Carbamide peroxide whitening of nonvital single discolored teeth: case reports.

PubMed

Caughman, W F; Frazier, K B; Haywood, V B

1999-03-01

Patients who present with a single discolored tooth represent a significant restorative challenge. These case reports describe an economic and conservative treatment option for these patients. The situations presented demonstrate techniques for bleaching with carbamide peroxide in a traditional nightguard or with an inside-outside technique to achieve acceptable esthetic results on isolated nonvital discolored teeth. Although these techniques may not be effective in all cases, they do not compromise or eliminate any future treatment options.

Case report 834: Chronic sclerosing osteomyelitis of the mandible with long bone periostitis.

PubMed

Stewart, A; Carneiro, R; Pollock, L; Shaw, D

1994-04-01

We present the case of a patient with primary chronic osteomyelitis of the mandible, the radiological appearance of which is compatible with a diagnosis of chronic sclerosing osteomyelitis. The accompanying femoral and tibial periosteal reactive new bone formation and the benign clinical course suggest that this presentation may represent a form of chronic multifocal osteomyelitis.

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

On Impact: A Case of a Student with Head Injuries

ERIC Educational Resources Information Center

Buckley, Valerie A.; Chesire, David J.; Canto, Angela I.

2011-01-01

This article describes a case of a student with head injuries. While the symptom presentation for students with traumatic brain injury (TBI) can be vastly different, this case represents common symptoms seen in students who are recovering from a concussion. The authors suggest that school psychologists query the teacher and parents about their…

Disinfectant Residual: Representative Monitoring and Minimum Residual Implications

EPA Science Inventory

In this presentation we will: review history of distribution system chlorine monitoring siting, review State regulations and guidance, present a case study demonstrating a chlorine monitoring locations evaluation, and present an evaluation of Six–Year Review 3 (SYR3) disinfectant...

Parenteral organophosphorus poisoning in a rural emergency department: a case report

PubMed Central

2013-01-01

Background Poisoning is a common presentation in the emergency department. Oral exposures to organophosphorus compounds are especially frequent in rural and agricultural regions of South Asia and throughout the developing world. Case presentation Here we report a case of deliberate self-harm with an organophosphorus pesticide via the relatively uncommon parenteral route. A young woman injected herself with chlorpyriphos. Although the cholinergic effects were mild, cellulitis and abscess development were noted as a result. Conclusion Resource limited agricultural countries like Nepal present health care workers with numerous challenges in poisoning management. This case represents a rare but potentially morbid method of agrochemical poison exposure. PMID:24321121

The Power of a Question: A Case Study of Two Organizational Knowledge Capture Systems

NASA Technical Reports Server (NTRS)

Cooper, Lynn P.

2003-01-01

This document represents a presentation regarding organizational knowledge capture systems which was delivered at the HICSS-36 conference held from January 6-9, 2003. An exploratory case study of two knowledge resources is offered. Then, two organizational knowledge capture systems are briefly described: knowledge transfer from practitioner and the use of questions to represent knowledge. Finally, the creation of a database of peer review questions is suggested as a method of promoting organizational discussions and knowledge representation and exchange.

A qualitative analysis of student-written law and ethics cases: A snapshot of PY2 student experience.

PubMed

Karwaki, Tanya E; Hazlet, Thomas K

2017-05-01

This study was designed to better understand pharmacy students' experiences and recognition of legal and ethical tensions existing in pharmacy practice as demonstrated in student-written law and ethics cases. A qualitative analysis of 132 student-written cases representing the team efforts of 1053 students over a 12-year time period was conducted. Student-written cases were coded and analyzed thematically. Our results demonstrate the types of ethical and legal issues our students have experienced in pharmacy practice during the first five quarters of their professional education. Our data highlight three themes: 1) ethical dilemmas presented when the law is misapplied; 2) ethical dilemmas presented when an institutional policy or law was viewed as insufficient; and 3) ethical dilemmas presented as provider distress. The third theme was further subdivided into five subthemes. The themes that emerged from this study represent some of the ethical dilemmas that second professional year students have encountered and how these dilemmas may intersect with legal boundaries. Educators can use cases demonstrating these themes to reinforce law and ethics education in the curriculum, thus helping prepare students for pharmacy practice. This article recommends how and when to use case examples. Copyright © 2017 Elsevier Inc. All rights reserved.

Giant thoracic schwannoma presenting with abrupt onset of abdominal pain: a case report

PubMed Central

2009-01-01

Introduction Giant intradural extramedullary schwannomas of the thoracic spine are not common. Schwannomas, that is, tumors derived from neoplastic Schwann cells, and neurofibromas represent the most common intradural extramedullary spinal lesions. We report the case of a patient with a giant thoracic schwannoma presenting unusually with acute abdominal pain and with delayed neurological impairment. Case presentation A 26-year-old Hispanic man with no previous medical problems presented with acute periumbilical pain. After extensive work-up including an exploratory laparotomy for appendectomy, magnetic resonance imaging scans of the lumbar and thoracic spine revealed a giant intradural extramedullary thoracic schwannoma within the spinal canal posterior to the T9, T10, and T11 vertebral bodies. Magnetic resonance imaging signal prolongation was noted in the spinal cord both rostral and caudal to the schwannoma. The patient underwent an urgent laminectomy from T8 to L1. After sacrificing the T10 root, the tumor was removed en bloc. Postoperatively, the patient improved significantly gaining antigravity strength in both lower extremities. Conclusion The T10 dermatome is represented by the umbilical region. This referred pain may represent a mechanism by which a giant thoracic schwannoma may present as acute abdominal pain. Acute, intense abdominal pain with delayed neurologic deficit is a rare presentation of a thoracic schwannoma but should be considered as a possible cause of abdominal pain presenting without clear etiology. Although these lesions may be delayed in their diagnosis, early diagnosis and treatment may lead to an improved clinical outcome. PMID:19946504

Internationalizing the California State University: Case Studies.

ERIC Educational Resources Information Center

Sutter Richard L., Ed.; And Others

The 18 case studies in this volume represent a sample of the internationalization activities of the California State University system. Part 1 presents five papers on organizing for international education: "Internationalization of CSULB [California State University Long Beach]" by Dorothy Abrahamse et al.; "Institutional…

78 FR 72706 - Notice of Inventory Completion: Colorado State University, Fort Collins, CO

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-03

... bone beads buried with the adult female remains. Sometime during 1975, human remains representing, at... were identified. No associated funerary objects are present, although animal bone and a projectile.... Case 65 represents one partial individual mixed with bison bone. No known individuals were identified...

Judicial Reliance on Parental IQ in Appellate-Level Child Welfare Cases Involving Parents with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Callow, Ella; Tahir, Munazza; Feldman, Maurice

2017-01-01

Background: Parents with intellectual and developmental disabilities (IDDs) are over-represented in child welfare cases. Although IQ "per se" is an invalid indicator of parenting abilities, this study examined the prevalence of judicial consideration of parental IQ test evidence in US appellate cases. Methods: The present authors…

[Tuberculous abscess of the thoracic wall secondary to nodular tuberculosis: Atypical presentation in an older adult].

PubMed

Cajuste-Sequeira, Fritz; Bueno-Wong, Juan Luis; Rosas-Carrasco, Óscar; González-Vergara, Carolina; Bieletto-Trejo, Olivia

2017-01-01

Tuberculosis (tb) of the chest wall is uncommon and it represents less than 5% of all cases of musculoskeletal tb and only 1-2% of tb. We present the case of an elderly woman with tb of the chest wall secondary to a nodal tb with an unusual presentation. The diagnosis of this entity is difficult because the disease often mimics other diseases such as pyogenic abscess, chest wall.

Orthodontic Treatment in Adult Patient with Reduced Periodontium: A Case Report.

PubMed

Shintcovsk, Ricardo Lima; Knop, Luegya Amorim Henriques; Pinto, Ary Santos; Gandini, Luiz Gonzaga; Martins, Lídia Parsekian

2015-01-01

Patients presenting reduced periodontium represent a major concern for orthodontists. The purpose of this article is to present the clinical case of an adult patient who presented sequel of periodontal disease (diastemas) compromising her dental aesthetics. She was subjected to an orthodontic treatment with the application of light forces distant from the teeth with reduced periodontium. A periodontal support therapy was successfully implemented. The final stage of the treatment indicated satisfactory occlusal and periodontal characteristics.

The Academic Neutrality Argument: Philosophical Discourse and La Regle du Jeu.

ERIC Educational Resources Information Center

Palermo, James

1981-01-01

Presents case studies representing various points of view on the question of whether academic institutions can remain neutral. Excerpts are presented from the writings of Kenneth Strike, Robert H. Ennis, John Dewey, and Louis Althusser. (DB)

Civic Learning through Public Scholarship: Coherence among Diverse Disciplines

ERIC Educational Resources Information Center

Dostilio, Lina D.; Conti, Norman; Kronk, Rebecca; Weideman, Yvonne L.; Woodley, Sarah K.; Trun, Nancy

2013-01-01

This article presents three cases of community-engaged, or "public," scholarship across diverse disciplines (social science, natural science, and health science) in which the rigid boundaries of what has been conceived as traditional service-learning have been blurred. The innovations represented within these cases explicitly address…

Parental Compliance to Court-Ordered Treatment Interventions in Cases of Child Maltreatment.

ERIC Educational Resources Information Center

Famularo, Richard; And Others

1989-01-01

The study of 136 court cases representing 218 parents of abused or neglected children found parental compliance with court ordered treatment significantly lower in parents presenting with substance abuse and in parents who sexually and/or physically maltreated their children. (Author/DB)

"Irreconcilable Differences" between Parent and Child: A Case Report of Interactional Pathology.

ERIC Educational Resources Information Center

Tooley, Kay M.

1978-01-01

The article presents two illustrative case reports of an unusual type of child abuse: parents who use their child as a representative of their own unacceptable impulses, thereby perceiving the youngster as evil and seeking experts to confirm their mistaken opinions. (Author/DLS)

Neural differences in processing of case particles in Japanese: an fMRI study

PubMed Central

Hashimoto, Yosuke; Yokoyama, Satoru; Kawashima, Ryuta

2014-01-01

Introduction In subject–object–verb (SOV) languages, such as Japanese, sentence processing proceeds incrementally to the late presentation of the head (verb). Japanese case particles play a crucial role in sentence processing; however, little is known about how these particles are processed. In particular, it is still unclear how the functional difference between case particles is represented in the human brain. Methods In this study, we conducted an fMRI experiment using an event-related design to directly compare brain activity during Japanese case particle processing among the nominative case ga, accusative case o, and dative case ni. Twenty five native Japanese speakers were asked to judge whether the presented character was a particle in a particle judgment task and whether the character ended with a specific vowel in a phonological judgment task, which was used as a control condition. Results A particle comparison demonstrated that the processing of ni was associated with significantly weaker brain activity than that of ga and o in the left middle frontal gyrus (MFG) and the inferior frontal gyrus (IFG). Significantly greater brain activity associated with ni relative to ga in the right IFG was also observed. Conclusion These results suggest that the Japanese case particles ga, ni, and o are represented differently in the brain. PMID:24683511

Post-cholecystectomy biliary injuries: one center experience.

PubMed

Fathy, Omar; Wahab, Mohamed Abdel; Hamdy, Emad; Elshoubary, Mohamed; Kandiel, Tharwat; Elraof, Ahmad Abd; Elhemaly, Mohamed; Salah, Tarek; Elhanafy, Ehab; Atef, Ehab; Sultan, Ahmad Mohamed; Elebiedy, Gamal; Anwar, Nabieh; Sultan, Ahmad

2011-01-01

Post-cholecystectomy bile duct injuries (BDIs) represent a challenge in diagnosis and management. From March 1995 to August 2009, 274 patients with post-cholecystectomy BDIs were managed at our center. All patients were subjected to laboratory tests, sonography, ERCP and MRCP. The management varied according to the type of injury. Seventy-one (25.9%) LC and 203 (74.1%) OC were performed; 8(2.9%) were detected intraoperatively; 270 patients were referred from other hospitals. From those discovered intraoperatively, 7 had hepatico-jejunostomy and one died from severe peritonitis; 11 (4%) presented with generalized and 112 (40.9%) with localized peritonitis. The leak site was the cystic duct (57 cases), accessory duct in the liver bed (5 cases), right hepatic duct (4 cases) and lateral tear in the CBD (12 cases). Endoscopic stenting was performed for all of them. The remaining 34 patients had a completely ligated distal duct and therefore had hepatico-jejunostomy Roux loop; 143 patients (52.2%) presented with early (79 cases) and late (64 cases) jaundice; 126 cases had hepatico-jejunostomy. The remaining 17 patients were treated by balloon dilatation. Endoscopic stenting can manage cases with cystic or accessory duct leak while, hepatico-jejunostomy Roux loop represents the golden procedure for management of transected or ligated CBD.

Magnetic resonance and computed tomographic features of 4 cases of canine congenital thoracic vertebral anomalies

PubMed Central

Berlanda, Michele; Zotti, Alessandro; Brandazza, Giada; Poser, Helen; Calò, Pietro; Bernardini, Marco

2011-01-01

Magnetic resonance and computed tomography features of 4 cases of canine congenital vertebral anomalies (CVAs) are discussed. Two of the cases represent unusual presentations for such anomalies that commonly affect screw-tail or toy breeds. Moreover, the combination of CVAs and a congenital peritoneo-pericardial diaphragmatic hernia has never before been imaged. PMID:22654139

Fusion of Scores in a Detection Context Based on Alpha Integration.

PubMed

Soriano, Antonio; Vergara, Luis; Ahmed, Bouziane; Salazar, Addisson

2015-09-01

We present a new method for fusing scores corresponding to different detectors (two-hypotheses case). It is based on alpha integration, which we have adapted to the detection context. Three optimization methods are presented: least mean square error, maximization of the area under the ROC curve, and minimization of the probability of error. Gradient algorithms are proposed for the three methods. Different experiments with simulated and real data are included. Simulated data consider the two-detector case to illustrate the factors influencing alpha integration and demonstrate the improvements obtained by score fusion with respect to individual detector performance. Two real data cases have been considered. In the first, multimodal biometric data have been processed. This case is representative of scenarios in which the probability of detection is to be maximized for a given probability of false alarm. The second case is the automatic analysis of electroencephalogram and electrocardiogram records with the aim of reproducing the medical expert detections of arousal during sleeping. This case is representative of scenarios in which probability of error is to be minimized. The general superior performance of alpha integration verifies the interest of optimizing the fusing parameters.

[Pseudo-Bartter syndrome--2 cases].

PubMed

Jóźwiak, Lucyna; Jaroszyński, Andrzej; Baranowicz-Gaszczyk, Iwona; Borowicz, Ewa; Ksiazek, Andrzej

2010-01-01

Bartter syndrome represents the group of renal disturbances characterized by hypokaliemia and metabolic alkalosis. Some diseases could display hypokalemic metabolic alkalosis without primary tubular dysfunction. These disorders are called pseudo-Bartter syndrome. In this paper we present 2 cases of pseudo-Bartter syndrome related among to other things to overuse of diuretic drugs.

Reversible cerebral vasoconstriction syndrome precipitated by airplane descent: Case report.

PubMed

Hiraga, Akiyuki; Aotsuka, Yuya; Koide, Kyosuke; Kuwabara, Satoshi

2017-10-01

Background Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by segmental vasospasm. Vasoactive agents and childbirth have been reported as precipitating factors for RCVS; however, RCVS induced by altitude change or air travel has rarely been reported. Case We present a case of a 74-year-old woman who presented with thunderclap headache during airplane descent. Magnetic resonance angiography demonstrated segmental vasoconstriction that improved 9 days after onset. Conclusion These findings indicate that airplane descent may be a trigger of RCVS. The time course of headache in the present case was similar to that of prolonged headache attributed to airplane travel, indicating that RCVS during air travel may have previously been overlooked and that some headache attributed to airplane travel cases may represent a milder form of RCVS.

Primary hepatic choriocarcinoma: a rare cause of spontaneous haemoperitoneum in an adult

PubMed Central

Bakhshi, Girish D.; Borisa, Ashok D.; Bhandarwar, Ajay H.; Tayade, Mukund B.; Yadav, Rajesh B.; Jadhav, Yogesh R.

2012-01-01

Choricarcinoma is a beta human chorionic gonadotrophin secreting neoplasm pertinent to uterus and pregnancy mostly. It occurs primarily in gonads but rarely in extragonadal sites. Primary hepatic choriocarcinoma is an extremely rare tumor. Most of the reported cases are seen in infants representing metastasis from an occult placental choriocarcinoma. Till date, only 7 cases of primary hepatic choriocarcinoma in adults have been reported in literature. We present a case of a 40-yearold male presenting as haemoperitoneum due to ruptured hepatic tumor. He underwent emergency left lateral segmentectomy. He died on 10th postoperative day. The surgical specimen and autopsy findings confirmed it to be primary hepatic choriocarcinoma. This is the first case report from Indian Subcontinent. A brief case report and review of literature is presented. PMID:24765472

Drug-induced seizures in children and adolescents presenting for emergency care: current and emerging trends.

PubMed

Finkelstein, Y; Hutson, J R; Freedman, S B; Wax, P; Brent, J

2013-01-01

Seizures may be the presenting manifestation of acute poisoning in children. Knowledge of the etiologic agent, or likely drug-class exposure, is crucial to minimize morbidity and optimize care. To describe the agents most commonly responsible for pediatric drug-induced seizures, whose evaluation included a medical toxicology consultation in the United States. Using the 37 participating sites of the Toxicology Investigators Consortium (ToxIC) Case Registry, a cross-country surveillance tool, we conducted an observational study of a prospectively collected cohort. We identified all pediatric (younger than 18 years) reports originating from an Emergency Department (ED) which included a chemical or drug-induced seizure, and required a medical toxicology consultation between April 1, 2010 and March 31, 2012. Results. We identified 142 pediatric drug-induced seizure cases (56% male), which represent nearly 5% of pediatric cases requiring bedside consultation by medical toxicologists. One-hundred and seven cases (75%) occurred in children aged 13-18 years, and 86 (61%) resulted from intentional ingestions. Antidepressants were the most commonly identified agents ingested (n = 61; 42%), of which bupropion was the leading drug (n = 30; 50% of antidepressants), followed by anticholinergics/antihistamines (n = 31; 22%). All antidepressant-induced seizures in teenagers were intentional and represented self-harm behavior. Sympathomimetic agents, including street drugs, represent the most common agents in children younger than 2 years (n = 4/19). Antidepressants, and specifically bupropion, are presently the most common medications responsible for pediatric drug-induced seizures requiring medical toxicology consultation in the United States. In teenagers presenting with new-onset seizures of unknown etiology, the possibility of deliberate self-poisoning should be explored, since most drug-induced seizures in this age group resulted from intentional ingestion.

Rapid occurrence of left ventricular thrombus associated with platinum-based chemotherapy plus cetuximab for the treatment of metastatic squamous cell carcinoma of the head and neck: A case report.

PubMed

Ikeda, Atsushi; Yamachika, Eiki; Mizutani, Masahide; Matsubara, Masakazu; Moritani, Norifumi; Nakatsuji, Kazuki; Iida, Seiji

2017-11-01

Platinum-based chemotherapy plus cetuximab represents the first-line treatment for recurrent or metastatic squamous cell carcinoma of the head and neck. The most common adverse events associated with cetuximab are infusion reactions and skin reactions, and a risk of venous thromboembolic events has also recently been reported in association with cetuximab. It is well known that thrombosis is a common complication of malignancy, and represents the second most frequent cause of mortality in cancer patients. The present study reports the case of a 79-year-old man who presented with lung and liver metastases from tongue squamous cell carcinoma, for which platinum-based chemotherapy plus cetuximab was administered. After 1 cycle, the patient showed rapid growth of a left ventricular (LV) thrombus, despite ongoing antiplatelet therapy for an old myocardial infarction. Anticoagulant therapy was administered to treat the LV thrombus, which resolved within 1 week. To the best of our knowledge, this represents the first reported case of rapidly occurring LV thrombus associated with platinum-based chemotherapy plus cetuximab. Platinum-based chemotherapy plus cetuximab may be associated with a higher risk of embolic thrombus.

Identifying Stakeholders and Their Preferences about NFR by Comparing Use Case Diagrams of Several Existing Systems

NASA Astrophysics Data System (ADS)

Kaiya, Haruhiko; Osada, Akira; Kaijiri, Kenji

We present a method to identify stakeholders and their preferences about non-functional requirements (NFR) by using use case diagrams of existing systems. We focus on the changes about NFR because such changes help stakeholders to identify their preferences. Comparing different use case diagrams of the same domain helps us to find changes to be occurred. We utilize Goal-Question-Metrics (GQM) method for identifying variables that characterize NFR, and we can systematically represent changes about NFR using the variables. Use cases that represent system interactions help us to bridge the gap between goals and metrics (variables), and we can easily construct measurable NFR. For validating and evaluating our method, we applied our method to an application domain of Mail User Agent (MUA) system.

Langerhans cell histiocytosis: recurrent lesions affecting mandible in a 10-year-old patient.

PubMed

Loducca, S V; Mantesso, A; Araújo, N S; Magalhães, M H

2001-01-01

Hand-Schuller-Christian disease is a multifocal variant of eosinophilic granuloma, characterised by the classical triad of bony lesions, exophthalmos and diabetes insipidus. This case relates recurrent Langerhans' cell histiocytosis lesions presented as destruction of periodontal support associated with diabetes in a 10-year-old patient. Medical history suggests that the case represents a case of Hand-Schuller Christian disease.

Traumatic globe luxation associated with orbital fracture in a child: a case report and literature review.

PubMed

Amaral, Márcio Bruno Figueiredo; Carvalho, Matheus Furtado; Ferreira, André Baptista; Mesquita, Ricardo Alves

2015-03-01

Orbital fracture associated with traumatic globe luxation is rare, as it generally requires trauma with high energy for this to occur. The present case report focused on a child who had been hit by a motorcycle, leading to a globe luxation of the left eye and fractures of the superolateral orbital walls. The patient presented initial cosmetic and psychological benefits from the repositioning of the intact globe and the reduction of the orbital fractures. However, a subsequent evisceration of the globe was required due to persistent proptosis and pain. An ocular prosthesis was also implanted, thus recovering the patient's aesthetics. Thirty-four well-documented cases of traumatic globe luxation could be found in the English literature since 1970. The mean age of patients presenting traumatic globe luxation was 29.5 years. The male gender proved to be more prevalent, with traffic collisions representing the most common accident etiology. Direct orbital trauma with fractures of medial and floor walls displacing the globe into the maxillary sinus represented the most common injury mechanism (38.2 %), followed by an elongated object entering the orbit (26.5 %). Optical nerve avulsion is the most serious complication seen in association with traumatic globe luxation, with the repositioning of the initial globe, with no enucleation or evisceration, representing the main form of management.

Regional Networks in Education: A Case Study of an Austrian Project

ERIC Educational Resources Information Center

Rauch, Franz

2013-01-01

This case study presents the development of networks in education, using the Austrian IMST (Innovations Make Schools Top) project as illustration. The regional networks are coordinated in every Austrian federal province by groups made up of teachers, representatives of the educational authorities, and members of academia. In the framework of the…

Sigmoid Volvulus Through a Transmesenteric Hernia.

PubMed

Brandão, Pedro Nuno; Martins, Vilma; Silva, Cristina; Davide, José

2017-06-01

Internal hernias are a rare pathology with very low incidence. Transmesenteric hernias represent less than 10% of all cases and may occur at any age. They involve more often the small bowel and, more rarely, the colon. We present a case of a sigmoid volvulus through a transmesenteric hernia in a 19-year-old patient.

You Sound Taller on the Telephone: A Practitioner's View of the Principalship.

ERIC Educational Resources Information Center

Dunklee, Dennis R.

This book presents a comprehensive case study of the professional life of a fictional school principal. Based entirely on case-study methodology, all the episodes discussed in the book depict actual events in everyday education leadership practice and represent a real-life education leadership experience through episodic progression. The case…

The virtual case: a new method to completely digitize cytological and histological slides.

PubMed

Demichelis, F; Barbareschi, M; Dalla Palma, P; Forti, S

2002-08-01

The purpose of this study was to present a new method for handling histological/cytological cases. Thanks to the introduction of information technology in pathology, including the amenities afforded by robotic microscopes and digital imaging, tissue slides can be represented and evaluated using digital techniques in order to construct virtual cases through completely automated procedures. A virtual case (VC) is composed of a collection of digital images representing a histological/cytological slide at all magnification levels together with all relevant clinical data. In the present study, we describe an automated system to manage robotic microscope and image acquisition for the proper construction of VCs. These can then be viewed on a computer by means of an interface ("user-friendly") that allows one to select the more appropriate fields and to examine them at different magnifications, rapidly going from panoramic views to high resolution and vice versa. In comparison with glass slides, VCs have several advantages arising from their digital nature and can be considered a common platform for a wide range of applications such as teleconsultation, education, research, and quality control and proficiency tests.

Cogeneration technology alternatives study. Volume 4: Heat Sources, balance of plant and auxiliary systems

NASA Technical Reports Server (NTRS)

1980-01-01

Data and information established for heat sources balance of plant items, thermal energy storage, and heat pumps are presented. Design case descriptions are given along with projected performance values. Capital cost estimates for representative cogeneration plants are also presented.

Synchronous adrenocortical neoplasms, paragangliomas, and pheochromocytomas: syndromic considerations regarding an unusual constellation of endocrine tumors.

PubMed

LeBlanc, Melissa; Tabrizi, Mohsen; Kapsner, Patricia; Hanson, Joshua Anspach

2014-12-01

The most common clinical syndromes presenting with paragangliomas and/or pheochromocytomas as their endocrine components are multiple endocrine neoplasia type 2, neurofibromatosis, Von Hippel-Lindau syndrome, Carney-Stratakis syndrome, Carney triad, and the recently described hereditary paraganglioma syndrome. Only Carney triad is known to also present with adrenocortical adenomas, currently representing the only described syndrome in which all 3 of the aforementioned tumors are found together. In most cases, prototypical lesions of the triad such as gastrointestinal stromal tumor and pulmonary chondromas are also seen. We present a case of a young woman with synchronous paragangliomas, adrenal/extra-adrenal cortical neoplasms, and pheochromocytoma without genetic mutations for multiple endocrine neoplasia 2, Von Hippel-Lindau syndrome, neurofibromatosis, and succinate dehydrogenase. We speculate that this represents a previously undescribed presentation of Carney triad and, at the very least, indicates the need for monitoring for the development of other tumors of the triad. Copyright © 2014 Elsevier Inc. All rights reserved.

Late post-treatment radiographic changes 3 years following chemoradiation for glioma: the importance of histopathology.

PubMed

Galante, Joao R; Rodriguez, Fausto; Grossman, Stuart A; Strowd, Roy E

2017-07-18

Treatment-related changes can mimic brain tumor progression both clinically and radiographically. Distinguishing these two entities represents a major challenge in neuro-oncology. No single imaging modality is capable of reliably achieving such distinction. While histopathology remains the gold standard, definitive pathological criteria are also lacking which can further complicate such cases. We report a patient with high-grade glioma who, after initially presenting with histopathologically confirmed pseudoprogression 10 months following treatment, re-presented 3 years following concurrent chemoradiation with clinical and radiographic changes that were most consistent with progressive disease but for which histopathology revealed treatment effects without active glioma. This case highlights the potential late onset of treatment-related changes and underscores the importance of histopathologic assessment even years following initial therapy.

Severe dysphagia as the presenting symptom of Wernicke-Korsakoff syndrome in a non-alcoholic man.

PubMed

Karaiskos, Ilias; Katsarolis, Ioannis; Stefanis, Leonidas

2008-02-01

We present the case of a non-alcoholic man, who, following severe malnutrition, presented with dysphagia that necessitated gastrostomy tube placement. The patient subsequently developed encephalopathy, at which point thiamine deficiency was suspected and thiamine supplementation initiated. The encephalopathy and the dysphagia resolved, but the patient was left with a dense amnestic deficit consistent with Korsakoff syndrome. MRI at the time of the encephalopathy revealed lesions consistent with Wernicke-Korsakoff syndrome. This case represents a remarkable example of Wernicke-Korsakoff syndrome that for a prolonged time period had as its sole manifestation severe dysphagia. To our knowledge, there is only one similar case reported in the literature. This case serves to alert neurologists that isolated dysphagia may be the presenting symptom of this classic neurological syndrome even in the absence of alcoholism.

Possible association of Down syndrome and exstrophy-epispadias complex: report of two new cases and review of the literature.

PubMed

Reutter, Heiko; Bökenkamp, Arend; Ebert, Anne-Karolin; Rösch, Wolfgang; Boemers, Thomas M; Nöthen, Markus M; Ludwig, Michael

2009-07-01

In the past, several midline defects have been associated with Down syndrome (DS) on a regular basis, e.g. heart defects, cleft lip and palate, neural tube defects, omphalocele and anal atresia. The exstrophy-epispadias complex (EEC) represents a rare midline defect, rarely described in association with DS. Here, we report on the co-occurrence of DS and EEC in two, so far, unreported cases and present a review of the literature. We suggest that EEC represents a rare but inherent part in the spectrum of DS-associated midline defects.

Management of interstitial ectopic pregnancies with a combined intra-amniotic and systemic approach.

PubMed

Swank, Morgan L; Harken, Tabetha R; Porto, Manuel

2013-08-01

Approximately 2% of all pregnancies are ectopic; of these, 4% are interstitial or cervical. There exists no clear consensus as to whether surgical or medical management is superior. We present three cases of advanced nonfallopian tube ectopic pregnancies from 6 to 8 weeks of gestation. Our first two cases were managed with a combined intrafetal, intra-amniotic and systemic approach using methotrexate and potassium chloride, whereas our third case was managed with an intra-amniotic approach alone. Our combined approach cases were successful, with resolution of human chorionic gonadotropin in 50 and 34 days, whereas our single approach case re-presented with bleeding requiring uterine artery embolization and operative removal of products of conception. Patients presenting with advanced interstitial or cervical pregnancies who are clinically stable can be offered medical management with a combined approach.

Tinea pedis presenting as asymmetric purpuric papules on the sole of the foot: a case report.

PubMed

Chen, Jennifer Yan Fei; Stroz, Marianne J; Adam, David N

2015-01-01

In this report we describe a unique case of tinea pedis. A 29-year-old man presented with a 3-day history of asymptomatic purpuric papules predominantly on his left foot. Potassium hydroxide preparation demonstrated fungal hyphae and culture yielded Trichophyton mentagrophytes. This patient presented unusually with purpuric papules, unlike the three commonly described types of tinea pedis. Given the morphology, positive potassium hydroxide slide preparation, T. mentagrophytes on fungal culture and clinical response to ketoconazole cream, we conclude that this represents a unique variant of tinea pedis. We recognize that even common dermatological diagnoses can have unique presentations, and it is important for clinicians to maintain a broad differential for new dermatologic cases.

Tinea Pedis Presenting as Asymmetric Purpuric Papules on the Sole of the Foot: A Case Report

PubMed Central

Chen, Jennifer Yan Fei; Stroz, Marianne J.; Adam, David N.

2015-01-01

In this report we describe a unique case of tinea pedis. A 29-year-old man presented with a 3-day history of asymptomatic purpuric papules predominantly on his left foot. Potassium hydroxide preparation demonstrated fungal hyphae and culture yielded Trichophyton mentagrophytes. This patient presented unusually with purpuric papules, unlike the three commonly described types of tinea pedis. Given the morphology, positive potassium hydroxide slide preparation, T. mentagrophytes on fungal culture and clinical response to ketoconazole cream, we conclude that this represents a unique variant of tinea pedis. We recognize that even common dermatological diagnoses can have unique presentations, and it is important for clinicians to maintain a broad differential for new dermatologic cases. PMID:25873874

Judicial Reliance on Parental IQ in Appellate-Level Child Welfare Cases Involving Parents with Intellectual and Developmental Disabilities.

PubMed

Callow, Ella; Tahir, Munazza; Feldman, Maurice

2017-05-01

Parents with intellectual and developmental disabilities (IDDs) are over-represented in child welfare cases. Although IQ per se is an invalid indicator of parenting abilities, this study examined the prevalence of judicial consideration of parental IQ test evidence in US appellate cases. The present authors conducted Boolean searches of Westlaw Corporation's case database since 1999. The present authors used a six-question checklist to survey the 42 most recent American appellate cases involving termination of parental rights (TPR) decisions that included evidence of parental intellectual and developmental disabilities based on IQ. In 86% of cases, parental low IQ was presented as a barrier to parenting competence. Higher courts uphold TPR decision in 81% of cases involving parents with intellectual and developmental disabilities. Parental IQ scores are routinely relied upon to judge parenting capacity in custody cases where parents have intellectual and developmental disabilities. The present authors recommend more comprehensive assessments examining a broader range of contextual variable that may impact on parenting abilities. © 2016 John Wiley & Sons Ltd.

Malignant sigmoidoduodenal fistula.

PubMed

Shapey, I M; Mahmood, K; Solkar, M H

2014-01-01

Duodenocolic fistula is a rare complication of malignant colonic disease especially when involving and originating from the sigmoid colon. We aim to discuss the unusual clinical presentation of this case as well as the investigation and management of duodenocolic fistulas. A 91 year old lady presented as an emergency to a general surgical service at a District General Hospital with diarrhoea, vomiting and weight loss. Computed Tomography (CT) reported a large ovarian cyst elevating the sigmoid colon into immediate proximity of the duodenum. Adenocarcinoma was confirmed on histology obtained by colonoscopy. A classic apple core lesion with fistulating tract from the sigmoid colon to the duodenum was synchronously demonstrated on barium enema. Sigmoido-duodenal fistulae represent a complex manifestation of gastrointestinal pathologies. Management options must be considered in the context of patient wishes, their co-morbidities, and predicted post-operative outcome. In most cases this is likely to represent a non-operative approach, however surgical resection may benefit selected cases on occasion. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Breast cancer metastasis in distal phalanx of the big toe. Case report].

PubMed

Carlesimo, B; Tempesta, M; Fioramonti, P; Bistoni, G; Ruggiero, M; Marchetti, F

2009-01-01

Breast cancer represents the most prevalent malignancies in women and bone is the first site of metastasis in 26-50% of cases. Usually metastasis involve limbs in 16%. We present a rare case of 47-year-old woman, who underwent to monolateral mastectomy for lobular cancer. After 8 years from surgery, she presented pain, swelling and functional limitations, gradually increasing, to the left big toe. X-rays and MRI showed a lucent area of bone destruction on the shaft of the distal phalanx of the left big toe. Surgical biopsy on the excised bone assessed for breast cancer metastasis.

Edema associated with quetiapine

PubMed Central

Koleva, Hristina K.; Erickson, Mark A.; Vanderlip, Erik R.; Tansey, Janeta; Mac, Joseph; Fiedorowicz, Jess G.

2010-01-01

Background Edema associated with quetiapine has been described in only one case report to date and represents a potentially serious adverse reaction. Methods We present a case series of three patients who developed bilateral leg edema following initiation of quetiapine. Results One of these patients had a recurrence of edema with subsequent rechallenge. Another patient developed quetiapine-induced edema following a prior episode of olanzapine-induced edema. All the cases present a compelling temporal relationship between the drug challenge and the adverse event. Conclusions Prompt recognition and intervention with discontinuation of the offending agent is important for this potentially serious, seemingly idiosyncratic, vascular complication. PMID:19439156

Cracking the Crack Dance: A Case Report on Cocaine-induced Choreoathetosis.

PubMed

Narula, Naureen; Siddiqui, Faraz; Katyal, Nakul; Krishnan, Nithya; Chalhoub, Michel

2017-12-22

Movement disorders represent one of the less common presentations of cocaine toxicity observed in clinical practice. Given the magnitude of crack cocaine use, it is vital to understand the underlying pathogenesis. We present a case of a patient who clinically exhibited cocaine-induced choreoathetosis. The diagnosis was confirmed after ruling out all other organic causes of de novo choreoathetoid movement. This case highlights the association of cocaine with choreoathetoid movements. We propose a preliminary understanding of the underlying pathogenesis, which may help intensivists better recognize this uncommon phenomenon.

Giant gastrointestinal stromal tumour of rare sarcomatoid epithelioid subtype: Case study and literature review

PubMed Central

Lech, Gustaw; Korcz, Wojciech; Kowalczyk, Emilia; Guzel, Tomasz; Radoch, Marcin; Krasnodębski, Ireneusz Wojciech

2015-01-01

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract, but they represent less than 3% of all gastrointestinal tract malignancies. This is a detailed case study of a 52-year-old male patient treated for very uncommon histological subtype of gastric GIST with atypical clinical presentation, asymptomatic progress and late diagnosis. The resected tumour, giant in diameters, was confirmed to represent the most rare histopathologic subtype of GISTs - sarcomatoid epithelioid GIST. We report this case and review the literature with a special focus on pathomorphological evaluation, biological aggressiveness and prognostic factors. To our knowledge this is the first report of giant GIST of very uncommon sarcomatoid epithelioid subtype. It is concluded that clinicians should pay attention to the fact that initial diagnosis may be delayed due to mildly asymptomatic and non-specific clinical presentation. Asymptomatic tumours diagnosed at a late stage, which is often the case, can be large on presentation. Prognosis for patients diagnosed with GIST depend on tumour size, mitotic rate, histopathologic subtype and tumour location. That is why early diagnosis and R0 resection, which is usually feasible and safe even in giant gastric sarcomatoid epithelioid subtype of GISTs, are the key factors for further treatment and good prognosis. PMID:25805949

Cervicothoracic epidural hematoma in a toddler with miosis, ptosis, nonspecific symptoms, and no history of major trauma: case report.

PubMed

Root, Brandon K; Schartz, Derrek A; Calnan, Dan R; Hickey, William F; Bauer, David F

2018-06-01

Spinal epidural hematomas are uncommon in children. The diagnosis can be elusive as most cases present without a history of trauma, while symptoms can be atypical. We encountered a 35-month-old male presenting with nonspecific symptoms and no history of trauma. He later developed unilateral miosis and ptosis; MRI discovered a subacute cervicothoracic epidural which was promptly evacuated. The patient made an excellent recovery. We emphasize the frequent absence of identifiable trauma and the importance of thorough imaging when this entity is suspected. Miosis and ptosis, likely representing a partial Horner syndrome, is an extremely rare presentation, this being one of the only reported cases.

Subacute Hypophysitis with Panhypopituitarism as First Presentation of HIV and Syphilis Coinfection.

PubMed

Alves, Rute; França, Margarida

2017-01-01

Infection by Treponema pallidum still represents a clinical challenge due to its various forms of presentation. HIV coinfection added diversity and changed the natural history of syphilis as a systemic infection. We present a rare case of subacute hypophysitis and panhypopituitarism due to an early active neurosyphilis in a previously unknown HIV coinfected patient.

A unique case of spontaneous regression of metastatic papillary renal cell carcinoma: a case report

PubMed Central

Lim, Rebecca; Tan, Puay Hoon; Cheng, Christopher; Agasthian, Thirugnanam; Tan, Hwei Ling; Teh, Bin Tean

2009-01-01

Spontaneous regression of cancer is a rare, but well documented, phenomenon. We present a unique case of an 82 year old Chinese male who experienced spontaneous regression of histologically-verified metastatic type II papillary renal cell carcinoma in the absence of intervening systemic therapy or surgery. This is the first reported case of spontaneous regression of papillary renal cell carcinoma. The mechanism of spontaneous regression remains unknown, and represents a challenge for existing oncology paradigms. PMID:19918481

We the People: Indiana and the United States Constitution. Lectures in Observance of the Bicentennial of the Constitution.

ERIC Educational Resources Information Center

Furlong, Partick J.; And Others

These lectures, presented in observance of the U.S. Constitution bicentennial celebration, consider selected constitutionally significant law cases that occurred in Indiana. These cases are representative of U.S. constitutional development and of the relationship of Indiana to the U.S. Constitution. Patrick Furlong, in "The South Bend…

An Interesting Case of Retropharyngeal Lymph Nodal Metastases in a Case of Iodine-Refractory Thyroid Cancer.

PubMed

Harisankar, Chidambaram Natrajan Balasubramanian; Vijayabhaskar, Ramakrishnan

2018-01-01

Metastases to cervical lymph node are fairly common in differentiated thyroid cancer. In iodine-refractory disease, the disease may persist in the thyroid bed, cervical lymph nodes, lungs, or the bones commonly. Retropharyngeal lymph nodal involvement in thyroid cancer is unusual and may even be the presenting complaint. We represent a case of iodine-refractory thyroid cancer with retropharyngeal lymph nodal involvement in addition to lung metastases.

Maxillary canine-first premolar bilateral transposition in a Class III patient: A case report.

PubMed

Potrubacz, Maciej Iancu; Tepedino, Michele; Chimenti, Claudio

2016-05-01

Tooth transposition is a rare dental anomaly that often represents a challenge for the clinician. The case of a girl with skeletal Class III malocclusion and concomitant maxillary canine-first premolar bilateral transposition, followed from 7 to 17 years of age, is presented. After a first phase of treatment aimed at resolving the Class III malocclusion, the transposition was maintained and the case finalized with a multibracket appliance.

Adolescent muscle dysmorphia and family-based treatment: a case report.

PubMed

Murray, Stuart B; Griffiths, Scott

2015-04-01

A growing body of evidence suggests that the prevalence of male body dissatisfaction and muscle dysmorphia is rising. To date, however, there is no published evidence on the efficacy of treatments for muscle dysmorphia. We present the case of a 15-year-old boy who met full diagnostic criteria for muscle dysmorphia, whose symptoms were treated into remission with eating disorder-focused, family-based treatment. The age of this patient fell within the time period in which symptoms of muscle dysmorphia are most likely to develop and this case represents the first published case report of family-based treatment for muscle dysmorphia in this age group. Thus, this case report has important implications for clinicians considering treatment options for presentations of muscle dysmorphia when first presenting in adolescence. Implications for the development of treatment guidelines for muscle dysmorphia and for the diagnostic debate surrounding muscle dysmorphia are also discussed. © The Author(s) 2014.

The use of effective treatments: the case of an adolescent girl with anorexia nervosa in the context of a conversion disorder.

PubMed

Goldstein, Mandy; Madden, Sloane; Peters, Lorna

2013-04-01

The use of empirically supported treatment (EST) has been shown to enhance treatment outcome. The purpose of this case study was to suggest that ESTs further encourage effective reconceptualisation and the ongoing delivery of effective treatment, especially in the case of complex or atypical presentations or response to treatment. This report describes the case of an adolescent girl who underwent Maudsley family-based treatment for anorexia nervosa (AN) for a period of 12 months. Atypical response lead to an understanding of her presentation as representing a primary conversion disorder, within which AN symptoms were conceptualised as another somatic conversion of emotional distress. The report details her clinical presentation and management over the course of her illness. The case offers an important opportunity to explore the central role of the use of ESTs in guiding effective treatment delivery.

Surgical treatment in stenosing rectal cancer.

PubMed

Deaconescu, V; Simion, L; Alecu, M; Ionescu, S; Mastalier, B; Straja, N D

2014-01-01

Rectal cancer represents an important health issue, which involves multidisciplinary treatment, posing a major surgical challenge, both in terms of diagnosis and treatment. Between 2009-2013, we analysed 83 patients with stenosing rectal cancer operated on at the Clinic of General Surgery II of Colentina Clinical Hospital and at the Clinic of General Surgery I of "Prof. Dr. Al. Trestioreanu"€ Oncology Institute, in Bucharest. Gender distribution was: 51 males and 32 females. Average age was 65 years old. The most frequently encountered symptoms were colicky abdominal pain and rectorrhagia. 25 patients presented intestinal occlusion phenomena at admission, the other 58 cases being in subocclusive stage. In occlusive stages: 17 patients presented with resectable tumour, while 8 patients had locally advanced neoplastic forms (€œfrozen pelvis€), left iliac colostomy with tumour biopsy being the chosen approach. In subocclusive stages: 5 cases had unresectable tumours for which left iliac anus with tumour biopsy was performed; 53 cases presented with resectable tumour, for which the Hartmann procedure (12 patients) and left iliac colostomy with tumour biopsy (41 patients) were performed. Depending on the histopathological result, patients were submitted to radio- and chemotherapy.Tumour resection was possible in 70 cases (84.33%), only 34 of these (40.96%) being with radical intent. Treatment for stenosing rectal cancer is multimodal,represented by surgical approach, radio- and chemotherapy. The rationality behind surgery as a first therapeutic gesture in the given study group was represented by the need to treat occlusive type complications, patients benefitting subsequently from radio- and chemotherapy. The opportunity of a second surgical intervention, with the objective to remove the tumour, was established based on the therapeutic response to radio- and chemotherapy. Celsius.

Emerging Cases of Powassan Virus Encephalitis in New England: Clinical Presentation, Imaging, and Review of the Literature

PubMed Central

Piantadosi, Anne; Rubin, Daniel B.; McQuillen, Daniel P.; Hsu, Liangge; Lederer, Philip A.; Ashbaugh, Cameron D.; Duffalo, Chad; Duncan, Robert; Thon, Jesse; Bhattacharyya, Shamik; Basgoz, Nesli; Feske, Steven K.; Lyons, Jennifer L.

2016-01-01

Background. Powassan virus (POWV) is a rarely diagnosed cause of encephalitis in the United States. In the Northeast, it is transmitted by Ixodes scapularis, the same vector that transmits Lyme disease. The prevalence of POWV among animal hosts and vectors has been increasing. We present 8 cases of POWV encephalitis from Massachusetts and New Hampshire in 2013–2015. Methods. We abstracted clinical and epidemiological information for patients with POWV encephalitis diagnosed at 2 hospitals in Massachusetts from 2013 to 2015. We compared their brain imaging with those in published findings from Powassan and other viral encephalitides. Results. The patients ranged in age from 21 to 82 years, were, for the most part, previously healthy, and presented with syndromes of fever, headache, and altered consciousness. Infections occurred from May to September and were often associated with known tick exposures. In all patients, cerebrospinal fluid analyses showed pleocytosis with elevated protein. In 7 of 8 patients, brain magnetic resonance imaging demonstrated deep foci of increased T2/fluid-attenuation inversion recovery signal intensity. Conclusions. We describe 8 cases of POWV encephalitis in Massachusetts and New Hampshire in 2013–2015. Prior to this, there had been only 2 cases of POWV encephalitis identified in Massachusetts. These cases may represent emergence of this virus in a region where its vector, I. scapularis, is known to be prevalent or may represent the emerging diagnosis of an underappreciated pathogen. We recommend testing for POWV in patients who present with encephalitis in the spring to fall in New England. PMID:26668338

Framing deadly domestic violence: why the media's spin matters in newspaper coverage of femicide.

PubMed

Gillespie, Lane Kirkland; Richards, Tara N; Givens, Eugena M; Smith, M Dwayne

2013-02-01

The news media play a substantial role in shaping society's perceptions of social issues, including domestic violence. However, minimal research has been conducted to examine whether news media frame stories of femicide within the context of domestic violence. Using frame analysis, the present research compares newspaper articles representing 113 cases of femicide that define the murder as domestic violence to a random sample of 113 cases without coverage defining the femicide as domestic violence. Findings indicate that both groups are represented by multiple frames, including a previously unidentified frame that places the femicide in the context of domestic violence as a social problem.

A new worm infiltrating the human cornea: A report of three cases.

PubMed

McBurney-Lin, Shan; Khorram, David; Gee, Stephen; Hoberg, Eric P; Klassen-Fischer, Mary K; Neafie, Ronald C

2018-03-01

To characterize a new species of parasitic nematode that triggers uveitis. Three previously healthy, relatively young people each contracted a corneal stromal nematode that, upon surgical removal and examination, did not match any known nematodes. Clinical ocular findings included corneal opacification, visible corneal worms, conjunctival injection, and uveitis. The three cases presented here represent a previously undescribed parasitic infection of the cornea by an unidentified nematode. These findings may represent a previously unrecognized zoonotic infection from wildlife sources and potentially a newly documented nematode requiring description. Future clinical findings regarding this newly described nematode are needed to further develop our understanding of the disease.

Late recurrent urothelial carcinoma in the Studer neobladder: conversion to continent reservoir

PubMed Central

Kotb, AF; Alkosiry, M; AbdElkawy, N; Atta, MA

2012-01-01

Bladder cancer represents a considerable issue in Egypt and the Middle East. Radical cystectomy and orthotopic neobladder represent the standard of care for managing cases with invasive bladder tumour. There are few cases reported in the literature considering the urothelial recurrence in the urethra, connected to neobladder. We are presenting a rare case of a young female patient, with an aggressive urothelial tumour, recurring 13-year post-radical cystectomy, and the Studer neobladder. Our case was managed by urethrectomy and conversion of the neobladder into continent reservoir, with good short-term oncological and functional outcomes. We can conclude that bladder cancer cases should be followed thoroughly throughout their life. Follow-up urethroscopy and cytology should be done for all cases of post-radical cystectomy, regardless of patients’ symptoms. Key message Late urothelial recurrence of post-radical cystectomy is possible and, in our case, happened 13 years following surgery. The Studer neobladder can be safely converted into continent reservoir, allowing good functional outcomes. Also, recurrence in the Studer neobladder can be safely managed, allowing good oncological outcomes, without the need for any ureteroileal interventions. PMID:22973413

Malaria in rural Mozambique. Part I: Children attending the outpatient clinic

PubMed Central

Guinovart, Caterina; Bassat, Quique; Sigaúque, Betuel; Aide, Pedro; Sacarlal, Jahit; Nhampossa, Tacilta; Bardají, Azucena; Nhacolo, Ariel; Macete, Eusébio; Mandomando, Inácio; Aponte, John J; Menéndez, Clara; Alonso, Pedro L

2008-01-01

Background Malaria represents a huge burden for the health care services across Africa. Describing malaria attending health services contributes to quantify the burden and describe the epidemiology and clinical presentation. Methods Retrospective analysis of data collected through the Manhiça morbidity surveillance system (Mozambique) on all paediatric visits (<15 years) to the outpatient clinic from June 2003 to May 2005. Age-specific minimum community-based incidence rates (MCBIRs) of malaria were calculated using demographic surveillance system data. Malaria was defined as fever or history of fever in the preceding 24 hours with asexual Plasmodium falciparum parasitaemia of any density in the blood smear. Results A total of 94,941 outpatient visits were seen during the study period, of which 30.5% had malaria. Children younger than three years accounted for almost half of the total malaria cases and children aged ≥ 5 years represented 36.4% of the cases. Among children who presented with malaria, 56.7% had fever and among children who presented with fever or a history of fever only 37.2% had malaria. The geometric mean parasitaemia in malaria cases was 8582.2 parasites/μL, peaking in children aged two to three years. 13% of malaria cases had a PCV<25% and the mean PCV in malaria cases increased gradually with age, ranging from 27.8% in children aged 2–12 months to 34.4% in ≥ 5 years. The percentage of cases admitted or transferred showed a clear decreasing trend with age. MCBIRs of outpatient malaria per 1,000 child years at risk for the whole study period were of 394 in infants, 630 in children aged 1 to <5 years and 237 in children aged five years or more. A clustering of the cases was observed, whereby most children never had malaria, some had a few episodes and very few had many episodes. Conclusion Preventive measures should be targeted at children younger than three years, as they carry the highest burden of malaria. Children aged 5–15 years represent around a third of the malaria cases and should also be included in control programmes. Concern should be raised about presumptive treatment of fever cases with artemisinin-combination therapies, as many children will, according to IMCI guidelines, receive treatment unnecessarily. PMID:18302770

Malaria in rural Mozambique. Part I: children attending the outpatient clinic.

PubMed

Guinovart, Caterina; Bassat, Quique; Sigaúque, Betuel; Aide, Pedro; Sacarlal, Jahit; Nhampossa, Tacilta; Bardají, Azucena; Nhacolo, Ariel; Macete, Eusébio; Mandomando, Inácio; Aponte, John J; Menéndez, Clara; Alonso, Pedro L

2008-02-26

Malaria represents a huge burden for the health care services across Africa. Describing malaria attending health services contributes to quantify the burden and describe the epidemiology and clinical presentation. Retrospective analysis of data collected through the Manhiça morbidity surveillance system (Mozambique) on all paediatric visits (<15 years) to the outpatient clinic from June 2003 to May 2005. Age-specific minimum community-based incidence rates (MCBIRs) of malaria were calculated using demographic surveillance system data. Malaria was defined as fever or history of fever in the preceding 24 hours with asexual Plasmodium falciparum parasitaemia of any density in the blood smear. A total of 94,941 outpatient visits were seen during the study period, of which 30.5% had malaria. Children younger than three years accounted for almost half of the total malaria cases and children aged > or = 5 years represented 36.4% of the cases. Among children who presented with malaria, 56.7% had fever and among children who presented with fever or a history of fever only 37.2% had malaria. The geometric mean parasitaemia in malaria cases was 8582.2 parasites/muL, peaking in children aged two to three years. 13% of malaria cases had a PCV<25% and the mean PCV in malaria cases increased gradually with age, ranging from 27.8% in children aged 2-12 months to 34.4% in > or = 5 years. The percentage of cases admitted or transferred showed a clear decreasing trend with age. MCBIRs of outpatient malaria per 1,000 child years at risk for the whole study period were of 394 in infants, 630 in children aged 1 to <5 years and 237 in children aged five years or more. A clustering of the cases was observed, whereby most children never had malaria, some had a few episodes and very few had many episodes. Preventive measures should be targeted at children younger than three years, as they carry the highest burden of malaria. Children aged 5-15 years represent around a third of the malaria cases and should also be included in control programmes. Concern should be raised about presumptive treatment of fever cases with artemisinin-combination therapies, as many children will, according to IMCI guidelines, receive treatment unnecessarily.

Recap and Program Plan Update

DOT National Transportation Integrated Search

2015-03-12

Initial Workshop-I held on September 18, 2014 at the Volpe Center - Overview of DOT GPS Adjacent Band Compatibility Assessment Plan and plans/timeline for implementation - Presentation on GPS use cases and list of representative GPS receivers - Descr...

Several unusual cases of child abuse.

PubMed

Palmer, H; Weston, J T

1976-10-01

All childhood deaths which occurred in New Mexico during 1974 and 1975 were reviewed. Nine fatal instances of abuse were identified representing the entire spectrum of physical abuse: neglect, abuse in a single episode of injury, repetitive abuse, or sexual abuse. Several cases are summarized. These are unusual either in the distribution of pathologic findings or in the problems encountered in court presentation.

A Case Study Showing How One Young Child Represented Issues Concerned with Attachment and Separation in Her Spontaneous Explorations

ERIC Educational Resources Information Center

Arnold, Cath

2009-01-01

This paper presents a case study of a young child, demonstrating evidence of a connection between "enveloping" objects and understanding presence and absence of a temporary and permanent nature. The starting point for the researcher was: an interest in identifying schemas or repeated patterns in order to understand cognitive development and; a…

Use of autologous fat grafting for the correction of burn scar contracture in the hand: a case report

PubMed Central

Al-Hayder, Shems; Gramkow, Christina; Trojahn Kølle, Stig-Frederik

2017-01-01

Abstract Severe burn injuries to the hand represent a topic of great concern due to long-term complications such as hypertrofic burn scar and contracture, which may result in loss of function. We present a case of burn scar contracture in the hand of a child undergoing Z-plasty and lipofilling. PMID:28971111

Neighborhoods and Schools: Using Charter School Policy to Foster District Change

ERIC Educational Resources Information Center

Allen, Ann

2010-01-01

This article presents the case of community leaders who used the charter school policy as a way to effect district change for the benefit of a neighborhood in need. The case represents the potential of charter school policy to reshape the political and institutional arrangements of urban school districts, and it reengages the idea of what makes…

Innovation and Consolidation in Curriculum Development and Reform: The Case of the New Social Studies

ERIC Educational Resources Information Center

Parry, Lindsay

2007-01-01

The New Social Studies movement of the 1960s and 1970s represents a significant era of curriculum development and reform in the United States, which had international implications. This article presents an Australian case study of the experiences of curriculum workers involved in the development of an elementary social studies curriculum in the…

Growing into the Role: Empowerment of a Music Educator through Application of a Symbolic Interaction Theory

ERIC Educational Resources Information Center

Cox, Patricia J.

