from China would be likely to lead to continuation or recurrence of material injury within...

  8. Case Study of above Average Elementary School

    ERIC Educational Resources Information Center

    Mendez-Morse, Sylvia; Klinker, JoAnn Franklin

    2005-01-01

    This case study explores the duty of midmanagement administrators to enforce district policies with which they do not necessarily agree. The case addresses the issues of moral leadership, distribution of power, emotional responses that impact decision making, class differences, and equity. It also examines the role conflict that many married…

  9. Language and Content: The Case of Law.

    ERIC Educational Resources Information Center

    Beasley, Colin J.

    A discussion of the teaching and learning of English for special purposes focuses on the interrelationship of content and language, particularly in the case of education for the legal professions. It is noted that law students must both study a large corpus of case and statute law and legal principles and learn the language of the law, with its…

  10. Singularly Perturbed Equations in the Critical Case.

    DTIC Science & Technology

    1980-02-01

    asymptotic properties of the differential equation (1) in the noncritical case (all ReXi (t) ɘ) . We will consider the critical case (k 0) ; the...the inequality (3), that is, ReXi (t,a) < 0 (58) The matrix ca(t,a) , consisting of the eigenvectors corresponding to w 0 , now has the form I (P -(t

  11. Ameloblastic fibrosarcoma: Report of a case

    PubMed Central

    Akinyamoju, Akindayo O; Olusanya, Adeola A; Adeyemi, Bukola F; Kolude, B

    2013-01-01

    Ameloblastic fibrosarcoma (AFS) is a rare odontogenic malignancy with benign epithelial and malignant ectomesenchymal components. About 66 cases have been reported in the medical literature. We therefore report an additional case as well as a review of literature to add to the existing knowledge on this rare lesion. PMID:24574665

  12. Cheyletiella dermatitis: a report of fourteen cases.

    PubMed

    Lee, B W

    1991-02-01

    Cheyletiella dermatitis is an infrequently reported eruption caused by an ectoparasite whose normal hosts are household pets. Fourteen cases, documented over an eight-year period, are reported. All cases were found in one practice in a small community. Typical patients are female, aged forty years or younger, who experience pruritic papules in the winter months. Cheyletiella dermatitis is not a rare problem.

  13. Abdominal shotgun trauma: A case report

    PubMed Central

    Toutouzas, Konstantinos G; Larentzakis, Andreas; Drimousis, Panagiotis; Riga, Maria; Theodorou, Dimitrios; Katsaragakis, Stylianos

    2008-01-01

    Introduction One of the most lethal mechanisms of injury is shotgun wound and particularly the abdominal one. Case presentation We report a case of a 45 years old male suffering abdominal shotgun trauma, who survived his injuries. Conclusion The management of the abdominal shotgun wounds is mainly dependent on clinical examination and clinical judgment, while requires advanced surgical skills. PMID:18625076

  14. An Exceptional Case of Diabetic Ketoacidosis.

    PubMed

    Van de Vyver, Celine; Damen, Jorn; Haentjens, Carl; Ballaux, Dominique; Bouts, Benoit

    2017-01-01

    We present a case of diabetic ketoacidosis, known as one of the most serious metabolic complications of diabetes. We were confronted with rapid neurological deterioration and unseen glycaemic values, which reached almost 110 mmol/L, subsequently resulting in hyperkalaemia and life-threatening dysrhythmias. This is the first reported live case with such high values of blood glucose and a favourable outcome.

  15. Cases, Simulacra, and Semantic Web Technologies

    ERIC Educational Resources Information Center

    Carmichael, P.; Tscholl, M.

    2013-01-01

    "Ensemble" is an interdisciplinary research and development project exploring the potential role of emerging Semantic Web technologies in case-based learning across learning environments in higher education. Empirical findings have challenged the claim that cases "bring reality into the classroom" and that this, in turn, might…

  16. Teaching Case: Security Breach at Target

    ERIC Educational Resources Information Center

    Plachkinova, Miloslava; Maurer, Chris

    2018-01-01

    This case study follows the security breach that affected Target at the end of 2013 and resulted in the loss of financial data for over 70 million customers. The case provides an overview of the company and describes the reasons that led to one of the biggest security breaches in history. It offers a discussion on Target's vendor management…

  17. Chemical Case Studies: Science-Society "Bonding."

    ERIC Educational Resources Information Center

    Hofstein, Avi; Nae, Nehemia

    1981-01-01

    Describes a unit designed to illustrate the "science-society-technology connection," in which three case studies of the chemical industry in Israel are presented to high school chemistry students. Chosen for the unit are case studies on copper production in Timna, on plastics, and on life from the Dead Sea. (CS)

  18. The Validity of the Utilities Case.

    ERIC Educational Resources Information Center

    Jones, Linda F.; Fadely, L. Dean

    During the past decade, debators have become more flexible in their affirmative analysis of the resolution. One case approach that an affirmative team may adopt is the utilities or no-needs need case in which they argue for the elimination of the status quo because it is unnecessary or restrictive or both. This paper examines: (1) the four…

  19. Case Studies of Environmental Risks to Children.

    ERIC Educational Resources Information Center

    Goldman, Lynn R.

