Primary aneurysmal bone cyst of coronoid process

PubMed Central

Goyal, Amit; Tyagi, Isha; Syal, Rajan; Agrawal, Tanu; Jain, Manoj

2006-01-01

Background Aneurysmal bone cysts are relatively uncommon in the facial skeleton. These usually affect the mandible but origin from the coronoid process is even rarer. To the best of our knowledge, this is the first reported case of a coronoid process aneurysmal bone cyst presenting as temporal fossa swelling. Case presentation A 17 year old boy presented with a progressively increasing swelling in the left temporal region developed over the previous 8 months. An expansile lytic cystic lesion originating from the coronoid process of the left mandible and extending into the infratemporal and temporal fossa regions was found on CT scan. It was removed by a superior approach to the infratemporal fossa. Conclusion Aneurysmal bone cyst of the coronoid process can attain enormous dimensions until the temporal region is also involved. A superior approach to the infratemporal fossa is a reasonable approach for such cases, providing wide exposure and access to all parts of the lesion and ensuring better control and complete excision. PMID:16533409

Heating, moisture, and water budgets of tropical and midlatitude squall lines - Comparisons and sensitivity to longwave radiation

NASA Technical Reports Server (NTRS)

Tao, W.-K.; Simpson, J.; Sui, C.-H.; Ferrier, B.; Lang, S.; Scala, J.; Chou, M.-D.; Pickering, K.

1993-01-01

A 2D time-dependent and nonhydrostatic numerical cloud model is presently used to estimate the heating, moisture, and water budgets in the convective and stratiform regions for both a tropical and a midlatitude squall line. The model encompasses a parameterized, three-class ice phase microphysical scheme and longwave radiative transfer process. It is noted that the convective region plays an important role in the generation of stratiform rainfall for both cases. While a midlevel minimum in the moisture profile for the tropical case is due to vertical eddy transport in the convective region, the contribution to the heating budget by the cloud-scale fluxes is minor; by contrast, the vertical eddy heat-flux is relatively important for the midlatitude case due to the stronger vertical velocities present in the convective cells.

A Giant Vulvar Mass: A Case Study of Cellular Angiofibroma

PubMed Central

Aydın, Ümit; Terzi, Hasan; Turkay, Ünal; Eruyar, Ahmet Tuğrul; Kale, Ahmet

2016-01-01

Cellular angiofibroma is a mesenchymal tumor that affects both genders. Nucci et al. first described it in 1997. Cellular angiofibroma is generally a small and asymptomatic mass that primarily arises in the vulvar-vaginal region, although rare cases have been reported in the pelvic and extrapelvic regions. It affects women most often during the fifth decade of life. The treatment requires simple local excision due to low local recurrence and no chance of metastasization. The current study presents a case of angiofibroma in the vulvar region that measured approximately 20 cm. PMID:27293929

Glomus tumor presenting as complex regional pain syndrome of the left upper limb: a case report.

PubMed

Macharia, Chege; Nthumba, Peter M

2015-12-29

Glomus tumors of the hand are rare, benign but debilitating neoplasms arising from the neuromyoarterial glomus body. They may present a diagnostic dilemma, and take years with multiple consultations and investigations before an appropriate diagnosis is made, but once a diagnosis is made, surgical excision is curative. This is a case presentation of a 35-year-old African man who presented with complex regional pain syndrome of his left upper extremity, whose genesis was found to be a glomus tumor of the pulp of his left middle finger. Surgical excision resulted in resolution of the chronic regional pain syndrome and a return to a normal lifestyle. Chronic regional pain syndrome is a rare presentation of a glomus tumor, which has only been previously reported in patients with neurofibromatosis type 1, and one patient who did not have neurofibromatosis. Patients with glomus tumors may spend many years in pain and distress because of misdiagnosis. Sensitization and education of both the public and health care workers will help in early diagnosis and treatment of this otherwise potentially disabling pathology for which surgical excision is curative.

Cervical bronchogenic cysts in head and neck region.

PubMed

Ustundag, Emre; Iseri, Mete; Keskin, Gurkan; Yayla, Berna; Muezzinoglu, Bahar

2005-06-01

Congenital cysts of the neck are not uncommon. Most of these are thyroglossal, branchial cleft and thymic cysts. Bronchogenic cysts are uncommon developmental anomalies of the tracheobronchial tree and rarely occur in the neck. More than 70 cases of bronchogenic cysts in the head and neck region have been reported in the literature. We report three cases presenting with neck swelling in the hyoid region that were diagnosed as bronchogenic cysts based on clinical and histopathological findings.

Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: a case series

PubMed Central

2009-01-01

Introduction Perioperative spinal myoclonus is extremely rare. Many anaesthetists and perioperative practitioners may not diagnose or manage this complication appropriately when it occurs. This case report of unusual acute spinal myoclonus following regional anaesthesia highlights certain aspects of this rare complication that have not previously been published. Case presentations A series of four consecutive patients who developed acute lower-limb myoclonus following spinal or epidural anaesthesia are described. The case series occurred at three different hospitals and involved four anaesthetists over a 3-year period. Two Caucasian men, aged 90-years-old and 67-years-old, manifested unilateral myoclonus. Two Caucasian women, aged 64-years-old and 53-years-old, developed bilateral myoclonus. Myoclonus was self-limiting in one patient, treated with further regional anaesthesia in one patient and treated with intravenous midazolam in two patients. The overall outcome was good in all patients, with no recurrence or sequelae in any of the patients. Conclusion This case series emphasizes that spinal myoclonus following regional anaesthesia is rare, has diverse pathophysiology and can have diverse presentations. The treatment of perioperative spinal myoclonus should be directed at the aetiology. Anaesthetists and perioperative practitioners who are unfamiliar with this rare complication should be reassured that it may be treated successfully with midazolam. PMID:19830168

An unusual case of fatal pulmonary hemorrhage in pregnancy

PubMed Central

Dissanayake, N. L. A; Madegedara, Dushantha

2011-01-01

Rickettsial diseases are common in Srilanka. The spotted fever group of rickettsiae presents in many ways, including very severe disease causing significant morbidity and mortality. A regional variation of the Rickettsia conorii subspecies and differences in clinical presentations are reported. This case describes disseminated Rickettsia conorii infection in a pregnant woman presenting with endocarditis. PMID:21886958

A Rare, Unusual Presentation of Primary Tuberculosis in the Temporomandibular Joint.

PubMed

Towdur, Geetha N; Upasi, Amarnath P; Veerabhadrappa, Umashankara Kagathur; Rai, Kirthikumar

2018-04-01

Tuberculosis (TB) is a very common health problem in developing nations such as India. It can present as its primary form or as secondary forms (extrapulmonary TB). Maxillofacial manifestations of TB compose nearly 10% of all extrapulmonary manifestations of the disease. Extrapulmonary TB involving the maxillofacial region is very rare and can present in any tissues in this region. These infections generally involve the head and neck through hematogenous or lymphatic routes. Very few cases of primary TB of the temporomandibular joint (TMJ) have been reported in the literature. The presentation of TB infection of the TMJ can resemble arthritis, osteomyelitis, or any other kind of chronic joint disease. It is very important to diagnose this disease at an early stage. If left untreated, it can prove fatal within 5 years in more than half the cases. Therefore, early diagnosis and management of these cases is critical. This article describes a case of primary TB of the TMJ that presented as a preauricular swelling. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Redefining Region: Social Construction in a Regional Watershed Education Partnership.

ERIC Educational Resources Information Center

Alibrandi, Marsha

What constitutes a region? In what ways do people define or construct the regions in which they live and work? This paper presents findings of a case study of a regional watershed partnership that examined the social ecological processes of social construction-in-action. The study sought to examine how a major watershed's educators collaborated to…

Giant Cutaneous Horn Overlying A Verruca at an Uncommon Site: Medical Marvel vs Superstitious Dilemma.

PubMed

Sanjeeva, Karthik Kathladka; Ali, Puttur Sainuddin Mohammed Ameer; Pinto, Malcolm; Rao, Srikar; Rai, Arvind Shivram

2015-04-01

Cutaneous horn has been a matter of discussion to mankind since time immemorial and a subject of fascination for the layman. There have been instances where certain groups saw it with angst and disgust, with a person having a large cutaneous horn on an exposed area getting a dismal look. We present a case of a 64-year-old man with a giant cutaneous horn over his left gluteal region. Cutaneous horns more commonly present in the sun-exposed areas. In our case it has presented in an uncommon site. The patient had delayed and denied medical treatment due to his superstitious beliefs, after having sought advice from faith healers leading to progression of the disease. This case has been presented for its giant size (rare variety), its location being over the gluteal region (photo-protected site) and its benign histopathology suggestive of wart in spite of the giant size.

SKS splitting results in central Italy and Dinaric region inside the AlpArray-CASE project

NASA Astrophysics Data System (ADS)

Salimbeni, S.; Prevolnik, S.; Pondrelli, S.; Molinari, I.; Stipcevic, J.; Kissling, E.; Šipka, V.; Herak, M.

2017-12-01

In the framework of the AlpArray project (AlpArray Seismic Network, 2015), the complementary "Central Adriatic Seismic Experiment" (CASE; AlpArray Seismic Network, 2016) was established as collaboration between ETH Zürich, University of Zagreb, INGV and Republic Hydrometeorological Service of Republic of Srpska. The CASE project consists of 9 temporary stations, installed in October 2016, located in Bosnia and Herzegovina, Croatia and Italy. Temporary broadband seismic stations, with the permanent stations present in the region shared by the Croatian Seismological Service and INGV, make an almost continuous transect cutting the Central-Southern Appenines, the central Adriatic region, central External Dinarides and finishing at the eastern margin of the Internal Dinarides. The presence of the the Apenninic and Dinarides slabs, verging in opposite directions and plunging along the opposite sides of the Adriatic plate, make this area a peculiar spot to understand the complex dynamic of the region. Various tomographic images (e.g. Bijwaard and Spakman, 2000; Piromallo and Morelli, 2003) shows not continuous slabs under the Appenines and the Dinarides, suggesting the presence of slab-gaps right beneath the region covered by the CASE experiment. Here we present the preliminary results of the SKS splitting analysis performed on the data recorded by the temporary and permanent seismic stations included in the CASE project. The new results, in combination with previous interpretation, will provide clues about how Northern and Southern Apennines are connected at depth, how the slab rollback of the Apennines thrust belt acted and if and how the Apennines are in relation with the Dinaric region. Together with the measurements from previous studies and from the AlpArray project, our new data will support the mapping of the seismic anisotropy deformation pattern from Western Alps to Pannonian region.

Local and Regional Spread of Primary Conjunctival Squamous Cell Carcinoma.

PubMed

Desai, Shilpa J; Pruzan, Noelle L; Geske, Michael J; Jeng, Bennie H; Bloomer, Michele M; Vagefi, M Reza

2016-04-06

Two cases of biopsy-proven conjunctival squamous cell carcinoma (SCC) that developed local and regional spread are described. The cases involved a 65-year-old woman and a 79-year-old man who were initially treated at outside institutions for SCC of the conjunctiva. The patients did not have a history of immune compromise. The female patient presented with direct extension into the lacrimal gland but deferred recommended exenteration. Despite eventual exenteration, she developed metastasis to a neck node 6 months later, which was treated with radiotherapy. The male patient presented with local recurrence and a parotid node metastasis treated with exenteration, parotidectomy, selective neck dissection, and postoperative radiotherapy. Review of the outside pathology of both cases revealed positive tumor margins at the time of original resection. Local control of conjunctival SCC is of critical importance to reduce the risk of orbital extension and regional spread.

Metastatic clear cell eccrine hidradenocarcinoma of the vulva: survival after primary surgical resection.

PubMed

Massad, L S; Bitterman, P; Clarke-Pearson, D L

1996-05-01

A case of clear cell eccrine hidradenocarcinoma of the vulva metastatic to regional lymph nodes with long survival after surgical resection is presented. Like the only other case reported to date, this suggests that surgical therapy alone may be adequate, even when metastasis is present.

Regional Disparities in Educational Development: A Controversial Issue.

ERIC Educational Resources Information Center

Carron, Gabriel, Ed.; Chau, Ta Ngoc, Ed.

To complement a volume of case studies, these four papers and an introduction discuss the problem of regional disparities in educational development from several different perspectives. Varying points of view are presented on the relationship between regional educational disparities and socioeconomic, political, and cultural development; the…

Transformation of a vascularised iliac crest or scapula bone to a pedicled osteomuscular transplant for reconstruction of distant defects in the head and neck region: a new method of transforming two island flaps to one longer island flap.

PubMed

Kärcher, Hans; Feichtinger, Matthias

2014-12-01

Bone defects in the maxillofacial region after ablative surgery require reconstructive surgery, usually using microvascular free flaps. This paper presents a new method of reconstructing extensive defects in patients not suitable for microvascular surgery using prefabrication of a vascularised osteomuscular flap from the scapula or iliac crest bone. Three patients who were treated with this new technique are presented. Two patients (one mandibular defect and one defect in the maxillary region) received prefabricated osteomuscular flaps from the iliac crest bone using the latissimus dorsi muscle as a pedicle. One patient also presenting a mandibular defect after tumour surgery received a scapula transplant for reconstruction of the defect using the pectoralis major muscle as pedicle. In all three cases vital bone could be transplanted. The pedicle was strainless in all three cases. Minor bone loss could be seen initially only in one case. The results are stable now and one patient received dental implants for later prosthetic treatment. The presented two-step surgery provides an excellent method for reconstruction of bony defects in the maxillofacial region in patients where microvascular surgery is not possible due to reduced state of health or lack of recipient vessels. Copyright © 2010. Published by Elsevier Ltd.

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

ERIC Educational Resources Information Center

Mallory-Boyle, Nancy

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

Cholesteatoma in the Sellar Region Presenting as Hypopituitarism and Diabetes Insipidus

PubMed Central

Kong, Xiangyi; Wu, Huanwen; Ma, Wenbin; Li, Yongning; Xing, Bing; Kong, Yanguo; Wang, Renzhi

2016-01-01

Abstract Clinically significant sellar cysts unrelated to pituitary adenomas are uncommon. Intracranial cholesteatomas are also rare and are most common in the middle ear and mastoid region. We report an even rarer case of cholesteatoma in the sellar region—a challenging diagnosis guided by clinical presentations, radiological signs, and biopsy, aiming at emphasize the importance of considering cholesteatoma when making differential diagnoses of sellar lesions. We present a case of cholesteatoma in the sellar region in a 56-year-old man with hypopituitarism, diabetes insipidus, and cystic imaging findings. It was difficult to make an accurate diagnosis before surgery. We present detailed analysis of the patient's disease course and review pertinent literature. The patient underwent a surgical exploration and tumor resection through a transsphenoidal approach. Pathologic results revealed a cholesteatoma. The patient's symptoms improved a lot after surgery, and the postoperative period was uneventful. Taken together, the lesion's imaging appearance, pathological characteristics, and clinical features were all unique features that lead to a diagnosis of cholesteatoma. As we did not see such reports by Pubmed and EMBASE, we believe this is the first reported case of sellar cholesteatoma presenting in this manner. This article emphasized that cholesteatomas, although rare, should be considered part of the differential diagnosis of sellar lesions. PMID:26962793

Leiomyoma of the sternothyroid muscle.

PubMed

Rowe, Meghan E; Khorsandi, Azita S; Guerrero, Dominick R; Brett, Elise M; Sarlin, Jonathan; Urken, Mark L

2016-01-01

Leiomyomas are benign cutaneous tumors of smooth muscle origin. Only a small percentage of leiomyomas arise in the head and neck region. We present the first case of leiomyoma arising in the sternothyroid muscle of the neck. We analyze the clinical presentation, pathology, and histology for a single case study. The histologic findings of the tumor located in the sternothyroid muscle support the diagnosis of leiomyoma. This is the first case of leiomyoma arising in the sternothyroid muscle, and only the second reported case of leiomyoma in the strap muscles of the neck. Leiomyoma should be included in the differential diagnosis of soft tissue tumors in the head and neck region. A histological analysis is essential in determining both tumor type and subtype, which will inform the proper course of treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Supernumerary Teeth in the Maxillary Anterior Region: The Dilemma of Early Versus Late Surgical Intervention.

PubMed

Sarne, Ofer; Shapira, Yehoshua; Blumer, Sigalit; Finkelstein, Tamar; Schonberger, Shirley; Bechor, Naomi; Shpack, Nir

Supernumerary teeth are the most common developmental dental anomalies in the maxillary anterior region causing interference to the developing permanent incisors resulting in poor dental and facial esthetics. Two different opinions regarding the timing for surgical removal of the supernumerary teeth are presented. In this case report, three brothers with supernumerary teeth in the maxillary anterior region are presented, their surgical and orthodontic management and outcome are discussed.

TDP-43 in the hypoglossal nucleus identifies amyotrophic lateral sclerosis in behavioral variant frontotemporal dementia.

PubMed

Halliday, Glenda M; Kiernan, Matthew C; Kril, Jillian J; Mito, Remika; Masuda-Suzukake, Masami; Hasegawa, Masato; McCann, Heather; Bartley, Lauren; Dobson-Stone, Carol; Kwok, John B J; Hornberger, Michael; Hodges, John R; Tan, Rachel H

2016-07-15

The hypoglossal nucleus was recently identified as a key brain region in which the presence of TDP-43 pathology could accurately discriminate TDP-43 proteinopathy cases with clinical amyotrophic lateral sclerosis (ALS). The objective of the present study was to assess the hypoglossal nucleus in behavioral variant frontotemporal dementia (bvFTD), and determine whether TDP-43 in this region is associated with clinical ALS. Twenty-nine cases with neuropathological FTLD-TDP and clinical bvFTD that had not been previously assessed for hypoglossal TDP-43 pathology were included in this study. Of these 29 cases, 41% (n=12) had a dual diagnosis of bvFTD-ALS at presentation, all 100% (n=12) of which demonstrated hypoglossal TDP-43 pathology. Of the 59% (n=17) cohort that presented with pure bvFTD, 35% (n=6) were identified with hypoglossal TDP-43 pathology. Review of the case files of all pure bvFTD cases revealed evidence of possible or probable ALS in 5 of the 6 hypoglossal-positive cases (83%) towards the end of disease, and this was absent from all cases without such pathology. In conclusion, the present study validates grading the presence of TDP-43 in the hypoglossal nucleus for the pathological identification of bvFTD cases with clinical ALS, and extends this to include the identification of cases with possible ALS at end-stage. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

The nasogastric tube syndrome: two case reports and review of the literature.

PubMed

Apostolakis, L W; Funk, G F; Urdaneta, L F; McCulloch, T M; Jeyapalan, M M

2001-01-01

The nasogastric tube syndrome is a potentially life-threatening complication of an indwelling nasogastric (NG) tube. The syndrome is thought to result from ulceration and infection of the posterior cricoid region with subsequent dysfunction of vocal cord abduction. This dysfunction may present as complete loss of vocal cord abduction manifested as serious airway compromise. Reports of this syndrome are infrequent, with only 29 cases published to date. Two additional cases of nasogastric tube syndrome diagnosed at the University of Iowa Hospitals and Clinics over a 2-year period are presented. A search of MEDLINE (1966 through February 1999), including review of those articles' references identified seven previous publications, including 29 case reports. These 29 cases are reviewed and the findings summarized. Twenty-nine cases of NG tube syndrome are identified, with 16 of these occurring in the preantibiotic period. Including the two cases presented here, 15 contemporary patients are examined. Among these 15 cases, 10 required tracheostomy, on average 8.5 days after NG tube placement. Although the fully manifested syndrome presents quite dramatically, we suspect that a clinical spectrum of severity exists with less severe cases going unrecognized. Consistent with previous reports, we found that direct visualization of the postcricoid region is required to rule out the diagnosis and recommend such action be taken whenever the diagnosis is suspected. Treatment should include establishment of a safe airway, removal of the tube whenever possible, antibiotic therapy, and antireflux therapy.

[Hansen's disease in the northern region of Brazil--1986].

PubMed

Britto, R da S

1989-12-01

Some general facts about Hansen's Disease are presented: in the world, in the Americas, in 1986, with the purpose to focalize on the Northern Region of Brazil (Amazon Valley) where an attempt is made to specify, State, the clinical forms in the active registry, the respective coefficients of Prevalence, about the cases detected during the year, by clinical forms and the correspondent Coefficient of Incidence, the age range of less than 15 years, and above 15 years; and to analyze according to the township in the State of Amazonas in a series of 8 years, from 1979 to 1986, the registered cases under control and also without control, the new cases, by clinical form and Coefficient of Incidence, the positive cases among students in the capital and also in the country, and with more details, still by township and by Public Health Registry, in 1986, with the population, new cases, and Coefficient of Incidence, cases of the active registry, cases under control, Coefficient of Incidence, the relationship between patients/inhabitants, cases according to the decreasing intensity as far as the Prevalence and Health Department Regions: all this to give an idea, in detail, inclusive statistics, of the real position of Hansen's Disease in the Northern Region (Amazon Valley), with the highest figures of Prevalence and even of Incidence, in comparison with other Regions of the country, and to stress the grave situation of the endemic proportions of the disease, in Brazil in general and in that Regions, in particular.

Rocky Mountain Spotted Fever Characterization and Comparison to Similar Illnesses in a Highly Endemic Area—Arizona, 2002–2011

PubMed Central

Traeger, Marc S.; Regan, Joanna J.; Humpherys, Dwight; Mahoney, Dianna L.; Martinez, Michelle; Emerson, Ginny L.; Tack, Danielle M.; Geissler, Aimee; Yasmin, Seema; Lawson, Regina; Hamilton, Charlene; Williams, Velda; Levy, Craig; Komatsu, Kenneth; McQuiston, Jennifer H.; Yost, David A.

2015-01-01

Background Rocky Mountain spotted fever (RMSF) has emerged as a significant cause of morbidity and mortality since 2002 on tribal lands in Arizona. The explosive nature of this outbreak and the recognition of an unexpected tick vector, Rhipicephalus sanguineus, prompted an investigation to characterize RMSF in this unique setting and compare RMSF cases to similar illnesses. Methods We compared medical records of 205 patients with RMSF and 175 with non-RMSF illnesses that prompted RMSF testing during 2002–2011 from 2 Indian reservations in Arizona. Results RMSF cases in Arizona occurred year-round and peaked later (July–September) than RMSF cases reported from other US regions. Cases were younger (median age, 11 years) and reported fever and rash less frequently, compared to cases from other US regions. Fever was present in 81% of cases but not significantly different from that in patients with non-RMSF illnesses. Classic laboratory abnormalities such as low sodium and platelet counts had small and subtle differences between cases and patients with non-RMSF illnesses. Imaging studies reflected the variability and complexity of the illness but proved unhelpful in clarifying the early diagnosis. Conclusions RMSF epidemiology in this region appears different than RMSF elsewhere in the United States. No specific pattern of signs, symptoms, or laboratory findings occurred with enough frequency to consistently differentiate RMSF from other illnesses. Due to the nonspecific and variable nature of RMSF presentations, clinicians in this region should aggressively treat febrile illnesses and sepsis with doxycycline for suspected RMSF. PMID:25697743

Rare Infratentorial and Supratentorial Localization of Juvenile Angiofibroma: A Case Report.

PubMed

Pašalić, Ivan; Trninić, Ines; Nemir, Jakob; Jednačak, Hrvoje; Žarković, Kamelija; Mrak, Goran

2016-01-01

Angiofibromas are rare tumors of the head and neck that mostly occur in the sphenopalatine region. We present a case of angiofibroma in a young male patient with an unusual and extremely rare localization, which to our knowledge has not been described before. It was situated in the tentorium and spread to the supratentorial and infratentorial regions. The patient initially presented with symptoms of increased intracranial pressure. After a diagnostic evaluation was done, the whole tumor was successfully removed using the supratentorial and infratentorial approach and the microsurgical technique. © 2016 S. Karger AG, Basel.

Micrometeorite erosion of the man rings as a source of plasma in the inner Saturnian plasma torus

NASA Technical Reports Server (NTRS)

Pospieszalska, M. K.; Johnson, R. E.

1991-01-01

Micrometeorite bombardment is presently suggested to be a source of water molecules and molecular ions in the region between the outer edge of the main rings of Saturn and Encedalus, adding to those neutrals and plasma that are generated by the sputtering of icy satellites. In view of uncertainties concerning the magnitude and distribution of the ring source, an examination is conducted of limiting cases. The implications of such cases for the Cassini division are calculated, and a discussion of their possible relevance to the region's neutral and plasma cloud is presented.

Symptom presentations and other characteristics of colorectal cancer patients and the diagnostic performance of the Auckland Regional Grading Criteria for Suspected Colorectal Cancer in the South Auckland population.

PubMed

Hsiang, John C; Bai, Wayne; Lal, Dinesh

2013-09-13

This study reviews the presenting symptoms of colorectal cancer in the ethnically diverse Middlemore Hospital referral population of South Auckland, New Zealand. The performance of the newly introduced Auckland Regional Grading Criteria as prediction tool for selecting colorectal cancer cases referred from primary care was evaluated in this group. Retrospective review of all colorectal cancer (CRC) cases diagnosed between January 2006 and January 2011. Information extracted from case note review was used to grade patients using the Auckland Regional Grading Criteria. A total of 799 patients were included. The commonest symptoms were: rectal bleeding (25.5-42.3%) and change in bowel habit (20.6-26.8%). Low-risk symptoms including abdominal pain (16.3-46.8%) and weight loss (18.4-26.1%) were not uncommon. 64.4% of Maori and 64.9% of Pacific patients had stage III or IV cancers. Pacific patients had more stage IV disease, 37.7% (p<0.001) and were less likely to undergo tumour resection, 26.0% (p<0.001). The Auckland Regional Grading Criteria would miss 24.7% of the patients with CRC in the referral population. While rectal bleeding and change in bowel habit are frequent presenting symptoms, low-risk atypical symptoms including constipation, weight loss and abdominal pain were not uncommon. Significant proportion of Pacific patients present with late-stage disease. The current Auckland Regional grading criteria would miss significant proportion of our study population with colorectal cancer.

Corporate social responsibility for regional sustainability after mine closure: a case study of mining company in Indonesia

NASA Astrophysics Data System (ADS)

Syarif, Andi Erwin; Hatori, Tsuyoshi

2017-06-01

Creating a soft-landing path for mine closure is key to the sustainability of the mining region. In this research, we presents a case of mine closure in Soroako, a small mining town in the north-east of South Sulawesi province, in the center of Sulawesi Island in Indonesia. Especially we investigates corporate social responsibility (CSR) programs of a mining company, PT Vale Indonesia Tbk (PTVI), towards a soft-landing of mine closure in this region. The data of the CSR programs are gathered from in-depth interviews, the annual reports and managerial reports. Furthermore we presents an integrated view of CSR to close mining in a sustainable manner. We then evaluate CSR strategies of the company and its performance from this viewpoint. Based on these steps, the way to improve the CSR mine closure scenario for enhancing the regional sustainability is discussed and recommended.

Factors Contributing to the Accumulation of Primary Teacher's Debts to the Government of Tanzania: A Case Study for Dar Es Salaam Region

ERIC Educational Resources Information Center

Kombo, Ibun

2015-01-01

This paper presents the findings of the study which was conducted to determine factors contributing to the accumulation of primary school teacher's debts to the Government of Tanzania, a case study of Dar es Salaam Region in its three municipalities namely, Ilala, Kinondoni and Temeke. Data was obtained through sampling method which also helped to…

SEQATOMS: a web tool for identifying missing regions in PDB in sequence context.

PubMed

Brandt, Bernd W; Heringa, Jaap; Leunissen, Jack A M

2008-07-01

With over 46 000 proteins, the Protein Data Bank (PDB) is the most important database with structural information of biological macromolecules. PDB files contain sequence and coordinate information. Residues present in the sequence can be absent from the coordinate section, which means their position in space is unknown. Similarity searches are routinely carried out against sequences taken from PDB SEQRES. However, there no distinction is made between residues that have a known or unknown position in the 3D protein structure. We present a FASTA sequence database that is produced by combining the sequence and coordinate information. All residues absent from the PDB coordinate section are masked with lower-case letters, thereby providing a view of these residues in the context of the entire protein sequence, which facilitates inspecting 'missing' regions. We also provide a masked version of the CATH domain database. A user-friendly BLAST interface is available for similarity searching. In contrast to standard (stand-alone) BLAST output, which only contains upper-case letters, our output retains the lower-case letters of the masked regions. Thus, our server can be used to perform BLAST searching case-sensitively. Here, we have applied it to the study of missing regions in their sequence context. SEQATOMS is available at http://www.bioinformatics.nl/tools/seqatoms/.

Case Studies in Regional Energy Planning. Papers presented at a symposium at the Annual Meeting of the American Association for the Advancement of Science (142nd, Boston, Massachusetts, February 18-24, 1976).

ERIC Educational Resources Information Center

Blanpied, William A., Ed.; Vermilye, Gretchen, Ed.

The papers reproduced in this collection were originally prepared for presentation at a February 1976 symposium at the annual meeting of the American Association for the Advancement of Science. The symposium summarized a series of three regional seminars on National Energy Policy in a Regional Context; these seminars were held in Minnesota, New…

Neonatal and congenital malaria: a case series in malaria endemic eastern Uganda.

PubMed

Olupot-Olupot, Peter; Eregu, Emma I E; Naizuli, Ketty; Ikiror, Julie; Acom, Linda; Burgoine, Kathy

2018-04-20

Congenital malaria is the direct infection of an infant with malaria parasites from their mother prior to or during birth. Neonatal malaria is due to an infective mosquito bite after birth. Neonatal and congenital malaria (NCM) are potentially life-threatening conditions that are believed to occur at relatively low rates in malaria endemic regions. However, recent reports suggest that the number of NCM cases is increasing, and its epidemiology remains poorly described. NCM can mimic other neonatal conditions and because it is thought to be rare, blood film examinations for malaria are not always routinely performed. Consequently, many cases of NCM are likely to be undiagnosed. A retrospective chart review for all neonates admitted with suspected sepsis between January and July 2017 was conducted and noted four cases of NCM since routine malaria testing was introduced as part of standard of care for suspected sepsis at Mbale Regional Referral Hospital Neonatology Unit. This description highlights the need to conduct routine malaria diagnostic testing for febrile neonates in malaria endemic areas, and supports the urgent need to undertake pharmacological studies on therapeutic agents in this population. Four cases (two congenital malaria cases and two neonatal malaria cases) are described after presenting for care at the Mbale Regional Referral Hospital Neonatal Unit (Mbale RRH-NNU). The maternal age was similar across the cases, but both neonatal malaria cases were born to primigravidae. At presentation three cases had fever and history of fever, but one was hypothermic (34.8 °C) and no history of fever. One case of congenital malaria had low birth weight, while the other was born to an HIV positive mother. Both cases of congenital malaria presented with poor feeding, in addition one of them had clinical jaundice. The neonatal malaria cases presented in the third week compared to the congenital malaria cases that presented within 48 h after birth. All of the cases of NCM were treated with intravenous artesunate. The admitting clinicians also instituted a course of antibiotics empirically to cover against possible bacterial co-infections. All four cases recovered and were discharged alive. At the Mbale RRH-NNU, the finding of cases of NCM was not expected, therefore, neonates presenting with features of suspected sepsis in malaria endemic settings should be routinely screened for NCM. There is currently a lack of appropriate guidelines for treatment of NCM in the era of artemisinin-based combination therapy (ACT), therefore, efforts to establish the safety profile and efficacy of ACT anti-malarials in neonates to guide development of evidence-based treatment guidelines for NCM are needed.

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.…

The same molecular mechanism at the maternal meiosis I produces mono- and dicentric 8p duplications.

PubMed Central

Floridia, G.; Piantanida, M.; Minelli, A.; Dellavecchia, C.; Bonaglia, C.; Rossi, E.; Gimelli, G.; Croci, G.; Franchi, F.; Gilgenkrantz, S.; Grammatico, P.; Dalprá, L.; Wood, S.; Danesino, C.; Zuffardi, O.

1996-01-01

We studied 16 cases of 8p duplications, with a karyotype 46,XX or XY,dup(8p), associated with mental retardation, facial dysmorphisms, and brain defects. We demonstrate that these 8p rearrangements can be either dicentric (6 cases) with the second centromere at the tip of the short arm or monocentric (10 cases). The distal 8p23 region, from D8S349 to the telomere, including the defensin 1 locus, is deleted in all the cases. The region spanning from D8S252 to D8S265, at the proximal 8p23 region, is present in single copy, and the remaining part of the abnormal 8 short arm is duplicated in the dicentric cases and partially duplicated in the monocentric ones. The distal edge of the duplication always spans up to D8S552 (8p23.1), while its proximal edge includes the centromere in the dicentric cases and varies from case to case in the monocentric ones. The analysis of DNA polymorphisms indicates that the rearrangement is consistently of maternal origin. In the deleted region, only paternal alleles were present in the patient. In the duplicated region, besides one paternal allele, some loci showed two different maternal alleles, while others, which were duplicated by FISH analysis, showed only one maternal allele. We hypothesize that, at maternal meiosis I, there was abnormal pairing of chromosomes 8 followed by anomalous crossover at the regions delimited by D8S552 and D8S35 and by D8S252 and D8S349, which presumably contain inverted repeated sequences. The resulting dicentric chromosome, 8qter-8p23.1(D8S552)::8p23.1-(D8S35)-8q ter, due to the presence of two centromeres, breaks at anaphase I, generating an inverted duplicated 8p, dicentric if the breakage occurs at the centromere or monocentric if it occurs between centromeres. Images Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 PMID:8644743

Alsatian versus Standard German: Regional Language Bilingual Primary Education in Alsace

ERIC Educational Resources Information Center

Harrison, Michelle Anne

2016-01-01

This article examines the current situation of regional language bilingual primary education in Alsace and contends that the regional language presents a special case in the context of France. The language comprises two varieties: Alsatian, which traditionally has been widely spoken, and Standard German, used as the language of reference and…

REGIONAL ASSESSMENT OF LANDSCAPE AND DEMOGRAPHIC CHANGE EFFECTS IN THE MEDITERRANEAN REGION, THE MOROCCO CASE STUDY (1981 - 2003)

EPA Science Inventory

The effect of changes in landscape factors on socioeconomics was analyzed

locally and regionally. The method presented here allows mapping changes in vegetation cover

trends over large areas quickly and inexpensively, thus providing policy-makers with a technical

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…

Subacute Thyroiditis: Clinical Presentation and Long Term Outcome

PubMed Central

Alfadda, Assim A.; Sallam, Reem M.; Elawad, Ghadi E.; AlDhukair, Hisham; Alyahya, Mossaed M.

2014-01-01

Few studies have been reported from the Kingdom of Saudi Arabia (SA) to describe the clinical presentation and long term outcomes of subacute thyroiditis (SAT). Our aim was to review the demographic, anthropometric, clinical presentation, laboratory results, treatment, and disease outcome in Riyadh region and to compare those with results from different regions of the Kingdom and different parts of the world. We reviewed the medical files of patients who underwent thyroid uptake scan during an 8-year period in King Khalid University Hospital. Only 25 patients had confirmed diagnosis of thyroiditis. Age and gender distribution were similar to other studies. Most patients presented with palpitation, goiter, and weight change. Elevated thyroid hormones, suppressed thyroid-stimulating hormone, and elevated ESR were reported. Among those, 7 cases of SAT were recorded. β-Blockers were prescribed to 57% and nonsteroidal anti-inflammatory drugs to 29% of SAT. Long follow-up demonstrated that 85.7% of SAT cases recovered, while 14.3% developed permanent hypothyroidism. In conclusion, SAT is uncommon in the central region of SA. Compared to the western region, corticosteroid is not commonly prescribed, and permanent hypothyroidism is not uncommon. A nation-wide epidemiological study to explain these interprovincial differences is warranted. PMID:24803929

Presentation and Treatment of Histoplasmosis in Pediatric Oncology Patients: Case Series and Review of the Literature.

PubMed

Hess, Jennifer; Fondell, Andrew; Fustino, Nicholas; Malik, Jeff; Rokes, Christopher

2017-03-01

Histoplasmosis is an endemic fungus in several regions of the United States. The diagnosis and treatment of this infection can be challenging in pediatric oncology patients. We present 5 patients diagnosed with histoplasmosis while receiving treatment at a midsize pediatric oncology center in Iowa. Two cases occurred in patients with acute lymphoblastic leukemia and 3 cases in patients with solid tumors. All patients were treated with antifungal therapy and demonstrated excellent clinical response. Histoplasmosis should be considered as a potential cause of nonspecific febrile illness, pulmonary masses, and bone marrow suppression in immunocompromised patients in endemic regions. Prompt and accurate diagnosis can facilitate timely antifungal therapy and avoidance of prolonged hospital stays, invasive testing, unnecessary antibiotics, and unwarranted anticancer therapies.

[Epidemiological profile of rabies in the northwestern region of São Paulo State, from 1993 to 2007].

PubMed

Queiroz, Luzia Helena; de Carvalho, Cristiano; Buso, Daniel Sartori; Ferrari, Clara Isabel de Lucca; Pedro, Wagner André

2009-01-01

The epidemiology of animal rabies in the region of Araçatuba, in the northwest of São Paulo State, from 1993 to 2007, is described according to the results from diagnoses made at laboratories in the region, using the fluorescent antibody and mouse inoculation tests. Out of 10,579 samples analyzed, 4.9% were positive (518/10,579). Dogs accounted for 67% of the cases (346/518) and these occurred between 1993 and 1997. Among the other positive samples, 16% (84/518) were in cattle and 9.7% (50/518) were in bats. Among the 42 municipalities in the region, 23 (55%) presented at least one rabies-positive case, while 13 of them had cases in bats. Three distinct cycles of rabies were identified in the northwestern region of the State of São Paulo: the urban cycle characterized predominantly by canine rabies (1993 to 1997); and the aerial and rural cycles starting in 1998, with predominance of cases in bats in urban areas and in herbivores.

Giant Angiofibroma of the Scrotum in a Child.

PubMed

Arena, Salvatore; Barresi, Valeria; Romeo, Carmelo

2016-07-01

We present a unique case of angiofibroma of the scrotum in a 3-year-old child. A previous red plaque has been observed in the same region since the neonatal period. The boy underwent total excision of the mass. We suggest a close follow-up of any erythematous lesion of the genital region; in case of rapid increase, it is important to proceed to prompt surgical excision. Copyright © 2016 Elsevier Inc. All rights reserved.

Oral medicine case book 51: actinic cheilitis in a patient with oculocutaneous albinism.

PubMed

Wood, N H; Moodley, A

2013-07-01

Patients with oculocutaneous albinism are more prone to sun-induced damage due to the lack of melanin. Actinic cheilitis is a potentially malignant disorder that occurs due to chronic UV-B radiation to the vermillion region of the lip, a region that is already at risk due to its morphology. A case of actinic cheilitis in a patient with oculocutaneous albinism is presented with a literature review.

The South: Birmingham Case Study, and The South as a Region. Grade Five (Unit IV). Resource Unit. Project Social Studies.

ERIC Educational Resources Information Center

Minnesota Univ., Minneapolis. Project Social Studies Curriculum Center.

A case study on Birmingham is presented in the first part of this resource unit on regional studies designed for fifth graders. The objective of the sequent occupance unit is to illustrate the impact which the discovery and utilization of a large natural resource, namely, iron ore, can have on the development of a city, in the hope that students…

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

Hantavirus pulmonary syndrome in Tucumán province associated to an unexpected viral genotype.

PubMed

Ciancaglini, Matías; Bellomo, Carla M; Torres Cabreros, Clara L; Alonso, Daniel; Bassi, Sabrina C; Iglesias, Ayelén A; Martínez, Valeria P

2017-01-01

We describe the characterization of the viral genotype involved in the first case of hantavirus pulmonary syndrome reported in Tucumán, a Northwestern province of Argentina. A 23-year-old woman, with no record of travel history and previously diagnosed with an antiphospholipid syndrome, died after 11 days of severe cardiopulmonary insufficiency. Among the four endemic regions of hantavirus pulmonary syndrome in Argentina, the Northwest Region has the highest incidence, exceeding 50% of all reported cases in the country. Until now, only Salta and Jujuy (2 out of the 6 provinces composing the Northwest Region), reported cases of hantavirus pulmonary syndrome, all of which occurred in the Yungas Forest area. Remarkably, the viral genotype characterized in this case showed higher nucleotide identity with the Andes-BsAs genotype most prevalent in Buenos Aires province, located 1400 km apart from Tucumán, than with any of the commonly found genotypes in the Northwest Region. The Andes-BsAs genotype has been associated with 30% lethality and interhuman transmission in Buenos Aires province. Interhuman transmission cannot be ruled out in the present case.

Lessons for the Global Spatial Data Infrastructure : international case study analysis

DOT National Transportation Integrated Search

2002-01-01

This report presents a RAND analysis of international collaboration for the Global Spatial Data Infrastructure (GSDI). Ten in-depth international and regional collaboration case studies were conducted to assess lessons learned for GSDI development an...

Rocky mountain spotted fever characterization and comparison to similar illnesses in a highly endemic area-Arizona, 2002-2011.

PubMed

Traeger, Marc S; Regan, Joanna J; Humpherys, Dwight; Mahoney, Dianna L; Martinez, Michelle; Emerson, Ginny L; Tack, Danielle M; Geissler, Aimee; Yasmin, Seema; Lawson, Regina; Hamilton, Charlene; Williams, Velda; Levy, Craig; Komatsu, Kenneth; McQuiston, Jennifer H; Yost, David A

2015-06-01

Rocky Mountain spotted fever (RMSF) has emerged as a significant cause of morbidity and mortality since 2002 on tribal lands in Arizona. The explosive nature of this outbreak and the recognition of an unexpected tick vector, Rhipicephalus sanguineus, prompted an investigation to characterize RMSF in this unique setting and compare RMSF cases to similar illnesses. We compared medical records of 205 patients with RMSF and 175 with non-RMSF illnesses that prompted RMSF testing during 2002-2011 from 2 Indian reservations in Arizona. RMSF cases in Arizona occurred year-round and peaked later (July-September) than RMSF cases reported from other US regions. Cases were younger (median age, 11 years) and reported fever and rash less frequently, compared to cases from other US regions. Fever was present in 81% of cases but not significantly different from that in patients with non-RMSF illnesses. Classic laboratory abnormalities such as low sodium and platelet counts had small and subtle differences between cases and patients with non-RMSF illnesses. Imaging studies reflected the variability and complexity of the illness but proved unhelpful in clarifying the early diagnosis. RMSF epidemiology in this region appears different than RMSF elsewhere in the United States. No specific pattern of signs, symptoms, or laboratory findings occurred with enough frequency to consistently differentiate RMSF from other illnesses. Due to the nonspecific and variable nature of RMSF presentations, clinicians in this region should aggressively treat febrile illnesses and sepsis with doxycycline for suspected RMSF. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Trip internalization and mixed-use development : a case study of Austin Texas.

DOT National Transportation Integrated Search

2009-12-01

The Capital Area Metropolitan Planning Organization (CAMPO) in the Austin, TX region is incorporating : a new regional growth concept, the Activity Centers for its Long-Range Transportation Plan. The planned : Activity Centers would present such feat...

Unusual tumour ablations: report of difficult and interesting cases.

PubMed

Mauri, Giovanni; Nicosia, Luca; Varano, Gianluca Maria; Shyn, Paul; Sartori, Sergio; Tombesi, Paola; Di Vece, Francesca; Orsi, Franco; Solbiati, Luigi

2017-01-01

Image-guided ablations are nowadays applied in the treatment of a wide group of diseases and in different organs and regions, and every day interventional radiologists have to face more difficult and unusual cases of tumour ablation. In the present case review, we report four difficult and unusual cases, reporting some tips and tricks for a successful image-guided treatment.

Numerical investigation of rotating stall in centrifugal compressor with vaned and vaneless diffuser

NASA Astrophysics Data System (ADS)

Halawa, Taher; Alqaradawi, Mohamed; Gadala, Mohamed S.; Shahin, Ibrahim; Badr, Osama

2015-06-01

This study presents a numerical simulation of the stall and surge in a centrifugal compressor and presents a descriptionof the stall development in two different cases. The first case is for a compressor with vaneless diffuser and the second is for a compressor with vaned diffuser of the vane island shape. The main aim of this study is to compare the flow characteristics and behavior for the two compressors near the surge operating condition and provide further understanding of the diffuser role when back flow occurs at surge. Results showed that for a locationnear the diffuser entrance, the amplitude of the static pressure fluctuations for the vaneless diffuser case is higher than that for the vaned diffuser case near surge condition. These pressure fluctuations in the case of the vaneless diffuser appear with a gradual decrease of the mean pressure value as a part of the surge cycle. While for the case of the vaned diffuser, the pressure drop during surge occurs faster than the case of the vaneless diffuser. Also, results indicated that during surge in the case of vaneless diffuser, there is a region with low velocity and back flow that appears as a layer connecting all impeller passages near shroud surface and this layer develops in size with time. On the other hand, for the case of vaned diffuser during surge, the low velocity regions appear in random locations in some passages and these regions expand with time towards the shroud surface. Results showed that during stall, the impeller passages are exposed to identical impact from stall cells in the case of vaneless diffuser while the stall effect varies from passage to another in the case of the vaned diffuser.

Characterization of Puumala hantavirus in bank voles from two regions in the Netherlands where human cases occurred.

PubMed

de Vries, A; Vennema, H; Bekker, D L; Maas, M; Adema, J; Opsteegh, M; van der Giessen, J W B; Reusken, C B E M

2016-07-01

Puumala hantavirus (PUUV) is the most common and widespread hantavirus in Europe and is associated with a mild form of haemorrhagic fever with renal syndrome in humans, called nephropathia epidemica. This study presents the molecular characterization of PUUV circulating in bank voles in two regions of the Netherlands. Most human cases of hantavirus infection are from these two regions. Phylogenetic analysis of the (partial) S, M and L-segments indicated that the Dutch strains belong to the CE lineage, which includes PUUV strains from France, Germany and Belgium. We have identified two distinct groups of PUUV, corresponding with their geographic origin and with adjoining regions in neighbouring countries.

Progress of Education in the Asian Region. Statistical Supplement.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and Oceania.

This work is a supplement to an earlier work entitled, "Progress of Education in the Asian Region: a Statistic Review", (ED 035 490) which contained statistical data up to 1967. This supplement presents statistical data up to 1969 for regional aggregates and up to 1970 for individual countries in some cases. As in the Review, the…

SERA Scenarios of Early Market Fuel Cell Electric Vehicle Introductions: Modeling Framework, Regional Markets, and Station Clustering; NREL (National Renewable Energy Laboratory)

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

Melaina, M.

This presentation provides an overview of the Scenario Evaluation and Regionalization Analysis (SERA) model, describes the methodology for developing scenarios for hydrogen infrastructure development, outlines an example "Hydrogen Success" scenario, and discusses detailed scenario metrics for a particular case study region, the Northeast Corridor.

[Central nervous system dysgerminoma: a clinicopathological study of 3 cases].

PubMed

Bellil, Selma; Braham, Emna; Limaiem, Faten; Bellil, Khadija; Chelly, Ines; Mekni, Amina; Haouet, Slim; Zitouna, Moncef; Jemel, Hafedh; Khaldi, Moncef; Kchir, Nidhameddine

2009-03-01

Intracranial germ cell tumors are rarely seen and typically localize in the pineal or suprasellar region. The largest category of germ cell tumors is dysgerminoma. to describe clinicopathological features and immunohistochemical profile of dysgerminomas. We report three cases of central nervous system dysgerminomas. There were two young women and a man who were 6, 11 and 23-year-old. They presented with symptoms of insipidus diabetes (n=3) with association to visual field defects in the third case. Radiological findings showed a supra seller lesion in two cases. Double localization in the pineal and suprasellar regions was seen in the third case. Histologic examination and immunohistochemical study of surgical specimen were consistent with primary central nervous system dysgerminoma.

Clinical characteristics and public health management of invasive meningococcal group W disease in the East Midlands region of England, United Kingdom, 2011 to 2013.

PubMed

Bethea, Jane; Makki, Sophia; Gray, Steve; MacGregor, Vanessa; Ladhani, Shamez

2016-06-16

In England and Wales, meningococcal disease caused by group W has historically been associated with outbreaks of disease among travellers to high-risk countries. Following a large outbreak associated with travel to the Hajj in 2000, the number of cases declined and, in 2008, only 19 laboratory-confirmed cases were identified nationally. In 2013, in the East Midlands region of England, eight cases of meningococcal disease caused by this serogroup were recorded, compared with six from 2011 to 2012. To explore this further, data for all cases with a date of onset between 1 January 2011 and 31 December 2013 were collected. Data collected included geographical location, clinical presentation and outcome. Fourteen cases were identified; two died as a result of their illness and two developed long-term health problems. No commonality in terms of geographical location, shared space or activities was identified, suggesting that group W is circulating endemically with local transmission. Clinical presentation was variable. Half presented with symptoms not typical of a classical meningococcal disease, including two cases of cellulitis, which may have implications for clinicians, in terms of timely identification and treatment, and public health specialists, for offering timely antibiotic chemoprophylaxis to close contacts. This article is copyright of The Authors, 2016.

Low-fat and fat-free pleomorphic lipomas: a diagnostic challenge.

PubMed

Sachdeva, Mandi P; Goldblum, John R; Rubin, Brian P; Billings, Steven D

2009-07-01

Pleomorphic lipomas are benign tumors that most commonly present as subcutaneous masses in the head and neck, shoulder, or back region of middle-aged to elderly men. They are related to spindle cell lipomas based on shared cytogenetic aberrations and histologic features. When little or no fat is present, the diagnosis can be challenging. A review of 38 pleomorphic lipomas seen in consultation revealed 7 cases in which fat was present in reduced (<5%) amounts (n = 5) or absent (n = 2). Six of 7 cases were from men with a mean age of 59 years. Excluding 1 case where the site was not specified, they all presented as solitary well-circumscribed subcutaneous masses in the head and neck (n = 3) or shoulder (n = 2) region. The seventh case was an intradermal tumor from the nose of a 48-year-old woman. All displayed pleomorphic and multinucleated floret cells interspersed among bland spindle cells and ropey collagen. They were diffusely immunoreactive for CD34. Referring diagnoses, when provided, included myxofibrosarcoma, giant cell fibroblastoma, and granulomatous rosacea for the tumor from the nose; none considered pleomorphic lipomas. When fat is absent or present in reduced amounts, clinical context and identification of classic nonlipogenic components are essential for the diagnosis of pleomorphic lipomas.

Incidence of congenital syphilis in the South Region of Brazil.