2004-01-01

This article presents aspects of professional development, using a narrative case-history approach. It represents the author's own case as an illustration of the kind of integrative experience that may occur as women assume professional careers. In this article, the author weaves the scholarly and theoretical components into the reality of a lived…

Muscle dysmorphia symptomatology during a period of religious fasting: a case report.

PubMed

Murray, Stuart B; Rieger, Elizabeth; Touyz, Stephen W

2011-01-01

We present a case of muscle dysmorphia in a Muslim male, whose muscle dysmorphia symptomatology markedly escalated during a period of religious fasting, in which abstinence from food and liquid during daylight hours was endorsed. This case represents the first attempt to delineate the relative centrality of eating versus exercise practices in muscle dysmorphia presentations, and suggests that the maintenance of muscle dysmorphia is inclusive of a central eating component, irrespective of exercise status, lending support to the notion of conceptualising muscle dysmorphia within an eating disorder spectrum. Implications and further research are discussed. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.

Cranial Neuropathies and Neuromuscular Weakness: A Case of Mistaken Identity

PubMed Central

Adams, Daniel Z.; King, Andrew; Kaide, Colin

2017-01-01

We describe a case of wound botulism initially thought to represent Miller-Fisher variant Guillain-Barré syndrome (MFS). Botulism classically presents with the so-called “four D’s” (diplopia, dysarthria, dysphagia, dry mouth) with symmetric, descending weakness. MFS presents with a triad of limb-ataxia, areflexia, and ophthalmoplegia, with variable cranial nerve and extremity involvement. The distinction can be difficult but is important as early initiation of botulinum antitoxin is associated with improved patient outcomes in cases of botulism. Furthermore, it is important to recognize intravenous drug use as a risk factor in the development of botulism, especially given an increase in injection drug use. PMID:29849352

Cranial Neuropathies and Neuromuscular Weakness: A Case of Mistaken Identity.

PubMed

Adams, Daniel Z; King, Andrew; Kaide, Colin

2017-08-01

We describe a case of wound botulism initially thought to represent Miller-Fisher variant Guillain-Barré syndrome (MFS). Botulism classically presents with the so-called "four D's" (diplopia, dysarthria, dysphagia, dry mouth) with symmetric, descending weakness. MFS presents with a triad of limb-ataxia, areflexia, and ophthalmoplegia, with variable cranial nerve and extremity involvement. The distinction can be difficult but is important as early initiation of botulinum antitoxin is associated with improved patient outcomes in cases of botulism. Furthermore, it is important to recognize intravenous drug use as a risk factor in the development of botulism, especially given an increase in injection drug use.

Ovarian torsion in a three-year-old girl.

PubMed

Ochsner, Todd Justin; Roos, Joel A; Johnson, Andrew S; Henderson, Janet L

2010-05-01

Ovarian torsion is the fifth most encountered gynecological emergency requiring surgery. Representing only 2.7% of surgical emergencies, it is an entity that is worth being familiar with in the emergency department (ED). Untreated ovarian torsion may result in loss of ovarian function, tissue necrosis, and death from thromboembolism or sepsis. Presenting with vague symptoms and abdominal pain, diagnosing ovarian torsion can be difficult, especially in children. The objective of this article is to present a case of pediatric ovarian torsion and to review its epidemiology, diagnosis, and treatment. A 3-year-old girl presented to the ED with vomiting, fever, anorexia, and abdominal pain. Initially diagnosed with appendicitis by physical examination and computed tomography scan, this patient was taken to the operating room for surgical exploration. The patient was subsequently found to have ovarian torsion, which was treated appropriately. Although a rare phenomenon, this case serves to increase awareness of the clinical presentation of ovarian torsion in the pediatric patient. Abdominal pain in the female child represents a challenging differential diagnosis, for which a physician must consider ovarian torsion. Copyright (c) 2010. Published by Elsevier Inc.

Seclusions and Restraints: Selected Cases of Death and Abuse at Public and Private Schools and Treatment Centers. Testimony Before the Committee on Education and Labor, House of Representatives. GAO-09-719T

ERIC Educational Resources Information Center

Kutz, Gregory D.

2009-01-01

The Government Accountability Office (GAO) recently testified before the Committee on Education and Labor, House of Representatives, regarding allegations of death and abuse at residential programs for troubled teens. The document presents the statement of Gregory D. Kutz, Managing Director, Forensic Audits and Special Investigations. Recent…

Primary cutaneous adenosquamous carcinoma of the penis: the first characterization of HPV status in this rare and diagnostically challenging entity with review of glandular carcinomas of the penis.

PubMed

Rush, P S; Shiau, J M; Hibler, B P; Longley, B J; Downs, T M; Bennett, D D

2016-12-01

Glandular and pseudoglandular tumors of the penile skin are extremely uncommon and can present diagnostic challenges. Primary adenosquamous carcinoma of the penis is an extremely rare tumor, composed of distinct areas of malignant squamous and glandular cells, making it a diagnostically challenging entity. The World Health Organization (WHO) recognizes several subtypes of squamous cell carcinoma (SCC), each with its own distinctive pathologic appearance, clinical associations and prognosis. Among these variants is the exceedingly uncommon adenosquamous carcinoma (ASC), representing 1%-2% of all SCC of the penis. Recent large studies have interrogated the presence of human papillomavirus (HPV) in malignant penile tumors and have shown specific morphologic patterns and clinical presentations to associate with HPV status. However, given the rarity of the adenosquamous variant of SCC, it has largely been excluded from these studies. The glandular components of these lesions can present a confusing appearance, particularly when a large tumor is represented on a small biopsy. Here we describe a difficult histologic presentation of this rare tumor, with the first published characterization of the HPV status of this subtype. This case represents a distinctly unusual case of metastatic HPV-positive primary cutaneous adenosquamous carcinoma of the penis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Painful tic convulsif: Case series and literature review].

PubMed

Revuelta-Gutiérrez, Rogelio; Velasco-Torres, Héctor Sebastián; Vales Hidalgo, Lourdes Olivia; Martínez-Anda, Jaime Jesús

The coexistence of hemifacial spasm and trigeminal neuralgia, a clinical entity known as painful tic convulsive, was first described in 1910. It is an uncommon condition that is worthy of interest in neurosurgical practice, because of its common pathophysiology mechanism: Neuro-vascular compression in most of the cases. To present 2 cases of painful tic convulsive that received treatment at our institution, and to give a brief review of the existing literature related to this. The benefits of micro-surgical decompression and the most common medical therapy used (botulin toxin) are also presented. Two cases of typical painful tic convulsive are described, showing representative slices of magnetic resonance imaging corresponding to the aetiology of each case, as well as a description of the surgical technique employed in our institution. The immediate relief of symptomatology, and the clinical condition at one-year follow-up in each case is described. A brief review of the literature on this condition is presented. This very rare neurological entity represents less than 1% of rhizopathies and in a large proportion of cases it is caused by vascular compression, attributed to an aberrant dolichoectatic course of the vertebro-basilar complex. The standard modality of treatment is micro-vascular surgical decompression, which has shown greater effectiveness and control of symptoms in the long-term. However medical treatment, which includes percutaneous infiltration of botulinum toxin, has produced similar results at medium-term in the control of each individual clinical manifestation, but it must be considered as an alternative in the choice of treatment. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Repetitive Breech Presentations at Term

PubMed Central

Zigo, Imrich; Sivakova, Jana; Moricova, Petra; Kapustova, Ivana; Krivus, Stefan; Danko, Jan

2013-01-01

The authors present a case of 38-year-old laboring woman with four-time repetitive breech presentation of the fetus at term. This rare condition affects the mode of delivery and represents serious obstetrical problem as it is associated with increased perinatal morbidity or mortality. The authors give details on risk factors for breech presentation, its diagnosis, and the discussion points on possible causes leading to repetitive breeches in laboring women. PMID:23984133

Reasoning with case histories of process knowledge for efficient process development

NASA Technical Reports Server (NTRS)

Bharwani, Seraj S.; Walls, Joe T.; Jackson, Michael E.

1988-01-01

The significance of compiling case histories of empirical process knowledge and the role of such histories in improving the efficiency of manufacturing process development is discussed in this paper. Methods of representing important investigations as cases and using the information from such cases to eliminate redundancy of empirical investigations in analogous process development situations are also discussed. A system is proposed that uses such methods to capture the problem-solving framework of the application domain. A conceptual design of the system is presented and discussed.

Summary of SPT based field case history data of CETIN (2016) database

USGS Publications Warehouse

Onder Cetin, K.; Seed, Raymond B.; Kayen, Robert E.; Moss, Robb E. S.; Bilge, H. Tolga; Ilgac, Makbule; Chowdhury, Khaled

2016-01-01

This report provides documentation of the Cetin et al. (2016) field performance case histories, probabilistic maximum likelihood assessment and the sources of differences between the liquefaction triggering resistance estimations (CRR values) of the widely used liquefaction triggering relationships of Seed et al. (1985), Cetin et al. (2004, 2016) and Boulanger and Idriss (2012). Cetin et al. (2016-a) presented a concise summary of the improved database and the updated triggering relationships. For the sake of completeness, as part of Chapter 2 of this report, Cetin et al. (2016-a) manuscript is re-presented, as edited to include the electronic supplements, and a broader and more detailed documentation of all of case histories. This broader and more detailed documentation along with the interpretations of other researchers is presented in Appendix A. Similarly, site response analyses details and results from Cetin (2000) is re-presented in Appendix B. To enable the readers to quickly refer to Cetin and Seed (2004), it is also included in Appendix C. The sources of differences between the liquefaction triggering resistance estimations (CRR values) of the widely used liquefaction triggering relationships of Seed et al. (1985), Cetin et al. (2004) and Boulanger and Idriss (2012) were discussed in Cetin et al. (2016-b). Again, for the sake of completeness, as part of Chapter 3 of this report, Cetin et al. (2016-b) manuscript is re-presented, as edited to the include of electronic supplements, and a detailed response to issues addressed by Idriss and Boulanger (2012). Also, the technical response letter (Cetin, 2014) prepared at the request of the members of the NRC Committee on the State of the Art and Practice in Earthquake Induced Soil Liquefaction Assessment, is given in Appendix D, which is helpful to follow the technical discussions. This report is intended only as a concise summary of a vast amount of data. The interpretations presented are those of the research team. A more detailed description of some of the details of the methods and procedures used to evaluate and analyze these field performance case histories is also presented in Cetin (2000) and Cetin et al. (2000) though the final evaluations presented in this report are the most recent interpretations undertaken under these current studies.

An Exceptional Case of Suture Granuloma 30 Years Following an Open Repair of Achilles Tendon Rupture: A Case Report.

PubMed

Ergin, Ömer Naci; Demirel, Mehmet; Özmen, Emre

2017-01-01

Rupture of the Achilles' tendon is a common injury occurring particularly in middle-aged men due to sports trauma. Operative treatment is preferred generally due to lower risk of re-rupture. Possible complications of the operation include suture granulomas. Suture granulomas might represent a foreign body reaction, which itself is the end-stage response of the inflammatory wound-healing process to biomaterials. It may occur with both absorbable and non-absorbable suture materials such as silk in our case. The aim of this study is to present a case of a delayed foreign body reaction 30 years after open repair of the Achilles tendon with silk sutures. Our case is a 38-year-old male who presented to our outpatient clinic with complaints of swelling and pain around the posterior region of the ankle for the past 3 months. He had a history of open Achilles tendon repair at the age of 3 at the site of complaints. Physical examination was positive for a mass under the incision scar. Magnetic resonance imaging report was positive for a granulomatosis formation. The patient was booked for an operation to remove the mass. Suture granuloma represents a tissue reaction against the suture material. Orthopedic literature is sparse for such cases and case reports. Both because of its rarity in orthopedic literature and the amount of time between the surgery and reaction, our report is a valuable addition to the literature.

HGNET-BCOR Tumors of the Cerebellum: Clinicopathologic and Molecular Characterization of 3 Cases.

PubMed

Appay, Romain; Macagno, Nicolas; Padovani, Laetitia; Korshunov, Andrey; Kool, Marcel; André, Nicolas; Scavarda, Didier; Pietsch, Torsten; Figarella-Branger, Dominique

2017-09-01

The central nervous system (CNS) high-grade neuroepithelial tumor with BCOR alteration (CNS HGNET-BCOR) is a recently described molecular entity. We report 3 new CNS HGNET-BCOR cases sharing common clinical presentation and pathologic features. The 3 cases concerned children aged 3 to 7 years who presented with a voluminous mass of the cerebellum. Pathologic features included proliferation of uniform spindle to ovoid cells with fine chromatin associated with a rich arborizing capillary network. Methylation profiling classified these cases as CNS HGNET-BCOR tumors. Polymerase chain reaction analysis confirmed the presence of internal tandem duplications in the C-terminus of BCOR (BCOR-ITD), a characteristic of these tumors, in all 3 cases. Immunohistochemistry showed a strong nuclear BCOR expression. In 2 cases, local recurrence occurred within 6 months. The third case, a patient who received a craniospinal irradiation after total surgical removal followed by a metronomics maintenance with irinotecan, temozolomide, and itraconazole, is still free of disease 14 months after diagnosis. In summary, CNS HGNET-BCOR represents a rare tumor occurring in young patients with dismal prognosis. BCOR nuclear immunoreactivity is highly suggestive of a BCOR-ITD. Whether CNS HGNET-BCOR should be classified among the category of "embryonal tumors" or within the category of "mesenchymal, nonmeningothelial tumors" remains to be clarified. Because CNS HGNET-BCOR share pathologic features and characteristic BCOR-ITD with clear cell sarcoma of the kidney, these tumors may represent local variants of the same entity.

Laryngeal actinomycosis in an immunocompromised patient.

PubMed

Patel, Sheylan; Jaworek, Aaron J; Patel, Vatsal; Duckworth, Lizette Vila; Sawhney, Raja; Chheda, Neil N

2014-11-01

Actinomycosis of the larynx represents an unusual presentation for a common bacterium comprising the oral and oropharyngeal florae. There are few cases reported in the literature of laryngeal actinomycosis occurring primarily in the immunocompromised population. Here, we present a case in a 74-year-old man that occurred in the setting of neutropenia as a result of chemotherapy. Once the diagnosis was made with biopsy of the larynx, the infection was resolved after a prolonged course of penicillin-based therapy. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Infiltrating Ductal Carcinoma Co-Existing with Intraductal Papillary Carcinoma of Male Breast: A Rare Case Report.

PubMed

Kumar, Mayank; Pottipati, Bhaswanth; Arakeri, Surekha U; Javalgi, Anita P

2017-06-01

Male breast carcinomas are rare tumours, accounting for less than 1% of all malignancies in men. Intracystic Papillary Carcinoma (IPC) in males is a very rare entity, representing 5-7.5% of all male breast carcinomas. It lacks the classical clinical, radiological and cytological features of malignancy and usually presents as a benign-appearing lump. We report a case of Infiltrating Ductal Carcinoma (IDC) co-existing with intracystic papillary carcinoma in a 53-year-old male who presented with lump in the right breast.

Infiltrating Ductal Carcinoma Co-Existing with Intraductal Papillary Carcinoma of Male Breast: A Rare Case Report

PubMed Central

Pottipati, Bhaswanth; Arakeri, Surekha U.; Javalgi, Anita P.

2017-01-01

Male breast carcinomas are rare tumours, accounting for less than 1% of all malignancies in men. Intracystic Papillary Carcinoma (IPC) in males is a very rare entity, representing 5-7.5% of all male breast carcinomas. It lacks the classical clinical, radiological and cytological features of malignancy and usually presents as a benign-appearing lump. We report a case of Infiltrating Ductal Carcinoma (IDC) co-existing with intracystic papillary carcinoma in a 53-year-old male who presented with lump in the right breast. PMID:28764176

Focusing on Presentation Instead of Representation: Perspectives on Representational and Non-Representational Language-Games for Educational History and Theory

ERIC Educational Resources Information Center

Fendler, Lynn; Smeyers, Paul

2015-01-01

Debates in science seem to depend on referential language-games, but in other senses they do not. This article addresses non-representational theory. It is a branch of newer approaches to cultural geography that strive to get a handle on spatial relationships not by representing them, but rather by presenting them. In this case, present connotes…

Merged MMCR-WSR88D Reflectivities at SGP

DOE Data Explorer

Dong, Xiquan

2008-03-05

There are substantial attenuations of MMCR signals for very large LWP and during precipitation events. We have used the nearest precipitation radar (WSR-88D) to merge two measurements to better represent such selected cases. In the near future, we are going to provide all the cumulus cases from Jan. 1997 to present whenever the two datasets are available. The original 2 data sets:

Symptomatic Falciparum Malaria After Living in a Nonendemic Area for 10 Years: Recrudescence or Indigenous Transmission?

PubMed

Salas-Coronas, Joaquín; Soriano-Pérez, Manuel Jesús; Lozano-Serrano, Ana B; Pérez-Moyano, Rosario; Porrino-Herrera, Carmen; Cabezas-Fernández, María Teresa

2017-06-01

AbstractWe report the case of a patient from Mali who, after 10 years of living in Spain, presented with symptomatic Plasmodium falciparum malaria without having visited an endemic area during that time. We cannot completely rule out the possibility of indigenous transmission, but this case most likely represents recrudescence of an infection acquired over 10 years earlier.

A system for aerodynamic design and analysis of supersonic aircraft. Part 4: Test cases

NASA Technical Reports Server (NTRS)

Middleton, W. D.; Lundry, J. L.

1980-01-01

An integrated system of computer programs was developed for the design and analysis of supersonic configurations. The system uses linearized theory methods for the calculation of surface pressures and supersonic area rule concepts in combination with linearized theory for calculation of aerodynamic force coefficients. Interactive graphics are optional at the user's request. Representative test cases and associated program output are presented.

Emerging Cases of Powassan Virus Encephalitis in New England: Clinical Presentation, Imaging, and Review of the Literature.

PubMed

Piantadosi, Anne; Rubin, Daniel B; McQuillen, Daniel P; Hsu, Liangge; Lederer, Philip A; Ashbaugh, Cameron D; Duffalo, Chad; Duncan, Robert; Thon, Jesse; Bhattacharyya, Shamik; Basgoz, Nesli; Feske, Steven K; Lyons, Jennifer L

2016-03-15

Powassan virus (POWV) is a rarely diagnosed cause of encephalitis in the United States. In the Northeast, it is transmitted by Ixodes scapularis, the same vector that transmits Lyme disease. The prevalence of POWV among animal hosts and vectors has been increasing. We present 8 cases of POWV encephalitis from Massachusetts and New Hampshire in 2013-2015. We abstracted clinical and epidemiological information for patients with POWV encephalitis diagnosed at 2 hospitals in Massachusetts from 2013 to 2015. We compared their brain imaging with those in published findings from Powassan and other viral encephalitides. The patients ranged in age from 21 to 82 years, were, for the most part, previously healthy, and presented with syndromes of fever, headache, and altered consciousness. Infections occurred from May to September and were often associated with known tick exposures. In all patients, cerebrospinal fluid analyses showed pleocytosis with elevated protein. In 7 of 8 patients, brain magnetic resonance imaging demonstrated deep foci of increased T2/fluid-attenuation inversion recovery signal intensity. We describe 8 cases of POWV encephalitis in Massachusetts and New Hampshire in 2013-2015. Prior to this, there had been only 2 cases of POWV encephalitis identified in Massachusetts. These cases may represent emergence of this virus in a region where its vector, I. scapularis, is known to be prevalent or may represent the emerging diagnosis of an underappreciated pathogen. We recommend testing for POWV in patients who present with encephalitis in the spring to fall in New England. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Transport Test Problems for Hybrid Methods Development

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

Shaver, Mark W.; Miller, Erin A.; Wittman, Richard S.

2011-12-28

This report presents 9 test problems to guide testing and development of hybrid calculations for the ADVANTG code at ORNL. These test cases can be used for comparing different types of radiation transport calculations, as well as for guiding the development of variance reduction methods. Cases are drawn primarily from existing or previous calculations with a preference for cases which include experimental data, or otherwise have results with a high level of confidence, are non-sensitive, and represent problem sets of interest to NA-22.

Successful conservative management of symptomatic bilateral dorsal patellar defects presenting with cartilage involvement and bone marrow edema: MRI findings.

PubMed

Kwee, Thomas C; Sonneveld, Heleen; Nix, Maarten

2016-05-01

The dorsal patellar defect is a relatively rare entity that involves the superolateral quadrant of the patella. It is usually considered to represent a delayed ossification process, although its exact origin remains unclear. Because of its usually innocuous nature and clinical course, invasive interventions are generally deemed unnecessary, although curretage has been successfully performed on symptomatic cases. This case report presents a rather unusual case of symptomatic bilateral dorsal patellar defects with cartilage involvement and widespread surrounding bone marrow edema as demonstrated by magnetic resonance imaging (MRI). Both cartilage involvement and bone marrow edema should be considered part of the spectrum of associated MRI findings that can be encountered in this entity. Furthermore, the presented case shows that symptomatic dorsal patellar defects can be treated conservatively with success and that (decrease of) pain symptoms are likely related to (decrease of) bone marrow edema.

Paraneoplastic scleroderma-like tissue reactions in the setting of an underlying plasma cell dyscrasia: a report of 10 cases.

PubMed

Magro, Cynthia M; Iwenofu, Hans; Nuovo, Gerard J

2013-07-01

Systemic plasma cell dyscrasias have diverse manifestations in the skin and include an inflammatory paraneoplastic process. We encountered cases of scleroderma and eosinophilic fasciitis in the setting of an underlying plasma cell dyscrasia. Ten cases of scleroderma-like tissue reactions in the setting of an underlying plasma cell dyscrasia were encountered. The biopsies were stained for Transforming growth factor (Transforming growth factor) beta, IgG4, kappa, and lambda. Patients presented with a sclerodermoid reaction represented by eosinophilic fasciitis (5 cases), morphea (3 cases), and systemic scleroderma (2 cases). The mean age of presentation was 70 years with a striking female predominance (4:1). Acral accentuation was noted in 8 cases. In 6 of the cases, the cutaneous sclerosis antedated (4 cases) by weeks to 2 years or occurred concurrently (2 cases) with the initial diagnosis of the plasma cell. The biopsies showed changes typical of eosinophilic fasciitis and/or scleroderma. In 5 cases, light chain-restricted plasma cells were present on the biopsy. There was staining of the plasma cells for Transforming growth factor beta in 3 out of 5 cases tested. In any older patient presenting with a sudden onset of eosinophilic fasciitis or scleroderma especially with acral accentuation, investigations should be conducted in regards to an underlying plasma cell dyscrasia.

Recap, One-on-One Discussions, and Moving Forward

DOT National Transportation Integrated Search

2014-12-04

Recap. Initial WorkshopI held on September 18, 2014 at the Volpe Center. Overview of DOT GPS Adjacent Band Compatibility Assessment Plan and plans/timeline for implementation. Presentation on GPS use cases and list of representative GPS receivers....

Gallbladder adenoma with focal adenocarcinoma.

PubMed

Ciurea, S; Matei, E; Petrisor, P; Luca, L; Boros, Mirela; Herlea, V; Popescu, I

2008-01-01

The majority of polypoid lesions of the gallbladder are cholesterolosis pseudopolyps. True neoplastic GB polyps are represented mainly by adenomas. The case of a 52-year old male patient with an adenomatous polyp of the GB with focal adenocarcinoma is presented.

COMPREHENSIVE STANDARDS: THE POWER GENERATION CASE

EPA Science Inventory

This study presents an illustrative data base of material quantities and environmental effluents in the fuel cycles for alternative technologies of thermally generated power. The entire fuel cycle for each of the alternative ten technologies is outlined for a representative power...

A Case Study of Representing Signal Transduction in Liver Cells as a Feedback Control Problem

ERIC Educational Resources Information Center

Singh, Abhay; Jayaraman, Arul; Hahn, Juergen

2007-01-01

Cell signaling pathways often contain feedback loops where proteins are produced that regulate signaling. While feedback regulatory mechanisms are commonly found in signaling pathways, there is no example available in the literature that is simple enough to be presented in an undergraduate control class. This paper presents a simulation study of…

Researching Disturbed, Disturbing Art: Using Typography to Re/Present Educational Research

ERIC Educational Resources Information Center

Loveless, Douglas J.; Bhattacharya, Kakali; Griffith, Bryant

2012-01-01

This paper argues that typography can be an affective re/presentational strategy when used as a medium within the research framework of arts-based inquiry. Grounded in a larger comparative case study exploring the experiences of two elementary teachers in south Texas, the purpose of this paper is to (1) situate typography within the field of…

Integrated computer-aided forensic case analysis, presentation, and documentation based on multimodal 3D data.

PubMed

Bornik, Alexander; Urschler, Martin; Schmalstieg, Dieter; Bischof, Horst; Krauskopf, Astrid; Schwark, Thorsten; Scheurer, Eva; Yen, Kathrin

2018-06-01

Three-dimensional (3D) crime scene documentation using 3D scanners and medical imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) are increasingly applied in forensic casework. Together with digital photography, these modalities enable comprehensive and non-invasive recording of forensically relevant information regarding injuries/pathologies inside the body and on its surface. Furthermore, it is possible to capture traces and items at crime scenes. Such digitally secured evidence has the potential to similarly increase case understanding by forensic experts and non-experts in court. Unlike photographs and 3D surface models, images from CT and MRI are not self-explanatory. Their interpretation and understanding requires radiological knowledge. Findings in tomography data must not only be revealed, but should also be jointly studied with all the 2D and 3D data available in order to clarify spatial interrelations and to optimally exploit the data at hand. This is technically challenging due to the heterogeneous data representations including volumetric data, polygonal 3D models, and images. This paper presents a novel computer-aided forensic toolbox providing tools to support the analysis, documentation, annotation, and illustration of forensic cases using heterogeneous digital data. Conjoint visualization of data from different modalities in their native form and efficient tools to visually extract and emphasize findings help experts to reveal unrecognized correlations and thereby enhance their case understanding. Moreover, the 3D case illustrations created for case analysis represent an efficient means to convey the insights gained from case analysis to forensic non-experts involved in court proceedings like jurists and laymen. The capability of the presented approach in the context of case analysis, its potential to speed up legal procedures and to ultimately enhance legal certainty is demonstrated by introducing a number of representative forensic cases. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

A Method to Represent Heterogeneous Materials for Rapid Prototyping: The Matryoshka Approach.

PubMed

Lei, Shuangyan; Frank, Matthew C; Anderson, Donald D; Brown, Thomas D

The purpose of this paper is to present a new method for representing heterogeneous materials using nested STL shells, based, in particular, on the density distributions of human bones. Nested STL shells, called Matryoshka models, are described, based on their namesake Russian nesting dolls. In this approach, polygonal models, such as STL shells, are "stacked" inside one another to represent different material regions. The Matryoshka model addresses the challenge of representing different densities and different types of bone when reverse engineering from medical images. The Matryoshka model is generated via an iterative process of thresholding the Hounsfield Unit (HU) data using computed tomography (CT), thereby delineating regions of progressively increasing bone density. These nested shells can represent regions starting with the medullary (bone marrow) canal, up through and including the outer surface of the bone. The Matryoshka approach introduced can be used to generate accurate models of heterogeneous materials in an automated fashion, avoiding the challenge of hand-creating an assembly model for input to multi-material additive or subtractive manufacturing. This paper presents a new method for describing heterogeneous materials: in this case, the density distribution in a human bone. The authors show how the Matryoshka model can be used to plan harvesting locations for creating custom rapid allograft bone implants from donor bone. An implementation of a proposed harvesting method is demonstrated, followed by a case study using subtractive rapid prototyping to harvest a bone implant from a human tibia surrogate.

Lapatinib-induced acute generalized exanthematous pustulosis

PubMed Central

Lakshmi, Chembolli; Pillai, Suma; Srinivas, C. R.

2010-01-01

Acute generalized exanthematous pustulosis (AGEP) is a pustular eruption, mainly drug induced often accompanied by fever and neutrophilic leukocytosis presenting as scarlatiniform erythema over the flexures evolving into numerous tiny non follicular pustules. We present a case report of a 56-year old woman, who had undergone mastectomy, treated with lapatinib for metastatic disease, and who presented with multiple erythematous papules and plaques with peripheral pustules. She also developed painful pyogenic granuloma-like lesions over the pulp of toe and over the proximal nail folds.All the lesions subsided following withdrawal of lapatinib. Although AGEP has been reported with imatinib (a multikinase inhibitor), there have been no reports of serious reactions with lapatinib, an EGFR inhibitor. This case could represent the first case report of AGEP to the EGFR inhibitor, lapatinib. PMID:23130185

Small-intestine pneumocystis jiroveci pseudotumor as an acquired immunodeficiency syndrome-presenting illness: report of a case and review of the literature.

PubMed

Zhou, Yi; Shetty, Jayarama; Pins, Michael R

2012-09-01

A Pneumocystis jiroveci infection-associated mass clinically mimicking a malignancy (ie, pseudotumor) is rare and usually occurs in the lung in association with Pneumocystis pneumonia. Pneumocystis jiroveci pseudotumors of the small intestine are extremely rare and represent an unusual form of disseminated P jiroveci infection. We present a case of small-intestine P jiroveci pseudotumor as an acquired immunodeficiency syndrome-presenting illness in a patient with coinfection with cytomegalovirus, no pulmonary symptoms, and no known risk factors for human immunodeficiency virus infection. This case reinforces the potential importance of cytomegalovirus coinfection in the disseminated form of Pneumocystis infection and illustrates the importance of an expanded differential diagnosis when confronted with a clinically atypical mass lesion.

A case of postmenopausal androgen excess.

PubMed

Lambrinoudaki, Irene; Dafnios, Nikos; Kondi-Pafiti, Agathi; Triantafyllou, Nikos; Karopoulou, Evangelia; Papageorgiou, Anastasia; Augoulea, Areti; Armeni, Eleni; Creatsa, Maria; Vlahos, Nikolaos

2015-10-01

Ovarian steroid cell tumors are very rare but potentially life-threatening neoplasms. They represent less than 0.1% of all ovarian tumors, typically present in premenopausal women and frequently manifest with virilization. Signs of hyperandrogenism may appear in postmenopausal women due to tumorοus and non-tumorοus adrenal and ovarian causes as well due to the normal aging process. In any case, steroid cell tumor should be suspected in postmenopausal women who present with rapid progressive androgen excess symptoms. This report describes a case of a 67-year-old postmenopausal woman with signs of hyperandrogenism, where an ovarian steroid cell tumor was diagnosed and treated by laparoscopic bilateral salpingo-oophorectomy and synchronous hysterectomy.

Intestinal obstruction caused by omphalomesenteric duct remnant: usefulness of laparoscopy.

PubMed

Bueno Lledó, J; Serralta Serra, A; Planeéis Roig, M; Dobón Giménez, F; Ibáñez Palacín, F; Rodero Rodero, R

2003-10-01

The anomalies related to omphalomesenteric duct remnant constitute an uncommon cause of intestinal obstruction, of which Meckel"s diverticulum and its variants represent the most important clinical presentation. In most cases they are asymptomatic and usually affect young patients. When symptomatic, they usually present episodes of gastrointestinal bleeding or acute abdomen syndromes caused by strangulation of intestinal loops as a result of fibrous intraabdominal remnants or inflammation produced by the diverticulum. In most cases, the unexpected presence of these alterations makes intraoperative diagnosis necessary. Treatment is surgical and consists in exeresis of the diverticulum or the fibrous band causing the clinical picture. We report two cases of persistence of the vitelline duct resolved by laparoscopic approach.

Primary renal angiosarcoma with progressive clinical course despite surgical and adjuvant treatment: A case report

PubMed Central

CELEBI, FILIZ; PILANCI, KEZBAN NUR; SAGLAM, SEZER; BALCI, NUMAN CEM

2015-01-01

Angiosarcoma is an extremely rare, high-grade malignancy, which accounts for <2% of all soft-tissue sarcomas. Cases of primary renal angiosarcoma represent 1% of these. Angiosarcomas involving the kidney usually originate from metastatic skin lesions or primary visceral lesions and most often occur in the sixth and seventh decades of life. The present study describes a case of primary renal angiosarcoma that presented as a large right-sided renal mass with symptoms of flank pain. Despite surgical removal of the tumor, recurrent disease with associated lung metastases was identified at the surgical site following adjuvant chemotherapy. The patient succumbed to the disease 13 months after the diagnosis. PMID:25789072

Fatal Liver Cyst Rupture Due to Anabolic Steroid Use: A Case Presentation.

PubMed

Hansma, Patrick; Diaz, Francisco J; Njiwaji, Chantel

2016-03-01

Liver cysts are commonly found incidentally from imaging scans or at autopsy. These benign neoplasms vary in size and represent a heterogeneous group of disorders, for which the demographics, risk factors, apparent inciting event, clinical presentation, and outcome are varied. Complications that can develop from a liver cyst include development of spontaneous hemorrhage, infection, and/or obstruction. Although the etiology of liver cysts varies, fatal rupture of a hemorrhagic liver cyst due to anabolic steroid use is a rare occurrence. In fact, there are few reported cases in journal literature. We report a case of a fatal liver cyst rupture with resultant hemoperitoneum in the presence of anabolic steroid (stanozolol) use.

Characterizing the HIV epidemic in the prairie provinces

PubMed Central

Becker, Marissa L; Kasper, Ken; Pindera, Carla; Cheang, Mary; Rodger, Debbie; Sanche, Stephen; Skinner, Stuart; Gill, M John

2012-01-01

BACKGROUND: The numbers and demographics of HIV-positive patients in care between 2003 and 2007 in the prairie provinces were examined. METHODS: Estimates of HIV-positive patients presenting to care between 2003 and 2007 were obtained from four clinic registries in Manitoba, Saskatchewan and southern Alberta. Detailed data were collected from clinical records of new patients in 2007. RESULTS: By the end of December 2007, 2263 HIV-positive persons were in care in Manitoba, Saskatchewan and southern Alberta. Males and females accounted for 1674 (74.0%) and 589 of the cases, respectively. Overall, there was a 12% increase per year in new HIV cases to care between 2003 and 2007 (P=0.026), with the rate of increase for males being 60% higher than for females over this time period (P=0.002). In 2007, there were 222 new HIV cases to care (37.4% female). Heterosexual contact was the most common HIV risk, but diversity was seen across sites with frequent injection drug use and men who have sex with men risk in Saskatchewan and southern Alberta, respectively. The Aboriginal population remains heavily over-represented, with approximately 36.0% of new cases being Aboriginal. Late presentation was common across all care sites, with 35.1% of cases presenting with CD4 counts of less than 200 cells/mm3. DISCUSSION: Heterosexual risk is the most common risk reported for HIV acquisition, but injection drug use risk remains significant in Saskatchewan. Aboriginals are over-represented at all sites, and in Saskatchewan accounted for the majority of new cases seen. In contrast to national trends, numbers of new and late diagnoses are increasing in the praire provinces, and this has significant treatment implications and potential public health consequences. Further efforts need to be made to facilitate earlier testing and linkage to care. PMID:23449046

The determination of the botanical origin in honeys with over-represented pollen: combination of melissopalynological, sensory and physicochemical analysis.

PubMed

Rodopoulou, Maria-Anna; Tananaki, Chrysoula; Dimou, Maria; Liolios, Vasilios; Kanelis, Dimitrios; Goras, Georgios; Thrasyvoulou, Andreas

2018-05-01

Pollen analysis of honey is the basic method for the determination of its botanical origin. However, the presence of over-represented pollen in honeys may lead the analysis to false results. This can be more severe if this pollen is present in unifloral under-represented honeys of commercial importance (e.g. thyme honey). In the present study, we investigated the abundance of over-represented pollen grains on several quality characteristics in honey samples. In particular, we mixed honeys characterised as over-represented, specifically chestnut and eucalyptus, with thyme honeys in different analogies, and we also analysed the melissopalynological, organoleptic, physicochemical (water content, electrical conductivity, colour) and volatile characteristics of the blends. The most sensitive parameters were the microscopic characteristics, followed by the organoleptic ones. Blends of thyme honey with an originally low percentage of thyme pollen were the most influenced and could not be characterised as unifloral regarding their melissopalynological characteristics, even when they were mixed with small quantities of honeys with over-represented pollen (i.e. 5%). The present study confirms that, in the case of presence of over-represented pollen in honeys, pollen analysis alone cannot give trustworthy results for the determination of the botanical origin, even though their exclusion during pollen analysis, when they are present in percentages of up to 30%, could provide more accurate results. Consequently, pollen analysis should also be combined with the other analyses, especially in honeys with under-represented and over-represented pollens, to give safer results for the botanical characterisation of honeys. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Atmospheric energetics as related to cyclogenesis over the eastern United States. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

West, P. W.

1973-01-01

A method is presented to investigate the atmospheric energy budget as related to cyclogenesis. Energy budget equations are developed that are shown to be advantageous because the individual terms represent basic physical processes which produce changes in atmospheric energy, and the equations provide a means to study the interaction of the cyclone with the larger scales of motion. The work presented represents an extension of previous studies because all of the terms of the energy budget equations were evaluated throughout the development period of the cyclone. Computations are carried out over a limited atmospheric volume which encompasses the cyclone, and boundary fluxes of energy that were ignored in most previous studies are evaluated. Two examples of cyclogenesis over the eastern United States were chosen for study. One of the cases (1-4 November, 1966) represented an example of vigorous development, while the development in the other case (5-8 December, 1969) was more modest. Objectively analyzed data were used in the evaluation of the energy budget terms in order to minimize computational errors, and an objective analysis scheme is described that insures that all of the resolution contained in the rawinsonde observations is incorporated in the analyses.

Lymphogranuloma venereum: a hidden emerging problem, Barcelona, 2011.

PubMed

Vargas-Leguas, H; Garcia de Olalla, P; Arando, M; Armengol, P; Barbera, Mj; Vall, M; Vives, A; Martin-Ezquerra, G; Alsina, M; Blanco, J; Munoz, C; Caballero, E; Andreu, A; Ros, M; Gorrindo, P; Dominguez, A; Cayla, Ja

2012-01-12

From the beginning of 2007 until the end of 2011, 146 cases of lymphogranuloma venereum (LGV) were notified to the Barcelona Public Health Agency. Some 49% of them were diagnosed and reported in 2011, mainly in men who have sex with men. Almost half of them, 32 cases, were reported between July and September. This cluster represents the largest since 2004. This article presents the ongoing outbreak of LGV in Barcelona.

Ecthyma gangrenosum mimicking acute invasive fungal sinusitis in an immunocompromised patient.

PubMed

Hekiert, Adrianna M; Cohen, Michael B; Montone, Kathleen T; Palmer, James N; Govindaraj, Satish

2010-06-01

Ecthyma gangrenosum is a rare necrotizing cutaneous infection usually caused by Pseudomonas aeruginosa. We report a case of ecthyma gangrenosum presenting as a sinonasal eschar and mimicking acute invasive fungal sinusitis in an immunocompromised 39-year-old man with a hematologic malignancy. To the best of our knowledge, this represents the first case of ecthyma gangrenosum affecting the sinonasal mucosa to be reported in the literature.

Familial dopa-responsive cervical dystonia.

PubMed

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

2006-02-28

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

Importation of dengue by soldiers returning from East Timor to north Queensland, Australia.

PubMed

Kitchener, Scott; Leggat, Peter A; Brennan, Leonard; McCall, Bradley

2002-01-01

Soldiers based in Townsville, Australia, returned from East Timor following peacekeeping operations during the wet season of 1999 to 2000. This represented the potential to import dengue virus into north Queensland, a dengue receptive area of Australia. This article seeks to outline the measures taken by the Australian Defence Force (ADF) to prevent local transmission and to present the outcomes. Soldiers returning to north Queensland were provided with education on dengue fever and in the fortnight before return, their living areas were subjected to intensive vector control measures, in order to reduce the risk of acquisition of dengue. They were further encouraged to present early with any febrile illness following their return to Townsville. Provisionally diagnosed dengue cases were notified to the state public health authorities immediately and cases were isolated until suitable vector control programs were implemented or the potentially viremic period exceeded. Serologic and virologic investigations were undertaken to identify the passage and probable serotype or confirm the presence and serotype of dengue virus. Nine serologically confirmed cases of dengue were identified as viremic in north Queensland. Six cases were identified as arising from dengue serotype 2, two were from serotype 3, and one case was ill defined. No dengue cases have been reported in the local population 4 months following these ADF cases. Local outbreaks of dengue fever have occurred in north Queensland following the importation of dengue virus in returned travelers. The successful prevention of local transmission in these circumstances was contributed to by early notification of cases and prevention of transmission through isolation of cases and collaboration between ADF and state and local public health authorities in vector control. The management of potentially viremic returning service personnel represents a future challenge for the ADF.

Understanding What It Means for Assurance Cases to "Work"

NASA Technical Reports Server (NTRS)

Rinehart, David J.; Knight, John C.; Rowanhill, Jonathan

2017-01-01

This report is the result of our year-long investigation into assurance case practices and effectiveness. Assurance cases are a method for working toward acceptable critical system performance. They represent a significant thread of applied assurance methods extending back many decades and being employed in a range of industries and applications. Our research presented in this report includes a literature survey of over 50 sources and interviews with nearly a dozen practitioners in the field. We have organized our results into seven major claimed assurance case benefits and their supporting mechanisms, evidence, counter-evidence, and caveats.

Fraudulent Credentials. Joint Hearing before the Subcommittee on Health and Long-Term Care and the Subcommittee on Housing and Consumer Interests of the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Aging.

Hearings on the promotion and purchase of fraudulent credentials are presented, along with the results of an inquiry conducted by a Subcommittee of the Select Committee on Aging of the House of Representatives. Cases of persons who obtained fraudulent credentials and/or illegally practiced a profession are described. Testimony from state licensing…

Outcome of single-trajectory rigid endoscopic third ventriculostomy and biopsy in the management algorithm of pineal region tumors: a case series and review of the literature.

PubMed

Abbassy, Mahmoud; Aref, Khaled; Farhoud, Ahmed; Hekal, Anwar

2018-05-28

Tumors within the pineal region represent 1.5 to 8.5% of the pediatric brain tumors and 1.2% of all brain tumors. A management algorithm has been proposed in several publications. The algorithm includes endoscopic third ventriculostomy (ETV) and biopsy in cases presenting with hydrocephalus. In this series, we are presenting the efficacy of a single-trajectory approach for both ETV and biopsy. Eleven cases were admitted to Alexandria main university hospital from 2013 to 2016 presenting with pineal region tumors and hydrocephalus. Mean age at diagnosis was 11 years (1-27 years). All cases had ETV and biopsy using rigid ventriculoscope through a single trajectory from a burr hole planned on preoperative imaging. Follow-up period was 7-48 months. All 11 cases presented with hydrocephalus and increased intracranial pressure manifestations. Histopathological diagnosis was successful in 9 out of 11 cases (81.8%). Three cases were germ-cell tumors, two cases were pineoblastomas, two cases were pilocytic astrocytomas, and two cases were grade 2 tectal gliomas. Five of the ETV cases (45.5%) failed and required VPS later on. Other complications of ETV included one case of intraventricular hemorrhage and a case with tumor disseminated to the basal cisterns. In our series, we were able to achieve ETV and biopsy through a single trajectory and a rigid endoscope with results comparable to other studies in the literature.

Use of observational and model-derived fields and regime model output statistics in mesoscale forecasting

NASA Technical Reports Server (NTRS)

Forbes, G. S.; Pielke, R. A.

1985-01-01

Various empirical and statistical weather-forecasting studies which utilize stratification by weather regime are described. Objective classification was used to determine weather regime in some studies. In other cases the weather pattern was determined on the basis of a parameter representing the physical and dynamical processes relevant to the anticipated mesoscale phenomena, such as low level moisture convergence and convective precipitation, or the Froude number and the occurrence of cold-air damming. For mesoscale phenomena already in existence, new forecasting techniques were developed. The use of cloud models in operational forecasting is discussed. Models to calculate the spatial scales of forcings and resultant response for mesoscale systems are presented. The use of these models to represent the climatologically most prevalent systems, and to perform case-by-case simulations is reviewed. Operational implementation of mesoscale data into weather forecasts, using both actual simulation output and method-output statistics is discussed.

New exact solutions of the Dirac and Klein-Gordon equations of a charged particle propagating in a strong laser field in an underdense plasma

NASA Astrophysics Data System (ADS)

Varró, Sándor

2014-03-01

Exact solutions are presented of the Dirac and Klein-Gordon equations of a charged particle propagating in a classical monochromatic electromagnetic plane wave in a medium of index of refraction nm<1. In the Dirac case the solutions are expressed in terms of new complex polynomials, and in the Klein-Gordon case the found solutions are expressed in terms of Ince polynomials. In each case they form a doubly infinite set, labeled by two integer quantum numbers. These integer numbers represent quantized momentum components of the charged particle along the polarization vector and along the propagation direction of the electromagnetic radiation. Since this radiation may represent a plasmon wave of arbitrary high amplitude, propagating in an underdense plasma, the solutions obtained may have relevance in describing possible quantum features of novel acceleration mechanisms.

Intraosseous pleomorphic adenoma: case report and review of the literature.

PubMed

Aver-De-Araujo, L M; Chaves-Tarquinio, S B; Neuzling-Gomes, A P; Etges, A

2002-01-01

Pleomorphic adenoma is the most common neoplasm of the salivary glands, affecting mainly the parotid gland. The preferential intraoral site of this tumor is the palate. A case of a 31-year-old woman with an intraosseous pleomorphic adenoma located in the maxilla (left paramedian region), showing an approximate evolution of one year is reported. The present intraosseous case represents a rare location, with the tumor probably originating from glandular epithelial remnants captured during embryogenesis. In a review of the literature of 142 cases of intragnathic localization (24% in the maxilla) are identified. A slight predominance of women was observed (56%), with 55% of the patients being affected during the 5th to 7th decade of life. The tumors were malignant in 94% of the cases, with special predominance of mucoepidermoid carcinoma (65%). Intraosseous pleomorphic adenomas are rare, with the present patient being the 6th case reported in the literature and the second found in the maxilla. Mean age of the 5 previously reported cases was 58.8 years.

Intraductal fibroadenomatosis: an unusual variant of fibroadenoma.

PubMed

Chung, Alice; Scharre, Karen; Wilson, Matthew

2008-01-01

We present a case of a benign breast lesion that contains histopathologic characteristics of fibroadenoma, phyllodes tumor, intraductal adenoma and papilloma. This may represent an unusual variant of fibroadenoma that has not been described in the literature and its likelihood of recurrence is unknown.

[Toxocariasis, a neglected disease in Switzerland ?

PubMed

Duréault, Amélie; Perez Valdes, Carlos; Weber, Lalensia; Ogna, Adam; Sempoux, Christine; Manuel, Oriol; Delaloye, Julie

2017-04-12

Toxocariasis is a zoonotic disease that occurs when humans are infected by the parasites Toxocara canis or Toxocara cati. Toxocariasis is highly prevalent in tropical areas, but can also be found in industrialized countries, particularly in rural areas. Clinical presentation can range from asymptomatic infection to more severe disease. Diagnosis of toxocariasis is based on suggestive clinical findings, eosinophilia and a positive serological testing. Albendazole represents the first-line treatment, associated with corticosteroids in case of severe disease. Here we describe three clinical cases of toxocariasis in order to illustrate the clinical presentation, diagnosis and treatment of this unrecognized disease.

Melanoma in situ and syringoma: a rare collision tumor. Clinical-pathological report of a case*

PubMed Central

Umbert-Millet, Pablo; Quintana-Codina, Monica; Salleras-Redonnet, Montse

2017-01-01

Collision or contiguous tumors, defined as two or more distinct tumors occurring at one site, are often an unexpected finding and may represent a diagnostic challenge, as clinical and histological presentations do not always coincide. Various combinations of collision tumors have been described with respect to melanocytic lesions, with the most frequently reported being the combination of nevus and basal cell carcinoma. We present an unusual case on the nose involving a melanoma in situ and a clinically-inapparent syringoma, which, to the best of our knowledge, is the first report of this combination. PMID:29267461

Secondary signet-ring cell adenocarcinoma of urinary bladder from a gastric primary.

PubMed

Sharma, Pramod K; Vijay, Mukesh K; Das, Ranjit K; Chatterjee, Uttara

2011-05-01

Primary bladder tumor is a frequent urological malignancy, whereas the incidence of secondary bladder tumor from a distant organ is quite rare. Secondary bladder neoplasms represent 1% of all malignant bladder tumors, of which distant metastases from stomach account for about 4% of cases. We present the case of a 30-year-old male who underwent partial gastrectomy for Signet-ring cell carcinoma of the stomach and presented 2 years later with hematuria. On computerized tomography scan, a bladder tumor was found which was resected cystoscopically. The histopathological examination revealed secondary Signet-ring cell adenocarcinoma of the urinary bladder.

Operational effectiveness and quality assurance mechanisms with stochastic demand of blood supply: blood bank case study.

PubMed

Smith, Alan D

2011-01-01

A general overview of various blood products operational effectiveness and related strategies that can be utilised by service providers (in particular, healthcare providers) is presented in the present study. In terms of the massive volumes of blood products, the North American blood centres collect more than eight million units of whole blood, which represents appropriately 50% of the US and Quebec, Canada?s volunteer donor blood supply. A case study of the quality inspection and inventory control concerns of the Central Blood Bank, located in the metropolitan area of Pittsburgh, PA, is presented. Initially, brief introduction to its general operating environment is followed by sections describing its general situation, quality-service initiatives, and followed by a fairly detailed discussion of the practical applications of lessons learned from the case study.

[Retrospective study regarding the contribution of Italian nurses to the debate on the Englaro case: between paradigms of catholic and non-religious bioethics].

PubMed

Sansoni, Julita; Minnella, Giuseppe; Mitello, Lucia

2010-01-01

This study presents the results of a retrospective study evaluating the contribution of Italian nurses to the public debate on the Englaro case, analysing the articles published by two major daily newspapers during a precise period. The data collected testify to the intensity of the debate that involved the whole nation in which many diverse social and professional categories took part. The nursing category was principally represented by the Sisters of Mercy who, at the insistence of the media, gave their own opinion although their role in this context was more as personal assistants to Eluana Englaro rather than representatives of a professional category expressing a bioethical opinion.

Sinonasal Lymphoma Presenting as a Probable Sanctuary Site for Relapsed B Acute Lymphoblastic Leukaemia: A Case Report and Review of the Literature.

PubMed

Lim, W Y; Care, R; Lau, M; Chiruka, S; Dawes, P J D

2015-01-01

Sinonasal lymphoma is a non-Hodgkin lymphoma (NHL) representing 1.5% of all lymphomas. It presents as an unremitting ulceration with progressive destruction of midline sinonasal and surrounding structures. Poor prognosis warrants early treatment although diagnosis is challenging and frequently delayed. It is usually primary in origin and to our knowledge the sinonasal region has never been reported as a sanctuary site in leukaemia/lymphoma relapse. We present a unique case of B-cell ALL (acute lymphoblastic leukaemia) with late relapse to the nasal septum as a sinonasal lymphoblastic lymphoma and with genetic support for this as a sanctuary site.

Accidental death in autoerotic maneuvers.

PubMed

Focardi, Martina; Gualco, Barbara; Norelli, GianAristide

2008-03-01

The authors from the Florence Forensic Department present a case that demonstrates the paradigms attached to accidental deaths while performing autoerotic maneuvers. The incidents of such practices are underestimated and are only the tip of the iceberg since they do not represent the cases that are never reported due to successful practice. After analyzing the statistic data, the authors describe the case and discuss about the element that prove the accidental nature of the death and the importance of the correct application of forensic methodology at the scene and in the mortuary.

[Smallpox virus as biological weapon].

PubMed

Kondrusik, Maciej; Hermanowska-Szpakowicz, Teresa

2003-02-01

Smallpox, because of its high case-fatality rate, easy transmission from human to human, lack of specific treatment represents nowadays one of the main threats in bioterrorist attacks. Over the centuries, naturally occurring smallpox with its case-fatality over 30 percent and its ability to spread in any climate and season has been treated as the most dangerous infectious disease. But it is now, 25 years after the last documented case of smallpox and cessation of routine vaccination in present mobile and susceptible population, smallpox virus spread might be rapid and devastating.

Nucleosynthesis in the neighborhood of a black hole

NASA Technical Reports Server (NTRS)

Chakrabarti, Sandip K.

1986-01-01

The preliminary results from simulations of nucleosynthesis inside a thick accretion disk around a black hole are discussed as a function of the accretion rate, the viscosity parameter, and the mass of the black hole. Results for the Bondi accretion case are also presented. Taking the case of a 10-solar mass and a 10 to the 6th-solar mass central Schwarzschild hole, detailed evolution of a representative element of matter as it accretes into the hole is presented in the case when the initial abundance (at the outer edge of the disk) is the same as the solar abundance. It is suggested that such studies may eventually shed light on the composition of the outgoing jets observed in the active galaxies and SS433.

Coupled rotor/airframe vibration analysis program manual. Volume 2: Sample input and output listings

NASA Technical Reports Server (NTRS)

Cassarino, S.; Sopher, R.

1982-01-01

Sample input and output listings obtained with the base program (SIMVIB) of the coupled rotor/airframe vibration analysis and the external programs, G400/F389 and E927 are presented. Results for five of the base program test cases are shown. They represent different applications of the SIMVIB program to study the vibration characteristics of various dynamic configurations. Input and output listings obtained for one cycle of the G400/F389 coupled program are presented. Results from the rotor aeroelastic analysis E927 also appear. A brief description of the check cases is provided. A summary of the check cases for all the external programs interacting with the SIMVIB program is illustrated.

Bifid condyle of the mandible with associated polythelia and manual anomalies.

PubMed

Zohar, Y; Laurian, N

1987-12-01

Syndromes of oro-mandibular-skeletal anomalies are confusing by their ambiguous and overlapping components. It is our purpose to bring attention to a case comprising a group of anomalies: bifid mandibular condyle, asymmetric contralateral ascending ramus of the mandible, supernumerary nipples (polythelia), supernumerary-rudimentary postaxial sixth fingers and clinodactyly. The associated malformations presented do not correspond to any previous report. The case may therefore represent a new malformation syndrome.

Brucellosis associated with deep vein thrombosis.

PubMed

Tolaj, Ilir; Mehmeti, Murat; Ramadani, Hamdi; Tolaj, Jasmina; Dedushi, Kreshnike; Fejza, Hajrullah

2014-11-19

Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left leg.

A Domain-Specific System for Representing Knowledge of Both Man-Made Objects and Human Actions. Evidence from a Case with an Association of Deficits

ERIC Educational Resources Information Center

Vannuscorps, Gilles; Pillon, Agnesa

2011-01-01

We report the single-case study of a brain-damaged individual, JJG, presenting with a conceptual deficit and whose knowledge of living things, man-made objects, and actions was assessed. The aim was to seek for empirical evidence pertaining to the issue of how conceptual knowledge of objects, both living things and man-made objects, is related to…

The presence of both horseshoe and a supernumerary kidney associated with coarctation of aorta.

PubMed

Unal, M; Erem, C; Serçe, K; Tuncer, C; Bostan, M; Gökçe, M

1995-01-01

Congenital urinary malformations associated with congenital heart disease are very rare. We present a case of horseshoe and supernumerary kidney associated with coarctation of aorta diagnosed by a combination of techniques of teleradiography, aortography, intravenous pyelography; ultrasonography, magnetic resonance imaging, and Dimercapto Succinic Acid (DMSA) and Diethylene Triamine Pentacetate (DTPA) imaging. This case represents the first reported instance of horseshoe and supernumerary kidney associated with coarctation of aorta.

[Several cases of giant epulis observed in West Africa].

PubMed

Cantaloube, D; Larroque, G; Ndiaye, R; Rives, J M; Seurat, P

1987-01-01

The presenting symptomatology in 9 cases of giant epulis seen in West Africa was constantly difficulties in mastication or even speech, and on some occasions tumefaction of the face. A certain number of factors are involved in the development of these benign tumors, and although inflammation represents the primum movens of this affection, other causes, including some specific to the African continent, must be considered with a view to a pathogenic approach.