    1995-01-01

    Presents case studies on children's exposure to pesticides, including risks through the use of the insecticide aldicarb on bananas, the home use of diazinon, and the use of interior house paint containing mercury. These cases illustrate how regulatory agencies, parents, health-care providers, and others who come into contact with children have…

  20. Mineral scale management. Part 1, Case studies

    Treesearch

    Peter W. Hart; Alan W. Rudie

    2006-01-01

    Mineral scale increases operating costs, extends downtime, and increases maintenance requirements. This paper presents several successful case studies detailing how mills have eliminated scale. Cases presented include calcium carbonate scale in a white liquor strainer, calcium oxalate scale in the D0 stage of the bleach plant, enzymatic treatment of brown stock to...

  1. Plague and the gallium scan: case report

    SciTech Connect

    Stahly, T.L.; Shoop, J.D.

    1975-11-01

    Inflammation in the right axillary lymph nodes and the meninges was detected by $sup 67$Ga-citrate scans in an 11-year-old boy with Yersinia pestis infection. This case provides another example of $sup 67$Ga localizing to areas of infection, indicating potential utility in future cases of bubonic plague. (auth)

  2. Collaboration in Distance Education. International Case Studies.

    ERIC Educational Resources Information Center

    Moran, Louise, Ed.; Mugridge, Ian, Ed.

    This book contains nine case studies of collaboration in distance education. The case studies focus on such aspects of collaboration in distance education as the following: roles of individual institutional partners; importance of personal relationships; benefits of collaboration to individual partners; conflicts between collaboration and…

  3. The cost of an Ebola case.

    PubMed

    Bartsch, Sarah M; Gorham, Katrin; Lee, Bruce Y

    2015-02-01

    As the most recent outbreak of Ebola virus disease (EVD) in West Africa continues to grow since its initial recognition as a Public Health Emergency of International Concern, an unanswered question is what is the cost of a case of Ebola? Understanding this cost will help decision makers better understand the impact of each case of EVD, benchmark this against that of other diseases, prioritize which cases may require response, and begin to estimate the cost of Ebola outbreaks. To date, the scientific literature has not characterized this cost per case. Therefore, we developed a mathematical model to estimate the cost of an EVD case from the provider and societal perspectives in the three most affected countries of Guinea, Liberia, and Sierra Leone. Our model estimates the total societal cost of an EVD case with full recovery ranges from $480 to $912, while that of an EVD case not surviving ranges from $5929 to $18 929, varying by age and country. Therefore, as of 10 December 2014, the estimated total societal costs of all reported EVD cases in these three countries range from $82 to potentially over $356 million.

  4. 7 CFR 29.3536 - Order (case).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Order (case). 29.3536 Section 29.3536 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 95) § 29.3536 Order (case). The state of tobacco with respect to its moisture content. [30 FR 9207...

  5. 7 CFR 29.2287 - Order (case).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

  6. 7 CFR 29.3045 - Order (case).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Order (case). 29.3045 Section 29.3045 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Order (case). The state of tobacco with respect to its moisture content. [24 FR 8771, Oct. 29, 1959...

  7. 7 CFR 29.1045 - Order (case).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Order (case). 29.1045 Section 29.1045 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1045 Order (case). The state of tobacco with respect to its moisture content. [42 FR...

  8. Salmonella paratyphi spondylitis: a case report.

    PubMed

    Kumar, Pradeep; Mahmoodi, Seyed Mohsen; Kalaparambil Moosa, Nooruddin; Edgar, Michael; Samt, Hussain Al; Hussain, Riyaz Amirali

    2008-05-01

    This is a case report of acute L3/4 vertebral osteomyelitis due to Salmonella paratyphi A confirmed by culture from vertebral needle biopsy. From a review of the literature this is the first reported case with bacteriological confirmation. The rarity of Salmonella paratyphi spondylitis and the options for treatment are discussed.