PubMed

Serafim, Anie Savi; Moretti, Gustavo Pasquali; Serafim, Guilherme Savi; Niero, Cintia Vieira; da Rosa, Maria Inês; Pires, Maria Marlene de Souza; Simões, Priscyla Waleska Targino de Azevedo

2014-01-01

The aim of this study was to establish the incidence rates of congenital syphilis in the South Region of Brazil from 2001 to 2009. Temporal ecological and descriptive study based on the cases recorded by the System of Information of Notifiable Diseases. The incidence of congenital syphilis has been increasing in the South Region of Brazil since 2004; the highest incidence rates were in women who received prenatal care (113.5 new cases per 100,000 births, p<0.001), who were diagnosed with syphilis at pregnancy (69.8 new cases per 100,000 births, p=0.001), and whose partner did not undergo treatment for syphilis (53.1 new cases per 100,000 births, p=0.001). The population of the present study mostly consisted of adult black women with low educational levels who attended prenatal care, who were diagnosed with syphilis during pregnancy, and whose partners were not treated for syphilis. Based on these results, actions are recommended to reduce the incidence of this disease, which is preventable by early diagnosis and appropriate treatment. The present was merely an ecological study; therefore, further investigations are necessary to elucidate the causes of these findings.

Geospatial-temporal distribution of Tegumentary Leishmaniasis in Colombia (2007–2016)

PubMed Central

Herrera, Giovanny; Pradilla, Iván; Vera, Mauricio

2018-01-01

Background Tegumentary Leishmaniasis (TL) is a neglected disease with worldwide distribution and considered a public health problem, especially in Latin America. In Colombia, the governmental epidemiological surveillance system (SIVIGILA) is responsible for collecting information on the presentation of cases of TL from each of the municipalities and departments. In absence of a study compiling and analyzing currently available metadata of TL in Colombia, this study describes the geospatial-temporal distribution of TL and identifies the regions of the country on which prevention measures should be established in order to control the disease. Methodology/Principal findings This is an exploratory descriptive analysis of the distribution of TL in Colombia. Information was collected on new cases of the disease during the years 2007–2016 from the Colombian reporting system (SIVIGILA). Incidence calculations were made based on population estimates by departments and biogeographical regions. Time evolution is shown in biennial maps. A 10-year series was analyzed, showing that the Amazon region is the most affected in terms of incidence, while the Andean region has the highest number of cases with a high variability among the departments that make it up. In those departments where there is a greater reported diversity of vector species, a large number of cases was observed. Conclusions/Significance Transmission dynamics of TL in Colombia in the past 10 years have been variable, with a greater concentration of cases in the central and southern departments. The present study contributes to improve the understanding of the patterns of distribution of TL in Colombia and can be a basis for future studies of impact evaluation of Health policies in the country and the region. PMID:29624582

Implementation of a Regional Virtual Tumor Board: A Prospective Study Evaluating Feasibility and Provider Acceptance

PubMed Central

Marshall, Christy L.; Petersen, Nancy J.; Naik, Aanand D.; Velde, Nancy Vander; Artinyan, Avo; Albo, Daniel; Berger, David H.

2014-01-01

Abstract Background: Tumor board (TB) conferences facilitate multidisciplinary cancer care and are associated with overall improved outcomes. Because of shortages of the oncology workforce and limited access to TB conferences, multidisciplinary care is not available at every institution. This pilot study assessed the feasibility and acceptance of using telemedicine to implement a virtual TB (VTB) program within a regional healthcare network. Materials and Methods: The VTB program was implemented through videoconference technology and electronic medical records between the Houston (TX) Veterans Affairs Medical Center (VAMC) (referral center) and the New Orleans (LA) VAMC (referring center). Feasibility was assessed as the proportion of completed VTB encounters, rate of technological failures/mishaps, and presentation duration. Validated surveys for confidence and satisfaction were administered to 36 TB participants to assess acceptance (1–5 point Likert scale). Secondary outcomes included preliminary data on VTB utilization and its effectiveness in providing access to quality cancer care within the region. Results: Ninety TB case presentations occurred during the study period, of which 14 (15%) were VTB cases. Although one VTB encounter had a technical mishap during presentation, all scheduled encounters were completed (100% completion rate). Case presentations took longer for VTB than for regular TB cases (p=0.0004). However, VTB was highly accepted with mean scores for satisfaction and confidence of 4.6. Utilization rate of VTB was 75%, and its effectiveness was equivalent to that observed for non-VTB cases. Conclusions: Implementation of VTB is feasible and highly accepted by its participants. Future studies should focus on widespread implementation and validating the effectiveness of this model. PMID:24845366

A possible case of complex regional pain syndrome of the nose?

PubMed

Faraj-Hakim, S; Bleys, R L A W; Buwalda, J; de Ru, J A

2012-01-01

We present a case report of a patient with a putative diagnosis of complex regional pain syndrome of the nose. We would like to bring this disorder to the attention of rhinologists. A 53-year-old man presented with a history of extreme, constant, debilitating pain in his nose that started after he underwent several extensive nasal surgeries. Examination revealed atrophic nasal mucous membranes at the nasal septum. No other abnormalities were found. The pain did not diminish despite administration of analgesics and neuropathic pain medications. We propose a diagnosis of complex regional pain syndrome of the nose. The large number of nasal surgeries performed worldwide and the far reaching consequences of this debilitating syndrome indicate that it merits further investigation to determine whether it is a distinct disorder that should be recognized as such.

[Acute knee pain in pregnancy. Case report of Regional Transient Osteoporosis].

PubMed

García Renedo, Raúl Javier; Ortiz Menéndez, Antonio; Giráldez Sánchez, Miguel; Ribera Zabalbeascoa, Juan; Gonzalo, David H

2010-01-01

The article presents the case of a patient who after her first pregnacy, during the immediate postpartum period, suffered a femoral supracondylar fracture complicated by bone marrow edema syndrome (BMES), also known as regional temporary osteoporosis (RTO). The fracture of the distal femur was treated with an open reduction and internal fixation of the distal femur by means of a minimally invasive procedure. Copyright © 2009 Elsevier España, S.L. All rights reserved.

[Reconstruction of an air-gun injury track in the neck region--a case report].

PubMed

Woźniak, Krzysztof; Nowaczek-Dziocha, Elzbieta; Moskała, Artur; Urbanik, Andrzej; Pohl, Jerzy

2009-01-01

The authors present a case of an air-gun injury of the neck region with a foreign body left in situ. The DICOM files obtained during clinical CT examination (including computed tomography angiography) gave the opportunity for three-dimensional reconstructions of the location of the pellet, neighboring blood vessels and the bullet track--essential for a successful analysis of a possible version according to the testimonies related to the critical event.

Proceedings of the seventh Northern region paediatric colloquium.

PubMed

Barkla, Xanthe; Kaplan, Carole

2014-01-01

Ethical and legal dilemmas frequently arise in paediatric practice. Given the nature of the speciality, these issues are relevant to both the medical and legal professions. To this end, senior figures from the medical and legal professions in the Northern region have met on a regular basis in order to discuss anonymised case material. We report on the proceedings of the seventh such meeting. Six cases are described and key points arising from the subsequent discussion are presented.

A rare case of intraoral lipoma in a six year-old child: a case report

PubMed Central

Venkateswarlu, Meduri; Geetha, Paramkusam; Srikanth, Mandadi

2011-01-01

One type of soft tissue lesions of the oral cavity is lipoma, which is a kind of benign tumor composed of mature lipid cells. Although the lipoma presents as one of the most common mesenchymal neoplasms, most tend to develop on the trunk and proximal portions of the extremities. However, lipomas in the oral and maxillofacial region are much less frequent. Here we present a case of an intraoral lipoma in a six year-old child. PMID:21449215

Pneumopyopericardium mimicking an inferior ST elevation myocardial infarction with regional electrocardiogram changes: a case report.

PubMed

Ratnayake, Eranda Chamara; Premaratne, Sandamali; Lokunarangoda, Niroshan; Fernando, Sanduni; Fernando, Nilanthi; Ponnamperuma, Chandrike; Santharaj, W Samuel

2015-04-30

Pneumopyopericardium is a rare disease with poor prognosis. The usual presentation is with fever, shortness of breath and haemodynamic compromise. The Electrocardiogram changes associated with this disease entity would be similar to pericarditis such as concave shaped ST elevations in all leads with PR sagging. Pneumopyopericardium mimicking an acute ST Elevation Myocardial Infarction, with regional Electrocardiogram changes has hitherto not been described in world literature. We describe the case of a 48 year old native Sri Lankan man, presenting with chest pain and Electrocardiogram changes compatible with an Acute ST Elevation Myocardial Infarction, subsequently found to have Pneumopyopericardium secondary to an oesophageal tear. Retrospective history revealed repetitive vomiting due to heavy alcohol consumption, prior to presentation. It unfortunately led to a fatal outcome. Pneumopyopericardium may mimic an acute ST elevation myocardial infarction with associated regional Electrocardiogram changes. A high degree of suspicion should be maintained and an adequate history should always be obtained prior to any intervention in all ST Elevation Myocardial Infarction patients.

Juvenile primary extranasopharyngeal angiofibroma, presenting as cheek swelling

PubMed Central

Nandhini, J; Ramasamy, S; Kaul, Ronak Nazir; Austin, Ravi David

2018-01-01

Angiofibroma is a locally advancing immensely vascular tumor that essentially arises from the nasopharynx. The clinical characteristics of extranasopharyngeal angiofibroma (ENA) do not accord to that of nasopharyngeal angiofibroma and can present a diagnostic confront. We describe a case of primary juvenile ENA in a 19-year-old patient who presented with a rapidly enlarging mass of the cheek region. The case is unusual because of its anatomic location. The diagnostic and management particulars are sketched. PMID:29491611

Transient Ejector Analysis (TEA) code user's guide

NASA Technical Reports Server (NTRS)

Drummond, Colin K.

1993-01-01

A FORTRAN computer program for the semi analytic prediction of unsteady thrust augmenting ejector performance has been developed, based on a theoretical analysis for ejectors. That analysis blends classic self-similar turbulent jet descriptions with control-volume mixing region elements. Division of the ejector into an inlet, diffuser, and mixing region allowed flexibility in the modeling of the physics for each region. In particular, the inlet and diffuser analyses are simplified by a quasi-steady-analysis, justified by the assumption that pressure is the forcing function in those regions. Only the mixing region is assumed to be dominated by viscous effects. The present work provides an overview of the code structure, a description of the required input and output data file formats, and the results for a test case. Since there are limitations to the code for applications outside the bounds of the test case, the user should consider TEA as a research code (not as a production code), designed specifically as an implementation of the proposed ejector theory. Program error flags are discussed, and some diagnostic routines are presented.

Trends Developments.

ERIC Educational Resources Information Center

ASPBAE Courier Service, 1981

1981-01-01

This issue contains extracts from twenty-one country reports and case studies presented to the Unesco Regional Seminar on Adult Education and Development in Bangkok, November 24-December 4, 1980. The excerpts have an emphasis on innovations in adult education in the region. Countries and programs discussed include (1) community…

Injuries caused by aquatic animals in Brazil: an analysis of the data present in the information system for notifiable diseases.

PubMed

Reckziegel, Guilherme Carneiro; Dourado, Flávio Santos; Garrone Neto, Domingos; Haddad Junior, Vidal

2015-01-01

We present a review of injuries in humans caused by aquatic animals in Brazil using the Information System for Notifiable Diseases [ Sistema de Informação de Agravos de Notificação (SINAN)] database. A descriptive and retrospective epidemiological study was conducted from 2007 to 2013. A total of 4,118 accidents were recorded. Of these accidents, 88.7% (3,651) were caused by venomous species, and 11.3% (467) were caused by poisonous, traumatic or unidentified aquatic animals. Most of the events were injuries by stingrays (69%) and jellyfish (13.1%). The North region was responsible for the majority of reports (66.2%), with a significant emphasis on accidents caused by freshwater stingrays (92.2% or 2,317 cases). In the South region, the region with the second highest number of records (15.7%), jellyfish caused the majority of accidents (83.7% or 452 cases). The Northeastern region, with 12.5% of the records, was notable because almost all accidents were caused by toadfish (95.6% or 174 cases). Although a comparison of different databases has not been performed, the data presented in this study, compared to local and regional surveys, raises the hypothesis of underreporting of accidents. As the SINAN is the official system for the notification of accidents by venomous animals in Brazil, it is imperative that its operation be reviewed and improved, given that effective measures to prevent accidents by venomous animals depend on a reliable database and the ability to accurately report the true conditions.

Environmental management on the basis of Complex Regional Indicators Concept: case of the Murmansk region

NASA Astrophysics Data System (ADS)

Kozlov, A.; Gutman, S.; Zaychenko, I.; Rytova, E.; Nijinskaya, P.

2015-09-01

The article presents an approach to sustainable environmental development of the Murmansk region of the Russian Federation based on the complex regional indicators as a transformation of a balance scorecard method. The peculiarities of Murmansk region connected with sustainable environmental development are described. The complex regional indicators approach allows to elaborate the general concept of complex regional development taking into consideration economic and non-economic factors with the focus on environmental aspects, accumulated environmental damage in particular. General strategic chart of sustainable environmental development of the Murmansk region worked out on the basis of complex regional indicators concept is composed. The key target indicators of sustainable ecological development of the Murmansk region are presented for the following strategic chart components: regional finance; society and market; industry and entrepreneurship; training, development and innovations. These charts are to be integrated with international environmental monitoring systems.

Hyperactivity of the default-mode network in first-episode, drug-naive schizophrenia at rest revealed by family-based case-control and traditional case-control designs.

PubMed

Guo, Wenbin; Liu, Feng; Chen, Jindong; Wu, Renrong; Li, Lehua; Zhang, Zhikun; Chen, Huafu; Zhao, Jingping

2017-03-01

Abnormal regional activity and functional connectivity of the default-mode network (DMN) have been reported in schizophrenia. However, previous studies may have been biased by unmatched case-control design. To limit such bias, the present study used both the family-based case-control design and the traditional case-control design to investigate abnormal regional activity of the DMN in patients with schizophrenia at rest.Twenty-eight first-episode, drug-naive patients with schizophrenia, 28 age-, sex-matched unaffected siblings of the patients (family-based controls, FBC), and 40 healthy controls (HC) underwent resting-state functional magnetic resonance imaging (fMRI) scans. The group-independent component analysis and fractional amplitude of low-frequency fluctuation (fALFF) methods were used to analyze the data.Patients with schizophrenia show increased fALFF in an overlapped region of the right superior medial prefrontal cortex (MPFC) relative to the FBC and the HC. Compared with the HC, the patients and the FBC exhibit increased fALFF in an overlapped region of the left posterior cingulate cortex/precuneus (PCC/PCu). Furthermore, the z values of the 2 overlapped regions can separate the patients from the FBC/HC, and separate the patients/FBC from the HC with relatively high sensitivity and specificity.Both the family-based case-control and traditional case-control designs reveal hyperactivity of the DMN in first-episode, drug-naive patients with paranoid schizophrenia, which highlights the importance of the DMN in the neurobiology of schizophrenia. Family-based case-control design can limit the confounding effects of environmental factors in schizophrenia. Combination of the family-based case-control and traditional case-control designs may be a viable option for the neuroimaging studies.

Characterization of Lunar Polar Illumination from a Power System Perspective

NASA Technical Reports Server (NTRS)

Fincannon, James

2008-01-01

This paper presents the results of illumination analyses for the lunar south and north pole regions obtained using an independently developed analytical tool and two types of digital elevation models (DEM). One DEM was based on radar height data from Earth observations of the lunar surface and the other was a combination of the radar data with a separate dataset generated using Clementine spacecraft stereo imagery. The analysis tool enables the assessment of illumination at most locations in the lunar polar regions for any time and any year. Maps are presented for both lunar poles for the worst case winter period (the critical power system design and planning bottleneck) and for the more favorable best case summer period. Average illumination maps are presented to help understand general topographic trends over the regions. Energy storage duration maps are presented to assist in power system design. Average illumination fraction, energy storage duration, solar/horizon terrain elevation profiles and illumination fraction profiles are presented for favorable lunar north and south pole sites which have the potential for manned or unmanned spacecraft operations. The format of the data is oriented for use by power system designers to develop mass optimized solar and energy storage systems.

Applications of a new wall function to turbulent flow computations

NASA Astrophysics Data System (ADS)

Chen, Y. S.

1986-01-01

A new wall function approach is developed based on a wall law suitable for incompressible turbulent boundary layers under strong adverse pressure gradients. This wall law was derived from a one-dimensional analysis of the turbulent kinetic energy equation with gradient diffusion concept employed in modeling the near-wall shear stress gradient. Numerical testing cases for the present wall functions include turbulent separating flows around an airfoil and turbulent recirculating flows in several confined regions. Improvements on the predictions using the present wall functions are illustrated. For cases of internal recirculating flows, one modification factor for improving the performance of the k-epsilon turbulence model in the flow recirculation regions is also included.

Proceedings of the Regional Seminar on Earthquake Engineering (13th) Held in Istanbul, Turkey on 14-24 September 1987.

DTIC Science & Technology

1987-09-01

Geological Survey, MS977, Menlo Park , CA 94025, USA. , TURKISH NATIONAL COMMITTEE FOR EARTHQUAKE ENGINEERING THIRTEENTH REGIONAL SEMINALR ON EARTQUAKE...this case the conditional probability P(E/F1) will also depend in general on t . A simple example of a case of this type was developed by the present...These studies took Into cosideration all the available date eoncerning the dynamic characteristics of different type * of buildings. A first attempt was

Unusual presentation of sunburn.

PubMed

Verma, Gopalkrishna G; Dave, Dhaval; Byrne, Eileen

2008-10-01

We present three cases of sunburn to the head, presenting with oedema of the face in children aged 6, 9 and 13 years. Oedema was predominantly on the forehead and temporal region; a direct effect of gravity was associated with erythema of the scalp. Sunburn healed without any complications.

Patent vitellointestinal duct as paraumblical abcess: A rare presentation

PubMed Central

Rekhi, Harnam Singh; Mittal, Sushil; Singh, Gurtej; Rekhi, Balwinder Kaur; Dugg, Pankaj

2015-01-01

Introduction Umbilical and paraumblical abscess can occur in children with presenting complaint of discharge from umbilical region. However, patent vitello intestinal duct presenting as paraumblical abscess is rare phenomenon. Presentation of case One year old male child presented with complain of discharge from umbilical region since birth. Incision & drainage done twice thinking it to be paraumblical abscess. Discussion Vitellointestinal duct as abscess is rare presentation but it should be considered as a differential diagnosis of discharging umbilicus as management of abscess and patent duct are different. Conclusion Patent vitellointestinal duct can present as paraumbilical abscess, and it should be kept in differential diagnosis specifically in children. PMID:26301682

Incidence of Leptospirosis infection in the East Zone of Sao Paulo City, Brazil

PubMed Central

2013-01-01

Background Leptospirosis is a zoonosis which is spread through contamined running water. This contaminations is seriously affected by the flooding which occurs in the area surrounding the Aricanduva river. The transmission of the disease results mainly from the contact of water with soil contaminated by the urine of infected animals. We aimed to conduct an epidemiological survey on Leptospirosis cases in Sao Paulo East Zone area. Method The analysis conducted in this study was based on data collected from the health authorities of that region close the Aricanduva river between 2007 and 2008 years, which give the rates of confirmed cases, mortality and death from human Leptospirosis. Other information concerned with the relationships among rainfall index, points of flooding and incidence of Leptospirosis. Results We observed a direct and important water contamination. Records of flooding points and dates of the reported cases in the region showed a direct relationship from which the period of higher rainfall also recorded an increase in cases. The annual record of the city and the region and rainfall regions also presented correlation. Conclusion The association between the indices of flooding and Leptospirosis cases indicates that preventive measures are necessary to avoid exposing the community. PMID:23672682

Nanostructures, systems, and methods for photocatalysis

DOEpatents

Reece, Steven Y.; Jarvi, Thomas D.

2015-12-08

The present invention generally relates to nanostructures and compositions comprising nanostructures, methods of making and using the nanostructures, and related systems. In some embodiments, a nanostructure comprises a first region and a second region, wherein a first photocatalytic reaction (e.g., an oxidation reaction) can be carried out at the first region and a second photocatalytic reaction (e.g., a reduction reaction) can be carried out at the second region. In some cases, the first photocatalytic reaction is the formation of oxygen gas from water and the second photocatalytic reaction is the formation of hydrogen gas from water. In some embodiments, a nanostructure comprises at least one semiconductor material, and, in some cases, at least one catalytic material and/or at least one photosensitizing agent.

Rickettsia rickettsii infecting Rhipicephalus sanguineus sensu lato (Latreille 1806), in high altitude atlantic forest fragments, Ceara State, Brazil.

PubMed

Silva, Arannadia Barbosa; Duarte, Myrian Morato; da Costa Cavalcante, Robson; de Oliveira, Stefan Vilges; Vizzoni, Vinicius Figueiredo; de Lima Duré, Ana Íris; de Melo Iani, Felipe Campos; Machado-Ferreira, Erik; Gazêta, Gilberto Salles

2017-09-01

In Brazil, Spotted Fever (SF) is caused by Rickettsia rickettsii and Rickettsia parkeri strain Atlantic Forest. In recent years, several human cases of a milder SF have been reported from the Maciço de Baturité region of Ceará State. Previous studies in this region found R. parkeri strain Atlantic Forest to be present in Rhipicephalus sanguineus sensu lato and Amblyomma ovale ticks. The present study isolated and identified the Rickettsia spp. present in this new endemic area in Brazil. In March 2015, R. sanguineus s.l. and A. ovale were collected in rural areas of the Maciço de Baturité region, and subjected to the isolation technique. A bacterium was isolated from one R. sanguineus s.l., which phylogenetic analysis clustered to the R. rickettsii group. In conclusion, R. rickettsii bacteria is circulating in the studied area and may in future have an impact on the clinical diagnoses and consequently cause changes in the profile of the disease in the region. In addition, we suggest the increase of epidemiological and environmental surveillance in the area, in order to prevent Brazilian Spotted Fever cases. Copyright © 2017. Published by Elsevier B.V.

Phenotypic variability of the cat eye syndrome. Case report and review of the literature.

PubMed

Rosias, P R; Sijstermans, J M; Theunissen, P M; Pulles-Heintzberger, C F; De Die-Smulders, C E; Engelen, J J; Van Der Meer, S B

2001-01-01

We present a male infant with preauricular skin tags and pits, downslanting palpebral fissures, hypertelorism, ectopic anus, hypospadias, and hypoplastic left heart syndrome. The clinical features in our patient show phenotypic overlap with the cat eye syndrome, as illustrated by the review of 105 reported cases. Cytogenetic analysis revealed a supernumerary marker chromosome, which was identified by microdissection and fluorescence in situ hybridization as an isodicentric chromosome 22(pter --> q11.2::q11.2 --> pter). It was proved with probes specific for the cat eye syndrome critical region that this region was present in quadruplicate in the propositus. We conclude that CES is characterized by large phenotypic variability, ranging from near normal to severe malformations, as reflected in the neurodevelopmental outcome. Preauricular skin tags and/or pits are the most consistent features, and suggest the presence of a supernumerary bisatellited marker chromosome 22 derived from duplication of the CES critical region.

Multiple Crimean-Congo Hemorrhagic Fever Virus Strains Are Associated with Disease Outbreaks in Sudan, 2008–2009

PubMed Central

Aradaib, Imadeldin E.; Erickson, Bobbie R.; Karsany, Mubarak S.; Khristova, Marina L.; Elageb, Rehab M.; Mohamed, Mohamed E. H.; Nichol, Stuart T.

2011-01-01

Background Crimean-Congo hemorrhagic fever (CCHF) activity has recently been detected in the Kordufan region of Sudan. Since 2008, several sporadic cases and nosocomial outbreaks associated with high case-fatality have been reported in villages and rural hospitals in the region. Principal Findings In the present study, we describe a cluster of cases occurring in June 2009 in Dunkop village, Abyei District, South Kordufan, Sudan. Seven CCHF cases were involved in the outbreak; however, clinical specimens could be collected from only two patients, both of whom were confirmed as acute CCHF cases using CCHF-specific reverse transcriptase polymerase chain reaction (RT-PCR). Phylogenetic analysis of the complete S, M, and L segment sequences places the Abyei strain of CCHF virus in Group III, a virus group containing strains from various countries across Africa, including Sudan, South Africa, Mauritania, and Nigeria. The Abyei strain detected in 2009 is genetically distinct from the recently described 2008 Sudanese CCHF virus strains (Al-fulah 3 and 4), and the Abyei strain S and L segments closely match those of CCHF virus strain ArD39554 from Mauritania. Conclusions The present investigation illustrates that multiple CCHF virus lineages are circulating in the Kordufan region of Sudan and are associated with recent outbreaks of the disease occurring during 2008–2009. PMID:21655310

Model for determining logistic distribution center: case study of Mount Merapi eruption disaster

NASA Astrophysics Data System (ADS)

Ai, T. J.; Wigati, S. S.

2017-01-01

As one of the most active volcano in the earth, Mount Merapi is periodically erupted and it is considered as a natural disaster for the surrounding area. Kabupaten Sleman as one of the nearest location to this mount has to be always prepared to this disaster. The local government already set three different groups of region, in which potentially affected by Mount Merapi eruption, called KRB I, KRB II, and KRB III. Region KRB III is the closest area to the mount crater and most often affected by the eruption disaster. Whenever KRB III is affected, people live in that area usually being transfer to the next region set that is KRB II. The case presented in this paper is located at the KRB II region, which is the second closest region to the mount crater. A humanitarian distribution system has to be set in this region, since usually this region is became the location of shelters for KRB III population whenever a ‘big’ eruption is happened. A mathematical model is proposed in this paper, for determining the location of distribution center, vehicle route, and the amount of goods delivered to each customer. Some numerical illustration are presented in order to know the behavior of the proposed model.

Nonsyndromic Bilateral Multiple Impacted Supernumerary Mandibular Third Molars: A Rare and Unusual Case Report

PubMed Central

Reddy, G. Siva Prasad; Reddy, G. V.; Krishna, I. Venkata; Regonda, Shravan Kumar

2013-01-01

A supernumerary tooth is that which is present additionally to the normal series and can be found in any region of the dental arch. An impacted tooth is defined as the one which is embedded in the alveolus, so that its eruption is prevented, or the tooth is locked in position by bone or the adjacent teeth. The occurrence of multiple supernumerary teeth in only one patient in the absence of an associated systemic condition or syndrome is considered as a rare phenomenon. The occurrence of supernumerary teeth in the lower molar region is rare. A prevalence of less than 2% of cases occurring in this region has been estimated. Their occurrence presents a clinical problem for orthodontists and oral surgeons. The cause, frequency, complications, and surgical operation of impacted teeth are always interesting subjects for study and research. An impacted tooth can result in caries, pulp disease, periapical and periodontal disease, temporomandibular joint disorder, infection of the fascial space, root resorption of the adjacent tooth, and even oral and maxillofacial tumours. The management of impacted wisdom teeth has changed over the past 20 years from removal of nonsymptomatic third molars to simple observation. The aim of this paper is to present a rare case of bilateral multiple impacted supernumerary mandibular third molars. PMID:23476818

BCR-ABL1- positive chronic myeloid leukemia with erythrocytosis presenting as polycythemia vera: a case report.

PubMed

Cornea, Mihaela I Precup; Levrat, Emmanuel; Pugin, Paul; Betticher, Daniel C

2015-04-08

The World Health Organization classification of chronic myeloproliferative disease encompasses eight entities of bone marrow neoplasms, among them Breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1-positive chronic myeloid leukemia and polycythemia vera. Polycythemia vera requires, in the majority of cases (95%), the negativity of Breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1 rearrangement and the presence of the Janus kinase 2 mutation. We report a case of erythrocytosis as the primary manifestation of a chronic myeloid leukemia, with the presence of the Philadelphia chromosome and the Breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1 fusion gene, and in the absence of any Janus kinase 2 mutation. A 68-year-old Caucasian woman, with a history of cigarette consumption and obstructive sleep apnoea syndrome (undergoing continuous positive airway pressure treatment) had presented to our institution with fatigue and a hemoglobin level of 18.6g/L, with slight leukocytosis at 16G/L, and no other anomalies on her complete blood cell count. Examination of her arterial blood gases found only a slight hypoxemia; erythropoietin and ferritin levels were very low and could not explain a secondary erythrocytosis. Further analyses revealed the absence of any Janus kinase 2 mutation, thus excluding polycythemia vera. Taken together with a high vitamin B12 level, we conducted a Breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1 gene analysis and bone marrow cytogenetic analysis, both of which returned positive, leading to the diagnosis of chronic myeloid leukemia. To date, this case is the first description of a Breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1-positive chronic myeloid leukemia, presenting with erythrocytosis as the initial manifestation, and mimicking a Janus kinase 2 V617F-negative polycythemia vera. Her impressive response to imatinib therapy underscores the importance of not missing this diagnosis.

Unusual Case of Gunshot Injury to the Face

PubMed Central

Guruprasad, Yadavalli; Giraddi, Girish

2011-01-01

An unusual case of facial gunshot injury with the missile lodged in the cervical spine region, but without any neurological impairment, is reported. The extent of tissue damage and missile track termination in a male patient who sustained gunshot trauma to the face was assessed by plain radiography and by computed tomography scans. The patient was treated conservatively and observed for clinical manifestations of neurological deficit for one year. We present a case of gunshot injury to the face with the missile lodged in the cervical spine region and atypical absence of clinical manifestation that may occur even when a bullet remains in the vicinity of the cervical spine. PMID:21915384

Posttraumatic epidermal inclusion cyst of the deep infratemporal fossa.

PubMed

Acarturk, T O; Stofman, G M

2001-01-01

The authors report a case of an epidermal inclusion cyst found in the deep infratemporal fossa 12 years after the patient sustained blunt trauma to that region. Posttraumatic epidermal inclusion cysts are rare and occur mainly in the fingers, palms, and soles. Introduction of the epidermal elements into the dermis during the trauma is thought to be the cause. This case is rare in presentation, with few reports in the English literature that describe an epidermal inclusion cyst in the deep infratemporal fossa. Review of the English literature disclosed no other cases of epidermal inclusion cyst after blunt trauma involving the deep infratemporal region.

Report of the COSPAR mars special regions colloquium

USGS Publications Warehouse

Kminek, G.; Rummel, J.D.; Cockell, C.S.; Atlas, R.; Barlow, N.; Beaty, D.; Boynton, W.; Carr, M.; Clifford, S.; Conley, C.A.; Davila, A.F.; Debus, A.; Doran, P.; Hecht, M.; Heldmann, J.; Helbert, J.; Hipkin, V.; Horneck, G.; Kieft, Thomas L.; Klingelhoefer, G.; Meyer, M.; Newsom, H.; Ori, G.G.; Parnell, J.; Prieur, D.; Raulin, F.; Schulze-Makuch, D.; Spry, J.A.; Stabekis, P.E.; Stackebrandt, E.; Vago, J.; Viso, M.; Voytek, M.; Wells, L.; Westall, F.

2010-01-01

In this paper we present the findings of a COSPAR Mars Special Regions Colloquium held in Rome in 2007. We review and discuss the definition of Mars Special Regions, the physical parameters used to define Mars Special Regions, and physical features on Mars that can be interpreted as Mars Special Regions. We conclude that any region experiencing temperatures > -25 ??C for a few hours a year and a water activity > 0.5 can potentially allow the replication of terrestrial microorganisms. Physical features on Mars that can be interpreted as meeting these conditions constitute a Mars Special Region. Based on current knowledge of the martian environment and the conservative nature of planetary protection, the following features constitute Mars Special regions: Gullies and bright streaks associated with them, pasted-on terrain, deep subsurface, dark streaks only on a case-by-case basis, others to be determined. The parameter definition and the associated list of physical features should be re-evaluated on a regular basis. ?? 2010 COSPAR. Published by Elsevier Ltd. All rights reserved.

Western U.S.-Canada crossborder case study : activity 2 : task D : conduct regional and local trucking case studies

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Technical Capability Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM proje...

Nameless, New Haven, and Nicholls

ERIC Educational Resources Information Center

Kurland, Jordan E.

2008-01-01

This article presents three recent American Association of University Professors (AAUP) cases that involved the dismissal of a senior non-tenure-track member of the faculty. The most recent case resulted in the investigating committee's report on Nicholls State University, a regional public institution in Louisiana. Preceding Nicholls was an…

New trends in transportation and land use scenario planning : five case studies of regional and local scenario planning efforts

DOT National Transportation Integrated Search

2010-04-01

This report summarizes important findings from a literature review on scenario planning processes and a scan of stakeholders. It also presents case studies on innovative, next generation scenario planning efforts. The project team defined next ...

REGIONAL ASSESSMENT OF LANDSCAPE AND DEMOGRAPHIC CHANGE EFFECTS IN THE MEDITERRANEAN REGION, THE MOROCCO CASE STUDY (1981-2003)

EPA Science Inventory

The method presented here allows mapping changes in vegetation cover trends over large areas quickly and inexpensively, thus providing policy-makers with a technical capacity to locate and assess areas of environmental instability and improve their ability to positively respond o...

Risk Factors for Fatal Outcome From Rocky Mountain Spotted Fever in a Highly Endemic Area—Arizona, 2002–2011

PubMed Central

Regan, Joanna J.; Traeger, Marc S.; Humpherys, Dwight; Mahoney, Dianna L.; Martinez, Michelle; Emerson, Ginny L.; Tack, Danielle M.; Geissler, Aimee; Yasmin, Seema; Lawson, Regina; Williams, Velda; Hamilton, Charlene; Levy, Craig; Komatsu, Ken; Yost, David A.; McQuiston, Jennifer H.

2016-01-01

Background Rocky Mountain spotted fever (RMSF) is a disease that now causes significant morbidity and mortality on several American Indian reservations in Arizona. Although the disease is treatable, reported RMSF case fatality rates from this region are high (7%) compared to the rest of the nation (<1%), suggesting a need to identify clinical points for intervention. Methods The first 205 cases from this region were reviewed and fatal RMSF cases were compared to nonfatal cases to determine clinical risk factors for fatal outcome. Results Doxycycline was initiated significantly later in fatal cases (median, day 7) than nonfatal cases (median, day 3), although both groups of case patients presented for care early (median, day 2). Multiple factors increased the risk of doxycycline delay and fatal outcome, such as early symptoms of nausea and diarrhea, history of alcoholism or chronic lung disease, and abnormal laboratory results such as elevated liver aminotransferases. Rash, history of tick bite, thrombocytopenia, and hyponatremia were often absent at initial presentation. Conclusions Earlier treatment with doxycycline can decrease morbidity and mortality from RMSF in this region. Recognition of risk factors associated with doxycycline delay and fatal outcome, such as early gastrointestinal symptoms and a history of alcoholism or chronic lung disease, may be useful in guiding early treatment decisions. Healthcare providers should have a low threshold for initiating doxycycline whenever treating febrile or potentially septic patients from tribal lands in Arizona, even if an alternative diagnosis seems more likely and classic findings of RMSF are absent. PMID:25697742

Sporotrichosis in Sub-Himalayan India

PubMed Central

Verma, Santwana; Verma, Ghanshyam K.; Singh, Gagandeep; Kanga, Anil; Shanker, Vinay; Singh, Digvijay; Gupta, Poonam; Mokta, Kiran; Sharma, Vinita

2012-01-01

Sporotrichosis is endemic in the Sub-Himalayan belt, which ranges from the northern to the north-eastern Indian subcontinent. Similar to many parts of the developing world, sporotrichosis is commonly recognized clinically in this region however consolidated epidemiological data is lacking. We report epidemiological, clinical and microbiological data from a hundred culture positive cases of sporotrichosis. Out of 305 clinically suspicious cases of sporotrichosis, a total of 100 isolates were identified as Sporothrix schenckii species complex (S. schenckii) on culture. Out of the culture proven cases 71% of the cases presented with lymphocutaneous type of lesions while 28% had fixed localized type and 1% had disseminated sporotrichosis. Presentation with lesions on hands was most frequently seen in 32% with arm (23%) and face (21%) in that sequence. The male to female ratio was 1∶1.27. Age ranged from 1 ½ years to 88 years. Mean age was 43.25 years. Disease was predominantly seen in the fourth to sixth decade of life with 58% cases between 31 and 60 years of age. Since the first report from the region there has been a steady rise in the number of cases of sporotrichosis. Seasonal trends reveal that most of the patients visited for consultation in the beginning of the year between March and April. This is the first study, from the most endemic region of the Sub-Himalayan belt, to delve into epidemiological and clinical details of such a large number of culture proven cases over a period of more than eighteen years which would help in the understanding of the local disease pattern of sporotrichosis. PMID:22720100

Sporotrichosis in sub-himalayan India.

PubMed

Verma, Santwana; Verma, Ghanshyam K; Singh, Gagandeep; Kanga, Anil; Shanker, Vinay; Singh, Digvijay; Gupta, Poonam; Mokta, Kiran; Sharma, Vinita

2012-01-01

Sporotrichosis is endemic in the Sub-Himalayan belt, which ranges from the northern to the north-eastern Indian subcontinent. Similar to many parts of the developing world, sporotrichosis is commonly recognized clinically in this region however consolidated epidemiological data is lacking. We report epidemiological, clinical and microbiological data from a hundred culture positive cases of sporotrichosis. Out of 305 clinically suspicious cases of sporotrichosis, a total of 100 isolates were identified as Sporothrix schenckii species complex (S. schenckii) on culture. Out of the culture proven cases 71% of the cases presented with lymphocutaneous type of lesions while 28% had fixed localized type and 1% had disseminated sporotrichosis. Presentation with lesions on hands was most frequently seen in 32% with arm (23%) and face (21%) in that sequence. The male to female ratio was 1∶1.27. Age ranged from 1 ½ years to 88 years. Mean age was 43.25 years. Disease was predominantly seen in the fourth to sixth decade of life with 58% cases between 31 and 60 years of age. Since the first report from the region there has been a steady rise in the number of cases of sporotrichosis. Seasonal trends reveal that most of the patients visited for consultation in the beginning of the year between March and April. This is the first study, from the most endemic region of the Sub-Himalayan belt, to delve into epidemiological and clinical details of such a large number of culture proven cases over a period of more than eighteen years which would help in the understanding of the local disease pattern of sporotrichosis.

A Case Study of Spirituality in Senior Center Education: Qualitative Research in Adult Education

ERIC Educational Resources Information Center

Demarse, Laura

2016-01-01

This article presents a case study on the role of spirituality in adult education at a suburban senior center located in the southeast region of the country. The purpose of the case study was to understand the deeply personal role of spirituality in adult education as seen through teaching seniors and examine the personal manifestation of…

Achondroplasia with 47, xxy karyotype: a case report of the neonatal diagnosis of an extremely unusual association

PubMed Central

2012-01-01

Background The association of achondroplasia and Klinefelter syndrome is extremely rare. To date, five cases have been previously reported, all of them diagnosed beyond the postnatal period, and only one was molecularly characterized. We describe the first case of this unusual association diagnosed in the neonatal period, the clinical findings and the molecular studies undertaken. Case presentation The boy was born at term with clinical and radiological features indicating the diagnosis of achondroplasia or hypochondroplasia combined with the prenatal karyotype of Klinefelter syndrome (47,XXY). Neonatal FGFR3 mutation screening showed that the newborn was heterozygous for the classic achondroplasia G340R mutation. Microsatellite marker analysis showed that the sex chromosome aneuploidy had arisen from a non-disjunction error in paternal meiosis I, with a recombination event in the pseudoautosomal region 1 (PAR1). Conclusion Specific mutation analysis is appropriate to confirm the clinical diagnosis of achondroplasia for appropriate diagnosis, prognosis, and genetic counseling, especially when the karyotype does not explain the abnormal prenatal sonographic findings. In the present case, a recombination event was observed in the PAR1 region, although recombinational events in paternally derived Klinefelter syndrome cases are much rarer than expected. PMID:22747519

Patterns of Plasmodium vivax and Plasmodium falciparum malaria underscore importance of data collection from private health care facilities in India.

PubMed

Gupta, Sangeeta; Gunter, James T; Novak, Robert J; Regens, James L

2009-10-12

This study describes patterns of falciparum and vivax malaria in a private comprehensive-care, multi-specialty hospital in New Delhi from July 2006 to July 2008. Malarial morbidity by Plasmodium species (Plasmodium falciparum, Plasmodium vivax, or Plasmodium sp.) was confirmed using microscopy and antigen tests. The influence of seasonal factors and selected patient demographics on morbidity was evaluated. The proportions of malaria cases caused by P. falciparum at the private facility were compared to data from India's National Vector Borne Disease Control Programme (NVBDCP) during the same period for the Delhi region. In New Delhi, P. faciparum was the dominant cause of cases requiring treatment in the private hospital during the period examined. The national data reported a smaller proportion of malaria cases caused by P. falciparum in the national capital region than was observed in a private facility within the region. Plasmodium vivax also caused a large proportion of the cases presenting clinically at the private hospital during the summer and monsoon seasons. The proportion of P. falciparum malaria cases tends to be greatest during the post-monsoon season while the proportion of P. vivax malaria cases tends to be greatest in the monsoon season. Private hospital data demonstrate an under-reporting of malaria case incidences in the data from India's national surveillance programme during the same period for the national capital region.

Adenoid cystic carcinoma: An unusual presentation.

PubMed

Pushpanjali, M; Sujata, D Naga; Subramanyam, S Bala; Jyothsna, M

2014-05-01

The adenoid cystic carcinoma is a relatively rare epithelial tumor of the major and minor salivary glands, accounting for about 1% of all malignant tumor of the oral and maxillofacial regions. Peak incidence occurs between the 5(th) and 6(th) decades of life. The clinical and pathological findings typical of this tumor include slow growth, peri-neural invasion, multiple local recurrences and distant metastasis. Herein, we report a case of adenoid cystic carcinoma of oropharynx with unusual clinical presentation. The diagnosis of this case and importance of cytology in diagnosing such cases is discussed.

Adenoid cystic carcinoma: An unusual presentation

PubMed Central

Pushpanjali, M; Sujata, D Naga; Subramanyam, S Bala; Jyothsna, M

2014-01-01

The adenoid cystic carcinoma is a relatively rare epithelial tumor of the major and minor salivary glands, accounting for about 1% of all malignant tumor of the oral and maxillofacial regions. Peak incidence occurs between the 5th and 6th decades of life. The clinical and pathological findings typical of this tumor include slow growth, peri-neural invasion, multiple local recurrences and distant metastasis. Herein, we report a case of adenoid cystic carcinoma of oropharynx with unusual clinical presentation. The diagnosis of this case and importance of cytology in diagnosing such cases is discussed. PMID:25328314

An unusual presentation: trichomycosis (trichobacteriosis) capitis in an infant.

PubMed

Takcı, Zennure; Karadağ, Ayşe Serap

2014-01-01

Trichomycosis (trichobacteriosis) is an asymptomatic superficial bacterial colonization of the hair shaft that is clinically characterized by pale yellowish, reddish or blackish sticky, cylindrical concretions surrounding the hair shaft in the axillary or pubic region. As far as we know, the first and only case of trichomycosis capitis was reported in a 8-year-old boy in 2011. We encountered no cases of trichomycosis in infancy in the literature. The current case displays an atypical presentation of trichobacteriosis involving head hair in a 10-month-old male infant.

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

Hirst, M.; Grewal, P.; Flannery, A.

Screening of families clinically ascertained for the fragile X syndrome phenotype revealed two mentally impaired males who were cytogenetically negative for the fragile X chromosome. In both cases, screening for the FMR1 trinucleotide expansion mutation revealed a rearrangement within the FMR1 gene. In the first case, a 660-bp deletion is present in 40% of peripheral lymphocytes. PCR and sequence analysis revealed it to include the CpG island and the CGG trinucleotide repeat, thus removing the FMR1 promoter region and putative mRNA start site. In the second case, PCR analysis demonstrated that a deletion extended from a point proximal to FMR1more » to 25 kb into the gene, removing all the region 5{prime} to exon 11. The distal breakpoint was confirmed by Southern blot analysis and localized to a 600-bp region, and FMR1-mRNA analysis in a cell line established from this individual confirmed the lack of a transcript. These deletion patients provide further confirmatory evidence that loss of FMR1 gene expression is indeed responsible for mental retardation. Additionally, these cases highlight the need for the careful examination of the FMR1 gene, even in the absence of cytogenetic expression, particularly when several fragile X-like clinical features are present. 31 refs., 6 figs.« less

Leishmania (Viannia) naiffi: rare enough to be neglected?

PubMed

Fagundes-Silva, Giselle Aparecida; Romero, Gustavo Adolfo Sierra; Cupolillo, Elisa; Yamashita, Ellen Priscila Gadelha; Gomes-Silva, Adriano; Guerra, Jorge Augusto de Oliveira; Da-Cruz, Alda Maria

2015-09-01

In the Brazilian Amazon, American tegumentary leishmaniasis (ATL) is endemic and presents a wide spectrum of clinical manifestations due, in part, to the circulation of at least seven Leishmania species. Few reports of Leishmania (Viannia) naiffi infection suggest that its occurrence is uncommon and the reported cases present a benign clinical course and a good response to treatment. This study aimed to strengthen the clinical and epidemiological importance of L. (V.) naiffi in the Amazon Region (Manaus, state of Amazonas) and to report therapeutic failure in patients infected with this species. Thirty Leishmania spp samples isolated from cutaneous lesions were characterised by multilocus enzyme electrophoresis. As expected, the most common species was Leishmania (V.) guyanensis (20 cases). However, a relevant number of L. (V.) naiffi patients (8 cases) was observed, thus demonstrating that this species is not uncommon in the region. No patient infected with L. (V.) naiffi evolved to spontaneous cure until the start of treatment, which indicated that this species may not have a self-limiting nature. In addition, two of the patients experienced a poor response to antimonial or pentamidine therapy. Thus, either ATL cases due to L. (V.) naiffi cannot be as uncommon as previously thought or this species is currently expanding in this region.

Kimura's Disease without Peripheral Eosinophilia: An Unusual and Challenging Case Simulating Venous Malformation on Imaging Studies-Case Report and Review of literature.

PubMed

Dokania, Vivek; Patil, Digvijay; Agarwal, Ketan; Thakur, Prajakta; Prajapati, Piyush

2017-06-01

Kimura's Disease (KD) is a rare chronic inflammatory disorder presenting as multiple painless solitary subcutaneous nodules, predominantly in the head and neck region and frequently associated with regional lymphadenopathy and/or salivary gland involvement. Because of painless nature and indolent course, there is usually a delay in the patient's presentation. KD may radiologically mimic other chronic inflammatory conditions like tuberculosis, vascular malformations and neoplasms. Clinical correlation and histological evaluation along with elevated peripheral eosinophil and serum IgE level are considered important for confirmatory diagnosis. We report a case of painless swelling over right submandibular region extending to the right superficial parotid. The haematological reports were within normal limits. Ultrasound (USG), Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiogram (MRA) favoured a diagnosis of venous malformation. However, histopathological examination of excised lesion confirmed a diagnosis of KD. This case proves the possibility of the KD even in the absence of peripheral eosinophilia and/ or elevated serum IgE level, and may mimic venous malformation on imaging studies. Therefore, KD must find a place in the differentials of solitary painless neck swelling even in the absence of peripheral eosinophilia and/or elevated IgE level.

Congenital Malaria in China

PubMed Central

Liu, Xue; Culleton, Richard; Tao, Li; Xia, Hui; Gao, Qi

2014-01-01

Abstract Background Congenital malaria, in which infants are directly infected with malaria parasites from their mother prior to or during birth, is a potentially life-threatening condition that occurs at relatively low rates in malaria-endemic regions. It is recognized as a serious problem in Plasmodium falciparum–endemic sub-Saharan Africa, where recent data suggests that it is more common than previously believed. In such regions where malaria transmission is high, neonates may be protected from disease caused by congenital malaria through the transfer of maternal antibodies against the parasite. However, in low P. vivax–endemic regions, immunity to vivax malaria is low; thus, there is the likelihood that congenital vivax malaria poses a more significant threat to newborn health. Malaria had previously been a major parasitic disease in China, and congenital malaria case reports in Chinese offer valuable information for understanding the risks posed by congenital malaria to neonatal health. As most of the literature documenting congenital malaria cases in China are written in Chinese and therefore are not easily accessible to the global malaria research community, we have undertaken an extensive review of the Chinese literature on this subject. Methods/Principal Findings Here, we reviewed congenital malaria cases from three major searchable Chinese journal databases, concentrating on data from 1915 through 2011. Following extensive screening, a total of 104 cases of congenital malaria were identified. These cases were distributed mainly in the eastern, central, and southern regions of China, as well as in the low-lying region of southwest China. The dominant species was P. vivax (92.50%), reflecting the malaria parasite species distribution in China. The leading clinical presentation was fever, and other clinical presentations were anaemia, jaundice, paleness, diarrhoea, vomiting, and general weakness. With the exception of two cases, all patients were cured with antimalarial drugs such as chloroquine, quinine, artemether, and artesunate. Conclusions The symptoms of congenital malaria vary significantly between cases, so clear and early diagnosis is difficult. We suggest that active surveillance might be necessary for neonates born to mothers with a history of malaria. PMID:24626148

Gliosarcomas arising from the pineal gland region: uncommon localization and rare tumors.

PubMed

Sugita, Yasuo; Terasaki, Mizuhiko; Tanigawa, Ken; Ohshima, Koichi; Morioka, Motohiro; Higaki, Koichi; Nakagawa, Setsuko; Shimokawa, Shoko; Nakashima, Susumu

2016-02-01

Gliosarcomas are a variant of glioblastomas and present a biphasic pattern, with coexisting glial and mesenchymal components. In this study, two unusual cases are presented. Case 1 is a 52-year-old woman with a headache and memory disturbance for a month. Case 2 is an 18-year-old man with a headache lasting two weeks. In both cases, an MRI revealed enhancing T1-low to iso, T2-iso to high intensity lesions in the pineal gland region. Histologically, in case 1, the tumor showed spindle cell proliferation with disorganized fascicles and cellular pleomorphism. Tumor cells variously exhibited oncocytic transformation. Immunohistochemically, most of the spindle tumor cells were positive for myoglobin and desmin. Some of the tumor cells were positive for GFAP and S-100 protein. On the other hand, all tumor cells were positive for CD133, Musashi1, and SOX-2 which are the markers of neural stem cells. In case 2, the tumor showed monotonous proliferation of short spindle cells with disorganized fascicles and cellular atypism. The morphological distinction between glial and mesenchymal components was not apparent. Immunohistochemically, most of the spindle tumor cells were positive for desmin. Glial tumor cells that were dispersed within the sarcoma as single cells were positive for GFAP. In addition, all tumor cells were positive for CD133, Musashi1 and SOX-2. Based on these microscopic appearances, and immunohistochemical findings, these cases were diagnosed as gliosarcomas arising from the pineal gland region. These results also indicated that pluripotential cancer stem cells differentiated into glial and muscle cell lines at the time of tumor growth. In a survey of previous publications on gliosarcoma arising from the pineal gland, these cases are the second and third reports found in English scientific writings. © 2015 Japanese Society of Neuropathology.