Intracystic breast carcinoma. An important differential diagnosis in postmenopausal patients presenting with a rapidly growing breast cyst. Management and literature review.

PubMed

Salemis, Nikolaos S

2018-03-16

Intracystic breast carcinoma is a rare clinical entity accounting for 0.5-2% of all breast cancers. It represents a distinctive clinical form rather a histological subtype of breast cancer and can either be in situ or invasive tumor. We herein describe a rare case of intracystic breast carcinoma arising from the wall of a cyst in a postmenopausal patient, who presented with a rapidly growing complex breast cyst. Diagnostic evaluation and management of the patient are discussed along with a review of the literature. Complex breast cysts may represent a diagnostic and therapeutic challenge. An underlying malignancy has been reported in 21-31% of the cases. Preoperative diagnosis is challenging. Complex breast cysts with thick wall, thick inner septations, and intracystic solid components should undergo histological evaluation in order to rule out an underlying malignancy. The cytological analysis may be inconclusive. Ultrasound-guided biopsy is the diagnostic modality of choice. The correlation of clinical features, with imaging and histopathological findings is very important for the optimal treatment. In cases of discordance, a complete surgical excision is necessary with careful assessment of the extent of the disease and appropriate treatment.

Evaluating Hospital-Based Surveillance for Outbreak Detection in Bangladesh: Analysis of Healthcare Utilization Data

PubMed Central

Nikolay, Birgit; Salje, Henrik; Sturm-Ramirez, Katharine; Azziz-Baumgartner, Eduardo; Homaira, Nusrat; Iuliano, A. Danielle; Paul, Repon C.; Hossain, M. Jahangir; Cauchemez, Simon; Gurley, Emily S.

2017-01-01

Background The International Health Regulations outline core requirements to ensure the detection of public health threats of international concern. Assessing the capacity of surveillance systems to detect these threats is crucial for evaluating a country’s ability to meet these requirements. Methods and Findings We propose a framework to evaluate the sensitivity and representativeness of hospital-based surveillance and apply it to severe neurological infectious diseases and fatal respiratory infectious diseases in Bangladesh. We identified cases in selected communities within surveillance hospital catchment areas using key informant and house-to-house surveys and ascertained where cases had sought care. We estimated the probability of surveillance detecting different sized outbreaks by distance from the surveillance hospital and compared characteristics of cases identified in the community and cases attending surveillance hospitals. We estimated that surveillance detected 26% (95% CI 18%–33%) of severe neurological disease cases and 18% (95% CI 16%–21%) of fatal respiratory disease cases residing at 10 km distance from a surveillance hospital. Detection probabilities decreased markedly with distance. The probability of detecting small outbreaks (three cases) dropped below 50% at distances greater than 26 km for severe neurological disease and at distances greater than 7 km for fatal respiratory disease. Characteristics of cases attending surveillance hospitals were largely representative of all cases; however, neurological disease cases aged <5 y or from the lowest socioeconomic group and fatal respiratory disease cases aged ≥60 y were underrepresented. Our estimates of outbreak detection rely on suspected cases that attend a surveillance hospital receiving laboratory confirmation of disease and being reported to the surveillance system. The extent to which this occurs will depend on disease characteristics (e.g., severity and symptom specificity) and surveillance resources. Conclusion We present a new approach to evaluating the sensitivity and representativeness of hospital-based surveillance, making it possible to predict its ability to detect emerging threats. PMID:28095468

A Method to Represent Heterogeneous Materials for Rapid Prototyping: The Matryoshka Approach

PubMed Central

Lei, Shuangyan; Frank, Matthew C.; Anderson, Donald D.; Brown, Thomas D.

2015-01-01

Purpose The purpose of this paper is to present a new method for representing heterogeneous materials using nested STL shells, based, in particular, on the density distributions of human bones. Design/methodology/approach Nested STL shells, called Matryoshka models, are described, based on their namesake Russian nesting dolls. In this approach, polygonal models, such as STL shells, are “stacked” inside one another to represent different material regions. The Matryoshka model addresses the challenge of representing different densities and different types of bone when reverse engineering from medical images. The Matryoshka model is generated via an iterative process of thresholding the Hounsfield Unit (HU) data using computed tomography (CT), thereby delineating regions of progressively increasing bone density. These nested shells can represent regions starting with the medullary (bone marrow) canal, up through and including the outer surface of the bone. Findings The Matryoshka approach introduced can be used to generate accurate models of heterogeneous materials in an automated fashion, avoiding the challenge of hand-creating an assembly model for input to multi-material additive or subtractive manufacturing. Originality/Value This paper presents a new method for describing heterogeneous materials: in this case, the density distribution in a human bone. The authors show how the Matryoshka model can be used to plan harvesting locations for creating custom rapid allograft bone implants from donor bone. An implementation of a proposed harvesting method is demonstrated, followed by a case study using subtractive rapid prototyping to harvest a bone implant from a human tibia surrogate. PMID:26120277

Theoretical Models for Evaluation of Volatile Emissions to Air During Dredged Material Disposal with Applications to New Bedford Harbor, Massachusetts

DTIC Science & Technology

1989-05-01

model otherwise. 7. One or more partial differential equations can be presented to describe the minutia of chemical behavior in the various locales of...enjoys a voluminous literature heritage beyond the point of realistic applications to the natural environment in many cases. Hill, Myers, and Brannon...represented by the point A in Figure 2. This point may be representative of the recently deposited and exposed surface of dredged sediment in the delta

Recap and Program Plan Update [GPS Adjacent Band Compatibility Assessment Workshop IV RTCA - Washington, DC

DOT National Transportation Integrated Search

2015-10-02

Initial WorkshopI held on September 18, 2014 at the Volpe Center; Overview of DOT GPS Adjacent Band Compatibility Assessment Plan and plans/timeline for implementation; Presentation on GPS use cases and list of representative GPS receivers; Descri...

Levelized Cost and Levelized Avoided Cost of New Generation Resources in the Annual Energy Outlook

EIA Publications

2017-01-01

This paper presents average values of levelized costs for generating technologies entering service in 2019, 2022, and 2040 as represented in the National Energy Modeling System (NEMS) for the Annual Energy Outlook 2017 (AEO2017) Reference case.

Fixation orientation in ankle fractures with syndesmosis injury.

PubMed

Nimick, Craig J; Collman, David R; Lagaay, Pieter

2013-01-01

Accurate reduction of the syndesmosis has been shown to be an important prognostic factor for functional outcome in ankle injuries that disrupt the syndesmosis. The purpose of the present case series was to assess the fixation orientation and the position of the fibula within the tibial incisura after open reduction and internal fixation of ankle fractures with syndesmosis injury. Computed tomography was used to assess the accuracy of the reduction. Twelve patients were included in the present case series. A ratio representing the relationship between the tibia and fibula and the orientation of the syndesmotic fixation was measured preoperatively and postoperatively and compared with the uninjured contralateral ankle, representing the patient's normal anatomy. The measurements were accomplished electronically to one tenth of 1 mm using Stentor Intelligent Informatics, I-site, version 3.3.1 (Phillips Electronics; Andover, MA). Posteriorly oriented syndesmotic fixation caused posterior translation of the fibula with respect to the tibia and anteriorly oriented syndesmotic fixation caused anterior translation. Copyright © 2013. Published by Elsevier Inc.

Temporo-mandibular joint chondrosarcoma: Case report and review of the literature.

PubMed

Giorgione, C; Passali, F M; Varakliotis, T; Sibilia, M; Ottaviani, F

2015-06-01

Chondrosarcoma is a malignant mesenchymal tumour of cartilaginous origin. It represents 11% of all malignant primary bone tumours, and the pelvis, ribs, femur and humerus are most frequently involved. Chondrosarcoma of the head and neck region is a rare disease, and represents approximately 0.1% of all head and neck neoplasms. This report describes a rare localisation of chondrosarcoma in a 56-year-old man who presented with swelling in the right preauricular area and mild limitation and pain in the mouth opening. Since 1959, just a few cases of temporomandibular joint (TMJ) chondrosarcoma have been described. Computed tomography revealed a large mass (39 x 46 x 40 mm) in the right preauricular and parotid region with morpho-structural alterations of the condyle and an intense periostotic reaction. The tumour was treated by total parotidectomy and condylotomy. The VII cranial nerve was preserved. Histopathologic examination revealed a low grade chondrosarcoma with a 50% proliferation index. At present, the patient is still receiving routine follow-up after radiotherapy and physiotherapy.

Propagation of flexural and membrane waves with fluid loaded NASTRAN plate and shell elements

NASA Technical Reports Server (NTRS)

Kalinowski, A. J.; Wagner, C. A.

1983-01-01

Modeling of flexural and membrane type waves existing in various submerged (or in vacuo) plate and/or shell finite element models that are excited with steady state type harmonic loadings proportioned to e(i omega t) is discussed. Only thin walled plates and shells are treated wherein rotary inertia and shear correction factors are not included. More specifically, the issue of determining the shell or plate mesh size needed to represent the spatial distribution of the plate or shell response is of prime importance towards successfully representing the solution to the problem at hand. To this end, a procedure is presented for establishing guide lines for determining the mesh size based on a simple test model that can be used for a variety of plate and shell configurations such as, cylindrical shells with water loading, cylindrical shells in vacuo, plates with water loading, and plates in vacuo. The procedure for doing these four cases is given, with specific numerical examples present only for the cylindrical shell case.

Vortex generation and mixing in three-dimensional supersonic combustors

NASA Technical Reports Server (NTRS)

Riggins, D. W.; Vitt, P. H.

1993-01-01

The generation and evolution of the flow vorticity established by instream injector ramps in a high Mach number/high enthalpy scramjet combustor flow-field are described in detail for a number of computational cases. Classical fluid dynamic circulation is presented for these cases in order to clarify the spatial distribution and convection of the vorticity. The ability of the simulations to accurately represent Stokes Law of circulation is discussed and shown. In addition, the conservation of swirl (effectively the moment-of-momentum theorem) is presented for these flows. The impact of both turbulent diffusion and the vortex/ramp non-uniformity on the downstream mixing rate is clearly illustrated. A correlation over the length of the combustor between fuel-air mixing and a parameter called the vortex stirring length is demonstrated. Finally, computational results for a representative ramp injector are compared with experimental data. Influence of the stream vorticity on the effective turbulent Prandtl number used in the simulation is discussed.

Atypical Cutaneous Presentations of Sarcoidosis: Two Case Reports and Review of the Literature.

PubMed

Leverenz, David L; Henderson, Christopher; Shah, Ankoor

2018-06-14

The goal of this review is to provide the reader with an updated summary of the cutaneous manifestations of systemic sarcoidosis, with a particular emphasis on the predilection of sarcoidosis for scars, tattoos, and other areas of traumatized skin. While the mechanism underlying the propensity for traumatized skin to develop sarcoidosis lesions remains unclear, several theories have been proposed including the idea that cutaneous sarcoidosis represents an exuberant, antigen-driven foreign-body response, as well as the theory that traumatized skin represents an immunocompromised district with altered local immune trafficking and neural signaling. In this review, we present two cases in which the development of cutaneous lesions in scars and tattoos was integral to the diagnosis of systemic sarcoidosis. We then review the various cutaneous manifestations of systemic sarcoidosis, the clinical characteristics and differential diagnosis of scar and tattoo sarcoidosis, the proposed mechanism by which traumatized skin is prone to developing sarcoidosis lesions, and current treatments for cutaneous sarcoidosis.

Mature vs. Active Deep-Seated Landslides: A Comparison Through Two Case Histories in the Alps

NASA Astrophysics Data System (ADS)

Delle Piane, Luca; Perello, Paolo; Baietto, Alessandro; Giorza, Alessandra; Musso, Alessia; Gabriele, Piercarlo; Baster, Ira

2016-06-01

Two case histories are presented, concerning the still poorly known alpine deep-seated gravitational slope deformations (DSD) located nearby Lanzada (central Italian Alps), and Sarre (north-western Italian Alps). The Lanzada DSD is a constantly monitored, juvenile, and active phenomenon, partly affecting an existing hydropower plant. Its well-developed landforms allow a precise field characterization of the instability-affected area. The Sarre DSD is a mature, strongly remodeled phenomenon, where the only hazard factor is represented by secondary instability processes at the base of the slope. In this case, the remodeling imposed the adoption of complementary analytical techniques to support the field work. The two presented studies had to be adapted to external factors, namely (a) available information, (b) geological and geomorphological setting, and (c) final scope of the work. The Lanzada case essentially relied upon accurate field work; the Sarre case was mostly based on digital image and DTM processing. In both cases a sound field structural analysis formed the necessary background to understand the mechanisms leading to instability. A back-analysis of the differences between the study methods adopted in the two cases is finally presented, leading to suggestions for further investigations and design.

Investigation of Future Thermal Comforts in a Tropical Megacity Using Coupling of Energy Balance Model and Large Eddy Simulation

NASA Astrophysics Data System (ADS)

Sueishi, T.; Yucel, M.; Ashie, Y.; Varquez, A. C. G.; Inagaki, A.; Darmanto, N. S.; Nakayoshi, M.; Kanda, M.

2017-12-01

Recently, temperature in urban areas continue to rise as an effect of climate change and urbanization. Specifically, Asian megacities are projected to expand rapidly resulting to serious in the future atmospheric environment. Thus, detailed analysis of urban meteorology for Asian megacities is needed to prescribe optimum against these negative climate modifications. A building-resolving large eddy simulation (LES) coupled with an energy balance model is conducted for a highly urbanized district in central Jakarta on typical daytime hours. Five cases were considered; case 1 utilizes present urban scenario and four cases representing different urban configurations in 2050. The future configurations were based on representative concentration pathways (RCP) and shared socio-economic pathways (SSP). Building height maps and land use maps of simulation domains are shown in the attached figure (top). Case 1 3 focuses on the difference of future scenarios. Case 1 represents current climatic and urban conditions, case 2 and 3 was an idealized future represented by RCP2.6/SSP1 and RCP8.5/SSP3, respectively. More complex urban morphology was applied in case 4, vegetation and building area were changed in case 5. Meteorological inputs and anthropogenic heat emission (AHE) were calculated using Weather Research and Forecasting (WRF) model (Varquez et al [2017]). Sensible and latent heat flux from surfaces were calculated using an energy balance model (Ashie et al [2011]), with considers multi-reflection, evapotranspiration and evaporation. The results of energy balance model (shown in the middle line of figure), in addition to WRF outputs, were used as input into the PArallelized LES Model (PALM) (Raasch et al [2001]). From standard new effective temperature (SET*) which included the effects of temperature, wind speed, humidity and radiation, thermal comfort in urban area was evaluated. SET* contours at 1 m height are shown in the bottom line of the figure. Extreme climate change increase average SET* as expected; however, construction of dense high-rise buildings (case 2) can minimize this effect due to increased shading throughout the district. Acknowledgement: This research was supported by the Environment Research and Technology Development Fund (S-14) of the Ministry of the Environment, Japan.

Concomitant presentation of Anderson-Tawil syndrome and myasthenia gravis in an adult patient: A case report.

PubMed

Fan, Rui; Ji, Ruirui; Zou, Wenxin; Wang, Guoliang; Wang, Hu; Penney, Daniel James; Luo, Jin Jun; Fan, Yuxin

2016-10-01

Andersen-Tawil syndrome (ATS) is an autosomal dominant, multisystem channelopathy characterized by periodic paralysis, ventricular arrhythmias and distinctive dysmorphic facial or skeletal features. The disorder displays marked intrafamilial variability and incomplete penetrance. Myasthenia gravis (MG) is an autoimmune disorder that demonstrates progressive fatigability, in which the nicotinic acetylcholine receptor (AChR) at neuromuscular junctions is the primary autoantigen. The present study reports a rare case of a 31-year-old woman with a history of morbid obesity and periodic weakness, who presented with hemodynamic instability, cardiogenic shock and facial anomalies. Laboratory results revealed hypokalemia and an elevated anti-AChR antibody expression levels. Electrocardiography demonstrated prolonged QT-interval, ST-elevation, and subsequent third-degree atrioventricular block. Neurological examination revealed bilateral ptosis, horizontal diplopia, dysarthria and generalized weakness. No mutations in the potassium channel inwardly rectifying subfamily J member 2 gene were detected in the present case. The patient was treated with oral potassium supplementation and an acetylcholinesterase inhibitor (pyridostigmine), after which the symptoms were improved. To the best of our knowledge, the present case report was the first to describe concomitant presentation of both ATS and MG, which represents a diagnostic and therapeutic challenge.

A method for modeling finite-core vortices in wake-flow calculations

NASA Technical Reports Server (NTRS)

Stremel, P. M.

1984-01-01

A numerical method for computing nonplanar vortex wakes represented by finite-core vortices is presented. The approach solves for the velocity on an Eulerian grid, using standard finite-difference techniques; the vortex wake is tracked by Lagrangian methods. In this method, the distribution of continuous vorticity in the wake is replaced by a group of discrete vortices. An axially symmetric distribution of vorticity about the center of each discrete vortex is used to represent the finite-core model. Two distributions of vorticity, or core models, are investigated: a finite distribution of vorticity represented by a third-order polynomial, and a continuous distribution of vorticity throughout the wake. The method provides for a vortex-core model that is insensitive to the mesh spacing. Results for a simplified case are presented. Computed results for the roll-up of a vortex wake generated by wings with different spanwise load distributions are presented; contour plots of the flow-field velocities are included; and comparisons are made of the computed flow-field velocities with experimentally measured velocities.

46 CFR 6.01 - Procedures for effecting individual waivers of navigation and vessel inspection laws and...

Code of Federal Regulations, 2011 CFR

2011-10-01

... the designated representative of the Commandant, as the case may be) reaches the conclusion referred... representative at the port or place where the vessel is located. In the case of a vessel in any foreign port or... representative or the designated representative of the Commandant, as the case may be) shall promptly examine...

Visualization and Analysis of Light Pollution: a Case Study in Hong Kong

NASA Astrophysics Data System (ADS)

Wu, B.; Wong, H.

2012-07-01

The effects of light pollution problems in metropolitan areas are investigated in this study. Areas of Hong Kong are used as the source of three typical study cases. One case represents the regional scale, a second represents the district scale, and a third represents the street scale. Two light pollution parameters, Night Sky Brightness (NSB) and Street Light Level (SLL), are the focus of the analyses. Light pollution visualization approaches in relation to the different scales include various light pollution maps. They provide straightforward presentations of the light pollution situations in the study areas. The relationship between light pollution and several social-economic factors such as land use, household income, and types of outdoor lighting in the scale areas given, are examined. Results show that: (1) Land use may be one factor affecting light pollution in the regional scale; (2) A relatively strong correlation exists between light pollution and household income in the district scale; (3) The heaviest light pollution in the street scale is created by spotlights and also the different types of lighting from shops. The impact of the latter is in relation to the shop profile and size.

Malignant Neoplasia of the Sex Skin in 2 Chimpanzees (Pan troglodytes).

PubMed

Beck, Amanda P; Magden, Elizabeth R; Buchl, Stephanie J; Baze, Wallace B

2016-04-01

This report describes 2 cases of spontaneous malignant neoplasia within the sex skin of aged female chimpanzees. In both cases, the initial presentation resembled nonhealing traumatic wounds to the sex skin, with different degrees of infection, ulceration, and tissue necrosis. Histopathology of the lesions confirmed the diagnosis of squamous cell carcinoma in one case and of adenocarcinoma with metastasis in the other. Advanced age and previous trauma likely contributed to the development of the neoplasias in both cases; long-term sun exposure may also have contributed to the development of the squamous cell carcinoma. To our knowledge, these 2 cases represent the first reports of sex skin neoplasia in chimpanzees.

Granulomatous mastitis caused by histoplasma and mimicking inflammatory breast carcinoma.

PubMed

Osborne, B M

1989-01-01

Two cases of a lobular, necrotizing granulomatous process causing a unilateral painful breast mass mimicking carcinoma are presented for comparison. While the morphologic appearance in each case was that of lobular granulomatous mastitis, the etiologic agent in one case appeared to be Histoplasma capsulatum, based on Grocott methenamine silver staining, and represents the second reported case of histoplasmosis involving only breast parenchyma. Awareness of the rare entity, granulomatous mastitis, is important for the pathologist because the definitive diagnosis is made microscopically. Thorough evaluation of the breast tissue is essential for its management and should eventually contribute to the clarification of its etiology.

Multilevel Complex Networks and Systems

NASA Astrophysics Data System (ADS)

Caldarelli, Guido

2014-03-01

Network theory has been a powerful tool to model isolated complex systems. However, the classical approach does not take into account the interactions often present among different systems. Hence, the scientific community is nowadays concentrating the efforts on the foundations of new mathematical tools for understanding what happens when multiple networks interact. The case of economic and financial networks represents a paramount example of multilevel networks. In the case of trade, trade among countries the different levels can be described by the different granularity of the trading relations. Indeed, we have now data from the scale of consumers to that of the country level. In the case of financial institutions, we have a variety of levels at the same scale. For example one bank can appear in the interbank networks, ownership network and cds networks in which the same institution can take place. In both cases the systemically important vertices need to be determined by different procedures of centrality definition and community detection. In this talk I will present some specific cases of study related to these topics and present the regularities found. Acknowledged support from EU FET Project ``Multiplex'' 317532.

International Perspectives of Distance Learning in Higher Education

ERIC Educational Resources Information Center

Moore, Joi L., Ed.; Benson, Angela D., Ed.

2012-01-01

This book, written by authors representing 12 countries and five continents, is a collection of international perspectives on distance learning and distance learning implementations in higher education. The perspectives are presented in the form of practical case studies of distance learning implementations, research studies on teaching and…

Whose Child Is This?

ERIC Educational Resources Information Center

Illinois Advisory Committee on Nonpublic Schools, Lansing.

This document presents eight statements representative of positions taken by participants in a conference held to explore the relationship between the state and non-public schools. A historical perspective on the role of the parents in education, a lawyer's case for parental responsibility in education, parent involvement and parent rights are…

77 FR 26768 - Food and Drug Administration/International Society for Pharmaceutical Engineering Cosponsorship...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... year, FDA speakers provide updates on current efforts affecting the development of global regulatory strategies, while industry professionals from some of today's leading pharmaceutical companies present case... hear directly from FDA experts and representatives of global regulatory authorities on best practices...

Conference as Journey: Honouring Our Pedagogical Roots

ERIC Educational Resources Information Center

Asfeldt, Morten; Beames, Simon

2012-01-01

Most educators have spent many days and thousands of dollars attending academic conferences around the world, only to find themselves sitting in ballrooms, listening to speakers and watching PowerPoint presentations. In most cases, this conference format represents a profound pedagogical contradiction for outdoor and experiential educators. This…

Religion, Community Service, and Identity in American Youth.

ERIC Educational Resources Information Center

Youniss, James; McLellan, Jeffrey A.; Yates, Miranda

1999-01-01

Presents evidence connecting community service and religiousness in American youth. These data from nationally representative samples strengthen the case that the many contemporary youth who take religion seriously are vibrantly engaged in their schooling, in the betterment of communities, and the development of identities that presage healthy…

Post-mortem CT: Hounsfield unit profiles obtained in the lungs with respect to the cause of death assessment.

PubMed

Schober, Daniel; Schwendener, Nicole; Zech, Wolf-Dieter; Jackowski, Christian

2017-01-01

Segmentation of the lungs using post-mortem computed tomography (PMCT) data was so far not feasible due to post-mortem changes such as internal livores. Recently, an Osirix plug-in has been developed allowing automatically segmenting lungs also in PMCT data. The aim of this study was to investigate if the Hounsfield unit (HU) profiles obtained in PMCT data of the segmented lung tissue present with specific behaviour in relation to the cause of death. In 105 PMCT data sets of forensic cases, the entire lung volumes were segmented using the Mia Lite plug-in on Osirix. HU profiles of the lungs were generated and correlated to cause of death groups as assessed after forensic autopsy (cardiac death, fatal haemorrhage, craniocerebral injury, intoxication, drowning, hypothermia, hanging and suffocation). Especially cardiac death cases, intoxication cases, fatal haemorrhage cases and hypothermia cases showed very specific HU profiles. In drowning, the profiles showed two different behaviours representing wet and dry drowning. HU profiles rather varied in craniocerebral injury cases, hanging cases as well as in suffocation cases. HU profiles of the lungs segmented from PMCT data may support the cause of death diagnosis as they represent specific morphological changes in the lungs such as oedema, congestion or blood loss. Especially in cardiac death, intoxication, fatal haemorrhage, hypothermia and drowning cases, HU profiles may be very supportive for the forensic pathologist.

Canine histiocytic sarcoma presenting as a target lesion on brain magnetic resonance imaging and as a solitary pulmonary mass.

PubMed

Hicks, Jill; Barber, Renee; Childs, Bronwen; Kirejczyk, Shannon Gm; Uhl, Elizabeth W

2017-04-17

A 6-year-old spayed female miniature schnauzer presented with generalized seizures and progressive multifocal intracranial neurologic disease. Thoracic radiographs and computed tomography (CT) revealed a large solitary pulmonary mass within the right cranial lung lobe. On brain magnetic resonance imaging (MRI), a solitary intraparenchymal mass within the left piriform lobe had a "target" appearance on both pre- and postcontrast sequences. Cerebrospinal fluid was unremarkable and histopathology indicated both masses represented histiocytic sarcoma. This case represents an uncommonly reported MRI appearance of histiocytic sarcoma in the canine brain and a large, solitary-appearing pulmonary histiocytic sarcoma in the same dog. © 2017 American College of Veterinary Radiology.

An Ontology for Representing Geoscience Theories and Related Knowledge

NASA Astrophysics Data System (ADS)

Brodaric, B.

2009-12-01

Online scientific research, or e-science, is increasingly reliant on machine-readable representations of scientific data and knowledge. At present, much of the knowledge is represented in ontologies, which typically contain geoscience categories such as ‘water body’, ‘aquifer’, ‘granite’, ‘temperature’, ‘density’, ‘Co2’. While extremely useful for many e-science activities, such categorical representations constitute only a fragment of geoscience knowledge. Also needed are online representations of elements such as geoscience theories, to enable geoscientists to pose and evaluate hypotheses online. To address this need, the Science Knowledge Infrastructure ontology (SKIo) specializes the DOLCE foundational ontology with basic science knowledge primitives such as theory, model, observation, and prediction. Discussed will be SKIo as well as its implementation in the geosciences, including case studies from marine science, environmental science, and geologic mapping. These case studies demonstrate SKIo’s ability to represent a wide spectrum of geoscience knowledge types, to help fuel next generation e-science.

Lattice dynamics approach to determine the dependence of the time-of-flight of transversal polarized acoustic waves on external stress

NASA Astrophysics Data System (ADS)

Tarar, K. S.; Pluta, M.; Amjad, U.; Grill, W.

2011-04-01

Based on the lattice dynamics approach the dependence of the time-of-flight (TOF) on stress has been modeled for transversal polarized acoustic waves. The relevant dispersion relation is derived from the appropriate mass-spring model together with the dependencies on the restoring forces including the effect of externally applied stress. The lattice dynamics approach can also be interpreted as a discrete and strictly periodic lumped circuit. In that case the modeling represents a finite element approach. In both cases the properties relevant for wavelengths large with respect to the periodic structure can be derived from the respective limit relating also to low frequencies. The model representing a linear chain with stiffness to shear and additional stiffness introduced by extensional stress is presented and compared to existing models, which so far represent each only one of the effects treated here in combination. For a string this effect is well known from musical instruments. The counteracting effects are discussed and compared to experimental results.

Representing vision and blindness.

PubMed

Ray, Patrick L; Cox, Alexander P; Jensen, Mark; Allen, Travis; Duncan, William; Diehl, Alexander D

2016-01-01

There have been relatively few attempts to represent vision or blindness ontologically. This is unsurprising as the related phenomena of sight and blindness are difficult to represent ontologically for a variety of reasons. Blindness has escaped ontological capture at least in part because: blindness or the employment of the term 'blindness' seems to vary from context to context, blindness can present in a myriad of types and degrees, and there is no precedent for representing complex phenomena such as blindness. We explore current attempts to represent vision or blindness, and show how these attempts fail at representing subtypes of blindness (viz., color blindness, flash blindness, and inattentional blindness). We examine the results found through a review of current attempts and identify where they have failed. By analyzing our test cases of different types of blindness along with the strengths and weaknesses of previous attempts, we have identified the general features of blindness and vision. We propose an ontological solution to represent vision and blindness, which capitalizes on resources afforded to one who utilizes the Basic Formal Ontology as an upper-level ontology. The solution we propose here involves specifying the trigger conditions of a disposition as well as the processes that realize that disposition. Once these are specified we can characterize vision as a function that is realized by certain (in this case) biological processes under a range of triggering conditions. When the range of conditions under which the processes can be realized are reduced beyond a certain threshold, we are able to say that blindness is present. We characterize vision as a function that is realized as a seeing process and blindness as a reduction in the conditions under which the sight function is realized. This solution is desirable because it leverages current features of a major upper-level ontology, accurately captures the phenomenon of blindness, and can be implemented in many domain-specific ontologies.

Gender identity disorder in a five-year-old boy.

PubMed Central

Herman, S. P.

1983-01-01

Markedly effeminate behavior in a young boy is a source of concern and confusion for parents, teachers, and the child. It also represents a therapeutic dilemma for the child psychiatrist. The case of a five-year-old boy with gender identity disorder of childhood is presented and the literature on hypotheses of etiology, treatment, and long-term follow-up is reviewed. The ethical and philosophical questions posed by such a case are discussed. PMID:6880245

Brucellosis Associated with Deep Vein Thrombosis

PubMed Central

Tolaj, Ilir; Mehmeti, Murat; Ramadani, Hamdi; Tolaj, Jasmina; Dedushi, Kreshnike; Fejza, Hajrullah

2014-01-01

Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left leg. PMID:25568754

Fibroblastic connective tissue nevus: a rare cutaneous lesion analyzed in a series of 25 cases.

PubMed

de Feraudy, Sébastien; Fletcher, Christopher D M

2012-10-01

Fibroblastic connective tissue nevus (FCTN) represents a rare and distinct benign cutaneous mesenchymal lesion of fibroblastic/myofibroblastic lineage, which broadens the spectrum of lesions presently recognized as connective tissue nevus. A series of 25 cases of FCTN has been analyzed to further characterize the clinicopathologic spectrum and immunohistochemical features of this entity. Sixteen patients were female (64%) and 9 were male (36%), with age at presentation ranging from 1.5 months to 58 years (median, 10 y). Most patients presented with a solitary, slowly growing, painless plaque-like or nodular skin lesion. Eleven cases (44%) arose on the trunk, 9 (36%) on the head and neck, and 5 (20%) on the limbs. The lesion was present for a median duration of 11.5 months (mean, 13.2 mo). Grossly, the lesions were tan-brown to tan-white, smooth, and firm. Their size ranged from 0.3 to 2.0 cm in greatest dimension (mean size, 0.67 cm; median, 0.6 cm). All tumors showed poor circumscription and were situated primarily in the reticular deep dermis, extending into the superficial subcutis in 13 cases (52%). The lesion was associated with papillomatous epidermis in 17 cases (70%) and the presence of adipose tissue in the reticular dermis in 14 cases (60.9%). All tumors were composed of a proliferation of bland intradermal fibroblastic/myofibroblastic cells with indistinct palely eosinophilic cytoplasm and tapering nuclei, with no significant cytologic atypia or pleomorphism, arranged in short-intersecting fascicles and entrapping appendages. No mitoses were identified. Immunostains showed positivity for CD34 in 20 of 23 cases (87%) and weak focal positivity for smooth muscle actin in 9 of 19 cases (47%). No case stained positively for desmin or S100 protein. Clinical follow-up was obtained for 14 patients (median duration, 4 y). No tumor recurred locally, even when surgical excision was incomplete. No lesion metastasized. FCTN occurs most commonly as a plaque on the trunk and head/neck of children, involves deep dermis and superficial subcutis, and stains mainly for CD34. FCTN most likely represents a localized developmental dermal anomaly; it is entirely benign and should not be confused with dermatofibrosarcoma protuberans or other neoplasms such as dermatomyofibroma.

Two cases of cerebral aneurysms in HIV+ children.

PubMed

Fulmer, B B; Dillard, S C; Musulman, E M; Palmer, C A; Oakes, J

1998-01-01

Two cases of fusiform cerebral aneurysms in human immunodeficiency virus (HIV) positive children are presented. To our knowledge, only 9 patients with this association have been reported. One of our patients represents the first report of a patient with an aneurysm associated with varicella-zoster vasculitis. One patient presented with a subarachnoid hemorrhage, Hunt-Hess grade IV, and posed difficult surgical management. The other patient suffered a cerebral infarct with a resulting hemiparesis. The first patient had a ventriculostomy placed, initially improved, and subsequently died from rebleeding. The second patient improved with medical management. AIDS arteriopathy, and specifically fusiform aneurysms, are being increasingly reported. The various presentations of this surgically challenging entity in light of other AIDS-related syndromes pose difficult management decisions. On occasion, the intracranial aneurysm may be the initial form of presentation as was present in our first patient.

Solid pseudopapillary tumor of the pancreas: case report and literature review.

PubMed

Camacho-Aguilera, José Francisco; Romero-Mejía, César; Valenzuela-Espinoza, Alfonso

2010-01-01

Solid pseudopapillary tumor of the pancreas is an epithelial tumor of low malignancy that primarily affects young women and represents approximately 1-2% of all pancreatic neoplasms. We present a case of this type of tumor treated in the General Hospital of Tijuana, Mexico, as well as a review of the literature. We present the case of a 37-year-old female with symptomatology of early satiety and abdominal distension. During open cholecystectomy we found a tumor in the body of the pancreas. Biopsy was done, establishing the diagnosis of solid pseudopapillary tumor of the pancreas. The patient was treated successfully with distal pancreatectomy and splenectomy. Solid pseudopapillary tumor of the pancreas is a rare neoplasm. It is more frequent in young women and has an unknown etiology. Clinical manifestations include abdominal pain, sensation of plenitude or early satiety, abdominal mass, nausea and vomiting. Laboratory tests are usually normal. Computerized axial tomography may show a large encapsulated heterogeneous mass. Diagnosis is established through biopsy and surgery is the best treatment for this pathological entity. One may conclude that the solid pseudopapillary tumor is a differential diagnosis in the presence of pancreatic tumors, although due to its rarity it is not the first option to discard. Surgery represents the best treatment for this pathological entity and should be attempted in all cases, independent of the size of the pancreatic injury.

Bias reduction in repeated-measures observational studies by the use of propensity score: the case of enteral sedation for critically ill patients.

PubMed

Umbrello, Michele; Mistraletti, Giovanni; Corbella, Davide; Cigada, Marco; Salini, Silvia; Morabito, Alberto; Iapichino, Gaetano

2012-12-01

Within the evidence-based medicine paradigm, randomized controlled trials represent the "gold standard" to produce reliable evidence. Indeed, planning and implementing randomized controlled trials in critical care medicine presents limitations because of intrinsic and structural problems. As a consequence, observational studies still occur frequently. In these cases, propensity score (PS) (probability of receiving a treatment conditional on observed covariates) is an increasingly used technique to adjust the results. Few studies addressed the specific issue of a PS correction of repeated-measures designs. Three techniques for correcting the analysis of nonrandomized designs (matching, stratification, regression adjustment) are presented in a tutorial form and applied to a real case study: the comparison between intravenous and enteral sedative therapy in the intensive care unit setting. After showing the results before and after the use of PS, we suggest that such a tool allows to partially overcoming the bias associated with the observational nature of the study. It permits to correct the estimates for any observed covariate, while unobserved confounders cannot be controlled for. Propensity score represents a useful additional tool to estimate the effects of treatments in nonrandomized studies. In the case study, an enteral sedation approach was equally effective to an intravenous regime, allowing for a lower level of sedation and spare of resources. Copyright © 2012 Elsevier Inc. All rights reserved.

Lightweight Expression of Granular Objects (LEGO) Content Modeling Using the SNOMED CT Observables Model to Represent Nursing Assessment Data.

PubMed

Johnson, Christie

2016-01-01

This poster presentation presents a content modeling strategy using the SNOMED CT Observable Model to represent large amounts of detailed clinical data in a consistent and computable manner that can support multiple use cases. Lightweight Expression of Granular Objects (LEGOs) represent question/answer pairs on clinical data collection forms, where a question is modeled by a (usually) post-coordinated SNOMED CT expression. LEGOs transform electronic patient data into a normalized consumable, which means that the expressions can be treated as extensions of the SNOMED CT hierarchies for the purpose of performing subsumption queries and other analytics. Utilizing the LEGO approach for modeling clinical data obtained from a nursing admission assessment provides a foundation for data exchange across disparate information systems and software applications. Clinical data exchange of computable LEGO patient information enables the development of more refined data analytics, data storage and clinical decision support.

Animal reservoir, natural and socioeconomic variations and the transmission of hemorrhagic fever with renal syndrome in Chenzhou, China, 2006-2010.

PubMed

Xiao, Hong; Tian, Huai-Yu; Gao, Li-Dong; Liu, Hai-Ning; Duan, Liang-Song; Basta, Nicole; Cazelles, Bernard; Li, Xiu-Jun; Lin, Xiao-Ling; Wu, Hong-Wei; Chen, Bi-Yun; Yang, Hui-Suo; Xu, Bing; Grenfell, Bryan

2014-01-01

China has the highest incidence of hemorrhagic fever with renal syndrome (HFRS) worldwide. Reported cases account for 90% of the total number of global cases. By 2010, approximately 1.4 million HFRS cases had been reported in China. This study aimed to explore the effect of the rodent reservoir, and natural and socioeconomic variables, on the transmission pattern of HFRS. Data on monthly HFRS cases were collected from 2006 to 2010. Dynamic rodent monitoring data, normalized difference vegetation index (NDVI) data, climate data, and socioeconomic data were also obtained. Principal component analysis was performed, and the time-lag relationships between the extracted principal components and HFRS cases were analyzed. Polynomial distributed lag (PDL) models were used to fit and forecast HFRS transmission. Four principal components were extracted. Component 1 (F1) represented rodent density, the NDVI, and monthly average temperature. Component 2 (F2) represented monthly average rainfall and monthly average relative humidity. Component 3 (F3) represented rodent density and monthly average relative humidity. The last component (F4) represented gross domestic product and the urbanization rate. F2, F3, and F4 were significantly correlated, with the monthly HFRS incidence with lags of 4 months (r = -0.289, P<0.05), 5 months (r = -0.523, P<0.001), and 0 months (r = -0.376, P<0.01), respectively. F1 was correlated with the monthly HFRS incidence, with a lag of 4 months (r = 0.179, P = 0.192). Multivariate PDL modeling revealed that the four principal components were significantly associated with the transmission of HFRS. The monthly trend in HFRS cases was significantly associated with the local rodent reservoir, climatic factors, the NDVI, and socioeconomic conditions present during the previous months. The findings of this study may facilitate the development of early warning systems for the control and prevention of HFRS and similar diseases.

Parasites of the Raccoon, Procyon lotor

USGS Publications Warehouse

Clark, G.M.; Herman, C.M.

1959-01-01

At least 76 species of parasites have been reported from raccoons. These include 4 species of protozoa, 27 nematodes, 20 trematodes, 7 cestodes, 3 acanthocephala, and 15 arthropods. In many cases these represent single reports. In other cases some of the parasites are known to be of frequent occurrence and broad geographical range on the basis of several surveys that have been conducted. During the past 30 years 260 raccoons have been examined for parasites at the Patuxent Research Refuge. While most of these animals were collected on the refuge, several were from other localities in Maryland and a few from outside this state. The known distribution and occurrence of parasites of the raccoon are presented on charts and representative specimens of some of those collected at the Patuxent Research Refuge are demonstrated.

Addison's disease presenting with perimyocarditis.

PubMed

Baranski Lamback, Elisa; Morandi, Grazia; Rapti, Eleni; Christov, Georgi; Brogan, Paul A; Hindmarsh, Peter

2018-01-26

Polyglandular autoimmune syndrome (PGA) and eosinophilic granulomatosis with polyangiitis (EGPA) do not seem to represent a coincidental association. A case of a 15-year-old boy is reported who presented with severe systemic inflammation, perimyocarditis and cardiogenic shock, in whom EGPA was initially suspected and later diagnosed with autoimmune adrenalitis with PGA. The severity of the systemic inflammation and perimyocarditis suggests a more widespread autoimmune-mediated process. Autoimmune adrenal insufficiency should be considered in all cases of pericarditis and perimyocarditis, especially when the severity of clinical manifestations exceeds the expected for the severity of the cardiac findings, as timely identification and prompt treatment may be life-saving.

Secondary signet-ring cell adenocarcinoma of urinary bladder from a gastric primary

PubMed Central

Sharma, Pramod K.; Vijay, Mukesh K.; Das, Ranjit K.; Chatterjee, Uttara

2011-01-01

Primary bladder tumor is a frequent urological malignancy, whereas the incidence of secondary bladder tumor from a distant organ is quite rare. Secondary bladder neoplasms represent 1% of all malignant bladder tumors, of which distant metastases from stomach account for about 4% of cases. We present the case of a 30-year-old male who underwent partial gastrectomy for Signet-ring cell carcinoma of the stomach and presented 2 years later with hematuria. On computerized tomography scan, a bladder tumor was found which was resected cystoscopically. The histopathological examination revealed secondary Signet-ring cell adenocarcinoma of the urinary bladder. PMID:21747602

Severe pediculosis capitus: a case of "crusted lice" with autoeczematization.

PubMed

Connor, Cody J; Selby, John C; Wanat, Karolyn A

2016-03-16

Pediculosis humanus capitus infestations are common and classically present with intense pruritus of the scalp. Although many treatment options are available, lice are becoming more resistant to conventional therapies and severe clinical presentations are bound to become more prevalent. We present a case of treatment-resistant pediculosis capitus resulting in diffuse autoeczematization of the torso and extremities and severe crusting and scaling of the scalp, which we called "crusted lice." This eruption differs from the well-described id reaction known as "pediculid" and represents a more dramatic manifestation of rampant infestation. This paper provides an up-to-date review of treatment options available for pediculosis humanus capitus, including newer medications like the ones that eventually led to resolution of our patient's extreme infestation.

Bilateral maxillary brown tumors in a patient with primary hyperparathyroidism: Report of a rare entity and review of literature

PubMed Central

Soundarya, N; Sharada, P; Prakash, Nilima; Pradeep, GL

2011-01-01

Brown tumors are erosive bony lesions caused by rapid osteoclastic activity and peritrabecular fibrosis due to hyperparathyroidism, resulting in a local destructive phenomenon. The classical “brown tumor” is commonly seen in ends of long bones, the pelvis and ribs. Facial involvement is rare and, when present, usually involves the mandible. We report a case of 60-year-old male with a rare initial presentation of primary hyperparathyroidism with bilateral maxillary brown tumors. The present case represents the third report of the bilateral maxillary brown tumors in a patient with primary hyperparathyroidism. Differential diagnosis is important for the right treatment choice. It should exclude other giant cell lesions that affect the maxillae. PMID:21731279

Control means for a gas turbine engine

NASA Technical Reports Server (NTRS)

Beitler, R. S.; Sellers, F. J.; Bennett, G. W. (Inventor)

1982-01-01

A means is provided for developing a signal representative of the actual compressor casing temperature, a second signal representative of compressor inlet gas temperature, and a third signal representative of compressor speed. Another means is provided for receiving the gas temperature and compressor speed signals and developing a schedule output signal which is a representative of a reference casing temperature at which a predetermined compressor blade stabilized clearance is provided. A means is also provided for comparing the actual compressor casing temperature signal and the reference casing temperature signal and developing a clearance control system representative of the difference. The clearance control signal is coupled to a control valve which controls a flow of air to the compressor casing to control the clearance between the compressor blades and the compressor casing. The clearance control signal can be modified to accommodate transient characteristics. Other embodiments are disclosed.

77 FR 56714 - Agency Information Collection (Statement of Accredited Representative in Appealed Case...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... Representative in Appealed Case, VA Form 646. OMB Control Number: 2900-0042. Type of Review: Extension of a... (Statement of Accredited Representative in Appealed Case) Activities Under OMB Review AGENCY: Board of Veterans' Appeals, Department of Veterans Affairs. ACTION: Notice. SUMMARY: In compliance with the...

A branchial cyst of the pyriform fossa transoral laser resection: a case report.

PubMed

Abdelfattah, Hesham Mostafa; Ahmed, Mohammed Elrabie; Ahmed, Mona El-Rabie; Ahmed, Mohamed Abd El-Kader; Moussa, Abd-Elmateen

2016-02-01

Pyriform sinus malformations represent rare third and fourth branchial anomalies. Fistulae at the latter site were initially described and make up less than 1 % of all brachial anomalies. They may be discovered incidentally, or may present as a neck mass with recurrent infection, dysphagia, or airway compromise, and can be an unusual cause of dysphonia in infant and children. Here, we present a case of third branchial cyst located in pharyngeal wall of the left pyriform sinus which presented with dysphonia since birth in a 6-year-old girl. Transoral CO2 laser excision was carried out successfully with no communicating tract. The patient's dysphonia showed progressive regression at 1-year follow-up. Third branchial cyst in the left pyriform sinus (Bailey's type IV) is an unusual cause of dysphonia in pediatric. Our present case report is the first brachial cyst to be reported in the pyriform fossa and the second branchial anomalies to be excised transorally with CO2 laser.

Primary gastric Burkitt lymphoma: a rare cause of life-threatening haematemesis.

PubMed

Ayoub, Fares; Forde, Justin J; Patel, Niraj; Markham, Merry

2017-08-22

Lymphomas are the second most common gastric malignancy following gastric adenocarcinoma. The majority of gastric lymphomas are either mucosa-associated lymphoid tissue lymphomas or diffuse large B-cell lymphomas. Primary gastric Burkitt lymphoma is a subtype of non-Hodgkin's lymphoma and represents an aggressive and rare malignancy with only a small number of cases reported worldwide. Clinical and radiological presentation is non-specific and mimics other gastric lymphomas. Diagnosis is established with pathological evaluation. Due to the paucity of cases, treatment of this condition is not well studied and is extrapolated from paediatric and adult literature of Burkitt lymphoma not isolated to the stomach. We present the case of a male patient with primary gastric Burkitt lymphoma who initially presented with life-threatening haematemesis, later achieving complete remission with treatment. We discuss the epidemiology, presentation and management of gastric Burkitt lymphoma. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Designing for Mathematical Abstraction

ERIC Educational Resources Information Center

Pratt, Dave; Noss, Richard

2010-01-01

Our focus is on the design of systems (pedagogical, technical, social) that encourage mathematical abstraction, a process we refer to as "designing for abstraction." In this paper, we draw on detailed design experiments from our research on children's understanding about chance and distribution to re-present this work as a case study in designing…

Moving Apart and Coming Together: Discourse, Engagement, and Deep Learning

ERIC Educational Resources Information Center

Gomoll, Andrea S.; Hmelo-Silver, Cindy E.; Tolar, Erin; Šabanovic, Selma; Francisco, Matthew

2017-01-01

An important part of "doing" science is engaging in collaborative science practices. To better understand how to support these practices, we need to consider how students collaboratively construct and represent shared understanding in complex, problem-oriented, and authentic learning environments. This research presents a case study…

An Investigation of the Representativeness Heuristic: The Case of a Multiple Choice Exam

ERIC Educational Resources Information Center

Chernoff, Egan J.; Mamolo, Ami; Zazkis, Rina

2016-01-01

By focusing on a particular alteration of the comparative likelihood task, this study contributes to research on teachers' understanding of probability. Our novel task presented prospective teachers with multinomial, contextualized sequences and asked them to identify which was least likely. Results demonstrate that determinants of…

A Case Study in Conflict Management.

ERIC Educational Resources Information Center

Chase, Lawrence J.; Smith, Val R.

This paper presents a model for a message-centered theory of human conflict based on the assumption that conflict will result from the pairing of any two functional messages that share a common antecedent but contain different consequences with oppositely signed affect. The paper first shows how to represent conflict situations diagrammatically…

A Business Educator's Guide to Transitioning to a Digital Curriculum

ERIC Educational Resources Information Center

Roberts, Scott D.; Rains, Russell E.; Perry, Gregory E.

2012-01-01

The authors, representing three key digital media business disciplines, present a case for how business curriculum could be updated to include a strong digital element without recreating the entire business school enterprise or spending millions on new faculty and technology. The three key disciplines are technology, law, and marketing.

Remote Viewing and Computer Communications--An Experiment.

ERIC Educational Resources Information Center

Vallee, Jacques

1988-01-01

A series of remote viewing experiments were run with 12 participants who communicated through a computer conferencing network. The correct target sample was identified in 8 out of 33 cases. This represented more than double the pure chance expectation. Appendices present protocol, instructions, and results of the experiments. (Author/YP)

"Why Are They Bombing Innocent Iraqis?": Political Literacy among Primary Pupils

ERIC Educational Resources Information Center

Maitles, Henry; Deuchar, Ross

2004-01-01

This article presents case studies of political literacy among primary pupils. While researching primary pupils' understanding of "enterprise", the researchers added interviews connecting this concept to the Iraq war. A sample of 10 non-representative Scottish primary schools from seven local education authorities has provided the…

Strategies for Adult Education. Practices in Western Europe.

ERIC Educational Resources Information Center

Titmus, Colin

European case studies on strategies for adult education are presented as representative or exemplary approaches to universal access. Each is described within a historical and social context: the British Community Colleges and the Open University; the Swedish Study Circles; the Evening Folk High School in Germany; the social-cultural animation…

Hershey Montessori Farm School, 2001: Unmasking Individual Truth.

ERIC Educational Resources Information Center

Kahn, David

2001-01-01

Presents information on the Hershey Montessori Farm School in Huntsburg, Ohio, after a year of operation. Includes beginning case studies, which represent individual change to a higher level of personal realization and social cooperation. Focuses on development of the farm community as the backdrop for personal change and healing, which…

Enhancing Students' Language Skills through Blended Learning

ERIC Educational Resources Information Center

Banditvilai, Choosri

2016-01-01

This paper presents a case study of using blended learning to enhance students' language skills and learner autonomy in an Asian university environment. Blended learning represents an educational environment for much of the world where computers and the Internet are readily available. It combines self-study with valuable face-to-face interaction…

Promoting Resilience through Adversity: Increasing Positive Outcomes for Expelled Students

ERIC Educational Resources Information Center

Coleman, Nadia

2015-01-01

This article endeavours to increase educators' understanding of the experiences of students who have been expelled from school in order to represent this critical stakeholder group in future policy development and programme implementation. Students' perspectives are presented through thick description in this narrative case study. Findings…

Bilateral Mycobacterium chelonae Keratitis after Phacoemulsification Cataract Surgery.

PubMed

Martinez, Jaime D; Amescua, Guillermo; Lozano-Cárdenas, Jesus; Suh, Leejee H

2017-01-01

The purpose of this manuscript is to report the case of an 81-year-old patient who presented with bilateral keratitis after phacoemulsification surgery. Cultures came back positive for Mycobacterium chelonae . Despite aggressive topical and systemic antimicrobial treatment, the patient developed a corneal perforation in both eyes, treated with corneal glue in the right eye and corneoscleral patch in the left eye. After two years of follow-up, patient was free of infection in the right eye with visual acuity of 20/200 and the left eye progressed to phthisis bulbi. We present an unusual case of bilateral Mycobacterium chelonae keratitis associated with phacoemulsification cataract surgery. This case represents the importance of making clinicians aware of this devastating infection and highlights the need for better management to improve outcomes.

Dysphagia lusoria: a late onset presentation.

PubMed

Bennett, Alice Louise; Cock, Charles; Heddle, Richard; Morcom, Russell Kym

2013-04-21

Dysphagia lusoria is a term used to describe dysphagia secondary to vascular compression of the oesophagus. The various embryologic anomalies of the arterial brachial arch system often remain unrecognised and asymptomatic, but in 30%-40% of cases can result in tracheo-oesophageal symptoms, which in the majority of cases manifest as dysphagia. Diagnosis of dysphagia lusoria is via barium swallow and chest Computed tomography scan. Manometric abnormalities are variable, but age-related manometric changes may contribute to clinically relevant dysphagia lusoria in patients who present later in life. Our report describes a case of late-onset dysphagia secondary to a right aortic arch with an aberrant left subclavian artery, which represents a rare variant of dysphagia lusoria. The patient had proven additional oesophageal dysmotility with solid bolus only and a clinical response to dietary modification.

A Dynamic Infrastructure for Interconnecting Disparate ISR/ISTAR Assets (the ITA Sensor Fabric)

DTIC Science & Technology

2009-07-01

areas of sensor identification, classification, interoperability and sensor data sharing, dissemination and consumability. This paper presents the ITA...sensors in the area of operations. This paper also presents a use case scenario developed in partnership with the U.S. Army Research Laboratory (ARL) and... paper we describe the Fabric, and its application to a simulated representative coalition operation scenario. The Fabric spans the network from the

Dural arteriovenous fistula as a treatable dementia.

PubMed

Enofe, Ikponmwosa; Thacker, Ike; Shamim, Sadat

2017-04-01

Dementia is a chronic loss of neurocognitive function that is progressive and irreversible. Although rare, dural arteriovenous fistulas (DAVFs) could present with a rapid decline in neurocognitive function with or without Parkinson-like symptoms. DAVFs represent a potentially treatable and reversible cause of dementia. Here, we report the case of an elderly woman diagnosed with a DAVF after presenting with new-onset seizures, deteriorating neurocognitive function, and Parkinson-like symptoms.

Dural arteriovenous fistula as a treatable dementia

PubMed Central

Enofe, Ikponmwosa; Thacker, Ike

2017-01-01

Dementia is a chronic loss of neurocognitive function that is progressive and irreversible. Although rare, dural arteriovenous fistulas (DAVFs) could present with a rapid decline in neurocognitive function with or without Parkinson-like symptoms. DAVFs represent a potentially treatable and reversible cause of dementia. Here, we report the case of an elderly woman diagnosed with a DAVF after presenting with new-onset seizures, deteriorating neurocognitive function, and Parkinson-like symptoms. PMID:28405088

Secondary abdominal appendicular ectopic pregnancy.

PubMed

Nama, Vivek; Gyampoh, Bright; Karoshi, Mahantesh; McRae, Reynold; Opemuyi, Isaac

2007-01-01

Although the case fatality rate for ectopic pregnancies has decreased to 0.08% in industrialized countries, it still represents 3.8% of maternal mortality in the United States alone. In developing countries, the case fatality rate varies from 3% to 27%. Laparoscopic management of tubal pregnancies is now the standard form of treatment where this technology is available. Abdominal pregnancies are rare, and secondary implantation of tubal ectopic pregnancies is the most common cause of abdominal gestations. We present an interesting case of secondary implantation of a tubal ectopic pregnancy to highlight the appendix as a possible secondary implantation site after a tubal ectopic pregnancy.

12 Years delayed postoperative spinal recurrence of craniopharyngioma. Case report and literature review.

PubMed

Marchesini, Nicolò; Soda, Christian; Ricci, Umberto Maria; Sedia, Mattia; Sala, Francesco; Pinna, Giampietro

2017-12-04

A case of delayed spinal adamantinomatous craniopharyngioma recurrence is presented. A 54-year-old male patient was admitted in our Emergency Department complaining of urinary disorders and leg pains. He underwent surgical removal of intraventricular craniopharyngioma 12 years previously. On MR imaging a well-circumscribed intradural cistyc mass at the T12 level was reavealed. A T11 and T12 laminotomy was performed and total removal of the tumour was achieved. Histology examination showed adamantinous craniopharyngioma. The authors believe that this represents the third case described of spinal craniofaryngioma recurrence and the first involving the dorsal spine.

A case of vascular Ehlers-Danlos Syndrome with a cardiomyopathy and multi-system involvement.