  9. Salmonella paratyphi spondylitis: a case report

    PubMed Central

    Mahmoodi, Seyed Mohsen; Kalaparambil Moosa, Nooruddin; Edgar, Michael; Samt, Hussain Al; Hussain, Riyaz Amirali

    2007-01-01

    This is a case report of acute L3/4 vertebral osteomyelitis due to Salmonella paratyphi A confirmed by culture from vertebral needle biopsy. From a review of the literature this is the first reported case with bacteriological confirmation. The rarity of Salmonella paratyphi spondylitis and the options for treatment are discussed. PMID:18008092

  10. The Consulting Challenge: A Case Competition

    ERIC Educational Resources Information Center

    Sachau, Daniel A.; Naas, Patricia A.

    2010-01-01

    The Consulting Challenge is a yearly case competition in which teams of graduate students respond to a request for proposals (RFP) for consulting services. The case and RFP are based on a problem that a host organization has experienced. Over 3 days, students meet with representatives of the host organization, analyze data, prepare a proposal for…

  11. Case to Cause: Back to the Future

    ERIC Educational Resources Information Center

    Abramovitz, Mimi; Sherraden, Margaret S.

    2016-01-01

    This article reopens the historic debate about the roles of micro and macro practice in social work and encourages the profession to find ways to achieve a better balance between case and cause in education, practice, and research. To this end, it traces the history of the case versus cause debate including conceptual frameworks for rebalancing…

  12. Racism in the Classroom: Case Studies.

    ERIC Educational Resources Information Center

    Duhon, Gwendolyn M.

    This book presents 20 cases that address racism in one form or another. Many of the cases are from actual experience. They are intended to bring out actual or possible solutions so that student teachers, novice teachers, and seasoned teachers can find ideas for solving racist problems in their classrooms. The first part focuses on the early years,…

  13. Case Study: Camptocormia, a Rare Conversion Disorder.

    ERIC Educational Resources Information Center

    Rajmohan, Velayudhan; Thomas, Biju; Sreekumar, Kumaran

    2004-01-01

    Camptocormia is a condition characterized by severe frontal flexion of the spinal cord and knees, with passive drooping of both arms. It occurs as a form of conversion disorder. Some cases are associated with behavioral problems. A case of camptocormia of 2-year duration in a south Indian adolescent girl with oppositional defiant disorder and…

  14. Retroperitoneal extraadrenal paraganglioma report of two cases.

    PubMed

    Becheanu, G; Laky, D

    1997-01-01

    Two cases with retroperitoneal tumours affecting young women who cannot undergo surgery were investigated by biopsy and needle sampling. One of these cases presented a mainly alveolar histologic pattern and was easily diagnosed by immunohistochemical means, as well as a chromaffin paraganglioma. We discussed different diagnoses and approaches in the literature.

  15. 36 CFR 254.16 - Case closing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Case closing. 254.16 Section 254.16 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LANDOWNERSHIP ADJUSTMENTS Land Exchanges § 254.16 Case closing. (a) Title transfers. Unless otherwise agreed, and...

  16. Using Case Studies: An International Approach

    ERIC Educational Resources Information Center

    McClam, Tricia; Woodside, Marianne

    2005-01-01

    Case studies as an instructional strategy have been used in many disciplines, including law, teacher education, science, medicine, and business. Among the benefits of this method of instruction are involving students in learning, developing their critical thinking skills, promoting communication, and engaging in critical analysis. Case studies are…

  17. The Undergraduate Case Research Study Model

    ERIC Educational Resources Information Center

    Vega, Gina

    2010-01-01

    Student-written cases are powerful pedagogical tools that can lead to improved understanding of business situations, more informed analysis, emphasis on reflection, and clearer expository writing, all of which are critical skills for business students. Cases provide an opportunity for students to enjoy an active learning experience and derive the…

  18. Multiple Personality Disorder: Concepts and Cases.

    ERIC Educational Resources Information Center

    Lindsley, Hope L.

    1992-01-01

    Presents two case examples illustrating nature and etiology of multiple personality disorder in two clients and describing their entry into counseling and progress through treatment. Compares and contrasts cases in areas of diagnosis, symptoms, history, and treatment. Suggests that mental health counselors combine firmness with flexibility in…

  19. KQED: A Case Study in Confusion.

    ERIC Educational Resources Information Center

    Huttenstine, Marian L.; Hamner, Claire

    The United States Supreme Court's ruling in the "Houchins v KQED" case exemplifies the confusion of that court concerning any consistent view of the First Amendment of the United States Constitution, especially in terms of newsgathering and prior restraint. In this case, the Court reversed a lower court's decision that had held invalid a…

  20. The Case Management Team: Building Community Connections.

    ERIC Educational Resources Information Center

    Lippert, Toni

    This guidebook presents ideas about how families and case managers can use case management to increase the integration of people with developmental disabilities into their communities, and how public officials and advocates can promote the trend toward community integration. The guide advocates implementation of the integration philosophy, which…