Regional Pericarditis Status Post Cardiac Ablation: A Case Report

PubMed Central

Orme, Joseph; Eddin, Moneer; Loli, Akil

2014-01-01

Context: Regional pericarditis is elusive and difficult to diagnosis. Healthcare providers should be familiar with post-cardiac ablation complications as this procedure is now widespread and frequently performed. The management of regional pericarditis differs greatly from that of acute myocardial infarction. Case report: A 52 year-old male underwent atrial fibrillation ablation and developed severe mid-sternal chest pain the following day with electrocardiographic findings suggestive of acute myocardial infarction, and underwent coronary angiography, a left ventriculogram, and 2D transthoracic echocardiogram, all of which were unremarkable without evidence of obstructive coronary disease, wall motion abnormalities, or pericardial effusions. Ultimately, the patient was diagnosed with regional pericarditis. After diagnosis, the patient's presenting symptoms resolved with treatment including nonsteroidal anti-inflammatory agents and colchicine. Conclusion: This is the first reported case study of regional pericarditis status post cardiac ablation. Electrocardiographic findings were classic for an acute myocardial infarction; however, coronary angiography and left ventriculogram demonstrated no acute coronary occlusion or ventricular wall motion abnormalities. Healthcare professionals must remember that the electrocardiographic findings in pericarditis are not always classic and that pericarditis can occur status post cardiac ablation. PMID:25317395

Abnormal vessel of the ear associated with congenital arteriovenous malformation in the postauricular region.

PubMed

Dixit, Shilpi Gupta; Dixit, Rakesh

2013-08-01

Variations in the branching pattern of the common, external, and internal carotid arteries can present as arteriovenous malformations, and their basis can be explained embryologically. Our case was a rare variation presenting as a congenital, very gradually increasing bluish painless swelling at the region of the left lobule of the ear arising from an abnormal vessel (from the postauricular artery) which was explored under general anesthesia through a postauricular curved incision. The abnormal vessel and other feeding vessels were ligated and a sclerosing agent injected. Anomalies of pharyngeal arch arteries like our case can be found resulting from the persistence of channels that normally disappear, and prior knowledge of these anomalies is essential before surgeries like mastoidectomy to prevent alarming hemorrhage.

Climatology of meteorological ``bombs'' in the New Zealand region

NASA Astrophysics Data System (ADS)

Leslie, L. M.; Leplastrier, M.; Buckley, B. W.; Qi, L.

2005-06-01

The purpose of this paper is to present a recently developed climatology of explosively developing south eastern Tasman Sea extra-tropical cyclones, or meteorological “bombs”, using a latitude dependent definition for meteorological bombs based on that of Simmonds and Keay (2000a, b), and Lim and Simmonds (2002). These highly transient systems, which have a damaging impact upon New Zealand, are frequently accompanied by destructive winds, flood rains, and coastal storm surges. Two cases are selected from the climatology and briefly described here. The first case study is the major flood and storm force wind event of June 20 to 21, 2002 that affected the Coromandel Peninsula region of the North Island of New Zealand. The second case was a “supercyclone” bomb that developed well to the southwest of New Zealand region during May 29 to 31, 2004, but which could easily have formed in the New Zealand region with catastrophic consequences. It was well-captured by the new high resolution Quikscat scatterometer instrument.

Primary pulmonary plasmacytoma with diffuse alveolar consolidation: a case report.

PubMed

Mohammad Taheri, Zohreh; Mohammadi, Forouzan; Karbasi, Mehrdad; Seyfollahi, Leila; Kahkoei, Shahram; Ghadiany, Mojtaba; Fayazi, Nader; Mansouri, Davood

2010-06-13

Solitary extramedullary plasmacytomas are plasma cell tumors that tend to develop in mucosa-associated lymphoid tissues including the sinonasal or nasopharyngeal regions. Primary plasmacytoma of the lung is exceedingly rare and often presents as a solitary mass or nodule in mid-lung or hilar areas and diagnosed after resection. Herein, we report a case of primary pulmonary plasmacytoma that presented with diffuse alveolar consolidation and diagnosed by transbronchial lung biopsy.

Primary Pulmonary Plasmacytoma with Diffuse Alveolar Consolidation: A Case Report

PubMed Central

Mohammad Taheri, Zohreh; Mohammadi, Forouzan; Karbasi, Mehrdad; Seyfollahi, Leila; Kahkoei, Shahram; Ghadiany, Mojtaba; Fayazi, Nader; Mansouri, Davood

2010-01-01

Solitary extramedullary plasmacytomas are plasma cell tumors that tend to develop in mucosa-associated lymphoid tissues including the sinonasal or nasopharyngeal regions. Primary plasmacytoma of the lung is exceedingly rare and often presents as a solitary mass or nodule in mid-lung or hilar areas and diagnosed after resection. Herein, we report a case of primary pulmonary plasmacytoma that presented with diffuse alveolar consolidation and diagnosed by transbronchial lung biopsy. PMID:21151727

Phytodermatitis caused by Ceratocephalus falcatus (Ranunculacea).

PubMed

Karaca, Semsettin; Kulac, Mustafa; Kucuker, Hudaverdi

2005-01-01

Ceratocephalus falcatus is a member of Ranunculacea family that forms part of the flora of the Sinanpasa and Dinar regions of Afyon city in Turkey. Ceratocephalus falcatus has laxative properties and has been used for treating hemorrhoids, rheumatismal diseases and wounds. Here, a case of phytodermatitis caused by this remedy used for relieving knee pain is presented. This plant should be kept in mind when a case of phytodermatitis with vesicles or bullae presents at clinics.

Patterns of regional head and neck lymph node metastasis in primary conjunctival malignant melanoma

PubMed Central

Lim, M; Tatla, T; Hersh, D; Hungerford, J

2006-01-01

Objective To correlate patterns of regional lymph node metastasis with the site of origin in primary conjunctival malignant melanoma. Design Retrospective analysis (1990–2003) of clinical data. Setting Two London tertiary referral centres. Participants 12 patients presenting with regional metastases after failed local treatment for conjunctival malignant melanoma. Results 6 cases predominantly involving the temporal conjunctiva metastasised to the pre‐auricular lymph nodes. Two cases predominantly involving the nasal conjunctiva metastasised to the submandibular nodes. Of the two cases with purely multifocal disease, one metastasised to the pre‐auricular nodes and another to both submandibular and parotid nodes. One primary conjunctival malignant melanoma had its origin in temporal conjunctiva but metastasised to submandibular nodes, and another case originating from nasal conjunctiva metastasised to pre‐auricular nodes. Conclusions Temporal conjunctival melanotic lesions tend to metastasise clinically to pre‐auricular lymph nodes and nasal conjunctival melanotic lesions metastasise to the submandibular lymph nodes. Patterns appear consistent with laboratory‐based anatomically mapped lymphatic drainage basins of the conjunctiva. PMID:16928703

Epidemiology of enteric disease in C-EnterNet’s pilot site – Waterloo region, Ontario, 1990 to 2004

PubMed Central

Keegan, Victoria A; Majowicz, Shannon E; Pearl, David L; Marshall, Barbara J; Sittler, Nancy; Knowles, Lewinda; Wilson, Jeffery B

2009-01-01

OBJECTIVE: The objective of the present study was to describe the epidemiology of reportable enteric illness in Ontario’s Waterloo region, including comparing calculated incidence rates with published rates, and adjusting for under-reporting to determine the number of community cases, where published data were available. METHODS: Descriptive analyses were performed on reportable disease data for 13 enteric diseases collected in the Waterloo region from 1990 to 2004. Poisson and negative binomial regression analyses were used to investigate differences in incidence rates among age, sex, the 15 years of data and seasons. Disease-specific incidence rates were calculated and compared with the literature, where possible. Under-reporting ratios from the literature were applied to estimate the number of cases of campylobacteriosis, nontyphoidal salmonellosis and verotoxigenic Escherichia coli infection at the community level. RESULTS: Over the study period, the average annual age- and sex-adjusted incidence rates per 100,000 population were highest for campylobacteriosis (49.69 cases), followed by giardiasis (31.87 cases) and nontyphoidal salmonellosis (25.97 cases). The incidence of most enteric illnesses peaked in the summer. The highest incidence occurred in young children, followed by adults in their 20s. Diarrhea (85.4%) was the most frequently reported symptom, food (57.4%) was the most commonly reported probable source, and home (41.7%) and travel (37.0%) were the two most frequently reported risk settings. CONCLUSIONS: Enteric illness was a significant health burden in the Waterloo region from 1990 to 2004. Because reportable disease data are subject to under-reporting, it is likely that the true burden is greater than estimated in the present study. PMID:20808465

Atypical Ewing sarcoma breakpoint region 1 fluorescence in-situ hybridization signal patterns in bone and soft tissue tumours: diagnostic experience with 135 cases.

PubMed

Vargas, A Cristina; Selinger, Christina I; Satgunaseelan, Laveniya; Cooper, Wendy A; Gupta, Ruta; Stalley, Paul; Brown, Wendy; Soper, Judy; Schatz, Julie; Boyle, Richard; Thomas, David M; Tattersall, Martin H N; Bhadri, Vivek A; Maclean, Fiona; Bonar, S Fiona; Scolyer, Richard A; Karim, Rooshdiya Z; McCarthy, Stanley W; Mahar, Annabelle; O'Toole, Sandra A

2016-12-01

Recurrent Ewing sarcoma breakpoint region 1 (EWSR1) gene rearrangements characterize a select group of bone and soft tissue tumours. In our routine diagnostic practice with fluorescence in-situ hybridization (FISH), we have occasionally observed EWSR1 gene rearrangements in tumours not associated classically with EWSR1 translocations. This study aimed to review our institutional experience of this phenomenon and also to highlight the occurrence of unusual EWSR1 FISH signals (i.e. 5' centromeric region or 3' telomeric region signals) that do not fulfil the published diagnostic criteria for rearrangements. Using an EWSR1 break-apart probe, we performed FISH assays on formalin-fixed paraffin-embedded tissue sections from 135 bone and soft tissue specimens as part of their routine diagnostic work-up. EWSR1 gene rearrangements were identified in 51% of cases, 56% of which also showed an abnormal FISH signal pattern (in addition to classically rearranged signals). However, atypical FISH signals were present in 45% of the non-rearranged cases. In addition, we observed tumours unrelated to those described classically as EWSR1-associated that were technically EWSR1-rearranged in 6% of cases. Borderline levels of rearrangement (affecting 10-30% of lesional cells) were present in an additional 17% of these cases. While our study confirmed that FISH is a sensitive and specific tool in the diagnosis of EWSR1-associated tumours, atypical FISH signals and classical rearrangement in entities other than EWSR1-associated tumours can occur. Therefore, it is essential that the FISH result not be used as an isolated test, but must be evaluated in the context of clinical features, imaging, pathological and immunohistochemical findings. © 2016 John Wiley & Sons Ltd.

Giant Occipitocervical Lipomas: Evaluation with Two Cases

PubMed Central

Basmaci, Mehmet; Hasturk, Askin E

2012-01-01

Lipomas are capsulated benign tumours that are commonly found in all body parts. A lipoma is a well-defined mesenchymal tumour that arises from the adipose tissue. Although giant lipomas are rare in the head and neck regions, when they are located here, they are most commonly found in the subcutaneous posterior neck area. Recurrence as well as invasion is very rare after total surgical excision. In this article, we present two rare cases of giant lipomas in the posterior occipitocervical region, which is an exceptional location. PMID:23112521

Malignant hemangiopericytoma of pituitary fossa.

PubMed

Das, Prasenjit; Haresh, Kunhi P; Suri, Vaishali; Sharma, Mehar Chand; Sharma, Bhawani Shankar; Sarkar, Chitra

2010-01-01

Intracranial hemangiopericytomas are rare tumors with aggressive behavior. Other than the meninges, this lesion has rarely been reported in periventricular and sellar region. We report a case of malignant hemangiopericytoma in sellar region in a 47-year-old male who presented with history of sudden onset of bilateral visual disturbances. To best of our knowledge, this is the second case report of malignant hemangiopericytoma in this location. As this intracranial lesion shows aggressive behavior, in the form of recurrence or extracranial metastasis in comparison to its extracranial counterparts, diagnosis should be made cautiously.

Benign fibrous histiocytoma of the fronto-temporo-parietal region: a case report and review of the literature

PubMed Central

Chen, Hongxu; Li, Pengcheng; Liu, Zhiyong; Xu, Jianguo; Hui, Xuhui

2015-01-01

Primary benign fibrous histiocytoma (BFH) at the skull is extremely rare. Here we report a case of a 22-year-old man presented with a 1-year history of progressive enlargement subcutaneous mass on the right side of the fronto-temporo-parietal region without symptoms. The tumor was radical resected through craniotomy and the bone defect was repaired by pre-plasticity titanium mesh. Histopathologic examination confirmed a benign fibrous histiocytoma, and no signs of tumor recurrence were detected at 3-year follow-up. PMID:26823894

Lesion network localization of criminal behavior

PubMed Central

Darby, R. Ryan; Horn, Andreas; Fox, Michael D.

2018-01-01

Following brain lesions, previously normal patients sometimes exhibit criminal behavior. Although rare, these cases can lend unique insight into the neurobiological substrate of criminality. Here we present a systematic mapping of lesions with known temporal association to criminal behavior, identifying 17 lesion cases. The lesion sites were spatially heterogeneous, including the medial prefrontal cortex, orbitofrontal cortex, and different locations within the bilateral temporal lobes. No single brain region was damaged in all cases. Because lesion-induced symptoms can come from sites connected to the lesion location and not just the lesion location itself, we also identified brain regions functionally connected to each lesion location. This technique, termed lesion network mapping, has recently identified regions involved in symptom generation across a variety of lesion-induced disorders. All lesions were functionally connected to the same network of brain regions. This criminality-associated connectivity pattern was unique compared with lesions causing four other neuropsychiatric syndromes. This network includes regions involved in morality, value-based decision making, and theory of mind, but not regions involved in cognitive control or empathy. Finally, we replicated our results in a separate cohort of 23 cases in which a temporal relationship between brain lesions and criminal behavior was implied but not definitive. Our results suggest that lesions in criminals occur in different brain locations but localize to a unique resting state network, providing insight into the neurobiology of criminal behavior. PMID:29255017

Early diagnosis of regional odontodysplasia in an infant.

PubMed

Canela, Alfredo Hiram Carrillo; Rezende, Karla Mayra Pinto E Carvalho; Benitez, Mirtha; Bönecker, Marcelo

2012-03-01

Regional odontodysplasia is a rare and significant dental malformation. It is a dental alteration of unknown etiology, involving both mesodermal and ectodermal dental components, which present clinical, radiographic, and histologic features. This article reports a clinical case of a 10-month-old child who was diagnosed with regional odontodysplasia in the maxilla, confirmed by radiographic examination, with a follow-up of 5 years. The clinical, radiographic, and histologic features were reviewed.

PLANNING MODELS FOR URBAN WATER SUPPLY EXPANSION. VOLUME 1. PLANNING FOR THE EXPANSION OF REGIONAL WATER SUPPLY SYSTEMS

EPA Science Inventory

A three-volume report was developed relative to the modelling of investment strategies for regional water supply planning. Volume 1 is the study of capacity expansion over time. Models to aid decision making for the deterministic case are presented, and a planning process under u...

Comparison of the larynx-associated lymphoid tissue in the false vocal cords and subglottis in pediatric autopsies.

PubMed

Rossi e Silva, Renata Calciolari; Olegário, Janainna Grazielle Pacheco; Abate, Débora Tavares de Rezende e Silva; Salge, Ana Karina Marques; Peres, Luiz César; Corrêa, Rosana Rosa Miranda; Castro, Eumenia Costa da Cunha; Teixeira, Vicente de Paula Antunes

2012-12-15

The aim this work was to compare the distribution of cellular phenotypes of the LF in the FVC to the ones in the subglottic region in pediatric autopsy, relating this distribution to age and different causes of death. We analyzed 60 larynges of newborns and children autopsied in the period from 1993 to 2003. The fragments were prepared in order to perform histochemical and immunohistochemical techniques. The morphological analysis showed cases that presented LF only in FVC (35%), LF only in the subglottic region (20%), lack of LF in FVC (30%) and lymphoid aggregates, which did not characterize an LF (15%). The cases of LF in the subglottic region were significantly younger compared to the ones that presented LF in the FVC (p=0.017). The LF in the subglottic region was bigger than the LF in the FVC (p=0.020). There was no significant difference between the cause of death and cellular phenotype for both FVC and the subglottic region. In conclusion, the cells that make up the LF in the FVC in newborns and children younger than one year have functional characteristics similar to LF cells in the subglottic region, suggesting that there are similarities with LALT. Copyright © 2012 Elsevier GmbH. All rights reserved.

Sympathetically maintained pain presenting first as temporomandibular disorder, then as parotid dysfunction.

PubMed

Giri, Subha; Nixdorf, Donald

2007-08-01

Complex regional pain syndrome (CRPS) is a chronic condition that usually affects extremities, such as the arms or legs. It is characterized by intense pain, swelling, redness, hypersensitivity in a region not defined by a single peripheral nerve and additional sudomotor effects, such as excessive sweating. The clinical criteria for the diagnosis of sympathetically maintained pain as outlined by the International Association for the Study of Pain include: Onset following an initiating noxious event (CRPS-type I) or nerve injury (CRPS-type II). Spontaneous allodynia that is not limited to peripheral nerve distribution and is not proportionate to the inciting event; abnormal sudomotor activity, skin blood flow abnormality, edema, other autonomic symptoms; and exclusion of other conditions that may otherwise contribute to the extent of the symptoms. Only 13 cases of CRPS involving sympathetically maintained pain in the head and neck region have been described, and all reported trauma as the identifiable etiologic factor. The case presented here is another occurrence of sympathetically maintained pain in the head and neck region, but without nerve injury as a clear initiating factor.

[Seasonal and regional distribution of tularemia cases in Amasya, Turkey].

PubMed

Yanık, Keramettin; Sarıaydın, Muzaffer; Uzun, M Önder; Çoban, Ahmet Yılmaz; Seçilmiş, Halil

2015-01-01

Tularemia have attracted attention due to increased number of cases since 2009 in Amasya region which is located at Central Blacksea Region of Turkey. The aims of this letter were to provide information about the disease, to emphasize the importance of early treatment due to the outbreak peak in our province between 2009-2012 and water chlorination in epidemic areas. A total of 250 tularemia-suspected patients (117 female, 133 male; mean age: 42 yrs) who were admitted to our hospital with the symptoms of sore throat, fever, malaise and/or presence of neck mass, from 20 different locations within last four years were included in the study. Serum samples of 73 (29.2%) patients yielded ≥ 1/160 titers with F.tularensis microagglutination test which were considered as positive. All positive cases presented with the oropharyngeal form of the disease. The year with the highest number of tularemia cases was 2010. When the regional distribution was evaluated, it was detected that positive cases have precipitated especially in the southeastern (highland area) and northeastern (lowland area) parts of Amasya (34/73; 46.6%). Majority of the tularemia cases (53/73; 72.6%) were identified in colder seasons. The number of cases in rural and urban centers have decreased after 2010. In conclusion, it is considered that the emergence of new cases is likely to persist due to the geographical characteristics of Amasya and occupational properties (livestock breeding) of the population. Therefore, the clinicians should consider tularemia in differential diagnosis of the cases originated from risky rural areas.

Sympathetic blocks for the treatment of complex regional pain syndrome: A case series.

PubMed

Gungor, Semih; Aiyer, Rohit; Baykoca, Buse

2018-05-01

To present the successful treatment of complex regional pain syndrome type -1 utilizing sympathetic blocks. Severe pain interfering with activities of daily living and temporary disability secondary to complex regional pain syndrome. Complex regional pain syndrome type-1 with involvement of lower extremity (2 patients), and upper extremity (1 patient). We report the management of 3 patients with diagnosis of complex regional pain syndrome type-1 by early institution of sympathetic blocks for diagnostic and therapeutic purposes. All 3 patients were able to tolerate physical therapy only after adequate pain relief had been achieved with institution of sympathetic blocks. All 3 patients responded very favorably to sympathetic blocks with dramatic reversal of pathology. All patients reported almost complete resolution of pain, symptoms, and signs within 6 months duration after diagnosis of complex regional pain syndrome. All 3 patients were able to wean their pain medications and achieve normal activities of daily living without any significant limitations. All patients were able to return to full-time employment. Treatment options are limited and there is lack of high quality research regarding the efficacy of sympathetic blocks in the treatment of complex regional pain syndrome. As presented in this case series, sympathetic blocks maybe very effective in the treatment of complex regional pain syndrome in a subset of patients. Thus, early institution of sympathetic blocks should be considered in complex regional pain syndrome prior to physical therapy and consideration of more invasive pain management interventions.

Synthesis in land change science: methodological patterns, challenges, and guidelines.

PubMed

Magliocca, Nicholas R; Rudel, Thomas K; Verburg, Peter H; McConnell, William J; Mertz, Ole; Gerstner, Katharina; Heinimann, Andreas; Ellis, Erle C

Global and regional economic and environmental changes are increasingly influencing local land-use, livelihoods, and ecosystems. At the same time, cumulative local land changes are driving global and regional changes in biodiversity and the environment. To understand the causes and consequences of these changes, land change science (LCS) draws on a wide array synthetic and meta-study techniques to generate global and regional knowledge from local case studies of land change. Here, we review the characteristics and applications of synthesis methods in LCS and assess the current state of synthetic research based on a meta-analysis of synthesis studies from 1995 to 2012. Publication of synthesis research is accelerating, with a clear trend toward increasingly sophisticated and quantitative methods, including meta-analysis. Detailed trends in synthesis objectives, methods, and land change phenomena and world regions most commonly studied are presented. Significant challenges to successful synthesis research in LCS are also identified, including issues of interpretability and comparability across case-studies and the limits of and biases in the geographic coverage of case studies. Nevertheless, synthesis methods based on local case studies will remain essential for generating systematic global and regional understanding of local land change for the foreseeable future, and multiple opportunities exist to accelerate and enhance the reliability of synthetic LCS research in the future. Demand for global and regional knowledge generation will continue to grow to support adaptation and mitigation policies consistent with both the local realities and regional and global environmental and economic contexts of land change.

Burden and trends of type-specific human papillomavirus infections and related diseases in the latin america and Caribbean region.

PubMed

Parkin, D Maxwell; Almonte, Maribel; Bruni, Laia; Clifford, Gary; Curado, Maria-Paula; Piñeros, Marion

2008-08-19

We present the burden of human papillomavirus (HPV)-related cancers (cancers of the cervix, anogenital region, oral cavity and pharynx) in terms of incidence and mortality, for the countries of the Latin America and Caribbean region. The region is a high-risk area for cancer of the cervix and, although incidence has declined since the 1960s, projected demographic changes imply that the actual burden of new cases will increase by more than 75% in the next 20 years, while the average and at diagnosis will increase. Approximately 65% of cervical cancer cases and 50% of the high risk lesions are associated with HPV-16 and 18. Incidence rates of other HPV-related cancers are significantly lower. The paper also describes the estimated impact of genital warts and the limited data available on the occurrence of HPV infections of the upper aerodigestive tract in the region.

A rare case of thyroid haemangiosarcoma.

PubMed

Del Rio, Paolo; Cataldo, Simona; Sommaruga, Lucia; Corcione, Luigi; Guazzi, Anna; Sianesi, Mario

2007-01-01

The incidence of haemangiosarcoma in the literature is variable especially in the Alpine region and in Austria, ranging from 2 to 10% of all thyroid neoplastic lesions. This thyroid disease is characterised by positive endothelial markers (CD 31, CD 34 and FVIII), and co-positive markers for cytokeratins, epithelial membrane antigen and a loss of thyroglobulin can sometimes be found. Immunochemistry does not help the physician to classify the neoplasia as a variant of anaplastic carcinoma or sarcoma of endothelial origin. We present a case of epithelioid haemangiosarcoma in an elderly woman from outside the Alpine region with a contralateral papillary cancer treated by total thyroidectomy. The prognosis is poor and case reports are rare.

Epithelioid hemangioendothelioma derived from the spine region: case report and review of the literature.

PubMed

Gokhan, Guzide Ayse; Akyuz, Mahmut; Gurer, Inanc Elif; Tuncer, Recai

2006-06-01

Epithelioid hemangioendotheliomas (EHE) are rare vascular tumors which generally originate from soft tissues and visceral organs. Primary bone EHEs, especially those occurring in the spine region, are extremely rare. Our case is that of a 30-year-old man who was admitted to hospital with low back pain, difficulty in walking, post-voiding urinary incontinence and numbness in the caudal area. X-ray showed a lytic process affecting the vertebra L2 and collapse of L1. Vertebrectomy of L1 and gross total tumor resection were performed. Histopathological and immunohistochemical findings of the tumor tissue supported the diagnosis of EHE. The case, which to the best of our knowledge is only the fifth such reported case, is presented with its clinicopathological findings and a review of the literature.

Clinical presentation of Lyme disease in the higher-risk region of Quebec: a retrospective descriptive study.

PubMed

Charbonneau, Audrey; Charette, Louis-Philippe; Rouleau, Geneviève; Savary, Mélissa; Wilson, Alexandra; Heer, Emily; Bériault, Karine; de Pokomandy, Alexandra

2018-03-23

Lyme disease is emerging in Canada. This study aimed to describe the use of serologic testing for the disease in the La Pommeraie health region in southern Quebec between 2012 and 2015 and to describe the clinical presentation of laboratory-confirmed cases. The medical charts of all patients investigated for Lyme disease at the Brome-Missisquoi-Perkins Hospital's laboratory between 2012 and 2015 were reviewed for results of serologic testing. Laboratory diagnosis was based on 2-tiered testing: cases had to have positive results of both the enzyme immunoassay and the Western blot test (IgM or IgG). We collected data on clinical presentation for patients assessed at the hospital or at the La Pommeraie Family Medicine Unit. Over the study period, 720 patients were investigated for Lyme disease. There was a more than fivefold increase in requests for serologic testing from 2012 (53) to 2015 (273). The number of confirmed cases increased from 2012 (3) to 2013 (19) and remained stable thereafter (19 in 2014, 18 in 2015). Fifty patients were positive for IgM with or without IgG positivity, and 9 patients were IgG-positive only. Chart reviews were completed for 278 of the 720 patients, including 38 of the 59 laboratory-confirmed cases. Among the 29 IgM-positive patients, the most common symptoms were fever (17 patients [59%]), fatigue (14 [48%]), myalgia (12 [41%]) and headaches (10 [34%]). Twenty-three (79%) had some cutaneous manifestation, including specifically erythema migrans (14 [48%]). A tick bite was reported by 11 patients (38%). Of the 44 patients in the entire study population who presented with erythema migrans, 15 (34%) had confirmed Lyme disease. Requests for serologic testing for Lyme disease increased in the La Pommeraie health region over recent years. Cutaneous manifestations, fever and myalgia were the most common symptoms of IgM-positive cases. Most patients did not report a tick bite. Copyright 2018, Joule Inc. or its licensors.

Clinical presentation of Lyme disease in the higher-risk region of Quebec: a retrospective descriptive study

PubMed Central

Charbonneau, Audrey; Charette, Louis-Philippe; Rouleau, Geneviève; Savary, Mélissa; Wilson, Alexandra; Heer, Emily; Bériault, Karine; de Pokomandy, Alexandra

2018-01-01

Background: Lyme disease is emerging in Canada. This study aimed to describe the use of serologic testing for the disease in the La Pommeraie health region in southern Quebec between 2012 and 2015 and to describe the clinical presentation of laboratory-confirmed cases. Methods: The medical charts of all patients investigated for Lyme disease at the Brome-Missisquoi-Perkins Hospital's laboratory between 2012 and 2015 were reviewed for results of serologic testing. Laboratory diagnosis was based on 2-tiered testing: cases had to have positive results of both the enzyme immunoassay and the Western blot test (IgM or IgG). We collected data on clinical presentation for patients assessed at the hospital or at the La Pommeraie Family Medicine Unit. Results: Over the study period, 720 patients were investigated for Lyme disease. There was a more than fivefold increase in requests for serologic testing from 2012 (53) to 2015 (273). The number of confirmed cases increased from 2012 (3) to 2013 (19) and remained stable thereafter (19 in 2014, 18 in 2015). Fifty patients were positive for IgM with or without IgG positivity, and 9 patients were IgG-positive only. Chart reviews were completed for 278 of the 720 patients, including 38 of the 59 laboratory-confirmed cases. Among the 29 IgM-positive patients, the most common symptoms were fever (17 patients [59%]), fatigue (14 [48%]), myalgia (12 [41%]) and headaches (10 [34%]). Twenty-three (79%) had some cutaneous manifestation, including specifically erythema migrans (14 [48%]). A tick bite was reported by 11 patients (38%). Of the 44 patients in the entire study population who presented with erythema migrans, 15 (34%) had confirmed Lyme disease. Interpretation: Requests for serologic testing for Lyme disease increased in the La Pommeraie health region over recent years. Cutaneous manifestations, fever and myalgia were the most common symptoms of IgM-positive cases. Most patients did not report a tick bite. PMID:29588280

Extending the temporal context of ethnobotanical databases: the case study of the Campania region (southern Italy)

PubMed Central

De Natale, Antonino; Pezzatti, Gianni Boris; Pollio, Antonino

2009-01-01

Background Ethnobotanical studies generally describe the traditional knowledge of a territory according to a "hic et nunc" principle. The need of approaching this field also embedding historical data has been frequently acknowledged. With their long history of civilization some regions of the Mediterranean basin seem to be particularly suited for an historical approach to be adopted. Campania, a region of southern Italy, has been selected for a database implementation containing present and past information on plant uses. Methods A relational database has been built on the basis of information gathered from different historical sources, including diaries, travel accounts, and treatises on medicinal plants, written by explorers, botanists, physicians, who travelled in Campania during the last three centuries. Moreover, ethnobotanical uses described in historical herbal collections and in Ancient and Medieval texts from the Mediterranean Region have been included in the database. Results 1672 different uses, ranging from medicinal, to alimentary, ceremonial, veterinary, have been recorded for 474 species listed in the data base. Information is not uniformly spread over the Campanian territory; Sannio being the most studied geographical area and Cilento the least one. About 50 plants have been continuously used in the last three centuries in the cure of the same affections. A comparison with the uses reported for the same species in Ancient treatises shows that the origin of present ethnomedicine from old learned medical doctrines needs a case-by-case confirmation. Conclusion The database is flexible enough to represent a useful tool for researchers who need to store and compare present and previous ethnobotanical uses from Mediterranean Countries. PMID:19228384

Risk factors for fatal outcome from rocky mountain spotted Fever in a highly endemic area-Arizona, 2002-2011.

PubMed

Regan, Joanna J; Traeger, Marc S; Humpherys, Dwight; Mahoney, Dianna L; Martinez, Michelle; Emerson, Ginny L; Tack, Danielle M; Geissler, Aimee; Yasmin, Seema; Lawson, Regina; Williams, Velda; Hamilton, Charlene; Levy, Craig; Komatsu, Ken; Yost, David A; McQuiston, Jennifer H

2015-06-01

Rocky Mountain spotted fever (RMSF) is a disease that now causes significant morbidity and mortality on several American Indian reservations in Arizona. Although the disease is treatable, reported RMSF case fatality rates from this region are high (7%) compared to the rest of the nation (<1%), suggesting a need to identify clinical points for intervention. The first 205 cases from this region were reviewed and fatal RMSF cases were compared to nonfatal cases to determine clinical risk factors for fatal outcome. Doxycycline was initiated significantly later in fatal cases (median, day 7) than nonfatal cases (median, day 3), although both groups of case patients presented for care early (median, day 2). Multiple factors increased the risk of doxycycline delay and fatal outcome, such as early symptoms of nausea and diarrhea, history of alcoholism or chronic lung disease, and abnormal laboratory results such as elevated liver aminotransferases. Rash, history of tick bite, thrombocytopenia, and hyponatremia were often absent at initial presentation. Earlier treatment with doxycycline can decrease morbidity and mortality from RMSF in this region. Recognition of risk factors associated with doxycycline delay and fatal outcome, such as early gastrointestinal symptoms and a history of alcoholism or chronic lung disease, may be useful in guiding early treatment decisions. Healthcare providers should have a low threshold for initiating doxycycline whenever treating febrile or potentially septic patients from tribal lands in Arizona, even if an alternative diagnosis seems more likely and classic findings of RMSF are absent. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Case report: Sporotrichosis from the Northern Territory of Australia.

PubMed

Subedi, Shradha; Kidd, Sarah E; Baird, Robert W; Coatsworth, Nicholas; Ralph, Anna P

2014-12-01

We report three cases of lymphocutaneous infection caused by the thermally dimorphic fungus, Sporothrix schenckii from Australia's tropical Northern Territory. Two cases were acquired locally, making them the first to be reported from this region. All three cases presented with ulceration in the limb; however, the classical sporotrichoid spread was present only in the first two cases. Their occurrence within several weeks of each other was suggestive of a common source of environmental contamination such as hay used as garden mulch. Diagnoses were delayed in each case, with each patient having substantial exposure to ineffective antibiotics before the correct diagnosis was made. These cases bring the total number of reported sporotrichosis cases in Australia since 1951 to 199. Lessons from these cases are to consider the diagnosis of sporotrichosis in lesions of typical appearance, even in geographical settings from where this pathogen has not previously been reported. © The American Society of Tropical Medicine and Hygiene.

The West Nile Virus outbreak in Israel (2000) from a new perspective: the regional impact of climate change.

PubMed

Paz, Shlomit

2006-02-01

The West Nile Virus (WNV) outbreak in Israel in 2000 appeared after medical and climatic warning signs. Re-analysis of the epidemic from a new viewpoint, the regional impact of global warming, especially the worsening in the summers' heat conditions, is presented. The disease appeared averagely at a lag of 3-9 weeks (strongest correlation = lag of 7 weeks). The minimum temperature was found as the most important climatic factor that encourages the disease earlier appearance. Extreme heat is more significant than high air humidity for increasing WNV cases. An early extreme rise in the summer temperature could be a good indicator of increased vector populations. While 93.5% of cases were in the metropolitan areas, the disease was not reported in the sub-arid regions. The outbreak development was comparable to the cases from Romania (1996) and NYC (1999). Each of those epidemics appeared after a long heatwave.

Laser therapy in the management of dental and oro-facial trauma

NASA Astrophysics Data System (ADS)

Darbar, Arun A.

2007-02-01

This is a clinical presentation demonstrating the efficacy of laser therapy in the treatment of patients presenting with trauma to both the hard and soft tissue in the orofacial region. The use of laser therapy aids the management of these cases where the patients often present with anxiety and a low pain threshold. The outcomes in these cases indicate good patient acceptance of the treatment, enhanced repair and tissue response suggesting that this form of treatment can be indicated for these patients. A combination of hard and soft lasers are used for the comprehensive dental management and treatment of these cases. The lasers used are a 810nm diode and an Er.CrYSGG.

Partnering for Transportation Success at Acadia National Park : A Case Study of the Island Explorer Shuttle Bus System at Mount Desert Island and Acadia National Park.

DOT National Transportation Integrated Search

2003-05-01

This report presents the first in a series of case studies on lessons learned from planning and : implementing alternative transportation systems (ATS) and from developing partnerships with : local and regional communities. The report is supported by...

Improving the Quality of Teaching in a State-Owned, Regional University

ERIC Educational Resources Information Center

Ballerini, Aldo A.; Albarran, Manuel I.

2013-01-01

The authors present a case study discussing student-oriented initiatives to enhance academic achievement. They focus on the academic, psychosocial and motivational weaknesses of students showing how these can be overcome with strategic projects to aid students in their first year of higher education. The case study, a multi-million US dollar…

Environmental Education in Action - III: Case Studies of Public Involvement in Environmental Policy.

ERIC Educational Resources Information Center

Schoenfeld, Clay, Comp.; Desinger, John F., Comp.

Presented here are 27 case studies of public involvement in environmental policy. These are examples of environmental education or communications programs developed by local, state, regional or national environmental action groups. The reports tell how the groups have successfully, or unsuccessfully, mobilized public opinion in favor of beneficent…

A diabetic patient presenting with stiff hand following fasciectomy for Dupuytren's contracture: A case report.

PubMed

Fournier, Katia; Papanas, Nikolaos; Compson, Jonathan P; Maltezos, Efstratios

2008-10-27

Reported is the case of a 68-year-old male presenting with severe wrist and hand stiffness following surgery for a Dupuytren's contracture. Complications of surgery or rehabilitation and complex regional pain syndrome were excluded as factors explaining this stiffness. Given the patient's diabetes mellitus and the striking similarity with the typical diabetic stiff hand, it is suggested that diabetes may have contributed to the development of the complication.

Metastatic hidradenocarcinoma: Surgery and chemotherapy

PubMed Central

Amel, Trabelsi; Olfa, Gharbi; Faten, Hammedi; Makrem, Hochlef; Slim, Ben Ahmed; Moncef, Mokni

2009-01-01

Context: Hidradenocarcinoma is a rare carcinoma of high malignant potential. It most metastasizes to regional lymph nodes and distant viscera. Case report: We report a case of 52-year-old woman who presented with an invasive hidradenocarcinoma of the finger, treated with surgical excision. The patient presented with skin and lymph node metastases four years after, treated by chemotherapy. Conclusion: Hidradenocarcinoma is an aggressive tumor. It seems important to use adjuvant therapies particularly for recurrent and metastatic forms. PMID:22666726

Laryngeal Involvement of Rhabdomyosarcoma in an Adult

PubMed Central

Abali, Hüseyin; Aksoy, Sercan; Sungur, Arzu; Yalçin, Suayib

2003-01-01

Background Although initial presentation of sarcomas in the head and neck region is relatively common, involvements of the larynx by rhabdomyosarcoma either primary or metastatic have been reported rarely. Case report A case of rhabdomyosarcoma in the right thigh, which involved laryngeal structures three years after the diagnosis, is presented. Conclusions The laryngeal involvement by primary and metastatic rhabdosarcomas is very rare, however when it occurs it can result in life treating upper airway obstruction. After emergency intervention, radiotherapy and / or chemotherapy must be undertaken for long-term benefit and surgery may be helpful only in selected cases. PMID:14556654

Malaria and other febrile diseases among travellers: the experience of a reference centre located outside the Brazilian Amazon Region.

PubMed

Dotrário, Andréa Beltrami; Menon, Lucas José Bazzo; Bollela, Valdes Roberto; Martinez, Roberto; de Almeida E Araújo, Daniel Cardoso; da Fonseca, Benedito Antônio Lopes; Santana, Rodrigo de C

2016-05-26

Malaria is endemic in countries located in tropical and sub-tropical regions. The increasing flow of domestic and international travellers has made malaria a relevant health problem even in non-endemic regions. Malaria has been described as the main diagnosis among travellers presenting febrile diseases after returning from tropical countries. In Brazil, malaria transmission occurs mainly in the Amazon region. Outside this area, malaria transmission is of low magnitude. This cross-sectional study aimed to describe the experience in the diagnosis of malaria in a reference centre located outside the Brazilian Amazon Region, emphasizing the differences in clinical and laboratory markers between cases of malaria and those of other febrile diseases (OFD). Medical charts from adult patients (≥18 years) who underwent a thick smear test (TST) for malaria, between January 2001 and December 2014, were retrospectively reviewed. A total of 458 cases referred to perform the TST were included. Malaria was diagnosed in 193 (42 %) episodes. The remaining 265 episodes (58 %) were grouped as OFD. The majority of malaria episodes were acquired in the Brazilian Amazon Region. The median time between the onset of symptoms and the TST was 7 days. Only 53 (11.5 %) episodes were tested within the first 48 h after symptom onset. Comparing malaria with OFD, jaundice, nausea, vomiting, and reports of fever were more prevalent in the malaria group. Low platelet count and elevated bilirubin levels were also related to the diagnosis of malaria. The results indicate that outside the endemic area travellers presenting febrile disease suspected of being malaria underwent diagnostic test after considerable delay. The reporting of fever combined with a recent visit to an endemic area should promptly evoke the hypothesis of malaria. In these cases, specific diagnostic tests for malaria should be a priority. For cases that jump this step, the presence of elevated bilirubin or thrombocytopaenia should also indicate a diagnosis of malaria.

Malaria in U.S. military forces: a description of deployment exposures from 2003 through 2005.

PubMed

Ciminera, Paul; Brundage, John

2007-02-01

U.S. service members are often deployed to regions endemic for malaria. Preventive measures play an important role in mitigating the risk of disease and adverse effects on mission performance. Currently, a large contingent of U.S. forces is deployed in malarious regions in southeast and southwest Asia. The purpose of this study was to describe malaria cases reported by the tri-service reportable medical events system in terms of exposure (deployment history) and latency of infection. We conducted a retrospective analysis of population health data routinely collected for disease surveillance. All malaria reports received into the Defense Medical Surveillance System by January 3, 2006 with a date of onset between January 1, 2000 and December 31, 2005 in which the individual diagnosed is a member of the active or reserve military components linked to personnel and deployment data were analyzed to determine assignment and deployment history. The main outcome measure was the ICD9-CM diagnosis of malaria (Plasmodium vivax, P. falciparum, P. ovale, P. malaria, and unspecified malaria) by date of onset and days from exposure. A total of 423 cases of malaria were reported during the study period. The Army (n = 325) and the Marine Corps (n = 46) had the highest number of reported cases. Plasmodium vivax (n = 242) and P. falciparum (n = 92) caused nearly four-fifths of all reported cases. During the period from 2003 through 2005, 34% of deployed cases were exposed to more than one malaria-endemic region. Seventy-four cases had been assigned in the Republic of Korea, and all were present in Korea during the high risk transmission period. Seventy-eight cases had documented service in Afghanistan; only 4 had off-season exposure and no other documented exposures. Sixty cases had documented exposure during Operation Iraqi Freedom (OIF). Only six seasonally exposed and six off seasonally exposed OIF cases had no other documented exposure. Fifty percent of Korean cases were diagnosed during an exposure season, and only 3% of Afghan cases were diagnosed during an exposure season. Soldiers in today's military can be exposed to more than one malaria-endemic region prior to diagnosis. This presents new complexities for disease monitoring and prevention policy development.

An adult spindle cell rhabdomyosarcoma in the head and neck region with long-term survival: a case report

PubMed Central

2014-01-01

Introduction Spindle cell rhabdomyosarcoma of the head and neck is a very rare tumor in adults. We report on one case with long-term survival. Case presentation A 41-year-old nonsmoking Caucasian man presented in June 2007 with a painless swelling under his tongue. A diagnosis of a soft tissue sarcoma, and a myofibrosarcoma in particular, was made via biopsy. After multimodal treatment, including local and systemic therapy, our patient remained disease-free until September 2010. The local recurrence was treated unsuccessfully with various chemotherapy regimens. In September 2011, our patient underwent surgical resection again, and a spindle cell rhabdomyosarcoma was diagnosed. To analyze the mismatch between the original diagnosis of a myofibrosarcoma and the second diagnosis, the two specimens were reassessed, and a final diagnosis of a spindle cell rhabdomyosarcoma was made. In 2012 and 2013, our patient suffered further recurrences that were surgically treated, and he is still alive with disease six years and 10 months after the initial diagnosis in June 2007. Conclusions In adults, the spindle cell rhabdomyosarcoma tumor is very rare in the head and neck region. In contrast to childhood tumors, spindle cell rhabdomyosarcoma in adulthood is often associated with a poor prognosis. In the present case, the radical surgical treatment might have helped to prolong the patient’s overall survival, which has lasted more than six years. To our knowledge, this is the longest overall survival reported so far for this tumor entity in the head and neck region. PMID:24946859

Evaluation of bacterial meningitis surveillance data of the northern region, Ghana, 2010-2015

PubMed Central

Kaburi, Basil Benduri; Kubio, Chrysantus; Kenu, Ernest; Ameme, Donne Kofi; Mahama, Jacob Yakubu; Sackey, Samuel Oko; Afari, Edwin Andrew

2017-01-01

Introduction Bacterial meningitis is a disease of major public health importance especially for countries such as Ghana; whose northern part lies within the meningitis belt. The Northern region of Ghana has been recording cases with outbreaks over the years. In order to generate evidence to improve surveillance, we described the epidemiology of bacterial meningitis using surveillance data of the northern region. Methods Bacterial meningitis datasets from January 2010 to December 2015 for all the 26 districts of the Northern region were retrieved from line lists. Data were analyzed in terms of person, place, time, and identity of causative organisms using descriptive statistics. The results were presented as proportions, rates, tables and graphs. Results A total of 1,176 cases were reported. Of these, 53.5% (629/1,176) were males. The proportion of cases aged 0 to 29 years was 77.4%. The Overall Case Fatality Rate (CFR) was 9.7% (114/1,176). About 65% of all cases were recorded from January to April. Only 23.7% (279/1,176) of cases were laboratory-confirmed. Neisseria meningitides and Streptococcus pneumonia accounted for 91.4% of confirmed cases. Over the period, the incidence reduced from 9.0/100,000 population to 3.8/100,000 population and CFR reduced from 16.6% to 5.7%. Conclusion Most cases of bacterial meningitis were recorded in the dry season and in persons younger than 30 years. Less than a quarter of cases were laboratory confirmed, and no new bacteria species were identified. Both morbidity and mortality rates were on the decline. There is the need to consolidate these gains by intensifying meningitis surveillance and improving on the rate of laboratory case confirmation. PMID:28904692

Evaluation of bacterial meningitis surveillance data of the northern region, Ghana, 2010-2015.

PubMed

Kaburi, Basil Benduri; Kubio, Chrysantus; Kenu, Ernest; Ameme, Donne Kofi; Mahama, Jacob Yakubu; Sackey, Samuel Oko; Afari, Edwin Andrew

2017-01-01

Bacterial meningitis is a disease of major public health importance especially for countries such as Ghana; whose northern part lies within the meningitis belt. The Northern region of Ghana has been recording cases with outbreaks over the years. In order to generate evidence to improve surveillance, we described the epidemiology of bacterial meningitis using surveillance data of the northern region. Bacterial meningitis datasets from January 2010 to December 2015 for all the 26 districts of the Northern region were retrieved from line lists. Data were analyzed in terms of person, place, time, and identity of causative organisms using descriptive statistics. The results were presented as proportions, rates, tables and graphs. A total of 1,176 cases were reported. Of these, 53.5% (629/1,176) were males. The proportion of cases aged 0 to 29 years was 77.4%. The Overall Case Fatality Rate (CFR) was 9.7% (114/1,176). About 65% of all cases were recorded from January to April. Only 23.7% (279/1,176) of cases were laboratory-confirmed. Neisseria meningitides and Streptococcus pneumonia accounted for 91.4% of confirmed cases. Over the period, the incidence reduced from 9.0/100,000 population to 3.8/100,000 population and CFR reduced from 16.6% to 5.7%. Most cases of bacterial meningitis were recorded in the dry season and in persons younger than 30 years. Less than a quarter of cases were laboratory confirmed, and no new bacteria species were identified. Both morbidity and mortality rates were on the decline. There is the need to consolidate these gains by intensifying meningitis surveillance and improving on the rate of laboratory case confirmation.

An unusual case of hematemesis and epistaxis caused by a pheochromocytoma.

PubMed

Ugur, Kader; Girgin, Mustafa; Bahcecioglu, İbrahim Halil; Artas, Hakan; Selcuk Simsek, Fikri; Aydin, Suleyman

2018-01-01

Pheochromocytoma is a rare catecholamine-secreting neoplasm that is the cause of hypertension in <0.2% of patients with hypertension. We encountered an unusual case of pheochromocytoma involving hematemesis and epistaxis episodes with accompanying hypertensive attacks. Venous ectasia was detected in the esophagus. Abdominal magnetic resonance imaging revealed an adenoma in the left adrenal region. The present case illustrates that pheochromocytoma can mimic different clinical conditions.

Enterovirus D68 disease and molecular epidemiology in Australia.

PubMed

Levy, Avram; Roberts, Jason; Lang, Jurissa; Tempone, Simone; Kesson, Alison; Dofai, Alfred; Daley, Andrew J; Thorley, Bruce; Speers, David J

2015-08-01

Enterovirus D68 (EV-D68) has received considerable recent attention as a cause of widespread respiratory illness. Neurological syndromes such as acute flaccid paralysis following EV-D68 infection have also been reported in a small number of cases. To summarize the clinical and epidemiological characteristics of laboratory confirmed EV-D68 cases in Australia. We combined EV-D68 data acquired through laboratory surveillance in Western Australia with cases from national enterovirus surveillance and regional acute flaccid paralysis (AFP) surveillance. Clinical data was obtained for EV-D68 cases and capsid protein sequences were used for phylogenetic analysis. Sporadic cases of EV-D68 were recorded in Australia since 2008, with peaks in activity during 2011 and 2013. EV-D68 was primarily associated with respiratory disease, but was also detected in cerebrospinal fluid of one patient and faeces of two patients presenting with AFP. EV-D68 has been circulating in Western Australia and is likely to have also been present in the wider region for a number of years, causing primarily respiratory disease. Detection of EV-D68 in cerebrospinal fluid of one patient and in faeces of two AFP cases reinforces the association between EV-D68 and neurological disease. Copyright © 2015 Elsevier B.V. All rights reserved.

A unique case of a discontinuous duplication 3q26.1-3q28 resulting from a segregation error of a maternal complex chromosomal rearrangement involving an insertion and an inversion.

PubMed

Rodríguez, Laura; Bhatt, Samarth S; García-Castro, Mónica; Plasencia, Ana; Fernández-Toral, Joaquín; Abarca, Elena; de Bello Cioffi, Marcelo; Liehr, Thomas

2014-02-10

Until now, few cases of partial trisomy of 3q due to segregation error of parental balanced translocation and segregation of a duplicated deficient product resulting from parental pericentric inversion have been reported so far. Only five cases of chromosomal insertion malsegregation involving 3q region are available yet, thus making it relatively rare. In this case report, we are presenting a unique case of discontinuous partial trisomy of 3q26.1-q28 region which resulted from a segregation error of two insertions involving 3q26.1 to 3q27.3 and 3q28 regions with ~21Mb and ~2Mb sizes, respectively. The maternally inherited insertion was cytogenetically characterized as der(8)(8pter→8p22::3q26→3q27.3::3q28→3q28::8p22→8qter) and the patient's major clinical features involved Dandy Walker malformation, sub-aortic ventricular septal defect, upslanting palpebral fissures, clinodactyly, hirsutism, and prominent forehead. Besides, a review of the literature involving cases with similar chromosomal imbalances and cases with "3q-duplication syndrome" is also provided. Copyright © 2013 Elsevier B.V. All rights reserved.

Late-onset en coup de sabre of the skull.

PubMed

Mohan, Shaun V; Nittur, Vinay; Stevens, Kathryn J

2013-10-01

En coup de sabre is a rare subtype of linear scleroderma that characteristically affects the skin, underlying muscle, and bone of the frontoparietal region of the face and scalp. It typically presents in the first two decades of life, and may be associated with focal neurological deficits. We present a case of late-onset en coup de sabre of the frontal bone where the diagnosis was further complicated by a history of breast cancer, prior trauma to the region, and use of topical medication.