PubMed

Lan, Nick Si Rui; Fietz, Michael; Pachter, Nicholas; Paul, Vincent; Playford, David

Ehlers-Danlos Syndrome comprises a heterogeneous group of heritable connective tissue disorders resulting from various gene mutations. We present an unusual case of vascular Ehlers-Danlos Syndrome with distinctive physical characteristics and a cardiomyopathy with features suggesting isolated left ventricular non-compaction. The cardiac features represent the first report of a cardiomyopathy associated with a mutation in the COL3A1 gene. This case also illustrates the multi-system nature of Ehlers-Danlos Syndrome and the complexity of managing patients with the vascular subtype. Copyright © 2018 Elsevier Inc. All rights reserved.

Case study of first episode schizophrenia in pregnancy and postpartum.

PubMed

Kast, Kristopher A; Agarkar, Smita

2017-08-01

Patients with first-episode psychosis of peripartum onset commonly prove to have a mood-disorder diathesis; however, a proportion of cases represent first-episode schizophrenia. We present such a case and discuss the clinical relevance of recognizing this small but important population of new mothers. These patients are at considerable risk of misdiagnosis, resulting in ineffective maintenance therapy, poorer recovery of function, and development of treatment resistance. Accurate diagnosis in the peripartum period will impact treatment decisions and long-term therapy. Clinicians need to be vigilant, especially during maintenance therapy, to identify these patients and ensure appropriate antipsychotic therapy is provided.

Superolateral dislocation of the intact mandibular condyle associated with panfacial fracture: a case report and literature review.

PubMed

Amaral, Márcio Bruno; Bueno, Sebastião Cristian; Silva, Alice Araújo Ferreira; Mesquita, Ricardo Alves

2011-06-01

Superolateral dislocation of the intact mandibular condyle (SDIMC) is rare. This case report focuses on a 15-year-old teenager who was involved in a motor vehicle accident as well a literature review regarding the SDIMC. Clinical examination demonstrated a diffuse edema in the midfacial area and a left lateral deflection of the mandible, including an open bite and a crepitation in the symphyseal region. Three-dimensional computed tomography scans were taken, which presented a superolateral dislocation of the left mandibular condyle as well as panfacial fracture. The patient was set in intermaxillary fixation for 2 weeks and underwent subsequent active jaw physiotherapy, the evaluation of which presented satisfactory results. This case study also presents a literature review, which demonstrated 21 well-documented cases of SDIMC. The patients' mean age was of 29 years. The male gender proved to be more prevalent, with road traffic collisions representing the most common form of accident. Type II, with unilateral dislocation, proved to be the most common. The mean reduction time was 7 days. The open methods were the most commonly used reduction methods. Mandible fracture was associated with dislocation in 82% of the cases, with other facial fractures appearing in only 23% of the cases. Patient follow up presented satisfactory results in 59% of the cases. © 2011 John Wiley & Sons A/S.

Mesenteric-portal axis thrombosis and deep venous thrombosis in a patient with inferior vena cava agenesis.

PubMed

Lluis Pons, Laia; Chahri Vizcarro, Nadia; Llaverias Borrell, Silvia; Miquel Abbad, Carlos

2017-06-01

Splenoportal axis thrombosis not associated with cirrhosis or neoplasms has a prevalence lower than 5 per 10,000 people. An etiologic factor responsible for portal thrombosis is finally identified in most cases, usually systemic thrombogenic factors or predisposing local factors. However, despite a detailed study of all etiologic factors, up to 30% of cases are eventually considered as idiopathic in origin. We report the case of a 41-year-old patient who presented with abdominal pain and lower extremity edema. The patient was diagnosed with portal and mesenteric-portal confluence thrombosis, bilateral deep venous thrombosis and right lumbar vein thrombosis based on an abdominal CT scan. This was associated with a likely congenital inferior vena cava agenesis. This malformation is present in approximately 5% of patients with deep vein thrombosis even though it represents a rare cause of portal thrombosis. The fact that several thromboses developed simultaneously makes this a unique and isolated case in the current literature as no similar cases have been reported thus far.

Laparoscopic excision of rectosigmoid endometriotic plaque and cul de sac obliteration in deeply infiltrating endometriosis: a case report.

PubMed

Fragulidis, G P; Oreopulu, F V; Vezakis, A; Sofoudis, C; Kalambokas, E; Koutoulidis, V; Vlahos, N F

2016-01-01

Endometriosis represents a main cause of infertility and pelvic pain affecting 3-43% among reproductive age women. Deep pelvic endometriosis is defined as subperitoneal infiltration of endometrial implants in the uterosacral ligaments, rectum, rectovaginal septum, vagina or bladder. The authors present a case of a 29-year-old patient who underwent laparoscopic excision of extensive endometriotic plaque in rectovaginal septum accompanied with deeply infiltrating endometriosis (DIE) and chronic pelvic pain (CPP).

Planar xanthomas secondary to post-transplantation cholangiopathy in a 16-month-old boy.

PubMed

Patel, Nirali; Norberg, Adam; Hogeling, Marcia

2018-05-01

Planar xanthomas in children represent rare dermatologic findings associated with abnormalities in lipid metabolism. While planar xanthomas in Alagille's syndrome have been well described in the literature, there have been no cases reported of eruptive xanthomas in pediatric liver transplant patients. Herein we report a case of a 16-month-old boy status post-liver transplantation who presents with planar xanthomas secondary to cholangiopathy. A brief review of xanthomas and the related literature is also provided. © 2018 Wiley Periodicals, Inc.

General image method in a plane-layered elastostatic medium

NASA Technical Reports Server (NTRS)

Fares, N.; Li, V. C.

1988-01-01

The general-image method presently used to obtain the elastostatic fields in plane-layered media relies on the use of potentials in order to represent elastic fields. For the case of a single interface, this method yields the displacement field in closed form, and is applicable to antiplane, plane, and three-dimensional problems. In the case of multiplane interfaces, the image method generates the displacement fields in terms of infinite series whose convergences can be accelerated to improve method efficiency.

Perthes disease in a 2-year-old child.

PubMed

Dhas, Daphne; Viswanath, Aparna; Latimer, Mark David

2015-03-02

Perthes disease represents a transient interruption of the blood supply to the femoral head followed by collapse and subsequent remodelling. The majority of cases present between the ages of 4 and 10 years. We report the case of a child who developed a painful right-sided limp some days after his second birthday. The limp was initially interpreted as a transient synovitis of the hip. However, when the limp persisted, further investigations revealed that he had Perthes disease. 2015 BMJ Publishing Group Ltd.

Perthes disease in a 2-year-old child

PubMed Central

Dhas, Daphne; Viswanath, Aparna

2015-01-01

Perthes disease represents a transient interruption of the blood supply to the femoral head followed by collapse and subsequent remodelling. The majority of cases present between the ages of 4 and 10 years. We report the case of a child who developed a painful right-sided limp some days after his second birthday. The limp was initially interpreted as a transient synovitis of the hip. However, when the limp persisted, further investigations revealed that he had Perthes disease. PMID:25733084

Laser induced thermal therapy (LITT) for pediatric brain tumors: case-based review

PubMed Central

Riordan, Margaret

2014-01-01

Integration of Laser induced thermal therapy (LITT) to magnetic resonance imaging (MRI) have created new options for treating surgically challenging tumors in locations that would otherwise have represented an intrinsic comorbidity by the approach itself. As new applications and variations of the use are discussed, we present a case-based review of the history, development, and subsequent updates of minimally invasive MRI-guided laser interstitial thermal therapy (MRgLITT) ablation in pediatric brain tumors. PMID:26835340

Cheilitis granulomatosa associated with lupus erythematosus discoid and treated with methotrexate: report of a case*

PubMed Central

Nazzaro, Gianluca; Muratori, Simona; Carrera, Carlo Giovanni; Coggi, Antonella; Gianotti, Raffaele

2015-01-01

We present the rare case of a 47-year-old patient, suffering from cheilitis granulomatosa and lupus erythematosus discoid: this association is really exceptional because only once reported in English literature. In addition, the treatment of cheilitis granulomatosa is a challenge for the dermatologist: the gold standard, represented by steroids, is in fact designed as a short-time option. Our report confi rms the good efficacy of methotrexate as a steroid-sparing agent. PMID:26312716

Hallucinogen persisting perception disorder after psilocybin consumption: a case study.

PubMed

Espiard, Marie-Laure; Lecardeur, Laurent; Abadie, Pascale; Halbecq, Isabelle; Dollfus, Sonia

2005-08-01

The recurrence of flashbacks without acute or chronic hallucinogen consumption has been recognized in the DSM IV criteria as the hallucinogen persisting perception disorder (HPPD). Perceptual disturbances may last for 5 years or more and represent a real psychosocial distress. We reported here a case of a 18-year-old young man presenting HPPD after a mixed intoxication with psylocibin and cannabis. This report shows symptomatic recurrences persisting more than 8 months. Various differential diagnoses were evoked and our therapeutic strategies were described.

Performance of alkaline battery cells used in emergency locator transmitters

NASA Technical Reports Server (NTRS)

Haynes, G. A.; Sokol, S.; Motley, W. R., III; Mcclelland, E. L.

1984-01-01

The characteristics of battery power supplies for emergency locator transmitters (ELT's) were investigated by testing alkaline zinc/manganese dioxide cells of the type typically used in ELT's. Cells from four manufacturers were tested. The cells were subjected to simulated environmental and load conditions representative of those required for survival and operation. Battery cell characteristics that may contribute to ELT malfunctions and limitations were evaluated. Experimental results from the battery cell study are discussed, and an evaluation of ELT performance while operating under a representative worst-case environmental condition is presented.

A hypnotically mediated guided imagery intervention for intrusive imagery: creating ground for figure.

PubMed

Appel, P R

1999-04-01

Intrusive imagery can be seen as a cognitive dysfunction in the assimilation and accommodation of the psychological material represented by those images. From a gestalt psychological perspective, the intrusive image represents a figure without a ground that can provide meaning and context. Hypnotically mediated guided imagery interventions can be used to create a ground for the rogue image that metaphorically is an unassimilated figure; and thus allow for the creation of a new cognitive scheme. Four case examples are presented as well as a model for the intervention.

Ossified Intracranial Meningiomas: Description of the First Series of Cases and Review of the Literature.

PubMed

Caffo, Maria; Caruso, Gerardo; Barresi, Valeria; Tomasello, Francesco

2016-10-01

Metaplastic meningiomas are characterized by mesenchymal differentiation with formation of bone, cartilage, fat, or xanthomatous elements. However the presence of extensive areas of ossification is rare in meningiomas. In addition, intracranial location of ossified meningiomas is uncommon. Surgical management represents the optimal treatment for ossified meningiomas, but ossification may interfere with surgery and condition outcome. By reviewing patient records and contacting patients, families, and referring physicians, the following information was gathered: age, sex, tumor location, clinical presentation, preoperative and postoperative functional status, and surgical data. Each surgical specimen had been formalin-fixed, paraffin-embedded, and cut into parallel 4-μm-thick sections for histological evaluation. Our literature search identified 8 cases, all of whom had undergone surgical treatment. Histopathological analysis revealed the presence of disorganized bone spicules with solitary oval osteocytic nuclei and lined by osteoblasts, with clear evidence of bone tissue in at least 50% of tumor tissue. Here we present the largest series, to our knowledge, of surgically treated intracranial ossified meningiomas reported to date. The mechanism of ossification in these meningiomas remains unclear, and various hypotheses have been formulated. Complete lesion removal, or subtotal debulking in those cases characterized by tenacious adherences to vascular structures and/or critical areas, may represent the optimal treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Coexistence of gastrointestinal stromal tumor (GIST) and colorectal adenocarcinoma: A case report.

PubMed

Efstathios, Papalambros; Athanasios, Petrou; Papaconstantinou, Ioannis; Alexandros, Papalambros; Frangisca, Sigala; Sotirios, Georgopoulos; Evangelos, Felekouras; Athanasios, Giannopoulos

2007-08-21

Gastrointestinal stromal tumors (GIST) represent the most common mesenchymal tumors of the digestive tract. Over the last ten years the management of GISTs has dramatically altered but their coexistence with other gasrointesinal tumors of different histogenesis presents a special interest. The coexistence of GISTs with other primaries is usually discovered incidentally during GI surgery for carcinomas. We present here, a case of a 66-year-old patient with intestinal GIST and a synchronous colorectal adenocarcinoma discovered incidentally during surgical treatment of the recurrent GIST. Immunohistochemical examination revealed the concurrence of histologically proved GIST (strongly positive staining for c-kit, vimentin, SMA, and focal positive in S-100, while CD-34 was negative) and Dukes Stage C, (T3, N3, M0 according the TNM staging classification of colorectal cancer). The coexistence of GIST with either synchronous or metachronous colorectal cancer represents a phenomenon with increasing number of relative reports in the literature the last 5 years. In any case of GIST the surgeon should be alert to recognize a possible coexistent tumor with different histological origin and to perform a thorough preoperative and intraoperative control. The correct diagnosis before and at the time of the surgical procedure is the cornerstone that secures the patients' best prognosis.

Klatskin-mimicking lesions--a case series and literature review.

PubMed

Dumitrascu, Traian; Ionescu, Mihnea; Ciurea, Silviu; Herlea, Vlad; Lupescu, Ioana; Popescu, Irinel

2010-01-01

Obstruction of the hepatic hilum in patients without prior surgery is generally due to hilar adenocarcinoma (Klatskin tumor). However, not all the hilar strictures are malignant. Although uncommon, benign strictures of the proximal bile duct should be taken into consideration in differential diagnosis of Klatskin tumors, since the incidence could reach up to 25% of patients with presumed Klatskin tumor diagnosis. This group of benign proximal bile duct strictures (Klatskin-mimicking lesions) is usually represented by segmental fibrosis and non-specific chronic inflammation. The clinical and imaging features can not differentiate between benign and malignant strictures. Herein, we present a case series of three patients with benign proximal bile duct strictures (representing 4.1% of 73 patients resected with presumptive preoperative diagnosis of Klatskin tumor) and literature review. There are presented the clinical and biochemical features, imaging preoperative workup, surgical treatment and histological analysis of the specimen, along with postoperative outcome. For benign strictures of the hilum limited resections are curative. However, despite new diagnosis tools developed in the last years, patients with hilar obstructions still require unnecessary extensive resections due to impossibility of excluding the malignancy. In all cases of proximal bile duct obstruction presumed malignant, they should be managed accordingly, even with the risk of over-treatment for some benign lesions.

Rhabdomyosarcoma of the urinary bladder in adults: predilection for alveolar morphology with anaplasia and significant morphologic overlap with small cell carcinoma.

PubMed

Paner, Gladell P; McKenney, Jesse K; Epstein, Jonathan I; Amin, Mahul B

2008-07-01

Rhabdomyosarcoma (RMS) represents the most common malignant soft tissue tumor in children and adolescents with the urinary bladder representing a frequent site. Most of these urinary bladder tumors are embryonal RMS, predominantly the botryoid subtype. RMSs of the urinary bladder in adults are distinctively rare and the subject of only case reports. We report the clinicopathologic features of 5 bladder neoplasms with rhabdomyosarcomatous differentiation in adults and emphasize the differential diagnosis in the adult setting. The patients, 4 men and 1 woman, ranged in age from 23 to 85 years (mean 65.4 y). Gross hematuria was the most common initial symptom, although 2 patients had metastatic disease at presentation. Four cases were pure primary RMSs of the bladder and 1 case was a sarcomatoid urothelial carcinoma with RMS representing the extensive heterologous component. All 5 cases demonstrated a diffuse growth pattern (ie, non-nested), of which 4 cases had nuclear anaplasia (Wilms criteria without the atypical mitotic figure requirement); only 1 case (the sarcomatoid carcinoma) showed obvious rhabdomyoblastic differentiation (ie, strap cells). Three cases were of the alveolar subtype (1 admixed with embryonal histology) and 2 were RMS, not further classified. Microscopically, all tumors had a primitive undifferentiated morphology with cells containing scant cytoplasm, varying round to fusiform nuclei with even chromatin distribution, and frequent mitoses. The degree of morphologic overlap with small cell carcinoma of the bladder, a relatively more common round cell tumor in adults, was striking. The epithelial component of the sarcomatoid carcinoma was high-grade invasive urothelial carcinoma with glandular differentiation. No other case had previous history of bladder cancer or concurrent carcinoma in situ or invasive urothelial carcinoma. All tumors showed immunohistochemical expression for desmin, myogenin, and/or MyoD1. Synaptophysin was performed in 4 cases, and 3 showed weak cytoplasmic immunoreactivity. Two patients received chemotherapy, 2 underwent cystectomy, and 1 had transurethral resection alone. Outcome data were available in 4 cases, and all 4 died of disease (1, 4, 8, and 8 mo). In conclusion, (1) RMS of the urinary bladder in adults more commonly presents as a primitive round blue cell neoplasm that has significant morphologic and immunohistochemical overlap with small cell carcinoma of the bladder. (2) Although RMS in children generally have a botryoid embryonal histology with favorable outcome, bladder RMS in adults frequently demonstrates alveolar or unclassified histology, commonly with anaplasia, and have a uniformly aggressive clinical course.

Critical analysis of consecutive unilateral cleft lip repairs: determining ideal sample size.

PubMed

Power, Stephanie M; Matic, Damir B

2013-03-01

Objective : Cleft surgeons often show 10 consecutive lip repairs to reduce presentation bias, however the validity remains unknown. The purpose of this study is to determine the number of consecutive cases that represent average outcomes. Secondary objectives are to determine if outcomes correlate with cleft severity and to calculate interrater reliability. Design : Consecutive preoperative and 2-year postoperative photographs of the unilateral cleft lip-nose complex were randomized and evaluated by cleft surgeons. Parametric analysis was performed according to chronologic, consecutive order. The mean standard deviation over all raters enabled calculation of expected 95% confidence intervals around a mean tested for various sample sizes. Setting : Meeting of the American Cleft Palate-Craniofacial Association in 2009. Patients, Participants : Ten senior cleft surgeons evaluated 39 consecutive lip repairs. Main Outcome Measures : Preoperative severity and postoperative outcomes were evaluated using descriptive and quantitative scales. Results : Intraclass correlation coefficients for cleft severity and postoperative evaluations were 0.65 and 0.21, respectively. Outcomes did not correlate with cleft severity (P  =  .28). Calculations for 10 consecutive cases demonstrated wide 95% confidence intervals, spanning two points on both postoperative grading scales. Ninety-five percent confidence intervals narrowed within one qualitative grade (±0.30) and one point (±0.50) on the 10-point scale for 27 consecutive cases. Conclusions : Larger numbers of consecutive cases (n > 27) are increasingly representative of average results, but less practical in presentation format. Ten consecutive cases lack statistical support. Cleft surgeons showed low interrater reliability for postoperative assessments, which may reflect personal bias when evaluating another surgeon's results.

America's Elderly at Risk. A Report Presented by the Chairman of the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Aging.

This report examines the health risks and related financial risks faced by America's elderly. Documentation of the elderly's increased financial risk is presented which is based on data from a case study of the elderly in Massachusetts and on an analysis of the elderly's out-of-pocket health care costs using data from the Health Care Financing…

Using Earth Observations to Understand and Predict Infectious Diseases

NASA Technical Reports Server (NTRS)

Soebiyanto, Radina P.; Kiang, Richard

2015-01-01

This presentation discusses the processes from data collection and processing to analysis involved in unraveling patterns between disease outbreaks and the surrounding environment and meteorological conditions. We used these patterns to estimate when and where disease outbreaks will occur. As a case study, we will present our work on assessing the relationship between meteorological conditions and influenza in Central America. Our work represents the discovery, prescriptive and predictive aspects of data analytics.

Continent vesicovaginal fistula

PubMed Central

de Toledo, Luís Gustavo Morato; Santos, Victor Espinheira; Maron, Paulo Eduardo Gourlat; Vedovato, Bruno César; Fucs, Moacyr; Perez, Marjo Deninson Cardenuto

2013-01-01

ABSTRACT Vesicovaginal fistula is an abnormal communication between the bladder and vagina and represents the most frequent type of fistula in the urinary tract. The most common cause in Brazil is iatrogenic fistula, secondary to histerectomia. Classically these women present continuous urinary leakage from the vagina and absence of micturition, with strong negative impact on their quality of life. We present a case of totally continent vesicovaginal fistula, with a follow-up of 11 years with no complications. PMID:23579756

Grassmann phase space methods for fermions. II. Field theory

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

Dalton, B.J., E-mail: bdalton@swin.edu.au; Jeffers, J.; Barnett, S.M.

In both quantum optics and cold atom physics, the behaviour of bosonic photons and atoms is often treated using phase space methods, where mode annihilation and creation operators are represented by c-number phase space variables, with the density operator equivalent to a distribution function of these variables. The anti-commutation rules for fermion annihilation, creation operators suggests the possibility of using anti-commuting Grassmann variables to represent these operators. However, in spite of the seminal work by Cahill and Glauber and a few applications, the use of Grassmann phase space methods in quantum-atom optics to treat fermionic systems is rather rare, thoughmore » fermion coherent states using Grassmann variables are widely used in particle physics. This paper presents a phase space theory for fermion systems based on distribution functionals, which replace the density operator and involve Grassmann fields representing anti-commuting fermion field annihilation, creation operators. It is an extension of a previous phase space theory paper for fermions (Paper I) based on separate modes, in which the density operator is replaced by a distribution function depending on Grassmann phase space variables which represent the mode annihilation and creation operators. This further development of the theory is important for the situation when large numbers of fermions are involved, resulting in too many modes to treat separately. Here Grassmann fields, distribution functionals, functional Fokker–Planck equations and Ito stochastic field equations are involved. Typical applications to a trapped Fermi gas of interacting spin 1/2 fermionic atoms and to multi-component Fermi gases with non-zero range interactions are presented, showing that the Ito stochastic field equations are local in these cases. For the spin 1/2 case we also show how simple solutions can be obtained both for the untrapped case and for an optical lattice trapping potential.« less

Cystic echinococcosis in Romania: the pediatric approach.

PubMed

Neghina, Raul; Neghina, Adriana M; Marincu, Iosif; Iacobiciu, Ioan

2011-08-01

Cystic echinococcosis (CE) has represented a leading parasitic disease in Romania since 1862 when the first case was detected. Following the extremely high number of human and animal cases registered in 1995, Romania was framed in the forefront of Europe and among the first countries worldwide. This review aims to overview and analyze important data concerning CE in Romania from a pediatric point of view. To fulfill these goals, we focused on information provided by major epidemiological studies and rare/unusual case presentations. CE represents a serious concern for both public health services and the society, mainly because of prolonged hospitalization and convalescence periods. Moreover, the situation is much more problematic in children because physical, psychical, or intellectual impairments may impact negatively on their developmental and educational progress. The management of the disease consumes considerable healthcare resources estimated at about 1500-2000 United States Dollar (USD) for each uncomplicated case and approximately double for the complicated ones. A systematic analysis of data framed important epidemiological characteristics that may be useful when assessing individuals at risk: children (0-19 years old) represented 22.1% of the total number of cases, patients aged 13 years were most frequently affected (p < 0.0001), male patients and rural inhabitants predominated (p = 0.01 and p < 0.0001, respectively), and pulmonary involvement was detected most frequently (p < 0.0001). Considering the immense burden of this disease in Romania, emphasis should be given to the wide-scale implementation of effective prophylactic measures toward its eradication. Among them, education of the population plays an important role and should begin in early childhood.

Enrollment Management Issue Analysis: Operating in a Post-Katrina Higher Education Environment

ERIC Educational Resources Information Center

Jones, Jacqueline; Das, Nabakrishna; Huggins, Desiree'; McNeely, Stanton, III

2008-01-01

A definition and brief history of enrollment management are presented. The challenges represented by Hurricane Katrina for enrollment management at one community technical college and a private 4-year college are identified along with three cases that illuminate the challenges. The need for rapid response planning is articulated. (Contains 1…

The Public's Fascination with Prodigious Youth

ERIC Educational Resources Information Center

Jolly, Jennifer L.; Bruno, Justin

2010-01-01

The past several centuries have presented well-documented cases of prodigious youth. Many represented extreme examples of children who had burned brightly and then faded into obscurity, succumbed to a mental illness or an early death, or entered into a career deemed below their mental capacity. These very public displays of mental prowess caused…

Sin Papeles y Rompiendo Barreras: Latino Students and the Challenges of Persisting in College

ERIC Educational Resources Information Center

Contreras, Frances

2009-01-01

Undocumented Latino students in higher education represent a resilient, determined, and inspirational group of high achievers who persevere and serve as a model for success. Here, Frances Contreras presents a qualitative case study consisting of twenty semistructured, in-depth interviews with undocumented Latino students in an effort to help…

Leading Educational Change Using a Neuropsychological Response-to-Intervention Approach: Linking Our Past, Present, and Future

ERIC Educational Resources Information Center

Witsken, Deborah; Stoeckel, Amanda; D'Amato, Rik Carl

2008-01-01

Neuropsychology may be described as the study of brain-behavior relationships (National Academy of Neuropsychology [NAN], 2001). Clinical neuropsychology represents the application of knowledge of the intricacies of these relationships to individual cases. Several authors have advocated for the application of neuropsychology to the public schools,…

The Hierarchy of Minority Languages in New Zealand

ERIC Educational Resources Information Center

de Bres, Julia

2015-01-01

This article makes a case for the existence of a minority language hierarchy in New Zealand. Based on an analysis of language ideologies expressed in recent policy documents and interviews with policymakers and representatives of minority language communities, it presents the arguments forwarded in support of the promotion of different types of…

Barriers to Successful Implementation of Technology Integration in Educational Settings: A Case Study

ERIC Educational Resources Information Center

Laferrière, T.; Hamel, C.; Searson, M.

2013-01-01

Representing issues discussed at the EduSummIT 2011 relative to essential conditions and barriers to successful technology integration, this article presents a systemic analysis of barriers that needed to be overcome for an information technology initiative (Remote Networked School project) to be successfully implemented. The analysis was…

Leading for Sustainability in Western Australian Regional Schools

ERIC Educational Resources Information Center

Pepper, Coral

2014-01-01

In this paper I report on leadership for sustainability in regional schools in Western Australia (WA) in the context of the Australian Sustainable Schools Initiative (AuSSI-WA). Case studies are developed to examine leading cultural change in eight WA regional schools with data presented in three representative narrative accounts. Consistency is…

Mindset Gap among SES Groups: The Case of Chile with Census Data

ERIC Educational Resources Information Center

Claro, Susana; Paunesku, David

2014-01-01

Students' academic motivation and their achievement is affected by the mindset that students hold about their own intelligence. The current study presents a unique nationally-representative dataset to study the relationship of Mindset and Achievement among different populations. With census data of Chilean 10th graders and their schools, the…

10 CFR 2.338 - Settlement of issues; alternative dispute resolution.

Code of Federal Regulations, 2010 CFR

2010-01-01

... that the attorney or other representative who is expected to try the case for each party be present and... further procedural steps before the presiding officer, of any right to challenge or contest the validity of the order entered into in accordance with the agreement, and of all rights to seek judicial review...

10 CFR 2.338 - Settlement of issues; alternative dispute resolution.

Code of Federal Regulations, 2011 CFR

2011-01-01

... that the attorney or other representative who is expected to try the case for each party be present and... further procedural steps before the presiding officer, of any right to challenge or contest the validity of the order entered into in accordance with the agreement, and of all rights to seek judicial review...

10 CFR 2.338 - Settlement of issues; alternative dispute resolution.

Code of Federal Regulations, 2012 CFR

2012-01-01

... that the attorney or other representative who is expected to try the case for each party be present and... further procedural steps before the presiding officer, of any right to challenge or contest the validity of the order entered into in accordance with the agreement, and of all rights to seek judicial review...

Monitoring an Online Course with the GISMO Tool: A Case Study

ERIC Educational Resources Information Center

Mazza, Riccardo; Botturi, Luca

2007-01-01

This article presents GISMO, a novel, open source, graphic student-tracking tool integrated into Moodle. GISMO represents a further step in information visualization applied to education, and also a novelty in the field of learning management systems applications. The visualizations of the tool, its uses and the benefits it can bring are…

Research and Action: The Role of an Educational Center.

ERIC Educational Resources Information Center

Flugman, Bert

1986-01-01

Discusses the Center for Advanced Study in Education (CASE) in Manhattan as a representative research and development center in a collaborative role with the New York City Schools. Presents its role as educational problem solver for immediate solutions rather than for interesting findings. Provides examples of three on-going problem solving…

Abdominal cocoon secondary to disseminated tuberculosis

PubMed Central

Puppala, Radha; Sripathi, Smiti; Kadavigere, Rajagopal; Koteshwar, Prakashini; Singh, Jyoti

2014-01-01

Abdominal cocoon, also known as sclerosing encapsulating peritonitis, represents a rare entity where a variable length of the small bowel is enveloped by a fibrocollagenous membrane giving the appearance of a cocoon. It may be asymptomatic and is often diagnosed incidentally at laparotomy. We present a rare case of abdominal cocoon due to abdominal tuberculosis. PMID:25239980

Lifelong Education and University Resources. The Development of Higher Education Series.

ERIC Educational Resources Information Center

International Association of Universities, Paris (France).

Redistribution and redeployment of university resources, both human and material, have begun in a number of countries to meet the new needs of lifelong education. Selected case studies that appear to be characteristic and representative of different types of university situations in different countries are presented in this book. Analysis of the…

Split delivery vehicle routing problem with time windows: a case study

NASA Astrophysics Data System (ADS)

Latiffianti, E.; Siswanto, N.; Firmandani, R. A.

2018-04-01

This paper aims to implement an extension of VRP so called split delivery vehicle routing problem (SDVRP) with time windows in a case study involving pickups and deliveries of workers from several points of origin and several destinations. Each origin represents a bus stop and the destination represents either site or office location. An integer linear programming of the SDVRP problem is presented. The solution was generated using three stages of defining the starting points, assigning busses, and solving the SDVRP with time windows using an exact method. Although the overall computational time was relatively lengthy, the results indicated that the produced solution was better than the existing routing and scheduling that the firm used. The produced solution was also capable of reducing fuel cost by 9% that was obtained from shorter total distance travelled by the shuttle buses.

Deciphering viscous flow of frictional melts with the mini-AMS method

NASA Astrophysics Data System (ADS)

Ferré, Eric C.; Chou, Yu-Min; Kuo, Ruo Lin; Yeh, En-Chao; Leibovitz, Natalie R.; Meado, Andrea L.; Campbell, Lucy; Geissman, John W.

2016-09-01

The anisotropy of magnetic susceptibility (AMS) is widely used to analyze magmatic flow in intrusive igneous bodies including plutons, sills and dikes. This method, owing its success to the rapid nature of measurements, provides a proxy for the orientation of markers with shape anisotropy that flow and align in a viscous medium. AMS specimens typically are 25 mm diameter right cylinders or 20 mm on-a-side cubes, representing a volume deemed statistically representative. Here, we present new AMS results, based on significantly smaller cubic specimens, which are 3.5 mm on a side, hence∼250 times volumetrically smaller than conventional specimens. We show that, in the case of frictional melts, which inherently have an extremely small grain size, this small volume is in most cases sufficient to characterize the pseudotachylyte fabric, particularly when magnetite is present. Further, we demonstrate that the mini-AMS method provides new opportunities to investigate the details of frictional melt flow in these coseismic miniature melt bodies. This new method offers significant potential to investigate frictional melt flow in pseudotachylyte veins including contributions to the lubrication of faults at shallow to moderate depths.

Using Complementary Acoustic and Optical Techniques for Quantitative Monitoring of Biomolecular Adsorption at Interfaces

PubMed Central

Konradi, Rupert; Textor, Marcus; Reimhult, Erik

2012-01-01

The great wealth of different surface sensitive techniques used in biosensing, most of which claim to measure adsorbed mass, can at first glance look unnecessary. However, with each technique relying on a different transducer principle there is something to be gained from a comparison. In this tutorial review, different optical and acoustic evanescent techniques are used to illustrate how an understanding of the transducer principle of each technique can be exploited for further interpretation of hydrated and extended polymer and biological films. Some of the most commonly used surface sensitive biosensor techniques (quartz crystal microbalance, optical waveguide spectroscopy and surface plasmon resonance) are briefly described and five case studies are presented to illustrate how different biosensing techniques can and often should be combined. The case studies deal with representative examples of adsorption of protein films, polymer brushes and lipid membranes, and describe e.g., how to deal with strongly vs. weakly hydrated films, large conformational changes and ordered layers of biomolecules. The presented systems and methods are compared to other representative examples from the increasing literature on the subject. PMID:25586027

Successful Treatment of Symptomatic Intracranial Carotid Artery Stenosis Using a 24-mm Long Bare Metal Coronary Stent.

PubMed

Rehman, Azeem A; Turner, Ryan C; Lucke-Wold, Brandon P; Boo, SoHyun

2017-06-01

Intracranial arterial atherosclerosis represents a common cause of stroke. Despite aggressive and optimal medical management, many patients will unfortunately suffer additional cerebrovascular events. The role of endovascular intervention for intracranial atherosclerotic disease continues to be uncertain, particularly in regard to extensive, symptomatic stenosis. We present a case of a 42-year-old man with a complex medical history who presented with recurrent ischemic stroke in the ipsilateral hemisphere despite optimal medical management. Given the length of stenosis and the luminal size of the intracranial cavernous and petrous segments of the internal carotid artery, we used a bare metal coronary stent (4.0 mm × 24 mm). This represents one of the longest stents deployed for intracranial disease reported in the literature. This case illustrates that a long coronary stent might be successfully used to manage extensive intracranial lesions. We also review the efficacy of using 1 very long stent versus multiple overlapping stents, with reference to the coronary angiography literature. Copyright © 2017 Elsevier Inc. All rights reserved.

Injectional anthrax at a Scottish district general hospital.

PubMed

Inverarity, D J; Forrester, V M; Cumming, J G R; Paterson, P J; Campbell, R J; Brooks, T J G; Carson, G L; Ruddy, J P

2015-04-01

This retrospective, descriptive case-series reviews the clinical presentations and significant laboratory findings of patients diagnosed with and treated for injectional anthrax (IA) since December 2009 at Monklands Hospital in Central Scotland and represents the largest series of IA cases to be described from a single location. Twenty-one patients who fulfilled National Anthrax Control Team standardized case definitions of confirmed, probable or possible IA are reported. All cases survived and none required limb amputation in contrast to an overall mortality of 28% being experienced for this condition in Scotland. We document the spectrum of presentations of soft tissue infection ranging from mild cases which were managed predominantly with oral antibiotics to severe cases with significant oedema, organ failure and coagulopathy. We describe the surgical management, intensive care management and antibiotic management including the first description of daptomycin being used to treat human anthrax. It is noted that some people who had injected heroin infected with Bacillus anthracis did not develop evidence of IA. Also highlighted are biochemical and haematological parameters which proved useful in identifying deteriorating patients who required greater levels of support and surgical debridement.

Listeriosis--a review of eighty-four cases.

PubMed

Paul, M L; Dwyer, D E; Chow, C; Robson, J; Chambers, I; Eagles, G; Ackerman, V

1994-04-18

To review the epidemiology, risk factors for acquisition, clinical features and outcomes of Listeria monocytogenes infection in Sydney. A retrospective study over the period 1983-1992 at four university teaching hospitals in Sydney. Cases were identified from microbiology laboratory records of the isolation of L. monocytogenes from sterile sites. Eighty-four cases were reviewed, with 72 patients (86%) having a predisposing underlying condition, including 13 perinatal patients (15%). Septicaemia (56%) and central nervous system disease (41%) were the major clinical presentations. Nineteen patients (23%) had hospital-associated infection. A mortality of 21% (18 patients) was directly attributable to L. monocytogenes infection, with another 10% (nine patients) dying of their underlying disease during admission. The 84 cases represented 80% of all L. monocytogenes cases occurring in Sydney during the study period. Listeriosis is predominantly a disease of the elderly or of immunosuppressed individuals, pregnant women and neonates. The presentation and outcome in these groups are similar to those reported in other Western countries. A significant feature of this study was the number of cases occurring in already hospitalised patients, suggesting that L. monocytogenes may be an important hospital-associated pathogen in immunocompromised patients.

Developmental delay and connective tissue disorder in four patients sharing a common microdeletion at 6q13-14.

PubMed

Van Esch, Hilde; Rosser, Elisabeth M; Janssens, Sandra; Van Ingelghem, Ingrid; Loeys, Bart; Menten, Bjorn

2010-10-01

Interstitial deletions of the long arm of chromosome 6 are rare, and most reported cases represent large, cytogenetically detectable deletions. The implementation of array comparative genome hybridisation in the diagnostic work-up of patients presenting with congenital disorders, including developmental delay, has enabled identification of many patients with smaller chromosomal imbalances. In this report, the cases are presented of four patients with a de novo interstitial deletion of chromosome 6q13-14, resulting in a common microdeletion of 3.7 Mb. All presented with developmental delay, mild dysmorphism and signs of lax connective tissue. Interestingly, the common deleted region harbours 16 genes, of which COL12A1 is a good candidate for the connective tissue pathology.

Molecular Characteristics of Mantle Cell Lymphoma Presenting with Clonal Plasma Cell Component

PubMed Central

Visco, Carlo; Hoeller, Sylvia; Malik, Jeffrey T.; Xu-Monette, Zijun Y.; Wiggins, Michele L.; Liu, Jessica; Sanger, Warren G.; Liu, Zhongfeng; Chang, Julie; Ranheim, Erik A.; Gradowski, Joel F.; Serrrano, Sergio; Wang, Huan-You; Liu, Qingquan; Dave, Sandeep; Olsen, Brian; Gascoyne, Randy D.; Campo, Elias; Swerdlow, Steven H.; Chan, Wing C.; Tzankov, Alexander; Young, Ken H.

2011-01-01

The normal counterparts of mantle cell lymphoma (MCL) are naïve quiescent B-cells that have not been processed through the germinal center (GC). For this reason, while lymphomas arising from GC or post-GC B-cells often exhibit plasmacytic differentiation, MCL rarely presents with plasmacytic features. Seven cases of MCL with a monotypic plasma cell (PC) population were collected from six centers and studied by immunohistochemistry, FICTION (Fluorescence immunophenotyping and Interphase Cytogenetics as a Tool for the Investigation of Neoplasms), capillary gel electrophoresis, and restriction fragment length polymorphism of immunoglobulin heavy chain analysis (RFLP/IgH) of microdissections of each of the MCL and PC populations to assess their clonal relationship. Clinical presentation was rather unusual compared to typical MCL, with two cases arising from extranodal soft-tissues of the head. All MCL cases were morphologically and immunohistochemically typical, bearing the t(11;14)(q13;q32). In all cases PC populations were clonal. In 5 of the 7 cases, the MCL and PC clones showed identical restriction fragments, indicating a common clonal origin of the neoplastic populations. The two cases with clonal diversity denoted the coexistence of two different tumors in a composite lymphoma/plasma cell neoplasm. Our findings suggest that MCL can present with a PC component that is often clonally related to the lymphoma, representing a rare but unique biological variant of this tumor. PMID:21263238

Coralline hydroxyapatite bone graft substitutes.

PubMed

Elsinger, E C; Leal, L

1996-01-01

The authors present a review of the various bone grafts currently available with special attention to coral bone grafts. Several of the benefits of coralline hydroxyapatite bone graft substitutes, such as safety and biocompatibility, will be addressed in this article, part of an ongoing investigation of coral bone grafts used in triple arthrodesis procedures. To date, eight cases have been performed. In seven cases, granular chips were employed to pack the subtalar joint. The final case, presented in this article, represents a 26-year-old male who, 2 years previously, sustained a calcaneal fracture with resultant shortening along the lateral column. A coralline hydroxyapatite block was used at the calcaneocuboid joint to achieve distraction. Clinically, the patient is progressing well at 10 months postoperatively. Radiographically, one can still clearly appreciate the margins of the bone graft at 5 months.

Chondroblastic osteosarcoma arising in the maxilla mimicking the radiographic and histological characteristics of cemento-osseous lesions: A case report.

PubMed

Li, Bin-Bin; Zhang, Jian-Yun; Gao, Yan

2017-05-01

Osteosarcomas of the jaw are comparatively rare and represent only 2-10% of all osteosarcomas. We herein present a rare case of an osteosarcoma exhibiting the radiographic and histological characteristics of cemento-osseous lesions in the alveolar ridge of the maxilla. A 53-year-old male patient presented with the complaint of gradual swelling of the left maxilla over 4 years. Radiography revealed an ill-defined radioopaque mass, intimately associated with the apices of the involved teeth, without a periosteal reaction. Microscopically, a cementicle-like structure was identified in the alveolar bone. In addition, the lesion exhibited typical characteristics of chondroblastic osteosarcoma in the body of the maxilla. The tumor contained abundant osteoid and cartilage intimately associated with anaplastic tumor cells. The cartilage displayed malignant-appearing cells in lacunae, and there was crowding at the periphery of the lobule where the spindle cells formed sheets. The differential diagnosis included primary osteosarcoma, concurrent cemento-osseous dysplasia and osteosarcoma, or a secondary osteosarcoma based on a pre-existing cemento-osseous lesion. The presence of the cementicle-like structure in the alveolar bone and the involvement of the periodontal ligament and alveolar bone proper were unique in our case. The general invasive growth pattern and the abundance of the irregular tumor bone helped establish the diagnosis of primary osteosarcoma. This case may represent evidence of the pathogenesis of primary osteosarcoma in the jaw.

Chondroblastic osteosarcoma arising in the maxilla mimicking the radiographic and histological characteristics of cemento-osseous lesions: A case report

PubMed Central

Li, Bin-Bin; Zhang, Jian-Yun; Gao, Yan

2017-01-01

Osteosarcomas of the jaw are comparatively rare and represent only 2–10% of all osteosarcomas. We herein present a rare case of an osteosarcoma exhibiting the radiographic and histological characteristics of cemento-osseous lesions in the alveolar ridge of the maxilla. A 53-year-old male patient presented with the complaint of gradual swelling of the left maxilla over 4 years. Radiography revealed an ill-defined radioopaque mass, intimately associated with the apices of the involved teeth, without a periosteal reaction. Microscopically, a cementicle-like structure was identified in the alveolar bone. In addition, the lesion exhibited typical characteristics of chondroblastic osteosarcoma in the body of the maxilla. The tumor contained abundant osteoid and cartilage intimately associated with anaplastic tumor cells. The cartilage displayed malignant-appearing cells in lacunae, and there was crowding at the periphery of the lobule where the spindle cells formed sheets. The differential diagnosis included primary osteosarcoma, concurrent cemento-osseous dysplasia and osteosarcoma, or a secondary osteosarcoma based on a pre-existing cemento-osseous lesion. The presence of the cementicle-like structure in the alveolar bone and the involvement of the periodontal ligament and alveolar bone proper were unique in our case. The general invasive growth pattern and the abundance of the irregular tumor bone helped establish the diagnosis of primary osteosarcoma. This case may represent evidence of the pathogenesis of primary osteosarcoma in the jaw. PMID:28529749

Non-verbal numerical cognition: from reals to integers.

PubMed

Gallistel; Gelman

2000-02-01

Data on numerical processing by verbal (human) and non-verbal (animal and human) subjects are integrated by the hypothesis that a non-verbal counting process represents discrete (countable) quantities by means of magnitudes with scalar variability. These appear to be identical to the magnitudes that represent continuous (uncountable) quantities such as duration. The magnitudes representing countable quantity are generated by a discrete incrementing process, which defines next magnitudes and yields a discrete ordering. In the case of continuous quantities, the continuous accumulation process does not define next magnitudes, so the ordering is also continuous ('dense'). The magnitudes representing both countable and uncountable quantity are arithmetically combined in, for example, the computation of the income to be expected from a foraging patch. Thus, on the hypothesis presented here, the primitive machinery for arithmetic processing works with real numbers (magnitudes).

The representation of healthcare end users' perspectives by surrogates in healthcare decisions: a literature review.

PubMed

Shah, Syed Ghulam Sarwar; Farrow, Alexandra; Robinson, Ian

2009-12-01

The representation of end users' perspectives in healthcare decisions requires involvement of their surrogates when the end users, i.e. certain patients, elderly people, children and people with disabilities, are unable to present their views. To review critical issues, and the advantages and disadvantages of involving surrogates in representing end users' perspectives in healthcare decisions. A systematic review of literature published in peer-reviewed journals from 1990 to 2005. Findings show that surrogates are used widely in health care and that they are necessary to represent end users' perspectives in healthcare decisions when the latter are unable to do so themselves. Critical issues in using surrogates include key ethical, social, cultural, legal and medico-technological factors; ascertaining the best interest of end users; potential conflict of interest; possible biased decisions and the burden on surrogates. The key advantage of surrogate involvement in healthcare decisions is their ability to represent end users' needs, values and wishes. The main disadvantages include potential discrepancies between the decisions and conclusions of surrogates and end users; the failure of surrogates to predict end users' preferences accurately and the lack of certainty that useful information will be obtained through the surrogacy process. This systematic review has revealed that the involvement of surrogates is an additional vital way to represent end users' perspectives in healthcare decisions where for a range of reasons their opinions are unable to be effectively ascertained. However, because of the heterogeneity of surrogates and end users, the selection of appropriate surrogates and deploying surrogate decisions require particularly careful consideration of their value in individual cases; thus, subsequent decision-making must be reviewed on a case-to-case basis to seek to ensure that the best interests, needs and wishes of the end user are fully and accurately represented.

33 CFR 19.01 - Procedures for effecting individual waivers of navigation and vessel inspection laws and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... the designated representative of the Commandant, as the case may be) reaches the conclusion referred... vessel is located. In the case of a vessel in any port or place of the Canal Zone or in any foreign port... designated representative or the designated representative of the Commandant, as the case may be) shall...

33 CFR 19.01 - Procedures for effecting individual waivers of navigation and vessel inspection laws and...

Code of Federal Regulations, 2011 CFR

2011-07-01

... the designated representative of the Commandant, as the case may be) reaches the conclusion referred... vessel is located. In the case of a vessel in any port or place of the Canal Zone or in any foreign port... designated representative or the designated representative of the Commandant, as the case may be) shall...

Co-occurrence of acanthosis nigricans and bladder adenocarcinoma – case report

PubMed Central

Silny, Wojciech; Żaba, Ryszard; Osmola-Mańkowska, Agnieszka; Mackiewicz-Wysocka, Małgorzata; Dańczak-Pazdrowska, Aleksandra

2013-01-01

Acanthosis nigricans (AN) is characterized by the occurrence of symmetrical velvety hyperpigmented plaques that can be observed in each location on the skin. However, the lesions are most frequently located in the axillary, inguinal and nuchal areas. Primarily, the lesions appear as hyperpigmented focuses which later transform into papillary lesions. There are two forms of the disease – benign and malignant. Malignant AN is considered to represent paraneoplastic syndrome co-occurring with advanced cancer, but as such it is not malignant. This article presents a case of a patient diagnosed with AN and coexisting bladder cancer and discusses the case in the context of available literature. PMID:24596525

[Prostatic localization revealing an acute myeloid leukemia. Apropos of a case].

PubMed

Smaoui, S; Lecomte, M J; Peraldi, R; Pernin, F

1998-09-01

The authors report an original case of acute myeloid leukaemia (AML) presenting in the form of acute urinary retention, confirmed by prostatic biopsy, with complete absence of any non-urological clinical features. Prostatic sites of leukaemia are frequent and classically reported, but often occur during the course of known leukaemia, and are rarely symptomatic, justifying biopsies in the presence of any prostatic symptoms. Immunolabelling represents the key to the diagnosis in the presence of undifferentiated cells demonstrated on prostatic biopsies. The outcome was fatal in this case, despite early chemotherapy. The clinical features, clinical course and therapeutic aspects of prostatic leukaemia are discussed.

Anomalous vertebral artery origins: the first and second reports of two variants.

PubMed

Hsu, Daniel P; Alexander, Ashley D; Gilkeson, Robert C

2010-06-01

We present two cases of aberrant origins of vertebral arteries. Case 1 is of a patient undergoing evaluation of an infrarenal aortic aneurysm stent graft. Computed tomography (CT) angiogram revealed an aberrant right vertebral artery that subsequently joined a second right vertebral artery that had the typical origin off the right subclavian artery. This represents an unusual anatomic variation not previously reported in the literature. Case 2 is of a patient being evaluated for thoracic aorta injury. CT angiogram of the chest revealed a five-vessel aortic arch with aberrant origin of the bilateral vertebral arteries distal to the left subclavian artery.

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

Casini, R.; Manso Sainz, R.

We present the frequency redistribution function for a polarized three-term atom of the Λ-type in the collisionless regime, and we specialize it to the case where both the initial and final terms of the three-state transition are metastable (i.e., with infinitely sharp levels). This redistribution function represents a generalization of the well-known R {sub II} function to the case where the lower terms of the transition can be polarized and carry atomic coherence, and it can be applied to the investigation of polarized line formation in tenuous plasmas, where collisional rates may be low enough that anisotropy-induced atomic polarization survivesmore » even in the case of metastable levels.« less

End-of-Life Care Decisions: Importance of Reviewing Systems and Limitations After 2 Recent North American Cases

PubMed Central

Burkle, Christopher M.; Benson, Jeffre J.

2012-01-01

Two recent and unfortunate North American cases involving end-of-life treatment highlight the difficulties surrounding medical futility conflicts. As countries have explored the greater influence that patients and their representatives may play on end-of-life treatment decisions, the benefits and struggles involved with such a movement must be appreciated. These 2 cases are used to examine the present systems existing in the United States and Canada for resolving end-of-life decisions, including the difficulty in defining medical futility, the role of medical ethics committees, and controversies involving surrogate decision making. PMID:23127734

Trisomy 22 with 'cat eye' anomaly.

PubMed Central

Cervenka, J; Hansen, C A; Franciosi, R A; Gorlin, R J

1977-01-01

The case of a 10-month-old girl with an extra G-like chromosome is presented. Quinacrine, trypsin-Giemsa, and reverse banding identified the extra chromosome as no. 22. The phenotype of the patient is unique in that unilateral iris coloboma was observed, unlike the 18 cases of full trisomy 22 already published. This represents the first reported case of full trisomy 22 with this coloboma, or 'cat eye' anomaly, which is usually associated with partial trisomy 22. It is suggested that the use of the term 'cat eye syndrome' be revised. The terms 'partial trisomy 22 syndrome' and 'trisomy 22 syndrome' should be used instead. Images PMID:336892

A possible case of natalizumab-dependent suicide attempt: A brief review about drugs and suicide

PubMed Central

Mumoli, Laura; Ciriaco, Miriam; Gambardella, Antonio; Bombardiere, Giuseppe Nicodemo; Valentino, Paola; Palleria, Caterina; Labate, Angelo; Russo, Emilio

2013-01-01

β-Interferon therapy is known to be a potential trigger of suicidal behavior, but this effect has not been previously reported for other multiple sclerosis (MS) treatments, such as, natalizumab. Here we report the case history of a 32-year-old woman affected by relapsing-remitting MS, who attempted suicide during natalizumab treatment. This case suggests that a suicidal ideation might be a rare side effect of natalizumab. Nevertheless, this case represents the first evidence of the new adverse drug reaction related to natalizumab treatment. We should alert clinicians to be aware of the possibility of paradoxical activation of suicidality during its therapeutic use. The main purpose of the present article is to use this case to review the possible relationship between suicidal behavior and drugs. PMID:24347991

A possible case of natalizumab-dependent suicide attempt: A brief review about drugs and suicide.

PubMed

Mumoli, Laura; Ciriaco, Miriam; Gambardella, Antonio; Bombardiere, Giuseppe Nicodemo; Valentino, Paola; Palleria, Caterina; Labate, Angelo; Russo, Emilio

2013-12-01

β-Interferon therapy is known to be a potential trigger of suicidal behavior, but this effect has not been previously reported for other multiple sclerosis (MS) treatments, such as, natalizumab. Here we report the case history of a 32-year-old woman affected by relapsing-remitting MS, who attempted suicide during natalizumab treatment. This case suggests that a suicidal ideation might be a rare side effect of natalizumab. Nevertheless, this case represents the first evidence of the new adverse drug reaction related to natalizumab treatment. We should alert clinicians to be aware of the possibility of paradoxical activation of suicidality during its therapeutic use. The main purpose of the present article is to use this case to review the possible relationship between suicidal behavior and drugs.

Fatal lightning strikes in Malaysia.

PubMed

Murty, O P; Kian, Chong Kah; Ari Husin, Mohammed Husrul; Nanta Kumar, Ranjeev Kumar; Mohammed Yusuf, Wan Yuhana W

2009-09-01

Lightning strike is a natural phenomenon with potentially devastating effects and represents one of the important causes of deaths from environmental phenomena. Almost every organ system may be affected as lightning current passes through the human body taking the shortest pathways between the contact points. A 10 years retrospective study (1996-2005) was conducted at University Hospital Kuala Lumpur (20 cases) also including cases during last 3 years from Hospital Tengku Ampuan Rahimah, Klang (7 cases) from the autopsy reports at Forensic Pathology Units of these 2 hospitals. Both these hospitals are attached to University of Malaya. There were 27 fatal cases of lightning strike with male preponderance(92.59%) and male to female ratio of 12.5:1. Majority of victims of lightning strike were from the age group between 30 and 39 years old. Most of the victims were foreign workers. Indonesians workers contributed to 59.26% of overall cases. Majority of them were construction workers who attributed i.e.11 of 27 cases (40.74%). Most of the victims were brought in dead (37.04%). In majority of the cases the lightning incidence occurred in the evenings, with the frequency of 15 of 27 cases (62.5%). The month of December represented with the highest number of cases (5 cases of 23 cases); 2004 had the highest incidence of lightning strike which was 5 (19.23%). Lightning strike incidence occurred when victims had taken shelter (25.9%) under trees or shades. Lightning strike in open areas occurred in 10 of 27 cases (37.0%). Head and neck were the most commonly affected sites with the incidence of 77.78% and 74% respectively in all the victims. Only 29.63% of the cases presented with ear bleeding.

Representing motion in a static image: constraints and parallels in art, science, and popular culture.

PubMed

Cutting, James E

2002-01-01

Representing motion in a picture is a challenge to artists, scientists, and all other imagemakers. Moreover, it presents a problem that will not go away with electronic and digital media, because often the pedagogical purpose of the representation of motion is more important than the motion itself. All satisfactory solutions evoke motion-for example, dynamic balance (or broken symmetry), stroboscopic sequences, affine shear (or forward lean), and photographic blur-but they also typically sacrifice the accuracy of the motion represented, a solution often unsuitable for science. Vector representations superimposed on static images allow for accuracy, but are not applicable to all situations. Workable solutions are almost certainly case specific and subject to continual evolution through exploration by imagemakers.

The pathology of methylmercury poisoning (Minamata disease): The 50th Anniversary of Japanese Society of Neuropathology.

PubMed

Eto, Komyo; Marumoto, Masumi; Takeya, Motohiro

2010-10-01

Methylmercury (Me-Hg) poisoning (Minamata disease: MD) is one of the most severe types of disease caused by humans to humans in Japan. The disease is a special class of food-borne methylmercury intoxication in humans as typified by the outbreak that began in 1953 in Minamata and its vicinity in Kumamoto Prefecture, Japan. There are 450 autopsy cases in Kumamoto and 30 autopsy cases in Niigata Prefecture related to MD in Japan. Two hundred and one cases in Kumamoto and 22 cases in Niigata showed pathological changes of MD. This report provides a brief research history and overview of the pathological changes of MD, and also presents representative cases of adult, infantile and fetal forms of MD among the 450 MD-related autopsy cases in Kumamoto Prefecture. © 2010 Japanese Society of Neuropathology.

A treatment-oriented typology of self-identified hypersexuality referrals.