A Case of First Branchial Cleft Fistula Presenting with an External Opening on the Root of the Helical Crus

PubMed Central

2018-01-01

Background First branchial cleft anomalies (FBCA) are rare clinical entities of the head and neck. Typically, the tract of the FBCA begins in the external auditory canal and ends in the postauricular or submandibular region. Case Presentation We present a case of a 23-year-old man who had a first branchial cleft fistula with atypical opening on the root of the helical crus. Complete excision of the tract, including the cuff of surrounding cartilage, was performed. Histopathology revealed a fistular tract lined with squamous epithelium. To our knowledge, this is the first case to be reported of type I FBCA with an opening on the root of the helical crus. The low incidence and varied presentation often result in misdiagnosis and inappropriate treatment. Conclusions In the patients with FBCA, careful recognition of atypical variants is essential for complete excision. PMID:29560006

Susac syndrome: the first case report in Peru.

PubMed

Rivadeneira-Sotelo, Carolina; Meza Vega, María; Segura-Chávez, Darwin; Castro-Suarez, Sheila

2017-08-30

Susac Syndrome is a rare entity, characterized by a triad of subacute encephalopathy, retinal artery occlusion and sensorineural hearing loss. It is more common in women and the age of onset fluctuates between 9-58 years of age. The pathogenesis is presented as microangiopathic changes at the cerebral, retinal and cochlear levels associated with an autoimmune mechanism. We present the case of a 31-year-old woman who started with a diffuse headache, puerile behavior, bradylalia and somnolence. As the disease progressed, she had auditory deficit and arterial obstruction of the right temporal retinal branch in retinal fluorescein angiography. Brain magnetic resonance showed rounded hyperintense lesions in the corpus callosum, periventricular region and cerebellum. This is the first reported case of Susac Syndrome in Peru, presented with the classic triad, which is an infrequent presentation. However, cases that show incomplete forms should be evaluated in a timely manner to initiate timely treatment and avoid irreversible consequences.

PubMed Central

Monga, S.; Jan, S.; Bahadur, S.; Jetley, S.; Kaur, H.

2017-01-01

SUMMARY Tuberculosis (TB) of the head and neck region is quite common in endemic countries, but is still misdiagnosed due to its varied presentation and different sites of involvement. The aims of the present study were to present the diversities of presentation of head and neck tuberculosis with the diagnostic predicaments faced during evaluation and to assess treatment response to anti-tubercular treatment (ATT). We analysed 48 patients with head and neck tuberculosis who presented to the Department of Otorhinolaryngology in our tertiary care urban hospital over a period of two years from 2013 to 2015 and recorded their data, which included presenting complaints, local and systemic examination findings, investigation results and treatment outcomes. The results showed that majority (64.5%) of cases were female and none of the patients were HIV positive. The most common manifestation was cervical lymphadenopathy (81.25%) with level II being the most commonly affected (31.3%). Three of the 48 patients had coexisting pulmonary TB. Fine needle aspiration cytology (FNAC), histopathological diagnosis and acid fast bacilli (AFB) staining were used to confirm diagnosis. All patients were treated with Category I ATT, which achieved cure in 96.8% of cases. Though cervical lymphadenitis is the most common presentation of head and neck TB, isolated involvement of the sinonasal region, larynx, oral cavity and other sub-sites are not solely unknown entities. It is, therefore, important for clinicians to be aware of atypical and misleading presentations and consider TB as a major differential diagnosis in the head and neck region, even in non-immunocompromised individuals. PMID:29327734

Magnetotelluric Studies for Hydrocarbon and Geothermal Resources: Examples from the Asian Region

NASA Astrophysics Data System (ADS)

Patro, Prasanta K.

2017-09-01

Magnetotellurics (MT) and the other related electrical and electromagnetic methods play a very useful role in resource exploration. This review paper presents the current scenario of application of MT in the exploration for hydrocarbons and geothermal resources in Asia. While seismics is the most preferred method in oil exploration, it is, however, beset with several limitations in the case of sedimentary targets overlain by basalts or evaporate/carbonate rocks where the high-velocity layers overlying the lower velocity layers pose a problem. In such cases, MT plays an important and, in some cases, a crucial role in mapping these potential reservoirs because of significant resistivity contrast generally observed between the basalts and the underlying sedimentary layers. A few case histories are presented that typically illustrate the role of MT in this context. In the case of geothermal exploration, MT is known to be highly effective in deciphering the target areas because of the conductivity structures arising from the presence and circulation of highly conductive fluids in the geothermal target areas. A few examples of MT studies carried out in some of the potential areas of geothermal significance in the Asian region are also discussed. While it is a relatively favorable situation for application of EM and MT methods in the case of exploration of the high-enthalpy region due to the development of well-defined conceptual models, still the low-enthalpy regions need to be understood well, particularly because of more complex structural patterns and the fluid circulation under relatively low-temperature conditions. Currently, a lot of modeling in both geothermal and hydrocarbon exploration is being done using three-dimensional techniques, and it is the right time to go for integration and three-dimensional joint inversion of the geophysical parameters such as resistivity, velocity, density, from MT, electromagnetics (EM), seismics and gravity.

Epidemiological Profile of Wild Rabies in Brazil (2002-2012).

PubMed

Rocha, S M; de Oliveira, S V; Heinemann, M B; Gonçalves, V S P

2017-04-01

Rabies is one of the most important zoonosis in the world with high impact on public health. Studies report the presence of Lyssavirus in reservoirs of the wild cycle, highlighting the role of wild canines, marmosets, and vampire and non-vampire bats as potential vectors of the disease to domestic animals and human beings. Therefore, the reintroduction of rabies in urban environments from reservoirs of the wild cycle is a matter of concern. This study describes the profile of rabies cases documented in Brazil from 2002 to 2012, with emphasis on the wild transmission cycle of the disease. We carried out a descriptive study using records with information on the time of infection, persons with infection and location of confirmed cases of rabies in humans and animals, as well as data on anti-rabies treatments obtained from the Information System of Notifiable Diseases (Sinan) database. Within the study period, 82 cases of rabies transmitted by wild animals to humans were reported, predominantly in rural areas of the northern and north-eastern regions. Of the cases in humans, 72% did not receive post-exposure prophylaxis. Among wild mammals, vampire bats were the most frequent vectors of the disease. In the north-east region, 460 terrestrial wild mammals were reported with confirmed rabies. Over the study period, 1703 bats were reported to carry the rabies virus. In the south-east region, the most frequently reported carriers of the virus were non-vampire bats. The midwest and northern regions presented a lower number of records of rabies cases among terrestrial wild mammals. However, the high number of rabies cases among bovines reflects the role of the vampire bat as a maintainer of the rabies virus in the rural cycle. The present results are key to adjust the planning of rabies control in Brazil to the current epidemiological trends. © 2015 Blackwell Verlag GmbH.

Epidermoid Cyst of Mandible Ramus: Case Report.

PubMed

Loxha, Mergime Prekazi; Salihu, Sami; Kryeziu, Kaltrina; Loxha, Sadushe; Agani, Zana; Hamiti, Vjosa; Rexhepi, Aida

2016-06-01

An epidermoid cyst is a benign cyst usually found on the skin. Bone cysts are very rare and if they appear in bone they usually appear in the distal phalanges of the fingers. Epidermoid cysts of the jaws are uncommon. We present a case, of a 41 year-old female patient admitted to our department because of pain and swelling in the parotid and masseteric region-left side. There was no trismus, pathological findings in skin, high body temperature level, infra-alveolar nerves anesthesia or lymphadenopathy present. The orthopantomography revealed a cystic lesion and a unilocular lesion that included mandibular ramus on the left side with 3 cm in diameter. Under total anesthesia, a cyst had been reached and was enucleated. Histopathologic findings showed that the pathologic lesion was an epidermoid cyst. Epidermoid and dermoid cysts are rare, benign lesions found throughout the body. Only a few cases in literature describe an intraossesus epidermoid cyst. Our case is an epidermoid cyst with a rare location in the region of the mandibular ramus. It is not associated with any trauma in this region except medical history reveals there was an operative removal of a wisdom tooth 12 years ago in the same side. These cysts are interesting from the etiological point of view. They should be considered in the differential diagnosis of other radiolucent lesions of the jaws. Surgically they have a very good prognosis, and are non-aggressive lesions.

Giant scrotal elephantiasis of inflammatory etiology: a case report

PubMed Central

Denzinger, Stefan; Watzlawek, Elke; Burger, Maximilian; Wieland, Wolf F; Otto, Wolfgang

2007-01-01

Background Scrotal lymphedema is rare outside endemic filariasis regions in Africa and Asia. It is of variable origin in the western world. Case presentation We present a case of a 40-year-old European man with massive elephantiasis of the scrotum attributed to chronic inflammation of the lower urinary tract caused by urinary outlet obstruction and diabetes mellitus. The patient underwent subtotal scrotectomy saving penis, testes and spermatic cords and followed by scrotal reconstruction with adequate cosmetic and functional outcome. Conclusion In this report we discuss a rare case of scrotal elephantiasis in an European patient, reflect on the etiology and the diagnostic and therapeutic approaches. Surgery can be successful even in giant scrotal elephantiasis. PMID:17543128

Oral Pyogenic Granuloma Associated With a Dental Implant Treated With an Er:YAG Laser: A Case Report.

PubMed

Kaya, Alper; Ugurlu, Faysal; Basel, Bilal; Sener, Cem B

2015-12-01

A pyogenic granuloma is a tumorlike proliferation that occurs slightly more often in females, frequently involving the gingiva in the maxillary region. Clinically, it presents as a sessile or pedunculated exophytic mass with a smooth or lobulated surface, which tends to bleed easily. Its color can range from pink to dark red. The most common treatment is surgical excision. This case report presents a pyogenic granuloma that formed around an implant 7 years after its insertion. Pyogenic granulomas associated with dental implants are extremely rare; this is the fourth reported case and the first case of pyogenic granuloma to be treated with an Er:YAG laser.

Anterior mandibular ameloblastoma

PubMed Central

Bhandarwar, Ajay H.; Bakhshi, Girish D.; Borisa, Ashok D.; Wagh, Amol; Kapoor, Rajat; Kori, Channabasappa G.

2012-01-01

Ameloblastoma is a benign odontogenic tumor. These are usually asymptomatic until a large size is attained. Ameloblastoma has tendency to spread locally and has a high recurrence rate. Majority of ameloblastomas (80%) arise from the mandible. Ameloblastoma arising from anterior mandibular region (symphysis-menti) is rare. Very few cases of midline anterior ameloblastomas are reported in the literature. They often require wide local excision. Reconstruction of mandible in these cases is challenging. We present a case of mandibular ameloblastoma arising from symphysis-menti. Patient underwent wide surgical excision of the tumor followed by immediate reconstruction using free fibular vascular flap, stabilized with titanium reconstructive plates. A brief case report ands review of literature is presented. PMID:24765429

[Visual Texture Agnosia in Humans].

PubMed

Suzuki, Kyoko

2015-06-01

Visual object recognition requires the processing of both geometric and surface properties. Patients with occipital lesions may have visual agnosia, which is impairment in the recognition and identification of visually presented objects primarily through their geometric features. An analogous condition involving the failure to recognize an object by its texture may exist, which can be called visual texture agnosia. Here we present two cases with visual texture agnosia. Case 1 had left homonymous hemianopia and right upper quadrantanopia, along with achromatopsia, prosopagnosia, and texture agnosia, because of damage to his left ventromedial occipitotemporal cortex and right lateral occipito-temporo-parietal cortex due to multiple cerebral embolisms. Although he showed difficulty matching and naming textures of real materials, he could readily name visually presented objects by their contours. Case 2 had right lower quadrantanopia, along with impairment in stereopsis and recognition of texture in 2D images, because of subcortical hemorrhage in the left occipitotemporal region. He failed to recognize shapes based on texture information, whereas shape recognition based on contours was well preserved. Our findings, along with those of three reported cases with texture agnosia, indicate that there are separate channels for processing texture, color, and geometric features, and that the regions around the left collateral sulcus are crucial for texture processing.

Unusual Presentation of Hydatidosis - Neck Lump Causing Costo-Vertebral Erosion

PubMed Central

Alam, Mehtab; Hasan, Syed-Abrar; Hashmi, Shahab-Farkhund

2016-01-01

Introduction: Hydatid disease caused by larval stage of Echinococcus has been recognized endemically in many countries. Liver and lungs are the most commonly affected organs. Involvement of the head and neck region is rare and bony erosion due to hydatidosis is even rarer. Case Report: We report a case of a 17-year-old girl from a poor socio-economic background who presented with a right sided supraclavicular lump, which after surgical excision and histopathological examination was diagnosed as hydatid cyst of neck. Conclusion: Because of its rarity in the neck region, primary diagnosis of hydatid cyst is overlooked and usually not included in the differential diagnosis of cystic neck swellings. A high index of suspicion is necessary to diagnose hydatid disease in an unusual location even in endemic areas. PMID:27738614

Cysticercosis: The day to day public health problem and the various sites affected by it - A one year study.

PubMed

Srikanth, S; Anandam, G

2013-07-01

The present study is done to highlight the various regions in the body affected by cysticercosis and to educate the people about the personal hygiene and prevention of the parasite. This is a study done on patients who were referred for swelling in the body, which were diagnosed as cysticercosis in one of their differential diagnosis clinically. During the 1 year study (from October 2011 to September 2012) we diagnosed seven cases of cysticercosis involving the various sites in the body. Our cases highlight the rare presentation of cysticercus infestation as cause of treatablelymphadenopathy. Cysticercosis should be included in the differential diagnosis of cervical swellings especially in endemic regions. Timely diagnosis and intervention help in preventing fatal complications.

3D optical tomography in the presence of void regions

NASA Astrophysics Data System (ADS)

Riley, J.; Dehghani, Hamid; Schweiger, Martin; Arridge, Simon R.; Ripoll, Jorge; Nieto-Vesperinas, Manuel

2000-12-01

We present an investigation of the effect of a 3D non-scattering gap region on image reconstruction in diffuse optical tomography. The void gap is modelled by the Radiosity-Diffusion method and the inverse problem is solved using the adjoint field method. The case of a sphere with concentric spherical gap is used as an example.

3D optical tomography in the presence of void regions.

PubMed

Riley, J; Dehghani, H; Schweiger, M; Arridge, S; Ripoll, J; Nieto-Vesperinas, M

2000-12-18

We present an investigation of the effect of a 3D non-scattering gap region on image reconstruction in diffuse optical tomography. The void gap is modelled by the Radiosity-Diffusion method and the inverse problem is solved using the adjoint field method. The case of a sphere with concentric spherical gap is used as an example.

Sporotrichosis from the Northern Territory of Australia

PubMed Central

Subedi, Shradha; Kidd, Sarah E.; Baird, Robert W.; Coatsworth, Nicholas; Ralph, Anna P.

2014-01-01

We report three cases of lymphocutaneous infection caused by the thermally dimorphic fungus, Sporothrix schenckii from Australia's tropical Northern Territory. Two cases were acquired locally, making them the first to be reported from this region. All three cases presented with ulceration in the limb; however, the classical sporotrichoid spread was present only in the first two cases. Their occurrence within several weeks of each other was suggestive of a common source of environmental contamination such as hay used as garden mulch. Diagnoses were delayed in each case, with each patient having substantial exposure to ineffective antibiotics before the correct diagnosis was made. These cases bring the total number of reported sporotrichosis cases in Australia since 1951 to 199. Lessons from these cases are to consider the diagnosis of sporotrichosis in lesions of typical appearance, even in geographical settings from where this pathogen has not previously been reported. PMID:25200259

Region Spherical Harmonic Magnetic Modeling from Near-Surface and Satellite-Altitude Anomlaies

NASA Technical Reports Server (NTRS)

Kim, Hyung Rae; von Frese, Ralph R. B.; Taylor, Patrick T.

2013-01-01

The compiled near-surface data and satellite crustal magnetic measured data are modeled with a regionally concentrated spherical harmonic presentation technique over Australia and Antarctica. Global crustal magnetic anomaly studies have used a spherical harmonic analysis to represent the Earth's magnetic crustal field. This global approach, however is best applied where the data are uniformly distributed over the entire Earth. Satellite observations generally meet this requirement, but unequally distributed data cannot be easily adapted in global modeling. Even for the satellite observations, due to the errors spread over the globe, data smoothing is inevitable in the global spherical harmonic presentations. In addition, global high-resolution modeling requires a great number of global spherical harmonic coefficients for the regional presentation of crustal magnetic anomalies, whereas a lesser number of localized spherical coefficients will satisfy. We compared methods in both global and regional approaches and for a case where the errors were propagated outside the region of interest. For observations from the upcoming Swarm constellation, the regional modeling will allow the production a lesser number of spherical coefficients that are relevant to the region of interest

Ewings Sarcoma: A Case of Respiratory Distress and Opacification That Was not Pneumonia.

PubMed

Wells, Jordee M; Spencer, Sandra P

2018-05-01

The Ewing sarcoma family of tumors typically appears in the second decade of life with regional pain and swelling of a long bone. The following case presents a pediatric patient, aged 4 years, given a diagnosis of Ewing sarcoma of the rib with the initial presentation of respiratory distress, hypoxia, and pleural effusion. Respiratory distress accounts for a large majority of emergency department visits annually, so it is the distinct responsibility of the emergency department physician to avoid premature closure in attributing the most common diagnoses to account for the presenting symptoms. In this case, the careful study of the initial radiographic findings led to further identification and characterization of the mass through thoracic computed tomography to suggest Ewing sarcoma, despite the patient's unlikely demographics and presentation.

Practical issues and lessons learned from multi-regional clinical trials via case examples: a Japanese perspective.

PubMed

Ando, Yuki; Hamasaki, Toshimitsu

2010-01-01

The multi-regional clinical trials (MRCTs) being administered in different regions of the world now play a major role in providing evidence for the efficacy and safety of new drugs amidst the simultaneous global development and worldwide registration of such drugs, in support of the expeditious availability of medical products to patients. However, such trials present considerable challenges as far as quality, design, implementation, analysis, and interpretation are concerned. In this article, we share our observations and lessons learned from the design, implementation, analysis, and interpretation of some MRCTs with case examples. Current Japanese regulatory guidance on MRCTs is introduced along with some suggestions for design, implementation, and interpretation. Copyright © 2010 John Wiley & Sons, Ltd.

Regional odontodysplasia involving three quadrants of the jaws: a case report.

PubMed

Quinderé, Lêda Bezerra; Cavalcante, Roberta Barroso; Nonaka, Cassiano Francisco Weege; Miguel, Márcia Cristina da Costa; de Souza, Lélia Batista

2010-01-01

Regional odontodysplasia is a rare developmental anomaly of the teeth that affects enamel and dentin. Its etiology is unknown, but the most accepted theory refers to circulatory disorders associated with vascular nevi. An uncommon case of regional odontodysplasia involving three quadrants of the jaws is reported. An 8-year-old boy was referred to the authors' institution with lack of teeth as a major symptom. There was no hereditary anomaly in the family. Extraoral examination revealed a brown discoloration on the skin on the right side of the face, neck, and chest. Detailed intraoral examination showed hypoplastic and carious teeth. Fistulae and gingival overgrowth were also observed. Radiographically, the affected teeth presented the pathognomonic image of "ghost teeth." Conservative treatment was instituted.

Distant and Regional Atmospheric Circulation Influences Governing Integrated Water Vapor Transport and the Occurrence of Extreme Precipitation Events

NASA Astrophysics Data System (ADS)

Bosart, L. F.; Papin, P. P.; Bentley, A. M.

2017-12-01

This presentation will show how the evolution of the large-scale and regional-scale atmospheric circulation contributes to the occurrence of extreme precipitation events (EPEs). An EPE requires that tropospheric moisture flux convergence (MFC) and the associated removal of hydrometeors be balanced by moisture replenishment via integrated (water) vapor transport (IVT) to continuously replenish condensed moisture. Moisture source regions may be distant or regional. Distant moisture sources may require the interaction of lower- and upper-level jet streams with a pre-existing mobile atmospheric disturbance to produce sufficient lift to condense moisture. Pre-existing regional moisture sources may require frontal lifting the presence of MFC to condense moisture. In cases of long-range IVT, such as moisture from a western North Pacific typhoon being drawn poleward along an atmospheric river (AR) toward the west coast of North America, moisture may be transported 1000s of kilometers along a low-level jet before a combination of dynamic and orographic lift results in an EPE. Alternatively, in the case of a typical summer warm and humid air mass over the continental United States, unused moisture may exist for several days in this air mass before sufficient MFC associated with a thermally direct mesoscale frontal circulation can concentrate and condense the moisture. In this case, there may be no long-range IVT via ARs. Instead, the atmospheric circulations may evolve to produce sustained MFC associated with mesoscale frontal circulations, especially in the presence of complex terrain, to produce an EPE. During this presentation, examples of EPEs associated with long-range IVT and distant MFC versus EPEs associated with regional MFC and mesoscale frontal circulations will be illustrated.

Primary non-Hodgkin's lymphoma of the infratemporal fossa: a rare case report.

PubMed

Thakur, Jagdeep S; Minhas, Ravinder S; Mohindroo, Narinder K; Sharma, Dev R; Mohindroo, Shobha; Thakur, Anamika

2009-06-21

The head and neck are two of the most common sites of extranodal non-Hodgkin's lymphoma (NHL). However, primary tumors of the infratemporal fossa are infrequent, and NHL in this region is extremely rare. We present a case of a 41-year-old female that presented with swelling in the right preauricular region that had persisted for the past two years. The patient was diagnosed as having a small lymphocytic NHL. She initially underwent chemo-radiation but reported relapse. The tumor was excised and again the patient underwent chemotherapy. The patient remained symptomatic and developed a second primary squamous cell carcinoma in the right retromolar trigone. We discussed NHL with an emphasis on extranodal manifestations. Extranodal NHL that is limited to a single site can be managed by surgery and regular follow up. To the best of our knowledge, this is only the second case of primary NHL of the infratemporal fossa to be reported in the literature.

Pattern of sexually transmitted diseases in patients presenting at Ayub teaching hospital, Abbottabad.

PubMed

Razvi, Syed Kamran Amir; Najeeb, Shahzad; Nazar, Hassan Shahzad

2014-01-01

Sexually transmitted diseases are present in all societies across the globe. Different cultures and societies show a different spectrum of these diseases. The last study conducted in Hazara division was back in 1995. We have conducted this study to see the recent trends and patterns of sexually transmitted diseases in the region. This cross-sectional study was conducted in Ayub Teaching Hospital, Abbottabad and included patients over a five year period from January 2010 till December 2014. Case sheets of 512 presenting with sexually transmitted diseases whose diagnosis was confirmed by related lab investigation were analysed retrospectively. Patients of all ages and both sexes were included. Out of these 512 patients only 47 were females and 465 were males. The age varied from 15-66 years. Gonorrhoea was the commonest disease with 231 cases. Genital warts were diagnosed in 60 cases. Non- gonococcal urethritis was seen in 57 patients. Genital Molluscum contagiosum was seen in 45 patients. Syphillis was diagnosed in 41 patients. Thirty-one cases of herpes genitalis, 25 cases of Chancroid, 13 cases of Lymphogranuloma venereum, were also seen. Five patients were found positive for HIV. Overwhelming majority of the patients were between the age of 19-35 years. 61% of the patients were married. The source of infection in male patients was mainly prostitutes (70%) but also included homosexual boys (21 %), married women (7.5%) and eunuchs (1.5%). The main source of infection in females was from husbands. The number of STD patients presenting in the region has increased significantly. The main factor is obviously the rise in population but also signifies the change in cultural and moral values.

Increasing Electronic Nose Recognition Ability by Laser Irradiation

NASA Astrophysics Data System (ADS)

Alejandra, Massacane; Juan, Vorobioff; Karina, Pierpauli; Norberto, Boggio; Silvia, Reich; Carlos, Rinaldi; Alfredo, Boselli; Alberto, Lamagna; Laura, Azcárate M.; Jorge, Codnia; Francisco, Manzano

2009-05-01

We present a method to increase the capability of an electronic nose to discriminate between a priori similar odours. We analyze the case of olive oil because it is well known that the characteristics of its aroma impair in many cases the discrimination between different kinds of olive oils especially when they are from similar geographic regions. In the present work we study how to improve the electronic nose performance for the above mentioned discrimination by the use of two IR laser wavelengths for vaporization.

Panniculitis associated with amyopathic dermatomyositis*

PubMed Central

Azevedo, Paula de Oliveira; Castellen, Natalia Roberta; Salai, Ana Flávia; Barbosa, Fernanda Santana; Alves, Célia Antônia Xavier de Moraes; Pinto, Clóvis Antonio Lopes

2018-01-01

Panniculitis is a rare clinical finding in dermatomyositis, with less than 30 cases reported and there is only one case associated with the amyopathic subtype described in the literature. The present report describes a 49-year-old female patient that one year after being diagnosed with amyopathic dermatomyositis, presented indurated, painful, erythematous to violaceous nodules located on the upper limbs, thighs and gluteal region. Skin biopsy revealed lobular panniculitis with a lymphocytic infiltrate. The patient was treated with prednisone and methotrexate, but remained unresponsive to treatment. PMID:29641712

Malaria in Brazil: what happens outside the Amazonian endemic region.

PubMed

de Pina-Costa, Anielle; Brasil, Patrícia; Di Santi, Sílvia Maria; de Araujo, Mariana Pereira; Suárez-Mutis, Martha Cecilia; Santelli, Ana Carolina Faria e Silva; Oliveira-Ferreira, Joseli; Lourenço-de-Oliveira, Ricardo; Daniel-Ribeiro, Cláudio Tadeu

2014-08-01

Brazil, a country of continental proportions, presents three profiles of malaria transmission. The first and most important numerically, occurs inside the Amazon. The Amazon accounts for approximately 60% of the nation's territory and approximately 13% of the Brazilian population. This region hosts 99.5% of the nation's malaria cases, which are predominantly caused by Plasmodium vivax (i.e., 82% of cases in 2013). The second involves imported malaria, which corresponds to malaria cases acquired outside the region where the individuals live or the diagnosis was made. These cases are imported from endemic regions of Brazil (i.e., the Amazon) or from other countries in South and Central America, Africa and Asia. Imported malaria comprised 89% of the cases found outside the area of active transmission in Brazil in 2013. These cases highlight an important question with respect to both therapeutic and epidemiological issues because patients, especially those with falciparum malaria, arriving in a region where the health professionals may not have experience with the clinical manifestations of malaria and its diagnosis could suffer dramatic consequences associated with a potential delay in treatment. Additionally, because the Anopheles vectors exist in most of the country, even a single case of malaria, if not diagnosed and treated immediately, may result in introduced cases, causing outbreaks and even introducing or reintroducing the disease to a non-endemic, receptive region. Cases introduced outside the Amazon usually occur in areas in which malaria was formerly endemic and are transmitted by competent vectors belonging to the subgenus Nyssorhynchus (i.e., Anopheles darlingi, Anopheles aquasalis and species of the Albitarsis complex). The third type of transmission accounts for only 0.05% of all cases and is caused by autochthonous malaria in the Atlantic Forest, located primarily along the southeastern Atlantic Coast. They are caused by parasites that seem to be (or to be very close to) P. vivax and, in a less extent, by Plasmodium malariae and it is transmitted by the bromeliad mosquito Anopheles (Kerteszia) cruzii. This paper deals mainly with the two profiles of malaria found outside the Amazon: the imported and ensuing introduced cases and the autochthonous cases. We also provide an update regarding the situation in Brazil and the Brazilian endemic Amazon.

Malaria in Brazil: what happens outside the Amazonian endemic region

PubMed Central

de Pina-Costa, Anielle; Brasil, Patrícia; Santi, Sílvia Maria Di; de Araujo, Mariana Pereira; Suárez-Mutis, Martha Cecilia; Santelli, Ana Carolina Faria e Silva; Oliveira-Ferreira, Joseli; Lourenço-de-Oliveira, Ricardo; Daniel-Ribeiro, Cláudio Tadeu

2014-01-01

Brazil, a country of continental proportions, presents three profiles of malaria transmission. The first and most important numerically, occurs inside the Amazon. The Amazon accounts for approximately 60% of the nation’s territory and approximately 13% of the Brazilian population. This region hosts 99.5% of the nation’s malaria cases, which are predominantly caused by Plasmodium vivax (i.e., 82% of cases in 2013). The second involves imported malaria, which corresponds to malaria cases acquired outside the region where the individuals live or the diagnosis was made. These cases are imported from endemic regions of Brazil (i.e., the Amazon) or from other countries in South and Central America, Africa and Asia. Imported malaria comprised 89% of the cases found outside the area of active transmission in Brazil in 2013. These cases highlight an important question with respect to both therapeutic and epidemiological issues because patients, especially those with falciparum malaria, arriving in a region where the health professionals may not have experience with the clinical manifestations of malaria and its diagnosis could suffer dramatic consequences associated with a potential delay in treatment. Additionally, because the Anopheles vectors exist in most of the country, even a single case of malaria, if not diagnosed and treated immediately, may result in introduced cases, causing outbreaks and even introducing or reintroducing the disease to a non-endemic, receptive region. Cases introduced outside the Amazon usually occur in areas in which malaria was formerly endemic and are transmitted by competent vectors belonging to the subgenus Nyssorhynchus (i.e., Anopheles darlingi, Anopheles aquasalis and species of the Albitarsis complex). The third type of transmission accounts for only 0.05% of all cases and is caused by autochthonous malaria in the Atlantic Forest, located primarily along the southeastern Atlantic Coast. They are caused by parasites that seem to be (or to be very close to) P. vivax and, in a less extent, by Plasmodium malariae and it is transmitted by the bromeliad mosquito Anopheles (Kerteszia) cruzii. This paper deals mainly with the two profiles of malaria found outside the Amazon: the imported and ensuing introduced cases and the autochthonous cases. We also provide an update regarding the situation in Brazil and the Brazilian endemic Amazon. PMID:25185003

Alopecia with foreign body granulomas induced by Radiesse injection: A case report.

PubMed

Liu, Ren-Feng; Kuo, Tseng-Tong; Chao, Yen-Yu; Huang, Yu-Huei

2018-02-26

Radiesse is a soft tissue filler which has been widely used for cosmetic enhancement. The safety of Radiesse has been thoroughly investigated via numerous studies. A late-onset complication of Radiesse injection consists of foreign body granulomas, with only three case reports in over 10 years of clinical use. Herein, we describe the case of a patient who experienced alopecia with foreign body granulomas at the injection region one month after receiving a Radiesse injection. To our knowledge, this is the first report in the English literature of alopecia as an adverse event associated with Radiesse injection. The present case reminded physicians to evaluate more cautiously the necessity of injecting filler into hair-bearing area for lifting purpose. This procedure may cause foreign body granulomatous reaction, which may result in hair loss at the injection region.

Hemangiopericytoma associated with multiple keratocystic odontogenic tumors in an adolescent patient: a case report.

PubMed

Brar, Rajdeep; Kulkarni, Sunita; Sheikh, Soheyl; Jindal, Sanjeev; Brar, Prabhleen

2008-06-01

Hemangiopericytoma, initially described by Stout and Murray in 1942 (1), is a rare vascular tumor arising from mesenchymal cells with pericytic differentiation. Hemangiopericytomas usually occur in the 5th decade of life and account for 3-5% of all soft tissue sarcomas and 1% of all vascular tumors (2). The tumor usually occurs in the limbs, pelvis, or head and neck region; 15-30% of all hemangiopericytomas occur in the head and neck (2,3). Here we present a case of hemangiopericytoma of the submandibular region with keratocystic odontogenic tumors in an adolescent patient.

Developmental Foreign Accent Syndrome: Report of a New Case

PubMed Central

Keulen, Stefanie; Mariën, Peter; Wackenier, Peggy; Jonkers, Roel; Bastiaanse, Roelien; Verhoeven, Jo

2016-01-01

This paper presents the case of a 17-year-old right-handed Belgian boy with developmental FAS and comorbid developmental apraxia of speech (DAS). Extensive neuropsychological and neurolinguistic investigations demonstrated a normal IQ but impaired planning (visuo-constructional dyspraxia). A Tc-99m-ECD SPECT revealed a significant hypoperfusion in the prefrontal and medial frontal regions, as well as in the lateral temporal regions. Hypoperfusion in the right cerebellum almost reached significance. It is hypothesized that these clinical findings support the view that FAS and DAS are related phenomena following impairment of the cerebro-cerebellar network. PMID:27014011

Dengue virus infection in a French traveller to the hilly region of Nepal in 2015: a case report.

PubMed

Gupta, Birendra Prasad; Adhikari, Anurag; Rauniyar, Ramanuj; Kurmi, Roshan; Upadhya, Bishnu Prasad; Jha, Bimlesh Kumar; Pandey, Basudev; Das Manandhar, Krishna

2016-03-21

Dengue viral infections are known to pose a significant risk during travel to tropical regions, but it is surprising to find dengue transmission in the hilly region of Nepal, which is over 1800mtr above sea level. A 43-year-old Caucasian female traveler from France presented with fever and abdominal pain following a diarrheal illness while visiting the central hilly region of Nepal. Over the course of 9 days, she developed fever, body aches, and joint pain, with hemorrhagic manifestation. She was hospitalized in India and treated with supportive care, with daily monitoring of her platelets. An assessment by enzyme-linked immunosorbent assay showed that she was positive for dengue non-structural protein 1. Upon her return to France, dengue virus was confirmed by reverse transcriptase-polymerase chain reaction. The district where this dengue case was reported is in the hilly region of Nepal, neighboring the capital city Kathmandu. To the best of our knowledge, there has previously been no dengue cases reported from the district. This study is important because it aims to establish a potential region of dengue virus circulation not only in the tropics, but also in the subtropics as well, which in Nepal may exceed elevations of 1800mtr. This recent case report has raised alarm among concerned health personnel, researchers, and organizations that this infectious disease is now on the way to becoming established in a temperate climate.

Second-Degree Interatrial Block in Hemodialysis Patients

PubMed Central

Enriquez, Andres; D'Amato, Anna; de Luna, Antoni Bayes; Baranchuk, Adrian

2015-01-01

Interatrial conduction delays manifest as a prolonged P-wave duration on surface ECG and the term interatrial block (IAB) has been coined. They are usually fixed, but cases of intermittent IAB have been described, suggesting functional conduction block at the Bachmann bundle region. We report 2 cases of patients on chronic hemodialysis therapy presenting with intermittent IAB. PMID:25755895

Institutionalizing China's Research University through Academic Mobility: The Case of PKU

ERIC Educational Resources Information Center

Xiaoguang, Shi

2015-01-01

Academic mobility is becoming a tread in academic life and a professional development globally, regionally and nationally. This article makes use of a case university--Peking University (PKU)--as an analytical approach to explore how and why academic mobility can happen in China's research universities. The author first presents an overview of the…

Intra Oral Fibrosarcoma with Various Histopathological Patterns: A Rare Case Report

PubMed Central

Reddy, A. Vikram Simha; Prakash, A. Ravi; Ram, V. Sai; Thorati, Rukmini Swathi

2015-01-01

Fibrosarcoma has been defined as a malignant mesenchymal tumour, the cells of which recapitulate the appearance of the normal fibroblast, with variable collagen production. Fibrosarcoma is a very uncommon tumour in the head and neck regions constituting only 0.05% of all the fibrosarcomas presenting in humans. They cause no characteristic symptoms and pose difficulty in clinical diagnosis. They have been classified histologically based on their distinct features into myxoid fibrosarcoma, low grade fibromyxoid fibrosarcoma and sclerosing epitheloid sarcoma. Here we present a rare case report of a 45-year-old male patient presenting with a maxillary fibrosarcoma, which histologically presented with different patterns. PMID:26393135

Matching mammographic regions in mediolateral oblique and cranio caudal views: a probabilistic approach

NASA Astrophysics Data System (ADS)

Samulski, Maurice; Karssemeijer, Nico

2008-03-01

Most of the current CAD systems detect suspicious mass regions independently in single views. In this paper we present a method to match corresponding regions in mediolateral oblique (MLO) and craniocaudal (CC) mammographic views of the breast. For every possible combination of mass regions in the MLO view and CC view, a number of features are computed, such as the difference in distance of a region to the nipple, a texture similarity measure, the gray scale correlation and the likelihood of malignancy of both regions computed by single-view analysis. In previous research, Linear Discriminant Analysis was used to discriminate between correct and incorrect links. In this paper we investigate if the performance can be improved by employing a statistical method in which four classes are distinguished. These four classes are defined by the combinations of view (MLO/CC) and pathology (TP/FP) labels. We use distance-weighted k-Nearest Neighbor density estimation to estimate the likelihood of a region combination. Next, a correspondence score is calculated as the likelihood that the region combination is a TP-TP link. The method was tested on 412 cases with a malignant lesion visible in at least one of the views. In 82.4% of the cases a correct link could be established between the TP detections in both views. In future work, we will use the framework presented here to develop a context dependent region matching scheme, which takes the number and likelihood of possible alternatives into account. It is expected that more accurate determination of matching probabilities will lead to improved CAD performance.

Case Studies on Technical and Vocational Education in Asia and the Pacific. Report of Regional Meeting (Kuala Lumpur, Malaysia, December 12-15, 1994). Exemplar Curriculum Project Working Group Report.

ERIC Educational Resources Information Center

Haas, Adrian, Ed.

This conference report provides summaries of presentations of country case studies from a project to investigate factors that impinged upon the status of technical and vocational education (TVE) in Asian and Pacific countries. The report includes the case study project terms of reference, a list of delegates, and agenda. Summaries follow of the…

[SPECT in diagnostic services and medical certification: a case report of depression in head injury].

PubMed

Banaś, Anna

2003-01-01

A case of severe organic affective disorder after head trauma with loss of consciousness is presented. While CT in this case was normal, SPECT brain perfusion imaging showed hipoperfusion in the right frontal lobe and the left temporal-parietal region. The psychologic tests: Benton, Bender, MMPI confirmed changes in CNS as well. These findings help to explain the severity and chronicity of disorders and medical certification.

Wide area lithologic mapping with ASTER thermal infrared data: Case studies for the regions in/around the Pamir Mountains and the Tarim basin

NASA Astrophysics Data System (ADS)

Ninomiya, Yoshiki; Fu, Bihong

2017-07-01

After the authors have proposed the mineralogical indices, e.g., Quartz Index (QI), Carbonate Index (CI), Mafic Index (MI) for ASTER thermal infrared (TIR) data, many articles have been applied the indices for the geological case studies and proved to be robust in extracting geological information at the local scale. The authors also have developed a system for producing the regional map with the indices, which needs mosaicking of many scenes considering the relatively narrow spatial coverage of each ASTER scene. The system executes the procedures very efficiently to find ASTER data covering a wide target area in the vast and expanding ASTER data archive. Then the searched ASTER data are conditioned, prioritized, and the indices are calculated before finally mosaicking the imagery. Here in this paper, we will present two case studies of the regional lithologic and mineralogic mapping of the indices covering very wide regions in and around the Pamir Mountains and the Tarim basin. The characteristic features of the indices related to geology are analysed, interpreted and discussed.

Computer assisted detection of abnormal airway variation in CT scans related to paediatric tuberculosis.

PubMed

Irving, Benjamin J; Goussard, Pierre; Andronikou, Savvas; Gie, Robert; Douglas, Tania S; Todd-Pokropek, Andrew; Taylor, Paul

2014-10-01

Airway deformation and stenosis can be key signs of pathology such as lymphadenopathy. This study presents a local airway point distribution model (LA-PDM) to automatically analyse regions of the airway tree in CT scans and identify abnormal airway deformation. In our method, the airway tree is segmented and the centreline identified from each chest CT scan. Thin-plate splines, along with a local mesh alignment method for tubular meshes, are used to register the airways and develop point distribution models (PDM). Each PDM is then used to analyse and classify local regions of the airway. This LA-PDM method was developed using 89 training cases and evaluated on a 90 CT test set, where each set includes paediatric tuberculosis (TB) cases (with airway involvement) and non-TB cases (without airway involvement). The LA-PDM was able to accurately distinguish cases with airway involvement with an AUC of the ROC classification (and 95% confidence interval) of 0.87 (0.77-0.94) for the Trachea-LMB-RMB region and 0.81 (0.68-0.90) for the RMB-RUL-BI region - outperforming a comparison method based on airway cross-sectional features. This has the potential to assist and improve airway analysis from CT scans by detecting involved airways and visualising affected airway regions. Copyright © 2014 Elsevier B.V. All rights reserved.

Case-mix fails to explain variation in mastectomy rates: management of screen-detected breast cancer in a UK region 1997–2003

PubMed Central

Caldon, L J M; Walters, S J; Reed, J A; Murphy, A; Worley, A; Reed, M W R

2004-01-01

Wide variation in the surgical management of breast cancer exists at hospital, regional, national and international level. To demonstrate whether variation in surgical practice observed at aggregate level between breast units persists following adjustment for case-mix, individual patient-level data from the Trent Breast Screening Programme Quality Assurance database (1997–2003) was analysed. Expected case-mix adjusted mastectomy rates were derived by logistic regression using the variables tumour size, site and grade, patient age and year of presentation, employing the region's overall case-mix adjusted practice as the reference population. The region's 11 breast screening units detected 5109 (3989 invasive) surgically managed primary breast cancers over the 6-year period. A total of 1828 mastectomies (Mx) were performed (Mx rate 35.8%, 95% confidence interval: 34.5–37.1%). Significant variation in mastectomy rates were observed between units (range 25–45%, P<0.0001), and persists following case-mix adjustment (P<0.0001). Two-fold variation in observed to expected unit mastectomy rate coefficient is demonstrated overall (range 0.66–1.36), increasing to almost four-fold variation in cancers less than 15 mm diameter (range 0.55–1.95). Significant variation in surgery for screen-detected primary breast cancer is not explained by case-mix. Further research is required to investigate potential patient and professional causative factors. PMID:15611797

[Tularaemia - a forgotten disease? Own experience].

PubMed

Yanushevych, Mariya; Komorowska-Piotrowska, Anna; Feleszko, Wojciech

2013-01-01

Tularaemia is an acute, animal-born disease, caused by Gram-negative aerobic bacilli - Francisella tularensis. Due to its high infectiousness and virulence it remains an epidemiological issue in some countries. The prevalence rate of tularaemia in the Scandinavian region, where most of the cases among European countries have been reported, it has remained stable since 2006, whereas in Poland a small, but stable increase has been observed. The first case of tularaemia in Poland was diagnosed in 1949 and since then more than 600 cases have been reported, mainly in the north-eastern and north-western regions of the country. In the majority of cases the infection has been transmitted by ixode bites or through direct contact with infected animals. Depending on the route of transmission, tularaemia can develop in different forms with a characteristic sudden onset of high fever and local lymphadenopathy. In Europe 95% of cases account for the ulceroglandular type, which characteristically presents with skin ulceration and inflammation of regional tissues and lymph nodes. This is the reason why it should always be taken into consideration in differential diagnosis of lymphadenitis, especially if its course is atypical or it does not respond to antibiotic therapy. The above mentioned atypical course of the disease and resistance to empirical treatment contribute to the challenge encountered by physicians in the process of diagnosis and treatment. The aim of the study is to present the most important data on tularaemia as an animal-born, infectious disease and to convince physicians to take it into consideration in the differential diagnosis of ymphadenopathy. We illustrate this article with the case of ulceroglandular type of tularemia diagnosed in a 5 year-old boy and describe the encountered diagnostic and therapeutic problems.

Intraocular gnathostomiasis: report of a case and review of literature.

PubMed

Pillai, Gopal S; Kumar, Anil; Radhakrishnan, Natasha; Maniyelil, Jayasree; Shafi, Tufela; Dinesh, Kavitha R; Karim, Shamsul

2012-04-01

Intraocular gnathostomiasis is a rare parasitic infection caused by the third-stage larvae of spiruroid nematode Gnanthostoma spp. seen mostly in tropical and subtropical regions. It is a food-borne zoonosis caused by ingestion of raw or undercooked freshwater fish, amphibians, reptiles, birds, and mammals, all of which are known to harbor advanced third-stage larvae of Gnanthostoma spp. To date, 74 cases of intraocular gnathostomiasis have been reported from 12 different countries. Only four countries have reported more than 10 cases each, and India shares the rare distinction of being one of them, with 14 cases. Surprisingly, not a single case of cutaneous gnanthostomiasis has ever been reported from India. We present one such case of intraocular gnathostomiasis in a 41-year-old male who presented with an actively motile worm attached to the iris, and we review the pertinent literature of all such cases reported from India.

Müllerian Agenesis in Cat Eye Syndrome and 22q11 Chromosome Abnormalities: A Case Report and Literature Review.

PubMed

AlSubaihin, Abdulmajeed; VanderMeulen, John; Harris, Kate; Duck, John; McCready, Elizabeth

2018-04-01

Although Müllerian agenesis is the second most common cause of primary amenorrhea the underlying etiology in most cases is unknown. Müllerian agenesis has been reported as a rare finding associated with chromosomal aberrations of the 22q11 chromosomal region including at least 1 individual with cat eye syndrome (CES) and 10 individuals with deletions or duplications of the 22q11.2 region. However, a potential link between 22q11 abnormalities and uterine malformations has been difficult to adequately ascertain because of the limited case reports in the literature. We report a second case of Müllerian agenesis in a girl with CES. A 16-year-old girl presented with bilateral colobomata, primary amenorrhea, and absence of the uterus and upper vagina on pelvic magnetic resonance imaging. Microarray analysis showed tetrasomy of the pericentromeric region of chromosome 22 diagnostic of CES. Müllerian aplasia/hypoplasia might represent a rare feature in CES and should be considered in the investigation of young girls with this syndrome. An increasing number of cases with 22q11 chromosome abnormalities and Müllerian agenesis further highlights the possibility of a gene within the 22q11 region that might mediate normal Müllerian development in girls. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Peripheral nerve blocks in patients with Ehlers-Danlos syndrome, hypermobility type: a report of 2 cases.

PubMed

Patzkowski, Michael S

2016-03-01

Ehlers-Danlos syndrome is an inherited disorder of collagen production that results in multiorgan dysfunction. Patients with hypermobility type display skin hyperextensibility and joint laxity, which can result in chronic joint instability, dislocation, peripheral neuropathy, and severe musculoskeletal pain. A bleeding diathesis can be found in all subtypes of varying severity despite a normal coagulation profile. There have also been reports of resistance to local anesthetics in these patients. Several sources advise against the use of regional anesthesia in these patients citing the 2 previous features. There have been reports of successful neuraxial anesthesia, but few concerning peripheral nerve blocks, none of which describe nerves of the lower extremity. This report describes 2 cases of successful peripheral regional anesthesia in the lower extremity. In case 1, a 16-year-old adolescent girl with hypermobility type presented for osteochondral grafting of tibiotalar joint lesions. She underwent a popliteal sciatic (with continuous catheter) and femoral nerve block under ultrasound guidance. She proceeded to surgery and tolerated the procedure under regional block and intravenous sedation. She did not require any analgesics for the following 15 hours. In case 2, an 18-year-old woman with hypermobility type presented for medial patellofemoral ligament reconstruction for chronic patella instability. She underwent a saphenous nerve block above the knee with analgesia in the distribution of the saphenous nerve lasting for approximately 18 hours. There were no complications in either case. Prohibitions against peripheral nerve blocks in patients with Ehlers-Danlos syndrome, hypermobility type, appear unwarranted. Published by Elsevier Inc.

Aggressive Angioimmunoblastic T Cell Lymphomas (AITL) with Soft Tissue Extranodal Mass Varied Histopathological Patterns with Peripheral Blood, Bone Marrow, and Splenic Involvement and Review of Literature.

PubMed

Mukherjee, Tanushri; Dutta, Rajat; Pramanik, S

2018-03-01

Angioimmunoblastic T cell lymphoma (AITL) is a peripheral T cell non-Hodgkin lymphoma with an aggressive fatal course and it has varied clinical presentation with an uncommon presentation when they present as soft tissue masses or when there is spill in the peripheral blood or there are composite lymphomas that are rare presentations. Common presentations include lymphadenopathy, fever and systemic symptoms, hemolytic anemias, skin rashes, and rheumatoid arthritis. The classical histopathology is absence of follicles in lymph nodes with presence of high endothelial venules and the tumor cells of small to medium-sized lymphocytes with pale cytoplasm mixed with reactive T cells. On immunohistochemistry, the cells are positive for CD3, CD4, CD10, BCL2, and CXCL13. In this observational study, the clinicopathologic presentation and the immunohistochemical profile of five cases who initially presented with a soft tissue mass which is an extremely rare presentation of this rare type of non-Hodgkin lymphoma that was diagnosed at our center with peripheral blood and bone marrow involvement and the clinicopathologic presentation, immunohistochemical profile, and response to treatment on follow-up are correlated with the literature review. One case had a fulminant and aggressive course and was fatal within 2 months of diagnosis. The rest of the four cases are on regular chemotherapy and follow-up. Our five cases had presented with soft tissue masses, two in the axillary regio,n two in the hand, and one in the scapular region with an extranodal presentation, and there was associated lymphadenopathy which developed subsequently with classic histomorphology and immunohistochemical findings. The age range was 46-54 years and all five cases were males. Three cases were with anemia (hemoglobin range 6.5-8.0 mg/dl) and all five cases were having peripheral blood plasmacytosis. Histopathology was classic with paracortical involvement with polymorphous population of cells with neoplastic lymphocytes of small and large sizes with numerous arborizing blood vessels which correspond to high endothelial venules. Microscopically, three architectural patterns; pattern I was seen in three cases (60%) and then pattern II and III in one case each (20% each). Immunohistochemistry revealed CD4+, CD8-, CXCL13+, CD10+, BCL6+, CD19, CD20, CD1a, Tdt, CD21, and CD23+ in follicular dendritic cells. AITL is a rare and aggressive non-Hodgkin lymphoma with varied clinical presentation with classic histomorphology with various patterns which may cause diagnostic dilemma and immunophenotypic findings, and prompt and early diagnosis is mandatory for institution of therapy.

Victoria's Regional Directors of Education and the Theory of Educational Administration: An Endangered Species.

ERIC Educational Resources Information Center

MacPherson, R. J. S.

This paper argues that a major review of the theory of educational administration is required if it is to regain a credible role in academic and practical circles. The argument, which considers the case of regional directors in Victoria, Australia (a role similarly endangered on present assumptions and trends), has four major parts. First is a…

The Permeability of Dialect Boundaries: A Case Study of the Region Surrounding Erie, Pennsylvania

ERIC Educational Resources Information Center

Evanini, Keelan

2009-01-01

This dissertation presents a dialectological study of the city of Erie, Pennsylvania, and the neighboring towns in the boundary area between the North and Midland dialect regions. Erie occupies a unique place in the dialect geography of North America, in that it appears to have switched status from the North to the Midland. Since the dialect…

Curriculum-Making in Pre-Vocational Education in the Lower Secondary School: A Regional Comparative Analysis within Europe

ERIC Educational Resources Information Center

Berger, Susanne; Canning, Roy; Dolan, Michael; Kurek, Slawomir; Pilz, Matthias; Rachwal, Tomasz

2012-01-01

This paper presents a pilot comparative research project on pre-vocational education in lower secondary schools (ISCED level 2) within regions in three European countries. The primary aim of the study was to better understand how the pre-vocational education curriculum is constructed and taught within schools. A case study methodology was selected…

Nonlinear dynamics of an elliptic vortex embedded in an oscillatory shear flow.