PubMed

Cantor, James M; Klein, Carolin; Lykins, Amy; Rullo, Jordan E; Thaler, Lea; Walling, Bobbi R

2013-07-01

Men and women have been seeking professional assistance to help control hypersexual urges and behaviors since the nineteenth century. Despite that the literature emphasizes that cases of hypersexuality are highly diverse with regard to clinical presentation and comorbid features, the major models for understanding and treating hypersexuality employ a "one size fits all" approach. That is, rather than identify which problematic behaviors might respond best to which interventions, existing approaches presume or assert without evidence that all cases of hypersexuality (however termed or defined) represent the same underlying problem and merit the same approach to intervention. The present article instead provides a typology of hypersexuality referrals that links individual clinical profiles or symptom clusters to individual treatment suggestions. Case vignettes are provided to illustrate the most common profiles of hypersexuality referral that presented to a large, hospital-based sexual behaviors clinic, including: (1) Paraphilic Hypersexuality, (2) Avoidant Masturbation, (3) Chronic Adultery, (4) Sexual Guilt, (5) the Designated Patient, and (6) better accounted for as a symptom of another condition.

Interchange between collagenous and lymphocytic colitis in severe disease with autoimmune associations requiring colectomy: a case report.

PubMed Central

Bowling, T E; Price, A B; al-Adnani, M; Fairclough, P D; Menzies-Gow, N; Silk, D B

1996-01-01

BACKGROUND--Collagenous colitis and lymphocytic colitis present with a similar clinical picture. Whether these conditions are separate entities or whether they represent different pathological stages of the same condition is an unresolved issue. PATIENT--This is a case of collagenous colitis following a fulminant course in which a colectomy was necessary. In the operative specimen the thickened collagen plate, which had been present only two weeks preoperatively had been lost and the pathology was of a lymphocytic colitis. Six months postoperatively this patient developed a CREST syndrome and primary biliary cirrhosis. CONCLUSIONS--This case shows the lability of the collagen plate and the common ground between collagenous and lymphocytic colitis, and presents evidence that these two conditions are different manifestations of the same disease. It also describes for the first time an association between collagenous colitis and CREST syndrome and primary biliary cirrhosis. Images Figure 1 Figure 3 Figure 4 Figure 5 PMID:8707130

Oversight Hearing on the Equal Employment Opportunity Commission's Enforcement Policies. Hearing before the Subcommittee on Employment Opportunities of the Committee on Education and Labor, House of Representatives, Ninety-Ninth Congress, First Session, Washington, DC, July 18, 1985.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and Labor.

This volume presents a transcript of discussion and statements presented at an oversight hearing before the House Subcommittee on Employment Opportunities. The hearing reviewed new enforcement policies of the Equal Employment Opportunity Commission (EEOC), which had the stated intent of increasing the litigation of individual cases of unlawful…

Adolescent Premature Ovarian Insufficiency Following Human Papillomavirus Vaccination

PubMed Central

Ward, Harvey Rodrick Grenville

2014-01-01

Three young women who developed premature ovarian insufficiency following quadrivalent human papillomavirus (HPV) vaccination presented to a general practitioner in rural New South Wales, Australia. The unrelated girls were aged 16, 16, and 18 years at diagnosis. Each had received HPV vaccinations prior to the onset of ovarian decline. Vaccinations had been administered in different regions of the state of New South Wales and the 3 girls lived in different towns in that state. Each had been prescribed the oral contraceptive pill to treat menstrual cycle abnormalities prior to investigation and diagnosis. Vaccine research does not present an ovary histology report of tested rats but does present a testicular histology report. Enduring ovarian capacity and duration of function following vaccination is unresearched in preclinical studies, clinical and postlicensure studies. Postmarketing surveillance does not accurately represent diagnoses in adverse event notifications and can neither represent unnotified cases nor compare incident statistics with vaccine course administration rates. The potential significance of a case series of adolescents with idiopathic premature ovarian insufficiency following HPV vaccination presenting to a general practice warrants further research. Preservation of reproductive health is a primary concern in the recipient target group. Since this group includes all prepubertal and pubertal young women, demonstration of ongoing, uncompromised safety for the ovary is urgently required. This matter needs to be resolved for the purposes of population health and public vaccine confidence. PMID:26425627

Cross-border-assisted reproduction: a qualitative account of UK travellers' experiences.

PubMed

Hudson, Nicky; Culley, Lorraine; Blyth, Eric; Norton, Wendy; Pacey, Allan; Rapport, Frances

2016-06-01

Surveys on patients' experiences of cross-border fertility treatment have reported a range of positive and challenging features. However, the number of such studies is limited, and there is no detailed qualitative account of the experiences of UK patients who travel overseas for fertility treatment. The present study used a cross-sectional, qualitative design and in-depth interviews. Fifty-one participants (41 women and 10 men, representing 41 treatment 'cases') participated in semi-structured interviews. The experiences reported were broadly positive with a large proportion of participants (39 cases, 95%) citing a favourable overall experience with only two cases (5%) reporting a more negative experience. Thematic analysis revealed 6 major categories and 20 sub-categories, which described the positive and challenging aspects of cross-border fertility travel. The positive aspects were represented by the categories: 'access', 'control' and 'care and respect'. The more challenging aspects were categorized as 'logistics and coordination of care', 'uncertainty' and 'cultural dissonance'. The study confirms findings from others that despite some challenges, there is a relatively high level of patient satisfaction with cross-border treatment with participants able to extend the boundaries of their fertility-seeking trajectories and in some cases, regain a sense of control over their treatment.

Signal Analysis of Automotive Engine Spark Ignition System using Case-Based Reasoning (CBR) and Case-based Maintenance (CBM)

NASA Astrophysics Data System (ADS)

Huang, H.; Vong, C. M.; Wong, P. K.

2010-05-01

With the development of modern technology, modern vehicles adopt electronic control system for injection and ignition. In traditional way, whenever there is any malfunctioning in an automotive engine, an automotive mechanic usually performs a diagnosis in the ignition system of the engine to check any exceptional symptoms. In this paper, we present a case-based reasoning (CBR) approach to help solve human diagnosis problem. Nevertheless, one drawback of CBR system is that the case library will be expanded gradually after repeatedly running the system, which may cause inaccuracy and longer time for the CBR retrieval. To tackle this problem, case-based maintenance (CBM) framework is employed so that the case library of the CBR system will be compressed by clustering to produce a set of representative cases. As a result, the performance (in retrieval accuracy and time) of the whole CBR system can be improved.

Performable Case Studies in Ethics Education.

PubMed

Robeson, Richard; King, Nancy M P

2017-09-12

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry-the creation and performance of short case studies designed specifically to raise bioethics issues for discussion-represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio.

Performable Case Studies in Ethics Education

PubMed Central

Robeson, Richard; King, Nancy M. P.

2017-01-01

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry—the creation and performance of short case studies designed specifically to raise bioethics issues for discussion—represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio. PMID:28895903

Outpatient pediatric community-acquired methicillin-resistant Staphylococcus aureus: a polymorphous clinical disease.

PubMed

Groner, Abraham; Laing-Grayman, Deborah; Silverberg, Nanette B

2008-02-01

Community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) presents numerous diagnostic and therapeutic problems for the outpatient physician, including the appropriate use of antibiotics and proper counseling of families on ways to prevent household spread. Most cases of CAMRSA in children involve soft tissue and skin infection, which is precisely the type of infection most likely to be diagnosed in a dermatology practice. We reviewed 8 pediatric cases of cutaneous CAMRSA that presented over 8 months. The 8 pediatric patients presented with one or more of the following: folliculitis (n=4), abscesses of the groin (n=3), impetiginized atopic dermatitis (AD)(n=2), pustules (n=2), bullous impetigo (n= 1), and nonbullous impetigo (n=1). Three caregivers of these children developed abscesses in exposed areas such as the forearm (n=3) and calf (n=1). The folliculitis cases involved the abdomen, groin and diaper region, buttocks, and inner thighs; the impetiginized AD did not differ from the distribution of the AD. The variety of clinical presentations and the spread in households represent a few of the many facets of CAMRSA in the pediatric dermatology outpatient setting.

Two- and Three-Dimensional Numerical Experiments Representing Two Limiting Cases of an In-Line Pair of Finger Seal Components

NASA Technical Reports Server (NTRS)

Braun, M. J.; Steinetz, B. M.; Kudriavtsev, V. V.; Proctor, M. P.; Kiraly, L. James (Technical Monitor)

2002-01-01

The work presented here concerns the numerical development and simulation of the flow, pressure patterns and motion of a pair of fingers arranged behind each other and axially aligned in-line. The fingers represent the basic elemental component of a Finger Seal (FS) and form a tight seal around the rotor. Yet their flexibility allows compliance with rotor motion and in a passive-adaptive mode complies also with the hydrodynamic forces induced by the flowing fluid. While the paper does not treat the actual staggered configuration of a finger seal, the inline arrangement represents a first step towards that final goal. The numerical 2-D (axial-radial) and 3-D results presented herein were obtained using a commercial package (CFD-ACE+). Both models use an integrated numerical approach, which couples the hydrodynamic fluid model (Navier-Stokes based) to the solid mechanics code that models the compliance of the fingers.

Match graph generation for symbolic indirect correlation

NASA Astrophysics Data System (ADS)

Lopresti, Daniel; Nagy, George; Joshi, Ashutosh

2006-01-01

Symbolic indirect correlation (SIC) is a new approach for bringing lexical context into the recognition of unsegmented signals that represent words or phrases in printed or spoken form. One way of viewing the SIC problem is to find the correspondence, if one exists, between two bipartite graphs, one representing the matching of the two lexical strings and the other representing the matching of the two signal strings. While perfect matching cannot be expected with real-world signals and while some degree of mismatch is allowed for in the second stage of SIC, such errors, if they are too numerous, can present a serious impediment to a successful implementation of the concept. In this paper, we describe a framework for evaluating the effectiveness of SIC match graph generation and examine the relatively simple, controlled cases of synthetic images of text strings typeset, both normally and in highly condensed fashion. We quantify and categorize the errors that arise, as well as present a variety of techniques we have developed to visualize the intermediate results of the SIC process.

Diplopia as the primary presentation of foodborne botulism.

PubMed

Khakshoor, Hamid; Moghaddam, Ali Akbar Saber; Vejdani, Amir Hossein; Armstrong, Blair K; Moshirfar, Majid

2012-05-01

Foodborne botulism is a serious condition caused by Clostridium botulinum neurotoxin. Clinically, botulism presents as bilateral cranial nerve neuropathy and descending paralysis. We report a unique presentation of botulism to remind clinicians of this potentially fatal condition. In this observational case report initial evaluation showed only esodeviation. This progressed to unilateral cranial nerve six (CN VI) paresis along with systemic signs. Clinical diagnosis was made based on in-depth history and concurrent symptoms in three other patients. Foodborne botulism presenting as diplopia and unilateral motility deficits is rare and can represent a diagnostic and therapeutic challenge to the ophthalmologist.

Diplopia as the primary presentation of foodborne botulism

PubMed Central

Khakshoor, Hamid; Moghaddam, Ali Akbar Saber; Vejdani, Amir Hossein; Armstrong, Blair K.; Moshirfar, Majid

2012-01-01

Foodborne botulism is a serious condition caused by Clostridium botulinum neurotoxin. Clinically, botulism presents as bilateral cranial nerve neuropathy and descending paralysis. We report a unique presentation of botulism to remind clinicians of this potentially fatal condition. In this observational case report initial evaluation showed only esodeviation. This progressed to unilateral cranial nerve six (CN VI) paresis along with systemic signs. Clinical diagnosis was made based on in-depth history and concurrent symptoms in three other patients. Foodborne botulism presenting as diplopia and unilateral motility deficits is rare and can represent a diagnostic and therapeutic challenge to the ophthalmologist. PMID:22993467

C-kit-positive gastric metastasis of lobular carcinoma of the breast masquerading as gastrointestinal stromal tumor.

PubMed

Vennapusa, Bharathi; Oman, Sarah A; Parasher, Gulshan; Cerilli, Lisa A

2010-10-01

A 61-year-old woman with no significant past history underwent gastric biopsies demonstrating a strongly c-kit-positive epithelioid malignancy, initially thought to represent gastrointestinal stromal tumor (GIST). Subsequent clinical and immunohistochemical evaluation proved the neoplasm to represent metastatic lobular carcinoma. This case illustrates that although c-kit is highly specific and sensitive for GIST, its expression may occur in a variety of other neoplasms, some of which morphologically resemble GIST and may present in the gastrointestinal tract as metastases. Therefore, a review of other c-kit-positive lesions is also highlighted.

Respiratory infections: pneumonia, lung abscess, and empyema.

PubMed

Puligandla, Pramod S; Laberge, Jean-Martin

2008-02-01

Pneumonia is an important clinical problem that affects children of all ages. Although effectively treated on an outpatient basis in the majority of cases, some children with respiratory infections still require hospitalization. This may be particularly true for patients with immunocompromise, for whom the lung represents the most common site of infection. Furthermore, respiratory infections represent a significant source of morbidity and mortality in this patient population. This article focuses on the clinical presentation, etiology, and treatment of childhood pneumonia, with special consideration given to the immunocompromised child. Two specific complications of pneumonia, lung abscess and empyema, are discussed.

Art of war hidden in Kolmogorov's equations.

PubMed

Lauren, Michael K; McIntosh, Gregory C; Perry, Nigel; Moffat, James

2007-03-01

Here we discuss how Kolmogorov's work on turbulence can be used as the inspiration for a new description of battlefield dynamics. The method presented may also represent a new way of describing self-organizing dynamical systems, in place of conventional differential equation approaches. The key finding is that the rate of attrition in a battle appears to be a function of the fractal dimension of the opposing forces. It is suggested that, this being the case, the fractal dimension could be used as a surrogate to represent the organizational efficiency of one force relative to another, commonly called Command and Control.

The Relationship between Multiple Intelligences and Iranian EFL Learners' Level of L2 Lexical Knowledge: The Case of Gender

ERIC Educational Resources Information Center

Biria, Reza; Boshrabadi, Abbas Mehrabi; Nikbakht, Elham

2014-01-01

Human cognitive competence represents individuals' subconscious knowledge of abilities, talents, and mental skills collectively called "multiple intelligences (MIs)", which play a pivotal role in facilitating human learning. Thus, the main objective of the present study was to determine the magnitude of the relationship existing between…

Lesson Study in Prospective Mathematics Teacher Education: Didactic and Paradidactic Technology in the Post-Lesson Reflection

ERIC Educational Resources Information Center

Rasmussen, Klaus

2016-01-01

This paper presents a detailed analysis of the post-lesson reflection, carried out in the context of eight cases of lesson study conducted by teams of Danish, lower secondary prospective teachers and their supervisors. The participants, representing different institutions, were all new to the lesson study format. Nevertheless, it is demonstrated…

A Child Constructs an Understanding of a Water Wheel in Five Media.

ERIC Educational Resources Information Center

Forman, George

1996-01-01

Presents case study of a child trying to represent and understand the water wheel as an example of knowledge construction from the constructivism perspective. Focuses on how his understanding of physical perspective taking advances through conflicts in the use of different media (telling, drawing, paper, clay, or wood model) and how the Reggio…

(Re)constructing and (Re)presenting Heritage: Education and Representation in an American Indian Homeland Preservation Project

ERIC Educational Resources Information Center

Graybeal, Lesley Marie

2011-01-01

Experiences of the Occaneechi Band of the Saponi Nation (Occaneechi) in constructing a heritage revitalization initiative known as the Homeland Preservation Project and organizing related educational programming were analyzed through an ethnographic case study. The purpose of the study was to understand the importance of the heritage museum as a…

Cross-Cultural Practices in Art Education: The Art Lunch Project in Turkey

ERIC Educational Resources Information Center

Acer, Dilek

2012-01-01

This article presents a selective review of the literature on cross-cultural art studies, with the aim of identifying their commonalities. The article includes a specific cross-cultural case study, the Art Lunch Project, which the author attended as a representative of Turkey, that aims to exchange practical teaching experiences. The participants…

Contemporary High-Profile Scientists and Their Interactions with the Community

ERIC Educational Resources Information Center

Smith, Dorothy V.; Mulhall, Pamela J.; Hart, Christina E.; Gunstone, Richard F.

2016-01-01

This article presents a case study of 10 high-profile Australian research scientists. These scientists are highly committed to engaging with the public. They interact with a wide range of groups in the community, including the traditional media. They are aware that they are seen as representatives of science at a time when the authority of science…

Using Palm Technology in Participatory Simulations of Complex Systems: A New Take on Ubiquitous and Accessible Mobile Computing

ERIC Educational Resources Information Center

Klopfer, Eric; Yoon, Susan; Perry, Judy

2005-01-01

This paper reports on teachers' perceptions of the educational affordances of a handheld application called Participatory Simulations. It presents evidence from five cases representing each of the populations who work with these computational tools. Evidence across multiple data sources yield similar results to previous research evaluations of…

The Use of Force Notation to Detect Students' Misconceptions: Mutual Interactions Case

ERIC Educational Resources Information Center

Serhane, Ahcene; Zeghdaoui, Abdelhamid; Debiache, Mehdi

2017-01-01

Using a conventional notation for representing forces on diagrams, students were presented with questions on the interaction between two objects. The results show that complete understanding of Newton's Third Law of Motion is quite rare, and that some problems relate to misunderstanding which force acts on each body. The use of the terms…

HIV-Related Knowledge and Attitudes among First Year Medical Students in Mumbai, India Adolescents

ERIC Educational Resources Information Center

Samant, Yogindra; Mankeshwar, Ranjit; Sankhe, Lalit; Parker, David L.

2006-01-01

Background: The total number of people with HIV (Human Immunodeficiency Virus) infection in India is estimated to be 10% of all global cases. People living with HIV in India often experience discrimination while receiving health care due to inadequate knowledge and fear among health care professionals. Data presented in this paper represents the…

8 CFR 1215.4 - Procedure in case of alien prevented from departing from the United States.

Code of Federal Regulations, 2010 CFR

2010-01-01

... IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS CONTROLS OF ALIENS DEPARTING FROM THE UNITED... represented by counsel of his own choice, (3) to have the opportunity to be heard and to present evidence, (4... the time and opportunity to produce evidence and witnesses on his own behalf, and (7) to reasonable...

Simulation of Subpixel Atmospherically Degraded Target Detectability in Cluttered Scenes

DTIC Science & Technology

2013-09-06

Number: The scientific or technical validity of this Contract Report is entirely the responsibility of the Contractor and the contents do not necessarily...September 6th 2012 and September 6th 2013. Results: Significant and representative cases are modeled and results are presented in an annex of the...3 4 Modeling an image degraded by the atmosphere

Diagnosis of a case of lipoid pneumonia by bronchoalveolar lavage.

PubMed

Spatafora, M; Bellia, V; Ferrara, G; Genova, G

1987-01-01

Exogenous lipoid pneumonia (ELP) was diagnosed by bronchoalveolar lavage (BAL) in a 57-year-old woman with a long history of using oily nose drops. Since clinical and roentgenological presentations are nonspecific, BAL, along with specific staining of recovered alveolar macrophages, represents a safe alternative to more invasive diagnostic procedures whenever a diagnosis of ELP is suspected.

Abdominal cocoon secondary to disseminated tuberculosis.

PubMed

Puppala, Radha; Sripathi, Smiti; Kadavigere, Rajagopal; Koteshwar, Prakashini; Singh, Jyoti

2014-09-19

Abdominal cocoon, also known as sclerosing encapsulating peritonitis, represents a rare entity where a variable length of the small bowel is enveloped by a fibrocollagenous membrane giving the appearance of a cocoon. It may be asymptomatic and is often diagnosed incidentally at laparotomy. We present a rare case of abdominal cocoon due to abdominal tuberculosis. 2014 BMJ Publishing Group Ltd.

Addressing the Pedagogical Purpose of Indigenous Displays: The Case of the National Museum of the American Indian

ERIC Educational Resources Information Center

Trofanenko, Brenda; Segall, Avner

2012-01-01

In museums with Indigenous objects, the exhibits present a particular representation of the culture and history of Indigenous peoples. More recently, the move toward partnerships with Indigenous communities represents a radical departure from long-held attitudes about the relationship between Indigenous people and museums. This article both…

Adrenocortical carcinoma with inferior vena cava, left renal vein and right atrium tumor thrombus extension

PubMed Central

Annamaria, Pronio; Silvia, Piroli; Bernardo, Ciamberlano; Alessandro, De Luca; Antonino, Marullo; Antonio, Barretta; Giuseppe, Mazzesi; Massimo, Rossi; Montesani, Chiara

2015-01-01

Introduction Adrenocortical carcinoma (ACC) is a rare, but highly aggressive type of tumor with an annual incidence of 1–2 cases per million. The prognosis is poor with a five-year overall survival rate of ∼35%. The poor prognosis may be related to the advanced stage at which the majority of ACCs are detected. Complete surgical resection remains the most effective treatment. Presentation of the case A 51-year-old female patient with recent onset of dyspepsia, ascites and peripheral edema was referred to our institution. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) displayed a 8 cm Ø right adrenal mass. Moreover a tumor thrombus jutted out into the IVC, left renal vein and right atrium. An echocardiographic evaluation confirmed the presence of the tumor thrombus in the right atrium. The patient underwent adrenalectomy with removal of its intravascular extension with the assistance of cardiopulmonary bypass and hypothermia. Discussion ACC is a rare malignancy and ACC with tumor thrombus extension is a rare presentation. Patients can present with a variety of sign and symptoms, depending on the extent of the tumor. CT scan of chest and abdomen represents the gold standard in ACC staging while magnetic resonance imaging (MRI) is preferred for tumor thrombus characterization. Complete surgical resection with a negative margin, R0 resection, is the only curative option for localized disease. Kidney sparing surgery should be performed when possible. Conclusion We present a rare case of Adrenocortical carcinoma with tumor thrombus extending into the IVC and right atrium. Complete resection with negative margins represents the best therapeutic chance for these patients. PMID:26355237

[Dengue shock syndrome].

PubMed

Docquir, J; Tuerlinckx, D; Bodart, E

2009-11-01

Célia, 21 month-old child, presented to our pediatric clinic a few months ago with a fever of unknown origin after a stay in St-Domingue with her parents. Complementary investigations led to a diagnosis of Dengue Fever. The condition, not very frequent and thus not well known in our countries, represents a major world health problem especially because of the global failure of prophylactic measures. If the disease is self-limited in most cases, severe form can occur, with significant mortality and morbidity. Delay in diagnosis and treatment of these severe cases is often fatal.

Family and Medical Leave Act of 1987. Joint Hearing on H.R. 925 before the Subcommittee on Civil Service and the Subcommittee on Compensation and Employee Benefits of the Committee on Post Office and Civil Service. House of Representatives, One Hundredth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U. S., Washington, DC. House Committee on Post Office and Civil Service.

The issue of parental leave following the birth or adoption of a child, or in the case of serious family medical problems, is discussed. Testimonies include: (1) general statements on the need for legislation regarding family and medical leave; (2) personal case histories involving the need for parental leave; and (3) presentations of official…

Vocal fold hemorrhage associated with coumadin therapy in an opera singer.

PubMed

Neely, J L; Rosen, C

2000-06-01

Vocal fold hemorrhage can represent a disastrous and potentially career ending injury to a singer or professional voice user. The risk factors of vocal fold hemorrhage, including laryngeal trauma, phonotrauma, aspirin and nonsteroidal antiinflammatories, and hormonal imbalances are well known. We present a case of an opera singer who developed recurrent vocal fold hemorrhage associated with coumadin anticoagulation therapy. This case highlights the importance of the risk of vocal fold hemorrhage to professional singers and professional voice users and offers an alternative to long-term coumadin therapy in this select population.

Utilization of the Safe Surgical Dislocation Approach of the Hip to Retrieve a Bullet from the Femoral Head

PubMed Central

Delaney, Ruth; Albright, Maurice; Rebello, Gleeson

2011-01-01

Retained intra-articular missiles from low-velocity handguns can lead to mechanical arthritis, synovitis, and lead toxicity. Various surgical approaches have been described to extract such foreign bodies from the hip joint. We present the case of a 17-year-old male in which the surgical dislocation approach was utilized to retrieve a bullet from the femoral head with a good short-term outcome. This case represents a rare application of the surgical hip dislocation approach for an unusual trauma. PMID:23198205

[A case report of very huge dermatofibrosarcoma protuberans].

PubMed

Hanagiri, T; Tanaka, T; Shimabukuro, T; Takemoto, H; Inoue, A; Sugitani, A; Ishii, M; Kurokawa, M

1990-03-01

A 63-year-old male with dermatofibrosarcoma protuberans of the right hip is presented. The patient noticed a small nontender mass 40 years ago and then the tumor enlarged gradually. The patient was very emaciated and needed to receive blood transfusions. The massive multinodular tumor was pedunculated and on it's surface, there were areas of hemorrhage and secondary infection. The operative specimen weighted 2270 g and measured up to 25 by 20 by 10 cm. To our knowledge, this case represents the largest primary tumor of a dermatofibrosarcoma protuberans in review of English literature.

Possible potassium chlorate nephrotoxicity associated with chronic matchstick ingestion.

PubMed

Thurlow, John S; Little, Dustin J; Baker, Thomas P; Yuan, Christina M

2013-06-01

We present a case of a 48-year-old active duty male soldier with a history of chronic exposure to potassium chlorate, later diagnosed with chronic interstitial nephritis. He reported regular matchstick consumption to prevent chigger (Trombicula autumnalis) bites, amounting to ∼5.8 g of potassium chlorate over 3 years. Potassium chlorate can cause anuric renal failure within days of a toxic dose. Its slow excretion and mechanism of action suggest that renal toxicity may result from lower-dose chronic exposure. This case represents possible sequelae of chronic potassium chlorate ingestion.

Possible potassium chlorate nephrotoxicity associated with chronic matchstick ingestion*

PubMed Central

Thurlow, John S.; Little, Dustin J.; Baker, Thomas P.; Yuan, Christina M.

2013-01-01

We present a case of a 48-year-old active duty male soldier with a history of chronic exposure to potassium chlorate, later diagnosed with chronic interstitial nephritis. He reported regular matchstick consumption to prevent chigger (Trombicula autumnalis) bites, amounting to ∼5.8 g of potassium chlorate over 3 years. Potassium chlorate can cause anuric renal failure within days of a toxic dose. Its slow excretion and mechanism of action suggest that renal toxicity may result from lower-dose chronic exposure. This case represents possible sequelae of chronic potassium chlorate ingestion. PMID:26064493

Clinical experience with Leptospermum honey use for treatment of hard to heal neonatal wounds: case series.

PubMed

Boyar, V; Handa, D; Clemens, K; Shimborske, D

2014-02-01

Preterm, critically ill neonates represent a challenge in wound healing. Many factors predispose infants to skin injuries, including decreased epidermal-dermal cohesion, deficient stratum corneum, relatively alkaline pH of skin surface, impaired nutrition and presence of multiple devices on the skin. We present a case series describing the use of medical-grade honey-Leptospermum honey (Medihoney), for successful treatment of slowly healing neonatal wounds, specifically stage 3 pressure ulcer, dehiscent and infected sternal wound, and full-thickness wound from an extravasation injury.

Isolated port-site metastasis after surgical staging for low-risk endometrioid endometrial cancer: A case report.

PubMed

Mautone, Daniele; Dall'asta, Andrea; Monica, Michela; Galli, Letizia; Capozzi, Vito Andrea; Marchesi, Federico; Giordano, Giovanna; Berretta, Roberto

2016-07-01

Port-site metastases (PSMs) are well-known potential complications of laparoscopic surgery for gynaecologic malignancies. The present case study reports PSM following laparoscopic surgery for Stage IA Grade 1 endometrioid endometrial cancer (EEC). The recurrence developed within 7 months following primary surgery and required surgical excision followed by adjuvant chemo-radio therapy. After 9 months, the patient remains disease-free. PSMs are rare complications following laparoscopic surgery. Amongst the 23 cases of endometrial cancer PSMs reported so far, only 4 followed EEC Stage IA Grade 1-2. The present study reports a rare case of PSM after Stage IA Grade 1 EEC. The clinical and prognostic relevance of PSMs has not been identified so far; and it is not known whether PSMs represent a local recurrence or a systemic recurrence. Surgeons should be aware that even low-risk EEC may be followed by PSMs and should take steps to prevent these rare recurrences.

[Writing and publication of a clinical case report].

PubMed

Târcoveanu, E; Roca, M; Mihăescu, T

2011-01-01

A case report represents a collection of detailed information about an individual patient, written with the purpose to disseminate clinical outcomes, not previously reported. Case reports provide a rich resource for teaching and research in medicine. Despite the limitation of case reports, these are useful to generate new hypothesis for future large scale clinical trials. A clinical case report should be well structured and convey a clear message. Elements of a case report are similar to all forms of medical scientific articles: title, structured abstract, introduction, case report, discussion, conclusion and references. A well written case report with literature support and a detailed description of management of the case has the greatest chances to be published. "Uniform Requirements for Manuscripts to Biomedical Journals" form the basis for most journal instructions regarding content and formatting and should be consulted when journal's instructions don't answer to author's questions. In this paper we present a case report check sheet to use as a form of self-evaluation, prior to submitting the articles.

Antibiotic-Associated Apoptotic Enterocolitis in the Absence of a Defined Pathogen: The Role of Intestinal Microbiota Depletion*

PubMed Central

Wurm, Philipp; Spindelboeck, Walter; Krause, Robert; Plank, Johannes; Fuchs, Gottfried; Bashir, Mina; Petritsch, Wolfgang; Halwachs, Bettina; Langner, Cord; Högenauer, Christoph

2017-01-01

Objective: Antibiotic therapy is a major risk factor for the development of diarrhea and colitis with varying severity. Often the origin of antibiotic-associated gastrointestinal deterioration remains elusive and no specific infectious agents could be discerned. Patients: We represent three cases of intractable high-volume diarrhea associated with combined antibiotic and steroid therapy in critically ill patients not fitting into established disease entities. Cases presented with severe apoptotic enterocolitis resembling acute intestinal graft-versus-host-disease. Microbiologic workup precluded known enteropathogens, but microbiota analysis revealed a severely depleted gut microbiota with concomitant opportunistic pathogen overgrowth. Interventions: Fecal microbiota transplantation, performed in one patient, was associated with correction of dysbiosis, rapid clinical improvement, and healing of enterocolitis. Conclusions: Our series represents a severe form of antibiotic-associated colitis in critically ill patients signified by microbiota depletion, and reestablishment of a physiologic gastrointestinal microbiota might be beneficial for this condition. PMID:28333760

Ewing's sarcoma of the cranial vault: a case report.

PubMed

Feki, Jihene; Guermazi, Zeineb; Kammoun, Brahim; Khanfir, Afef; Toumi, Nabil; Boudawara, Tahiya; Boudawara, Zaher; Daoud, Jamel; Frikha, Mounir

2017-12-01

Ewing's sarcoma is a malignant tumor that mainly affects young patients. It represents 10% of primary malignant tumors of the bone and 3% of malignant tumors of the child. Cranial localization is extremely rare representing less than 1% of all the localizations. We report a case of a 10-year-old girl who presented with an intracranial hypertension syndrome with left parietal mass of progressive installation. The X-ray skull showed a lytic lesion with irregular margins involving the left parietal bone. Brain magnetic resonance imaging revealed extensive parietal bone destruction involving both the inner and outer tables. The girl was operated in emergency. Histological examination concluded to Ewing's Sarcoma. The resection was incomplete (R1). The girl received induction's chemotherapy. The cerebral scanner evaluation showed no abnormalities. Then, she received consolidation's chemotherapy with concomitant local radiation therapy. Currently, the girl is in complete remission with a seven-month decline.

Screening Cereals Quality by Electronic Nose: the Example of Mycotoxins Naturally Contaminated Maize and Durum Wheat

NASA Astrophysics Data System (ADS)

Campagnoli, Anna; Dell'Orto, Vittorio; Savoini, Giovanni; Cheli, Federica

2009-05-01

Mycotoxins represent an heterogeneous group of toxic compounds from fungi metabolism. Due to the frequent occurrence of mycotoxins in cereals commodities the develop of cost/effective screening methods represent an important topic to ensure food and feed safety. In the presented study a commercial electronic nose constituted by ten MOS (Metal Oxide Sensors) was applied to verify the possibility of discriminating between mycotoxins contaminated and non-contaminated cereals. The described analytical approach was able to discriminate contaminated and non-contaminated samples both in the case of aflatoxins infected maize and deoxynivalenol infected durum wheat samples. In the case of maize data two sensors from the array revealed a partial relation with the level of aflatoxins. These results could be promising for a further improvement of electronic nose application in order to develop a semi-quantitative screening approach to mycotoxins contamination.

Severe vulvovaginitis as a presenting problem of type 2 diabetes in adolescent girls: a case series.

PubMed

Curran, Jacqueline; Hayward, Jenette; Sellers, Elizabeth; Dean, Heather

2011-04-01

This article describes the presentation of 4 adolescent girls who sought medical attention for severe vulvovaginitis and were subsequently found to have type 2 diabetes. Symptomatic vulvovaginitis is rare in adolescent girls, and its presence should alert health care providers to test for underlying hyperglycemia. These 4 girls represent 8.5% of the females with new-onset type 2 diabetes during a 3-year period (2007-2009). The 4 cases fulfilled the current Canadian Diabetes Association screening criteria for type 2 diabetes in youth, yet none of these girls had been screened. These cases highlight the need for better awareness of screening criteria for type 2 diabetes in adolescents. Consideration should be given in clinical practice guidelines to including the presence of unusual or severe infections as a risk factor for type 2 diabetes in youth.

Small cell sweat gland carcinoma of childhood

PubMed Central

Drut, R; Giménez, O P; Oliva, J

2005-01-01

Small cell sweat gland carcinoma appears to represent a very unusual histological type of sweat gland anlage tumour presenting in children. The differential diagnosis from other small blue cell tumours involving the skin is often difficult. The present report confirms the original observation describing two patients of 2 and 5 years of age harbouring cutaneous tumours. The histology of these lesions showed a monomorphic proliferation of small cells with a high mitotic rate and areas of necrosis. Immunohistochemically, the cells were negative for desmin, cytokeratin 7, cytokeratin 20, Cam 5.2, CD99, chromogranin, CD56, synaptophysin, and S-100, and focally positive for the pancytokeratin marker AE1/AE3, carcinoembryonic antigen (one case), and neurone specific enolase (one case). The prognosis of this type of tumour seems to be good. As more cases are added, the clinical pathological spectrum of the lesion will become better defined. PMID:16311358

[Acquired perforating dermatosis in the patient with chronic kidney disease – case report and literature review].

PubMed

Steć, Anna; Paluch-Oleś, Jolanta; Korolczuk, Agnieszka; Magdalena Grzebalska, Agnieszka; Kozioł-Montewka, Maria; Książek, Andrzej

Acquired perforating dermatosis (APD) represents a heterogenous group of skin disorders characterized histopathologically by transepithelial elimination (TEE) of dermal structures. APD is manifested clinically as multi-localized, papulo-nodular skin lesions accompanied by a refractory pruritus. APD typically coexists with long-term disorders, most often diabetic kidney disease (DKD). The paper presents a case of a 56-year-old male patient with chronic kidney disease (CKD) and concomitant acquired reactive perforating collagenosis (ARPC), which is a subtype of APD. Etiological theories of ARPC as well as current diagnostic and treatment principles in dermatosis were described. On the basis of the presented case report and the literature review attention was paid to diagnostic difficulties associated with APD. The assumption was made that APD can be an underdiagnosed disease and thus it is not treated correctly. According to the authors’ opinion, this is an important circumstance to popularize the knowledge about APD.

Correlation between clinical and histopathological diagnoses in periapical inflammatory lesions.

PubMed

Diegues, Liliane Lopes; Colombo Robazza, Carlos Roberto; Costa Hanemann, João Adolfo; Costa Pereira, Alessandro Antônio; Silva, Cléverson O

2011-08-01

  The purpose of the present study was to evaluate the correlation between clinical and histopathological diagnoses of periapical inflammatory lesions, focusing mainly on cystic conditions.   Files dating from 1998 to 2006 at the Oral Pathology Laboratory, School of Dentistry, Alfenas Federal University, Brazil, were reviewed to identify cases with histopathological diagnoses of periapical inflammatory lesions. A total of 1788 files were analyzed, and 255 cases were identified with clinical diagnoses of periapical inflammatory lesions.   The most prevalent clinical diagnosis was apical periodontal cyst (59%), followed by periapical granuloma (20%), and dentoalveolar abscess (2%). After histopathological analysis, 53% of the cases represented apical periodontal cyst, 42% periapical granuloma, and 5% dentoalveolar abscess.   The outcomes of the present study show a high prevalence of periapical cysts among periapical inflammatory lesions. Moreover, this study highlights the importance of histopathological evaluation for the correct diagnosis of periapical inflammatory lesions. © 2011 Blackwell Publishing Asia Pty Ltd.

Preliminary dynamic tests of a flight-type ejector

NASA Technical Reports Server (NTRS)

Drummond, Colin K.

1992-01-01

A thrust augmenting ejector was tested to provide experimental data to assist in the assessment of theoretical models to predict duct and ejector fluid-dynamic characteristics. Eleven full-scale thrust augmenting ejector tests were conducted in which a rapid increase in the ejector nozzle pressure ratio was effected through a unique bypass/burst-disk subsystem. The present work examines two cases representative of the test performance window. In the first case, the primary nozzle pressure ration (NPR) increased 36 percent from one unchoked (NPR = 1.29) primary flow condition to another (NPR = 1.75) over a 0.15 second interval. The second case involves choked primary flow conditions, where a 17 percent increase in primary nozzle flowrate (from NPR = 2.35 to NPR = 2.77) occurred over approximately 0.1 seconds. Transient signal treatment of the present dataset is discussed and initial interpretations of the results are compared with theoretical predictions for a similar STOVL ejector model.

Juvenile Papillomatosis of the Breast in a Pre-Pubertal Girl: An Uncommon Diagnosis.

PubMed

Kafadar, Mehmet Tolga; Anadolulu, Zeynep; Anadolulu, Ali İhsan; Tarini, Emine Zeynep

2018-01-01

Juvenile papillomatosis of the breast represents a rare benign proliferative disorder that affects women younger than thirty years of age. Although it is a localized lesion, it does not have well-demarcated margins. These patients tend to have a strong family history for cancer. As it has similar clinical presentation with that of a fibroadenoma, it usually receives the diagnosis of the latter in the preoperative period. Nonetheless, it has distinct microscopic features such as ductal papillomatosis and cysts that are helpful in the diagnosis. In this article, a case of juvenile papillomatosis diagnosed in a young girl who presented due to a mass of the breast was presented. For the fairly rare case, a total mass excision was performed with preserved breast tissue. The exact diagnosis was made by postoperative histopathological examination.

Cleft-palate lateral synechia syndrome: insight into the phenotypic spectrum of Fryns syndrome?

PubMed

Jaeger, April; Kapur, Raj; Whelan, Michael; Leung, Eric; Cunningham, Michael

2003-06-01

In 1972, Fuhrmann et al. (Humangenetik 1972;14:196-203) described a novel syndrome consisting of cleft palate (CP) and lateral synechiae (LS) between the palate and the floor of the mouth. This constellation of malformations, since denoted as cleft-palate lateral synechiae syndrome (CPLS), is a rare syndrome; only five cases have been reported since the original description. Because of the paucity of recognized cases, little is known regarding the phenotypic spectrum of this presumably autosomal dominant condition. We report two unrelated patients who presented with remarkably similar phenotypic features, including multiple intraoral synechiae (filiforme intraalveolar bands), cleft palate, micrognathia, and redundant lower lip tissue. Their phenotypic findings indicate a diagnosis of CPLS; however, case 3 (the monozygotic twin of case 2) had classic phenotypic features of Fryns syndrome. This report presents two new cases of CPLS, and suggests that the CPLS phenotype may represent the mild end of the Fryns syndrome phenotypic spectrum. Supplementary material for this article can be found on the Birth Defects Research (Part A) website (http://www.interscience.wiley.com/ jpages/1542-0752/suppmat/67/fig5.xls).

Nanomaterial Case Studies: Nanoscale Titanium Dioxide ...

EPA Pesticide Factsheets

This draft document presents two case studies of nanoscale titanium dioxide (nano-TiO2) used (1) to remove arsenic from drinking water and (2) as an active ingredient in topical sunscreen. The draft case studies are organized around a comprehensive environmental assessment approach that combines a product life cycle framework with the risk assessment paradigm. The document does not draw conclusions about potential risks. Rather, the case studies are intended to help identify what needs to be known in order to conduct a comprehensive environmental assessment of the potential risks related to nano-TiO2. This draft document is part of a process that will inform the development of EPA’s research strategy to support nanomaterial risk assessments. The complex properties of various nanomaterials make evaluating them in the abstract or with generalizations difficult if not impossible. Thus, this document focuses on two specific uses of nano-TiO2, as a drinking water treatment and as topical sunscreen. These case studies do not represent completed or even preliminary assessments; rather, they present the structure for identifying and prioritizing research needed to support future assessments.

Liver pathology in Malawian children with fatal encephalopathy

PubMed Central

Whitten, Richard; Milner, Danny A.; Yeh, Matthew M.; Kamiza, Steve; Molyneux, Malcolm E.; Taylor, Terrie E.

2010-01-01

A common clinical presentation of Plasmodium falciparum is parasitemia complicated by an encephalopathy for which other explanations cannot be found, termed cerebral malaria—an important cause of death in young children in endemic areas. Our objective was to study hepatic histopathology in Malawian children with fatal encephalopathy, with and without P falciparum parasitaemia, in order to assess the contributions of severe malaria. We report autopsy results from a series of 87 Malawian children who died between 1996 and 2008. Among 75 cases with P falciparum parasitaemia, 51 had intracerebral sequestered parasites, while 24 without sequestered parasites had other causes of death revealed by autopsy including 4 patients with clinicopathological findings which may represent Reye’s Syndrome. Hepatic histology in parasitaemic cases revealed very limited sequestration of parasites in hepatic sinusoids, even in cases with extensive sequestration elsewhere, but increased numbers of hemozoin-laden Kupffer cells were invariably present with a strong association with histological evidence of cerebral malaria by quantitative analysis. Of 12 patients who were consistently aparasitaemic during their fatal illness, 5 had clinicopathological findings which may represent Reye’s Syndrome. Hepatic sequestration of parasitized erythrocytes is not a feature of fatal malaria in Malawian children, and there is no structural damage in the liver. Reye’s syndrome may be an important cause of fatal encephalopathy in children in Malawi with and without peripheral parasitemia and warrants close scrutiny of aspirin use in malaria endemic areas. PMID:21396681

Synchronization with propagation - The functional differential equations

NASA Astrophysics Data System (ADS)

Rǎsvan, Vladimir

2016-06-01

The structure represented by one or several oscillators couple to a one-dimensional transmission environment (e.g. a vibrating string in the mechanical case or a lossless transmission line in the electrical case) turned to be attractive for the research in the field of complex structures and/or complex behavior. This is due to the fact that such a structure represents some generalization of various interconnection modes with lumped parameters for the oscillators. On the other hand the lossless and distortionless propagation along transmission lines has generated several research in electrical, thermal, hydro and control engineering leading to the association of some functional differential equations to the basic initial boundary value problems. The present research is performed at the crossroad of the aforementioned directions. We shall associate to the starting models some functional differential equations - in most cases of neutral type - and make use of the general theorems for existence and stability of forced oscillations for functional differential equations. The challenges introduced by the analyzed problems for the general theory are emphasized, together with the implication of the results for various applications.

Warfarin monitoring in nursing homes assessed by case histories. Do recommendations and electronic alerts affect judgements?

PubMed

Teruel, Reyes Serrano; Thue, Geir; Fylkesnes, Svein Ivar; Sandberg, Sverre; Kristoffersen, Ann Helen

2017-09-01

Older adults treated with warfarin are prone to complications, and high-quality monitoring is essential. The aim of this case history based study was to assess the quality of warfarin monitoring in a routine situation, and in a situation with an antibiotic-warfarin interaction, before and after receiving an electronic alert. In April 2014, a national web-based survey with two case histories was distributed among Norwegian nursing home physicians and general practitioners working part-time in nursing homes. Case A represented a patient on stable warfarin treatment, but with a substantial INR increase within the therapeutic interval. Case B represented a more challenging patient with trimethoprim sulfamethoxazole (TMS) treatment due to pyelonephritis. In both cases, the physicians were asked to state the next warfarin dose and the INR recall interval. In case B, the physicians could change their suggestions after receiving an electronic alert on the TMS-warfarin interaction. Three hundred and ninety eight physicians in 292 nursing homes responded. Suggested INR recall intervals and warfarin doses varied substantially in both cases. In case A, 61% gave acceptable answers according to published recommendations, while only 9% did so for case B. Regarding the TMS-warfarin interaction in case history B, the electronic alert increased the percentage of respondents correctly suggesting a dose reduction from 29% to 53%. Having an INR instrument in the nursing home was associated with shortened INR recall times. Practical advice on handling of warfarin treatment and drug interactions is needed. Electronic alerts as presented in electronic medical records seem insufficient to change practice. Availability of INR instruments may be important regarding recall time.

Diagnosis of penile fracture in primary care: a case report

PubMed Central

Akpinar, Ersin

2009-01-01

Introduction Penile fracture has been reported with sexual intercourse, masturbation, rolling over or falling on to the erect penis. Classically the history is with a sudden snap, pain, detumescence and a hematoma of the penis with deformity. Immediate surgical treatment is recommended. The patients may delay the admission due to fear and embarrassment or the condition may usually be underreported. Case presentation A 32-year-old man presented to primary care complaining of discoloration of penis without any significant history or symptom. Physical examination revealed swollen, ecchymotic, and deviated circumcised penis. Conclusion Although frequent and common diseases represent the majority of daily work, the primary care physician should be alert for possible unexpected history or symptom of a rare and often serious condition. PMID:19830047

A 71-Year-Old Female with Myocardial Infarction and Long-Standing Ulcers on the Thigh

PubMed Central

De Flammineis, Eduardo; Mulvaney, Patrick M.; Kraft, Stefan; Mihm Jr., Martin C.; Das, Shinjita; Kroshinsky, Daniela

2017-01-01

Calciphylaxis is most commonly encountered in patients with end-stage renal disease; however, it is increasingly observed in nonuremic patients as well. It is important to consider and diagnose nonuremic calciphylaxis early, as prompt treatment and mitigation of associated risk factors is essential to improve long-term outcomes for these patients. Here, we present the case of a 71-year-old woman with atrial fibrillation on warfarin, but without renal disease, who presented with two long-standing ulcers on her thigh and was diagnosed with the aid of biopsy with calciphylaxis. We review the existing literature on the subject and offer this case as a representative report of a clinicopathologic correlation for this disorder. PMID:29456997

Optic neuropathy secondary to a sphenoid-ethmoidal mucocele: Case report.

PubMed

Mora-Horna, E R; López, V G; Anaya-Alaminos, R; Ceriotto, A; Salcedo, G

2015-12-01

The case is presented of a 51-year old male patient with a history of blunt trauma in the frontal region and a one-year history of vision loss, proptosis and paresis of the lateral rectus muscle of the right eye. A right ethmoid and bilateral sphenoid mucocele was diagnosed. Drainage was performed using an external and endoscopic approach with improvement in symptoms without recurrence at 10 months. Sphenoid mucoceles represent 1% of all mucoceles and may present with different clinical manifestations. Surgical excision is the treatment of choice, and early intervention is indicated to prevent complications. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Case study: Optimizing fault model input parameters using bio-inspired algorithms

NASA Astrophysics Data System (ADS)

Plucar, Jan; Grunt, Onřej; Zelinka, Ivan

2017-07-01

We present a case study that demonstrates a bio-inspired approach in the process of finding optimal parameters for GSM fault model. This model is constructed using Petri Nets approach it represents dynamic model of GSM network environment in the suburban areas of Ostrava city (Czech Republic). We have been faced with a task of finding optimal parameters for an application that requires high amount of data transfers between the application itself and secure servers located in datacenter. In order to find the optimal set of parameters we employ bio-inspired algorithms such as Differential Evolution (DE) or Self Organizing Migrating Algorithm (SOMA). In this paper we present use of these algorithms, compare results and judge their performance in fault probability mitigation.

Secondary infection of haematoma following closed acromioclavicular joint dislocation

PubMed Central

Dupley, Leanne; Berg, Andrew James; Mohil, Randeep

2016-01-01

An unusual case of a patient presenting with a large infected haematoma following a traumatic grade II acromioclavicular joint dislocation is reported. Diagnosis of this rare complication, of an otherwise common self-limiting injury, was delayed until 19 days postinjury despite several presentations during this time with worsening swelling and pain. The patient was found to have significant tissue destruction by the time washout was performed and required multiple procedures to treat the infection. This case highlights the need for a high index of suspicion for complications, even following common self-limiting injuries, when patients represent with symptoms that do not fit the usual natural history of the condition, particularly if they have risk factors for bleeding and infection. PMID:26786526

Bilateral shotgun pellet pulmonary emboli

PubMed Central

Huebner, Stephen; Ali, Sayed

2012-01-01

Intravascular migration of bullets and other foreign bodies is a rare but known complication of penetrating trauma. Missile embolization can represent a diagnostic challenge because it may present in various and unexpected ways. We present the case of a 54-year-old female who sustained shotgun pellet emboli to the pulmonary arteries following a left upper extremity gunshot wound and related vascular surgery. The case illustrates bilateral embolization, and the embolic events occurred following surgery. Embolization should be considered in evaluating patients with gunshot wounds, particularly if there are anomalous symptoms or the projectile is not found in the original, or expected, location. Close attention to the location of the foreign bodies on serial radiographs may reveal the diagnosis of intravascular embolization. PMID:22690290

Bayesian network interface for assisting radiology interpretation and education

NASA Astrophysics Data System (ADS)

Duda, Jeffrey; Botzolakis, Emmanuel; Chen, Po-Hao; Mohan, Suyash; Nasrallah, Ilya; Rauschecker, Andreas; Rudie, Jeffrey; Bryan, R. Nick; Gee, James; Cook, Tessa

2018-03-01

In this work, we present the use of Bayesian networks for radiologist decision support during clinical interpretation. This computational approach has the advantage of avoiding incorrect diagnoses that result from known human cognitive biases such as anchoring bias, framing effect, availability bias, and premature closure. To integrate Bayesian networks into clinical practice, we developed an open-source web application that provides diagnostic support for a variety of radiology disease entities (e.g., basal ganglia diseases, bone lesions). The Clinical tool presents the user with a set of buttons representing clinical and imaging features of interest. These buttons are used to set the value for each observed feature. As features are identified, the conditional probabilities for each possible diagnosis are updated in real time. Additionally, using sensitivity analysis, the interface may be set to inform the user which remaining imaging features provide maximum discriminatory information to choose the most likely diagnosis. The Case Submission tools allow the user to submit a validated case and the associated imaging features to a database, which can then be used for future tuning/testing of the Bayesian networks. These submitted cases are then reviewed by an assigned expert using the provided QC tool. The Research tool presents users with cases with previously labeled features and a chosen diagnosis, for the purpose of performance evaluation. Similarly, the Education page presents cases with known features, but provides real time feedback on feature selection.

Bellini's duct carcinoma: A report of two cases and a review of the literature

PubMed Central

LI, YIFAN; JIN, LU; LIU, JIAJU; CHEN, DUQUN; SU, ZHENGMING; ZHOU, LIQUN; SHI, BENTAO; LAI, YONGQING

2016-01-01

Bellini's duct carcinoma (BDC) is a rare and aggressive variant of renal cell carcinoma that possesses an extremely poor prognosis. The greater the grade or stage of disease, the poorer the prognosis tends to be. This study presents two cases of BDC; one case of low grade BDC and one case of high grade BDC in a 47-year-old male and 74-year-old female, respectively. The 47-year-old male patient presented with painless gross hematuria, which had lasted for 3 weeks and subsequently underwent purely laparoscopic nephroureterectomy. After 4-years of follow-up, the patient remained disease-free. By contrast, a right renal tumor was identified in the 74-year-old female patient during a routine examination. Radical right nephrectomy and lymph node dissection were performed, however, 10 months after surgery the patient succumbed due to wide-spread metastasis. The two cases reported in the present study not only represent excellent examples of the disease spectrum, but also act as a reminder of the possibility of detecting BDC in an early stage of disease. Therefore, the epidemiology of BDC has been discussed, and the aggressive growth pattern of BDC has been presented in terms of signs, symptoms and imaging examinations, including ultrasonography, computed tomography (CT), angiography and single photon emission CT, in the early stage of disease. PMID:27313704

Bellini's duct carcinoma: A report of two cases and a review of the literature.

PubMed

Li, Yifan; Jin, L U; Liu, Jiaju; Chen, Duqun; Su, Zhengming; Zhou, Liqun; Shi, Bentao; Lai, Yongqing

2016-06-01

Bellini's duct carcinoma (BDC) is a rare and aggressive variant of renal cell carcinoma that possesses an extremely poor prognosis. The greater the grade or stage of disease, the poorer the prognosis tends to be. This study presents two cases of BDC; one case of low grade BDC and one case of high grade BDC in a 47-year-old male and 74-year-old female, respectively. The 47-year-old male patient presented with painless gross hematuria, which had lasted for 3 weeks and subsequently underwent purely laparoscopic nephroureterectomy. After 4-years of follow-up, the patient remained disease-free. By contrast, a right renal tumor was identified in the 74-year-old female patient during a routine examination. Radical right nephrectomy and lymph node dissection were performed, however, 10 months after surgery the patient succumbed due to wide-spread metastasis. The two cases reported in the present study not only represent excellent examples of the disease spectrum, but also act as a reminder of the possibility of detecting BDC in an early stage of disease. Therefore, the epidemiology of BDC has been discussed, and the aggressive growth pattern of BDC has been presented in terms of signs, symptoms and imaging examinations, including ultrasonography, computed tomography (CT), angiography and single photon emission CT, in the early stage of disease.

Reporting the Rhetoric, Implementation of the United Nations Convention on the Rights of the Child as Represented in Ireland's Second Report to the UN Committee on the Rights of the Child: A Critical Discourse Analysis

ERIC Educational Resources Information Center

Kiersey, Rachel A.; Hayes, Noirin

2010-01-01

Ireland's second periodic report to the United Nations Committee on the Rights of the Child (CRC) presents the government's case that it is succeeding in protecting and promoting the rights of all children in Ireland. This article presents a critical discourse analysis of the government's Report to the CRC. Using a refined critical discourse…

Exceptional soft tissues preservation in a mummified frog-eating Eocene salamander.

PubMed

Tissier, Jérémy; Rage, Jean-Claude; Laurin, Michel

2017-01-01

Fossils are almost always represented by hard tissues but we present here the exceptional case of a three-dimensionally preserved specimen that was 'mummified' (likely between 40 and 34 million years ago) in a terrestrial karstic environment. This fossil is the incomplete body of a salamander, Phosphotriton sigei , whose skeleton and external morphology are well preserved, as revealed by phase-contrast synchrotron X-ray microtomography. In addition, internal structures composed of soft tissues preserved in three dimensions are now identified: a lung, the spinal cord, a lumbosacral plexus, the digestive tract, muscles and urogenital organs that may be cloacal glands. These are among the oldest known cases of three-dimensional preservation of these organs in vertebrates and shed light on the ecology of this salamander. Indeed, the digestive tract contains remains of a frog, which represents the only known case of an extinct salamander that fed on a frog, an extremely rare type of predation in extant salamanders. These new data improve our scarce knowledge on soft tissue anatomy of early urodeles and should prove useful for future biologists and palaeontologists working on urodele evolutionary biology. We also suggest that the presence of bat guano and carcasses represented a close source of phosphorus, favouring preservation of soft tissues. Bone microanatomy indicates that P. sigei was likely amphibious or terrestrial, and was probably not neotenic.

An approach to the symbolic representation of brain arteriovenous malformations for management and treatment planning.