PubMed

Ryzhov, Eugene A

2017-11-01

The nonlinear dynamics of an elliptic vortex subjected to a time-periodic linear external shear flow is studied numerically. Making use of the ideas from the theory of nonlinear resonance overlaps, the study focuses on the appearance of chaotic regimes in the ellipse dynamics. When the superimposed flow is stationary, two general types of the steady-state phase portrait are considered: one that features a homoclinic separatrix delineating bounded and unbounded phase trajectories and one without a separatrix (all the phase trajectories are bounded in a periodic domain). When the external flow is time-periodic, the ensuing nonlinear dynamics differs significantly in both cases. For the case with a separatrix and two distinct types of phase trajectories: bounded and unbounded, the effect of the most influential nonlinear resonance with the winding number of 1:1 is analyzed in detail. Namely, the process of occupying the central stability region associated with the steady-state elliptic critical point by the stability region associated with the nonlinear resonance of 1:1 as the perturbation frequency gradually varies is investigated. A stark increase in the persistence of the central regular dynamics region against perturbation when the resonance of 1:1 associated stability region occupies the region associated with the steady-state elliptic critical point is observed. An analogous persistence of the regular motion occurs for higher perturbation frequencies when the corresponding stability islands reach the central stability region associated with the steady-state elliptic point. An analysis for the case with the resonance of 1:2 is presented. For the second case with only bounded phase trajectories and, therefore, no separatrix, the appearance of much bigger stability islands associated with nonlinear resonances compared with the case with a separatrix is reported.

Bell palsy in lyme disease-endemic regions of canada: a cautionary case of occult bilateral peripheral facial nerve palsy due to Lyme disease.

PubMed

Ho, Karen; Melanson, Michel; Desai, Jamsheed A

2012-09-01

Lyme disease caused by the spirochete Borrelia burgdorferi is a multisystem disorder characterized by three clinical stages: dermatologic, neurologic, and rheumatologic. The number of known Lyme disease-endemic areas in Canada is increasing as the range of the vector Ixodes scapularis expands into the eastern and central provinces. Southern Ontario, Nova Scotia, southern Manitoba, New Brunswick, and southern Quebec are now considered Lyme disease-endemic regions in Canada. The use of field surveillance to map risk and endemic regions suggests that these geographic areas are growing, in part due to the effects of climate warming. Peripheral facial nerve palsy is the most common neurologic abnormality in the second stage of Lyme borreliosis, with up to 25% of Bell palsy (idiopathic peripheral facial nerve palsy) occurring due to Lyme disease. Here we present a case of occult bilateral facial nerve palsy due to Lyme disease initially diagnosed as Bell palsy. In Lyme disease-endemic regions of Canada, patients presenting with unilateral or bilateral peripheral facial nerve palsy should be evaluated for Lyme disease with serologic testing to avoid misdiagnosis. Serologic testing should not delay initiation of appropriate treatment for presumed Bell palsy.

7p15 deletion as the cause of hand-foot-genital syndrome: a case report, literature review and proposal of a minimum region for this phenotype.

PubMed

Yokoyama, Emiy; Smith-Pellegrin, Dennise Lesley; Sánchez, Silvia; Molina, Bertha; Rodríguez, Alfredo; Juárez, Rocío; Lieberman, Esther; Avila, Silvia; Castrillo, José Luis; Del Castillo, Victoria; Frías, Sara

2017-01-01

Hand-foot-genital syndrome (HFGS) is a rare condition characterized by congenital malformations in the limbs and genitourinary tract. Generally, this syndrome occurs due to point mutations that cause loss of function of the HOXA13 gene, which is located on 7p15; however, there are some patients with HFGS caused by interstitial deletions in this region. We describe a pediatric Mexican patient who came to the Medical Genetics Department at the National Institute of Pediatrics because he presented with genital, hand and feet anomalies, facial dysmorphisms, and learning difficulties. Array CGH reported a 12.7 Mb deletion that includes HOXA13 . We compared our patient with cases of HFGS reported in the literature caused by a microdeletion; we found a minimum shared region in 7p15.2. By analyzing the phenotype in these patients, we suggest that microdeletions in this region should be investigated in all patients with clinical characteristics of HFGS who also present with dysplastic ears, mainly low-set implantation with a prominent antihelix, as well as a low nasal bridge and long philtrum.

Technical assistance for law-enforcement communications: Case study report two

NASA Technical Reports Server (NTRS)

Reilly, N. B.; Mustain, J. A.

1979-01-01

Two case histories are presented. In one study the feasibility of consolidating dispatch center operations for small agencies is considered. System load measurements were taken and queueing analysis applied to determine numbers of personnel required for each separate agency and for a consolidated dispatch center. Functional requirements were developed and a cost model was designed to compare relative costs of various alternatives including continuation of the present system, consolidation of a manual system, and consolidated computer-aided dispatching. The second case history deals with the consideration of a multi-regional, intrastate radio frequency for improved interregional communications. Sample standards and specifications for radio equipment are provided.

Cytogenetic, ras, and p53: studies in cases of canine neoplasms (hemangiopericytoma, mastocytoma, histiocytoma, chloroma).

PubMed

Mayr, B; Reifinger, M; Brem, G; Feil, C; Schleger, W

1999-01-01

Four case reports of mesenchymal neoplasms showing chromosomal abnormalities are presented. In a case of hemangiopericytoma trisomy 2 and centric fusion 19;21 were present. In a mastocytoma a deleted chromosome 35 was seen. A homogeneously staining region (HSR) on chromosome 1 was detected in a histiocytoma. Trisomy 5 and monosomy 31 were observed in a case of granulocytic sarcoma (chloroma). The lack of mutations in exons 1 and 2 of oncogenes N-ras, K-ras, and H-ras and exons 5, 6, 7, and 8 of tumor suppressor gene p53 in these four patients and in a larger series of investigated dogs (25 hemangiopericytomas, 12 mastocytomas, and 8 histiocytomas) is highlighted.

[Antituberculosis-drug resistance in the border of Brazil with Paraguay and Bolivia].

PubMed

Marques, Marli; Cunha, Eunice Atsuko Totumi; Evangelista, Maria do Socorro Nantua; Basta, Paulo Cesar; Marques, Ana Maria Campos; Croda, Julio; de Andrade, Sonia Maria Oliveira

2017-04-20

To estimate the rate of drug resistance among pulmonary tuberculosis (PTB) cases in the state of Mato Grosso do Sul, Brazil, and specifically in the border areas with Paraguay and Bolivia, as well as to identify associated risk factors. The present cross-sectional, epidemiological study focused on PTB cases recorded between January 2007 and December 2010 in the State Reportable Disease Information System with results of susceptibility tests to rifampicin, isoniazid, ethambutol, and streptomycin. Dependent variables were development of resistance to a single drug or any combination of drugs. Independent variables were being a new or treated case, living in border areas, presence/absence of diabetes, and history of alcoholism. There were 789 TBP cases with susceptibility testing. The following characteristics were associated with resistance: treated case (P = 0.0001), border region (P = 0.0142), alcoholism (P = 0.0451), and diabetes (P = 0.0708). The rates of combined, primary, and acquired resistance for the state were 16.3%, 10.6%, and 39.0%, vs. 22.3%, 19.2%, and 37.5% for the border region. The rates of combined, primary, and acquired multidrug resistance for the state were 1.8%, 0.6%, and 6.3%, vs. 3.1%, 1.2%, and 12.5% for the border region. In the border region, the state should investigate drug resistance in all patients with respiratory symptoms, determine the pattern of resistance in confirmed cases, adopt directly observed treatment for cases of PTB, and develop health actions together with neighboring countries. Across the state, the levels of acquired resistance should be monitored, with investigation of resistance in all treated cases and implementation of directly observed treatment especially among patients with diabetes or alcoholism.

Incidence of bovine clinical mastitis in Jammu region and antibiogram of isolated pathogens.

PubMed

Bhat, Adil Majid; Soodan, Jasvinder Singh; Singh, Rajiv; Dhobi, Ishfaq Ahmad; Hussain, Tufail; Dar, Mohammad Yousuf; Mir, Muheet

2017-08-01

This study was conducted to evaluate the incidence of clinical mastitis in bovines of Jammu region, to identify the infectious organisms responsible for it, and the antimicrobial sensitivity of isolated pathogens. The study was conducted on cases that were presented to the Medicine Division of Teaching Veterinary Clinical Complex, Faculty of Veterinary Sciences and Animal Husbandry, R.S. Pura, Jammu, Jammu and Kashmir. A total of 260 cases of bovines were presented from June 30, 2012, to July 01, 2013, out of which 30 cases were of clinical mastitis. The diagnosis of clinical mastitis was made on the basis of history and clinical examination of affected animals. Animal and quarter-wise incidence of clinical mastitis were found to be 11.5% and 5.76%, respectively. Of the 23 isolates obtained, Staphylococcus aureus (60.87%) was the most frequently isolated organism, followed by coagulase negative Staphylococci (13.04%), Streptococcus uberis (4.35%), Streptococcus dysgalactiae (8.69%), and Escherichia coli (13.04%). The antimicrobial sensitivity of isolates revealed maximum sensitivity to enrofloxacin, gentamicin, amoxicillin/sulbactam, ceftriaxone/tazobactam, ceftizoxime, ampicillin/sulbactam and least sensitivity for oxytetracycline and penicillin. Staphylococcus spp. is the major causative agent of clinical mastitis in bovines of Jammu region. The causative agents of the clinical mastitis were most sensitive to enrofloxacin and gentamicin.

Epidermoid Cyst of Mandible Ramus: Case Report

PubMed Central

Loxha, Mergime Prekazi; Salihu, Sami; Kryeziu, Kaltrina; Loxha, Sadushe; Agani, Zana; Hamiti, Vjosa; Rexhepi, Aida

2016-01-01

Introduction: An epidermoid cyst is a benign cyst usually found on the skin. Bone cysts are very rare and if they appear in bone they usually appear in the distal phalanges of the fingers. Epidermoid cysts of the jaws are uncommon. Case presentation: We present a case, of a 41 year-old female patient admitted to our department because of pain and swelling in the parotid and masseteric region–left side. There was no trismus, pathological findings in skin, high body temperature level, infra-alveolar nerves anesthesia or lymphadenopathy present. The orthopantomography revealed a cystic lesion and a unilocular lesion that included mandibular ramus on the left side with 3 cm in diameter. Under total anesthesia, a cyst had been reached and was enucleated. Histopathologic findings showed that the pathologic lesion was an epidermoid cyst. Discussion: Epidermoid and dermoid cysts are rare, benign lesions found throughout the body. Only a few cases in literature describe an intraossesus epidermoid cyst. Conclusion: Our case is an epidermoid cyst with a rare location in the region of the mandibular ramus. It is not associated with any trauma in this region except medical history reveals there was an operative removal of a wisdom tooth 12 years ago in the same side. These cysts are interesting from the etiological point of view. They should be considered in the differential diagnosis of other radiolucent lesions of the jaws. Surgically they have a very good prognosis, and are non-aggressive lesions. PMID:27594757

Large eddy simulation of a wing-body junction flow

NASA Astrophysics Data System (ADS)

Ryu, Sungmin; Emory, Michael; Campos, Alejandro; Duraisamy, Karthik; Iaccarino, Gianluca

2014-11-01

We present numerical simulations of the wing-body junction flow experimentally investigated by Devenport & Simpson (1990). Wall-junction flows are common in engineering applications but relevant flow physics close to the corner region is not well understood. Moreover, performance of turbulence models for the body-junction case is not well characterized. Motivated by the insufficient investigations, we have numerically investigated the case with Reynolds-averaged Naiver-Stokes equation (RANS) and Large Eddy Simulation (LES) approaches. The Vreman model applied for the LES and SST k- ω model for the RANS simulation are validated focusing on the ability to predict turbulence statistics near the junction region. Moreover, a sensitivity study of the form of the Vreman model will also be presented. This work is funded under NASA Cooperative Agreement NNX11AI41A (Technical Monitor Dr. Stephen Woodruff)

Radiotherapy on hidradenocarcinoma

PubMed Central

Lalya, Issam; Hadadi, Khalid; Tazi, El Mehdi; Lalya, Ilham; Bazine, Amine; Andaloussy, Khalid; Elmarjany, Mohamed; Sifat, Hassan; Hassouni, Khalid; Kebdani, Tayeb; Mansouri, Hamid; Benjaafar, Noureddine; Elgueddari, Brahim Khalil

2011-01-01

Context: Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. Case Report: We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy) and regional lymphatic chains (50 Gy), after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. Conclusion: Post operative radiotherapy allows better local control and should be mandatory when histological features predictive of recurrence are present: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread. PMID:22540063

Between universalism and regionalism: universal systematics from imperial Japan.

PubMed

Lee, Jung

2015-12-01

Historiographic discussions of the universality and regionality of science have to date focused on European cases for making regional science universal. This paper presents a new perspective by moving beyond European origins and illuminating a non-European scientist's engagement with the universality and regionality of science. It will examine the case of the Japanese botanist Nakai Takenoshin (1882-1952), an internationally recognized authority on Korean flora based at Tokyo Imperial University. Serving on the International Committee on Botanical Nomenclature in 1926, Nakai endorsed and acted upon European claims of universal science, whilst simultaneously unsettling them with his regionally shaped systematics. Eventually he came to promote his own systematics, built regionally on Korean flora, as the new universal. By analysing his shifting claims in relation to those of other European and non-European botanists, this paper makes two arguments. First, universalism and regionalism were not contradictory foundations of scientific practice but useful tools used by this non-European botanist in maintaining his scientific authority as a representative Japanese systematist. Second, his claims to universality and regionalism were both imperially charged. An imperially monopolized study of Korean plants left a regional imprint on Nakai's systematics. In order to maintain his scientific authority beyond its region of origin he had to assert either the expanding regionalism of 'East Asia' or universalism.

[One-stage reconstruction of zygomatico-orbital complex with the use of implants of different origin].

PubMed

Menabde, G T; Gvenetadze, Z V; Atskvereli, L Sh

2009-03-01

Reconstruction of zygomatico-orbital complex remains as one of the troublesome and topical problems at steady posttraumatic deformations and fresh traumas of the mentioned region. The present work provides analysis of our own experience of surgical treatment of patients suffering from posttraumatic deformations and defects of zygomatico-orbital complex. The work was based on the results of examination and treatment of 33 patients who underwent an operation during the period from 2003 to 2008 years. Of 33, 21 patients were operated due to fresh traumas of the zygomatico-orbital region, and 12 - due to steady posttraumatic deformations of the mentioned region. Of 33 clinical cases, 19 patients underwent reconstruction of zygomatico-orbital complex with the use of implant. In 11 cases implants were perforated titanic plates, in 6 cases - bone cement (Surgical Simplex P), and in 2 cases - combination of titanic plates with bone cement. The results of our investigations have shown that one-stage reconstruction of zygomatico-orbital complex with the use of titanic plates and bone cement liquidates functional and cosmetic disorders. It has been suggested that the use of elaborated complex approaches in treatment of posttraumatic deformations and fresh traumas of zygomatico-orbital region is reasonable and acceptable.

The frequency and characteristics of chronic widespread pain in general practice: a case-control study.

PubMed

Rohrbeck, Jens; Jordan, Kelvin; Croft, Peter

2007-02-01

Chronic widespread pain is common in the community but is not often diagnosed in primary care. One explanation may be that widespread pain is presented and treated in primary care as multiple episodes of regional pain. To determine whether patients who consult with multiple regional pain syndromes have characteristics consistent with chronic widespread pain. Case-control study. One general practice in North Staffordshire, UK. Participants were 148 cases who consulted regularly with different musculoskeletal pains over 5 years, and 524 controls who had not consulted for musculoskeletal pain during the same period. A postal questionnaire survey and medical record review were undertaken. Cases with musculoskeletal pain reported more health problems and higher levels of fatigue than controls, and significantly worse general health and greater sleep disturbance (odds ratios 3.3. and 3.1, respectively). They generally reported more severe symptoms and consulted more frequently for a range of problems, but this was not explained by a general propensity to consult. Patients who consult in primary care with multiple regional pain syndromes have similar characteristics to those associated with chronic widespread pain and fibromyalgia. Recognising the need for general approaches to pain management, rather than treating each syndrome as a regional problem of pain, may improve the outcome in such patients.

Circumferential Ciliary Body Cysts Presenting as Acute Pigment Dispersion and Ocular Hypertension.

PubMed

Sarıgül Sezenöz, Almila; Güngör, Sirel Gür; Kıratlı, Hayyam; Akman, Ahmet

2017-09-15

To report a case of circumferential neuroepithelial cyst of the ciliary body presenting with pigment dispersion (PD) and ocular hypertension. 48-year-old female patient presented with a complaint of pain in the left eye. On examination, visual acuity of the left eye was 0.9, and the intraocular pressure was 48 mmHg. Biomicroscopic anterior segment examination of the left eye revealed 4+ pigmented cells in the anterior chamber. Active PD from the pupillary region at 11 o'clock was noticed at the time of the examination. Ultrasound biomicroscopy demonstrated 360º cystic lesions of the ciliary body in the left eye. The patient was diagnosed as neuroepithelial cyst of the ciliary body. Our case is unique as it is the first case of circumferential neuroepithelial ciliary body cyst presenting with acute PD and ocular hypertension.

An unusual presentation of perforated appendicitis in epigastric region☆

PubMed Central

Odabasi, Mehmet; Arslan, Cem; Abuoglu, Hasan; Gunay, Emre; Yildiz, Mehmet Kamil; Eris, Cengiz; Ozkan, Erkan; Aktekin, Ali; Muftuoglu, M.A. Tolga

2013-01-01

INTRODUCTION Atypical presentations of appendix have been reported including backache, left lower quadrant pain and groin pain from a strangulated femoral hernia containing the appendix. We report a case presenting an epigastric pain that was diagnosed after computed tomography as a perforated appendicitis on intestinal malrotation. PRESENTATION OF CASE A 27-year-old man was admitted with a three-day history of epigastric pain. Physical examination revealed tenderness and defense on palpation of epigastric region. There was a left subcostal incision with the history of diaphragmatic hernia repair when the patient was 3 days old. He had an intestinal malrotation with the cecum fixed at the epigastric region and the inflamed appendix extending beside the left lobe of liver. DISCUSSION While appendicitis is the most common abdominal disease requiring surgical intervention seen in the emergency room setting, intestinal malrotation is relatively uncommon. When patients with asymptomatic undiagnosed gastrointestinal malrotation clinically present with abdominal pain, accurate diagnosis and definitive therapy may be delayed, possibly increasing the risk of morbidity and mortality. CONCLUSION Atypical presentations of acute appendicitis should be kept in mind in patients with abdominal pain in emergency room especially in patients with previous childhood operation for diaphragmatic hernia. PMID:24441442

Passive Acoustic Monitoring of the Environmental Impact of Oil Exploration on Marine Mammals in the Gulf of Mexico.

PubMed

Sidorovskaia, Natalia A; Ackleh, Azmy S; Tiemann, Christopher O; Ma, Baoling; Ioup, Juliette W; Ioup, George E

2016-01-01

The Gulf of Mexico is a region densely populated by marine mammals that must adapt to living in a highly active industrial environment. This paper presents a new approach to quantifying the anthropogenic impact on the marine mammal population. The results for sperm and beaked whales of a case study of regional population dynamics trends after the Deepwater Horizon oil spill, derived from passive acoustic-monitoring data gathered before and after the spill in the vicinity of the accident, are presented.

Research in Accrediting Efforts (Project REA). An Assessment on the Awarding of Academic Credit for CETA Activities in Illinois. Case Studies.

ERIC Educational Resources Information Center

Stoyanoff, Karen, Comp.; Klehm, Jeanette, Comp.

Summaries are presented of 15 case studies conducted at Illinois Comprehensive Employment and Training Act (CETA) regions to determine the kind of credentialing mechanisms that exist for awarding academic credit or some other record of achievement to those eligible participants who complete CETA training programs. Introductory material describes…

A case of Cotard syndrome: (123)I-IBZM SPECT imaging of striatal D(2) receptor binding.

PubMed

De Risio, Sergio; De Rossi, Giuseppe; Sarchiapone, Marco; Camardese, Giovanni; Carli, Vladimir; Cuomo, Chiara; Satta, Maria Antonietta; Di Giuda, Daniela

2004-01-15

A case of 'dèlire de nègation' that suddenly appeared in a 43-year-old male is presented. No alteration in regional cerebral blood, as measured by (99m)Tc-HMPAO-SPECT, was found, but (123)I-IBZM-SPECT analysis showed reduced striatal D(2) receptor binding that further decreased after treatment.

HYDRONEPHROSIS IN THE GOAT DUE TO NEOPLASIA. A CASE REPORT.

DTIC Science & Technology

The clinical history, gross and microscopic necropsy findings are presented in a case of hydronephrosis in a goat due to a primary neoplasm of the...urinary tract. The neoplasm, a transitional cell adenocarcinoma, had interfered with urine flow to a degree that hydronephrosis and subsequent uremia resulted. Metastases were found in the regional lymph nodes and lungs. (Author)

Integrating Education for Sustainability in Preservice Teacher Education: A Case Study from a Regional Australian University

ERIC Educational Resources Information Center

Mills, Reece; Tomas, Louisa

2013-01-01

Education for Sustainability (EfS) has been prioritised in the School of Education at James Cook University (JCU), Townsville, Australia. This article presents a case study that explores the ways in which teacher educators integrate EfS in their teaching in the Bachelor of Education (BEd) (Primary) at JCU, and their perceptions of enablers and…

A "Great Roads" Approach to Teaching Modern World History and Latin American Regional Survey Courses: A Veracruz to Mexico City Case Study.

ERIC Educational Resources Information Center

Brown, James Seay, Jr.; Sullivan-Gonzalez, Douglass

2002-01-01

Outlines an innovative way of teaching "World History Since 1500" at Samford University (Birmingham, Alabama) called the "great roads" approach, centered upon important roads in a country's history. Presents the "Veracruz to Mexico City corridor" case study used to teach a Latin American modern history course. (CMK)

Revision of loop colostomy under regional anaesthesia and sedation.

PubMed

Ng, Oriana; Thong, Sze Ying; Chia, Claramae Shulyn; Teo, Melissa Ching Ching

2015-05-01

Patients presenting for emergency abdominal procedures often have medical issues that cause both general anaesthesia and central neuraxial blockade to pose significant risks. Regional anaesthetic techniques are often used adjunctively for abdominal procedures under general anaesthesia, but there is limited published data on procedures done under peripheral nerve or plexus blocks. We herein report the case of a patient with recent pulmonary embolism and supraventricular tachycardia who required colostomy refashioning. Ultrasonography-guided regional anaesthesia was administered using a combination of ilioinguinal-iliohypogastric, rectus sheath and transversus abdominis plane blocks. This was supplemented with propofol and dexmedetomidine sedation as well as intermittent fentanyl and ketamine boluses to cover for visceral stimulation. We discuss the anatomical rationale for the choice of blocks and compare the anaesthetic conduct with similar cases that were previously reported.

Pericoronal occurrence of cemento-ossifying fibroma: an unexemplified and unusual case report with review of literature.

PubMed

K L, Kumaraswamy; R S, Arvind Babu; P, Sheshadri; Kumaran, Santhosh

2014-03-01

The Cemento-ossifying fibroma (COF) is an odontogenic neoplasm that is predominantly considered as a fibro osseous lesion of the jaw bone. The histogenetic origin of COF was thought to be derived from the periodontal cells, which have the ability to form fibrous, cementum and osseous tissue. Due to the periodontal cellular origin, the lesion often occurs in the radicular portion of the bicuspid and molar tooth region of the lower jaw. We present a case of Cemento-ossifying fibroma in a 43-year-old female in the pericoronal aspect of an impacted third molar mimicking an odontogenic lesion. The occurrence of COF in pericoronal region is an unusual site. This article also discusses about the various hamartomatous lesions occurring in the pericoronal region of the teeth.

Complex functional and epithetic rehabilitation after ablation of recurrent retroauricular basal cell carcinoma – a case study

PubMed Central

Reich, Waldemar; Exner, Anika; Winter, Eileen; Al-Nawas, Bilal; Eckert, Alexander Walter

2017-01-01

The reconstruction of extended defects of the concha poses a complex challenge for plastic surgeons. In cases of subtotal ablation, an alternative method designed especially for elderly oncological patients consists of epithetic rehabilitation. However, inserting an implant-retained concha epithesis proves challenging in patients with antecedents of deep resections involving the mastoid process. In the present case study, we report on the long-term treatment course (2009–2017) of a 79-year-old male patient suffering from a recurrent basal cell carcinoma of the retroauricular region. Following tumor resection, along with lateral mastoidectomy, reconstruction, and adjuvant radiotherapy, functional and esthetic deficits primarily due to peripheral facial nerve palsy were successfully managed using a multistep procedure. The procedure was completed by inserting an implant-retained concha epithesis, resulting in improved quality of life. Due to prior lateral mastoidectomy, ultra-short implants (4 mm) were inserted, partially at atypical positions. For maintaining healthy periimplant soft tissue, aftercare comprised cold plasma treatment. This oncologic case demonstrates the therapeutic necessity of using a broad spectrum of reconstructive procedures, along with their limitations, in a critical anatomic region. Specific features include the presentation of a workflow using ultra-short implants in a compromised mastoid region. Surgeons should consider alternative implant positions in the event of any compromised mastoid process. A particular emphasis has been put on meticulous aftercare to preserve healthy periimplant soft tissues. PMID:29423354

Clinical and epidemiological features of leishmaniasis in northwestern-Argentina through a retrospective analysis of recent cases.

PubMed

García Bustos, María F; González-Prieto, Gabriela; Ramos, Federico; Mora, María C; Hashiguchi, Yoshihisa; Parodi, Cecilia; Basombrío, Miguel A; Moreno, Sonia; Monroig, Sibila; Beckar, Josefina; Jaime, Daniela; Sajama, Jesús; Yeo, Matthew; Marco, Jorge D; Locatelli, Fabricio M; Barrio, Alejandra

2016-02-01

Leishmaniasis is a parasitic disease caused by hemoflagellates of the genus Leishmania and is transmitted to humans by the bite of infected phlebotomine sandflies. Depending on the Leishmania species, the disease has different clinical forms including cutaneous, mucocutaneous, and visceral manifestations. Previous studies performed in endemic zones of northwestern-Argentina, during epidemic outbreaks, have been important for detecting patients suffering from the acute phase of the disease, but have not given a complete representation of the clinical and epidemiological features in the region. Furthermore, due to the resurgence of leishmaniasis worldwide and in particular the large increase of international tourism to the region, it seems pertinent to update the current epidemiological and clinical profile of leishmaniasis in northwestern-Argentina. Here we present a retrospective analysis of 95 Leishmania positive cases, presenting between 2000 and 2014. Patients were derived from hospitals and diagnosed in our lab at the University of Salta, located in a non-endemic area in Salta, Argentina. We detected numerous extensive mucocutaneous cases (34/95, 35.8%) distinct from mucosal affected patients, some instances originating in locations with no previously reported human cases. Additionally patients suffering from concomitant diseases, besides leishmaniasis, were assessed. These included Chagas disease, syphilis, deep mycoses, tuberculosis, toxoplasmosis and intestinal parasitosis. This study updates the clinical and epidemiological features of leishmaniasis in northwestern-Argentina, and discusses the implications and management strategy for patients who acquire the disease in this region. Copyright © 2015 Elsevier B.V. All rights reserved.

Compression of the median nerve in the proximal forearm by a giant lipoma: A case report

PubMed Central

2008-01-01

Background Compression of the median nerve by a tumour in the elbow and forearm region is rare. We present a case of neuropathy of the median nerve secondary to compression by giant lipoma in the proximal forearm. Case presentation A 46-year-old man presented with a six month history of gradually worsening numbness and paresthesia on the palmar aspect of the left thumb and thenar eminence. Clinical examination reveals a hypoaesthesia in the median nerve area of the left index and thumb compared to the contralateral side. Electromyography showed prolonged sensory latency in the distribution of the median nerve corresponding to compression in the region of the pronator teres (pronator syndrome). Radiological investigations were initially reported as normal. Conservative treatment for one month did not result in any improvement. Surgical exploration was performed and a large intermuscular lipoma enveloped the median nerve was found. A complete excision of the tumour was performed. Postoperative revaluation the X-ray of the elbow was seen to demonstrate a well-circumscribed mass in the anterior aspect of the proximal forearm. At follow-up, 14 months after surgery, the patient noted complete return of the sensation and resolution of the paresthesia. Conclusion In case of atypical findings or non frequent localization of nerve compression, clinically interpreted as an idiopathic compression, it is recommended to make a pre-operative complementary Ultrasound or MRI study. PMID:18541043

CHARACTERIZING SITE HYDROLOGY (REGION 5)

EPA Science Inventory

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

Study of the Histopathologic Characteristics and Surface Morphologies of Glottic Carcinomas With Anterior Vocal Commissure Involvement.

PubMed

Wu, Jianhui; Zhao, Jing; Wang, Zhangfeng; Li, Zenghong; Luo, Jie; Liao, Bing; Yang, Zhiyun; Liu, Qihong; Wang, Bin; Wen, Weiping; Lei, Wenbin

2015-07-01

This article explores the features and the role of the anterior vocal commissure (AVC) structure and the surface morphologies of glottic carcinomas with AVC involvement to provide a reference for the selection of transoral carbon dioxide (CO2) laser surgery. A total of 31 cases of glottic carcinomas with AVC involvement from May 2012 to January 2014 were included. All patients underwent electronic laryngoscopic examinations and computed tomography scans to determine the surface morphology. After surgery, the tumor specimens were resected integrally, and axial serial sections parallel to the plane of vocal cords were taken to explore the features and possible invasion paths of the glottic carcinomas with AVC involvement. The rates of involvement of the supraglottis and subglottis were 71.4% and 14.8%, respectively, via the AVC. The involvement of the superficial layer of the unilateral or bilateral vocal cords without involvement of the vocal muscle in the AVC region (IVM) or the cartilage was present in 15 cases (48.4%). The involvement of the superficial layer of the unilateral and bilateral vocal cords occurred in 16 cases (51.6%) with the IVM in 13 cases and the involvement of the intermediate lamina of the thyroid cartilage (ITC) in 8 cases. The involvement of the ITC was associated with the involvement of the vocal muscle of the AVC region (P < 0.05). Among the pushing carcinomas, 15 of 21 (71.4%) presented with well-defined tumor mass, and 8 of 10 (80.0%) infiltrating carcinomas presented with multiple tumor nests that were often surrounded by fibrosis (P < 0.05). The AVC is an important path of invasion of subglottic in glottic carcinomas but less so for suparglottic. The Broyles' ligaments acted as a barrier against the spread of the tumors to the thyroid cartilage, but this role was obviously weaken by the involvement of the vocal muscle of the AVC region. The infiltrating carcinomas presented with multiple tumor nests in fibrous tissue. When CO2 laser microsurgery is considered as a treatment option, these facts should be kept in mind.

Study of the Histopathologic Characteristics and Surface Morphologies of Glottic Carcinomas With Anterior Vocal Commissure Involvement

PubMed Central

Wu, Jianhui; Zhao, Jing; Wang, Zhangfeng; Li, Zenghong; Luo, Jie; Liao, Bing; Yang, Zhiyun; Liu, Qihong; Wang, Bin; Wen, Weiping; Lei, Wenbin

2015-01-01

Abstract This article explores the features and the role of the anterior vocal commissure (AVC) structure and the surface morphologies of glottic carcinomas with AVC involvement to provide a reference for the selection of transoral carbon dioxide (CO2) laser surgery. A total of 31 cases of glottic carcinomas with AVC involvement from May 2012 to January 2014 were included. All patients underwent electronic laryngoscopic examinations and computed tomography scans to determine the surface morphology. After surgery, the tumor specimens were resected integrally, and axial serial sections parallel to the plane of vocal cords were taken to explore the features and possible invasion paths of the glottic carcinomas with AVC involvement. The rates of involvement of the supraglottis and subglottis were 71.4% and 14.8%, respectively, via the AVC. The involvement of the superficial layer of the unilateral or bilateral vocal cords without involvement of the vocal muscle in the AVC region (IVM) or the cartilage was present in 15 cases (48.4%). The involvement of the superficial layer of the unilateral and bilateral vocal cords occurred in 16 cases (51.6%) with the IVM in 13 cases and the involvement of the intermediate lamina of the thyroid cartilage (ITC) in 8 cases. The involvement of the ITC was associated with the involvement of the vocal muscle of the AVC region (P < 0.05). Among the pushing carcinomas, 15 of 21 (71.4%) presented with well-defined tumor mass, and 8 of 10 (80.0%) infiltrating carcinomas presented with multiple tumor nests that were often surrounded by fibrosis (P < 0.05). The AVC is an important path of invasion of subglottic in glottic carcinomas but less so for suparglottic. The Broyles’ ligaments acted as a barrier against the spread of the tumors to the thyroid cartilage, but this role was obviously weaken by the involvement of the vocal muscle of the AVC region. The infiltrating carcinomas presented with multiple tumor nests in fibrous tissue. When CO2 laser microsurgery is considered as a treatment option, these facts should be kept in mind. PMID:26200618

A rare cause of abdominal lymphadenopathy--tularemia: report of two pediatric cases.

PubMed

Gülhan, Belgin; Tezer, Hasan; Kanık-Yüksek, Saliha; Kılıç, Selçuk; Senel, Emrah

2014-01-01

Tularemia caused by Francisella tularensis occurs worldwide in the northern hemisphere, with great variation in geographic and temporal occurrence. It generally presents as an acute febrile disease with the major clinical presentations including the six classic forms of tularemia: ulceroglandular, glandular, oculoglandular, oropharyngeal, typhoidal, and pneumonic. In contrast to European countries, where the ulceroglandular form is more prominent, the oropharyngeal form is the most common presentation in Turkey. We present rare cases of oropharyngeal tularemia in a 16-year-old boy and nine-year-old girl. To the best of our knowledge, these are the firstly described abdominal lymphadenopathy cases from Turkey. The second case was admitted with erythema nodosum, and abdominal lymphadenopathy was detected during the investigation. Excisional lymph node biopsy revealed abdominal tularemia. It is necessary to consider tularemia in the differential diagnosis of abdominal lymphadenopathy in tularemia regions. We also conclude that oropharyngeal tularemia can cause lymphadenopathy in any part of the gastrointestinal tract.

Antifreeze on a freezing morning: ethylene glycol poisoning in a 2-year-old

PubMed Central

Hann, Gayle; Duncan, Dana; Sudhir, Gopakumar; West, Peter; Sohi, Dalbir

2012-01-01

This case report describes the presentation and management of a 2-year-old child who ingested a potentially fatal amount of ethylene glycol (EG). There are few published cases worldwide of EG poisoning in children managed with fomepizole. All cases described in the literature were managed in a paediatric intensive care unit. In this case, the child presented irritable, pale and confused with high anion gap metabolic acidosis. As there were no paediatric intensive care beds available in the region, the child was successfully managed in a high dependency area in our district general hospital. The child fully recovered and was discharged home in 7 days. The authors believe that multi-disciplinary team management and the use of fomepizole contributed to the positive outcome and this case raised many useful learning points. PMID:22605809

Relative costs of transporting low-level waste according to four postulated regional-management cases

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

Wilmot, E.L.; Shirley, C.G.

1982-01-01

Results presented in this paper show that almost any compact binding states into cooperating regions for disposal of LLW will reduce nationwide transportation costs markedly. As a corollary, the reduction of costs may reflect a two- to four-fold reduction of transportation distances with consequent reduction of risk to the public since risk generally decreases directly as transport distances decrease.

Positioning hospitals: a model for regional hospitals.

PubMed

Reddy, A C; Campbell, D P

1993-01-01

In an age of marketing warfare in the health care industry, hospitals need creative strategies to compete successfully. Lately, positioning concepts have been added to the health care marketer's arsenal of strategies. To blend theory with practice, the authors review basic positioning theory and present a framework for developing positioning strategies. They also evaluate the marketing strategies of a regional hospital to provide a case example.

Distance Education in Asia and the Pacific. Volume II. Proceedings of the Regional Seminar on Distance Education (Bangkok, Thailand, November 26-December 3, 1986).

ERIC Educational Resources Information Center

Asian Development Bank, Manila (Philippines).

The paper presented in this three-part conference report trace the growth and development of distance education in the Asian and Pacific region. Part 1 provides a general review. Part 2 contains the following case studies: "Distance Education in India" (S. P. Mullick); "Distance Education in Indonesia" (Professor Setijadi);…

Adoption of Web 2.0 Technology in Higher Education: A Case Study of Universities in National Capital Region, India

ERIC Educational Resources Information Center

Tyagi, Sunil

2012-01-01

The present study was conducted in six (6) Indian Universities at NCR (National Capital Region) of India to explore the usage analysis of Web 2.0 technologies in learning environment by faculty members. The investigator conducted a survey with the help of structured questionnaire on 300 respondents. A total of 300 self-administered questionnaires…

Inflammatory arthritis mimicking Complex Regional Pain Syndrome (CRPS) in a child: A case report.

PubMed

Egilmez, Zeliha; Turgut, Selin Turan; Icagasioglu, Afitap; Bicakci, Irem

2016-01-01

Joint complaints in childhood are seen frequently and differential diagnosis can be difficult. Juvenile idiopathic arthritis (JIA) is the most common rheumatological disease of childhood. It involves peripheral joint arthritis, chronic synovitis, and extra-articular manifestations. Accurate diagnosis can take a long time and sometimes multiple diagnoses are used while following the patient until a final diagnosis can be reached. Arthritis may be triggered by trauma and confused with other diseases like complex regional pain syndrome (CRPS), in which trauma plays a role in the etiology. In the present case, ankle pain in an 8-year-old girl was misdiagnosed as CRPS.

An anisotropic lens for transitioning plane waves between media of different permittivities

NASA Astrophysics Data System (ADS)

Stone, Alexander P.; Baum, Carl E.

1988-11-01

A particularly simple geometry is considered in which an inhomogeneous and anisotropic lens is specified for the transition of plane waves between media of different permittivities. The permittivities of the regions outside of the lens can be constant, but the permittivity of the lens region depends on position. Results are presented for a plane wave in the second medium propagating normally to the assumed plane boundary of that medium. The results for the case of normal incidence are then generalized to the case of nonnormal incidence. The conditions of transit time conservation and impedance matching are related to the Brewster angle.

Myiasis in humans: an overview and a report of two cases in the Republic of Panama.

PubMed

Powers, N R; Yorgensen, M L; Rumm, P D; Souffront, W

1996-08-01

This paper on myiasis provides varied references from documented sources as an overall review. A review of two case studies, a primary screwworm (cochliomyia hominivorax) infestation and a human botfly (Dermatobia hominis) infestation, as well as information on approaches to positive intervention and remediation are presented. Human myiasis found in the subtropical and tropical regions of the world is a health threat. As a result of the military's expanding role in medical support to various regions where myiasis is endemic, this paper serves to familiarize health care providers with this condition and to provide guidance when dealing with patients affected by myiasis.

Infusing research integrity principles and practices into a regional master's degree-intensive university: a case study.

PubMed

Thompson, Carla J; Podemski, Richard; Brown, H Quincy

2012-01-01

The need for institutions of higher education to advance research and scholarly integrity across graduate degree programs involves a strong commitment from each institution to develop a comprehensive approach for promoting responsible conduct of research (RCR). In response to this need, one master's-intensive regional university implemented a three-tier model project (focusing, developing, and evaluating/sustaining) for infusing research integrity principles and practices while promoting RCR. Components of the model and implementation strategies are presented as a case study analysis. Implications of the model for promoting the RCR are projected relative to graduate programs focused on applied research.

Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups

PubMed Central

SUNDFELD, Renato Herman; SUNDFELD-NETO, Daniel; MACHADO, Lucas Silveira; FRANCO, Laura Molinar; FAGUNDES, Ticiane Cestari; BRISO, André Luiz Fraga

2014-01-01

Superficial irregularities and certain intrinsic stains on the dental enamel surfaces can be resolved by enamel microabrasion, however, treatment for such defects need to be confined to the outermost regions of the enamel surface. Dental bleaching and resin-based composite repair are also often useful for certain situations for tooth color corrections. This article presented and discussed the indications and limitations of enamel microabrasion treatment. Three case reports treated by enamel microabrasion were also presented after 11, 20 and 23 years of follow-ups. PMID:25141208

A case of acute quadriplegia complicating Mediterranean spotted fever.

PubMed

Caroleo, Santo; Longo, Chiara; Pirritano, Domenico; Nisticò, Rita; Valentino, Paola; Iocco, Maurizio; Santangelo, Ermenegildo; Amantea, Bruno

2007-06-01

Mediterranean spotted fever is a rickettsiosis caused by Rickettsia conorii. Mediterranean spotted fever is considered to be a benign disease, however, approximately 10% of patients present with a severe systemic manifestation in which neurologic involvement occurs. We present a case of an 80-year-old man with a R. conorii infection who developed an acute quadriplegia secondary to an axonal polyneuropathy. The characteristic tache noire was observed on the lateral region of the thigh and elevated IgM antibody titres against R. conorii were detected by an indirect immunofluorescence test.

Aggressive Angiomyxoma of the Vulva Mimicking Clitoromegaly in a Young Child.

PubMed

Kawamura, Masataka; Matsumoto, Fumi; Matsui, Futoshi; Yazawa, Koji; Shimada, Kenji

2017-03-01

Aggressive angiomyxoma (AAM) is a rare soft tissue tumor of mesenchymal origin that chiefly involves the vulvar and perineal region. In 90% of cases, AAM presents in women of reproductive age with a peak incidence in the fourth decade of life. To date, AAM of the vulva in young children and infancy has never been reported. We present a case of AAM of the vulva that was initially interpreted as clitoromegaly in a 3-year-old girl. Copyright © 2016 Elsevier Inc. All rights reserved.

Missile injuries in head - neck and maxillo-facial region - an experience in eastern nepal.

PubMed

Wakode, P T; Ghimire, Anand; Acharya, Roshan

2008-06-01

Ballistic injuries to head-neck and maxillofacial region is quite common problem nowadays. Most of the time the injuries seem to be dreadful but the mechanism of the injuries caused by ballistics and the anatomical conditions of maxillofacial and head-neck region mitigate the severity of the injuries. Proper primary management followed by reconstruction and management of associated injuries decreases the mortality and morbidity of missile injuries in head-neck and maxillofacial region. Eleven cases of missile injuries in head-neck and maxillofacial region are included in the present study. The mechanism of the injury and the ideal management strategy for the ballistics injuries in the region has been discussed in the article.

Distribution of Lutzomyia longipalpis chemotype populations in São Paulo state, Brazil.

PubMed

Casanova, Claudio; Colla-Jacques, Fernanda E; Hamilton, James G C; Brazil, Reginaldo P; Shaw, Jeffrey J

2015-03-01

American visceral leishmaniasis (AVL) is an emerging disease in the state of São Paulo, Brazil. Its geographical expansion and the increase in the number of human cases has been linked to dispersion of Lutzomyia longipalpis into urban areas. To produce more accurate risk maps we investigated the geographic distribution and routes of expansion of the disease as well as chemotype populations of the vector. A database, containing the annual records of municipalities which had notified human and canine AVL cases as well as the presence of the vector, was compiled. The chemotypes of L. longipalpis populations from municipalities in different regions of São Paulo State were determined by Coupled Gas Chromatography - Mass Spectrometry. From 1997 to June 2014, L. longipalpis has been reported in 166 municipalities, 148 of them in the Western region. A total of 106 municipalities were identified with transmission and 99 were located in the Western region, where all 2,204 autochthonous human cases occurred. Both the vector and the occurrence of human cases have expanded in a South-easterly direction, from the Western to central region, and from there, a further expansion to the North and the South. The (S)-9-methylgermacrene-B population of L. longipalpis is widely distributed in the Western region and the cembrene-1 population is restricted to the Eastern region. The maps in the present study show that there are two distinct epidemiological patterns of AVL in São Paulo State and that the expansion of human and canine AVL cases through the Western region has followed the same dispersion route of only one of the two species of the L. longipalpis complex, (S)-9-methylgermacrene-B. Entomological vigilance based on the routes of dispersion and identification of the chemotype population could be used to identify at-risk areas and consequently define the priorities for control measures.

Distribution of Lutzomyia longipalpis Chemotype Populations in São Paulo State, Brazil

PubMed Central

Casanova, Claudio; Colla-Jacques, Fernanda E.; Hamilton, James G. C.; Brazil, Reginaldo P.; Shaw, Jeffrey J.

2015-01-01

Background American visceral leishmaniasis (AVL) is an emerging disease in the state of São Paulo, Brazil. Its geographical expansion and the increase in the number of human cases has been linked to dispersion of Lutzomyia longipalpis into urban areas. To produce more accurate risk maps we investigated the geographic distribution and routes of expansion of the disease as well as chemotype populations of the vector. Methodology/Principal Findings A database, containing the annual records of municipalities which had notified human and canine AVL cases as well as the presence of the vector, was compiled. The chemotypes of L. longipalpis populations from municipalities in different regions of São Paulo State were determined by Coupled Gas Chromatography – Mass Spectrometry. From 1997 to June 2014, L. longipalpis has been reported in 166 municipalities, 148 of them in the Western region. A total of 106 municipalities were identified with transmission and 99 were located in the Western region, where all 2,204 autochthonous human cases occurred. Both the vector and the occurrence of human cases have expanded in a South-easterly direction, from the Western to central region, and from there, a further expansion to the North and the South. The (S)-9-methylgermacrene-B population of L. longipalpis is widely distributed in the Western region and the cembrene-1 population is restricted to the Eastern region. Conclusion/Significance The maps in the present study show that there are two distinct epidemiological patterns of AVL in São Paulo State and that the expansion of human and canine AVL cases through the Western region has followed the same dispersion route of only one of the two species of the L. longipalpis complex, (S)-9-methylgermacrene-B. Entomological vigilance based on the routes of dispersion and identification of the chemotype population could be used to identify at-risk areas and consequently define the priorities for control measures. PMID:25781320

A novel class of Pseudoautosomal region 1 deletions downstream of SHOX is associated with Leri-Weill dyschondrosteosis.

PubMed

Benito-Sanz, Sara; Thomas, N Simon; Huber, Céline; Huber, Celine; Gorbenko del Blanco, Darya; Del Blanco, Darya Gorbenko; Aza-Carmona, Miriam; Crolla, John A; Maloney, Vivienne; Rappold, Gudrun; Argente, Jesús; Argente, Jesus; Campos-Barros, Angel; Cormier-Daire, Valérie; Cormier-Daire, Valerie; Heath, Karen E

2005-10-01

Leri-Weill dyschondrosteosis (LWD) is a pseudoautosomal dominant disorder characterized by disproportionate short stature and a characteristic curving of the radius, known as the "Madelung deformity." SHOX mutations resulting in SHOX haploinsufficiency have been found in LWD and in a variable proportion of patients with idiopathic short stature (ISS), whereas homozygous loss of SHOX results in the more severe Langer mesomelic dysplasia (LMD). Defects in SHOX have been identified in approximately 60% of LWD cases, whereas, in the remaining approximately 40%, the molecular basis is unknown. This suggests either genetic heterogeneity or the presence of mutations in unanalyzed regions of SHOX, such as the upstream, intragenic, or downstream regulatory sequences. Therefore, the pseudoautosomal region 1 (PAR1) of 80 patients with LWD, in whom SHOX deletions and mutations had been excluded, was screened for deletions by use of a new panel of microsatellite markers. We identified 12 patients with LWD who presented with a novel class of PAR1 deletions that did not include SHOX. The deletions were of variable size and mapped at least approximately 30-530 kb downstream of SHOX. In our cohort, this type of deletion accounted for 15% of cases. In all cases, the deletions cosegregated with the phenotype. No apparent phenotypic differences were observed between patients with SHOX deletions and those with this new class of PAR1 deletions. Thus, we present here the identification of a second PAR1 region implicated in the etiopathogenesis of LWD. Our findings suggest the presence of distal regulatory elements of SHOX transcription in PAR1 or, alternatively, the existence of an additional locus apparently involved in the control of skeletal development. Deletion analysis of this newly identified region should be included in the mutation screening of patients with LWD, LMD, and ISS.

[RADAR: a program for the prevention of suicide in adolescents in the region of Aysen, Chile, preliminary results].

PubMed

Bustamante, Francisco; Urquidi, Cinthya; Florenzano, Ramón; Barrueto, Carolina; de Los Hoyos, Jaime; Ampuero, Karla; Terán, Laura; Figueroa, María Inés; Farías, Magdalena; Rueda, María Livia; Giacaman, Eduardo

2018-02-01

We present the preliminary results of the implementation of RADAR: a community suicide prevention program in adolescents implemented in two high schools in a south region of Chile. In a pilot study, during 2016, we implemented RADAR in two high schools of Puerto Aysen, in in the Region of Aysen of Chile. A total of 409 actors were trained (among students, school teachers, caregivers and health professionals) for the screening and referral of high suicide risk adolescents. Out of a total of 144 students who passed the RADAR screening systems, 29 cases were detected as suicide risk (20%) and 27 of them were opportunely referred to the Emergency Service of the Hospital of Puerto Aysen. In the second RADAR screening campaign, 3 months later, 90% of the cases no longer presented suicide risk. These results show the high proportion of ado lescents at risk of suicide who are not visible by the health system and the feasibility of implementing RADAR in the community as an effective suicide prevention intervention.

Arsenic in groundwater in Bangladesh: A geostatistical and epidemiological framework for evaluating health effects and potential remedies

NASA Astrophysics Data System (ADS)

Yu, Winston H.; Harvey, Charles M.; Harvey, Charles F.

2003-06-01

This paper examines the health crisis in Bangladesh due to dissolved arsenic in groundwater. First, we use geostatistical methods to construct a map of arsenic concentrations that divides Bangladesh into regions and estimate vertical concentration trends in these regions. Then, we use census data to estimate exposure distributions in the regions; we use epidemiological data from West Bengal and Taiwan to estimate dose response functions for arsenicosis and arsenic-induced cancers; and we combine the regional exposure distributions and the dose response models to estimate the health effects of groundwater arsenic in Bangladesh. We predict that long-term exposure to present arsenic concentrations will result in approximately 1,200,000 cases of hyperpigmentation, 600,000 cases of keratosis, 125,000 cases of skin cancer, and 3000 fatalities per year from internal cancers. Although these estimates are very uncertain, the method provides a framework for incorporating better data as it becomes available. Moreover, we examine the remedy of drilling deeper wells in selected regions of Bangladesh. By replacing 31% of the wells in the country with deeper wells the health effects of drinking groundwater arsenic could be reduced by approximately 70% provided that arsenic concentrations in deep wells remain relatively low.

Emergency presentations of head and neck cancer: a modern perspective.

PubMed

Bannister, M; Vallamkondu, V; Ah-See, K W

2016-06-01

Head and neck cancer emergency presentations are uncommon but persistent. However, there is little published literature on this aspect of cancer and patient demographics. This study aimed to assess the incidence, patient profile, tumour site and stage of emergency cancer presentations in our region. Retrospective review of regional cancer database over a five-year period. Emergency presentations accounted for 7 per cent of all cases. There was no difference in patient age and risk factors between the emergency and non-emergency presentations. The emergency presentation group showed a greater proportion of female patients compared to the non-emergency presentation group (30 vs 15 per cent). In all emergency presentations, the cancer was at advanced stages. Oropharyngeal cancer was the commonest emergency presentation of cancer, but the third commonest in the non-emergency group. Emergency presentations are increasing annually. Female patients and oropharyngeal cancer showed greater representation compared to male patients and laryngeal cancer.

The occurrence of paraesthesia of the maxillary division of the trigeminal nerve after dental local anaesthetic use: a case report.

PubMed

Moorthy, Advan; Stassen, Leo F A

2015-01-01

Paraesthesia can be a complication of surgical intervention. Its occurrence after dental local anaesthetic use is a rare event in general dental practice. Reported cases have mainly described its presentation for the mandibular division of the trigeminal nerve with very few reports for the maxillary division of this nerve. This report describes a case of paraesthesia in the maxillary region following local anaesthetic use prior to removal of an upper molar tooth.

Geologic framework for the national assessment of carbon dioxide storage resources: U.S. Gulf Coast: Chapter H in Geologic framework for the national assessment of carbon dioxide storage resources

USGS Publications Warehouse

Roberts-Ashby, Tina L.; Brennan, Sean T.; Buursink, Marc L.; Covault, Jacob A.; Craddock, William H.; Drake II, Ronald M.; Merrill, Matthew D.; Slucher, Ernie R.; Warwick, Peter D.; Blondes, Madalyn S.; Gosai, Mayur A.; Freeman, P.A.; Cahan, Steven M.; DeVera, Christina A.; Lohr, Celeste D.; Warwick, Peter D.; Corum, Margo D.

2014-01-01

This report presents 27 storage assessment units (SAUs) within the United States (U.S.) Gulf Coast. The U.S. Gulf Coast contains a regionally extensive, thick succession of clastics, carbonates, salts, and other evaporites that were deposited in a highly cyclic depositional environment that was subjected to a fluctuating siliciclastic sediment supply and transgressive and regressive sea levels. At least nine major depositional packages contain porous strata that are potentially suitable for geologic carbon dioxide (CO2) sequestration within the region. For each SAU identified within these packages, the areal distribution of porous rock that is suitable for geologic CO2 sequestration is discussed, along with a description of the geologic characteristics that influence the potential CO2 storage volume and reservoir performance. These characteristics include reservoir depth, gross thickness, net-porous thickness, porosity, permeability, and groundwater salinity. Additionally, a characterization of the overlying regional seal for each SAU is presented. On a case-by-case basis, strategies for estimating the pore volume existing within structurally and (or) stratigraphically closed traps are also presented. Geologic information presented in this report has been employed to calculate potential storage capacities for CO2 sequestration in the SAUs that are assessed herein, although complete assessment results are not contained in this report.

Landslide and flood hazard assessment in urban areas of Levoča region (Eastern Slovakia)

NASA Astrophysics Data System (ADS)

Magulova, Barbora; Caporali, Enrica; Bednarik, Martin

2010-05-01

The case study presents the use of statistical methods and analysis tools, for hazard assessment of "urbanization units", implemented in a Geographic Information Systems (GIS) environment. As a case study, the Levoča region (Slovakia) is selected. The region, with a total area of about 351 km2, is widely affected by landslides and floods. The problem, for small urbanization areas, is nowadays particularly significant from the socio-economic point of view. It is considered, presently, also an increasing problem, mainly because of climate change and more frequent extreme rainfall events. The geo-hazards are evaluated using a multivariate analysis. The landslide hazard assessment is based on the comparison and subsequent statistical elaboration of territorial dependence among different input factors influencing the instability of the slopes. Particularly, five factors influencing slope stability are evaluated, i.e. lithology, slope aspect, slope angle, hypsographic level and present land use. As a result a new landslide susceptibility map is compiled and different zones of stable, dormant and non-stable areas are defined. For flood hazard map a detailed digital elevation model is created. A compose index of flood hazard is derived from topography, land cover and pedology related data. To estimate flood discharge, time series of stream flow and precipitation measurements are used. The assessment results are prognostic maps of landslide hazard and flood hazard, which presents the optimal base for urbanization planning.

Q fever in Spain: acute and chronic cases, 1981-1985.

PubMed

Tellez, A; Sainz, C; Echevarria, C; de Carlos, S; Fernandez, M V; Leon, P; Brezina, R

1988-01-01

Two hundred forty-nine cases of Q fever were documented at the laboratories of the Centro Nacional de Microbiología, Virología e Inmunología Sanitarias (CNMVIS) during the 5-year period 1981-1985. Two hundred thirty-four cases corresponded to acute infections, mostly sporadic but including two epidemics. The clinical presentation was respiratory in 74% of the cases and febrile in 18%. Fifteen cases, all but one of which were endocarditis, were categorized as chronic. The cases studied were referred from almost every region of Spain. The clinical and epidemiologic analyses and the number of cases reported permit only an approximation of the true incidence and characteristics of Q fever in Spain.

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2017-01-01

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

Excess of non-verbal cases of autism spectrum disorders presenting to orthodox clinical practice in Africa – a trend possibly resulting from late diagnosis and intervention

PubMed Central

Bakare, Muideen O; Munir, Kerim M

2012-01-01

Objectives Characteristics of children with autism spectrum disorders (ASDs) in Africa are not known because of unavailability of large-scale epidemiological studies in this region. This review explored the age at first presentation to orthodox clinical practice of African children with ASDs and their expressive language ability at presentation. Methods A literature search of case series and case reports of ASDs from Africa was done through PubMed/MEDLINE, Google Scholar, African Journals Online (AJOL), and archives of the Nigerian Journal of Psychiatry. Six articles included content relating to age of the child at first presentation to orthodox clinical practice and symptoms at presentation related to expressive language ability and therefore fulfilled the inclusion criteria. Suggestions are made to explain the observations emanating from the review. Results An excess of non-verbal over verbal cases of ASDs have been presenting to orthodox clinical practice and there is a common denominator of late presentation/diagnosis and in turn late intervention, with most cases presenting for the first time well above 8 years of age. Attempts to explain these observations included low levels of knowledge and awareness about ASDs in Africa; problems with help-seeking behaviour; and lack of mental healthcare facilities and trained personnel. Conclusions Enhancement of processes directed at ensuring early diagnosis and interventions, especially interventions aimed at improving speech and language development well and sufficiently early, may bring about a shift in the trend of excess non-verbal cases of ASDs over verbal cases presenting to orthodox clinical practice. PMID:22229024

Functional Reconstruction with Latissimus Dorsi Flap following Resection of an Extensive Basal Cell Carcinoma in the Shoulder Region: A Case Report

PubMed Central

Paprottka, Felix J.; Klimas, Dalius; Hebebrand, Detlev

2018-01-01

Large and ulcerating skin tumors have become a rarity in the modern Western world. However, these conditions can cause serious life-threatening complications. The case of a 60-year-old male Caucasian patient is reported, who had suffered from an extensive basal cell carcinoma in the right shoulder region for several years. The patient kept the lesion secret from his friends and family and delayed presentation to health care services. After an episode of tumor-related heavy bleeding, the patient was referred to our clinic and received a radical surgical tumor resection—followed by defect coverage with a latissimus dorsi myocutaneous flap. An alternative treatment option that could be offered to the patient would have been a mutilating surgical procedure with an arm amputation. By using this plastic reconstructive surgical technique, the main function of the shoulder joint was conserved. The presented case demonstrates options for defect coverage of problematic wounds in anatomically complex body regions—like the shoulder—by using a functional reconstruction using myocutaneous flaps. PMID:29896564

Elephantiasis nostras verrucosa of lower limb: a case report.

PubMed

Kalafi, Amir; Vasaghi, Attiyeh

2014-01-01

Elephantiasis nostras verrucosa (ENV) is a rare condition in which hyperkeratosis, fibrosis and disfiguration of dermis occurs. It is caused mostly by non infectious diseases such as surgery, trauma, tumors, and venous obstructions. To our knowledge there is not any case report of ENV in Middle East region. In this patient, ENV caused by trauma and Patient presented with enlargement of right lower limb.

Bullous impetigo caused by Streptococcus salivarius: a case report.

PubMed Central

Brook, I

1980-01-01

A 19-month-old child presented with bullous impetigo around the perineal region, penis, and left foot. Streptococcus salivarius was the only isolate recovered from the lesions. The child was treated with parenteral penicillin, debridement of the bulli, and local application of silver sulphadiazine cream. This case of bullous impetigo illustrates another aspect of the pathogenicity of Strep. salivarius. Images Fig. 1 Fig. 2 PMID:7002959

Epidemiological characteristics of dengue disease in Saurashtra region, India, during year 2015

PubMed Central

Mistry, Madhulika; Chudasama, Rajesh K.; Goswami, Yogesh; Dalwadi, Chintan; Mitra, Aarohi; Mehta, Garima

2017-01-01

Background: Dengue is an important vector-borne disease with a spectrum of classical fever to hemorrhagic fever to dengue shock syndrome. The present study was conducted with objective to study epidemiological and demographic characteristics of dengue infections during the year 2015 in Saurashtra region, Gujarat state, India. Materials and Methods: The study was conducted at Tertiary Care Hospital, Rajkot, during the year 2015. A total of 3312 blood samples were collected and tested for dengue NS1 antigen and IgM antibody by capture ELISA testing from various districts of Saurashtra region. A pretested structured data sheet was used as a tool for data collection, and data analysis was done. Results: Out of 3312 tested samples, 33.4% samples were found positive for dengue. Suspected cases were reported from all age groups, including majority from 15 to 24 years (31.1%) and 25 to 44 years (30.0%) and also 8.4% from 0 to 4 years. More than two-third (68.7%) of males were dengue positive than female cases. Significant numbers of cases (P < 0.01) were residing in urban areas (65.7%). Two-third cases (66.8%) diagnosed after 7 days of fever by IgM antibody test. Increasing number of dengue cases reported from July and reached to peak during October 2015. Conclusion: The present study reported that dengue mainly affected males and urban population. Perennial occurrence with seasonal increase during monsoon and postmonsoon months was reported. Effective implementation of vector control measures through efforts toward vector breeding source reduction and with the use of personal prophylactic measures against mosquito bites will help in reducing the dengue prevalence in the community. PMID:29302526

Characterizing Site Hydrology (Region 10, Seattle, WA)

EPA Science Inventory

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

CHARACTERIZING SITE HYDROLOGY (REGION 8 WORKSHOP)

EPA Science Inventory

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

Forecasting quantities of disused household CRT appliances--a regional case study approach and its application to Baden-Württemberg.

PubMed

Walk, Wolfgang

2009-02-01

Due to special requirements regarding logistics and recycling, disused cathode ray tube (CRT) appliances are handled in some countries as a separate waste fraction. This article presents a forecast of future household waste CRT quantities based on the past and present equipment of households with television sets and computer monitors. Additional aspects taken into consideration are the product life time distribution and the ongoing change in display technology. Although CRT technology is fading out, the findings of this forecast show that quantities of waste CRT appliances will not decrease before 2012 in Baden-Württemberg, Germany. The results of this regional case study are not quantitatively transferable without further analysis. The method provided allows analysts to consider how the time shift between production and discard could impact recycling options, and the method could be valuable for future similar analyses elsewhere.

Pigmented Paraaxillary Located "Complex" Basal Cell Carcinoma Imitating clinically irritated Melanocytic Lesion - Succesfull Surgical Approach in Bulgarian Patient.

PubMed

Voicu, Cristiana; Mihai, Mara; Lupu, Mihai; Patterson, James W; Koleva, Nely; Wollina, Uwe; Lotti, Torello; Lotti, Jacopo; França, Katlein; Batashki, Atanas; Gianfaldoni, Serena; Bakardzhiev, Ilko; Mangarov, Hristo; Tchernev, Georgi

2017-07-25

Basal cell carcinoma (BCC) is the most frequently encountered neoplasm worldwide. While nodular BCC is the most frequent clinical subtype, other forms of BCC, such as superficial, cystic, morpheiform, infiltrative, and pigmented may also be encountered. We present the case of a 67-year-old male with a relatively well-defined infiltrative, pigmented plaque with multiple colours and peripheral growth situated in the right axillary region. The histopathologic examination performed after complete surgical excision of the tumour revealed a complex pigmented BCC with macronodular, fibroepithelioma-like, cystic, focally infiltrative and basosquamous features. Uncommon locations of BCCs in sun-protected areas such as the axillary region require a higher degree of suspicion for diagnosis. The complex histology of the presented case, including subtypes with differing biologic attributes, emphasises the importance of histopathological examination in the diagnosis and therapeutic management of BCC.

[Analysis of the geographical distribution of cases of leprosy. Rio de Janeiro, 2001-2012].

PubMed

Gracie, Renata; Peixoto, Julia Novaes de Barros; Soares, Fabiane Bertoni Dos Reis; Hacker, Mariana de Andrea Vilas-Boas

2017-05-01

Studies have demonstrated that the geographical distribution of leprosy is related to different socioeconomic factors. This article aims to study the geographical distribution of leprosy in the state of Rio de Janeiro. The cases of leprosy reported in the 2001-2012 period were mapped according to municipality. Epidemiological and socioeconomic indicators were calculated. The ArcMap program was used for the construction of maps and Earth View to calculate the Bayesian rate. It was observed that leprosy is presented in hyper-endemic levels especially in the metropolitan area. However, there is also a reduction of the detection rate in the most recent study period. In municipalities in the metropolitan region and the north western region detection in children under 15 is high, indicating an active transmission situation. In municipalities in the south-central region and especially in the coastal region, there was a high proportion of cases diagnosed with level II disability, reflecting late diagnosis. There was no linear correlation between socioeconomic indicators and leprosy rate. These results contribute to the analysis of the geographical distribution of leprosy, important for the identification of areas for resource allocation, aiming to control and eliminate the disease.

Pericoronal Occurrence of Cemento-Ossifying Fibroma: An Unexemplified and Unusual Case Report with Review of Literature

PubMed Central

K.L, Kumaraswamy; R.S, Arvind Babu; P, Sheshadri; Kumaran, Santhosh

2014-01-01

The Cemento-ossifying fibroma (COF) is an odontogenic neoplasm that is predominantly considered as a fibro osseous lesion of the jaw bone. The histogenetic origin of COF was thought to be derived from the periodontal cells, which have the ability to form fibrous, cementum and osseous tissue. Due to the periodontal cellular origin, the lesion often occurs in the radicular portion of the bicuspid and molar tooth region of the lower jaw. We present a case of Cemento-ossifying fibroma in a 43-year-old female in the pericoronal aspect of an impacted third molar mimicking an odontogenic lesion. The occurrence of COF in pericoronal region is an unusual site. This article also discusses about the various hamartomatous lesions occurring in the pericoronal region of the teeth. PMID:24783159

Fluctuating residual limb volume accommodated with an adjustable, modular socket design: A novel case report.

PubMed

Mitton, Kay; Kulkarni, Jai; Dunn, Kenneth William; Ung, Anthony Hoang

2017-10-01

This novel case report describes the problems of prescribing a prosthetic socket in a left transfemoral amputee secondary to chronic patellofemoral instability compounded by complex regional pain syndrome. Case Description and Methods: Following the amputation, complex regional pain syndrome symptoms recurred in the residual limb, presenting mainly with oedema. Due to extreme daily volume fluctuations of the residual limb, a conventional, laminated thermoplastic socket fitting was not feasible. Findings and Outcomes: An adjustable, modular socket design was trialled. The residual limb volume fluctuations were accommodated within the socket. Amputee rehabilitation could be continued, and the rehabilitation goals were achieved. The patient was able to wear the prosthesis for 8 h daily and to walk unaided indoors and outdoors. An adjustable, modular socket design accommodated the daily residual limb volume fluctuations and provided a successful outcome in this case. It demonstrates the complexities of socket fitting and design with volume fluctuations. Clinical relevance Ongoing complex regional pain syndrome symptoms within the residual limb can lead to fitting difficulties in a conventional, laminated thermoplastic socket due to volume fluctuations. An adjustable, modular socket design can accommodate this and provide a successful outcome.

[Entomological investigations conducted around ten cases of yellow fever in 2009 in the Denguélé sanitary region, Côte-d'Ivoire].

PubMed

Konan, Y L; Fofana, D; Coulibaly, Z I; Diallo, A; Koné, A B; Doannio, J M C; Ekra, K D; Odéhouri-Koudou, P

2011-10-01

In November 2009, ten suspicious cases of yellow fever, including six deaths, were notified in the region of Denguélé, in the northwest of Côte-d'Ivoire. In order to evaluate the extent of yellow fever virus circulation and the risk for local people, a mission of entomological investigation was carried out by the Ministry of Health and Public Hygiene of Côte-d'Ivoire. Entomological investigations were conducted in the villages of confirmed cases (Banakoro and Tron-Touba) and the centers of consultation and hospitalization of cases during illness. Breteau index and recipient index were quasi nil. Aedes aegypti was absent among the captured mosquitoes. On the other hand, Aedes luteocephalus and Aedes opok were present at Banakoro and Tron-Touba with respective average biting rates of 0.8 and 0.6 bite/man/twilight. This situation of epidemic in the northwest of Côte-d'Ivoire could be explained by the deterioration of Denguélé region's health system which is a consequence of the war started in the country in 2002 and which has lowered the immunity of the population.

[Geographic expansion of hantavirus pulmonary syndrome in Argentina. The southernest case report].

PubMed

Bellomo, Carla; Nudelman, Julio; Kwaszka, Roberto; Vazquez, Gabriela; Cantoni, Gustavo; Weinzettel, Barbara; Larrieu, Edmundo G; Padula, Paula

2009-01-01

Since 1995 more than 1000 cases of hantavirus pulmonary syndrome (HPS) were reported in Argentina, a severe disease and often fatal to humans. Most cases were associated with Andes virus (AND) that caused few events of person-to-person transmission. Several lineages of pathogenic AND viruses have been described, including AND South, hosted by the rodent Oligoryzomys longicaudatus which affects the Patagonian region of Argentina and Chile. We studied the clinical and epidemiological characteristics of a HPS case. The objective was to describe the clinical presentation of the case, its epidemiology, the likely site of infection, the viral variant implicated and its relationship with the closest reported cases. We carried out the clinical follow up, serological and molecular diagnosis and the epidemiological research, including a rodent reservoir study. The clinical presentation of the case was the classical and moderate, caused by AND South virus. Its viral nucleotide sequence was compared with cases from Southern Argentina and Chile. This case was found to be the most Southern (48 degrees 46' 1.2'' S; 70 degrees 15' O) case reported and involved a new Argentinean province.

Magnetic resonance imaging findings of paracoccidioidomycosis in the musculoskeletal system.

PubMed

Savarese, Leonor G; Monsignore, Lucas M; de Andrade Hernandes, Mateus; Martinez, Roberto; Nogueira-Barbosa, Marcello H

2015-10-01

To describe magnetic resonance imaging (MRI) findings in musculoskeletal paracoccidioidomycosis (PCM). Retrospective case series study after IRB approval. Two musculoskeletal radiologists reviewed in consensus the MRI findings of 11 patients with microbiologically and/or pathologically proven osteoarticular PCM. The MRI evaluation included discrimination of abnormalities in joints, bones and soft tissues. Mean age of patients was 29 years (10-55 years), eight men and three women. Musculoskeletal involvement was the only or the primary presentation of the disease in seven patients (63%). Osteomyelitis was the most common presentation, with seven cases (63%). Primary arthritis was found in one patient (9%). Isolated extra-articular soft tissue PCM was found in three patients: myositis (2) and subcutaneous infection (1). All cases showed regions with signal intensity higher than or similar to the signal of muscle on T1-weighted images. Penumbra sign was present in five cases (45%). T2-weighted images showed reactive soft tissue oedema in eight cases (72%). Post-gadolinium images showed peripheral (8/9) or heterogeneous (1/9) enhancement. Synovial enhancement was present in all cases of joint involvement (6/6). Lipomatosis arborescens was documented in one case of chronic knee involvement. To our knowledge, this is the first case series describing MRI findings of musculoskeletal PCM. Musculoskeletal involvement was the primary presentation of the disease in most cases, and therefore, neoplasms were initially in the differential diagnosis. Osteomyelitis was the most common presentation, often with secondary involvement of joint and or soft tissue. © 2015 John Wiley & Sons Ltd.

Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007–08 and 2012–14

PubMed Central

Maze, Michael J.; Biggs, Holly M.; Rubach, Matthew P.; Galloway, Renee L.; Cash-Goldwasser, Shama; Allan, Kathryn J.; Halliday, Jo E. B.; Hertz, Julian T.; Saganda, Wilbrod; Lwezaula, Bingileki F.; Cleaveland, Sarah; Mmbaga, Blandina T.; Maro, Venance P.; Crump, John A.

2016-01-01

Background The sole report of annual leptospirosis incidence in continental Africa of 75–102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of this estimate over time, we estimated the incidence of acute leptospirosis in Kilimanjaro Region, northern Tanzania for the time period 2012–2014. Methodology and Principal Findings Leptospirosis cases were identified among febrile patients at two sentinel hospitals in the Kilimanjaro Region. Leptospirosis was diagnosed by serum microscopic agglutination testing using a panel of 20 Leptospira serovars belonging to 17 separate serogroups. Serum was taken at enrolment and patients were asked to return 4–6 weeks later to provide convalescent serum. Confirmed cases required a 4-fold rise in titre and probable cases required a single titre of ≥800. Findings from a healthcare utilisation survey were used to estimate multipliers to adjust for cases not seen at sentinel hospitals. We identified 19 (1.7%) confirmed or probable cases among 1,115 patients who presented with a febrile illness. Of cases, the predominant reactive serogroups were Australis 8 (42.1%), Sejroe 3 (15.8%), Grippotyphosa 2 (10.5%), Icterohaemorrhagiae 2 (10.5%), Pyrogenes 2 (10.5%), Djasiman 1 (5.3%), Tarassovi 1 (5.3%). We estimated that the annual incidence of leptospirosis was 11–18 cases per 100,000 population. This was a significantly lower incidence than 2007–08 (p<0.001). Conclusions We estimated a much lower incidence of acute leptospirosis than previously, with a notable absence of cases due to the previously predominant serogroup Mini. Our findings indicate a dynamic epidemiology of leptospirosis in this area and highlight the value of multi-year surveillance to understand leptospirosis epidemiology. PMID:27911902

Prevalence of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in three regions of England: a repeated cross-sectional study in primary care.

PubMed

Nacul, Luis C; Lacerda, Eliana M; Pheby, Derek; Campion, Peter; Molokhia, Mariam; Fayyaz, Shagufta; Leite, Jose C D C; Poland, Fiona; Howe, Amanda; Drachler, Maria L

2011-07-28

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or chronic fatigue syndrome (CFS) has been used to name a range of chronic conditions characterized by extreme fatigue and other disabling symptoms. Attempts to estimate the burden of disease have been limited by selection bias, and by lack of diagnostic biomarkers and of agreed reproducible case definitions. We estimated the prevalence and incidence of ME/CFS in three regions in England, and discussed the implications of frequency statistics and the use of different case definitions for health and social care planning and for research. We compared the clinical presentation, prevalence and incidence of ME/CFS based on a sample of 143,000 individuals aged 18 to 64 years, covered by primary care services in three regions of England. Case ascertainment involved: 1) electronic search for chronic fatigue cases; 2) direct questioning of general practitioners (GPs) on cases not previously identified by the search; and 3) clinical review of identified cases according to CDC-1994, Canadian and Epidemiological Case (ECD) Definitions. This enabled the identification of cases with high validity. The estimated minimum prevalence rate of ME/CFS was 0.2% for cases meeting any of the study case definitions, 0.19% for the CDC-1994 definition, 0.11% for the Canadian definition and 0.03% for the ECD. The overall estimated minimal yearly incidence was 0.015%. The highest rates were found in London and the lowest in East Yorkshire. All but one of the cases conforming to the Canadian criteria also met the CDC-1994 criteria, however presented higher prevalence and severity of symptoms. ME/CFS is not uncommon in England and represents a significant burden to patients and society. The number of people with chronic fatigue who do not meet specific criteria for ME/CFS is higher still. Both groups have high levels of need for service provision, including health and social care. We suggest combining the use of both the CDC-1994 and Canadian criteria for ascertainment of ME/CFS cases, alongside careful clinical phenotyping of study participants. This combination if used systematically will enable international comparisons, minimization of bias, and the identification and investigation of distinct sub-groups of patients with possibly distinct aetiologies and pathophysiologies, standing a better chance of translation into effective specific treatments.

Associating Mathematical Stories That Are Written by the 8th Grade Students Who Are Studying at Advantageous and Disadvantageous Regions' Schools with Their Mathematical Perceptions: Istanbul Case

ERIC Educational Resources Information Center

Bahadir, Elif

2017-01-01

In this study, mathematical stories written by 50 middle school students were analyzed. The study group consisted of two different student groups who were living in advantageous and disadvantageous regions in Istanbul. At the first stage, the students were presented a mathematical story called "My Fractal Tree", then told about what the…

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.

Mapping wetlands and surface water in the Prairie Pothole Region of North America: Chapter 16

USGS Publications Warehouse

Rover, Jennifer R.; Mushet, David M.

2015-01-01

The Prairie Pothole Region (PPR) is one of the most highly productive wetland regions in the world. Prairie Pothole wetlands serve as a primary feeding and breeding habitat for more than one-half of North America’s waterfowl population, as well as a variety of songbirds, waterbirds, shorebirds, and other wildlife. During the last century, extensive land conversions from grassland with wetlands to cultivated cropland and grazed pastureland segmented and reduced wetland habitat. Inventorying and characterizing remaining wetland habitat is critical for the management of wetland ecosystem services. Remote sensing technologies are often utilized for mapping and monitoring wetlands. This chapter presents background specific to the PPR and discusses approaches employed in mapping its wetlands before presenting a case study.

Knife inflicted penetrating injuries of the maxillofacial region: a descriptive, record-based study.

PubMed

Meer, M; Siddiqi, A; Morkel, J A; Janse van Rensburg, P; Zafar, S

2010-01-01

Penetrating knife injuries of the face are more common in South Africa than the rest of the world. These injuries can be life-threatening, especially where the major blood vessels of the face are involved. The approach to treatment should be multidisciplinary, beginning with the trauma unit to provide airway maintenance and haemodynamic stabilisation. An interventional radiologist may be consulted for angiography. The aim of the present study was to retrospectively analyse all cases of knife-inflicted penetrating injuries to the maxillofacial region with the knife in situ and subsequently develop a management protocol to be used by maxillofacial surgery registrars when presented with such cases. It was a retrospective, cross-sectional and record-based study, analysing all penetrating knife injuries reported at various hospitals for a period of 11 years. In this study, 24 cases of knife injuries were analysed. Twenty-one patients (87.5%) in this series were male and three (12.5%) were female. Of these 24 patients, 13 (54.2%) were coloured and 11 (45.8%) were black. There were no white or Indian patients. Post-surgical recovery of all patients was rapid and uneventful, and there were no fatalities. Patients with knife injuries to the face with no definite signs of vascular injury can thus be safely and accurately managed on the basis of physical examination and plain-film radiography. An angiogram is mandatory if the patient presents with excessive bleeding, an expanding haematoma or if the knife blade is in the region of any large vessels.

First report of canine ocular thelaziosis in the Muntenia Region, Romania.

PubMed

Tudor, Poliana; Bădicu, Adina; Mateescu, Romaniţa; Tudor, Niculae; Mateescu, Cosmin; Ionaşcu, Iuliana

2016-04-01

Ocular thelaziosis by Thelazia callipaeda is a vector-borne disease that infects domestic and wild carnivores as well as humans. In this paper, we present two cases of ocular thelaziosis in dogs that had never traveled outside Romania. Both presented with moderate conjunctivitis and ocular discharge. In total, 41 adult nematodes were removed from the conjunctival sacs of both dogs; these were identified via morphology as T. callipaeda. To the best of our knowledge, this is the first report of canine ocular thelaziosis caused by T. callipaeda from the Muntenia Region of Romania.

Clinical Characteristics of Q Fever and Etiology of Community-Acquired Pneumonia in a Tropical Region of Southern Taiwan: A Prospective Observational Study

PubMed Central

Lai, Chung-Hsu; Chang, Lin-Li; Lin, Jiun-Nong; Chen, Wei-Fang; Wei, Yu-Feng; Chiu, Chien-Tung; Wu, Jiun-Ting; Hsu, Chi-Kuei; Chen, Jung-Yueh; Lee, Ho-Sheng; Lin, Hsi-Hsun; Chen, Yen-Hsu

2014-01-01

Background The clinical characteristics of Q fever are poorly identified in the tropics. Fever with pneumonia or hepatitis are the dominant presentations of acute Q fever, which exhibits geographic variability. In southern Taiwan, which is located in a tropical region, the role of Q fever in community-acquired pneumonia (CAP) has never been investigated. Methodology/Principal Findings During the study period, May 2012 to April 2013, 166 cases of adult CAP and 15 cases of acute Q fever were prospectively investigated. Cultures of clinical specimens, urine antigen tests for Streptococcus pneumoniae and Legionella pneumophila, and paired serologic assessments for Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Q fever (Coxiella burnetii) were used for identifying pathogens associated with CAP. From April 2004 to April 2013 (the pre-study period), 122 cases of acute Q fever were also included retrospectively for analysis. The geographic distribution of Q fever and CAP cases was similar. Q fever cases were identified in warmer seasons and younger ages than CAP. Based on multivariate analysis, male gender, chills, thrombocytopenia, and elevated liver enzymes were independent characteristics associated with Q fever. In patients with Q fever, 95% and 13.5% of cases presented with hepatitis and pneumonia, respectively. Twelve (7.2%) cases of CAP were seropositive for C. burnetii antibodies, but none of them had acute Q fever. Among CAP cases, 22.9% had a CURB-65 score ≧2, and 45.8% had identifiable pathogens. Haemophilus parainfluenzae (14.5%), S. pneumoniae (6.6%), Pseudomonas aeruginosa (4.8%), and Klebsiella pneumoniae (3.0%) were the most common pathogens identified by cultures or urine antigen tests. Moreover, M. pneumoniae, C. pneumoniae, and co-infection with 2 pathogens accounted for 9.0%, 7.8%, and 1.8%, respectively. Conclusions In southern Taiwan, Q fever is an endemic disease with hepatitis as the major presentation and is not a common etiology of CAP. PMID:25033402

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

PubMed Central

Wanke, Bodo; Freitas, Dayvison Francis Saraiva; Coelho, Janice Mery Chicarino de Oliveira; Galhardo, Maria Clara Gutierrez; Lyra, Marcelo Rosandiski; Lourenço, Maria Cristina da Silva; Paes, Rodrigo de Almeida; do Valle, Antonio Carlos Francesconi

2017-01-01

Mycetoma is caused by the subcutaneous inoculation of filamentous fungi or aerobic filamentous bacteria that form grains in the tissue. The purpose of this study is to describe the epidemiologic, clinic, laboratory, and therapeutic characteristics of patients with mycetoma at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil, between 1991 and 2014. Twenty-one cases of mycetoma were included in the study. There was a predominance of male patients (1.3:1) and the average patient age was 46 years. The majority of the cases were from the Southeast region of Brazil and the feet were the most affected anatomical region (80.95%). Eumycetoma prevailed over actinomycetoma (61.9% and 38.1% respectively). Eumycetoma patients had positive cultures in 8 of 13 cases, with isolation of Scedosporium apiospermum species complex (n = 3), Madurella mycetomatis (n = 2) and Acremonium spp. (n = 1). Two cases presented sterile mycelium and five were negative. Six of 8 actinomycetoma cases had cultures that were identified as Nocardia spp. (n = 3), Nocardia brasiliensis (n = 2), and Nocardia asteroides (n = 1). Imaging tests were performed on all but one patients, and bone destruction was identified in 9 cases (42.68%). All eumycetoma cases were treated with itraconazole monotherapy or combined with fluconazole, terbinafine, or amphotericin B. Actinomycetoma cases were treated with sulfamethoxazole plus trimethoprim or combined with cycles of amikacin sulphate. Surgical procedures were performed in 9 (69.2%) eumycetoma and in 3 (37.5%) actinomycetoma cases, with one amputation case in each group. Clinical cure occurred in 11 cases (7 for eumycetoma and 4 for actinomycetoma), and recurrence was documented in 4 of 21 cases. No deaths were recorded during the study. Despite of the scarcity of mycetoma in our institution the cases presented reflect the wide clinical spectrum and difficulties to take care of this neglected disease. PMID:28192433

Emergency Pancreatico-Duodenectomy with Superior Mesenteric and Portal Vein Resection and Reconstruction Using a Gore-Tex Vascular Graft.

PubMed

Eftimie, Mihai Adrian; Lungu, Vasile; Tudoroiu, Marian; Vatachki, Genady; Batca, Severina; David, Leonard

2017-01-01

Emergency pancreatico-duodenectomy(EPD) is a very rare procedure and few reports are present in medical literature. It is an uncommon approach, usually used for emergency surgical treatment of abdominal trauma that involves the head of the pancreas or the duodenum, but it is also a surgical tool for the treatment of ruptured aneurysms, bleeding pseudocysts, duodenal perforations, uncontrollable hemorrhage from ulcers and tumors, severe infectious complications of acute pancreatitis or endoscopic retrograde cholangiopancreatography related complications (1,2). It is rarely used as the first line of treatment in case of acute bleeding from arterial pseudoaneurysm of the cephalad region of the pancreas. We present the case of a bleeding pseudoaneurysm of the cefalic region of the pancreas in a young patient with previously undiagnosed chronic pancreatitis and with suspicion of a malignant process located in the head of the pancreas. We performed a pancreatico-duodenectomy with resection of superior mesenteric and portal vein with reconstruction using Gore-Tex vascular graft due to probable venous abutment. Postoperative course was without any major complications, only minor grad-I pancreatic fistula was present. We determine that EPD is a useful tool in the treatment of such cases. It can be used as a first line of treatment or secondary to endovascular stenting or embolization. Celsius.

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

PubMed

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

2013-01-01

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

Clinical features and imaging findings in a case of Capgras syndrome

PubMed Central

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

2013-01-01

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

Perianal nodular hidradenocarcinoma. Case report.

PubMed

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

2010-01-01

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

Assessing Regional Emissions Reductions from Travel Efficiency: Applying the Travel Efficiency Assessment Method

EPA Pesticide Factsheets

This presentation from the 2016 TRB Summer Conference on Transportation Planning and Air Quality summarizes the application of the Travel Efficiency Assessment Method (TEAM) which analyzed selected transportation emission reduction strategies in three case

Cerebriform connective tissue nevus of lumbar.

PubMed

Chen, Jinbo; Chen, Liuqing; Duan, Yiqun; Li, Dongsheng; Dong, Bilin

2015-02-01

Connective tissue nevi represents a kind of hamartoma, and coalescence of the lesions in a cerebriform mode in the lumbar region without Proteus syndrome is rarely seen. Here, we report a 26-year-old woman presenting with nodules and plaques in her left lumbar region of 26 years in duration. Histopathological examination and Masson-trichrome stain showed increased dermal collagen bundles in a haphazard array. The diagnosis of connective tissue nevi was made. This is the first case report on cerebriform connective tissue nevi without Proteus syndrome in the lumbar region. © 2014 Japanese Dermatological Association.

Multi-scale statistical analysis of coronal solar activity

DOE PAGES

Gamborino, Diana; del-Castillo-Negrete, Diego; Martinell, Julio J.

2016-07-08

Multi-filter images from the solar corona are used to obtain temperature maps that are analyzed using techniques based on proper orthogonal decomposition (POD) in order to extract dynamical and structural information at various scales. Exploring active regions before and after a solar flare and comparing them with quiet regions, we show that the multi-scale behavior presents distinct statistical properties for each case that can be used to characterize the level of activity in a region. Information about the nature of heat transport is also to be extracted from the analysis.

Breech presentation and the cornual-fundal location of the placenta

PubMed Central

Sekulić, Slobodan; Ilinčić, Marko; Radeka, Gordana; Novakov-Mikić, Aleksandra; Simić, Svetlana; Podgorac, Jelena; Keković, Goran

2013-01-01

Aim To investigate the association of cornual-fundal location of the placenta and breech presentation at term delivery. Methods This study was conducted at the Department of Obstetrics and Gynecology, Novi Sad, in 2011. The inclusion criteria were delivery at ≥37 weeks of gestation, singleton gestation, and cornual-fundal location of the placenta determined by ultrasonography at ≥37 weeks of gestation when 3/4 or more of the placenta was in the cornual-fundal region. Results Out of 2750 ultrasound examinations performed, 143 showed cornual-fundal location of the placenta (frequency 5.2%). Eighty six cases had cephalic presentation (60.14%) and 57 (39.86%) had breech presentation. Of the remaining cases with non- cornual-fundal location, 2585 had cephalic presentation and 22 (0.84%) had breech presentation. The difference in the frequency of breech presentation between the cornual-fundal and non-cornual-fundal groups was significant (χ2 = 77.78, P < 0.001). Conclusion Cornual-fundal location of the placenta may be an important clue in resolving the etiology of a number of cases of breech presentation at term delivery. PMID:23630148

Testosterone-induced "Virilization" of Mesonephric Duct Remnants and Cervical Squamous Epithelium in Female-to-Male Transgenders: A Report of 3 Cases.

PubMed

Singh, Kamaljeet; Sung, C James; Lawrence, W Dwayne; Quddus, M Ruhul

2017-07-01

Mesonephric ducts regress in genotypic females, leaving behind few remnants. These vestigial structures are often recognized in the mesosalpinx and paracervical regions. We report here 3 cases of female-to-male transgenders who underwent hysterectomy following testosterone treatment. Both female and male genital structures were identified on histologic examination. Although the morphologic appearances of the specimens were unremarkable, histologically 1 case revealed a well-formed fallopian tube as well as an epididymis and 2 cases showed prostate glands to be present in the cervical squamous epithelium.

Clinicopathological analysis of salivary gland tumors over a 15-year period.

PubMed

Vasconcelos, Artur Cunha; Nör, Felipe; Meurer, Luise; Salvadori, Gabriela; Souza, Lélia Batista de; Vargas, Pablo Agustin; Martins, Manoela Domingues

2016-01-01

Salivary gland tumors (SGT) are rare neoplasms that generate interest due to their histopathological diversity and clinical behavior. The aims of the present study were to investigate clinicopathological aspects of SGTs diagnosed at a tertiary health center and compare the findings with epidemiological data from different geographic locations. Cases of tumor in the head and neck region at a single health center in the period between 1995 and 2010 were reviewed. Patient gender, age and ethnic group as well as anatomic location, histological type and clinical behavior of the tumor were recorded. Availability of complete information about these aspects was considered the inclusion criteria. Descriptive statistical analysis of the data was performed using the frequencies of categorical variables. Among the 2168 cases of tumors in the head and neck region, 243 (11.20%) cases were diagnosed in the salivary glands, 109 of which met the inclusion criteria: 85 (78%) benign tumors and 24 (22%) malignant tumors. Mean patient age was 46.47 years. The female gender accounted for 56 cases (51.4%) and the male gender accounted for 53 (48.3%). The major salivary glands were affected more (75.2%) than the minor glands. The most frequent benign and malignant SGTs were pleomorphic adenoma (81.2%) and adenoid cystic carcinoma (58.3%), respectively. In conclusion, pleomorphic adenoma and adenoid cystic carcinoma are the most frequent benign and malignant lesions, respectively. Comparing the present data with previous studies on SGTs, one may infer that some demographic characteristics and the predominance of malignant tumors vary in different geographic regions.

Use of Radon for Evaluation of Atmospheric Transport Models: Sensitivity to Emissions

NASA Technical Reports Server (NTRS)

Gupta, Mohan L.; Douglass, Anne R.; Kawa, S. Randolph; Pawson, Steven

2004-01-01

This paper presents comparative analyses of atmospheric radon (Rn) distributions simulated using different emission scenarios and the observations. Results indicate that the model generally reproduces observed distributions of Rn but there are some biases in the model related to differences in large-scale and convective transport. Simulations presented here use an off-line three-dimensional chemical transport model driven by assimilated winds and two scenarios of Rn fluxes (atom/cm s) from ice-free land surfaces: (A) globally uniform flux of 1.0, and (B) uniform flux of 1.0 between 60 deg. S and 30 deg. N followed by a sharp linear decrease to 0.2 at 70 deg. N. We considered an additional scenario (C) where Rn emissions for case A were uniformly reduced by 28%. Results show that case A overpredicts observed Rn distributions in both hemispheres. Simulated northern hemispheric (NH) Rn distributions from cases B and C compare better with the observations, but are not discernible from each other. In the southern hemisphere, surface Rn distributions from case C compare better with the observations. We performed a synoptic scale source-receptor analysis for surface Rn to locate regions with ratios B/A and B/C less than 0.5. Considering an uncertainty in regional Rn emissions of a factor of two, our analysis indicates that additional measurements of surface Rn particularly during April-October and north of 50 deg. N over the Pacific as well as Atlantic regions would make it possible to determine if the proposed latitude gradient in Rn emissions is superior to a uniform flux scenario.

Playing wind instruments as a potential aetiologic cofactor in external cervical resorption: two case reports.

PubMed

Gunst, V; Huybrechts, B; De Almeida Neves, A; Bergmans, L; Van Meerbeek, B; Lambrechts, P

2011-03-01

To present two cases of external cervical resorption (ECR) on maxillary incisors, in which the primary aetiologic factor is suggested to be pressure trauma by frequently playing wind instruments. The exact aetiological spectrum of ECR is still poorly understood. For resorption to occur, a defect in the cementum layer (trigger) is a likely prerequisite. Whilst the mechanism for continuation (stimulus) is still unclear, knowledge of potential predisposing factors is important in assessing patients at risk. Pressure generated by playing wind instruments could present an aetiological factor in ECR because it affects the cervical region of the root surface. The cases that are presented may confirm this hypothesis and the extent of resorption defects is shown by cone-beam computer tomography (CT) and micro-focus CT imaging techniques. © 2010 International Endodontic Journal.

Chronic granulomatous otitis externa as an initial presentation of cutaneous Crohn disease.

PubMed

Raynor, Eileen M

2014-08-01

In the limited number of Crohn disease cases involving the head and neck, there is a predilection for mucosal surfaces and rare reports of involvement in the postauricular region. To our knowledge, in all previously reported cases involving the head and neck, the patients had a known diagnosis of Crohn disease. This case describes a 10-year-old boy with a history of psoriasis and psoriasiform dermatitis who presented with bilateral chronic granulomatous otitis externa, obliteration of the external auditory canal, and fissuring, resulting in separation of the lobule from the preauricular skin. Pathologic examination results were consistent with granulomatous dermatitis concerning for cutaneous Crohn disease, and a subsequent gastroenterologic workup confirmed the diagnosis of Crohn disease. This is a report of chronic granulomatous otitis as the initial presentation of cutaneous Crohn disease in a child.

[Study of 103 cases of odontogenic cysts].

PubMed

Moctezuma-Bravo, Gustavo Sergio; Magallanes-González, Eduardo

2009-01-01

To describe characteristics of odontogenic cysts in a Mexican population. A retrospective study of 103 odontogenic cysts in 86 patients was done. The data were obtained from files of the Pathology Department of a General Hospital. We observed a frequency of the 8.13 % of odontogenic cysts (103) in 1266 pathological studies. The dentigerous cyst 56 % and odontogenic keratocyst 33 % were the most common odontogenic cysts. Sixty one percent of the cysts appeared in the second and third decades of life. In 71 cysts, 42 % appeared in the posterior region jaw, 29 % in the anterior region of the maxilla and 21 % in the posterior region of the maxilla. A 6.7 % developed a recurrence after treatment and a case of keratocyst of posterior region of the maxilla was associated with epidermoid carcinoma. The study included three women with the syndrome of carcinoma of the basal cell nevus, who presented multiple keratocysts. The dentigerous cysts and odontogenic keratocysts were the most frequent odontogenic cysts. They appeared mainly in the second and third decades of life.

22.5 MB DELETION OF 13q31.1-q34 ASSOCIATED WITH HPE, DWM, AND HSCR: A CASE REPORT AND REDEFINING THE SMALLEST DELETED REGIONS.

PubMed

Alp, M Y; Çebi, A H; Seyhan, S; Cansu, A; Aydin, H; Ikbal, M

2016-01-01

Partial deletion of the long arm of the chromosome 13, 13q deletion syndrome is a rare chromosomal disorder characterized by severe growth and mental retardation, microcephaly, facial dysmorphism, brain malformations (holoprosencephaly, Dandy-Walker malformation), distal limb defects, eye anomalies, genitourinary and gastrointestinal tract malformations (Hirschsprung's disease). Approximately 1.2 Mb region in 13q32 was suggested as minimal critical region which is responsible for severe mental and growth retardation and brain anomalies. Here we described a male patient with de novo interstitial deletion of 13q31.1-q34 associated with short stature, microcephaly, facial dysmorphism, clinodactyly, cryptorchidism, micropenis, epilepsy, HPE, DWM, and HSCR. According to the literature review, present case indicated that smallest deleted region associated with DWM and HPE might be located at the 13q32.3, limb defects 13q34, anogenital malformations 13q33.3-34, and HSCR 13q31.1-32.1.

MMS Observation of Magnetic Reconnection in the Turbulent Magnetosheath

NASA Astrophysics Data System (ADS)

Vörös, Z.; Yordanova, E.; Varsani, A.; Genestreti, K. J.; Khotyaintsev, Yu. V.; Li, W.; Graham, D. B.; Norgren, C.; Nakamura, R.; Narita, Y.; Plaschke, F.; Magnes, W.; Baumjohann, W.; Fischer, D.; Vaivads, A.; Eriksson, E.; Lindqvist, P.-A.; Marklund, G.; Ergun, R. E.; Leitner, M.; Leubner, M. P.; Strangeway, R. J.; Le Contel, O.; Pollock, C.; Giles, B. J.; Torbert, R. B.; Burch, J. L.; Avanov, L. A.; Dorelli, J. C.; Gershman, D. J.; Paterson, W. R.; Lavraud, B.; Saito, Y.

2017-11-01

In this paper we use the full armament of the MMS (Magnetospheric Multiscale) spacecraft to study magnetic reconnection in the turbulent magnetosheath downstream of a quasi-parallel bow shock. Contrarily to the magnetopause and magnetotail cases, only a few observations of reconnection in the magnetosheath have been reported. The case study in this paper presents, for the first time, both fluid-scale and kinetic-scale signatures of an ongoing reconnection in the turbulent magnetosheath. The spacecraft are crossing the reconnection inflow and outflow regions and the ion diffusion region (IDR). Inside the reconnection outflows D shape ion distributions are observed. Inside the IDR mixing of ion populations, crescent-like velocity distributions and ion accelerations are observed. One of the spacecraft skims the outer region of the electron diffusion region, where parallel electric fields, energy dissipation/conversion, electron pressure tensor agyrotropy, electron temperature anisotropy, and electron accelerations are observed. Some of the difficulties of the observations of magnetic reconnection in turbulent plasma are also outlined.

Regional pericarditis status post cardiac ablation: a case report.

PubMed

Orme, Joseph; Eddin, Moneer; Loli, Akil

2014-09-01

Regional pericarditis is elusive and difficult to diagnosis. Healthcare providers should be familiar with post-cardiac ablation complications as this procedure is now widespread and frequently performed. The management of regional pericarditis differs greatly from that of acute myocardial infarction. A 52 year-old male underwent atrial fibrillation ablation and developed severe mid-sternal chest pain the following day with electrocardiographic findings suggestive of acute myocardial infarction, and underwent coronary angiography, a left ventriculogram, and 2D transthoracic echocardiogram, all of which were unremarkable without evidence of obstructive coronary disease, wall motion abnormalities, or pericardial effusions. Ultimately, the patient was diagnosed with regional pericarditis. After diagnosis, the patient's presenting symptoms resolved with treatment including nonsteroidal anti-inflammatory agents and colchicine. This is the first reported case study of regional pericarditis status post cardiac ablation. Electrocardiographic findings were classic for an acute myocardial infarction; however, coronary angiography and left ventriculogram demonstrated no acute coronary occlusion or ventricular wall motion abnormalities. Healthcare professionals must remember that the electrocardiographic findings in pericarditis are not always classic and that pericarditis can occur status post cardiac ablation.

Paracoccidioidomycosis: an unusual presentation in a young girl disclosing an unnoted HIV-infection.

PubMed

Marques, Silvio Alencar; Camargo, Rosangela M P; Abbade, Luciana P F; Fortaleza, Carlos Magno C B; Marques, Mariangela E A

2010-02-01

The association of paracoccidioidomycosis with AIDS is apparently less frequent than expected. The authors present an unusual case of paracoccidioidomycosis in a 13-year-old female student which was later found to be the first opportunistic infection in the course of the patient's HIV-infection. The clinical presentation followed an accidental incised wound on the palmar region initially described as a 'sporotrichotic-chancre'. After good response under sulfamethoxazole-trimethoprin, the patient relapsed and presented an associated oral candidiasis. HIV-infection was documented and additional investigation showed CD4(+) T-cells=22/mm(3), CD8(+)=280 cell/mm(3) and viral load=4,043 log. This case report presents an uncommon dermatological-clinical picture in the youngest patient in which such association has been reported to date.

Long-term risk of sarcoma following radiation treatment for breast cancer

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

Taghian, A.; de Vathaire, F.; Terrier, P.