PubMed

Orlowski, Piotr; Mahmud, Imran; Kamran, Mudassar; Summers, Paul; Noble, Alison; Ventikos, Yiannis; Byrne, James V

2014-03-01

There is currently no standardised approach to arteriovenous malformation (AVM) reporting. Existing AVM classification systems focuses on angioarchitectural features and omit haemodynamic, anatomical and topological parameters intuitively used by therapists. We introduce a symbolic vocabulary to represent the state of an AVM of the brain at different stages of treatment. The vocabulary encompasses the main anatomic and haemodynamic features of interest in treatment planning and provides shorthand symbols to represent the interventions themselves in a schematic representation. The method was presented to 50 neuroradiologists from 14 countries during a workshop and graded 7.34 ± 1.92 out of ten for its usefulness as means of standardising and facilitating communication between clinicians and allowing comparisons between AVM cases. Feedback from the survey was used to revise the method and improve its completeness. For an AVM test case, participants were asked to produce a conventional written report and subsequently a diagrammatic report. The two required, on average, 6.19 ± 2.05 and 5.09 ± 3.01 min, respectively. Eighteen participants said that producing the diagram changed the way they thought about the AVM test case. Introduced into routine practice, the diagrams would represent a step towards a standardised approach to AVM reporting with consequent benefits for comparative analysis and communication as well as for identifying best treatment strategies.

SLUDGE TREATMENT PROJECT KOP DISPOSITION - THERMAL AND GAS ANALYSIS FOR THE COLD VACUUM DRYING FACILITY

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

SWENSON JA; CROWE RD; APTHORPE R

2010-03-09

The purpose of this document is to present conceptual design phase thermal process calculations that support the process design and process safety basis for the cold vacuum drying of K Basin KOP material. This document is intended to demonstrate that the conceptual approach: (1) Represents a workable process design that is suitable for development in preliminary design; and (2) Will support formal safety documentation to be prepared during the definitive design phase to establish an acceptable safety basis. The Sludge Treatment Project (STP) is responsible for the disposition of Knock Out Pot (KOP) sludge within the 105-K West (KW) Basin.more » KOP sludge consists of size segregated material (primarily canister particulate) from the fuel and scrap cleaning process used in the Spent Nuclear Fuel process at K Basin. The KOP sludge will be pre-treated to remove fines and some of the constituents containing chemically bound water, after which it is referred to as KOP material. The KOP material will then be loaded into a Multi-Canister Overpack (MCO), dried at the Cold Vacuum Drying Facility (CVDF) and stored in the Canister Storage Building (CSB). This process is patterned after the successful drying of 2100 metric tons of spent fuel, and uses the same facilities and much of the same equipment that was used for drying fuel and scrap. Table ES-l present similarities and differences between KOP material and fuel and between MCOs loaded with these materials. The potential content of bound water bearing constituents limits the mass ofKOP material in an MCO load to a fraction of that in an MCO containing fuel and scrap; however, the small particle size of the KOP material causes the surface area to be significantly higher. This relatively large reactive surface area represents an input to the KOP thermal calculations that is significantly different from the calculations for fuel MCOs. The conceptual design provides for a copper insert block that limits the volume available to receive KOP material, enhances heat conduction, and functions as a heat source and sink during drying operations. This use of the copper insert represents a significant change to the thermal model compared to that used for the fuel calculations. A number of cases were run representing a spectrum of normal and upset conditions for the drying process. Dozens of cases have been run on cold vacuum drying of fuel MCOs. Analysis of these previous calculations identified four cases that provide a solid basis for judgments on the behavior of MCO in drying operations. These four cases are: (1) Normal Process; (2) Degraded vacuum pumping; (3) Open MCO with loss of annulus water; and (4) Cool down after vacuum drying. The four cases were run for two sets of input parameters for KOP MCOs: (1) a set of parameters drawn from safety basis values from the technical data book and (2) a sensitivity set using parameters selected to evaluate the impact of lower void volume and smaller particle size on MCO behavior. Results of the calculations for the drying phase cases are shown in Table ES-2. Cases using data book safety basis values showed dry out in 9.7 hours and heat rejection sufficient to hold temperature rise to less than 25 C. Sensitivity cases which included unrealistically small particle sizes and corresponding high reactive surface area showed higher temperature increases that were limited by water consumption. In this document and in the attachment (Apthorpe, R. and M.G. Plys, 2010) cases using Technical Databook safety basis values are referred to as nominal cases. In future calculations such cases will be called safety basis cases. Also in these documents cases using parameters that are less favorable to acceptable performance than databook safety values are referred to as safety cases. In future calculations such cases will be called sensitivity cases or sensitivity evaluations Calculations to be performed in support of the detailed design and formal safety basis documentation will expand the calculations presented in this document to include: additional features of the drying cycle, more realistic treatment of uranium metal consumption during oxidation, larger water inventory, longer time scales, and graphing of results of hydrogen gas concentration.« less

Comprehensive Environmental Assessment Applied to ...

EPA Pesticide Factsheets

In September 2013, EPA announced the availability of the final report, Comprehensive Environmental Assessment Applied to Multiwalled Carbon Nanotube Flame-Retardant Coatings in Upholstery Textiles: A Case Study Presenting Priority Research Gaps for Future Risk Assessments. This final report presents a case study of multiwalled carbon nanotubes (MWCNTs); it focuses on the specific example of MWCNTs as used in flame-retardant coatings applied to upholstery textiles. This case study is organized around the comprehensive environmental assessment (CEA) framework, which structures available information pertaining to the product life cycle, environmental transport and fate, exposure-dose in receptors (i.e., humans, ecological populations, and the environment), and potential impacts in these receptors. A group of experts representing multiple disciplines and multiple sector perspectives used an earlier draft of the case study in conjunction with a structured workshop process to identify and prioritize research gaps that, if pursued, could inform future MWCNT assessment efforts. The final report is not a health, risk, or exposure assessment and as such does not draw conclusions about potential risks, or present an exhaustive review of the literature. Rather, it presents the MWCNT research priorities that experts identified in this application of CEA in order to aid research planning throughout the scientific community. The outcomes of these research efforts may subsequ

Recovery of Repressed Memories in Fibromyalgia Patients Treated With Hyperbaric Oxygen – Case Series Presentation and Suggested Bio-Psycho-Social Mechanism

PubMed Central

Efrati, Shai; Hadanny, Amir; Daphna-Tekoah, Shir; Bechor, Yair; Tiberg, Kobi; Pik, Nimrod; Suzin, Gil; Lev-Wiesel, Rachel

2018-01-01

Fibromyalgia Syndrome (FMS) is a condition considered to represent a prototype of central sensitization syndrome, characterized by chronic widespread pain and along with symptoms of fatigue, non-restorative sleep and cognitive difficulties. FMS can be induced by trauma, infection or emotional stress with cumulative evidence that dissociation is relatively frequent in FMS patients. Two randomized controlled trials have shown that hyperbaric oxygen therapy (HBOT) can induce neuroplasticity and be effective in patients suffering from FMS. In this paper we present, for the first time, case series of female fibromyalgia patients who, in the course of HBOT, suddenly recalled repressed traumatic memories of childhood sexual abuse (CSA). The surfacing of the repressed (dissociative) memories decades after the sexual abuse events was sudden and utterly surprising. No psychological intervention was involved. As the memories surfaced, the physical pain related to FMS subsided. In one patient who had brain single photon emission CT (SPECT) before and after HBOT, the prefrontal cortex appeared suppressed before and reactivated after. The 3 cases reported in this article are representative of a total of nine fibromyalgia patients who experienced a retrieval of repressed memory during HBOT. These cases provide insights on dissociative amnesia and suggested mechanism hypothesis that is further discussed in the article. Obviously, prospective studies cannot be planned since patients are not aware of their repressed memories. However, it is very important to keep in mind the possibility of surfacing memories when treating fibromyalgia patients with HBOT or other interventions capable of awakening dormant brain regions. PMID:29896150

Hyperthyroidism as a reversible cause of right ventricular overload and congestive heart failure

PubMed Central

Di Giovambattista, Raniero

2008-01-01

We describe a case of severe congestive heart failure and right ventricular overload associated with overt hyperthyroidism, completely reversed with antithyroid therapy in a few week. It represents a very unusual presentation of overt hyperthyroidism because of the severity of right heart failure. The impressive right ventricular volume overload made mandatory to perform transesophageal echo and angio-TC examination to exclude the coexistence of ASD or anomalous pulmonary venous return. Only a few cases of reversible right heart failure, with or without pulmonary hypertension, have been reported worldwide. In our case the most striking feature has been the normalization of the cardiovascular findings after six weeks of tiamazole therapy. PMID:18549503

Hemophagocytic lymphohistiocytosis secondary to T-cell/histiocyte-rich large B-cell lymphoma

PubMed Central

Devitt, Katherine; Cerny, Jan; Switzer, Bradley; Ramanathan, Muthalagu; Nath, Rajneesh; Yu, Hongbo; Woda, Bruce A.; Chen, Benjamin J.

2014-01-01

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening clinical syndrome characterized by dysregulation of the immune system. Impaired function of cytotoxic T cells and natural killer cells is often seen, and T-cell malignancies represent most cases of lymphoma-associated HLH. HLH associated with B-cell lymphoma is rare. We describe a case of a 30-year-old man who presented with fever, splenomegaly, and hyperferritinemia. Bone marrow biopsy revealed T-cell/histiocyte-rich large B-cell lymphoma, a rare, aggressive B-cell malignancy. This case highlights the interplay between a pro-inflammatory cytokine microenvironment and tumor-mediated immune suppression, and addresses the importance of accurately diagnosing these entities for appropriate clinical management. PMID:24955327

Hemophagocytic lymphohistiocytosis secondary to T-cell/histiocyte-rich large B-cell lymphoma.

PubMed

Devitt, Katherine; Cerny, Jan; Switzer, Bradley; Ramanathan, Muthalagu; Nath, Rajneesh; Yu, Hongbo; Woda, Bruce A; Chen, Benjamin J

2014-01-01

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening clinical syndrome characterized by dysregulation of the immune system. Impaired function of cytotoxic T cells and natural killer cells is often seen, and T-cell malignancies represent most cases of lymphoma-associated HLH. HLH associated with B-cell lymphoma is rare. We describe a case of a 30-year-old man who presented with fever, splenomegaly, and hyperferritinemia. Bone marrow biopsy revealed T-cell/histiocyte-rich large B-cell lymphoma, a rare, aggressive B-cell malignancy. This case highlights the interplay between a pro-inflammatory cytokine microenvironment and tumor-mediated immune suppression, and addresses the importance of accurately diagnosing these entities for appropriate clinical management.

[A case of SRY positive sex reversal in a domestic cat].

PubMed

Pieńkowska-Schelling, A; Becker, D; Pineroli, B; Schelling, C

2015-03-01

The present case report describes a stray cat with a female appearance. The new owners requested to neuter the animal. During surgery the veterinarian could not find any gonadal tissue. After puberty the cat showed more and more male behaviour. The owners of the cat were interested to know the cause of the abnormal behaviour, but forbid any further clinical tests or surgery. Based upon cytogenetic and molecular genetic experiments a diagnosis became possible. The uniform karyotype (38,XY) was in accordance with the karyotype of a male cat and it was possible to amplify the SR Y gene by PCR. The cat represents a case of SRYpositive sex reversal.

Synchronous oral paracoccidioidomycosis and pulmonary tuberculosis in an immunocompetent patient.

PubMed

Amorim Pellicioli, Ana Carolina; Neves-Silva, Rodrigo; Santos-Silva, Alan Roger; Vargas, Pablo Agustin; Lopes, Márcio Ajudarte

2015-06-01

Paracoccidioidomycosis (PCM) and tuberculosis (TB) are chronic granulomatous infectious diseases, in which the main form of contraction is through inhalation of the microorganism-Paracoccidioides brasiliensis and Mycobacterium tuberculosis. Oral involvement of PCM is observed in up to 70 % of the cases and usually presents clinically as ulcerations with granular surface showing tiny hemorrhagic areas. Oral presentation of TB is rare with prevalence smaller than 0.5 % of all cases. Clinical presentation of oral TB mainly consists of single ulcers with irregular limits and necrotic base. A 70-year-old immunocompetent man presented simultaneously oral PCM and pulmonary TB. Medical history revealed a previous diagnosis of pulmonary TB; however, even under treatment for TB, the patient remained with oral lesions and intense pulmonary fibrosis. The physician requested P. brasiliensis serological analysis, which resulted positive. Although the combination of PCM and TB has been reported in the literature, it is still considered an uncommon condition and their diagnosis may represent a challenge to healthcare professionals because of the similarity between their clinical and radiological presentations.

Occipital Condyle Syndrome: A Red Flag for Malignancy. Comprehensive Literature Review and New Case Report.

PubMed

Rodríguez-Pardo, Jorge; Lara-Lara, Manuel; Sanz-Cuesta, Borja E; Fuentes, Blanca; Díez-Tejedor, Exuperio

2017-05-01

To perform a literature review of the epidemiology, clinical presentation, diagnostic evaluation, and clinical course of occipital condyle syndrome, including a new case report. Occipital condyle syndrome (OCS) is a rare clinical syndrome, consisting of unilateral occipital headache accompanied by ipsilateral hypoglossal palsy. This headache typically radiates to the temporal region, and is triggered by contralateral head rotation. It is usually associated with skull base metastasis, often unrevealed in basic neuroimaging studies. OCS might be the first manifestation of malignancy, and its unfamiliarity can lead to a delay in the diagnosis. We performed a systematic literature review using PubMed and Embase for OCS, along with a new case report. A total of 35 cases (mean age 59 years, range 25-77), 24 (70%) men, presented typical unilateral headache followed by ipsilateral hypoglossal palsy from 0 to 150 days after headache presentation. In 16 patients (46%), initial neuroimaging studies were normal. OCS was due to skull base metastasis in 32 cases (91%). In 18 patients (51%), OCS was the first symptom of disease. OCS represents a warning sign and requires an exhaustive search for underlying neoplasm. An appropriate clinical evaluation can lead to an earlier diagnosis in patients with consistent headache. © 2016 American Headache Society.

[Cornual ectopic pregnancy. A report of a case and five-year-retrospective review].

PubMed

Ramírez Arreola, Leonardo; Nieto Galicia, Leyza Angélica; Escobar Valencia, Alfredo; Cerón Saldaña, Miguel Angel

2007-04-01

This article presents a clinical report of a cornual ectopic pregnancy as well as a five-year restrospective review of ectopic gestations at Hospital General de Matamoros Dr. Alfredo Pumarejo L, Tamaulipas, Mexico. The list with histopatological reports was checked up from January 2001 to May 2006. There were 66 results, of which only 31 files were complete. The presentation ages in these patients were between 16 and 39 years old, with a media of 25.6 years old and a mode of 21 years. The circumstances why patients attended to the hospital were: transvaginal bleeding and abdominal pain in 14 cases (45.1%), abdominal pain only in 12 cases (38.7%), and transvaginal bleeding only in five cases (16.2%). The clinical presentation was acute in 19 patients (61.3%), and it was insidious in 12 (38.7%). All women presented menstrual delay. Diagnoses were done by clinical findings in 12 women (38.7%), by clinical findings and ultrasonography in 18 (58.1%), and due to clinical findings and culdocentesis in just one patient (3.2%). Ectopic pregnancy was located in different places on each patient, such as: ampula, 24 cases (77.5%); isthmus, four patients (12.8%); fimbria, one case (3.2%); ovary, one woman (3.2%), and cornual in one patient (3.2%). Twenty-seven cases of broken ectopic pregnancies (87%), were found as transoperative findings, and the other four (13%) were not broken ectopic. There were not demises. Cornual ectopic pregnancy represents 1.5% of the ectopic gestations, as it is reported in the literature.

Locating Critical Circular and Unconstrained Failure Surface in Slope Stability Analysis with Tailored Genetic Algorithm

NASA Astrophysics Data System (ADS)

Pasik, Tomasz; van der Meij, Raymond

2017-12-01

This article presents an efficient search method for representative circular and unconstrained slip surfaces with the use of the tailored genetic algorithm. Searches for unconstrained slip planes with rigid equilibrium methods are yet uncommon in engineering practice, and little publications regarding truly free slip planes exist. The proposed method presents an effective procedure being the result of the right combination of initial population type, selection, crossover and mutation method. The procedure needs little computational effort to find the optimum, unconstrained slip plane. The methodology described in this paper is implemented using Mathematica. The implementation, along with further explanations, is fully presented so the results can be reproduced. Sample slope stability calculations are performed for four cases, along with a detailed result interpretation. Two cases are compared with analyses described in earlier publications. The remaining two are practical cases of slope stability analyses of dikes in Netherlands. These four cases show the benefits of analyzing slope stability with a rigid equilibrium method combined with a genetic algorithm. The paper concludes by describing possibilities and limitations of using the genetic algorithm in the context of the slope stability problem.

[A right sided colon volvulus with necrosis in a young patient. A case reported].

PubMed

Márquez-Díaz, Adrián; Ramírez-Ortega, Miguel Angel

2010-01-01

Colon volvulus (CV) is the twisting or rotation of an intestinal segment over the mesenterium, which causes occlusion and vascular compromise. It is a frequent disease in individuals over 65 years-old. We report a young patient with right CV and necrosis. A 17 year-old male with clinical findings of acute abdomen presented in the emergency room. During the surgical procedure, a right sided was found, CV with ileocecal valve and caecum ischemia and right colon necrosis with mesenteric vessels thrombosis. The case presented begun with sudden abdominal pain, with intestinal occlusion data, and widespread peritoneal rebound tenderles which suggested an intestinal occlusion. A simple abdomen Rx showed prominent right side colon distention with air levels in small bowel and a "coffee bean" image, suggestive of CVA hemicolectomy with termino-lateral ileocolic anastomosis was performed. Right-sided CV is considered as congenital in origin. They corresponded to 21% of cases in Mexico, with an average age of presentation at 62 years. The CV represents 10% of the causes of large bowel obstruction in Mexico. This is the first case in young people reported in Mexican literature.

The Role of Music in the Education of Young Male Workers in Nineteenth-Century Greece: The Case of Charity Institutions

ERIC Educational Resources Information Center

Barbaki, Maria

2015-01-01

This paper presents music teaching in nineteenth-century Greece orphanages and schools of destitute children, which were the main schools for vocational training of the working class in that period. Five representative institutions were selected. Music education for young male workers in nineteenth-century Greece was both in accord with and…

Congenital solitary intestinal fibromatosis.

PubMed

Numanoglu, A; Davies, J; Millar, A J W; Rode, H

2002-10-01

Neonatal intestinal obstruction due to a tumour is rare. We report a six-day-old male neonate who presented with abdominal distension and vomiting. Laparotomy revealed colonic obstruction caused by a stenosing fibrotic lesion in the proximal transverse colon. Histopathological examination of the resected specimen confirmed fibromatosis. We believe this represents the third reported case of solitary colonic fibromatosis. The literature on neonatal intestinal fibromatosis is reviewed.

Regional Centre of Expertise (RCE) Graz-Styria: A Process of Mobilization Facing Regional Challenges

ERIC Educational Resources Information Center

Mader, Clemens; Zimmermann, Friedrich M.; Steiner, Gerald; Risopoulos, Filippina

2008-01-01

Purpose: The purpose of this paper is to present how the Regional Centres of Expertise (RCE) Graz-Styria as well as RCEs as instruments can contribute to regional development. The RCE Graz-Styria is representing a case study of Central European RCEs. Design/methodology/approach: The paper describes the development process of RCE Graz-Styria.…

Two-Way Tables: Issues at the Heart of Statistics and Probability for Students and Teachers

ERIC Educational Resources Information Center

Watson, Jane; Callingham, Rosemary

2014-01-01

Some problems exist at the intersection of statistics and probability, creating a dilemma in relation to the best approach to assist student understanding. Such is the case with problems presented in two-way tables representing conditional information. The difficulty can be confounded if the context within which the problem is set is one where…

Multiple Visceral Resections for Synchronous Left and Transverse Colon Adenocarcinoma with Gastrocolic-cutaneous Fistula - Case Report and Literature Review.

PubMed

Bacalbasa, Nicolae; Stoica, Claudia; Balescu, Irina

2017-05-01

Synchronous adenocarcinomas of the colon represent a rare situation, characterized by the presence of at least two colonic malignancies separated by at least 4-cm distance, in the absence of submucosal spread. Gastrocolic-cutaneous fistulas also represent a rare complication associated with the presence of colonic or gastric adenocarcinomas. We present the case of a 61-year-old patient who presented for abdominal pain, vomiting, weight loss and cutaneous exteriorization of purulent liquid. Intraoperatively, a large centro-abdominal tumor with gastroduodenal, pancreatic and colonic invasion was found in association with a synchronous left colonic tumor. The tumors were resected en bloc with distal gastrectomy, cephalic pancreatoduodenectomy, segmental enterectomy, subtotal colectomy and upper abdominal lymph node dissection. The histopathological studies revealed the presence of two synchronous colonic tumors: one located on the transverse colon, with pancreatic, duodeno-jejunal and gastric invasion and gastrocolic-cutaneous fistula, and a second one located on the left colon. Both tumors proved to be moderately differentiated colonic adenocarcinomas. At 1-year follow-up the patient remains free of any recurrent disease. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Performance Assessment Uncertainty Analysis for Japan's HLW Program Feasibility Study (H12)

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

BABA,T.; ISHIGURO,K.; ISHIHARA,Y.

1999-08-30

Most HLW programs in the world recognize that any estimate of long-term radiological performance must be couched in terms of the uncertainties derived from natural variation, changes through time and lack of knowledge about the essential processes. The Japan Nuclear Cycle Development Institute followed a relatively standard procedure to address two major categories of uncertainty. First, a FEatures, Events and Processes (FEPs) listing, screening and grouping activity was pursued in order to define the range of uncertainty in system processes as well as possible variations in engineering design. A reference and many alternative cases representing various groups of FEPs weremore » defined and individual numerical simulations performed for each to quantify the range of conceptual uncertainty. Second, parameter distributions were developed for the reference case to represent the uncertainty in the strength of these processes, the sequencing of activities and geometric variations. Both point estimates using high and low values for individual parameters as well as a probabilistic analysis were performed to estimate parameter uncertainty. A brief description of the conceptual model uncertainty analysis is presented. This paper focuses on presenting the details of the probabilistic parameter uncertainty assessment.« less

Debulking Surgery for Clear Cell Carcinoma of the Ovary - A Case Report and Literature Review.

PubMed

Bacalbasa, Nicolae; Balescu, Irina; Filipescu, Alexandru

2017-10-01

Ovarian clear cell carcinoma represents a distinct histopathological subtype of epithelial ovarian cancer, with poor outcomes, especially in cases diagnosed in advanced stages of disease. However, even in these cases, it seems that the most effective treatment remains debulking surgery to no residual disease. We present the case of a 56-year-old patient diagnosed with a large pelvic mass invading the rectosigmoidal colon, and ileal loop who was successfully submitted to cytoreductive surgery to no residual disease. The histopathological studies demonstrated the presence of a well-differentiated clear cell ovarian carcinoma of the ovary. At 1-year follow-up there is no evidence of residual disease. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Fatal corrosive attack: a study of 13 cases from central Delhi, India.

PubMed

Behera, C; Rani, A; Pradhan, M; Dikshit, P C

2014-06-01

The present study is a retrospective analysis of 13 cases of deaths, which resulted from throwing of corrosives over the body. The cases were autopsied at the Department of Forensic Medicine, Maulana Azad Medical College & Associated Hospitals, Delhi, India, during a period of 13 years from July 1998 to June 2011. The cases represented approximately 0.1% of all autopsy cases during the same period. Data were analyzed with regard to the age, sex, place of occurrence, pattern of injury, survival period, and cause of death. Of these cases, 8 (61.54%) were male, and 5 (38.46%) were female. The most common age group of the victim was 21 to 30 years (46.15%). Six of the victims were attacked on the road side. Face and thorax were involved in all cases (100%). The average total body surface area of burn was 56.69%.The mean survival period was 28.2 days. In 53.85% of cases, the cause of death was septicemia.

Exploring Injury Panorama, Consequences, and Recovery among Bus Crash Survivors: A Mixed-Methods Research Study.

PubMed

Doohan, Isabelle; Björnstig, Ulf; Östlund, Ulrika; Saveman, Britt-Inger

2017-04-01

The aim of this study was to explore physical and mental consequences and injury mechanisms among bus crash survivors to identify aspects that influence recovery. The study participants were the total population of survivors (N=56) from a bus crash in Sweden. The study had a mixed-methods design that provided quantitative and qualitative data on injuries, mental well-being, and experiences. Results from descriptive statistics and qualitative thematic analysis were interpreted and integrated in a mixed-methods analysis. Among the survivors, 11 passengers (20%) sustained moderate to severe injuries, and the remaining 45 (80%) had minor or no physical injuries. Two-thirds of the survivors screened for posttraumatic stress disorder (PTSD) risk were assessed, during the period of one to three months after the bus crash, as not being at-risk, and the remaining one-third were at-risk. The thematic analysis resulted in themes covering the consequences and varying aspects that affected the survivors' recoveries. The integrated findings are in the form of four "core cases" of survivors who represent a combination of characteristics: injury severity, mental well-being, social context, and other aspects hindering and facilitating recovery. Core case Avery represents a survivor who had minor or no injuries and who demonstrated a successful mental recovery. Core case Blair represents a survivor with moderate to severe injuries who experienced a successful mental recovery. Core case Casey represents a survivor who sustained minor injuries or no injuries in the crash but who was at-risk of developing PTSD. Core case Daryl represents a survivor who was at-risk of developing PTSD and who also sustained moderate to severe injuries in the crash. The present study provides a multi-faceted understanding of mass-casualty incident (MCI) survivors (ie, having minor injuries does not always correspond to minimal risk for PTSD and moderate to severe injuries do not always correspond to increased risk for PTSD). Injury mitigation measures (eg, safer roadside material and anti-lacerative windows) would reduce the consequences of bus crashes. A well-educated rescue team and a compassionate and competent social environment will facilitate recovery. Doohan I , Björnstig U , Östlund U , Saveman BI . Exploring injury panorama, consequences, and recovery among bus crash survivors: a mixed-methods research study. Prehosp Disaster Med. 2017;32(2):165-174.

Ethical dilemmas among nurses as they transition to hospital case management: implications for organizational ethics, part I.

PubMed

O'Donnell, Lolita T

2007-01-01

To describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute hospital setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice in case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the organizations that employ them and the healthcare needs of the patients that they advocate for. 3. Aside from the importance of linking patient care outcomes with accountability, nurse case managers may need to advocate for policy change and system reform.

Relating Linear and Volumetric Variables Through Body Scanning to Improve Human Interfaces in Space

NASA Technical Reports Server (NTRS)

Margerum, Sarah E.; Ferrer, Mike A.; Young, Karen S.; Rajulu, Sudhakar

2010-01-01

Designing space suits and vehicles for the diverse human population present unique challenges for the methods of traditional anthropometry. Space suits are bulky and allow the operator to shift position within the suit and inhibit the ability to identify body landmarks. Limited suit sizing options also cause variability in fit and performance between similarly sized individuals. Space vehicles are restrictive in volume in both the fit and the ability to collect data. NASA's Anthropometric and Biomechanics Facility (ABF) has utilized 3D scanning to shift from traditional linear anthropometry to explore and examine volumetric capabilities to provide anthropometric solutions for design. Overall, the key goals are to improve the human-system performance and develop new processes to aid in the design and evaluation of space systems. Four case studies are presented that illustrate the shift from purely linear analyses to an augmented volumetric toolset to predict and analyze the human within the space suit and vehicle. The first case study involves the calculation of maximal head volume to estimate total free volume in the helmet for proper air exchange. Traditional linear measurements resulted in an inaccurate representation of the head shape, yet limited data exists for the determination of a large head volume. Steps were first taken to identify and classify a maximum head volume and the resulting comparisons to the estimate are presented in this paper. This study illustrates the gap between linear components of anthropometry and the need for overall volume metrics in order to provide solutions. A second case study examines the overlay of the space suit scans and components onto scanned individuals to quantify fit and clearance to aid in sizing the suit to the individual. Restrictions in space suit size availability present unique challenges to optimally fit the individual within a limited sizing range while maintaining performance. Quantification of the clearance and fit between similarly sized individuals is critical in providing a greater understanding of the human body's function within the suit. The third case study presented in this paper explores the development of a conformal seat pan using scanning techniques, and details the challenges of volumetric analyses that were overcome in order to develop a universal seat pan that can be utilized across the entire user population. The final case study explores expanding volumetric capabilities through generation of boundary manikins. Boundary manikins are representative individuals from the population of interest that represent the extremes of the population spectrum. The ABF developed a technique to take three-dimensional scans of individuals and manipulate the scans to reflect the boundary manikins' anthropometry. In essence, this process generates a representative three-dimensional scan of an individual from anthropometry, using another individual's scanned image. The results from this process can be used in design process modeling and initial suit sizing work as a three dimensional, realistic example of individuals from the population, maintaining the variability between and correlation to the relevant dimensions of interest.

[Application possibilities and initial experience with digital volume tomography in hand and wrist imaging].

PubMed

Goerke, Sebastian M; Neubauer, J; Zajonc, H; Thiele, J R; Kotter, E; Langer, M; Stark, G B; Lampert, F M

2015-02-01

During the last decade, DVT (digital volume tomography) imaging has become a widely used standard technique in head and neck imaging. Lower radiation exposure compared to conventional computed tomography (MDCT) has been described. Recently, DVT has been developed as an extremity scanner and as such represents a new imaging technique for hand surgery. We here describe the first 24 months experience with this new imaging modality in hand and wrist imaging by presenting representative cases and by describing the technical background. Furthermore, the method's advantages and disadvantages are discussed with reference to the given literature. © Georg Thieme Verlag KG Stuttgart · New York.

Single oral paracoccidioidomycosis mimicking other lesions: report of eight cases.

PubMed

de Oliveira Gondak, Rogério; Mariano, Fernanda Viviane; dos Santos Silva, Alan Roger; Vargas, Pablo Agustin; Lopes, Márcio Ajudarte

2012-01-01

Paracoccidioidomycosis is a fungal infection caused by Paracoccidioides brasiliensis. It is an endemic disease, representing a serious health problem in Latin American countries. This infection primarily affects the lungs and is acquired by inhalation of the fungus. It can spread to other organs and tissues, mainly the oral cavity affecting more adult men from 30 to 50 years of age. On clinical presentation, several signs associated with impaired general and nutritional conditions can be noted. Oral manifestation is more common in the soft palate, gingiva, lower lip, buccal mucosa, and tongue. The classical clinical presentation is a superficial ulcer with granular appearance and hemorrhagic points. Usually, the oral lesion is extensive and generalized. Although uncommon, when the oral manifestation is single, others lesions, particularly squamous cell carcinoma, must be included in the differential diagnosis. In this article, the authors discuss the unusual presentation of eight cases of single oral paracoccidioidomycosis and its diagnostic importance.

Eosinophilic Pleural Effusion: A Rare Manifestation of Hypereosinophilic Syndrome

PubMed Central

Okafor, Ndubuisi C.; Oso, Ayodeji A.; Oranu, Amanke C.; Wolff, Steven M.; Murray, John J.

2009-01-01

Several causes of eosinophilic pleural effusions have been described with malignancy being the commonest cause. Hypereosinophilic syndrome (HES) is a rare disease and very few cases have been reported of HES presenting as eosinophilic pleural effusion (EPE). We report a case of a 26-year-old male who presented with shortness of breath. He had bilateral pleural effusions, generalized lymphadenopathy, splenomegaly, and leukocytosis with marked peripheral blood eosinophilia. The pleural fluid was exudative, with 25%–30% eosinophilis, and absence of neoplastic cells. Hypereosinophilic syndrome was diagnosed after other causes of eosinophilia were excluded. He continued to be dyspneic with persistent accumulation of eosinophilic pleural fluid, even after his peripheral eosinophil count had normalized in response to treatment. This patient represents a very unusual presentation of HES with dyspnea and pleural effusions and demonstrates that treatment based on response of peripheral eosinophil counts, as is currently recommended, may not always be clinically adequate. PMID:20111739

Eosinophilic pleural effusion: a rare manifestation of hypereosinophilic syndrome.

PubMed

Okafor, Ndubuisi C; Oso, Ayodeji A; Oranu, Amanke C; Wolff, Steven M; Murray, John J

2009-01-01

Several causes of eosinophilic pleural effusions have been described with malignancy being the commonest cause. Hypereosinophilic syndrome (HES) is a rare disease and very few cases have been reported of HES presenting as eosinophilic pleural effusion (EPE). We report a case of a 26-year-old male who presented with shortness of breath. He had bilateral pleural effusions, generalized lymphadenopathy, splenomegaly, and leukocytosis with marked peripheral blood eosinophilia. The pleural fluid was exudative, with 25%-30% eosinophilis, and absence of neoplastic cells. Hypereosinophilic syndrome was diagnosed after other causes of eosinophilia were excluded. He continued to be dyspneic with persistent accumulation of eosinophilic pleural fluid, even after his peripheral eosinophil count had normalized in response to treatment. This patient represents a very unusual presentation of HES with dyspnea and pleural effusions and demonstrates that treatment based on response of peripheral eosinophil counts, as is currently recommended, may not always be clinically adequate.

An Adult Case of Bartter Syndrome Type III Presenting with Proteinuria

PubMed Central

Cha, Eun Jung; Hwang, Won Min; Yun, Sung-Ro; Park, Moon Hyang

2016-01-01

Bartter syndrome (BS) I–IV is a rare autosomal recessive disorder affecting salt reabsorption in the thick ascending limb of the loop of Henle. This report highlights clinicopathological findings and genetic studies of classic BS in a 22-year-old female patient who presented with persistent mild proteinuria for 2 years. A renal biopsy demonstrated a mild to moderate increase in the mesangial cells and matrix of most glomeruli, along with marked juxtaglomerular cell hyperplasia. These findings suggested BS associated with mild IgA nephropathy. Focal tubular atrophy, interstitial fibrosis, and lymphocytic infiltration were also observed. A genetic study of the patient and her parents revealed a mutation of the CLCNKB genes. The patient was diagnosed with BS, type III. This case represents an atypical presentation of classic BS in an adult patient. Pathologic findings of renal biopsy combined with genetic analysis and clinicolaboratory findings are important in making an accurate diagnosis. PMID:26755355

An Adult Case of Bartter Syndrome Type III Presenting with Proteinuria.

PubMed

Cha, Eun Jung; Hwang, Won Min; Yun, Sung-Ro; Park, Moon Hyang

2016-03-01

Bartter syndrome (BS) I-IV is a rare autosomal recessive disorder affecting salt reabsorption in the thick ascending limb of the loop of Henle. This report highlights clinicopathological findings and genetic studies of classic BS in a 22-year-old female patient who presented with persistent mild proteinuria for 2 years. A renal biopsy demonstrated a mild to moderate increase in the mesangial cells and matrix of most glomeruli, along with marked juxtaglomerular cell hyperplasia. These findings suggested BS associated with mild IgA nephropathy. Focal tubular atrophy, interstitial fibrosis, and lymphocytic infiltration were also observed. A genetic study of the patient and her parents revealed a mutation of the CLCNKB genes. The patient was diagnosed with BS, type III. This case represents an atypical presentation of classic BS in an adult patient. Pathologic findings of renal biopsy combined with genetic analysis and clinicolaboratory findings are important in making an accurate diagnosis.

MEGASTAR: The meaning of growth. An assessment of systems, technologies, and requirements. [methodology for display and analysis of energy production and consumption

NASA Technical Reports Server (NTRS)

1974-01-01

A methodology for the display and analysis of postulated energy futures for the United States is presented. A systems approach methodology including the methodology of technology assessment is used to examine three energy scenarios--the Westinghouse Nuclear Electric Economy, the Ford Technical Fix Base Case and a MEGASTAR generated Alternate to the Ford Technical Fix Base Case. The three scenarios represent different paths of energy consumption from the present to the year 2000. Associated with these paths are various mixes of fuels, conversion, distribution, conservation and end-use technologies. MEGASTAR presents the estimated times and unit requirements to supply the fuels, conversion and distribution systems for the postulated end uses for the three scenarios and then estimates the aggregate manpower, materials, and capital requirements needed to develop the energy system described by the particular scenario.

Ecstasy-Associated Pneumomediastinum

PubMed Central

Marasco, Silvana F; Lim, H Kiat

2007-01-01

INTRODUCTION Ecstasy, also known as MDMA (3,4, methylenedioxymethamphetamine), is a popular illicit party drug amongst young adults. The drug induces a state of euphoria secondary to its stimulant activity in the central nervous system. PATIENTS AND METHODS A database review at two major inner city hospitals was undertaken to identify patients presenting with pneumomediastinum and their charts reviewed. A Medline review of all reported cases of pneumomediastinum associated with ecstasy abuse was undertaken. RESULTS A total of 56 patients presenting with pneumomediastinum were identified over a 5-year period. Review of the charts revealed a history of ecstasy use in the hours prior to presentation in six of these patients, representing the largest series reported to date. CONCLUSIONS Review of previously reported cases reveals the likely mechanism is due to Valsalva manoeuvre during periods of extreme physical exertion, and not a direct pharmacological effect of the drug. PMID:17535617

A Novel Electrocardiographic Sign of an ST-Segment Elevation Myocardial Infarction-Equivalent: De Winter Syndrome.

PubMed

Goktas, Mustafa Ugur; Sogut, Ozgur; Yigit, Mehmet; Kaplan, Onur

2017-08-01

Patients with de Winter syndrome, also termed anterior ST-segment elevation myocardial infarction (STEMI)-equivalent, represent 2% of all patients with acute anterior myocardial infarctions admitted to emergency departments (EDs). STEMI-equivalents do not present with classical electrocardiogram (ECG) changes but exhibit a critical stenosis of the left anterior descending (LAD) coronary artery. This is under-recognized by clinicians and is therefore associated with high morbidity and mortality. Here, we report a rare case of a novel, typical, STEMI-equivalent ECG pattern without obvious ST-segment elevation in a 34-year-old female who presented to our ED with substantial chest pain and a large, acute, transmural anterior myocardial infarction caused by acute occlusion of the LAD coronary artery. However, she presented as a non-STEMI case. A definite diagnosis of de Winter syndrome was made on the basis of clinical and ECG findings.

Inguinal and anorectal Lymphogranuloma Venereum: a case series from a sexually transmitted disease center in Rome, Italy.

PubMed

Latini, Alessandra; Zaccarelli, Mauro; Paglia, Maria Grazia; Donà, Maria Gabriella; Giglio, Amalia; Moretto, Domenico; Vulcano, Antonella; Giuliani, Massimo; Colafigli, Manuela; Ambrifi, Marina; Pimpinelli, Fulvia; Cristaudo, Antonio

2017-06-02

Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by L1, L2, L3 serovars of C. trachomatis (CT). Since 2003, LGV cases have been increasing in Europe. Aim of this report is to describe the LGV cases diagnosed in the largest STI center in Rome, Italy, from 2000 to 2016. This report shows that two clinically and epidemiologically different series of cases exist, and that, at present, the ano-rectal LGV represents the clinical variant occurring more frequently among men having sex with men (MSM), particularly those HIV-infected. Ten cases of LGV were observed. Three were diagnosed in 2009 in HIV-negative heterosexuals patients that presented the classical genito-ulcerative form with lymphadenopathy. Seven cases were observed in 2015-2016 in HIV-infected MSM, that presented the rectal variant and L2b serovar infection; 4 of these had been misclassified as a chronic bowel disease. Chlamydia infection was confirmed by CT-specific PCR (ompA gene nested PCR), followed by sequence analysis to identify the serovar. All the patients were treated with doxycycline for 3 weeks, obtaining a complete response with healing of both clinical symptoms and dermatological lesions. Our findings suggest that, in case of persistent rectal symptoms in HIV-infected MSM, LGV should be taken into account and investigated through molecular analyses, in order to achieve a correct diagnosis and management of the patients.

The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC) case register: development and descriptive data.

PubMed

Stewart, Robert; Soremekun, Mishael; Perera, Gayan; Broadbent, Matthew; Callard, Felicity; Denis, Mike; Hotopf, Matthew; Thornicroft, Graham; Lovestone, Simon

2009-08-12

Case registers have been used extensively in mental health research. Recent developments in electronic medical records, and in computer software to search and analyse these in anonymised format, have the potential to revolutionise this research tool. We describe the development of the South London and Maudsley NHS Foundation Trust (SLAM) Biomedical Research Centre (BRC) Case Register Interactive Search tool (CRIS) which allows research-accessible datasets to be derived from SLAM, the largest provider of secondary mental healthcare in Europe. All clinical data, including free text, are available for analysis in the form of anonymised datasets. Development involved both the building of the system and setting in place the necessary security (with both functional and procedural elements). Descriptive data are presented for the Register database as of October 2008. The database at that point included 122,440 cases, 35,396 of whom were receiving active case management under the Care Programme Approach. In terms of gender and ethnicity, the database was reasonably representative of the source population. The most common assigned primary diagnoses were within the ICD mood disorders (n = 12,756) category followed by schizophrenia and related disorders (8158), substance misuse (7749), neuroses (7105) and organic disorders (6414). The SLAM BRC Case Register represents a 'new generation' of this research design, built on a long-running system of fully electronic clinical records and allowing in-depth secondary analysis of both numerical, string and free text data, whilst preserving anonymity through technical and procedural safeguards.

Management of Liver Trauma in Minia University Hospital, Egypt.

PubMed

Saleh, Abdel Fattah; Al Sageer, Emad; Elheny, Amr

2016-12-01

The aim of this study is to present the outcome of operative and non-operative management of patients with liver injury treated in a single institution depending on imaging. This study was conducted at the Causality Unit of Minia University Hospital, and included 60 patients with hepatic trauma from March 2012 to January 2013. In our study, males represent 80 % while females represent 20 % of the traumatized patients. The peak age for trauma found was 11-30 years. Blunt trauma is the most common cause of liver injury as it was the cause in 48 patients (80 %). Firearm injuries are the most common cause of penetrating trauma (60 %) followed by stab injuries (40 %). More than one half of our patients (34 out of 60) were treated with non-operative management (NOM) with a high success rate. The operative procedures done were suture hepatorrhaphy (20 cases), non-anatomical resection in one case, anatomical resection in one case, and damage control therapy using pads in two cases. In another two cases, nothing was done as subcapsular hematoma had resolved. Minia University Hospital is a big tertiary Hospital in Egypt at which blunt liver trauma is more common than penetrating liver trauma. Surgery is no longer the only option available. It has been reserved for extensive lesions with condition of hemodynamic instability or for the treatment of the complications. NOM is an effective treatment modality in most cases.

First-choice therapy for dogs presenting with diarrhoea in clinical practice.

PubMed

German, A J; Halladay, L J; Noble, P-J M

2010-11-20

Computerised referral histories were reviewed for dogs admitted to the University of Liverpool Small Animal Teaching Hospital between January 2000 and December 2008 with diarrhoea among the clinical signs. A total of 371 cases presenting to the referring veterinary surgeon were included in the study, and information was compiled regarding signalment, clinical signs and treatment given at the initial consultation. Various breeds, ages and sexes were represented. Antibacterials were used in 263 (71 per cent) cases, steroids in 71 (19 per cent) cases and miscellaneous antidiarrhoeal products (including probiotics, prebiotics, adsorbents and antimotility drugs) in 98 (26 per cent) cases. Other drugs used included antiemetics (48 of 371 [13 per cent] cases), gastric protectants (37 of 371 [10 per cent] cases) and sulfasalazine (26 of 371 [7 per cent] cases). Antibacterial administration was positively associated with hyperthermia (odds ratio [OR]=2.97, P=0.012) and anorexia (OR=2.17, P=0.0075), but negatively associated with both weight loss (OR=0.55, P=0.036) and tenesmus (OR=0.43, P=0.035). In contrast, use of antidiarrhoeal products was positively associated with the presence of faecal mucus (OR=1.77, P=0.043), and negatively associated with vomiting (OR=0.57, P=0.025) and weight loss (OR=0.52, P=0.033).

Aggregation and charging of sulfate and amidine latex particles in the presence of oxyanions.

PubMed

Sugimoto, Takuya; Cao, Tianchi; Szilagyi, Istvan; Borkovec, Michal; Trefalt, Gregor

2018-08-15

Electrophoretic mobility and time resolved light scattering are used to measure the effect on charging and aggregation of amidine and sulfate latex particles of different oxyanions namely, phosphate, arsenate, sulfate, and selenate. In the case of negatively charged sulfate latex particles oxyanions represent the coions, while they represent counterions in the case of the positively charged amidine latex. Repulsive interaction between the sulfate latex surface and the coions results in weak ion specific effects on the charging and aggregation. On the other hand the interaction of oxyanions with the amidine latex surface is highly specific. The monovalent dihydrogen phosphate ion strongly adsorbs to the positively charged surface and reverses the charge of the particle. This charge reversal leads also to the restabilization of the amidine latex suspension at the intermediate phosphate concentrations. In the case of dihydrogen arsenate the adsorption to amidine latex surface is weaker and no charge reversal and restabilization occurs. Similar differences are seen between the sulfate and selenate analogues, where selenate adsorbs more strongly to the surface as compared to the sulfate ion and invokes charge reversal. The present results indicate that ion specificity is much more pronounced in the case of counterions. Copyright © 2018 Elsevier Inc. All rights reserved.

Neuropsychologist Experts and Civil Capacity Evaluations: Representative Cases.

PubMed

Kaufmann, Paul M

2016-09-01

Clinical neuropsychologists accept more forensic referrals now and spend more time in forensic consulting than ever before. Recent surveys show weekly hours devoted to forensic consulting increased 97% in the past decade. During the same time period, the number of board certified neuropsychologists more than doubled. Under recently published Specialty Guidelines for Forensic Psychology, clinical neuropsychologists practice forensic psychology when applying scientific, technical, or specialized knowledge of neuropsychology to the law to assist in addressing legal, contractual, or administrative matters. Among those increasingly varied forensic referrals, clinical neuropsychologists are conducting more civil competency and capacity evaluations. Representative cases from three jurisdictions demonstrate how neuropsychologists provide expertize in matters involving testamentary capacity, contractual capacity, business judgments, and job capacity. Case presentations illustrate some of the strengths and weaknesses of neuropsychological evaluation of civil capacities. The article concludes with a "battle of experts" case involving five neuropsychologists with opposing opinions recently heard in a Federal Appellate court. Implications for neuropschology training and forensic competencies are considered. In offering quality services to the legal profession, neuropsychologists support the truth-seeking function of the judiciary, promote justice, protect the profession, and serve public policy. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

"Hair in the Bladder": An Unusual Finding.

PubMed

Cindolo, Luca; Bada, Maida; Bellocci, Roberto; De Francesco, Piergustavo; Castellan, Pietro; Berardinelli, Francesco; Neri, Fabio; Schips, Luigi

2017-01-01

Trichobezoar is a rare condition whereby a hairball is found in the human stomach or gastrointestinal tract, most frequently in young women, mainly in association with a psychiatric disorder. Trichobezoar cases have also been reported in the bladder and represent a rare complication of foreign bodies, called "hair nidus or hair ball," in patients with chronic catheter. Approximately 10% to 15% of patients on long-term urethral catheter or clean intermittent self-catheterization develop urinary tract stones. In a small minority of cases, bladder stones can develop around a foreign body that was introduced into the bladder. In the literature, there are few cases of foreign bladder bodies that formed stones over a hair nidus. Recognizing this condition can optimize the patient's quality of life. Herein, we present a case of a 71-year-old Caucasian male with a long-term catheter in hypocontractile urinary bladder secondary to injury of pelvic plexus after rectal surgery. He had a bladder stone caused by hair encrusted together. Hair is introduced into the bladder either by adherence to the catheter directly or by overlying the urethral meatus and being pushed internally. Regular hygiene and shaving of pubic area represent effective preventive measures to reduce this kind of complications in patients with chronic indwelling catheter or under a self-catheterization regimen.

Brown-McLean Syndrome in a Pediatric Patient

PubMed Central

Tourkmani, Abdo Karim; Martinez, Jaime D.; Berrones, David; Juárez-Domínguez, Brenda Y.; Beltrán, Francisco; Galor, Anat

2015-01-01

The purpose of this manuscript is to report the case of a 12-year-old patient who presented for routine ophthalmic examination after congenital cataract surgery performed at 2 months of age. The patient was diagnosed with bilateral Brown-McLean syndrome by slit lamp examination. No treatment was required because the patient was asymptomatic and had a clear central cornea. This is the first described case of Brown-McLean syndrome in a pediatric patient, representing the importance of clinical examination in the pediatric age group after cataract surgery because of the risk for patients of developing peripheral edema. PMID:26034485

Skull Base and Cervical Spine Involvement in Jansen Syndrome: Case Report.

PubMed

Khan, Rabia; Oakes, Peter; Fisahn, Christian; Burgess, Brittni; Kirkpatrick, Kristina M; Oskouian, Rod J; Tubbs, R Shane; Blount, Jeffrey P

2017-01-01

Metaphyseal chondrodysplasia, Jansen type (JMD), is a rare form of endochondral ossification resulting in short limbs and dwarfism. A child presented with JMD and was found to have involvement of the cervical spine. Conservative treatment was given to the patient who at the long-term follow-up continues to have no neurological findings or cervical spine instability. To our knowledge, this case represents the first report of involvement of the superior cervical spine in a patient with JMD. Clinicians should be aware of this potential albeit rare finding. © 2017 S. Karger AG, Basel.

Brown-McLean Syndrome in a Pediatric Patient.

PubMed

Tourkmani, Abdo Karim; Martinez, Jaime D; Berrones, David; Juárez-Domínguez, Brenda Y; Beltrán, Francisco; Galor, Anat

2015-01-01

The purpose of this manuscript is to report the case of a 12-year-old patient who presented for routine ophthalmic examination after congenital cataract surgery performed at 2 months of age. The patient was diagnosed with bilateral Brown-McLean syndrome by slit lamp examination. No treatment was required because the patient was asymptomatic and had a clear central cornea. This is the first described case of Brown-McLean syndrome in a pediatric patient, representing the importance of clinical examination in the pediatric age group after cataract surgery because of the risk for patients of developing peripheral edema.

Pleomorphic liposarcoma of the breast mimicking breast abscess in a 19-year-old postpartum female: a case report and review of the literature.

PubMed

Nandipati, Kalyana C; Nerkar, Hrishikesh; Satterfield, James; Velagapudi, Manasa; Ruder, Usha; Sung, Kae-Jae

2010-01-01

Sarcomas of the breast constitutes <1% of primary malignant breast tumors. Liposarcoma of the breast represents 3-24% of the primary breast sarcomas. Liposarcoma can arise from pre-existing benign lesions like fibroadenoma or from lipoid tissue in the breast. There are only few cases of liposarcoma of the breast in young females reported in the literature. Liposarcoma of the breast typically involves women with age after 50 years. In this article, we present a young woman with liposarcoma of the breast. © 2010 Wiley Periodicals, Inc.

Wind to Hydrogen in California: Case Study

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

Antonia, O.; Saur, G.

2012-08-01

This analysis presents a case study in California for a large scale, standalone wind electrolysis site. This is a techno-economic analysis of the 40,000 kg/day renewable production of hydrogen and subsequent delivery by truck to a fueling station in the Los Angeles area. This quantity of hydrogen represents about 1% vehicle market penetration for a city such as Los Angeles (assuming 0.62 kg/day/vehicle and 0.69 vehicles/person) [8]. A wind site near the Mojave Desert was selected for proximity to the LA area where hydrogen refueling stations are already built.

Li-Fraumeni syndrome presenting as mucosal melanoma: Case report and treatment considerations.

PubMed

Klein, Jonah D; Kupferman, Michael E

2017-02-01

Li-Fraumeni syndrome (LFS) is a familial cancer predisposition associated with a germline mutation in TP53. Patients with LFS are at risk of developing malignancies and require comprehensive screening. We describe an index case of LFS presenting with mucosal melanoma. A 21-year-old woman presented with a left maxillary mucosal lesion and a left neck mass. Biopsies revealed metastatic mucosal melanoma, which is a pathology previously unreported in LFS families. Genetic testing revealed LFS, with a germline TP53 mutation, and pedigree analysis identified 9 first-degree and second-degree relatives with hematologic malignancies. The patient underwent a maxillectomy and left neck dissection, followed by adjuvant radiotherapy. At 30-month follow-up, there was no evidence of local, regional, or distant failure, nor did she develop a second primary tumor. This represents the first reported case of LFS associated with mucosal melanoma. Treatment considerations, specifically the risks of adjuvant therapy in LFS, are discussed. © 2016 Wiley Periodicals, Inc. Head Neck 39: E20-E22, 2017. © 2016 Wiley Periodicals, Inc.

Retrospective study of congenital heart defects in 151 dogs.

PubMed

Tidholm, A

1997-03-01

The case records of 151 dogs diagnosed with congenital heart disease were reviewed retrospectively. The most common defect was aortic stenosis, accounting for 35 per cent of all cases, followed by pulmonic stenosis (20 per cent), ventricular septal defect (12 per cent), patent ductus arteriosus (11 per cent), mitral valve dysplasia (8 per cent), tricuspid valve dysplasia (7 per cent), endocardial fibroelastosis (1.9 per cent) and tetralogy of Fallot (0.6 per cent). Fifty-one breeds were represented, with golden retrievers, German shepherd dogs and boxers predominating. No overall sex predilection was obvious. Seventy-five per cent of the dogs were asymptomatic at presentation. The defects most often associated with presenting symptoms, such as dyspnoea, syncope, ascites, failure to grow and depression, were mitral valve dysplasia, atrial septal defect, tricuspid valve dysplasia and endocardial fibroelastosis. The latter presented with the most severe signs of heart failure. In some cases of aortic stenosis and pulmonic stenosis, where the defect could not be accurately visualised with two-dimensional echocardiography, Doppler echocardiographic examination was needed for definitive diagnosis.

Case Presentations Demonstrating Periodontal Treatment Variation: PEARL Network.

PubMed

Curro, Frederick A; Grill, Ashley C; Matthews, Abigail G; Martin, John; Kalenderian, Elisabeth; Craig, Ronald G; Naftolin, Frederick; Thompson, Van P

2015-06-01

Variation in periodontal terminology can affect the diagnosis and treatment plan as assessed by practicing general dentists in the Practitioners Engaged in Applied Research and Learning (PEARL) Network. General dentists participating in the PEARL Network are highly screened, credentialed, and qualified and may not be representative of the general population of dentists. Ten randomized case presentations ranging from periodontal health to gingivitis, to mild, moderate, and severe periodontitis were randomly presented to respondents. Descriptive comparisons were made between these diagnosis groups in terms of the treatment recommendations following diagnosis. PEARL practitioners assessing periodontal clinical scenarios were found to either over- or under-diagnose the case presentations, which affected treatment planning, while the remaining responses concurred with respect to the diagnosis. The predominant diagnosis was compared with that assigned by two practicing periodontists. There was variation in treatment based on the diagnosis for gingivitis and the lesser forms of periodontitis. Data suggests that a lack of clarity of periodontal terminology affects both diagnosis and treatment planning, and terminology may be improved by having diagnosis codes, which could be used to assess treatment outcomes. This article provides data to support best practice for the use of diagnosis coding and integration of dentistry with medicine using ICD-10 terminology.

Pyogenic granuloma associated with periodontal abscess and bone loss - A rare case report

PubMed Central

Panseriya, Bhrugesh J.; Hungund, Shital

2011-01-01

A diverse group of the pathologic process can produce the enlargement of soft tissues in the oral cavity and often present a diagnostic challenge. This soft tissue enlargement may represent a variation of the normal anatomic structure, inflammatory reaction, cyst, neoplasm, and developmental anomalies. A group of reactive hyperplasias, which develop in response to chronic recurring tissue injury that stimulates an excessive tissue repair response. The pyogenic granuloma (PG) is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration, and foreign materials or hormonal (pregnancy tumor) and rarely associated with bone loss. This paper presents a rare case of PG associated with periodontal abscess and bone loss in a 30-year-old male. PMID:22090773

Pyogenic granuloma associated with periodontal abscess and bone loss - A rare case report.

PubMed

Panseriya, Bhrugesh J; Hungund, Shital

2011-07-01

A diverse group of the pathologic process can produce the enlargement of soft tissues in the oral cavity and often present a diagnostic challenge. This soft tissue enlargement may represent a variation of the normal anatomic structure, inflammatory reaction, cyst, neoplasm, and developmental anomalies. A group of reactive hyperplasias, which develop in response to chronic recurring tissue injury that stimulates an excessive tissue repair response. The pyogenic granuloma (PG) is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration, and foreign materials or hormonal (pregnancy tumor) and rarely associated with bone loss. This paper presents a rare case of PG associated with periodontal abscess and bone loss in a 30-year-old male.