1991-07-01

Between 1954 and 1983, 7620 patients were treated for breast carcinoma at Institut Gustave Roussy (France). Of these patients, 6919 were followed for at least 1 year. Out of these, 11 presented with sarcomas thought to be induced by irradiation, 2 of which were Steward-Treves Syndrome, and 9 of which were sarcomas within the irradiated fields. All histological slides were reviewed and a comparison with those of breast cancer was done. The sites of these sarcomas were: parietal wall, 1 case; second costal cartilage, 1 case; infraclavicular region, 1 case; supraclavicular region, 2 cases; internal third of the clavicle, 2more » cases; axillary region 2 cases; and the internal side of the upper arm (Stewart-Treves syndrome), 2 cases. The median age of these 11 patients at the diagnosis of sarcomas was 65.8 (49-83). The mean latent period was 9.5 years (4-24). Three patients underwent radical mastectomy and nine modified radical mastectomy. Only one patient received chemotherapy. The radiation doses received at the site of the sarcoma were 45 Gy/18 fr. for 10 cases and 90-100 Gy for 1 case (due to overlapping between two fields). The histology was as follows: malignant fibrous histiocytoma, 5 cases; fibrosarcoma, 3 cases; lymphangiosarcoma, 2 cases; and osteochondrosarcoma, 1 case. The median survival following diagnosis of sarcoma was 2.4 years (4 months-9 years). Two patients are still alive: one with recurrence of her breast cancer, the other in complete remission, with 7 and 3 years follow-up, respectively. All other patients died from their sarcomas. The cumulative incidence of sarcoma following irradiation of breast cancer was 0.2% (0.09-0.47) at 10 years. The standardized incidence ratio (SIR) of sarcoma (observed n{number sign} of cases (Obs)/expected n{number sign} of cases (Exp) computed from the Danish Cancer Registry for the same period) was 1.81 (CI 0.91-3.23).« less

Meningioma presenting as temporal region swelling: Diagnosis by cytopathology and immunohistochemical confirmation on cell block preparation

PubMed Central

Nair, Anila Kunjulekshmi Amma Raveendran; Nayak, Nileena; Kattoor, Jayasree

2015-01-01

Meningiomas are common intracranial neoplasms. Meningomas are rarely subjected to fine-needle aspiration (FNA) studies. However, intraoperative squash preparations are commonly done. FNA of meningiomas are usually performed incidentally for cases with a clinical suspicion of some other disease such as metastatic carcinoma. We are reporting two cases, which were referred to our center with a diagnosis of metastatic carcinoma on FNA from swelling of the temporal region. We are discussing the characteristic cytomorphological features, which help in diagnosing meningiomas, the common cytological differentials, and the utility of immunohistochemistry (IHC) on cell block preparations in confirming the diagnosis, especially when there is a clinical differential diagnosis. PMID:26729986

Cutaneous anthrax in an unusual location: case report.

PubMed

Sari, Tugba; Koruk, Suda Tekin

2015-12-01

Cutaneous anthrax is well known, unlike anthrax of the lumbar region, which is not reported elsewhere. We present a case of anthrax of the lumbar region in a 50-year-old man. The infection was characterised by a wide, black eschar and oedema on an erythematous ground. After isolation of the Gram-positive bacilli from the skin lesions, prompt antibiotic treatment (intravenous sulbactam-ampicillin 1.5 g every six hours) was initiated. Following eradication of the bacilli after 14 days of antibiotic treatment, a split-thickness skin graft was applied. A diagnosis of anthrax depends on clinical suspicion. Early diagnosis, antibiotic and surgical treatment can facilitate the treatment and prevent development of complications.

An unusual encounter of an epidermoid cyst

PubMed Central

Sritharan, Kaji; Ghani, Yaser; Thompson, Hilary

2014-01-01

Epidermoid cysts are extremely common and can occur in any hair-containing area. We present the case of a 20-year-old man with an epidermoid cyst in the perianal region. Epidermal cysts have been described in this area previously after haemorrhoidectomy, but cysts of the size seen in this case are rare in the absence of previous anal trauma. The diagnosis was confirmed by excision biopsy. PMID:24825558

Increased Frequency of α-Synuclein in the Substantia Nigra in HIV Infection

PubMed Central

Khanlou, Negar; Moore, David J.; Chana, Gursharan; Cherner, Mariana; Lazzaretto, Deborah; Dawes, Sharron; Grant, Igor; Masliah, Eliezer; Everall, Ian P.

2014-01-01

The frequency of neurodegenerative markers among long surviving HIV infected individuals is unknown, therefore, the present study investigated the frequency of α-synuclein, β-amyloid and HIV-associated brain pathology in the brains of older HIV infected individuals. We examined the substantia nigra of 73 clinically well-characterized HIV infected individuals aged 50 to 76 years from the National NeuroAIDS Tissue Consortium. We also examined the frontal and temporal cortical regions of a subset of 36 individuals. The brain regions were examined for the presence of α-synuclein, β-amyloid and HIV-associated brain pathology. Neuritic α-synuclein expression was found in 16% (12/73) of the substantia nigra of the HIV+ cases and none of the older control cases (0/18). β-amyloid deposits were prevalent and found in nearly all of the HIV+ cases (35/36). Despite these increases of degenerative pathology, HIV-associated brain pathology was present in only 10% of cases. Among older HIV+ adults HIV-associated brain pathology does not appear elevated; however, the frequency of both α-synuclein and β-amyloid is higher than that found in older healthy persons. The increased prevalence of α-synuclein and β-amyloid in the brains of older HIV-infected individuals may predict an increased risk of developing neurodegenerative disease. PMID:19115126

Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya.

PubMed

Amro, Ahmad; Al-Dwibe, Hamida; Gashout, Aisha; Moskalenko, Olga; Galafin, Marlena; Hamarsheh, Omar; Frohme, Marcus; Jaeschke, Anja; Schönian, Gabriele; Kuhls, Katrin

2017-09-01

Cutaneous leishmaniasis (CL) is a major public health problem in Libya. In this paper, we describe the eco-epidemiological parameters of CL during the armed conflict period from January 2011 till December 2012. Current spatiotemporal distributions of CL cases were explored and projected to the future using a correlative modelling approach. In addition the present results were compared with our previous data obtained for the time period 1995-2008. We investigated 312 CL patients who presented to the Dermatology Department at the Tripoli Central Hospital and came from 81 endemic areas distributed in 10 districts. The patients presented with typical localized lesions which appeared commonly on the face, arms and legs. Molecular identification of parasites by a PCR-RFLP approach targeting the ITS1 region of the rDNA was successful for 81 patients with two causative species identified: L. major and L. tropica comprised 59 (72.8%) and 22 (27.2%) cases, respectively. Around 77.3% of L. tropica CL and 57.7% of L. major CL caused single lesions. Five CL patients among our data set were seropositive for HIV. L. tropica was found mainly in three districts, Murqub (27.3%), Jabal al Gharbi (27.3%) and Misrata (13.7%) while L. major was found in two districts, in Jabal al Gharbi (61%) and Jafara (20.3%). Seasonal occurrence of CL cases showed that most cases (74.2%) admitted to the hospital between November and March, L. major cases from November till January (69.4%), and L. tropica cases mainly in January and February (41%). Two risk factors were identified for the two species; the presence of previously infected household members, and the presence of rodents and sandflies in patient's neighborhoods. Spatiotemporal projections using correlative distribution models based on current case data and climatic conditions showed that coastal regions have a higher level of risk due to more favourable conditions for the transmitting vectors. Future projection of CL until 2060 showed a trend of increasing incidence of CL in the north-western part of Libya, a spread along the coastal region and a possible emergence of new endemics in the north-eastern districts of Libya. These results should be considered for control programs to prevent the emergence of new endemic areas taking also into consideration changes in socio-economical factors such as migration, conflicts, urbanization, land use and access to health care.

Mortality and Case Fatality Due to Visceral Leishmaniasis in Brazil: A Nationwide Analysis of Epidemiology, Trends and Spatial Patterns

PubMed Central

Martins-Melo, Francisco Rogerlândio; Lima, Mauricélia da Silveira; Ramos, Alberto Novaes; Alencar, Carlos Henrique; Heukelbach, Jorg

2014-01-01

Background Visceral leishmaniasis (VL) is a significant public health problem in Brazil and several regions of the world. This study investigated the magnitude, temporal trends and spatial distribution of mortality related to VL in Brazil. Methods We performed a study based on secondary data obtained from the Brazilian Mortality Information System. We included all deaths in Brazil from 2000 to 2011, in which VL was recorded as cause of death. We present epidemiological characteristics, trend analysis of mortality and case fatality rates by joinpoint regression models, and spatial analysis using municipalities as geographical units of analysis. Results In the study period, 12,491,280 deaths were recorded in Brazil. VL was mentioned in 3,322 (0.03%) deaths. Average annual age-adjusted mortality rate was 0.15 deaths per 100,000 inhabitants and case fatality rate 8.1%. Highest mortality rates were observed in males (0.19 deaths/100,000 inhabitants), <1 year-olds (1.03 deaths/100,000 inhabitants) and residents in Northeast region (0.30 deaths/100,000 inhabitants). Highest case fatality rates were observed in males (8.8%), ≥70 year-olds (43.8%) and residents in South region (17.7%). Mortality and case fatality rates showed a significant increase in Brazil over the period, with different patterns between regions: increasing mortality rates in the North (Annual Percent Change – APC: 9.4%; 95% confidence interval – CI: 5.3 to 13.6), and Southeast (APC: 8.1%; 95% CI: 2.6 to 13.9); and increasing case fatality rates in the Northeast (APC: 4.0%; 95% CI: 0.8 to 7.4). Spatial analysis identified a major cluster of high mortality encompassing a wide geographic range in North and Northeast Brazil. Conclusions Despite ongoing control strategies, mortality related to VL in Brazil is increasing. Mortality and case fatality vary considerably between regions, and surveillance and control measures should be prioritized in high-risk clusters. Early diagnosis and treatment are fundamental strategies for reducing case fatality of VL in Brazil. PMID:24699517

Social and economic consequences of onshore OCS-related activities in coastal Alabama: Final baseline report

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

Kelley, J.O.; Wade, W.W.

This report documents existing economic conditions in the coastal Alabama region and highlights industry sectors important to the region`s economy. This report discusses the interplay among different users of the region`s natural resources, noting the tourism, fishing and offshore natural gas industries. Data are presented that show how the tourism and natural gas industries contribute to the economic growth of coastal Alabama and the State of Alabama. The recent conflict between the offshore gas and tourism industries over the use of coastal Alabama resources is discussed. Several case studies highlight local area experience relative to economic growth, industry coexistence andmore » the importance of the coastal region`s natural resources to the local and state economies.« less

Acute hepatic encephalopathy presenting as cortical laminar necrosis: case report.

PubMed

Choi, Jong Mun; Kim, Yoon Hee; Roh, Sook Young

2013-01-01

We report on a 55-year-old man with alcoholic liver cirrhosis who presented with status epilepticus. Laboratory analysis showed markedly elevated blood ammonia. Brain magnetic resonance imaging (MRI) showed widespread cortical signal changes with restricted diffusion, involving both temporo-fronto-parietal cortex, while the perirolandic regions and occipital cortex were uniquely spared. A follow-up brain MRI demonstrated diffuse cortical atrophy with increased signals on T1-weighted images in both the basal ganglia and temporal lobe cortex, representing cortical laminar necrosis. We suggest that the brain lesions, in our case, represent a consequence of toxic effect of ammonia.

Diagnosis and Treatment of Paracoccidioidomycosis in the Maxillofacial Region: A Report of 5 Cases

PubMed Central

Araújo, André Vitor Alves; Cerqueira, Daniel Assunção; Cesconetto, Lorenzzo De Angeli; Provenzano, Nilton; de Oliveira, Eder Magno Ferreira

2018-01-01

Paracoccidioidomycosis is a fungal infection initially described in Brazil in 1908 by Adolfo Lutz. Manifestation of this disease depends on numerous factors, such as microorganism virulence, hormonal profile, genetic predisposition, nutrition, and immune system. It is characterized classically by cutaneous lesions, lymphadenopathy, and pulmonary involvement. It presents male predilection, which can be explained by the protective effect of female hormones. Classic presentation within oral cavity is a superficial ulcer characterized by hemorrhagic dots of moriform aspect. Treatment should be established individually and closely monitored. This manuscript aims at reporting five cases of this pathology. PMID:29850333

Diagnosis and Treatment of Paracoccidioidomycosis in the Maxillofacial Region: A Report of 5 Cases.

PubMed

Albuquerque Neto, Antonio Dionízio De; Araújo, André Vitor Alves; Cerqueira, Daniel Assunção; Cesconetto, Lorenzzo De Angeli; Provenzano, Nilton; de Oliveira, Eder Magno Ferreira

2018-01-01

Paracoccidioidomycosis is a fungal infection initially described in Brazil in 1908 by Adolfo Lutz. Manifestation of this disease depends on numerous factors, such as microorganism virulence, hormonal profile, genetic predisposition, nutrition, and immune system. It is characterized classically by cutaneous lesions, lymphadenopathy, and pulmonary involvement. It presents male predilection, which can be explained by the protective effect of female hormones. Classic presentation within oral cavity is a superficial ulcer characterized by hemorrhagic dots of moriform aspect. Treatment should be established individually and closely monitored. This manuscript aims at reporting five cases of this pathology.

Central neurocytoma presenting with gigantism: case report.

PubMed

Araki, Y; Sakai, N; Andoh, T; Yoshimura, S; Yamada, H

1992-08-01

We report a case of central neurocytoma presenting with gigantism. The patient was a 19-year-old man with a 2-year history of rapid growth. Computed tomography revealed a round, slightly enhancing calcified tumor in the septal region. This lesion was resected, and postoperative radiotherapy was given. The preoperative serum growth hormone level was 20.7 ng/mL, and postoperatively this fell to 0.9 ng/mL. Pituitary dysfunction was not noted either before or after the operation. A low level of production of growth hormone releasing factor was detected when tumor cells obtained during surgery were cultured.

Remote Triggering in the Koyna-Warna Reservoir-Induced Seismic Zone, Western India

NASA Astrophysics Data System (ADS)

Bansal, Abhey Ram; Rao, N. Purnachandra; Peng, Zhigang; Shashidhar, D.; Meng, Xiaofeng

2018-03-01

Dynamic triggering following large distant earthquakes has been observed in many regions globally. In this study, we present evidence for remote dynamic triggering in the Koyna-Warna region of Western India, which is known to be a premier site of reservoir-induced seismicity. Using data from a closely spaced broadband network of 11 stations operated in the region since 2005, we conduct a systematic search for dynamic triggering following 20 large distant earthquakes with dynamic stresses of at least 1 kPa in the region. We find that the only positive cases of dynamic triggering occurred during 11 April 2012, Mw8.6 Indian Ocean earthquake and its largest aftershock of Mw8.2. In the first case, microearthquakes started to occur in the first few cycles of the Love waves, and the largest event of magnitude 3.3 occurred during the first few cycles of the Rayleigh waves. The increase of microseismicity lasted for up to five days, including a magnitude 4.8 event occurred approximately three days later. Our results suggest that the Koyna-Warna region is stress sensitive and susceptible for remote dynamic triggering, although the apparent triggering threshold appears to be slightly higher than other regions.

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.

ENVIRONMENTAL ECONOMICS FOR WATERSHED RESTORATION

EPA Science Inventory

This book overviews non-market valuation, input-output analysis, cost-benefit analysis, and presents case studies from the Mid Atlantic Highland region, with all but the bare minimum econometrics, statistics, and math excluded or relegated to an appendix. It is a non-market valu...

Medicolegal Implications of Nosocomial Infections: A Case Report of Aspergillus Contamination during Cardiac Surgery.

PubMed

Tuchtan, Lucile; Piercecchi-Marti, Marie-Dominique; Dumon, Henri; Métras, Dominique; Léonetti, Georges; Bartoli, Christophe

2017-05-01

Nosocomial infections have become a major issue of public health and lead to an increasing number of suits for damages. We present a rare case of Aspergillus contamination during cardiac surgery, describe the medicolegal investigation, and present the new system for compensation of bodily injury after nosocomial infection in France, based on the law of March 4, 2002 on patient rights and quality in the health system. This case demonstrates the limits of compensation for nosocomial infections on the grounds of national solidarity. The expert report requested by the regional commission for conciliation and compensation is of fundamental importance in enabling the commission to decide between fault and inherent risk of treatment. © 2016 American Academy of Forensic Sciences.

On-line database of voltammetric data of immobilized particles for identifying pigments and minerals in archaeometry, conservation and restoration (ELCHER database).

PubMed

Doménech-Carbó, Antonio; Doménech-Carbó, María Teresa; Valle-Algarra, Francisco Manuel; Gimeno-Adelantado, José Vicente; Osete-Cortina, Laura; Bosch-Reig, Francisco

2016-07-13

A web-based database of voltammograms is presented for characterizing artists' pigments and corrosion products of ceramic, stone and metal objects by means of the voltammetry of immobilized particles methodology. Description of the website and the database is provided. Voltammograms are, in most cases, accompanied by scanning electron microphotographs, X-ray spectra, infrared spectra acquired in attenuated total reflectance Fourier transform infrared spectroscopy mode (ATR-FTIR) and diffuse reflectance spectra in the UV-Vis-region. For illustrating the usefulness of the database two case studies involving identification of pigments and a case study describing deterioration of an archaeological metallic object are presented. Copyright © 2016 Elsevier B.V. All rights reserved.

Multiple Sub-Epidermal Calcified Nodule Mimicking Eruptive Xanthoma: A Case Report and Review of the Literature

PubMed Central

Ozuguz, Pinar; Balta, Ilknur; Bozkurt, Ozlem; Unverdi, Hatice; Dostbil, Ahmet

2013-01-01

Sub-epidermal calcified nodule (SCN) is an uncommon form of idiopathic calcinosis. It usually occurs in children, particularly in the head and neck region, presenting as a solitary, painless, yellow-white nodule with papillomatous features. These lesions occur twice as common in males compared with females. The pathogenesis is uncertain, but the clinical and histological features of this lesion are distinctive. We report a case of 22-year-old man with multiple nodules bilaterally located on the dorsum of hands simulating eruptive xanthoma. Histopathological examination of one of the excised lesion confirmed the diagnosis showing epidermal and sub-epidermal deposition of calcium. This paper presents a review of the literature and adds a new case of SCN. PMID:24082201

Abulia following penetrating brain injury during endoscopic sinus surgery with disruption of the anterior cingulate circuit: case report.

PubMed

Grunsfeld, Alexander A; Login, Ivan S

2006-01-23

It is common knowledge that the frontal lobes mediate complex human behavior and that damage to these regions can cause executive dysfunction, apathy, disinhibition and personality changes. However, it is less well known that subcortical structures such as the caudate and thalamus are part of functionally segregated fronto-subcortical circuits, that can also alter behavior after injury. CASE PRESENTATION We present a 57 year old woman who suffered penetrating brain injury during endoscopic sinus surgery causing right basal ganglia injury which resulted in an abulic syndrome. Abulia does not result solely from cortical injury but can occur after disruption anywhere in the anterior cingulate circuit--in the case of our patient, most prominently at the right caudate.

Prostate carcinoma metastatic to the skin as an extrammamary Paget’s disease

PubMed Central

2012-01-01

Aim The current paper describes a case of prostatic adenocarcinoma metastatic to the skin presenting as an extrammamary Paget's disease, a very rare and poorly characterised morphological entity. We report a case of prostatic carcinoma metastatic to skin showing a pattern of extramammary Paget's disease which has not been clearly illustrated in the literature Case presentation: A 63 year-old man with prostatic adenocarcinoma developed cutaneous metastases after 16 years. The inguinal metastases were sessile and 'keratotic.' The tumour displayed solid, glandular areas as well as a polypoid region suggestive of extramammary Paget's disease were identified. Discussion and conclusions We review the diagnostic criteria that have led to the correct histopathological diagnosis in this case. A differential diagnosis of the pagetoid spread in the skin and various forms of cutaneous metastases determined by a prostatic adenocarcinoma as well as the role of immunohistochemistry in establishing the prostatic origin are presented in the context of this case. Although, morphologically the cells presented in the skin deposits were not characteristic for adenocarcinoma of prostate, immunohistochemistry for PSA and PSAP suggested a prostatic origin. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1395450057455276 PMID:22901743

Snakebite! Crotalinae Envenomation of a Man in Rhode Island.

PubMed

Zhang, Xiao C; Kearney, Alexis; Gibbs, Frantz J; Hack, Jason B

2016-01-04

The incidence of poisonous snakebites has regional variance. Health care providers' knowledge and comfort in treating these envenomated patients depends on the density of poisonous snakes in their environment, with practitioners in the southern U.S. typically treating more exposed patients than those in colder regions in the North. We present a rare case of a confirmed copperhead snakebite that occurred in Rhode Island. We will review Copperhead bites, clinical management and treatment options.

[Dipylidium caninum infection in a 2 year old infant: case report and literature review].

PubMed

Neira O, Patricia; Jofré M, Leonor; Muñoz S, Nelson

2008-12-01

Dipylidiasis is a zoonotic parasitic infection caused by the dog tapeworm Dipylidium caninum; it affects both feline and canine species and accidentally, humans. In Chile, as well as in other countries, it is an uncommon infection. A case of a 2 year old child from Casablanca, (a city located in the Valparaíso Region), with an infection by D. caninum, is presented. Clinical manifestations are reviewed, as well as epidemiology in domestic and wild animals, cases among the published national literature and its treatment and prevention strategies.

A rare disease in an atypical location-Kimura's Disease of the upper extremity.

PubMed

Lam, Alan Cheuk Si; Au Yeung, Rex Kwok Him; Lau, Vince Wing Hang

2015-12-01

Kimura's disease is a rare chronic inflammatory disorder predominantly affecting young Asian male patients, occurring mainly in the head and neck regions. Kimura's disease of the upper extremity is extremely rare, and previous case reports in the literature show similar imaging characteristics with consistent location at the medial epitrochlear region, predominantly with unilateral involvement. We present the first reported case of Kimura's disease affecting the anterolateral aspect of the upper arm, sparing the medial epitrochlear region, illustrating that with typical MR appearance and serology, the involvement of this rare disease in an atypical location still warrants consideration of this diagnosis. There was also bilateral asymmetrical involvement in our patient, suggesting the possibility of a propensity for Kimura's disease affecting the upper extremities to have bilateral involvement, which may necessitate imaging of the clinically asymptomatic contralateral limb in these patients for early lesion identification and treatment.

[Conjunctival fibrous histiocytoma simulating atipical pterygium in the Amazon region: case report].

PubMed

Carvalho, Roberto Murillo Limongi de Souza; Taleb, Alexandre; Carvalho, Giulianna Limongi de Souza; Avila, Marcos

2010-01-01

An inedited case in the Brazilian literature of conjunctival fibrous histiocytoma discovered during a wide scale community project accomplished by the team of the Center of Reference in Ophthalmology of the Hospital das Clínicas da Universidade Federal de Goiás in the Amazon region is reported. A 38 year-old caucasian woman presented with a vascularized lesion on the medial portion of the bulbar conjunctiva and caruncular region of the right eye with extension for the limbus and invading about 2 mm of the medial cornea resembling a pterygium. Pathologic findings revealed that the lesion was constituted by spindle-shaped cells, with storiform arrangement, and large histocytelike cells. The immunohistochemistry revealed strong positivity for vimentin and the neoplastic cells were negative for AE1/AE3, HMB 45, S 100 protein. The histopathologic diagnosis was fibrous histiocytoma. The evolution demonstrated the tumoral growth and the possibility of a malignant lesion.

Evaluating aerosol impacts on Numerical Weather Prediction in two extreme dust and biomass-burning events

NASA Astrophysics Data System (ADS)

Remy, Samuel; Benedetti, Angela; Jones, Luke; Razinger, Miha; Haiden, Thomas

2014-05-01

The WMO-sponsored Working Group on Numerical Experimentation (WGNE) set up a project aimed at understanding the importance of aerosols for numerical weather prediction (NWP). Three cases are being investigated by several NWP centres with aerosol capabilities: a severe dust case that affected Southern Europe in April 2012, a biomass burning case in South America in September 2012, and an extreme pollution event in Beijing (China) which took place in January 2013. At ECMWF these cases are being studied using the MACC-II system with radiatively interactive aerosols. Some preliminary results related to the dust and the fire event will be presented here. A preliminary verification of the impact of the aerosol-radiation direct interaction on surface meteorological parameters such as 2m Temperature and surface winds over the region of interest will be presented. Aerosol optical depth (AOD) verification using AERONET data will also be discussed. For the biomass burning case, the impact of using injection heights estimated by a Plume Rise Model (PRM) for the biomass burning emissions will be presented.

[Pilocytic astrocytoma of the cerebrum presenting in an elderly patient: a case report].

PubMed

Yoshida, Yuya; Tsukada, Toshiyuki; Hashimoto, Masaaki; Hayashi, Yutaka

2011-09-01

We report a case of pilocytic astrocytoma of the cerebrum presenting in an elderly patient. A 76-year-old man was admitted to our department due to the development of dysarthria. MRI showed a cystic mass with an enhanced small mural nodule in the left frontal lobe. At surgery, the cyst contents were aspirated, and the mural nodule was excised. Histological examination showed a pattern that is usually seen in pilocytic astrocytoma of the cerebellum, including loose and compact areas composed of pilocytic and stellate cells, a few eosinophilic granular bodies, but not Rosenthal fibers. Pilocytic astrocytoma is a common type of pediatric brain tumor that can arise within either the cerebellum or the hypothalamic/chiasmatic region, but rarely seen in the cerebral hemisphere at an advanced age. To our knowledge, only 45 cases of pilocytic astrocytoma of the cerebrum developing in an adult are reported. In those cases, the symptoms of the disease developed during the third decade of life. The onset at a most advanced age as in the present case is thought to be extremely rare.

Polarimetric imaging of uterine cervix: a case study.

PubMed

Pierangelo, Angelo; Nazac, André; Benali, Abdelali; Validire, Pierre; Cohen, Henri; Novikova, Tatiana; Ibrahim, Bicher Haj; Manhas, Sandeep; Fallet, Clément; Antonelli, Maria-Rosaria; Martino, Antonello-De

2013-06-17

We present a preliminary investigation of macroscopic polarimetric imaging of uterine cervix. Orthogonal state contrast (OSC) images of healthy and anomalous cervices have been taken in vivo at 550 nm. Four ex vivo cervix samples have been studied in full Muller polarimetry, at 550 nm and 700 nm, and characterized in detail by standard pathology. One sample was totally healthy, another one carried CIN lesions at very early stage (CIN1) in its visible exocervical region, while for the other two samples more advanced (CIN3) lesions were present, together with visible glandular epithelium (ectropion). Significant birefringence has been observed in the healthy regions of all six samples, both in vivo and ex vivo. Standard treatments of the Mueller images of the ex vivo samples allowed to quantify both retardation and depolarization. Retardation reached 60° in healthy regions, and disappeared in the anomalous regions of the other three ex vivo samples. The depolarization power was largest in healthy regions, and lower in CINs and ectropion. Possible origins of the observed effects are briefly discussed.

Navier-Stokes analysis of an oxidizer turbine blade with tip clearance

NASA Technical Reports Server (NTRS)

Gibeling, Howard J.; Sabnis, Jayant S.

1992-01-01

The Gas Generator Oxidizer Turbine (GGOT) Blade is being analyzed by various investigators under the NASA MSFC sponsored Turbine Stage Technology Team design effort. The present work concentrates on the tip clearance region flow and associated losses; however, flow details for the passage region are also obtained in the simulations. The present calculations simulate the rotor blade row in a rotating reference frame with the appropriate coriolis and centrifugal acceleration terms included in the momentum equation. The upstream computational boundary is located about one axial chord from the blade leading edge. The boundary conditions at this location were determined by using a Euler analysis without the vanes to obtain approximately the same flow profiles at the rotor as were obtained with the Euler stage analysis including the vanes. Inflow boundary layer profiles are then constructed assuming the skin friction coefficient at both the hub and the casing. The downstream computational boundary is located about one axial chord from the blade trailing edge, and the circumferentially averaged static pressure at this location was also obtained from the Euler analysis. Results were obtained for the 3-D baseline GGOT geometry at the full scale design Reynolds number. Details of the clearance region flow behavior and blade pressure distributions were computed. The spanwise variation in blade loading distributions are shown, and circumferentially averaged spanwise distributions of total pressure, total temperature, Mach number, and flow angle are shown at several axial stations. The spanwise variation of relative total pressure loss shows a region of high loss in the region near the casing. Particle traces in the near tip region show vortical behavior of the fluid which passes through the clearance region and exits at the downstream edge of the gap.

Aspergillus spinal epidural abscess: case presentation and review of the literature.

PubMed

Shweikeh, Faris; Zyck, Stephanie; Sweiss, Fadi; Sangtani, Ajleeta; Shweikeh, Mohammed; Issa, Husam; Steinmetz, Michael P; Markarian, Georges Z

2018-01-01

In this review, we present a case of Aspergillus spinal epidural abscess (ASEA) and review the literature. To provide further insight on a rare condition. A description of a patient with ASEA in a 58-year-old woman that was successfully treated with conservative management is presented. Following case presentation, a literature search (MedLine and PubMed) and assessment of epidemiology, presentation, diagnosis, treatments, and outcomes is performed. Review of the literature finds 26 reported cases. The infection occurs in males with a higher frequency (66.7%). The thoracic and lumbar regions are more likely afflicted (96.1%). Common symptoms are backache, neurological deficits, and fever. Most frequent comorbidities were malignancy, diabetes mellitus, and immunodeficiency. Complications were numerous and often catastrophic. Treatment entailed a combination of antibiotics and surgery. Overall, ASEA patients did poorly: death in majority (52%), minimal recovery in 22%, and others did attain full recovery (26%). Generally, this infection has high morbidity and mortality. Early identification is important to a successful outcome. Appropriate management with antifungals is central and proves to be effective as seen in the reported case though surgical intervention is usually a necessity as the literature suggests. From an epidemiological and public health perspective, particularly with recent outbreaks, understanding the treatment of this rare CNS infection becomes even more imperative.

Euglena gracilis and Trypanosomatids possess common patterns in predicted mitochondrial targeting presequences.

PubMed

Krnáčová, Katarína; Vesteg, Matej; Hampl, Vladimír; Vlček, Čestmír; Horváth, Anton

2012-10-01

Euglena gracilis possessing chloroplasts of secondary green algal origin and parasitic trypanosomatids Trypanosoma brucei, Trypanosoma cruzi and Leishmania major belong to the protist phylum Euglenozoa. Euglenozoa might be among the earliest eukaryotic branches bearing ancestral traits reminiscent of the last eukaryotic common ancestor (LECA) or missing features present in other eukaryotes. LECA most likely possessed mitochondria of endosymbiotic α-proteobacterial origin. In this study, we searched for the presence of homologs of mitochondria-targeted proteins from other organisms in the currently available EST dataset of E. gracilis. The common motifs in predicted N-terminal presequences and corresponding homologs from T. brucei, T. cruzi and L. major (if found) were analyzed. Other trypanosomatid mitochondrial protein precursor (e.g., those involved in RNA editing) were also included in the analysis. Mitochondrial presequences of E. gracilis and these trypanosomatids seem to be highly variable in sequence length (5-118 aa), but apparently share statistically significant similarities. In most cases, the common (M/L)RR motif is present at the N-terminus and it is probably responsible for recognition via import apparatus of mitochondrial outer membrane. Interestingly, this motif is present inside the predicted presequence region in some cases. In most presequences, this motif is followed by a hydrophobic region rich in alanine, leucine, and valine. In conclusion, either RR motif or arginine-rich region within hydrophobic aa-s present at the N-terminus of a preprotein can be sufficient signals for mitochondrial import irrespective of presequence length in Euglenozoa.

Propeller flap for treatment of a poststernotomy sternal fistula: a case report.

PubMed

Corradino, Bartolo; Di Lorenzo, Sara; Hubova, Martina; Cordova, Adriana

2014-11-01

The treatment of post-operative deep sternal wound infections is a real challenge for surgeons. Conservative treatment with debridement and vacuum-assisted closure (VAC) therapy is not always successful. In the most severe and chronic cases, a surgical debridement and reconstruction of the defect is mandatory. In this report, the authors present a case of a 61-year-old female patient with a chronic cutaneous fistula in the sternal region following a median sternotomy after coronary artery bypass. The patient had already undergone treatment with antibiotics, drainage of an abscess and local debridement, but the infection continued to relapse periodically. The authors decided to treat the fistula with debridement and reconstruction with a local freestyle propeller flap mobilised from the right parasternal region. The fistula healed without any complications. There has been no relapse, and the aesthetic result is satisfactory. The scar at the donor site is acceptable with a minimum alteration to the mammary region. Sternal fistulas after medial sternotomy are difficult to treat. The treatment method of debridement followed, in certain cases, by VAC therapy is quite controversial. A surgical procedure is sometimes necessary to speed healing. Mobilisation of a freestyle propeller flap represents a less invasive surgical approach to the treatment of sternal fistulas in cases of conservative treatment failure. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

[Regional ecological planning and ecological network construction: a case study of "Ji Triangle" Region].

PubMed

Li, Bo; Han, Zeng-Lin; Tong, Lian-Jun

2009-05-01

By the methods of in situ investigation and regional ecological planning, the present ecological environment, ecosystem vulnerability, and ecological environment sensitivity in "Ji Triangle" Region were analyzed, and the ecological network of the study area was constructed. According to the ecological resources abundance degree, ecological recovery, farmland windbreak system, environmental carrying capacity, forestry foundation, and ecosystem integrity, the study area was classified into three regional ecological function ecosystems, i. e., east low hill ecosystem, middle plain ecosystem, and west plain wetland ecosystem. On the basis of marking regional ecological nodes, the regional ecological corridor (Haerbin-Dalian regional axis, Changchun-Jilin, Changchun-Songyuan, Jilin-Songyuan, Jilin-Siping, and Songyuan-Siping transportation corridor) and regional ecological network (one ring, three links, and three belts) were constructed. Taking the requests of regional ecological security into consideration, the ecological environment security system of "Ji Triangle" Region, including regional ecological conservation district, regional ecological restored district, and regional ecological management district, was built.

The portrait of eikonal instability in Lovelock theories

NASA Astrophysics Data System (ADS)

Konoplya, R. A.; Zhidenko, A.

2017-05-01

Perturbations and eikonal instabilities of black holes and branes in the Einstein-Gauss-Bonnet theory and its Lovelock generalization were considered in the literature for several particular cases, where the asymptotic conditions (flat, dS, AdS), the number of spacetime dimensions D, non-vanishing coupling constants (α1, α2, α3 etc.) and other parameters have been chosen in a specific way. Here we give a comprehensive analysis of the eikonal instabilities of black holes and branes for the most general Lovelock theory, not limited by any of the above cases. Although the part of the stability analysis is performed here purely analytically and formulated in terms of the inequalities for the black hole parameters, the most general case is treated numerically and the accurate regions of instabilities are presented. The shared Mathematica® code allows the reader to construct the regions of eikonal instability for any desired values of the parameters.

Transient aero-thermal mapping of passive Thermal Protection system for nose-cap of Reusable Hypersonic Vehicle

NASA Astrophysics Data System (ADS)

Mahulikar, Shripad P.; Khurana, Shashank; Dungarwal, Ritesh; Shevakari, Sushil G.; Subramanian, Jayakumar; Gujarathi, Amit V.

2008-12-01

The temperature field history of passive Thermal Protection System (TPS) material at the nose-cap (forward stagnation region) of a Reusable Hypersonic Vehicle (RHV) is generated. The 3-D unsteady heat transfer model couples conduction in the solid with external convection and radiation that are modeled as time-varying boundary conditions on the surface. Results are presented for the following two cases: (1) nose-cap comprised of ablative TPS material only (SIRCA/PICA), and (2) nose-cap comprised of a combination of ablative TPS material with moderate thermal conductivity and insulative TPS material. Comparison of the temperature fields of SIRCA and PICA [Case (1)] indicates lowering of the peak stagnation region temperatures for PICA, due to its higher thermal conductivity. Also, the use of PICA and insulative TPS [Case (2)] for the nose-cap has higher potential for weight reduction than the use of ablative TPS alone.

Predictable ecology and geography of West Nile virus transmission in the central United States.

PubMed

Peterson, A Townsend; Robbins, Amber; Restifo, Robert; Howell, James; Nasci, Roger

2008-12-01

West Nile virus (WNV) arrived in North America and spread rapidly through the western hemisphere. We present a series of tests to determine whether ecological factors are consistently associated with WNV transmission to humans. We analyzed human WNV cases in the states of Illinois, Indiana, and Ohio in 2002 and 2003, building ecological niche models to associate WNV case occurrences with ecological and environmental parameters. In essentially all tests, both within states, among states, between years, and across the region, we found high predictivity of WNV case distributions, suggesting that one or more elements in the WNV transmission cycle has a strong ecological determination. Areas in the geographic region included in this study predicted as suitable for WNV transmission tended to have lower values of the vegetation indices in the summer months, pointing to consistent ecological differences between suitable and unsuitable areas.

Yellow fever in Pará State, Amazon region of Brazil, 1998-1999: entomologic and epidemiologic findings.

PubMed

Vasconcelos, P F; Rosa, A P; Rodrigues, S G; Rosa, E S; Monteiro, H A; Cruz, A C; Barros, V L; Souza, M R; Rosa, J F

2001-01-01

Yellow fever (YF) is frequently associated with high severity and death rates in the Amazon region of Brazil. During the rainy seasons of 1998 and 1999, 23 (eight deaths) and 34 (eight deaths) human cases of YF were reported, respectively, in different geographic areas of Pará State; most cases were on Marajó Island. Patients were 1 to 46 years of age. Epidemiologic and ecological studies were conducted in Afuá and Breves on Marajó Island; captured insects yielded isolates of 4 and 11 YF strains, respectively, from Haemagogus janthinomys pooled mosquitoes. The cases on Marajó Island in 1999 resulted from lack of vaccination near the focus of the disease and intense migration, which brought many nonimmune people to areas where infected vectors were present. We hypothesize that YF virus remains in an area after an outbreak by vertical transmission among Haemagogus mosquitoes.

Clarus multi-state regional demonstrations, evaluation of use case #2 : seasonal load restriction tool.

DOT National Transportation Integrated Search

2011-07-01

This report presents the results of an evaluation of the demonstration of an experimental seasonal load restriction decision support tool. This system offers state DOTs subsurface condition forecasts (such as moisture, temperature, and freeze-thaw tr...

Identifying Potential Regions of Copy Number Variation for Bipolar Disorder

PubMed Central

Chen, Yi-Hsuan; Lu, Ru-Band; Hung, Hung; Kuo, Po-Hsiu

2014-01-01

Bipolar disorder is a complex psychiatric disorder with high heritability, but its genetic determinants are still largely unknown. Copy number variation (CNV) is one of the sources to explain part of the heritability. However, it is a challenge to estimate discrete values of the copy numbers using continuous signals calling from a set of markers, and to simultaneously perform association testing between CNVs and phenotypic outcomes. The goal of the present study is to perform a series of data filtering and analysis procedures using a DNA pooling strategy to identify potential CNV regions that are related to bipolar disorder. A total of 200 normal controls and 200 clinically diagnosed bipolar patients were recruited in this study, and were randomly divided into eight control and eight case pools. Genome-wide genotyping was employed using Illumina Human Omni1-Quad array with approximately one million markers for CNV calling. We aimed at setting a series of criteria to filter out the signal noise of marker data and to reduce the chance of false-positive findings for CNV regions. We first defined CNV regions for each pool. Potential CNV regions were reported based on the different patterns of CNV status between cases and controls. Genes that were mapped into the potential CNV regions were examined with association testing, Gene Ontology enrichment analysis, and checked with existing literature for their associations with bipolar disorder. We reported several CNV regions that are related to bipolar disorder. Two CNV regions on chromosome 11 and 22 showed significant signal differences between cases and controls (p < 0.05). Another five CNV regions on chromosome 6, 9, and 19 were overlapped with results in previous CNV studies. Experimental validation of two CNV regions lent some support to our reported findings. Further experimental and replication studies could be designed for these selected regions. PMID:27605030

Excitation anisotropy in laser-induced-fluorescence spectroscopy: Broad-line excitation case

NASA Astrophysics Data System (ADS)

Hirabayashi, A.; Nambu, Y.; Fujimoto, T.

1986-01-01

Treatment of excitation anisotropy for Laser-Induced-Fluorescence Spectroscopy (LIFS) is extended to the intense excitation case. The depolarization coefficient is derived for intense excitation limit (linearly-polarized or unpolarized light excitation), and the result is presented in tables. For the region of intermediate intensity between the weak and intense excitation limits, the master equation is solved for specific example of transitions and its result is compared with experiment.

Plasma cell gingivitis - A rare case related to Colocasia (arbi) leaves.

PubMed

Bali, Deepika; Gill, Sanjeet; Bali, Amit

2012-09-01

Plasma cell gingivitis is an uncommon inflammatory condition of uncertain etiology often flavoured chewing gum, spices, foods, candies, or dentifrices. The diagnosis of plasma cell gingivitis is based on comprehensive history taking, clinical examination, and appropriate diagnostic tests. Here we are presenting a rare case of plasma cell gingivitis caused by consumption of colocasia (arbi) leaves. Colocasia is a kind of vegetable, very commonly consumed in the regions of North India.

Facilitators and barriers for the adoption, implementation and monitoring of child safety interventions: a multinational qualitative analysis.

PubMed

Scholtes, Beatrice; Schröder-Bäck, Peter; MacKay, J Morag; Vincenten, Joanne; Förster, Katharina; Brand, Helmut

2017-06-01

The efficiency and effectiveness of child safety interventions are determined by the quality of the implementation process. This multinational European study aimed to identify facilitators and barriers for the three phases of implementation: adoption, implementation and monitoring (AIM process). Twenty-seven participants from across the WHO European Region were invited to provide case studies of child safety interventions from their country. Cases were selected by the authors to ensure broad coverage of injury issues, age groups and governance level of implementation (eg, national, regional or local). Each participant presented their case and provided a written account according to a standardised template. Presentations and question and answer sessions were recorded. The presentation slides, written accounts and the notes taken during the workshops were analysed using thematic content analysis to elicit facilitators and barriers. Twenty-six cases (from 26 different countries) were presented and analysed. Facilitators and barriers were identified within eight general themes, applicable across the AIM process: management and collaboration; resources; leadership; nature of the intervention; political, social and cultural environment; visibility; nature of the injury problem and analysis and interpretation. The importance of the quality of the implementation process for intervention effectiveness, coupled with limited resources for child safety makes it more difficult to achieve successful actions. The findings of this study, divided by phase of the AIM process, provide practitioners with practical suggestions, where proactive planning might help increase the likelihood of effective implementation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Food poisoning associated with ingestion of wild wasp broods in the upstream region of the Lancang river valley, Yunnan province, China.

PubMed

Jiang, Li; Huang, Tian

2018-04-01

Food poisoning due to wild wasp broods ingestion has long been noted in the upstream region of the Lancang river valley, Yunnan province, China. This study describes the epidemiological and clinical features of the poisoning and possible causes. Surveillance data collected between 2008 and 2016 were analyzed to produce demographic data on patients, information on clinical presentations, wasp species identification, and estimations of possible risk factors for symptomatic cases. Eleven poisoning events were associated with the ingestion of wild wasp broods, including 46 exposed persons with 31 symptomatic living cases and 8 deceased cases that were reported in the Yunnan province between 2008 and 2016. Poisoning cases were only detected in the upstream region of the Lancang river valley in the autumn. The severity of the symptoms was correlated with an evident dose-effect relationship regarding the quantity ingested. The mean latent period from wild wasp broods ingestion to the onset of the symptoms was 10 h for symptomatic living cases and 7 h for deceased cases, respectively. Both gastrointestinal and neurological symptoms were commonly observed in the poisoning cases. The toxin source may be indirectly caused by the wasp broods due to the prevalence of local poisonous plants, such as Tripterygium wilfordii Hook F, Tripterygium hypoglaucum Hutch and Vaccinium bracteatum Thunb. Educational programs at the start of wasp harvest season in September in the high-risk area should be carried out to reduce the incidence of poisonings. Copyright © 2018 Elsevier Ltd. All rights reserved.

Clear cell renal cell carcinoma with osseous metaplasia: Rare case report.

PubMed

Agarwal, Swapnil; Bohara, Sangita; Jha, Ruchi; Khurana, Nita; Agarwal, P N

2015-01-01

Osseous metaplasia with clear cell renal cell carcinoma (RCC) is exceedingly rare. There are less than 20 reported cases of osseous metaplasia in association with RCC. We present a case of 39-year-old male patient presented to outpatient department with complaints of pain in the left lumbar region since 4 years. Computed tomography scan revealed a heterogeneous enhanced mass lesion having areas of necrosis and specks of calcification involving the left kidney. Clinicoradiological diagnosis of RCC was made and left radical nephrectomy was performed. Histological sections from the growth revealed features of clear cell carcinoma Fuhrman grade-2 with a focal area of metaplastic bone formation. The prognostic implications of calcification per se are not very clearly mentioned in the literature. Patients with osseous metaplasia generally present with early stage disease and a favorable prognosis. However, few of them were of high grade and poorer prognosis.

Cervical hemorrhage due to spontaneous rupture of the superior thyroid artery: Case report and review of the literature.

PubMed

Stenner, Markus; Helmstaedter, Victor; Spuentrup, Elmar; Quante, Gero; Huettenbrink, Karl-Bernd

2010-09-01

Beneath the different reasons for cervical masses, a spontaneous hemorrhage presents a rare and life-threatening condition. We present the rare case of a 62-year-old man who was presented with a dramatically enlarging cervical mass causing respiratory distress because of upper airway compression. An endotracheal intubation was lifesaving and avoided tracheotomy. A CT scan revealed a hematoma in the region of the left external carotid artery. An emergency angiography embolized a ruptured branch of the superior thyroid artery and surgery evacuated the hematoma. We discuss the rarity of the condition, reasons for a spontaneous rupture of the artery, and the diagnostic and treatment strategy. In addition, we review the literature on spontaneous thyroid artery hemorrhages, which, up to now, have been described only for the inferior thyroid artery. We conclude that the optimal management for cases of cervical hematoma is intubation, diagnosis, and angiography before surgery.

Acute hydrocephalus caused by intraspinal neurocysticercosis: case report

PubMed Central

2014-01-01

Background Intraspinal neurocysticercosis is an uncommon manifestation that may present as an isolated lesion. Furthermore, acute hydrocephalus caused by isolated intraspinal neurocysticercosis without concomitant cerebral involvement is extremely rare. Case presentation A 64-year-old man presented with a history of severe headache, an unsteady gait, and occasional urinary incontinence. Magnetic resonance imaging of the thoraco-lumbar spine revealed multiple, cystic, contrast-enhancing intraspinal lesions. A computed tomographic scan of the brain showed marked ventricular dilatation but no intraparenchymal lesions or intraventricular cysticercal lesions. This case of acute hydrocephalus was found to be caused by isolated intraspinal neurocysticercosis and was treated by ventriculoperitoneal shunt placement and surgical removal of the intraspinal lesions (which were histologically confirmed as neurocysticercosis), followed by administration of dexamethasone and albendazole. Conclusion Isolated spinal neurocysticercosis should be considered in the differential diagnosis of acute hydrocephalus when no explanation is found in the brain, particularly in geographical regions endemic for cysticercosis. PMID:24383427

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.

Case Report of a 21-Year-Old Man With Epidermolysis Bullosa Acquisita.

PubMed

Cyr, Janelle; Liu, Annie; Ghazarian, Danny; Siddha, Sanjay

Epidermolysis bullosa acquisita (EBA) is a rare acquired type of mechanobullous disease affecting the dermal-epidermal junction (DEJ) of trauma prone acral surfaces. It manifests as tense vesicles, bullae, and milia and typically heals as atrophic hypo- or hyperpigmented scars. Classic noninflammatory mechanobullous EBA typically presents at a mean age of 48 years. A 21-year-old man presented with a 2-year history of nonpainful papular-vesicular lesions on his hands, knees, and toes after minor trauma to these areas. Physical exam revealed postinflammatory hypopigmented scarring and milia to the bilateral dorsal hands and bilateral extensor elbows and knees, with tense blisters on the dorsal hand and patella regions. Direct immunofluorescence revealed strong linear IgG and IgM with weak focal positivity for IgA and C3 at the DEJ. Blood work revealed an increased diffuse gamma region of 71 g/L (6-13 g/L) on serum protein electrophoresis. Pathology showed a fibrotic underlying dermis, with subepidermal bullae and separation and no significant inflammation. The patient was started on colchicine. This case showcases an unusual early age of presentation for mechanobullous EBA and illustrates the importance of interpreting pathology in the context of clinical findings and maintaining a high index of suspicion for EBA in younger patients who present with classic findings. This case is unique as it is the first report of an association between EBA and polyclonal gammopathy and could be suggestive of chronic inflammation, which would fit with our patient's chronic history of EBA.

Parathyroid cysts: the Latin-American experience.

PubMed

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

2016-12-01

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

Exploration of large, rare copy number variants associated with psychiatric and neurodevelopmental disorders in individuals with anorexia nervosa.

PubMed

Yilmaz, Zeynep; Szatkiewicz, Jin P; Crowley, James J; Ancalade, NaEshia; Brandys, Marek K; van Elburg, Annemarie; de Kovel, Carolien G F; Adan, Roger A H; Hinney, Anke; Hebebrand, Johannes; Gratacos, Monica; Fernandez-Aranda, Fernando; Escaramis, Georgia; Gonzalez, Juan R; Estivill, Xavier; Zeggini, Eleftheria; Sullivan, Patrick F; Bulik, Cynthia M

2017-08-01

Anorexia nervosa (AN) is a serious and heritable psychiatric disorder. To date, studies of copy number variants (CNVs) have been limited and inconclusive because of small sample sizes. We conducted a case-only genome-wide CNV survey in 1983 female AN cases included in the Genetic Consortium for Anorexia Nervosa. Following stringent quality control procedures, we investigated whether pathogenic CNVs in regions previously implicated in psychiatric and neurodevelopmental disorders were present in AN cases. We observed two instances of the well-established pathogenic CNVs in AN cases. In addition, one case had a deletion in the 13q12 region, overlapping with a deletion reported previously in two AN cases. As a secondary aim, we also examined our sample for CNVs over 1 Mbp in size. Out of the 40 instances of such large CNVs that were not implicated previously for AN or neuropsychiatric phenotypes, two of them contained genes with previous neuropsychiatric associations, and only five of them had no associated reports in public CNV databases. Although ours is the largest study of its kind in AN, larger datasets are needed to comprehensively assess the role of CNVs in the etiology of AN.

Atlantoaxial joint distraction for treatment of basilar invagination secondary to rheumatoid arthritis.

PubMed

Goel, A; Pareikh, S; Sharma, P

2005-06-01

We present our experience of treating two cases of rheumatoid arthritis involving the craniovertebral junction and having marked basilar invagination by an alternative treatment method. In both the cases, the facets were osteoporotic and were not suitable for screw implantation. The patients were 66 and 72 years of age and both patients were females. Both the patients presented with complaints of progressively increasing spastic quadriparesis. Surgery involved attempts to reduce the basilar invagination and restore the height of the 'collapsed' lateral mass by manual distraction of the facets of the atlas and axis and forced impaction of titanium spacers in the joint in addition to bone graft harvested from the iliac crest. The procedure also provided stabilization of the region. No other fixation procedure involving wires, screws, plate and rods was carried out simultaneously. Following surgery both the patients showed symptomatic improvement and partial restoration of craniovertebral alignments. Follow-up is of 2 and 24 months. Distraction of the facets of atlas and axis and impaction of metal implant and bone graft in the facet joint can assist in reduction of basilar invagination and fixation of the region in selected cases of rheumatoid arthritis involving the craniovertebral junction.