Community assessment in a vertically integrated health care system.

PubMed Central

Plescia, M; Koontz, S; Laurent, S

2001-01-01

OBJECTIVES: In this report, the authors present a representative case of the implementation of community assessment and the subsequent application of findings by a large, vertically integrated health care system. METHODS: Geographic information systems technology was used to access and analyze secondary data for a geographically defined community. Primary data included a community survey and asset maps. RESULTS: In this case presentation, information has been collected on demographics, prevalent health problems, access to health care, citizens' perceptions, and community assets. The assessment has been used to plan services for a new health center and to engage community members in health promotion interventions. CONCLUSIONS: Geographically focused assessments help target specific community needs and promote community participation. This project provides a practical application for integrating aspects of medicine and public health. PMID:11344895

Results and current status of the NPARC alliance validation effort

NASA Technical Reports Server (NTRS)

Towne, Charles E.; Jones, Ralph R.

1996-01-01

The NPARC Alliance is a partnership between the NASA Lewis Research Center (LeRC) and the USAF Arnold Engineering Development Center (AEDC) dedicated to the establishment of a national CFD capability, centered on the NPARC Navier-Stokes computer program. The three main tasks of the Alliance are user support, code development, and validation. The present paper is a status report on the validation effort. It describes the validation approach being taken by the Alliance. Representative results are presented for laminar and turbulent flat plate boundary layers, a supersonic axisymmetric jet, and a glancing shock/turbulent boundary layer interaction. Cases scheduled to be run in the future are also listed. The archive of validation cases is described, including information on how to access it via the Internet.

Reconstruction of the gastric passage by a side-to-side gastrogastrostomy after failed vertical-banded gastroplasty: a case report

PubMed Central

Soll, Christopher; Müller, Markus K; Wildi, Stefan; Clavien, Pierre-Alain; Weber, Markus

2008-01-01

Introduction Vertical-banded gastroplasty, a technique that is commonly performed in the treatment of morbid obesity, represents a nonadjustable restrictive procedure which reduces the volume of the upper stomach by a vertical stapler line. In addition, a textile or silicone band restricts food passage through the stomach. Case presentation A 71-year-old woman presented with a severe gastric stenosis 11 years after vertical gastroplasty. We describe a side-to-side gastrogastrostomy as a safe surgical procedure to restore the physiological gastric passage after failed vertical-banded gastroplasty. Conclusion Occasionally, restrictive procedures for morbid obesity cannot be converted into an alternative bariatric procedure to maintain weight control. This report demonstrates that a side-to-side gastrogastrostomy is a feasible and safe procedure. PMID:18513454

Reactivation West Nile virus infection-related chorioretinitis.

PubMed

Beardsley, Robert; McCannel, Colin

2012-01-01

West Nile Virus is a relatively uncommon infection that can involve retinal and choroidal inflammation leading to photopsias, photophobia, and orbital pain. The diagnosis is made by clinical history, serology, and characteristic funduscopic exam and fluorescein angiography findings. Treatment involves primarily supportive care as there are no known effective anti-viral agents. Visual recovery is usually full. Here we present a case of West Nile Virus Infection Related chorioretinitis that demonstrated active linear chorioretinal lesions approximately one year after the initial infection was diagnosed and treated. The patient noted new onset blurry vision and floaters for two weeks prior to presentation. Antibody titers to West Nile Virus increased from baseline levels indicating active infection. This represents the first case of reactivation West Nile Virus Infection Related chorioretinitis that has been documented.

Corrosion-Fatigue Crack Growth in Plates: A Model Based on the Paris Law

PubMed Central

Toribio, Jesús; Matos, Juan-Carlos; González, Beatriz

2017-01-01

In this paper, a Paris law-based model is presented whereby crack propagation occurs under cyclic loading in air (fatigue) and in an aggressive environment (corrosion-fatigue) for the case of corner cracks (with a wide range of aspect ratios in the matter of the initial cracks) in finite-thickness plates of 316L austenitic stainless steel subjected to tension, bending, or combined (tension + bending) loading. Results show that the cracks tend during their growth towards a preferential propagation path, exhibiting aspect ratios slightly lower than unity only for the case of very shallow cracks, and diminishing as the crack grows (increasing the relative crack depth)—more intensely in the case of bending than in the case of tension (the mixed loading tension/bending representing an intermediate case). In addition, the crack aspect ratios during fatigue propagation evolution are lower in fatigue (in air) than in corrosion-fatigue (in aggressive environment). PMID:28772798

Changing Policy Framing as a Deliberate Strategy for Public Health Advocacy: A Qualitative Policy Case Study of Minimum Unit Pricing of Alcohol

PubMed Central

Katikireddi, Srinivasa Vittal; Bond, Lyndal; Hilton, Shona

2014-01-01

Context Scotland is the first country in the world to pass legislation introducing a minimum unit price (MUP) for alcohol in an attempt to reduce consumption and associated harms by increasing the price of the cheapest alcohol. We investigated the competing ways in which policy stakeholders presented the debate. We then established whether a change in framing helped explain the policy's emergence. Methods We conducted a detailed policy case study through analysis of evidence submitted to the Scottish parliament, and in-depth, one-to-one interviews (n = 36) with politicians, civil servants, advocates, researchers, and industry representatives. Findings Public- and voluntary-sector stakeholders tended to support MUP, while industry representatives were more divided. Two markedly different ways of presenting alcohol as a policy problem were evident. Critics of MUP (all of whom were related to industry) emphasized social disorder issues, particularly among young people, and hence argued for targeted approaches. In contrast, advocates for MUP (with the exception of those in industry) focused on alcohol as a health issue arising from overconsumption at a population level, thus suggesting that population-based interventions were necessary. Industry stakeholders favoring MUP adopted a hybrid framing, maintaining several aspects of the critical framing. Our interview data showed that public health advocates worked hard to redefine the policy issue by deliberately presenting a consistent alternative framing. Conclusions Framing alcohol policy as a broad, multisectoral, public health issue that requires a whole-population approach has been crucial to enabling policymakers to seriously consider MUP, and public health advocates intentionally presented alcohol policy in this way. This reframing helped prioritize public health considerations in the policy debate and represents a deliberate strategy for consideration by those advocating for policy change around the world and in other public health areas. PMID:24890247

Changing policy framing as a deliberate strategy for public health advocacy: a qualitative policy case study of minimum unit pricing of alcohol.

PubMed

Katikireddi, Srinivasa Vittal; Bond, Lyndal; Hilton, Shona

2014-06-01

Scotland is the first country in the world to pass legislation introducing a minimum unit price (MUP) for alcohol in an attempt to reduce consumption and associated harms by increasing the price of the cheapest alcohol. We investigated the competing ways in which policy stakeholders presented the debate. We then established whether a change in framing helped explain the policy's emergence. We conducted a detailed policy case study through analysis of evidence submitted to the Scottish parliament, and in-depth, one-to-one interviews (n = 36) with politicians, civil servants, advocates, researchers, and industry representatives. Public- and voluntary-sector stakeholders tended to support MUP, while industry representatives were more divided. Two markedly different ways of presenting alcohol as a policy problem were evident. Critics of MUP (all of whom were related to industry) emphasized social disorder issues, particularly among young people, and hence argued for targeted approaches. In contrast, advocates for MUP (with the exception of those in industry) focused on alcohol as a health issue arising from overconsumption at a population level, thus suggesting that population-based interventions were necessary. Industry stakeholders favoring MUP adopted a hybrid framing, maintaining several aspects of the critical framing. Our interview data showed that public health advocates worked hard to redefine the policy issue by deliberately presenting a consistent alternative framing. Framing alcohol policy as a broad, multisectoral, public health issue that requires a whole-population approach has been crucial to enabling policymakers to seriously consider MUP, and public health advocates intentionally presented alcohol policy in this way. This reframing helped prioritize public health considerations in the policy debate and represents a deliberate strategy for consideration by those advocating for policy change around the world and in other public health areas. © 2014 Milbank Memorial Fund.

Signal Analysis of Automotive Engine Spark Ignition System using Case-Based Reasoning (CBR) and Case-based Maintenance (CBM)

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

Huang, H.; Vong, C. M.; Wong, P. K.

2010-05-21

With the development of modern technology, modern vehicles adopt electronic control system for injection and ignition. In traditional way, whenever there is any malfunctioning in an automotive engine, an automotive mechanic usually performs a diagnosis in the ignition system of the engine to check any exceptional symptoms. In this paper, we present a case-based reasoning (CBR) approach to help solve human diagnosis problem. Nevertheless, one drawback of CBR system is that the case library will be expanded gradually after repeatedly running the system, which may cause inaccuracy and longer time for the CBR retrieval. To tackle this problem, case-based maintenancemore » (CBM) framework is employed so that the case library of the CBR system will be compressed by clustering to produce a set of representative cases. As a result, the performance (in retrieval accuracy and time) of the whole CBR system can be improved.« less

Seeking a balance between the statistical and scientific elements in psychometrics.

PubMed

Wilson, Mark

2013-04-01

In this paper, I will review some aspects of psychometric projects that I have been involved in, emphasizing the nature of the work of the psychometricians involved, especially the balance between the statistical and scientific elements of that work. The intent is to seek to understand where psychometrics, as a discipline, has been and where it might be headed, in part at least, by considering one particular journey (my own). In contemplating this, I also look to psychometrics journals to see how psychometricians represent themselves to themselves, and in a complementary way, look to substantive journals to see how psychometrics is represented there (or perhaps, not represented, as the case may be). I present a series of questions in order to consider the issue of what are the appropriate foci of the psychometric discipline. As an example, I present one recent project at the end, where the roles of the psychometricians and the substantive researchers have had to become intertwined in order to make satisfactory progress. In the conclusion I discuss the consequences of such a view for the future of psychometrics.

treeman: an R package for efficient and intuitive manipulation of phylogenetic trees.

PubMed

Bennett, Dominic J; Sutton, Mark D; Turvey, Samuel T

2017-01-07

Phylogenetic trees are hierarchical structures used for representing the inter-relationships between biological entities. They are the most common tool for representing evolution and are essential to a range of fields across the life sciences. The manipulation of phylogenetic trees-in terms of adding or removing tips-is often performed by researchers not just for reasons of management but also for performing simulations in order to understand the processes of evolution. Despite this, the most common programming language among biologists, R, has few class structures well suited to these tasks. We present an R package that contains a new class, called TreeMan, for representing the phylogenetic tree. This class has a list structure allowing phylogenetic trees to be manipulated more efficiently. Computational running times are reduced because of the ready ability to vectorise and parallelise methods. Development is also improved due to fewer lines of code being required for performing manipulation processes. We present three use cases-pinning missing taxa to a supertree, simulating evolution with a tree-growth model and detecting significant phylogenetic turnover-that demonstrate the new package's speed and simplicity.

Aircraft trace gas measurements during the London 2012 Olympics: Air quality and emission fluxes derived from sampling upwind and downwind of a megacity

NASA Astrophysics Data System (ADS)

Allen, G.; O'Shea, S.; Muller, J.; Jones, B.; O'Sullivan, D.; Lee, J. D.; Bauguitte, S.; Gallagher, M. W.; Percival, C.; Barratt, B.; McQuaid, J. B.; Illingworth, S.

2013-12-01

This study presents airborne in situ and remote sensing measurements recorded during July and August 2012, across the period of the London 2012 Summer Olympics and simultaneous with the Clear air for London (ClearfLo) ground-based measurement and modelling campaign. Through long-term (2-year) and intensive observation periods (Winter 2011 and Summer 2012), the ClearfLo programme aims to better understand emissions, as well as the chemical, dynamical and micro-meteorological processes which modulate air quality in the London urban environment - an important risk factor for both acute and chronic health effects. The work presented here focuses on two contrasting case studies within the summer ClearfLo period: 30 July 2012 and 9 August 2012, representing relatively clean background and polluted background cases, respectively, and characterised by well-mixed Atlantic westerly maritime inflow in the former and stagnant air (high pressure) in the latter. Measurements of CO, CO2, CH4, N2O, O3, HCN, and other gases measured on board the UK Facility for Airborne Atmospheric Measurement (FAAM) BAe-146 aircraft will be presented and interpreted, with emphasis on observed concentration gradients and tracer-tracer correlations as well as airmass vertical structure and airmass history upwind and downwind of central London in each case. By applying a simple advective model and making use of vertically resolved thermodynamic and composition data, we are able to derive emission strengths for these gases that are representative of the total enclosed surface area. Example emissions for these two cases range between 6x105 kg(C)/hr and 9x105 kg(C)/hr for CO2, and ~0.6x105 kg(C)/hr for CH4. This airborne sampling methodology highlights the unique utility of aircraft measurements to routinely and climatologically characterise emissions from area sources such as cities, and points to future missions to target localised hotspots and distributed point sources.

Creating ISO/EN 13606 archetypes based on clinical information needs.

PubMed

Rinner, Christoph; Kohler, Michael; Hübner-Bloder, Gudrun; Saboor, Samrend; Ammenwerth, Elske; Duftschmid, Georg

2011-01-01

Archetypes model individual EHR contents and build the basis of the dual-model approach used in the ISO/EN 13606 EHR architecture. We present an approach to create archetypes using an iterative development process. It includes automated generation of electronic case report forms from archetypes. We evaluated our approach by developing 128 archetypes which represent 446 clinical information items from the diabetes domain.

Intra-abdominal abscess demonstrating an unusually large intra-abdominal pattern on an indium-111 leukocyte scan

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

Black, R.R.; Fernandez-Ulloa, M.; ter Penning, B.

1988-12-01

Indium-111 WBC imaging of a patient with occult septicemia revealed a large focal pattern of radiopharmaceutical distribution within the abdominal cavity at 24 hours post radiopharmaceutical administration. This finding was felt to represent a large intra-abdominal abscess. A five liter peritoneal abscess was found at surgery. This case illustrates an unusual presentation of an intra-abdominal abscess.

Moving Stories: Exploring Children's Uses of Media in Their Story Telling and the Implications for Teaching about Narrative in Schools

ERIC Educational Resources Information Center

Parry, Becky

2010-01-01

This article draws on data from research with six ten-year-old children investigating the role of film and media in developing understandings of narrative. I present an account of one of the children, Connor (his chosen pseudonym), whose experiences represent a telling case of the dissonance found between children's knowledge and experience of…

What We Can Learn about Strategies, Language Learning, and Life from Two Extreme Cases: The Role of Well-Being Theory

ERIC Educational Resources Information Center

Oxford, Rebecca L.

2014-01-01

This article presents two foreign or second language (L2) learner histories representing the extreme ends of the spectrum of learner well-being. One story reflects the very positive learning experiences of a highly strategic learner, while the other story focuses on a less strategic learner's negative, long-lasting responses to a single traumatic…

Paroxysmal supraventricular tachycardia in an octogenarian.

PubMed

Lutwak, Nancy; Dill, Curt

2012-09-01

Paroxysmal supraventricular tachycardia is a common dysrhythmia that occurs at all ages. Its management is determined by presenting symptoms and previous history of the patient. Patients present with a continuum of symptoms ranging from palpitations to syncope. The incidence of supraventricular tachycardia increases with age. To discuss the etiology, precipitating factors, and acute management of supraventricular tachycardia; and to discuss nodal reentry circuits and representative electrocardiographic findings. We present the case of an 84-year-old man with gallstone pancreatitis, choledolcholithiasis, and cholecystitis complicated by paroxysmal supraventricular tachycardia. We review this dysrhythmia, emphasizing its significance in elderly patients. Supraventricular tachycardia is a common dysrhythmia that can result in syncope or myocardial infarction. We present a case of an elderly man with new-onset atrioventricular (AV) nodal reentry tachycardia, possibly precipitated by overdrive of his autonomic nervous system due to pain and infection. As the percentage of the elderly in our population is growing rapidly and the incidence of AV nodal reentry tachycardia increases with age, emergency physicians should be familiar with this dysrhythmia-its etiology, precipitating factors, presentations, and treatment. It will present more frequently in the future. Published by Elsevier Inc.

77 FR 39346 - Proposed Information Collection (Statement of Accredited Representative in Appealed Case, VA Form...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-02

... in Appealed Case, VA Form 646. OMB Control Number: 2900-0042. Type of Review: Extension of a... (Statement of Accredited Representative in Appealed Case, VA Form 646) Activity: Comment Request AGENCY: The Board of Veterans' Appeals (BVA), Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Board of...

Inflammatory Breast Carcinoma Presenting with Two Different Patterns of Cutaneous Metastases: Carcinoma Telangiectaticum and Carcinoma Erysipeloides

PubMed Central

Yaghoobi, Reza; Talaizade, Abdolhasan; Lal, Karan; Ranjbari, Nastaran; Sohrabiaan, Nasibe

2015-01-01

Cutaneous metastases can have many different clinical presentations. They are seen in patients with advanced malignant disease; however, they can be the initial manifestation of undetected malignancies. Inflammatory breast carcinoma is a rare and aggressive form of breast cancer that has a nonspecific appearance mimicking many benign conditions including mastitis, breast abscesses, and/or dermatitis. The authors report the case of a 40-year-old woman with inflammatory breast carcinoma presenting with violaceous papulovesicular lesions resembling lymphangioma circumscriptum and erythematous patches resembling erysipelas. These lesions represent two different types of cutaneous metastases, both of which were the initial signs of inflammatory breast carcinoma in the patient described herein. Skin biopsy of lesions confirmed invasive breast cancer and further prompted a work up for inflammatory breast carcinoma. This case demonstrates the importance of follow-up for all breast lesions, even those considered to be of benign nature, for they can be presenting signs of metastatic breast cancer. PMID:26345728

Using Wirtinger calculus and holomorphic matching to obtain the discharge potential for an elliptical pond

NASA Astrophysics Data System (ADS)

Strack, O. D. L.

2009-01-01

We present in this paper a new method for deriving discharge potentials for groundwater flow. Discharge potentials are two-dimensional functions; the discharge potential to be presented represents steady groundwater flow with an elliptical pond of constant rate of extraction or infiltration. The method relies on Wirtinger calculus. We demonstrate that it is possible, in principle, to construct a holomorphic function Ω(z), defined so as to produce the same gradient vector in two dimensions as that obtained from an arbitrary function F(x, y) along any Jordan curve ?. We will call Ω(z) the holomorphic match of F(x, y) along ?. Let the line ? be a closed contour bounding a domain ?, and let F(x, y) be defined in ? and represent the discharge potential for some case of divergent groundwater flow. Holomorphic matching makes it possible to create a function Ω(z), valid outside ?, such that ?Ω equals F(x, y) and the gradient of ?Ω equals that of F(x, y) along ?. (Note that the technique applies also if ? is the domain outside ?.) We can use this technique to construct solutions for cases of flow where there is nonzero divergence (due to infiltration or leakage, for example) in ? but zero divergence outside ?. The special case that the divergence within ? is constant and is zero outside ? is chosen to illustrate the approach and to obtain a solution that, to the knowledge of the author, does not exist in the field of groundwater flow.

Bizarre parosteal osteochondromatous proliferation (Nora's lesion): a retrospective study of 12 cases, 2 arising in long bones.

PubMed

Abramovici, Luigia; Steiner, German C

2002-12-01

Twelve cases of bizarre parosteal osteochondromatous proliferation (BPOP), also known as Nora's lesion, are reported. Ten lesions were located in the small bones of the hands, and 2 were located in long bones (femur and proximal tibia). Patient age ranged from 12 to 63 years (average, 30.3 years). Radiography of the lesions in the hand bones showed calcific masses attached to the underlying cortex, without interruption of the latter. The long bone lesions revealed unusual findings. In the femur, BPOP presented with extensive cortical destruction and was suggestive of a malignant lesion. This presentation has not been described to date. In the tibia, the lesion was located in the soft tissue without cortical attachment. This type of BPOP probably represents an immature lesion that over time will mature to solid cortical attachment. On histologic examination, all lesions demonstrated 3 distinct components with variable degrees of representation: (1) hypercellular cartilage with calcification and ossification, with the calcified cartilage having a characteristic basophilic tinctorial quality; (2) cancellous bone undergoing maturation; and (3) spindle cell stroma without cytologic atypia. In 1 case with a long-standing history, the cartilaginous component was minimal. BPOP, together with florid reactive periostitis and turret exostosis, may represent different stages in the development of a posttraumatic proliferative process. BPOP apparently arises from the periosteal tissues through a process of cartilaginous metaplasia. Copyright 2002, Elsevier Science (USA). All rights reserved.

Identification of 99 novel mutations in a worldwide cohort of 1,056 patients with a nephronophthisis-related ciliopathy.

PubMed

Halbritter, Jan; Porath, Jonathan D; Diaz, Katrina A; Braun, Daniela A; Kohl, Stefan; Chaki, Moumita; Allen, Susan J; Soliman, Neveen A; Hildebrandt, Friedhelm; Otto, Edgar A

2013-08-01

Nephronophthisis-related ciliopathies (NPHP-RC) are autosomal-recessive cystic kidney diseases. More than 13 genes are implicated in its pathogenesis to date, accounting for only 40 % of all cases. High-throughput mutation screenings of large patient cohorts represent a powerful tool for diagnostics and identification of novel NPHP genes. We here performed a new high-throughput mutation analysis method to study 13 established NPHP genes (NPHP1-NPHP13) in a worldwide cohort of 1,056 patients diagnosed with NPHP-RC. We first applied multiplexed PCR-based amplification using Fluidigm Access-Array™ technology followed by barcoding and next-generation resequencing on an Illumina platform. As a result, we established the molecular diagnosis in 127/1,056 independent individuals (12.0 %) and identified a single heterozygous truncating mutation in an additional 31 individuals (2.9 %). Altogether, we detected 159 different mutations in 11 out of 13 different NPHP genes, 99 of which were novel. Phenotypically most remarkable were two patients with truncating mutations in INVS/NPHP2 who did not present as infants and did not exhibit extrarenal manifestations. In addition, we present the first case of Caroli disease due to mutations in WDR19/NPHP13 and the second case ever with a recessive mutation in GLIS2/NPHP7. This study represents the most comprehensive mutation analysis in NPHP-RC patients, identifying the largest number of novel mutations in a single study worldwide.

Operations research in global health: a scoping review with a focus on the themes of health equity and impact.

PubMed

Bradley, Beverly D; Jung, Tiffany; Tandon-Verma, Ananya; Khoury, Bassem; Chan, Timothy C Y; Cheng, Yu-Ling

2017-04-18

Operations research (OR) is a discipline that uses advanced analytical methods (e.g. simulation, optimisation, decision analysis) to better understand complex systems and aid in decision-making. Herein, we present a scoping review of the use of OR to analyse issues in global health, with an emphasis on health equity and research impact. A systematic search of five databases was designed to identify relevant published literature. A global overview of 1099 studies highlights the geographic distribution of OR and common OR methods used. From this collection of literature, a narrative description of the use of OR across four main application areas of global health - health systems and operations, clinical medicine, public health and health innovation - is also presented. The theme of health equity is then explored in detail through a subset of 44 studies. Health equity is a critical element of global health that cuts across all four application areas, and is an issue particularly amenable to analysis through OR. Finally, we present seven select cases of OR analyses that have been implemented or have influenced decision-making in global health policy or practice. Based on these cases, we identify three key drivers for success in bridging the gap between OR and global health policy, namely international collaboration with stakeholders, use of contextually appropriate data, and varied communication outlets for research findings. Such cases, however, represent a very small proportion of the literature found. Poor availability of representative and quality data, and a lack of collaboration between those who develop OR models and stakeholders in the contexts where OR analyses are intended to serve, were found to be common challenges for effective OR modelling in global health.

Bilateral Breast Metastases from Vulvar Carcinoma: A Case Report and Literature Review

PubMed Central

Kalogerakos, K.; Dimopoulos, Johannes Carl Athanasios; Kalinoglou, N.

2017-01-01

Vulvar carcinoma is a rare disease that accounts for 3–5% of all gynecologic malignancies. Breast represents an unusual site of metastasis and only a few cases are reported. We describe the first case of bilateral metastatic breast carcinoma of vulvar origin, at an 80-year-old female patient. Six months after treatment of her primary disease, she presented with bilateral metastatic squamous cell breast carcinoma. Diagnosis was based on clinical, radiological, and histological facts. Breast although rare is another potential site of metastasis in vulvar cancer and thus mammary gland examination should be considered in the follow-up of these patients. Differential diagnosis between primary and metastatic lesions is of utmost importance for appropriate management. PMID:28487793

Dermoid cyst of the pancreas: A case report with literature review

PubMed Central

Lane, Jason; Vance, Ansar; Finelli, Daniel; Williams, Gary; Ravichandran, Pars

2012-01-01

Pancreatic dermoid cysts represent a rare entity with 35 cases described in the world literature, including the present one. Pre-operative diagnosis is difficult, with definitive diagnosis usually taking place intra-operatively. We report the case of a 63 year old male with a symptomatic, 6 cm cystic mass in the body of the pancreas. The pre-operative evaluation suggested a cystic neoplasm, but was indeterminate as to whether the lesion was benign or malignant. The diagnosis of dermoid cyst was made intra-operatively with frozen section. Although the diagnosis could not be made pre-operatively this retrospective report highlights the difficulty in evaluating cystic pancreatic lesions by imaging and summarizes the current body of knowledge on this rare entity. PMID:23365699

Severe hypothermia in myxoedema coma: a rewarming by extracorporeal circulation.

PubMed

Kogan, Alexander; Kassif, Yigal; Shadel, Mordechay; Shwarz, Yaron; Lavee, Jacob; Or, Jacob; Raanani, Ehud

2011-12-01

Myxoedema coma is the most lethal manifestation of hypothyroidism. It represents a true medical emergency, especially in the case of cardiovascular instability. Extracorporeal circulation is usually used for rewarming and for providing cardiac support in patients with severe hypothermia and, in addition, cardiovascular instability. We report the case of an 84-year-old woman who presented to the ED with accidental hypothermia associated with myxoedema that was successfully managed by veno-arterial extracorporeal blood rewarming. This case suggests that veno-arterial extracorporeal rewarming appears to achieve a rapid and consistent rewarming rate and is less invasive and more readily available than cardiopulmonary bypass. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Endovascular stenting of a chronic ruptured type B thoracic aortic dissection, a second chance: a case report.

PubMed

Arshad, Ali; Khan, Sumaira L; Whitaker, Simon C; Macsweeney, Shane T

2008-02-07

We aim to highlight the need for awareness of late complications of endovascular thoracic aortic stenting and the need for close follow-up of patients treated by this method. We report the first case in the English literature of an endovascular repair of a previously stented, ruptured chronic Stanford type B thoracic aortic dissection re-presenting with a type III endoleak of the original repair. Endovascular thoracic stenting is now a widely accepted technique for the treatment of thoracic aortic dissection and its complications. Long term follow up is necessary to ensure that late complications are identified and treated appropriately. In this case of type III endoleak, although technically challenging, endovascular repair was feasible and effective.

Successful treatment of facial systemic lupus erythematosus lesions with Dr Michaels® (Soratinex®) product family. A case report.

PubMed

Tirant, M; Bayer, P; Hercogovấ, J; Fioranelli, M; Gianfaldoni, S; Chokoeva, A A; Tchernev, G; Wollina, U; Novotny, F; Roccia, M G; Maximov, G K; França, K; Lotti, T

2016-01-01

Systemic lupus erythematosus (SLE) is a complex autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain and other organs. We report the case of a 7-year-old female patient with facial lesions of SLE since the age of 5. There was no significant family history and patient had been a healthy child from birth. The child presented with a malar rash, also known as a butterfly rash, with distribution over the cheeks but sparing the nasal bridge. This case represents the efficacy of the Dr. Michaels® (Soratinex®) product family in the successful resolution of facial lesions of SLE.

Robust blood-glucose control using Mathematica.

PubMed

Kovács, Levente; Paláncz, Béla; Benyó, Balázs; Török, László; Benyó, Zoltán

2006-01-01

A robust control design on frequency domain using Mathematica is presented for regularization of glucose level in type I diabetes persons under intensive care. The method originally proposed under Mathematica by Helton and Merino, --now with an improved disturbance rejection constraint inequality--is employed, using a three-state minimal patient model. The robustness of the resulted high-order linear controller is demonstrated by nonlinear closed loop simulation in state-space, in case of standard meal disturbances and is compared with H infinity design implemented with the mu-toolbox of Matlab. The controller designed with model parameters represented the most favorable plant dynamics from the point of view of control purposes, can operate properly even in case of parameter values of the worst-case scenario.

Linear Parameter Varying Control Synthesis for Actuator Failure, Based on Estimated Parameter

NASA Technical Reports Server (NTRS)

Shin, Jong-Yeob; Wu, N. Eva; Belcastro, Christine

2002-01-01

The design of a linear parameter varying (LPV) controller for an aircraft at actuator failure cases is presented. The controller synthesis for actuator failure cases is formulated into linear matrix inequality (LMI) optimizations based on an estimated failure parameter with pre-defined estimation error bounds. The inherent conservatism of an LPV control synthesis methodology is reduced using a scaling factor on the uncertainty block which represents estimated parameter uncertainties. The fault parameter is estimated using the two-stage Kalman filter. The simulation results of the designed LPV controller for a HiMXT (Highly Maneuverable Aircraft Technology) vehicle with the on-line estimator show that the desired performance and robustness objectives are achieved for actuator failure cases.

Malaria remains a military medical problem.

PubMed

World, M J

2001-10-01

To bring military medical problems concerning malaria to the attention of the Defence Medical Services. Seven military medical problems related to malaria are illustrated by cases referred for secondary assessment over the past five years. Each is discussed in relation to published data. The cases of failure of various kinds of chemoprophylaxis, diagnosis and treatment of malaria may represent just a fraction of the magnitude of the overall problem but in the absence of reliable published military medical statistics concerning malaria cases, the situation is unclear. Present experience suggests there are a number of persisting problems affecting the military population in relation to malaria. Only publication of reliable statistics will define their magnitude. Interim remedies are proposed whose cost-effectiveness remains to be established.

Reading the lesson: eliciting requirements for a mammography training application

NASA Astrophysics Data System (ADS)

Hartswood, M.; Blot, L.; Taylor, P.; Anderson, S.; Procter, R.; Wilkinson, L.; Smart, L.

2009-02-01

Demonstrations of a prototype training tool were used to elicit requirements for an intelligent training system for screening mammography. The prototype allowed senior radiologists (mentors) to select cases from a distributed database of images to meet the specific training requirements of junior colleagues (trainees) and then provided automated feedback in response to trainees' attempts at interpretation. The tool was demonstrated to radiologists and radiographers working in the breast screening service at four evaluation sessions. Participants highlighted ease of selecting cases that can deliver specific learning objectives as important for delivering effective training. To usefully structure a large data set of training images we undertook a classification exercise of mentor authored free text 'learning points' attached to training case obtained from two screening centres (n=333, n=129 respectively). We were able to adduce a hierarchy of abstract categories representing classes of lesson that groups of cases were intended to convey (e.g. Temporal change, Misleading juxtapositions, Position of lesion, Typical/Atypical presentation, and so on). In this paper we present the method used to devise this classification, the classification scheme itself, initial user-feedback, and our plans to incorporated it into a software tool to aid case selection.

Clinical and Molecular Characterization of Osteogenesis Imperfecta Type V

PubMed Central

Brizola, Evelise; Mattos, Eduardo P.; Ferrari, Jessica; Freire, Patricia O.A.; Germer, Raquel; Llerena Jr, Juan C.; Félix, Têmis M.

2015-01-01

Osteogenesis imperfecta type V (OI-V) has a wide clinical variability, with distinct clinical/radiological features, such as calcification of the interosseous membrane (CIM) between the radius-ulna and/or tibia-fibula, hyperplastic callus (HPC) formation, dislocation of the radial head (DRH), and absence of dentinogenesis imperfecta (DI). Recently, a single heterozygous mutation (c.-14C>T) in the 5′UTR of the IFITM5 gene was identified to be causative for OI-V. Here, we describe 7 individuals from 5 unrelated families that carry the c.-14C>T IFITM5 mutation. The clinical findings in these cases are: absence of DI in all patients, presence of blue sclera in 2 cases, and 4 patients with DRH. Radiographic findings revealed HPC in 3 cases. All patients presented CIM between the radius and ulna, while 4 patients presented additional CIM between the tibia and fibula. Spinal fractures by vertebral compression were observed in all individuals. The proportion of cases identified with this mutation represents 4% of OI cases at our institution. The clinical identification of OI-V is crucial, as this mutation has an autosomal dominant inheritance with variable expressivity. PMID:26648832

21 CFR 312.68 - Inspection of investigator's records and reports.

Code of Federal Regulations, 2010 CFR

2010-04-01

... particular individuals require a more detailed study of the cases, or unless there is reason to believe that the records do not represent actual case studies, or do not represent actual results obtained. ...

Status of steam generator tubing integrity at Jaslovske Bohunice NPP

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

Cepcek, S.

1997-02-01

Steam generator represents one of the most important component of nuclear power plants. Especially, loss of tubing integrity of steam generators can lead to the primary coolant leak to secondary circuit and in worse cases to the unit shut down or to the PTS events occurrence. Therefore, to ensure the steam generator tubing integrity and the current knowledge about tube degradation propagation and development is of the highest importance. In this paper the present status of steam generator tubing integrity in operated NPP in Slovak Republic is presented.

Catenaries in viscous fluid

NASA Astrophysics Data System (ADS)

Hanna, James; Chakrabarti, Brato

2015-11-01

Slender structures live in fluid flows across many scales, from towed instruments to plant blades to microfluidic valves. The present work details a simple model of a flexible structure in a uniform flow. We present analytical solutions for the translating, axially flowing equilibria of strings subjected to a uniform body force and linear drag forces. This is an extension of the classical catenaries to a five-parameter family of solutions, represented as trajectories in angle-curvature ``phase space.'' Limiting cases include neutrally buoyant towed cables and freely sedimenting flexible filaments. Now at University of California, San Diego.

A Petri net controller for distributed hierarchical systems. Thesis

NASA Technical Reports Server (NTRS)

Peck, Joseph E.

1991-01-01

The solutions to a wide variety of problems are often best organized as a distributed hierarchical system. These systems can be graphically and mathematically modeled through the use of Petri nets, which can easily represent synchronous, asynchronous, and concurrent operations. This thesis presents a controller implementation based on Petri nets and a design methodology for the interconnection of distributed Petri nets. Two case studies are presented in which the controller operates a physical system, the Center for Intelligent Robotic Systems for Space Exploration Dual Arm Robotic Testbed.

Laryngeal Adenoid Cystic Carcinoma: A Systematic Review.

PubMed

Marchiano, Emily; Chin, Oliver Y; Fang, Christina H; Park, Richard Chan; Baredes, Soly; Eloy, Jean Anderson

2016-03-01

Adenoid cystic carcinoma is a malignant minor salivary gland tumor that represents <1% of all laryngeal tumors. The submucosal location of laryngeal adenoid cystic carcinoma (LACC) results in delayed presentation. Here, we present the first systematic review of reported cases of LACC to determine trends in presentation, diagnostic and treatment modalities, and patient outcome. PubMed, Web of Science, MEDLINE, and EMBASE databases. A search of the above databases was done to identify articles reporting cases of LACC. The variables included in the analysis were patient demographics, presenting symptoms, tumor location, imaging, treatment, follow-up time, recurrence, and outcome. A total of 50 articles and 120 cases were included in the review. The most common presenting symptom was dyspnea (48.8%), followed by hoarseness (43.9%). LACC arose most frequently from the subglottis (56.7%). At presentation, 14.6% (13 of 89) of patients had regional disease. The average follow-up time was 54.0 months. At follow-up, distant metastasis was reported in 30 cases (33.3%). Surgery alone (43.3%) and surgery with radiotherapy (43.3%) were used most frequently and resulted in 57.1% and 55.3% of patients alive with no evidence disease at follow-up, respectively. LACC was most often located in the subglottis. Patients commonly presented with dyspnea and hoarseness. In this systematic review, surgery with radiotherapy and surgery alone were the most commonly employed treatment modalities, and both resulted in slightly more than 50% of patients alive with no evidence of disease at follow-up. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Changing epidemiology of melioidosis? A case of acute pulmonary melioidosis with fatal outcome imported from Brazil.

PubMed Central

Aardema, H.; Luijnenburg, E. M.; Salm, E. F.; Bijlmer, H. A.; Visser, C. E.; Van't Wout, J. W.

2005-01-01

Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is endemic in South East Asia and tropical regions of Northern Australia. Sporadic cases have been described elsewhere. In this article we present a case of acute pulmonary melioidosis with fatal outcome imported from Brazil. The most common pathogen causing severe community-acquired pneumonia in Brazil is Streptococcus pneumoniae. Other possible pathogens include Legionella spp., Mycoplasma pneumonia, Gram-negative rods and viruses. There are few reports of melioidosis in the Americas. This article represents the second known human case of melioidosis from Brazil. Recognition of melioidosis as a possible cause of severe pneumonia, even if a patient has not been travelling in a highly endemic area, is important because of the therapeutic consequences. The epidemiology of melioidosis will be reviewed. PMID:16181507

A rare case of giant occipital meningocele with Dandy Walker Syndrome: Can it grow bigger than this?

PubMed

Mankotia, Dipanker Singh; Satyarthee, Guru Dutta; Singh, Bhoopendra; Sharma, Bhawani Shankar

2016-01-01

Association of Dandy-Walker syndrome with occipital meningocele (OMC) is extremely rare and about thirty cases are reported till date in the Western literature. However, OMC is classified by Talamonti et al . into small, large, and giant categories with respective diameters were upto 5 cm in small, large with 5-9 cm, and giant with >9 cm. Usually the size of OMC progressively increases as raised intracranial pressure leads to compensatory cerebrospinal fluid escape into sac with the growth of children. Authors report an interesting case of an 18-month-old female child with extra-gigantic OMC, whose size was almost same since birth, representing the first case of its kind, who underwent successful surgical repair. Clinical presentation, radiological features, and surgical management options in literature are reviewed briefly for this rare disease association.

Facial peeling skin syndrome: a case report and a brief review.

PubMed

Janjua, Shahbaz Ahmad; Hussain, Ijaz; Khachemoune, Amor

2007-03-01

Peeling skin syndrome is an extremely rare genodermatosis of possible autosomal recessive inheritance, characterized by asymptomatic spontaneous exfoliation of the stratum corneum at a subcorneal or intracorneal level. It usually presents at birth or appears later in early childhood. The condition may be generalized or localized. Here we describe a case of localized continual skin peeling limited to the facial skin in a 6-month-old infant, with two other members of the family affected with the same condition. A few cases of localized skin peeling limited to the acral surfaces have been described in the literature, but a familial case of localized skin peeling limited to the facial skin has not been described before. We believe that our patient represents a new subtype of peeling skin syndrome, limited to the skin of the face.

Should Controls With Respiratory Symptoms Be Excluded From Case-Control Studies of Pneumonia Etiology? Reflections From the PERCH Study

PubMed Central

Hammitt, Laura L.; Deloria Knoll, Maria; Baggett, Henry C.; Brooks, W. Abdullah; Howie, Stephen R. C.; Kotloff, Karen L.; Levine, Orin S.; Madhi, Shabir A.; Murdoch, David R.; Scott, J. Anthony G.; Thea, Donald M.; Driscoll, Amanda J.; Karron, Ruth A.; Park, Daniel E.; Prosperi, Christine; Zeger, Scott L.; O’Brien, Katherine L.; Feikin, Daniel R.; O’Brien, Katherine L.; Levine, Orin S.; Knoll, Maria Deloria; Feikin, Daniel R.; DeLuca, Andrea N.; Driscoll, Amanda J.; Fu, Wei; Hammitt, Laura L.; Higdon, Melissa M.; Kagucia, E. Wangeci; Karron, Ruth A.; Li, Mengying; Park, Daniel E.; Prosperi, Christine; Wu, Zhenke; Zeger, Scott L.; Watson, Nora L.; Crawley, Jane; Murdoch, David R.; Brooks, W. Abdullah; Endtz, Hubert P.; Zaman, Khalequ; Goswami, Doli; Hossain, Lokman; Jahan, Yasmin; Ashraf, Hasan; Howie, Stephen R. C.; Ebruke, Bernard E.; Antonio, Martin; McLellan, Jessica; Machuka, Eunice; Shamsul, Arifin; Zaman, Syed M.A.; Mackenzie, Grant; Scott, J. Anthony G.; Awori, Juliet O.; Morpeth, Susan C.; Kamau, Alice; Kazungu, Sidi; Kotloff, Karen L.; Tapia, Milagritos D.; Sow, Samba O.; Sylla, Mamadou; Tamboura, Boubou; Onwuchekwa, Uma; Kourouma, Nana; Toure, Aliou; Madhi, Shabir A.; Moore, David P.; Adrian, Peter V.; Baillie, Vicky L.; Kuwanda, Locadiah; Mudau, Azwifarwi; Groome, Michelle J.; Baggett, Henry C.; Thamthitiwat, Somsak; Maloney, Susan A.; Bunthi, Charatdao; Rhodes, Julia; Sawatwong, Pongpun; Akarasewi, Pasakorn; Thea, Donald M.; Mwananyanda, Lawrence; Chipeta, James; Seidenberg, Phil; Mwansa, James; wa Somwe, Somwe; Kwenda, Geoffrey

2017-01-01

Abstract Many pneumonia etiology case-control studies exclude controls with respiratory illness from enrollment or analyses. Herein we argue that selecting controls regardless of respiratory symptoms provides the least biased estimates of pneumonia etiology. We review 3 reasons investigators may choose to exclude controls with respiratory symptoms in light of epidemiologic principles of control selection and present data from the Pneumonia Etiology Research for Child Health (PERCH) study where relevant to assess their validity. We conclude that exclusion of controls with respiratory symptoms will result in biased estimates of etiology. Randomly selected community controls, with or without respiratory symptoms, as long as they do not meet the criteria for case-defining pneumonia, are most representative of the general population from which cases arose and the least subject to selection bias. PMID:28575354

Representativeness of Tuberculosis Genotyping Surveillance in the United States, 2009-2010.

PubMed

Shak, Emma B; France, Anne Marie; Cowan, Lauren; Starks, Angela M; Grant, Juliana

2015-01-01

Genotyping of Mycobacterium tuberculosis isolates contributes to tuberculosis (TB) control through detection of possible outbreaks. However, 20% of U.S. cases do not have an isolate for testing, and 10% of cases with isolates do not have a genotype reported. TB outbreaks in populations with incomplete genotyping data might be missed by genotyping-based outbreak detection. Therefore, we assessed the representativeness of TB genotyping data by comparing characteristics of cases reported during January 1, 2009-December 31, 2010, that had a genotype result with those cases that did not. Of 22,476 cases, 14,922 (66%) had a genotype result. Cases without genotype results were more likely to be patients <19 years of age, with unknown HIV status, of female sex, U.S.-born, and with no recent history of homelessness or substance abuse. Although cases with a genotype result are largely representative of all reported U.S. TB cases, outbreak detection methods that rely solely on genotyping data may underestimate TB transmission among certain groups.

Representativeness of Tuberculosis Genotyping Surveillance in the United States, 2009–2010

PubMed Central

Shak, Emma B.; Cowan, Lauren; Starks, Angela M.; Grant, Juliana

2015-01-01

Genotyping of Mycobacterium tuberculosis isolates contributes to tuberculosis (TB) control through detection of possible outbreaks. However, 20% of U.S. cases do not have an isolate for testing, and 10% of cases with isolates do not have a genotype reported. TB outbreaks in populations with incomplete genotyping data might be missed by genotyping-based outbreak detection. Therefore, we assessed the representativeness of TB genotyping data by comparing characteristics of cases reported during January 1, 2009–December 31, 2010, that had a genotype result with those cases that did not. Of 22,476 cases, 14,922 (66%) had a genotype result. Cases without genotype results were more likely to be patients <19 years of age, with unknown HIV status, of female sex, U.S.-born, and with no recent history of homelessness or substance abuse. Although cases with a genotype result are largely representative of all reported U.S. TB cases, outbreak detection methods that rely solely on genotyping data may underestimate TB transmission among certain groups. PMID:26556930

Monoclonal origin of peritoneal implants and lymph node deposits in serous borderline ovarian tumors (s-BOT) with high intratumoral homogeneity.

PubMed

Horn, Lars-Christian; Höhn, Anne K; Einenkel, Jens; Siebolts, Udo

2014-11-01

Molecular studies have shown that the most prevalent mutations in serous ovarian borderline tumors (s-BOT) are BRAF and/or KRAS alterations. About one third of s-BOT represent peritoneal implants and/or lymph node involvement. These extraovarian deposits may be monoclonal or polyclonal in origin. To test both the hypotheses, mutational analyses using pyrosequencing for BRAF codon 600 and KRAS codon 12/13 and 61 of microdissected tissue was performed in 15 s-BOT and their invasive and noninvasive peritoneal implants. Two to 6 implants from different peritoneal sites were examined in 13 cases. Lymph node deposits were available for the analysis in 3 cases. Six s-BOT showed mutation in exon 2 codon 12 of the KRAS proto-oncogen. Five additional cases showed BRAF p.V600E mutation representing an overall mutation rate of 73.3%. Multiple (2-6) peritoneal implants were analyzed after microdissection in 13 of 15 cases. All showed identical mutational results when compared with the ovarian site of the disease. All lymph node deposits, including those with multiple deposits in different nodes, showed identical results, suggesting high intratumoral mutational homogeneity. The evidence presented in this study and the majority of data reported in the literature support the hypothesis that s-BOT with their peritoneal implants and lymph node deposits show identical mutational status of BRAF and KRAS suggesting a monoclonal rather than a polyclonal disease regarding these both tested genetic loci. In addition, a high intratumoral genetic homogeneity can be suggested. In conclusion, the results of the present study support the monoclonal origin of s-BOT and their peritoneal implants and lymph node deposits.

Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel.

PubMed

Graham, Stephen M; Ahmed, Tahmeed; Amanullah, Farhana; Browning, Renee; Cardenas, Vicky; Casenghi, Martina; Cuevas, Luis E; Gale, Marianne; Gie, Robert P; Grzemska, Malgosia; Handelsman, Ed; Hatherill, Mark; Hesseling, Anneke C; Jean-Philippe, Patrick; Kampmann, Beate; Kabra, Sushil Kumar; Lienhardt, Christian; Lighter-Fisher, Jennifer; Madhi, Shabir; Makhene, Mamodikoe; Marais, Ben J; McNeeley, David F; Menzies, Heather; Mitchell, Charles; Modi, Surbhi; Mofenson, Lynne; Musoke, Philippa; Nachman, Sharon; Powell, Clydette; Rigaud, Mona; Rouzier, Vanessa; Starke, Jeffrey R; Swaminathan, Soumya; Wingfield, Claire

2012-05-15

There is a critical need for improved diagnosis of tuberculosis in children, particularly in young children with intrathoracic disease as this represents the most common type of tuberculosis in children and the greatest diagnostic challenge. There is also a need for standardized clinical case definitions for the evaluation of diagnostics in prospective clinical research studies that include children in whom tuberculosis is suspected but not confirmed by culture of Mycobacterium tuberculosis. A panel representing a wide range of expertise and child tuberculosis research experience aimed to develop standardized clinical research case definitions for intrathoracic tuberculosis in children to enable harmonized evaluation of new tuberculosis diagnostic technologies in pediatric populations. Draft definitions and statements were proposed and circulated widely for feedback. An expert panel then considered each of the proposed definitions and statements relating to clinical definitions. Formal group consensus rules were established and consensus was reached for each statement. The definitions presented in this article are intended for use in clinical research to evaluate diagnostic assays and not for individual patient diagnosis or treatment decisions. A complementary article addresses methodological issues to consider for research of diagnostics in children with suspected tuberculosis.

Ultrasound diagnostic of mesonephric paraovarian cyst - case report

PubMed Central

Bohîlțea, RE; Cîrstoiu, MM; Turcan, N; Ionescu, CA

2016-01-01

Paraovarian cysts are a rare pathology, constituting 10-20% of the adnexal masses. The origin can be represented by paramesonephric ducts (Hydatid cysts of Morgagni), vestiges of mesonephric ducts also represented by mesothelium, or neoplastic (cystadenomas or cystadenofibromas) that are mostly benign. Borderline or malignant paraovarian tumors are encountered less often. This article presents a case of paraovarian cyst in a 37-year-old patient, with a history of 2 pregnancies, completed by cesarean. The patient sought medical attention for an asymptomatic voluminous ovarian cyst, detected in a routine ultrasound scan. Laboratory tests and tumor markers were within normal limits. Transvaginal ultrasound and color Doppler revealed a cystic adnexal mass with 10 cm transonic, smooth, homogeneous content, avascular walls with no internal papillary projections, with a “hyperechoic line” sign of delimitation from the ovarian capsule, mostly visible when the adnexa was mobilized. The diagnostic and curative laparoscopic surgery was successful, followed by a quick recovery. The histopathological exam confirmed the benignity and the origin of the paraovarian cyst. The case was discussed in the context of the literature review concerning this pathology, drawing attention to the real possibility of differentiating ovarian from paraovarian cysts by ultrasound. PMID:27974934

"Intermetamorphic" developmental stages in 150 million-year-old achelatan lobsters--The case of the species tenera Oppel, 1862.

PubMed

Haug, Joachim T; Haug, Carolin

2016-03-01

We re-investigated the fossil species tenera Oppel, 1862, an achelatan lobster (traditionally named Palinurina tenera) found in 150 million years old limestones of southern Germany. All known specimens attributed to this species show a mixture of characters, which in modern forms occur either in larvae or post-larval juveniles. Hence these specimens provide insight into a phase in ontogeny that is no longer present in the developmental sequence of any modern achelatan lobster, as the latter ones skip this phase and replace it by a drastic metamorphosis. Comparable cases have been described earlier, yet did only comprise single stages or two successive ones at most. In the here described case four developmental stages are preserved. The reconstructed ontogeny of tenera therefore represents the currently best known sequence of an early achelatan lobster that covers this specific intermediate phase. The largest known stage most likely still represents an immature of a yet undiscovered adult. These findings support the interpretation that early achelatan lobsters developed in a more gradual ontogenetic sequence than modern forms. It furthermore demonstrates that it was even more gradual than anticipated previously. Copyright © 2015 Elsevier Ltd. All rights reserved.

Intraoperative Transpedicular Onyx Injection to Reduce Vascularity of a Thoracic Hemangiopericytoma After Unsuccessful Preoperative Endovascular Embolization: a Technical Report.

PubMed

Mashaly, Hazem; Zhang, Zoe; Shaw, Andrew; Youssef, Patrick; Mendel, Ehud

2018-02-01

Hemangiopericytoma is a rare vascular tumor with central nervous system involvement representing only 1% of central nervous system tumors. They rarely affect the vertebral column. Complete surgical resection is the treatment of choice for hemangiopericytoma given their high rates of local recurrence. However, the high vascularity of such tumors with the risk of massive bleeding during surgery represents a significant challenge to surgeons. Therefore, preoperative endovascular embolization via the transarterial route has been advocated. In the current study, we present a case of a T12 hemangiopericytoma that was managed by a 2-stage surgical resection, with the use of intraoperative transpedicular onyx injection to reduce intraoperative blood loss following an unsuccessful trial of preoperative endovascular embolization. Preoperative endovascular embolization is not feasible in some cases due to the location of the segmental or radiculomedullary arteries in relation to tumor feeders and, rarely, small size of these arterial feeders. Percutaneous injection of onyx is an option. In this case report, we discuss direct intraoperative injection via a transpedicular route as a safe and effective method for decreasing the vascularity of some lesions and improving intraoperative blood loss. Copyright © 2017 by the Congress of Neurological Surgeons

Bilineal Extramedullary Blast Crisis as an Initial Presentation of Chronic Myeloid Leukemia: A Case Report and Literature Review

PubMed Central

Gao, Xiaoning; Li, Jie; Wang, Lili; Lin, Ji; Jin, Hongshi; Xu, Yihan; Wang, Nan; Zhao, Yu; Liu, Daihong; Yu, Li; Wang, Quanshun

2016-01-01

Patient: Male, 49 Final Diagnosis: T-lymphoid/myeloid bilineal blastic transformation of CML Symptoms: Rapidly enlarging mass in left neck Medication: — Clinical Procedure: Biopsy of the left submandibular lymph nodes Specialty: Hematology Objective: Rare co-existance of disease or pathology Background: Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder characterized by the Philadelphia chromosome generated by the reciprocal translocation t(9: 22)(q34;q11). CML is usually diagnosed in the chronic phase. Blast crisis represents an advanced phase of CML. Extramedullary blast crisis as the initial presentation of CML with bone marrow remaining in chronic phase is an unusual event. Further, extramedullary blast crisis with T lymphoid/myeloid bilineal phenotype as an initial presentation for CML is extremely unusual. Case Report: Here, we report the case of a 49-year-old male with rapidly enlarged submandibular lymph nodes. Biopsy specimen from the nodes revealed a characteristic appearance with morphologically and immunohistochemically distinct myeloblasts and T lymphoblasts co-localized in 2 adjacent regions, accompanied by chronic phase of the disease in bone marrow. The presence of the BCR/ABL1 fusion gene within both cellular populations in this case confirmed the extramedullary disease represented a localized T lymphoid/myeloid bilineal blastic transformation of CML. After 3 courses of combined chemotherapy plus tyrosine kinase inhibitor treatment, the mass was completely regressed with a 3-log decrease in BCR/ABL1 transcript from baseline. Five months after the diagnosis, the patient showed diminished vision, hand tremors, and weakness of lower extremities. Flow cytometric immunophenotyping of cerebrospinal fluid revealed the presence of myeloid blasts. An isolated central nervous system relapse of leukemia was identified. Following high-dose systemic and intrathecal chemotherapy, the patient continued to do well. Conclusions: The possibility of extramedullary blast crisis as an initial presentation in patients with CML should be considered. Further, an isolated central nervous system blast crisis should be considered if neurological symptoms evolve in patients who have shown a good response to therapy. PMID:27784881

The Role of Health in Climate Litigation

PubMed Central

Simmens, Samuel J.; Glicksman, Robert; Paddock, LeRoy; Kim, Daniel; Whited, Brittany

2018-01-01

Objectives. To examine how the courts, which play a critical role in shaping public policy, consider public health in climate change and coal-fired power plant lawsuits. Methods. We coded US local, state, and federal court decisions relating to climate change and coal-fired power plants from 1990 to 2016 (n = 873) and qualitatively investigated 139 cases in which litigants raised issues concerning the health impacts of climate change. We also conducted 78 interviews with key litigants, advocates, industry representatives, advising scientists, and legal experts. Results. Health has been a critical consideration in key climate lawsuits, but in a minority of cases. Litigants have presented health arguments most frequently and effectively in terms of airborne exposures. Health impacts have typically been used to gain standing and argue that the evidence for government actions is insufficient. Conclusions. The courts represent a pivotal branch of government in shaping climate policy. Increasing inclusion of health concerns in emergent areas of litigation could help drive more effective climate policymaking. PMID:29698089

Overview of Seismic Hazard and Vulnerability of Ordinary Buildings in Belgium: Methodological Aspects and Study Cases

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

Barszez, Anne-Marie; Camelbeeck, Thierry; Plumier, Andre

Northwest Europe is a region in which damaging earthquakes exist. Assessing the risks of damages is useful, but this is not an easy work based on exact science.In this paper, we propose a general tool for a first level assessment of seismic risks (rapid diagnosis). General methodological aspects are presented. For a given building, the risk is represented by a volume in a multi-dimensional space. This space is defined by axes representing the main parameters that have an influence on the risk. We notably express the importance of including a parameter to consider the specific value of cultural heritage.Then wemore » apply the proposed tool to analyze and compare methods of seismic risk assessment used in Belgium. They differ by the spatial scale of the studied area. Study cases for the whole Belgian Territory and for part of cities in Liege and Mons (Be) aim also to give some sense of the overall risk in Belgium.« less

Transcriptomic resources for environmental risk assessment: a case study in the Venice lagoon.

PubMed

Milan, M; Pauletto, M; Boffo, L; Carrer, C; Sorrentino, F; Ferrari, G; Pavan, L; Patarnello, T; Bargelloni, L

2015-02-01

The development of new resources to evaluate the environmental status is becoming increasingly important representing a key challenge for ocean and coastal management. Recently, the employment of transcriptomics in aquatic toxicology has led to increasing initiatives proposing to integrate eco-toxicogenomics in the evaluation of marine ecosystem health. However, several technical issues need to be addressed before introducing genomics as a reliable tool in regulatory ecotoxicology. The Venice lagoon constitutes an excellent case, in which the assessment of environmental risks derived from the nearby industrial activities represents a crucial task. In this context, the potential role of genomics to assist environmental monitoring was investigated through the definition of reliable gene expression markers associated to chemical contamination in Manila clams, and their subsequent employment for the classification of Venice lagoon areas. Overall, the present study addresses key issues to evaluate the future outlooks of genomics in the environmental monitoring and risk assessment. Copyright © 2014 Elsevier Ltd. All rights reserved.

Customary Homicides in Diyarbakir Province.

PubMed

Yilmaz, Eyyup; Canturk, Nergis; Erkol, Zerrin; Kumral, Bahadir; Okumus, Ali M

2015-09-01

This study presents an analysis of the causes of so-called honor killings in the context of "customary homicide" and a discussion of preventive measures. Finalized case files of customary homicide between January 1, 2007 and December 31, 2012 were retrospectively examined in Diyarbakir Province, Turkey. Of a total of 28 case victims, 17 (60.7%) were females and 11 (39.3%) were males. All perpetrators were male. There was a significant difference between male and female victims in terms of economic independence (p=0.000). A direct blood relationship or relationship by marriage (such as brother-in-law) was found to have a significant association with the gender of the victim (p<0.001). Multilevel educational activities targeting a transformation of the perception of women by society, replacement of patriarchal models with more modern attitudes, and encouragement of individuality may represent effective strategies that may help reduce the number of customary homicide, which represents a multifaceted problem. © 2015 American Academy of Forensic Sciences.

[Latex gloves dermatitis in health care workers].

PubMed

Mattei, O; Di Martino, T; Ferraro, P

2007-01-01

With regard to health care workers the irritative contact dermatitis represents about the 80% of all the dermopathies in sanitary staff whereas the allergic contact dermatitis covers approximately the 20% of the professional dermatoses. In our study 4 cases of allergy to latex in hospital nurses are presented; the clinical history is described for each of them as well as the resulting judgment of suitability to the specific work. In general population the allergy to latex is estimated to be approximately 1-6%; in sanitary staff it rises to 5-12%. We have to observe that not all the sensitive subjects show symptoms of allergy. Actually the 4 cases described represent less than 1% of the surveyed group. The sensitization is likely to be so reduced also thanks to the application of preventive guide-lines such as the one proposed by NIOSH. In Italy the criteria in preventing allergic reactions to latex are illustrated in a consensus document issued by a study-team from Italian Association of the Health Workers.

Ovarian preservation in a young patient with Gorlin syndrome and multiple bilateral ovarian masses.

PubMed

Morse, Christopher B; McLaren, Janet F; Roy, Darshan; Siegelman, Evan S; Livolsi, Virginia A; Gracia, Clarisa R

2011-07-01

To report a case of bilateral ovarian fibromas and ovarian leiomyomas in a young patient with Gorlin syndrome and to highlight issues of fertility preservation, ovarian conservation, and preimplantation genetic diagnosis in this population. Case report. University hospital. A 15-year-old female patient with Gorlin syndrome and bilateral ovarian masses. Ultrasound, magnetic resonance imaging, hormone analysis, and laparotomy with resection of ovarian fibromas. Preservation of ovarian function, pathologic diagnosis. Our patient represented an adolescent case of bilateral ovarian fibromas and leiomyomas in Gorlin syndrome presenting with menstrual irregularities. She was managed surgically with resection of the lesions and conservation of normal ovarian tissue. In Gorlin syndrome, ovarian fibromas are a common clinical manifestation. Patients with ovarian involvement may present with complex gynecologic needs and may have decreased fertility potential. Careful surgical management, follow-up, and counseling on options for future fertility should be offered to all patients. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Terminal ileum gangrene secondary to a type IV paraesophageal hernia.

PubMed

Hsu, Ching Tsai; Hsiao, Po Jen; Chiu, Chih Chien; Chan, Jenq Shyong; Lin, Yee Fung; Lo, Yuan Hung; Hsiao, Chia Jen

2016-02-28

Type IV paraesophageal hernia (PEH) is very rare, and is characterized by the intrathoracic herniation of the abdominal viscera other than the stomach into the chest. We describe a 78-year-old woman who presented at our emergency department because of epigastric pain that she had experienced over the past 24 h. On the day after admission, her pain became severe and was accompanied by right chest pain and dyspnea. Chest radiography revealed an intrathoracic intestinal gas bubble occupying the right lower lung field. Emergency explorative laparotomy identified a type IV PEH with herniation of only the terminal ileum through a hiatal defect into the right thoracic cavity. In this report, we also present a review of similar cases in the literature published between 1980 and 2015 in PubMed. There were four published cases of small bowel herniation into the thoracic cavity during this period. Our patient represents a rare case of an individual diagnosed with type IV PEH with incarceration of only the terminal ileum.

Percutaneous management of coronary sinus atrial septal defect: two cases representing the spectrum for device closure and a review of the literature.

PubMed

Sandeep, Nefthi; Slack, Michael C

2014-10-01

Coronary sinus atrial septal defects are the rarest defects of the atrial septum comprising <1% of the five different types of atrial septal defects. Despite the widespread adoption of percutaneous device closure of secundum atrial septal defects, the published experience with percutaneous device closure of coronary sinus atrial septal defects is limited to only a few isolated case reports because of uncertainty regarding safety and efficacy. Open-heart surgical repair remains the treatment of choice for coronary sinus atrial septal defects, although this may not be the only treatment option in selected cases. Herein we describe our own experience with two patients with different clinical presentations and our method of successful percutaneous coronary sinus atrial septal defect closure in each. We then present a review of the anatomic spectrum of coronary sinus atrial septal defects along with a review of contemporary surgical and percutaneous device treatment.

[Hangings in the material of Department of Forensic Medicine, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, in the years 2000-2010].

PubMed

Sumińska-Ziemann, Barbara; Bloch-Bogusławska, Elzbieta

2013-01-01

This study presents an analysis of suicides based on autopsy protocols from the years 2000-2010. Out of all autopsies conducted at Department of Forensic Medicine, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, 477 cases resulted from hanging. During this period the majority of hangings were recorded in 2010 (61 cases). The parameters assessed in this study included age, sex, post-mortem blood ethanol concentration and place of death of the victims. The age range of the deceased was similar in the group of men and women. Males represented the majority of victims of hanging (89%); only 11% of all the victims were females. The authors observed differences in blood alcohol level of the victims in association with their sex. Not present ethanol was noted in approx. 42% of men and 71% of women. More than 65% cases of suicide hangings were encountered in urban areas, in living quarters and outbuildings.

The use of computer-aided design/manufacturing (CAD/CAM) technology to aid in the reconstruction of congenitally deficient pediatric mandibles: A case series.

PubMed

Gougoutas, Alexander J; Bastidas, Nicholas; Bartlett, Scott P; Jackson, Oksana

2015-12-01

Microvascular reconstruction of the pediatric mandible, particularly when necessitated by severe, congenital hypoplasia, presents a formidable challenge. Complex cases, however, may be simplified by computer-aided design/computer-aided manufacturing (CAD/CAM) assisted surgical planning. This series represents the senior authors' preliminary experiences with CAD/CAM assisted, microvascular reconstruction of the pediatric mandible. Presented are two patients with hemifacial/bifacial microsomia, both with profound mandibular hypoplasia, who underwent CAD/CAM assisted reconstruction of their mandibles with vascularized fibula flaps. Surgical techniques, CAD/CAM routines employed, complications, and long-term outcomes are reported. Successful mandibular reconstructions were achieved in both patients with centralization of their native mandibles and augmentation of deficient mandibular subunits. No long-term complications were observed. CAD/CAM technology can be utilized in pediatric mandibular reconstruction, and is particularly beneficial in cases of profound, congenital hypoplasia requiring extensive, multi-planar, bony reconstructions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Vesical schistosomiasis with terminal hematuria in sub-Saharan patients.

PubMed

Pereira, J; Calleja, E; Marne, C; Borque, A

2014-03-01

To know the characteristics of vesical schistosomiasis caused by schistosoma hematobium in immigrant patients. The retrospective study of 41 cases microbiologically diagnosed in our hospital over the last 16 years is presented. Data was collected on origin, age, presentation form, diagnostic tests and treatment. All were African patients whose ages ranged from 4 to 32 years and who had terminal macroscopic hematuria. Most of the patients (85%) were men. In all of the cases, diagnosis was by a urinary microbiological study and in one case, cystoscopy with a biopsy of a typical vesical lesion. Terminal hematuria is the most representative clinical sign. They were treated with praziquantel. The epidemiology and intermittent terminal hematuria in African patients should lead to the suspicion of vesical schistosomiasis as the first diagnostic option. Urinary microbiological study is a rapid, non-invasive, test with high diagnostic yield that would avoid performing invasive studies. Its simple treatment assures high level of compliance and consequent efficacy. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

Recurrent mucinous adenocarcinoma of the ovary presenting as an inguino-labial hernia.

PubMed

Ben-Hur, H; Schachter, M; Mashiah, A; Lifschitz-Mercer, B; Pfeffermann, R

1996-01-01

We report a case of a 65-year-old woman who nine years previously had undergone total abdominal hysterectomy and bilateral salpingoophorectomy for a large ovarian cyst. During surgery the cyst had ruptured and some mucinous material had been spilled intraabdominally. Histopathological studies demonstrated the cyst to be a mucinous adenocarcinoma of low malignant potential. Appendectomy had also been performed due to an enlarged appendix, which proved to be a mucocoele. The patient had been lost to subsequent follow-up. Her current presenting symptom was a giant inguino-labial hernia of 25 cm diameter with two small skin perforations leaking a gelatinous discharge. Subsequent laparotomy and inguinal exploration have disclosed herniated small intestine with an attached metastatic multicystic mucinous adenocarcinoma. This case represents a case of borderline mucinous adeno-carcinoma-pseudomyxoma peritonei recurring in a unique pattern as a huge inguino-labial hernia, and serves to emphasize the possible consequences of spillage of ovarian cyst contents during surgery.

Formal Methods Case Studies for DO-333

NASA Technical Reports Server (NTRS)

Cofer, Darren; Miller, Steven P.

2014-01-01

RTCA DO-333, Formal Methods Supplement to DO-178C and DO-278A provides guidance for software developers wishing to use formal methods in the certification of airborne systems and air traffic management systems. The supplement identifies the modifications and additions to DO-178C and DO-278A objectives, activities, and software life cycle data that should be addressed when formal methods are used as part of the software development process. This report presents three case studies describing the use of different classes of formal methods to satisfy certification objectives for a common avionics example - a dual-channel Flight Guidance System. The three case studies illustrate the use of theorem proving, model checking, and abstract interpretation. The material presented is not intended to represent a complete certification effort. Rather, the purpose is to illustrate how formal methods can be used in a realistic avionics software development project, with a focus on the evidence produced that could be used to satisfy the verification objectives found in Section 6 of DO-178C.

Probabilistic Asteroid Impact Risk Assessment for the Hypothetical PDC17 Impact Exercise

NASA Technical Reports Server (NTRS)

Wheeler, Lorien; Mathias, Donovan

2017-01-01

Performing impact risk assessment for the 2017 Planetary Defense Conference (PDC17) hypothetical impact exercise, to take place at the PDC17 conference, May 15-20, 2017. Impact scenarios and trajectories are developed and provided by NASA's Near Earth Objects Office at JPL (Paul Chodas). These results represent purely hypothetical impact scenarios, and do not reflect any known asteroid threat. Risk assessment was performed using the Probabilistic Asteroid Impact Risk (PAIR) model developed by the Asteroid Threat Assessment Project (ATAP) at NASA Ames Research Center. This presentation includes sample results that may be presented or used in discussions during the various stages of the impact exercisecenter dot Some cases represent alternate scenario options that may not be used during the actual impact exercise at the PDC17 conference. Updates to these initial assessments and/or additional scenario assessments may be performed throughout the impact exercise as different scenario options unfold.

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

Hill, David P.; D’Eustachio, Peter; Berardini, Tanya Z.

The concept of a biological pathway, an ordered sequence of molecular transformations, is used to collect and represent molecular knowledge for a broad span of organismal biology. Representations of biomedical pathways typically are rich but idiosyncratic presentations of organized knowledge about individual pathways. Meanwhile, biomedical ontologies and associated annotation files are powerful tools that organize molecular information in a logically rigorous form to support computational analysis. The Gene Ontology (GO), representing Molecular Functions, Biological Processes and Cellular Components, incorporates many aspects of biological pathways within its ontological representations. Here we present a methodology for extending and refining the classes inmore » the GO for more comprehensive, consistent and integrated representation of pathways, leveraging knowledge embedded in current pathway representations such as those in the Reactome Knowledgebase and MetaCyc. With carbohydrate metabolic pathways as a use case, we discuss how our representation supports the integration of variant pathway classes into a unified ontological structure that can be used for data comparison and analysis.« less

Arthropods of medicoveterinary importance in zoos.

PubMed

Adler, Peter H; Tuten, Holly C; Nelder, Mark P

2011-01-01

Zoos present a unique assemblage of arthropods, captive vertebrates, free-roaming wildlife, humans, and plants, each with its own biota of symbiotic organisms. Arthropods of medicoveterinary importance are well represented in zoos, and an ample literature documents their influence in these animal-rich environments. Mosquitoes are of greatest significance because of the animal and human pathogens they transmit, followed by ectoparasites, many of which are exotic and present health risks to captive and native animals. Biting flies, cockroaches, filth flies, and triatomid bugs represent additional concerns. Integrated management programs for arthropods in zoos are commonplace. Zoos can play a role in biosurveillance, serving as an advanced guard for detecting exotic arthropods and vector-borne diseases. We provide the first review of arthropods of medicoveterinary importance in zoos. A case is made for the value of collaborations between entomologists and zoo personnel as a means of enhancing research and public education while safeguarding the health of captive animals and the public.

Clinical and laboratory profile of Zika virus infection in dengue suspected patients: A case series.

PubMed

Fernanda Estofolete, Cássia; Terzian, Ana Carolina Bernardes; Parreira, Ricardo; Esteves, Aida; Hardman, Lucas; Greque, Gilmar Valdir; Rahal, Paula; Nogueira, Maurício Lacerda

2016-08-01

The Zika virus (ZIKV) is an emerging arthropod-borne virus related to the dengue virus (DENV), and shows a similar clinical profile as other arboviral diseases, such as dengue and chikungunya virus (CHIKV). Historically, ZIKV has been associated with sporadic cases of human infection, but is now responsible for outbreaks worldwide. In Brazil, cases have been reported since 2015, with some cases causing severe disease. To identify clinical symptoms of Zika in patients in Dengue suspected patients. Description of a series of cases, wherein we analyzed 100 clinical samples collected from patients who exhibited acute febrile disease for ≤5days, from January to February 2016. In this study, we report 13 cases of ZIKV infection in adults presenting dengue-like symptoms in a DENV endemic area. All patients presented with fever, with myalgia being the second most frequently observed symptom. Two patients had rashes, but none of them had conjunctivitis. Other less frequent manifestations included headache, arthralgia, diarrhea, and nausea. The co-circulation of ZIKV and DENV is a serious public health concern, since it represents both a clinical and diagnostic challenge in endemic areas, as well as in the field of travel medicine. Copyright © 2016 Elsevier B.V. All rights reserved.

Actinic Prurigo Cheilitis: A Clinicopathologic Review of 75 Cases.

PubMed

Plaza, Jose A; Toussaint, Sonia; Prieto, Victor G; Mercadillo, Patricia; Diez de Medina, Juan C; Lourenco, Silvia; Batdorf, Bjorn; Sangueza, Martin

2016-06-01

Actinic prurigo (AP) is a chronic idiopathic photodermatosis that primarily affects American Indians in the United States and Mestizos in Latin American countries. Clinically, the onset of the disease is usually in the first decade of life but may appear initially in adult life, and it is characterized by symmetric involvement of sun-exposed areas of the skin, particularly areas of the face, resulting in polymorphic erythematous papules, macules, and plaques in different stages of evolution. Lower lip involvement includes swelling, scaling, fissures, hyperpigmentation, and ulcerations of the vermilion border. and in some cases could represent the only manifestation of the disease. The histopathologic features of AP have been studied; however, there is a controversy regarding whether AP cheilitis has distinct histopathologic features that could allow accurate separation from other specific and nonspecific forms of cheilitis. The diagnosis can be challenging, mainly when lip lesions are the only manifestation of the disease. In this study, the authors investigate the clinicopathologic features of 75 cases of AP cheilitis to provide further criteria for its diagnosis and classification. All 75 patients presented with lip lesions. Thirty-three cases were diagnosed as AP cheilitis with cutaneous lesions and 42 cases were diagnosed as AP cheilitis without cutaneous lesions (only lip lesions). Histologically, of the 33 cases with AP cheilitis with cutaneous lesions, 17 (52%) cases showed follicular cheilitis, and of the 42 cases that had only lip lesions, 18 (43%) cases showed follicular cheilitis. Histologically, AP cheilitis can present as follicular cheilitis; thus, supporting the diagnosis. Also, our findings confirm that lip lesions can present as the only manifestation of the disease, showing typical histological and clinical features. This form of cheilitis has not being well described in the dermatologic and dermatopathologic literature.

Chronic lingual papulosis: new, independent entity or "mature" form of transient lingual papillitis?

PubMed

Bouquot, Jerry E; Adibi, Shawn S; Sanchez, Maga

2012-01-01

Several acute, usually pediatric variants of edematous, symptomatic fungiform lingual papillitis have been reported since the 1990s, most notably transient lingual papillitis (TLP); but no chronic forms have been mentioned. Is there a chronic counterpart, akin to the older palatal examples of inflammatory papillary hyperplasia? The objective of this study was to clinicopathologically characterize a previously unreported entity with clustered, chronic fibrous papules (nonsyndromic) of the tongue. Cases were collected from clinics in 2 dental schools. Five women and 4 men were identified with multiple, moderately firm, slightly pedunculated, normally colored masses clustered at the tip of the tongue (n = 4), covering the dorsal surface (n = 4) or on the lateral border (n = 1); 2 showed several erythematous or edematous papules (similar to TLP) admixed with fibrous papules. Patient ages ranged from 31 to 62 years (average 49) and all lesions had been present for many years. All lesions were asymptomatic except for the lateral border lesion, which presented with a burning sensation and mild tenderness (disappeared with antifungal medication). Five cases were associated with mouth breathing or a tongue-thrust habit; 4 were associated with geographic tongue or fissured tongue. Four papules were biopsied. All were composed of dense, avascular fibrous tissue with no or very few inflammatory cells; one showed focal mild neovascularity and edema. The lesion appeared to represent altered filiform papillae, more so than fungiform papillae. Chronic lingual papulosis (CLP) is an innocuous entity represented by focal or diffuse enlargement of numerous lingual papillae, primarily the filiform papillae. It appears to usually have an adult onset and most likely represents papillary reaction to very low-grade, chronic irritation or desiccation. Some cases with childhood onset, however, seem to be variations of normal anatomy. No treatment or biopsy is required, but a number of systemic disorders and syndromes must be ruled out before applying the CLP diagnosis. Copyright © 2012 Elsevier Inc. All rights reserved.

Cutaneous hidradenocarcinoma: a clinicopathological, immunohistochemical, and molecular biologic study of 14 cases, including Her2/neu gene expression/amplification, TP53 gene mutation analysis, and t(11;19) translocation.

PubMed

Kazakov, Dmitry V; Ivan, Doina; Kutzner, Heinz; Spagnolo, Dominic V; Grossmann, Petr; Vanecek, Tomas; Sima, Radek; Kacerovska, Denisa; Shelekhova, Ksenia V; Denisjuk, Natalja; Hillen, Uwe; Kuroda, Naoto; Mukensnabl, Petr; Danis, Dusan; Michal, Michal

2009-05-01

We present a series of 14 cases of cutaneous hidradenocarcinomas. The patients included 6 women and 8 men ranging in age at diagnosis from 34 to 93 years. All but 1 patient presented with a solitary nodule. There was no predilection site. One patient presented with multiple lesions representing metastatic nodules. Of 12 patients with available follow-up, 2 died of disease, whereas the remaining 10 patients were alive but 3 of them experienced a local recurrence in the course of the disease. Grossly, the tumors ranged in size from 1.2 to 6 cm. Microscopically, of the 14 primary tumors, 9 showed low-grade cytomorphology, whereas the remaining 5 neoplasms were high-grade lesions. The residuum of a hidradenoma was present in 5 of the 14 primaries. The mitotic rate was highly variable, ranging from 2 to 64 mitoses per 10 high-power field. The cellular composition of the tumors varied slightly, with clear cells, epidermoid cells, and transitional forms being present in each case. In 1 case, there was metaplastic transformation into sarcomatoid carcinoma. Glandular differentiation varied from case to case and appeared most commonly as simple round glands or as cells with intracytoplasmic lumens. Necrosis en masse was detected in 8 specimens. One specimen represented a reexcision and was unusual as it showed a well-demarcated intradermal proliferation of relatively bland clear cells accompanied by an overlying intraepidermal growth of clear cells resembling hidradenoacanthoma simplex. Despite the bland appearance, the tumor metastasized to a lymph node. Immunohistochemically, 5 of the 8 specimens studied for Her2/neu expression were negative, whereas 3 specimens from 2 cases yielded score +2, but all the 3 specimens with score 2+ subsequently proved negative for Her2/neu gene amplification by fluorescence in situ hybridization. Of 10 primaries studied, 4 tumors showed positive p53 immunoreaction in more than 25% of the cells comprising the malignant portion of the lesions, in 2 cases, a minority of the neoplastic cells (10%-20%) demonstrated nuclear staining, whereas the remaining 4 cases were negative. Of 9 specimens of hidradenocarcinoma studied for TP53 mutations, 2 harbored mutations, whereas the remaining 7 specimens showed the wild-type sequence. Of 11 specimens studied for translocation t(11;19), 2 cases harbored the translocation. It is concluded that cutaneous hidradenocarcinomas show some microscopic heterogeneity and comprise both low- and high-grade lesions that cytologically are similar to their benign counterpart, the hidradenoma. Within the spectrum of low-grade lesions, there seem to exist tumors almost indistinguishable from hidradenomas but still being capable of regional or distant metastasis. Similar to hidradenomas, hidradenocarcinomas show a t(11;19) translocation, but it is a significantly rarer event. Even rarer is the amplification of the Her2/neu gene. Of note is the relatively low frequency of TP53 mutations despite a high rate of p53 protein expression at the immunohistochemical level.

Practical strategies for developing the business case for hospital glycemic control teams.

PubMed

Magee, Michelle F; Beck, Adam

2008-09-01

Many business models may be used to make the business case for support of a multidisciplinary team to implement targeted glucose control in the hospital. Models may be hospital-supported or self-supporting. In the former, the hospital provides financial support based on improved documentation opportunities, reduction in length of stay, and improved resource utilization. In the latter, clinical revenues for diabetes management offsets costs of salary, fringe benefits, and overheads. A combination of these strategies may also be used. The business plan presented to administration must justify return on investment. It is imperative to involve hospital administration, particularly representatives from coding, billing, and finance, in the development of the business plan. The business case for hospital support will be based on opportunities related to improving accuracy of documentation and coding for diabetes-related diagnoses, including level of control and complications present, on reduction in length of stay and on optimization of resource utilization through reduction in morbidity and mortality (cost aversion). The case for revenue generation through billing for clinical services will be based on opportunities to increase the provision of glycemic management services in the hospital. Examples from the literature and of analyses to support each of these models are presented. (c) 2008 Society of Hospital Medicine.

RF Ablation of Giant Hemangiomas Inducing Acute Renal Failure: A Report of Two Cases

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

Tilborg, Aukje A. J. M. van, E-mail: a.vantilborg@vumc.nl; Dresselaars, Helena F.; Scheffer, Hester J.

ObjectiveIn patients that require treatment for hepatic giant cavernous hemangiomas (GCH), radiofrequency ablation (RFA) has been suggested to represent a safe and effective alternative to invasive surgery. In a recent report of bipolar RFA, using two expandable needle electrodes, was uneventfully performed in patients with large GCH (>10 cm). The objective of this report is to present two cases in which bipolar RFA of symptomatic GCH was complicated by acute kidney injury.Materials and methodsIn 2015 we treated two patients for very large symptomatic GCH (15.7 and 25.0 cm) with bipolar RFA during open laparotomy.ResultsIn both patients the urine showed a red–brown discolorationmore » directly after the ablation. They became anuric and presented with progressive dyspnea, tachypnea, and tachycardia, requiring hemodialysis for a period of 1 month in one case. Lab results revealed hemepigment-induced acute kidney. Both patients fully recovered and both showed a complete relief of symptoms at 3 months following the procedure.ConclusionRFA for large GCHs can cause hemepigment-induced acute kidney injury due to massive intravascular hemolysis. The presented cases suggest that caution is warranted and advocate an upper limit regarding the volume of GCHs that can be safely ablated.« less

Multilevel thoracic hemangioma with spinal cord compression in a pediatric patient: case report and review of the literature.

PubMed

Cherian, Jacob; Sayama, Christina M; Adesina, Adekunle M; Lam, Sandi K; Luerssen, Thomas G; Jea, Andrew

2014-09-01

Vertebral hemangiomas are common benign vascular tumors of the spine. It is very rare for these lesions to symptomatically compress neural elements. If spinal cord compression does occur, it usually involves only a single level. Multilevel vertebral hemangiomas causing symptomatic spinal cord compression have never been reported in the pediatric population to the best of our knowledge. We report the case of a 15-year-old boy presenting with progressive paraparesis due to thoracic spinal cord compression from a multilevel thoracic hemangioma (T5-T10) with epidural extension. Because of his progressive neurological deficit, he was initially treated with urgent multilevel decompressive laminectomies from T4 to T11. This was to be followed by radiotherapy for residual tumor, but the patient was unfortunately lost to follow-up. He re-presented 3 years later with recurrent paraparesis and progressive disease. This was treated with urgent radiotherapy with good response. As of 6 months follow-up, he has made an excellent neurological recovery. In this report, we present the first case of a child with multilevel vertebral hemangiomas causing symptomatic spinal cord compression and review the literature to detail the pathophysiology, management, and treatment of other cases of spinal cord compression by vertebral hemangiomas.

Isolation of Leptospira interrogans serovar Hardjoprajitno from a calf with clinical leptospirosis in Chile.

PubMed

Salgado, Miguel; Otto, Barbara; Moroni, Manuel; Sandoval, Errol; Reinhardt, German; Boqvist, Sofia; Encina, Carolina; Muñoz-Zanzi, Claudia

2015-03-18

Although Leptospira isolation has been reported in Chilean cattle, only serological evidence of serovar Hardjo bovis infection has been routinely reported. The present report provides characterization of the pathological presentation and etiology of a clinical case of leptospirosis in a calf from the Los Rios Region in Chile. In a dairy herd in southern Chile, 11 of 130 calves died after presenting signs such as depression and red-tinged urine. One of these calves, a female of eight months, was necropsied, and all the pathological findings were consistent with Leptospira infection. A urine sample was submitted to conventional bacteriological analysis together with highly specific molecular biology typing tools, in order to unravel the specific Leptospira specie and serovar associated with this clinical case. A significant finding of this study was that the obtained isolate was confirmed by PCR as L. interrogans, its VNTR profile properly matching with L. interrogans Hardjoprajitno as well as its specific genomic identity revealed by secY gen. Leptospira interrogans serovar Hardjoprajitno was associated with the investigated calf clinical case. This information adds to the value of serologic results commonly reported, which encourage vaccination improvements to match circulating strains. In addition, this finding represents the first case report of this serovar in Chilean cattle.

Case Reports of Five Cancer Patients with Unusual Course.

PubMed

Payrhuber, Dietmar; Thieves, Karin; Sangaletti, Piero; Muehlmann, Josef; Frass, Michael

2018-06-16

 The analysis of the periodic table of elements by Jan Scholten opened the way for a new kind of classification and repertorisation of homeopathic remedies. Thereby, group analysis (resorting to series and stages) makes precise prescriptions possible. This approach appears to yield striking results, even in severe cases. Whereas Hahnemann stressed the emotional state ('Gemüthssymptome', Organon § 210) when choosing a remedy, Scholten 200 years later investigated the mental picture that represents a life conflict or even a life theme that may maintain the disease process. The person's environment, emotional traumas or a conflict drives him or her to suppress and dissect painful emotions. Such compensations can become subconscious and so strong that they can no longer be controlled; they then influence the patient with a highly destructive energy.  We present five case reports, each dealing with an unusual clinical course of severe cancer associated with homeopathic treatment using the Scholten method.  By presenting these cases, we consider how the constitution (lifelong signs and symptoms of the patient) and the mental state are interwoven and, as a complex mechanism, might provoke disease.  The appropriate homeopathic remedy, reflecting the Scholten approach, seemed to have beneficial impact on the disease process of the five individuals presented. The Faculty of Homeopathy.

Neonatal Bartter syndrome and unilateral ectopic renal cyst as new renal causes of hydrops fetalis: two case reports and review of the literature.

PubMed

Çetinkaya, Merih; Durmaz, Oguzhan; Büyükkale, Gökhan; Ozbek, Sibel; Acar, Deniz; Kilicaslan, Isin; Kavuncuoglu, Sultan

2013-07-01

Non-immune hydrops fetalis (NIHF) is a challenging entity as it represents the end stage of several different disorders. Renal and genitourinary causes of NIHF are rare and include congenital renal malformations, tumors and ureter-urethra disorders. Herein, two NIHF cases with different renal causes were presented. The first case that had antenatal NIHF was diagnosed neonatal Bartter syndrome. The second case of NIHF with antenatal large cyst in the surrenal gland area required surgery and ectopic renal cyst was diagnosed. To our best of knowledge, these are the first reports of NIHF associated with neonatal Bartter syndrome and ectopic renal cyst in neonates. Although it may be coincidental, these cases suggest that both neonatal Bartter syndrome and unilateral ectopic renal cyst may cause NIHF development in neonates by several different mechanisms. Therefore, these two rare entities should be suspected in cases of NIHF with similar findings.

Prediction of Disease Case Severity Level To Determine INA CBGs Rate

NASA Astrophysics Data System (ADS)

Puspitorini, Sukma; Kusumadewi, Sri; Rosita, Linda

2017-03-01

Indonesian Case-Based Groups (INA CBGs) is case-mix payment system using software grouper application. INA CBGs consisting of four digits code where the last digits indicating the severity level of disease cases. Severity level influence by secondary diagnosis (complications and co-morbidity) related to resource intensity level. It is medical resources used to treat a hospitalized patient. Objectives of this research is developing decision support system to predict severity level of disease cases and illustrate INA CBGs rate by using data mining decision tree classification model. Primary diagnosis (DU), first secondary diagnosis (DS 1), and second secondary diagnosis (DS 2) are attributes that used as input of severity level. The training process using C4.5 algorithm and the rules will represent in the IF-THEN form. Credibility of the system analyzed through testing process and confusion matrix present the results. Outcome of this research shows that first secondary diagnosis influence significant to form severity level predicting rules from new disease cases and INA CBGs rate illustration.

Continuous Minor Bleeding from Tumor Surface in Patients with Craniopharyngiomas: Case Series of Nonobstructive Hydrocephalus.

PubMed

Shoji, Takuhiro; Kawaguchi, Tomohiro; Ogawa, Yoshikazu; Watanabe, Mika; Fujimura, Miki; Tominaga, Teiji

2018-06-05

Nonobstructive hydrocephalus in patients with craniopharyngiomas is uncommon. We describe our surgical series of 25 consecutive patients with craniopharyngioma who presented with hydrocephalus. Obstructive hydrocephalus was evident in most cases, and nonobstructive hydrocephalus was revealed in three cases. Even after improvement of cerebrospinal fluid (CSF) pathway obstruction by tumor removal, 10 patients (40%) required CSF diversion. Preoperative imaging study revealed thin intraventricular hemorrhage or superficial siderosis in five cases, and CSF examination revealed hemosiderin-laden phagocytes in one case. These findings indicate continuous bleeding into the CSF that might be associated with CSF malabsorption. We also describe a representative case of craniopharyngioma associated with nonobstructive hydrocephalus due to continuous minor bleeding from the tumor surface in a 62-year-old man with a complaint of disorientation and a decline in daily living activity.Our study demonstrated that minor bleeding into the CSF is a possible mechanism of the development of nonobstructive hydrocephalus in patients with craniopharyngiomas. Georg Thieme Verlag KG Stuttgart · New York.

BACTERIAL MENINGITIS AND OTHER DISEASES AFFECTING THE MENINGES—A Review of 349 Cases

PubMed Central

Cover, William L.

1949-01-01

Three hundred and forty-nine cases of disease affecting the meninges were observed at the San Bernardino County Charity Hospital in an eight year period. A total of 29 patients with meningococcal, H. influenzae and pneumococcal meningitis were treated. There were four deaths, of which three occurred during the first 24 hours in the hospital. Of 22 cases of unclassified meningitis, four probably were tuberculous, four probably were meningococcal and two probably were of virus origin. Under present treatment programs the differentiation between viral and bacterial meningitides is difficult and it is possible, therefore, that the reported incidence of the two groups may not represent the facts. Of 22 cases of unclassified meningitis, 12 had no specific characteristics which would permit a clinical diagnosis. One of the patients died. Of 70 cases of clinical meningitis, the infecting organism was identified in 69 per cent. Meningococcal meningitis made up only 17 per cent of 70 cases of purulent meningitis observed between July 1, 1945, and July 1, 1948. PMID:18137216

Revisiting Mendel and the Paradox of Gene Restoration

NASA Astrophysics Data System (ADS)

Lolle, Susan J.

2006-03-01

According to the laws of classical Mendelian genetics, genetic information contained in the nuclear genome is stably inherited and is transmitted from one generation to the next in a predictable manner. Several exceptions to the principle of stable inheritance are known but all represent specialized cases where the mechanisms have been relatively well defined. We have recently demonstrated that Arabidopsis plants can inherit specific DNA sequence information that was not present in the chromosomal genome of their parents. This process appears to occur throughout the nuclear genome. Based on our findings we propose that this process represents a completely novel and hitherto unknown mechanism for the maintenance and inheritance of DNA sequence information.

The influence of climate variables on dengue in Singapore.

PubMed

Pinto, Edna; Coelho, Micheline; Oliver, Leuda; Massad, Eduardo

2011-12-01

In this work we correlated dengue cases with climatic variables for the city of Singapore. This was done through a Poisson Regression Model (PRM) that considers dengue cases as the dependent variable and the climatic variables (rainfall, maximum and minimum temperature and relative humidity) as independent variables. We also used Principal Components Analysis (PCA) to choose the variables that influence in the increase of the number of dengue cases in Singapore, where PC₁ (Principal component 1) is represented by temperature and rainfall and PC₂ (Principal component 2) is represented by relative humidity. We calculated the probability of occurrence of new cases of dengue and the relative risk of occurrence of dengue cases influenced by climatic variable. The months from July to September showed the highest probabilities of the occurrence of new cases of the disease throughout the year. This was based on an analysis of time series of maximum and minimum temperature. An interesting result was that for every 2-10°C of variation of the maximum temperature, there was an average increase of 22.2-184.6% in the number of dengue cases. For the minimum temperature, we observed that for the same variation, there was an average increase of 26.1-230.3% in the number of the dengue cases from April to August. The precipitation and the relative humidity, after analysis of correlation, were discarded in the use of Poisson Regression Model because they did not present good correlation with the dengue cases. Additionally, the relative risk of the occurrence of the cases of the disease under the influence of the variation of temperature was from 1.2-2.8 for maximum temperature and increased from 1.3-3.3 for minimum temperature. Therefore, the variable temperature (maximum and minimum) was the best predictor for the increased number of dengue cases in Singapore.

Aspects of renal function in patients with colorectal cancer in a gastroenterology clinic of a county hospital in Western Romania.

PubMed

Velciov, Silvia; Hoinoiu, B; Hoinoiu, Teodora; Popescu, Alina; Gluhovschi, Cristina; Grădinaru, Oana; Popescu, Mădalină; Moţiu, Flavia; Timar, R; Gluhovschi, G H; Sporea, I

2013-01-01

Colorectal cancer represents the third cause of cancer. Since its detection in due time is important resolution, appropriate monitoring is mandatory. The present study deals with the relationship between colorectal cancer and renal function, as well as other associated risk factors. Chronic kidney disease (CKD) represents a risk factor of cancer, both in non-dialysed patients and especially in dialysed patients and in patients with renal transplant. It can get aggravated with cancer in general and particularly with colorectal cancer, partly related to the toxins that cannot be appropriately eliminated because of renal functional disturbances. At the same time, immunosuppressive therapy used for treating glomerular or secondary nephropathies represents an important risk factor of cancer. Some patients with colorectal cancer were found to present also impaired renal function, a fact whose significance is still little known. The object of the present paper is an analysis of the case records of a clinic of gastroenterology on the relationship between colorectal cancer and renal functional impairment. We found in the patients with colorectal cancer under study a glomerular filtration rate (GFR calculated with the EPI formula) of < 60 ml/min/1.73m2 in 31/180 patients, respectively 17.22% of the cases, a value that is similar to that in specialised literature. We also analysed associated risk factors that could be related to renal function impairment in these patients: age, gender, anaemia, diabetes mellitus and hypertension. These could represent, together with the colorectal cancer of the investigated patients, risk factors affecting on the one hand renal function, and on the other hand, potentially increasing the risk of cancer. Correction of these risk factors would have beneficial effects on patients. The relationship between renal functional impairment, respectively CKD, and colorectal cancer is to be regarded from the point of view of complex reciprocity: the impairment of the renal function is a factor of risk of colorectal cancer and colorectal cancer can influence renal function of these patients. This report of reciprocity based on important pathogenic mechanisms also interrelates with factors of risk consecutive to both renal function impairment and colorectal cancer.

Department of Defense Strategic and Business Case Analyses for Commercial Products in Secure Mobile Computing

DTIC Science & Technology

2011-06-01

Selected Security Features in BlackBerry and SME PED Devices...Figure 1, the blue bars represent the net present value (NPV) of costs for current DoD wireless services on the unclassified (e.g., BlackBerry ) and...PDA], Blackberry , iPhone, etc.) for both Battle Command applications and communications and secure data only that needs to be classified as part of

A Systems Analysis and Design Case Study for a Business Modeling Learning Experience for a Capstone CIS/IS Systems Development Class

ERIC Educational Resources Information Center

Russell, Jack; Russell, Barbara

2015-01-01

The goal is to provide a robust and challenging problem statement for a capstone, advanced systems analysis and design course for CIS/MIS/CS majors. In addition to the problem narrative, a representative solution for much of the business modeling deliverables is presented using the UML paradigm. A structured analysis deliverable will be the topic…

Fast flux locked loop

DOEpatents

Ganther, Jr., Kenneth R.; Snapp, Lowell D.

2002-09-10

A flux locked loop for providing an electrical feedback signal, the flux locked loop employing radio-frequency components and technology to extend the flux modulation frequency and tracking loop bandwidth. The flux locked loop of the present invention has particularly useful application in read-out electronics for DC SQUID magnetic measurement systems, in which case the electrical signal output by the flux locked loop represents an unknown magnetic flux applied to the DC SQUID.

True or false coral snake: is it worth the risk? A Micrurus corallinus case report.

PubMed

Strauch, Marcelo Abrahão; Souza, Guilherme Jones; Pereira, Jordana Nahar; Ramos, Tyelli Dos Santos; Cesar, Marcelo Oliveira; Tomaz, Marcelo Amorim; Monteiro-Machado, Marcos; Patrão-Neto, Fernando Chagas; Melo, Paulo A

2018-01-01

Bites provoked by the genus Micrurus represent less than 1% of snakebite cases notified in Brazil, a tiny fraction compared with other genus such as Bothrops and Crotalus , which together represent almost 80% of accidents. In addition to their less aggressive behavior, habits and morphology of coral snakes are determinant factors for such low incidence of accidents. Although Micrurus bites are rare, victims must be rescued and hospitalized in a short period of time, because this type of envenoming may evolve to a progressive muscle weakness and acute respiratory failure. We report an accident caused by Micrurus corallinus involving a 28-year-old Caucasian sailor man bitten on the hand. The accident occurred in a recreational camp because people believed the snake was not venomous. The victim presented neurological symptoms 2 h after the accident and was taken to the hospital, where he received antielapidic serum 10 h after the bite. After the antivenom treatment, the patient presented clinical evolution without complications and was discharged 4 days later. We reinforce that it is essential to have a health care structure suitable for the treatment of snakebite. Besides, the manipulation of these animals should only be carried out by a team of well-equipped and trained professionals, and even so with special attention.

Thermal activation of dislocations in large scale obstacle bypass

NASA Astrophysics Data System (ADS)

Sobie, Cameron; Capolungo, Laurent; McDowell, David L.; Martinez, Enrique

2017-08-01

Dislocation dynamics simulations have been used extensively to predict hardening caused by dislocation-obstacle interactions, including irradiation defect hardening in the athermal case. Incorporating the role of thermal energy on these interactions is possible with a framework provided by harmonic transition state theory (HTST) enabling direct access to thermally activated reaction rates using the Arrhenius equation, including rates of dislocation-obstacle bypass processes. Moving beyond unit dislocation-defect reactions to a representative environment containing a large number of defects requires coarse-graining the activation energy barriers of a population of obstacles into an effective energy barrier that accurately represents the large scale collective process. The work presented here investigates the relationship between unit dislocation-defect bypass processes and the distribution of activation energy barriers calculated for ensemble bypass processes. A significant difference between these cases is observed, which is attributed to the inherent cooperative nature of dislocation bypass processes. In addition to the dislocation-defect interaction, the morphology of the dislocation segments pinned to the defects play an important role on the activation energies for bypass. A phenomenological model for activation energy stress dependence is shown to describe well the effect of a distribution of activation energies, and a probabilistic activation energy model incorporating the stress distribution in a material is presented.

[Anterior skull-base schwannoma].

PubMed

Esquivel-Miranda, Miguel; De la O Ríos, Elier; Vargas-Valenciano, Emmanuelle; Moreno-Medina, Eva

Schwannomas are nerve sheath tumours that originate in Schwann cells. They are usually solitary and sporadic and manifest on peripheral, spinal or cranial nerves. Intracranial schwannomas tend to manifest on the eighth cranial nerve, particularly in patients with neurofibromatosis type2. Anterior skull-base schwannomas represent less than 1% of all intracranial schwannomas. They are more frequent in young people and are typically benign. These tumours represent a diagnostic challenge due to their rarity and difficult differential diagnosis, and numerous theories have been postulated concerning their origin and development. In this article, we present the case of a 13-year-old male with a single anterior cranial-base tumour not associated with neurofibromatosis who presented with headache, papilloedema, eye pain and loss of visual acuity. Complete resection of the tumour was performed, which was histopathologically diagnosed as a schwannoma. The patient made a complete clinical recovery with abatement of all symptoms. We conducted a review of the literature and found 66 cases worldwide with this diagnosis. We describe the most relevant epidemiological and clinical characteristics of this kind of tumour and its relation with the recently discovered and similar olfactory schwannoma. Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

Risk-stratification, resource availability, and choice of surgical location for the management of parturients with abnormal placentation: a survey of United States-based obstetric anesthesiologists.

PubMed

Grant, T R; Ellinas, E H; Kula, A O; Muravyeva, M Y

2018-05-01

Parturients with abnormally adherent placentas present anesthetic challenges that include risk-stratification, management planning and resource utilization. The labor and delivery unit may be remote from the main operating room services. Division chiefs of North American obstetric anesthesiology services were surveyed about their practices and management of parturients with an abnormally adherent placenta. Eighty-four of 122 chiefs, representing 103 hospital sites, responded to the survey (response rate 69%). Sixty-one percent of respondents agreed that women with preoperative placental imaging that was "suspicious" of placenta accreta represented a lower risk category; all other suggested descriptions fell into a higher risk category. Seventy-nine percent of respondents indicated that lower risk cases were managed on the labor and delivery unit, while 71% indicated that higher risk cases would be managed in the main operating room. Institutions where all cases were managed on the labor and delivery unit had better access to human and technical resources, were less remote from their main operating areas, and promoted neuraxial rather than general anesthesia, even for parturients perceived to be at higher risk. Obstetric anesthesia leaders identified patients at lower clinical risk and those less likely to require greater resources. Additional resources were available in institutions where all abnormal placentation cases were managed on the labor and delivery unit. Practitioners should consider risk-stratification and resource availability when planning high-risk cases. Copyright © 2018 Elsevier Ltd. All rights reserved.

The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC) case register: development and descriptive data

PubMed Central

Stewart, Robert; Soremekun, Mishael; Perera, Gayan; Broadbent, Matthew; Callard, Felicity; Denis, Mike; Hotopf, Matthew; Thornicroft, Graham; Lovestone, Simon

2009-01-01

Background Case registers have been used extensively in mental health research. Recent developments in electronic medical records, and in computer software to search and analyse these in anonymised format, have the potential to revolutionise this research tool. Methods We describe the development of the South London and Maudsley NHS Foundation Trust (SLAM) Biomedical Research Centre (BRC) Case Register Interactive Search tool (CRIS) which allows research-accessible datasets to be derived from SLAM, the largest provider of secondary mental healthcare in Europe. All clinical data, including free text, are available for analysis in the form of anonymised datasets. Development involved both the building of the system and setting in place the necessary security (with both functional and procedural elements). Results Descriptive data are presented for the Register database as of October 2008. The database at that point included 122,440 cases, 35,396 of whom were receiving active case management under the Care Programme Approach. In terms of gender and ethnicity, the database was reasonably representative of the source population. The most common assigned primary diagnoses were within the ICD mood disorders (n = 12,756) category followed by schizophrenia and related disorders (8158), substance misuse (7749), neuroses (7105) and organic disorders (6414). Conclusion The SLAM BRC Case Register represents a 'new generation' of this research design, built on a long-running system of fully electronic clinical records and allowing in-depth secondary analysis of both numerical, string and free text data, whilst preserving anonymity through technical and procedural safeguards. PMID:19674459

Management of patients during hunger strike and refeeding phase.

PubMed

Eichelberger, M; Joray, M L; Perrig, M; Bodmer, M; Stanga, Z

2014-01-01

Hunger strikers resuming nutritional intake may develop a life-threatening refeeding syndrome (RFS). Consequently, hunger strikers represent a core challenge for the medical staff. The objective of the study was to test the effectiveness and safety of evidence-based recommendations for prevention and management of RFS during the refeeding phase. This was a retrospective, observational data analysis of 37 consecutive, unselected cases of prisoners on a hunger strike during a 5-y period. The sample consisted of 37 cases representing 33 individual patients. In seven cases (18.9%), the hunger strike was continued during the hospital stay, in 16 episodes (43.2%) cessation of the hunger strike occurred immediately after admission to the security ward, and in 14 episodes (37.9%) during hospital stay. In the refeed cases (n = 30), nutritional replenishment occurred orally, and in 25 (83.3%) micronutrients substitutions were made based on the recommendations. The gradual refeeding with fluid restriction occurred over 10 d. Uncomplicated dyselectrolytemia was documented in 12 cases (40%) within the refeeding phase. One case (3.3%) presented bilateral ankle edemas as a clinical manifestation of moderate RFS. Intensive medical treatment was not necessary and none of the patients died. Seven episodes of continued hunger strike were observed during the entire hospital stay without medical complications. Our data suggested that seriousness and rate of medical complications during the refeeding phase can be kept at a minimum in a hunger strike population. This study supported use of recommendations to optimize risk management and to improve treatment quality and patient safety in this vulnerable population. Copyright © 2014 Elsevier Inc. All rights reserved.

Using Case-Based Pedagogy in the Philippines: A Narrative Inquiry

NASA Astrophysics Data System (ADS)

Arellano, Elvira L.; Barcenal, Tessie L.; Bilbao, Purita P.; Castellano, Merilin A.; Nichols, Sharon E.; Tippins, Deborah J.

2001-04-01

This study features use of case-based pedagogy as a context for exploring science teacher education reform. A central premise of the study is that science teacher education reform is a complex process characterised by the individual and collective narrative histories of teachers. The study was conducted at West Visayas State University in the Philippines as a collaborative research endeavour involving two US and four Filipino science teacher educators. The centrepiece of this study was a case experience prompted by reflection on prospective and practicing elementary teachers' written cases. Results of the study are presented here as a layered narrative. An initial layer explores how a case, written by a prospective teacher, was interwoven with her past and future life history. A second layer looks at sociocultural and professional tensions that mediated the participants' case experience. A third layer represents how the case experience provided a community that supported critical reflection among the research team members. Implications from the study emphasise that case-based pedagogy can serve as a basis for critical reflection to inform community-based approaches to science teacher education pedagogical and research reform.

Putting environmental economics in perspective: case study of Four Corners Power Plant, New Mexico.

PubMed Central

Bartlit, J R

1979-01-01

Environmental control costs can be made to appear much larger in impact than they actually are by placing costs in misleading contexts or failing to provide perspective. It is essential for continued public support of environmental health programs that this practice be countered by more meaningful presentations of economic data. As an example, analytic methods appropriate to the case of a large coal-fired power plant in northwestern New Mexico are developed and disucssed. Pollution control expenditures at the Four Corners Power Plant in northwestern New Mexico were presented to the public as costing $82 annually. Although this figure may be the correct one, data were collected and analyzed to show that this cost represented an increase of only 5 to 60 cents on a $100 electricity bill for the consumer of electricity. PMID:507248

A case of metronidazole-resistant Trichomonas vaginalis in pregnancy.

PubMed

Forbes, Georgina L; Drayton, Rachel; Forbes, Gavin D

2016-09-01

Trichomonas vaginalis is a sexually transmitted protozoan infection resulting in vulvo-vaginitis and altered vaginal discharge in symptomatic women. Trichomoniasis has been implicated in causing adverse pregnancy outcomes such as low birth weight and pre-term labour. Metronidazole is the recommended first-line treatment for trichomonal infection. Other nitroimidazoles, such as tinidazole, are used as alternative regimens with similar activity but at a greater expense. Treatment failure usually represents patient non-compliance or re-infection, although metronidazole resistance has previously been documented. Antimicrobial susceptibility testing for T. vaginalis is currently not available in the UK. Patients with disease unresponsive to first-line treatments pose a major challenge, as therapeutic options are limited. We present the case of a patient with presumed resistant infection during pregnancy, and the additional treatment issues that this presented. © The Author(s) 2015.

A discussion on the origin of quantum probabilities

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

Holik, Federico, E-mail: olentiev2@gmail.com; Departamento de Matemática - Ciclo Básico Común, Universidad de Buenos Aires - Pabellón III, Ciudad Universitaria, Buenos Aires; Sáenz, Manuel

We study the origin of quantum probabilities as arising from non-Boolean propositional-operational structures. We apply the method developed by Cox to non distributive lattices and develop an alternative formulation of non-Kolmogorovian probability measures for quantum mechanics. By generalizing the method presented in previous works, we outline a general framework for the deduction of probabilities in general propositional structures represented by lattices (including the non-distributive case). -- Highlights: •Several recent works use a derivation similar to that of R.T. Cox to obtain quantum probabilities. •We apply Cox’s method to the lattice of subspaces of the Hilbert space. •We obtain a derivationmore » of quantum probabilities which includes mixed states. •The method presented in this work is susceptible to generalization. •It includes quantum mechanics and classical mechanics as particular cases.« less

Imitating the Great Imitator The Intersection of Sarcoidosis and Hodgkin's Lymphoma A Report of Two Cases.

PubMed

Outlaw, Darryl; Mehta, Amitkumar; Dalvi, Sam R

2018-06-01

Sarcoidosis and Hodgkin's lymphoma represent two distinct diseases with different pathogenic mechanisms, therapeutic interventions, and prognoses. Nevertheless, both diseases can have overlapping presentations, thus blurring the line between successful identification and treatment. A propensity to develop one of these diseases following diagnosis of the other has long been appreciated. Here we review two cases of presumed sarcoidosis that were ultimately diagnosed as Hodgkin's lymphoma. Both patients initially presented with non-specific symptoms and underwent a thorough workup, including histological evaluation demonstrating non-caseating granulomas without evidence of malignancy. Both patients started sarcoid-directed therapies with relapse of symptoms. Repeat imaging and tissue biopsy eventually led to the diagnosis of stage IVB Hodgkin's lymphoma. After the initiation of Hodgkin's-directed therapies, both patients showed marked clinical responses, and entered complete remission.

Parasuicidal poisoning by intramuscular injection of insecticide: A case report.

PubMed

Liu, Huimin; Kan, Baotian; Jian, Xiangdong; Zhang, Wei; Zhou, Qian; Wang, Jieru

2013-09-01

Suicidal poisoning by ingestion of organophosphate (OP) insecticides represents a serious emergency with a high mortality rate. However, attempted suicide via the parenteral route has rarely been reported. The present study reports a case of parasuicide by self-injection of an organophosphorus insecticide (phoxim, phenylglyoxylonitrile oxime O,O-diethyl phosphorothioate) into the distal region of the left arm. The patient developed necrosis at the injection site and an abscess of the affected limb following injection. A fasciotomy and surgical debridement resulted in the symptoms of the patient disappearing within a few days and were vital in shortening the course of the disease.

Parasuicidal poisoning by intramuscular injection of insecticide: A case report

PubMed Central

LIU, HUIMIN; KAN, BAOTIAN; JIAN, XIANGDONG; ZHANG, WEI; ZHOU, QIAN; WANG, JIERU

2013-01-01

Suicidal poisoning by ingestion of organophosphate (OP) insecticides represents a serious emergency with a high mortality rate. However, attempted suicide via the parenteral route has rarely been reported. The present study reports a case of parasuicide by self-injection of an organophosphorus insecticide (phoxim, phenylglyoxylonitrile oxime O,O-diethyl phosphorothioate) into the distal region of the left arm. The patient developed necrosis at the injection site and an abscess of the affected limb following injection. A fasciotomy and surgical debridement resulted in the symptoms of the patient disappearing within a few days and were vital in shortening the course of the disease. PMID:24137249

[Fault, sacrifice and traumatic neurosis. Apropos of a case].

PubMed

Clervoy, P; Lebigot, F

1994-04-01

The present case is one of a patient suffering from traumatic neurosis, on whom psychotherapeutic work has been possible. The traumatic experience, which dates back to the Franco-Algerian War, could have gradually started making sense in the context of its onset and of the state in which the relationship between the patient and his father remained at the time. Something along the lines of an irrevocable mistake, irrevocable since logically referred to as a serious moral mistake on the part of the father towards his son, renders humanely comprehensible his upkeep of his atrocity as represented by the repetition of the revival symptoms.

Melorheostosis with ipsilateral nevus sebaceus (didymosis melorheosebacea).

PubMed

Tinschert, Sigrid; Stein, Anette; Göldner, Burkhard; Dietel, Manfred; Happle, Rudolf

2003-01-01

We report an unusual case of unilateral melorheostosis and ipsilateral extensive sebaceous nevus. Because the two conditions affected the same side of the body, we hypothesize that they originated from a common genetic mechanism. The temporal and spatial co-occurrence may represent a further example of non-allelic didymosis (twin spotting). The embryo would carry two different recessive mutations at one gene locus or at linked loci on either of a pair of homologous chromosomes. Postzygotic recombination occurring during early embryonic development would result in two different populations of cells homozygous for either mutation. If this concept holds true, the present case may be described as " didymosis melorheosebacea ".