Arteriolymphatic Fistula: An Unusual Cause of Spontaneous Swelling in the Left Supraclavicular Region

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

Karuppiah Viswanathan, Ashok Mithra, E-mail: ashokmithrakv@gmail.com; Irodi, Aparna; Keshava, Shyamkumar N., E-mail: aparna-shyam@yahoo.com

2016-09-15

An abnormal fistulous communication between an artery and lymphatic system is a rare occurrence. We report a 38-year-old male presenting with sudden onset, spontaneous, pulsatile swelling in the left supraclavicular region following a recent cardiac catheterisation via right femoral arterial access. On evaluation, he was found to have a femoral arteriolymphatic fistula. He was managed conservatively with ultrasound-guided compression with complete resolution of symptoms at follow-up. This case describes a hitherto unknown complication of percutaneous vascular cannulation presenting in an unusual manner, diagnosed with Doppler Ultrasonography and CT angiography and managed effectively with a non-invasive therapeutic image-guided manoeuvre.

Technical Modifications for Intraoral Quadrangular Le Fort II Osteotomy.

PubMed

Klug, Clemens; Cede, Julia

2017-02-01

The intraoral quadrangular Le Fort II osteotomy (IQLFIIO) represents a reliable surgical method in cases of midfacial deficiency with good functional, esthetic, and stable long-term results. In this technical note, we present 3 surgical modifications to previous reports: 1) inferior orbital rim osteotomy by angulated piezosurgical instruments, thereby avoiding the use of chisels in the orbital region; 2) osteosynthetic fixation only laterally at the zygomatic buttress with 2 L-shaped miniplates, thus avoiding paranasal osteosynthesis; and 3) advancement step camouflage in the lateral infraorbital region with a compound mass of autologous bone chips and fibrin glue with the intention to reduce bone block-associated side effects. Thirteen consecutive patients presenting with midfacial deficiency and Class III malocclusion were treated by IQLFIIO and mandibular osteotomy. In all cases, osteotomy and consecutive down fracture could be conducted as planned using the piezotome. No atypical fractures were encountered. No cases of infraorbital nerve anesthesia developed. Midfacial hypesthesia was found in 54% of the operated sides after 3 months, in 23% after 6 months, and in 13% after 12 months. The 5-month postoperative 3-dimensional scans revealed osseous healing at the infraorbital advancement step. Our results suggest that IQLFIIO can be conducted fully without chisels in the orbital region. Implementation of piezosurgery in IQLFIIO allows for safe bone cutting in the orbital region. Two miniplates and step camouflage with fibrin glue-stabilized bone chips were sufficient for osseous healing. Future studies will focus on quantitative soft to hard tissue changes that occur with IQLFIIO advancement. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Cancer Incidence in Saudi Arabia: 2012 Data from the Saudi Cancer Registry

PubMed Central

Bazarbashi, Shouki; Eid, Haya Al; Minguet, Joan

2017-01-01

Background: In order to most appropriately allocate healthcare and research funding for cancer, it is important to have accurate population-based incidence data. The Saudi Cancer Registry (SCR) provides such information, covering the time period from 1994 to the present day. The current report concerns an overview of cancer incidence statistics for Saudi Arabia in 2012. Methods: The SCR collects data from healthcare facilities throughout the Kingdom of Saudi Arabia. All newly diagnosed cases of cancer are recorded, with information on site and histology. For the present report, age-standardised and age-specific incidence rates (ASR, AIR, respectively) were calculated, with attention to gender-specific and regional differences. Results: The total number of incident cases of cancer identified by the SCR in 2012 was 14,336, with 6,791 (47.5%) among males and 7,545 (52.6%) among females. Of this total, 11,034 cases (76.9%) occurred in patients of Saudi origin. For Saudi males, the overall ASR (inc. all cancer sites) was 78.1 per 100,000 people, while that for females was 86.7. Incidence varied by region, with the Eastern region and Riyadh displaying the highest ASRs for both males and females, and Hail and Jazan displaying the lowest. Incidence varied by gender, with colorectal cancer (13.3%), non-Hodgkin lymphoma (NHL; 8.4%), and leukaemia (8.2%) being the most common types in males, and breast (25.8%), thyroid (11.7%), and colorectal cancers (9.3%) being the most common in females. Conclusions: This analysis of cancer incidence in Saudi Arabia demonstrated significant differences according to gender, age, and region of the Kingdom. The data should help ensure the most appropriate allocation of resources, with the aim of minimising the healthcare burden associated with cancer. PMID:28952273

Cancer Incidence in Saudi Arabia: 2012 Data from the Saudi Cancer Registry

PubMed

Bazarbashi, Shouki; Al Eid, Haya; Minguet, Joan

2017-09-27

Background: In order to most appropriately allocate healthcare and research funding for cancer, it is important to have accurate population-based incidence data. The Saudi Cancer Registry (SCR) provides such information, covering the time period from 1994 to the present day. The current report concerns an overview of cancer incidence statistics for Saudi Arabia in 2012. Methods: The SCR collects data from healthcare facilities throughout the Kingdom of Saudi Arabia. All newly diagnosed cases of cancer are recorded, with information on site and histology. For the present report, age-standardised and age-specific incidence rates (ASR, AIR, respectively) were calculated, with attention to gender-specific and regional differences. Results: The total number of incident cases of cancer identified by the SCR in 2012 was 14,336, with 6,791 (47.5%) among males and 7,545 (52.6%) among females. Of this total, 11,034 cases (76.9%) occurred in patients of Saudi origin. For Saudi males, the overall ASR (inc. all cancer sites) was 78.1 per 100,000 people, while that for females was 86.7. Incidence varied by region, with the Eastern region and Riyadh displaying the highest ASRs for both males and females, and Hail and Jazan displaying the lowest. Incidence varied by gender, with colorectal cancer (13.3%), non-Hodgkin lymphoma (NHL; 8.4%), and leukaemia (8.2%) being the most common types in males, and breast (25.8%), thyroid (11.7%), and colorectal cancers (9.3%) being the most common in females. Conclusions: This analysis of cancer incidence in Saudi Arabia demonstrated significant differences according to gender, age, and region of the Kingdom. The data should help ensure the most appropriate allocation of resources, with the aim of minimising the healthcare burden associated with cancer. Creative Commons Attribution License

Electric bicycle-related injuries presenting to a provincial hospital in China: A retrospective study.

PubMed

Zhou, Sheng Ang; Ho, Andrew Fu Wah; Ong, Marcus Eng Hock; Liu, Nan; Pek, Pin Pin; Wang, Yi Qing; Jin, Tao; Yan, Guang Zhao; Han, Nan Nan; Li, Gang; Xu, Li Ming; Cai, Wen Wei

2017-06-01

The use of electric bicycles (EBs) in China is growing. In the present study, we aimed to characterize the pattern and outcomes of EB-related injuries presenting to a major general hospital in China.This was a retrospective review of EB-related injuries presenting to Zhejiang Provincial People's Hospital from 2008 to 2011. Cases were identified from medical records according to diagnosis codes. Data captured included demographics, injury characteristics, and outcomes.A total of 3156 cases were reviewed in the present study. There were 1460 cases of traffic accidents, of which 482 cases were EB-related (32.7%). In addition, most of EB-related cases (44.6%) belonged to the 41- to 60-year-old age group. Median injury severity score was 10. Moreover, 34.9% underwent surgery and 24.7% were admitted to intensive care unit. The median hospitalization cost was 14,269 USD. Fracture (56.5%) was the most frequently diagnosed injury type, and head was the most commonly injured body region (31.1%).EB-related injuries have become a major health concern, making up a sizeable proportion of injuries presenting to the emergency department. Therefore, it is necessary to establish injury prevention and strategies for EB road safety. Implementation of policy such as compulsory helmet use, as well as popularization of EB road safety education should be considered to improve the current situation of EB-related injuries in China.

Regional fringe analysis for improving depth measurement in phase-shifting fringe projection profilometry

NASA Astrophysics Data System (ADS)

Chien, Kuang-Che Chang; Tu, Han-Yen; Hsieh, Ching-Huang; Cheng, Chau-Jern; Chang, Chun-Yen

2018-01-01

This study proposes a regional fringe analysis (RFA) method to detect the regions of a target object in captured shifted images to improve depth measurement in phase-shifting fringe projection profilometry (PS-FPP). In the RFA method, region-based segmentation is exploited to segment the de-fringed image of a target object, and a multi-level fuzzy-based classification with five presented features is used to analyze and discriminate the regions of an object from the segmented regions, which were associated with explicit fringe information. Then, in the experiment, the performance of the proposed method is tested and evaluated on 26 test cases made of five types of materials. The qualitative and quantitative results demonstrate that the proposed RFA method can effectively detect the desired regions of an object to improve depth measurement in the PS-FPP system.

Morphological assessment of the mandibular canal trajectory in edentate subjects.

PubMed

Nimigean, Victor; Sîrbu, Valentin Daniel; Nimigean, Vanda Roxana; Bădiţă, Daniela Gabriela; Poll, Alexandru; Moraru, Simona Andreea; Păun, Diana Loreta

2018-01-01

The mandibular canal and its content represent the vital structure, which can complicate dentoalveolar surgical procedures in the posterior region of the mandible. The purpose of the present study was to determine the path the mandibular canal takes in relation to the horizontal and the vertical anatomical reference planes in edentate subjects, in order to minimize the risk of affecting its neurovascular content during various oral surgery procedures. Morphometric evaluations were performed on 12 dried fully edentulous human mandibles and on cone-beam computed tomography (CBCT) cross-sectional images of the mandible, from 20 patients with either partial or complete edentulism. Both methods were utilized, in three target areas (corresponding to the second premolar, to the first molar and to the second molar regions), in order to measure the distance between the mandibular canal and the following reference points: (i) the lateral (buccal) surface of the mandible (MC-BS distance); (ii) the medial (lingual) surface of the mandible (MC-LS distance); (iii) the alveolar surface of the mandible (MC-AS distance). The results were statistically processed in Stata MP/13 software package using analysis of variance (ANOVA) test. The mandibular canal crossed the trabecular bone from the posterior towards the anterior, and from the lingual towards the buccal, reaching the premolar region, distal to the mental foramen, where it was located in the centre of the trabecular bone, main topographic pattern encountered in 27 (84.37%) of the cases. In five (15.63%) of the cases, in the premolar region, the mandibular canal was located near the buccal cortical plate. The mandibular canal descended from the second molar region towards the premolar region, main topographic pattern found in 28 (87.5%) of the cases. In four (12.5%) cases, the mandibular canal had a descending trajectory in the molar regions and it took a slightly ascending course in the premolar region. According to the results, the second molar region represents the highest risk area in the accidental injury to the content of the mandibular canal, during various oral surgery procedures.

North-East monsoon rainfall extremes over the southern peninsular India and their association with El Niño

NASA Astrophysics Data System (ADS)

Singh, Prem; Gnanaseelan, C.; Chowdary, J. S.

2017-12-01

The present study investigates the relationship between extreme north-east (NE) monsoon rainfall (NEMR) over the Indian peninsula region and El Niño forcing. This turns out to be a critical science issue especially after the 2015 Chennai flood. The puzzle being while most El Niños favour good NE monsoon, some don't. In fact some El Niño years witnessed deficit NE monsoon. Therefore two different cases (or classes) of El Niños are considered for analysis based on standardized NEMR index and Niño 3.4 index with case-1 being both Niño-3.4 and NEMR indices greater than +1 and case-2 being Niño-3.4 index greater than +1 and NEMR index less than -1. Composite analysis suggests that SST anomalies in the central and eastern Pacific are strong in both cases but large differences are noted in the spatial distribution of SST over the Indo-western Pacific region. This questions our understanding of NEMR as mirror image of El Niño conditions in the Pacific. It is noted that the favourable excess NEMR in case-1 is due to anomalous moisture transport from Bay of Bengal and equatorial Indian Ocean to southern peninsular India. Strong SST gradient between warm western Indian Ocean (and Bay of Bengal) and cool western Pacific induced strong easterly wind anomalies during NE monsoon season favour moisture transport towards the core NE monsoon region. Further anomalous moisture convergence and convection over the core NE monsoon region supported positive rainfall anomalies in case-1. While in case-2, weak SST gradients over the Indo-western Pacific and absence of local low level convergence over NE monsoon region are mainly responsible for deficit rainfall. The ocean dynamics in the Indian Ocean displayed large differences during case-1 and case-2, suggesting the key role of Rossby wave dynamics in the Indian Ocean on NE monsoon extremes. Apart from the large scale circulation differences the number of cyclonic systems land fall for case-1 and case-2 have also contributed for variations in NE monsoon rainfall extremes during El Niño years. This study indicates that despite having strong warming in the central and eastern Pacific, NE monsoon rainfall variations over the southern peninsular India is mostly determined by SST gradient over the Indo-western Pacific region and number of systems formation in the Bay of Bengal and their land fall. The paper concludes that though the favourable large scale circulation induced by Pacific is important in modulating the NE monsoon rainfall the local air sea interaction plays a key role in modulating or driving rainfall extremes associated with El Niño.

Evaluacion de Programas de Alfabetizacion. Consulta Tecnica Regional (Maracaibo, Venezuela, 30 Noviembre-6 Diciembre 1987) Informe Final. (Evaluation of Literacy Programs. Regional Technical Meeting (Maracaibo, Venezuela, November 30-December 6, 1987).

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Santiago (Chile). Regional Office for Education in Latin America and the Caribbean.

The objectives of this seminar were to identify problems in evaluating literacy programs and to design a working strategy to confront them. Four presentations included national case studies from Brazil, Honduras, Nicaragua, and Venezuela. Central questions asked concerned who and what were evaluated and how were the results to be used. In Brazil,…

Major Impact of Fleet Renewal Over Airports Located in the Most Important Region of Brazil

NASA Technical Reports Server (NTRS)

Maters, Rafael Waltz; deRoodeTorres, Roberta; Santo, Respicio A. Espirito, Jr.

2003-01-01

The present article discusses and analyses the major impacts of the Brazilian carriers fleet renewal regarding Brazilian airport infrastructure in the most important region of the country, the Southeast (SE). A brief historical overview of the country's airline fleet will be presented, demonstrating the need for its renewal (m fact, Brazilian carriers started a major fleet renewal program m the last five years), while analyzing the periods in which a new breed of aircraft was put into service by the major carriers operating in the SE region. The trend of operating the classic regional jets plus the forthcoming entry into service of the "large regional jets" (LRJ, 70-115 seaters) in several point-to-point routes are presented along with the country's carriers" reality of operating these former aircraft in several high-capacity and medium-range routes. The article will focus on the ability of four of the major Southeast's airports to cope with the fleet modernization, mainly due to the fact that the region studied is the most socioeconomic developed, by far, with the largest demand for air transportation, thus making the impacts much more perceptible for the communities and the airport management involved. With the emergence of these impacts, several new projects and investments are being discussed and pushed forward, despite budgetary constrains being a reality in almost every Brazilian city, even in the SE region. In view of this, the paper presents how the general planning could be carried out in order to adapt the airports' infrastructures in function of the proposed (and in some cases, necessary) fleet renewal. Ultimately, we will present the present picture and two future scenarios m order to determine the level of service in the existent passenger terminal facilities in the wake of the possible operation of several new aircraft. Keywords: Airline fleet planning, Airport planning, Regional development, Regional Jets.

Two novel mutations in the glycine-rich region of human PAX6 gene: Implications for an association of cataracts and anosmia with aniridia

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

Martha, A.; Ferrel, R.E.; Hittner, H.M.

1994-09-01

Aniridia (iris hyplasia) is a autosomal dominant congenital disorder of the eye. Mutations in the human aniridia (PAX6) gene have now been identified in many patients from various ethnic groups. In the present study we describe new mutations in this gene. Out of four mutations found, three were novel mutations; the fourth one is identical to the previously reported mutations (C{yields}T transition at nt 240). The three novel mutations analyzed were in the glycine-rich region (two) and in the proline/serine/threonine-rich (PST) region (one). Previously no mutations were reported for the glycine-rich region in humans. One of the mutations found inmore » this region is associated with cataracts in an aniridia family. The other splice mutation found in the PST domain is associated with anosmia (lack of sensation to smell) in a sporadic aniridia case. Two of the mutations presented here, one in the glycine-rich region and the other in the PST domain, were not detected by SSCR. These mutations could be detected by using MDE gel and heteroduplex information. All mutations found in the present study are similar in that 32 of 33 PAX6 mutations result in protein truncation and haploinsufficiency.« less

Incidence and clinical characteristics of ciguatera fish poisoning in Guadeloupe (French West Indies) between 2013 and 2016: a retrospective cases-series.

PubMed

Boucaud-Maitre, Denis; Vernoux, Jean-Paul; Pelczar, Stéphane; Daudens-Vaysse, Elise; Aubert, Lyderic; Boa, Sylvie; Ferracci, Serge; Garnier, Robert

2018-02-15

This retrospective case study analysed the incidence and symptoms of ciguatera fish poisoning (ciguatera) in Guadeloupe (French West Indies) between 2013 and 2016. Cases attending the emergency departments of the two public hospitals and the reports received by the regional health authority in charge of monitoring (ARS) were compiled. Two hundred and thirty-four cases of poisoning were observed, with a mean annual incidence of 1.47/10,000 (95% CI): 1.29-1.66), i.e 5 times higher than the previously reported incidence (1996-2006). The main species described as being responsible for poisoning were fish from the Carangidae family (n = 47) (jack), followed by fish from the Lutjanidae family (n = 27) (snapper), Serranidae family (n = 15) (grouper), Sphyraenidae family (n = 12) (barracuda), and Mullidae family (n = 12) (goatfish). One case of lionfish ciguatera was observed. 93.9% of patients experienced gastrointestinal symptoms, 76.0% presented neurological signs (mainly paresthesia, dysesthesia and pruritus) and 40.3% presented cardiovascular symptoms (bradycardia and/or hypotension). A high frequency (61.4%) of hypothermia (body temperature <36.5 °C) was observed. This study reports for the first time the relatively high frequency of cardiac symptoms and low body temperature. The monitoring of ciguatera poisoning throughout the Caribbean region must be improved, notably after reef disturbance due to Irma and Maria major cyclones.

Exploring Methodologies and Indicators for Cross-disciplinary Applications

NASA Astrophysics Data System (ADS)

Bernknopf, R.; Pearlman, J.

2015-12-01

Assessing the impact and benefit of geospatial information is a multidisciplinary task that involves the social, economic and environmental knowledge to formulate indicators and methods. There are use cases that couple the social sciences including economics, psychology, sociology that incorporate geospatial information. Benefit - cost analysis is an empirical approach that uses money as an indicator for decision making. It is a traditional base for a use case and has been applied to geospatial information and other areas. A new use case that applies indicators is Meta Regression analysis, which is used to evaluate transfers of socioeconomic benefits from different geographic regions into a unifying statistical approach. In this technique, qualitative and quantitative variables are indicators, which provide a weighted average of value for the nonmarket good or resource over a large region. The expected willingness to pay for the nonmarket good can be applied to a specific region. A third use case is the application of Decision Support Systems and Tools that have been used for forecasting agricultural prices and analysis of hazard policies. However, new methods for integrating these disciplines into use cases, an avenue to instruct the development of operational applications of geospatial information, are needed. Experience in one case may not be broadly transferable to other uses and applications if multiple disciplines are involved. To move forward, more use cases are needed and, especially, applications in the private sector. Applications are being examined across a multidisciplinary community for good examples that would be instructive in meeting the challenge. This presentation will look at the results of an investigation into directions in the broader applications of use cases to teach the methodologies and use of indicators that have applications across fields of interest.

[Considerations about the epidemiologic surveillance system on mesothelioma in Tuscany (Italy) after 25 years of activity].

PubMed

Chellini, Elisabetta; Martini, Andrea; Cacciarini, Valentina; Badiali, Anna Maria

2013-01-01

To present problems and opportunities related to the operating procedures developed by the Tuscan epidemiological surveillance system on mesothelioma during its 25 years of activity. All 1,224 mesotheliomas, registered up to 31.12. 2011, diagnosed in Tuscan residents during 1988-2009 by the Tuscan Operating Centre of the Italian registry, have been considered. In order to evaluate accuracy and completeness of cases, the following indicators by period are used for pleural mesotheliomas diagnosed during 1988-2009: the distribution of the sources of cases' diagnosis and report to the regional registry, the latency time between diagnosis and report, the age and sex specific rates, the ratio between standardized mortality and incidence rates. The distribution of type of interview and exposure classification by period for all cases were used to evaluate the collected and classified exposure information. Histology with immunohistochemistry became the chosen method (97.4% of histological cases in 2005- 2009). Since the second half of the Nineties, other Italian regional Operating Centres and, more recently, the Workers Compensation Authority (INAIL) became new important sources of case report. Nowadays, the mortality/incidence ratio is closer to 1. The latency time between diagnosis and case report have been reducing with a consequent increase in direct interviews to cases (from 20.3% in 1988-1993 to 71.4% in 2005-2009) and in exposure information and classification quality. The regional network with the effective cooperation of the Local Health Authorities produced relevant improvements in the quality of the epidemiological surveillance system. It is hoped that the new revision of the national Guidelines will succeed in taking into consideration all the improvements made by the surveillance system in order to get over the difficulties observed in defining and classifying cases and their asbestos exposure.

Complex regional pain syndrome (CRPS) with resistance to local anesthetic block: a case report.

PubMed

Maneksha, F R; Mirza, H; Poppers, P J

2000-02-01

We present a case of complex regional pain syndrome (CRPS) Type 1 in a 12-year-old girl. The patient did not respond to the usual therapeutic modalities used to treat CRPS, including physical therapy, lumbar sympathetic block, epidural local anesthetic block, intravenous lidocaine infusion, or other oral medications. Of note is the fact that, during epidural block, the patient demonstrated a resistance to local anesthetic neural blockade in the area of the body involved with the pain problem. The mechanism of this resistance could be related to the changes in the dorsal horn cells of the spinal cord, secondary to activation of N-methyl-D-aspartate receptors, which may play a role in the pathophysiology of this pain syndrome.

Wildlife conservation in fragmented tropical forests: A case of South Garo Hills, Meghalaya, North East India

Treesearch

Ashish Kumar; Bruce G. Marcot; Rohitkumar Patel

2017-01-01

This volume presents findings on, and implications for, wildlife conservation in the tropical forests in Garo Hills of Meghalaya state in the North East India. A companion volume presented the findings on forest fragmentation due to practice of slash and burn agriculture in the region. Both of the volumes summarize work completed over more than a decade on...

A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

PubMed Central

Zorlu, Sevgi; Cankaya, Abdulkadir Burak; Aktoren, Oya; Gencay, Koray

2015-01-01

The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case. PMID:26339511

[Based on the incidence of Creutzfeldt-Jakob disease in the Lanzarote healthcare area. Description of two definitive cases].

PubMed

Hernández-Ramos, F J; Martínez Martín, M; Esteban Robayna, M; Jensen Toll, F; Palacios Llopis, S

2005-01-01

We present two cases who have been diagnosed of definitive Creutzfeldt-Jakob disease in the health area of Lanzarote in the period January 2002 to January 2004. The two cases are presented with clinical description, complementary tests -- including electroencephalogram, 14-3-3 protein determination -- study of the prionic protein gene, and histopathologic findings. In this article, we try to show the importance of trying to reach a definitive diagnosis with the histopathologic study once there is clinical suspicion (a diagnosis that is probable or possible). In addition our cases show that communication between the clinical and the epidemiological coordinator of the regional community and the National Center of Epidemiology is very important. We refer to the clear growth in the incidence of the disease in the population of Lanzarote in the period above mentioned. Finally, we discuss whether this growth is or is not an isolated event.

Unilateral occipital nerve stimulation for bilateral occipital neuralgia: a case report and literature review

PubMed Central

Liu, Aijun; Jiao, Yongcheng; Ji, Huijun; Zhang, Zhiwen

2017-01-01

Objectives The aim of this study is to present a case of successful relief of bilateral occipital neuralgia (ON) using unilateral occipital nerve stimulation (ONS) and to discuss the possible underlying mechanisms. Materials and methods We present the case of a 59-year-old female patient with severe bilateral ON treated with unilateral ONS. We systematically reviewed previous studies of ONS for ON, discussing the possible mechanisms of ONS in the relief of ON. Results The patient reported complete pain relief after consistent unilateral ONS during the follow-up period. The underlying mechanisms may be linked to the relationship between pain and several brain regions, including the pons, midbrain, and periaqueductal gray. Conclusion ONS is an effective and safe option for treating ON. Future studies will be required to clarify the mechanisms by which unilateral occipital stimulation provided relief for bilateral neuralgia in this case. PMID:28176938

Unilateral occipital nerve stimulation for bilateral occipital neuralgia: a case report and literature review.

PubMed

Liu, Aijun; Jiao, Yongcheng; Ji, Huijun; Zhang, Zhiwen

2017-01-01

The aim of this study is to present a case of successful relief of bilateral occipital neuralgia (ON) using unilateral occipital nerve stimulation (ONS) and to discuss the possible underlying mechanisms. We present the case of a 59-year-old female patient with severe bilateral ON treated with unilateral ONS. We systematically reviewed previous studies of ONS for ON, discussing the possible mechanisms of ONS in the relief of ON. The patient reported complete pain relief after consistent unilateral ONS during the follow-up period. The underlying mechanisms may be linked to the relationship between pain and several brain regions, including the pons, midbrain, and periaqueductal gray. ONS is an effective and safe option for treating ON. Future studies will be required to clarify the mechanisms by which unilateral occipital stimulation provided relief for bilateral neuralgia in this case.

Integrated Approaches to Estuarine Use and Protection: Tampa Bay Ecosystem Services Case Study.

EPA Science Inventory

The Tampa Bay region faces projected stress from climate change, contaminants, nutrients, and of human development on a natural ecosystem that is valued (economically, aesthetically and culturally) in its present state. With fast-paced population increases, conversion and develop...

Terror Operations: Case Studies in Terrorism. U.S. Army DCSINT Handbook No. 1.01

DTIC Science & Technology

2005-08-15

relevant resource. A selected bibliography presents citations for detailed study of specific terrorism topics. Unless stated otherwise, masculine ...of instability within the region include hegemony , terrorism, proliferation of weapons of mass destruction, and ballistic missiles. Conflict is a

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.

Primary Chest Wall Abscess Mimicking a Breast Tumor That Occurred after Blunt Chest Trauma: A Case Report

PubMed Central

Masuda, Norikazu; Yasojima, Hiroyuki; Mizutani, Makiko; Nakamori, Shoji; Kanazawa, Toru; Kuriyama, Keiko; Mano, Masayuki; Sekimoto, Mitsugu

2014-01-01

Primary chest wall abscess occurring after blunt chest trauma is rare. We present the case of a 50-year-old woman who presented with a swelling in her left breast. The patient had experienced blunt chest trauma 2 months back. Needle aspiration revealed pus formation in the patient's chest. Computed tomography revealed a mass in the lower region of the left mammary gland, with thickening of the parietal pleura and skin and fracture of the fifth rib under the abscess. Following antibiotic administration and irrigation of the affected region, surgical debridement was performed. During surgery, we found that the pectoralis major muscle at the level of the fifth rib was markedly damaged, although the necrotic tissue did not contact the mammary gland. We diagnosed the lesion as a chest wall abscess that occurred in response to blunt chest trauma. Her postoperative course was uneventful. There has been no recurrence for six months after surgery. PMID:24660001

Computation of multi-dimensional viscous supersonic flow

NASA Technical Reports Server (NTRS)

Buggeln, R. C.; Kim, Y. N.; Mcdonald, H.

1986-01-01

A method has been developed for two- and three-dimensional computations of viscous supersonic jet flows interacting with an external flow. The approach employs a reduced form of the Navier-Stokes equations which allows solution as an initial-boundary value problem in space, using an efficient noniterative forward marching algorithm. Numerical instability associated with forward marching algorithms for flows with embedded subsonic regions is avoided by approximation of the reduced form of the Navier-Stokes equations in the subsonic regions of the boundary layers. Supersonic and subsonic portions of the flow field are simultaneously calculated by a consistently split linearized block implicit computational algorithm. The results of computations for a series of test cases associated with supersonic jet flow is presented and compared with other calculations for axisymmetric cases. Demonstration calculations indicate that the computational technique has great promise as a tool for calculating a wide range of supersonic flow problems including jet flow. Finally, a User's Manual is presented for the computer code used to perform the calculations.

Sympathetically maintained pain presenting first as temporomandibular disorder, then as parotid dysfunction.

PubMed

Giri, Subha; Nixdorf, Donald

2007-03-01

Complex regional pain syndrome (CRPS) is a chronic condition characterized by intense pain, swelling, redness, hypersensitivity and additional sudomotor effects. In all 13 cases of CRPS in the head and neck region reported in the literature, nerve injury was identified as the etiology for pain initiation. In this article, we present the case of a 30-year-old female patient with sympathetically maintained pain without apparent nerve injury. Her main symptoms--left-side preauricular pain and inability to open her mouth wide--mimicked temporomandibular joint arthralgia and myofascial pain of the masticatory muscles. Later, symptoms of intermittent preauricular pain and swelling developed, along with hyposalivation, which mimicked parotitis. After an extensive diagnostic process, no definitive underlying pathology could be identified and a diagnosis of neuropathic pain with a prominent sympathetic component was made. Two years after the onset of symptoms and initiation of care, treatment with repeated stellate ganglion blocks and enteral clonidine pharmacotherapy provided adequate pain relief.

Convergent dysregulation of frontal cortical cognitive and reward systems in eating disorders.

PubMed

Stefano, George B; Ptáček, Radek; Kuželová, Hana; Mantione, Kirk J; Raboch, Jiří; Papezova, Hana; Kream, Richard M

2013-05-10

A substantive literature has drawn a compelling case for the functional involvement of mesolimbic/prefrontal cortical neural reward systems in normative control of eating and in the etiology and persistence of severe eating disorders that affect diverse human populations. Presently, we provide a short review that develops an equally compelling case for the importance of dysregulated frontal cortical cognitive neural networks acting in concert with regional reward systems in the regulation of complex eating behaviors and in the presentation of complex pathophysiological symptoms associated with major eating disorders. Our goal is to highlight working models of major eating disorders that incorporate complementary approaches to elucidate functionally interactive neural circuits defined by their regulatory neurochemical phenotypes. Importantly, we also review evidence-based linkages between widely studied psychiatric and neurodegenerative syndromes (e.g., autism spectrum disorders and Parkinson's disease) and co-morbid eating disorders to elucidate basic mechanisms involving dopaminergic transmission and its regulation by endogenously expressed morphine in these same cortical regions.

Anorexia nervosa and Wernicke-Korsakoff syndrome: a case report

PubMed Central

2010-01-01

Introduction Wernicke's encephalopathy is an acute, potentially fatal, neuropsychiatric syndrome resulting from thiamine deficiency. The disorder is still greatly under-diagnosed, and failure to promptly identify and adequately treat the condition can lead to death or to the chronic form of the encephalopathy - Korsakoff's syndrome. Wernicke's encephalopathy has traditionally been associated with alcoholism but, in recent years, there has been an increase in the number of clinical settings in which the disorder is observed. Case presentation We report the case of a 45-year-old Caucasian woman who arrived at the emergency room presenting signs of marked malnutrition and mental confusion, ataxic gait and ophthalmoplegia. Main laboratory test findings included low serum magnesium and megaloblastic anemia. Brain magnetic resonance imaging revealed increased T2 signal in the supratentorial paraventricular region, the medial regions of the thalamus and the central and periaqueductal midbrain. The diagnosis of Wernicke's encephalopathy was made at once and immediate reposition of thiamine and magnesium was started. The patient had a long history of recurrent thoughts of being overweight, severe self-imposed diet restrictions and self-induced vomiting. She had also been drinking gin on a daily basis for the last eight years. One day after admittance the acute global confusional state resolved, but she presented severe memory deficits and confabulation. After six months of outpatient follow-up, memory deficits remained unaltered. Conclusion In this case, self-imposed long-lasting nutritional deprivation is thought to be the main cause of thiamine deficiency and subsequent encephalopathy, but adjunct factors, such as magnesium depletion and chronic alcohol misuse, might have played an important role, especially in the development of Korsakoff's syndrome. The co-morbidity between eating disorders and substance abuse disorders has emerged as a significant health issue for women, and the subgroup of patients with anorexia nervosa who also misuse alcohol is probably at a particular risk of developing Wernicke-Korsakoff syndrome. The present case report highlights this relevant issue. PMID:20646296

Incidence of foreign bodies in aerodigestive tract in vindhya region: our experience.

PubMed

Gupta, Richa; Poorey, V K

2014-06-01

Foreign bodies in aerodigestive tract are frequent occurrence and may lead to life threatening situation due to obstruction caused in respiratory passages. To present foreign body ingestion cases observed in a 5-year period at the S.S. Medical College and G.M. Hospital, Rewa (MP). The present study is a retrospective analysis including 108 patients of foreign bodies of aerodigestive tract of Vindhya region who presented to the S.S. Medical College and G.M. Hospital, Rewa from January 2008 to August 2012. About 92 patients of total 108 patients had evidence of foreign body in food passage with age ranging from 9 month to 85 years. Most patients 65 (70.65 %) belong to <10 year age group. Radiological evidence was found in 76 (82.6 %) patients. Most common foreign body was found to be coin 75 (81.52 %). The commonest site of lodgement was cricopharynx. About 16 patients of total 108 patients had evidence of foreign body in airway with age ranging from 9 months to 72 years. Most cases 8 (50 %) belong to <10 year age. Maximum cases showed vegetative foreign body with right bronchus (58.33 %) as commonest site of lodgement. Early detection by meticulous history, imaging modality and prompt management remains basis for favourable outcome and prevents future complications.

Primary Intracranial Germinomas: Retrospective Analysis of Five Cases.

PubMed

Abdallah, Anas; Asilturk, Murad; Uysal, Mustafa Levent; Emel, Erhan; Abdallah, Betul Guler; Bilgic, Bilge; Gundogdu, Gokcen

2018-01-01

Primary intracranial germinomas (PIGs) are rare malignant brain tumors that represent approximately 0.2% to 1.7% of all primary intracranial tumors. PIGs have infrequent, but there is a possibility of spinal cord metastases. In this study, clinical outcomes of five consecutive PIGs have been presented. Medical records were retrospectively reviewed in 1,849 cases of intracranial tumors who underwent surgery between the years 2005 and 2015 and cases confirmed as germinoma histopathologically were included in this study. Five cases of PIGs were detected in two female (40%) and 3 male (60%) patients. The mean age was 15.2±5.6 (8-23) years. The mean follow-up period was 52.3±56.4 (9-135) months. The most common complaint was headache (60%), followed by nausea±vomiting (40%). Four cases (80%) affected the suprasellar region while the fifth patient"s tumor was localized in the pineal region. The duration between the initial symptom and time of surgical intervention ranged between 15 days and 2 months. Twelve months after the first operation, one patient presented with drop seeding metastasis. Four-year survival (with exception of the case that died as a early surgical complication) was 100%. Gross total resection (GTR) was achieved in one patient. Surgical mortality rate was 20%. PIGs" morbidity rate was 60%. PIG is a mostly malignant tumor that generally affects the pediatric age group. They are radiosensitive tumors. Subtotal or near-total resection using stereotactic guide or direct surgery to confirm the histopathological diagnosis followed by chemotherapy and whole brain or in some cases craniospinal radiotherapy rather than GTR is therefore the treatment of choice.

A Novel Class of Pseudoautosomal Region 1 Deletions Downstream of SHOX Is Associated with Léri-Weill Dyschondrosteosis

PubMed Central

Benito-Sanz, Sara; Thomas, N. Simon; Huber, Céline; del Blanco, Darya Gorbenko; Aza-Carmona, Miriam; Crolla, John A.; Maloney, Vivienne; Argente, Jesús; Campos-Barros, Ángel; Cormier-Daire, Valérie; Heath, Karen E.

2005-01-01

Léri-Weill dyschondrosteosis (LWD) is a pseudoautosomal dominant disorder characterized by disproportionate short stature and a characteristic curving of the radius, known as the “Madelung deformity.” SHOX mutations resulting in SHOX haploinsufficiency have been found in LWD and in a variable proportion of patients with idiopathic short stature (ISS), whereas homozygous loss of SHOX results in the more severe Langer mesomelic dysplasia (LMD). Defects in SHOX have been identified in ∼60% of LWD cases, whereas, in the remaining ∼40%, the molecular basis is unknown. This suggests either genetic heterogeneity or the presence of mutations in unanalyzed regions of SHOX, such as the upstream, intragenic, or downstream regulatory sequences. Therefore, the pseudoautosomal region 1 (PAR1) of 80 patients with LWD, in whom SHOX deletions and mutations had been excluded, was screened for deletions by use of a new panel of microsatellite markers. We identified 12 patients with LWD who presented with a novel class of PAR1 deletions that did not include SHOX. The deletions were of variable size and mapped at least ∼30–530 kb downstream of SHOX. In our cohort, this type of deletion accounted for 15% of cases. In all cases, the deletions cosegregated with the phenotype. No apparent phenotypic differences were observed between patients with SHOX deletions and those with this new class of PAR1 deletions. Thus, we present here the identification of a second PAR1 region implicated in the etiopathogenesis of LWD. Our findings suggest the presence of distal regulatory elements of SHOX transcription in PAR1 or, alternatively, the existence of an additional locus apparently involved in the control of skeletal development. Deletion analysis of this newly identified region should be included in the mutation screening of patients with LWD, LMD, and ISS. PMID:16175500

Maxillary unicystic ameloblastoma: a case report.

PubMed

Agani, Zana; Hamiti-Krasniqi, Vjosa; Recica, Jehona; Loxha, Mergime Prekazi; Kurshumliu, Fisnik; Rexhepi, Aida

2016-10-18

Ameloblastoma is a benign epithelial odontogenic tumor. It is often aggressive and destructive, with the capacity to attain great size, erode bone and invade adjacent structures. Unicystic ameloblastoma is a rare odontogenic lesion, with clinical, radiographic and gross features of jaw cysts. The lesion histologically shows typical ameloblastomatous epithelium lining part of the cyst cavity with or without and/or mural tumor growth. Unicystic ameloblastoma usually presents in posterior mandibular ramus region, while it is rare and atypical in posterior maxillary region. . We report a case of 16 year old Kosovar male, Albanian ethnicity, who presented with a swelling located in right maxillary region. Clinical examination revealed a painless swelling extending from the maxillary right central incisor to the maxillary right first molar tooth. Panoramic radiograph disclosed a well corticated unilocular radiolucent lesion approximately 5 × 5 cm in diameter which was in contact with the roots of the teeth present inferiorly and with the maxillary sinus superiorly. Maxillary right canine impaction was noted and unerupted lateral incisor tooth was present inside the radiolucency. Preoperative diagnosis of the lesion was made as dentigerous cyst based on the age of the patient, location of the swelling, clinical and radiographic findings, but the unicystic ameloblastoma was also taken into consideration. The patient was treated by surgical enucleation of the lesion and extraction of lateral incisor tooth which was present inside the lesion. The histopathological examination of the lesion revealed confirmed finding for unicystic ameloblastoma mural form. No recurrence was observed in 1 year follow-up. Maxillary region is considered a rare and atypical location for unicystic ameloblastoma. We emphasize the importance of differential diagnosis of an odontogenic lesion with common clinical and radiological features that will impact the treatment planning and follow up. As oral health providers we should be aware that the unilocular radiolucencies may be unicystic ameloblastoma.

Solving the infeasible trust-region problem using approximations.

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

Renaud, John E.; Perez, Victor M.; Eldred, Michael Scott

2004-07-01

The use of optimization in engineering design has fueled the development of algorithms for specific engineering needs. When the simulations are expensive to evaluate or the outputs present some noise, the direct use of nonlinear optimizers is not advisable, since the optimization process will be expensive and may result in premature convergence. The use of approximations for both cases is an alternative investigated by many researchers including the authors. When approximations are present, a model management is required for proper convergence of the algorithm. In nonlinear programming, the use of trust-regions for globalization of a local algorithm has been provenmore » effective. The same approach has been used to manage the local move limits in sequential approximate optimization frameworks as in Alexandrov et al., Giunta and Eldred, Perez et al. , Rodriguez et al., etc. The experience in the mathematical community has shown that more effective algorithms can be obtained by the specific inclusion of the constraints (SQP type of algorithms) rather than by using a penalty function as in the augmented Lagrangian formulation. The presence of explicit constraints in the local problem bounded by the trust region, however, may have no feasible solution. In order to remedy this problem the mathematical community has developed different versions of a composite steps approach. This approach consists of a normal step to reduce the amount of constraint violation and a tangential step to minimize the objective function maintaining the level of constraint violation attained at the normal step. Two of the authors have developed a different approach for a sequential approximate optimization framework using homotopy ideas to relax the constraints. This algorithm called interior-point trust-region sequential approximate optimization (IPTRSAO) presents some similarities to the two normal-tangential steps algorithms. In this paper, a description of the similarities is presented and an expansion of the two steps algorithm is presented for the case of approximations.« less

Progressive posterior cortical dysfunction

PubMed Central

Porto, Fábio Henrique de Gobbi; Machado, Gislaine Cristina Lopes; Morillo, Lilian Schafirovits; Brucki, Sonia Maria Dozzi

2010-01-01

Progressive posterior cortical dysfunction (PPCD) is an insidious syndrome characterized by prominent disorders of higher visual processing. It affects both dorsal (occipito-parietal) and ventral (occipito-temporal) pathways, disturbing visuospatial processing and visual recognition, respectively. We report a case of a 67-year-old woman presenting with progressive impairment of visual functions. Neurologic examination showed agraphia, alexia, hemispatial neglect (left side visual extinction), complete Balint’s syndrome and visual agnosia. Magnetic resonance imaging showed circumscribed atrophy involving the bilateral parieto-occipital regions, slightly more predominant to the right. Our aim was to describe a case of this syndrome, to present a video showing the main abnormalities, and to discuss this unusual presentation of dementia. We believe this article can contribute by improving the recognition of PPCD. PMID:29213665

Coexistence of translocation(1,19) and the Philadelphia chromosome in a child's first presentation of chronic myeloid leukemia in blast crisis treated with dasatinib.

PubMed

Eckardt, Mark A; Chang, Vivian Y; Rao, Nagesh P; Federman, Noah

2011-11-01

Chronic myelogenous leukemia (CML) constitutes less than 5% of childhood leukemias. The authors describe a rare case of a 14-year-old boy who presented with CML in blast crisis. Unique to this patient was the evidence of both breakpoint cluster region-c-abl oncogene 1 (BCR-ABL1) fusions as well as an additional unbalanced t(1;19) translocation. This combination has not previously been reported in the same patient. Initial treatment with dasatinib achieved a complete cytogenetic response within 2 months of therapy. This case highlights the heterogeneous presentation of CML in children and rationale for use of dasatinib as a first-line agent for patients with blast crisis.

Three fatalities associated with the synthetic cannabinoids 5F-ADB, 5F-PB-22, and AB-CHMINACA.

PubMed

Angerer, V; Jacobi, S; Franz, F; Auwärter, V; Pietsch, J

2017-12-01

The use of synthetic cannabinoids (SC) has been widespread in certain groups of drug users for many years. In the scientific literature many intoxication cases and a number of fatalities after the use of synthetic cannabinoids were reported. In this paper three death cases are described with involvement of the synthetic cannabinoids 5F-PB-22, AB-CHMINACA, and 5F-ADB. The three cases occurred in the eastern region of Germany, which is known as a region of high methamphetamine abuse. All decedents were male, between 25 and 41 years old, and had a known history of drug use. Femoral blood concentrations of the synthetic cannabinoids were measured using a validated LC-MS/MS method. The concentration of 5F-PB-22 in the first case was 0.37ng/mL, the concentration of AB-CHMINACA in the second case was approximately 4.1ng/mL (extrapolated) and the 5F-ADB concentration in the third case was 0.38ng/mL. Compared to other published cases the concentrations in the here presented cases seem to be in the lower range. However, taking into account the scene of death, the results of the forensic autopsy and the full toxicological analysis, the deaths can be explained as a direct consequence of consumption of synthetic cannabinoids, although in case one and two relevant amounts of ethanol were found, and in case three trimipramine and olanzapine were present in non-toxic concentrations. It has to be noted that concentrations of synthetic cannabinoids in femoral blood cannot directly be judged as toxic or lethal due to the possibility of postmortem redistribution and the development of tolerance after frequent use. Therefore, all available information has to be considered carefully before stating SC use as the cause of death. Copyright © 2017 Elsevier B.V. All rights reserved.

Abulia following penetrating brain injury during endoscopic sinus surgery with disruption of the anterior cingulate circuit: Case report

PubMed Central

Grunsfeld, Alexander A; Login, Ivan S

2006-01-01

Background It is common knowledge that the frontal lobes mediate complex human behavior and that damage to these regions can cause executive dysfunction, apathy, disinhibition and personality changes. However, it is less well known that subcortical structures such as the caudate and thalamus are part of functionally segregated fronto-subcortical circuits, that can also alter behavior after injury. Case presentation We present a 57 year old woman who suffered penetrating brain injury during endoscopic sinus surgery causing right basal ganglia injury which resulted in an abulic syndrome. Conclusion Abulia does not result solely from cortical injury but can occur after disruption anywhere in the anterior cingulate circuit – in the case of our patient, most prominently at the right caudate. PMID:16430769

[Clinical features and prognostic factors of meningococcal disease: a case series study in Chile during the 2012-2013 outbreak].

PubMed

Matute, Isabel; Olea, Andrea; López, Darío; Loayza, Sergio; Nájera, Manuel; González, Claudia; Poffald, Lucy; Hirmas, Macarena; Delgado, Iris; Pedroni, Elena; Alfaro, Tania; Gormaz, Ana María; Sanhueza, Gabriel; Vial, Pablo; Dabanch, Jeannette; Gallegos, Doris; Aguilera, Ximena

2015-10-01

Meningococcal disease (MD) is a major global problem because of its case fatality rate and sequels. Since 2012 cases of serogroup W have increased in Chile, with nonspecific clinical presentation, high case fatality rate and serious consequences. To characterize the evolution and outcome of MD cases between January 2012 and March 2013 in Chile. Case series considering 149 MD cases of 7 regions. A questionnaire was applied and clinical records were reviewed, including individual, agent, clinical course and healthcare process variables. The analysis allowed to obtain estimates of the OR as likelihood of dying. 51.5% was meningococcemia, the case fatality rate reached 27%, prevailing serogroup W (46.6%). Factors that increased the probability of dying: > age, belonging to indigenous people, having lived a stressful event, having diarrhea, impaired consciousness, cardiovascular symptoms, low oxygen saturation and low Glasgow coma scale score. The case fatality rate exceeded normal levels and was higher in serogroup W. Increasing in this serogroup, associated to the increased presence of nonspecific symptoms or rapid progression to septicemia, hit a health system accustomed to more classic meningococcal disease presentation, which could partly explain the observed increased fatality rate.

Papillary tumor of the pineal region: two case studies and a review of the literature.

PubMed

Rickard, Kyle A; Parker, John R; Vitaz, Todd W; Plaga, Alexis R; Wagner, Stephanie; Parker, Joseph C

2011-01-01

Papillary tumor of the pineal region (PTPR) is a newly recognized distinct entity in the 2007 World Health Organization nomenclature. This tumor is characterized by epithelial-appearing areas with papillary features and more densely cellular areas that often display ependymal-like differentiation. Ultrastructurally, this rare neuroepithelial tumor possesses neuroendocrine, secretory, and ependymal organelles that likely originate from the subcommissural organ (SCO) near the aqueduct of Sylvius. To date, approximately fifty-seven described cases worldwide have been recognized, with ages ranging from 5 years to 66 years (mean age=32 years). Clinical presentation most often includes headache and obstructive hydrocephalus. The tumor, which is well circumscribed, may be cystic and radiographically is often considered to be consistent with the findings of a pineocytoma. Microscopic evaluation often demonstrates a lesion with papillary areas lined by epithelioid tumor cells with eosinophilic cytoplasm and more cellular areas with cells exhibiting clear or vacuolated cytoplasm. Perivascular and true rosettes may be identified. Distinctive immunohistochemical features including reactivity for keratins (AE1/AE3, CAM 5.2, CK18) and only focal GFAP staining help distinguish this neoplasm from an ependymoma. The relative paucity of data compiled for this tumor makes giving an accurate diagnosis and prognosis a daunting task. We discuss two additional cases of PTPR that presented to us within a three-month span in order to more fully elucidate the possible presentations of this rare entity. Furthermore, we examine now 59 reported cases of PTPR in order to review the current diagnostic and treatment modalities in addition to exploring emerging research encompassing this unusual neoplasm.

Central nervous system filariasis masquerading as a glioma: case report.

PubMed

Shrivastava, Adesh; Arora, Prateek; Khare, Akriti; Goel, Garima; Kapoor, Neelkamal

2017-09-01

Filariasis, an endemic zoonosis in the Southeast Asia region, has been reported to affect various organs as well as the central nervous system (CNS). Inflammatory reactions mimicking those from neoplastic lesions clinically and radiologically have been reported in the breast and urinary bladder. To date, a CNS manifestation of filarial infestation has been reported in the form of meningoencephalitis. The authors here present an interesting case of a young man presenting in status epilepticus, which on radiological evaluation appeared to be a glioma. However, postoperative histopathological examination changed the provisional diagnosis to a filarial infection of the CNS mimicking a primary CNS neoplasm.

[The role of the quality of hospital discharge records on the comparative evaluation of outcomes: the example of chronic obstructive pulmonary disease (COPD)].

PubMed

Fano, Valeria; D'Ovidio, Mariangela; del Zio, Katiuscia; Renzi, Davide; Tariciotti, Daniela; Agabiti, Nera; Argenti, Lucia; Cattaruzza, Maria Sofia; Fortino, Antonio

2012-01-01

To analyse the results of the regional comparative evaluation of the outcome "thirty days mortality after admission for reacutized Chronic obstructive pulmonary disease (COPD)" before and after a reabstract study. Reabstract study of clinical records included in the regional comparative evaluation. 232 clinical records retrieved from Grassi Hospital archives (years 2006-2007) and reviewed by two physicians and one nurse specifically trained. Models performed before and after reabstract study for comparative evaluation of the outcome were compared. Blind coding of diagnosis and interventions/procedures was completed according to a standard grid consistent with regional guidelines for Hospital Discharge Record coding. Other information was registered, if present on discharge record: smoking habit, number of reacutizations occurred within previous year, use of oxigen and/or other therapies, pneumological visit at discharge. The majority (94%) of reviewed cases were confirmed as being cases of COPD. A total of 168 cases (72%) have been identified as reacutized COPD coherent with enrolment criteria of regional program, 49 (21%) have been identified as COPD and only 15 cases (6%) resulted not affected by COPD. Results of the regional comparative model were substantially unchanged for Grassi hospital (RR =23 vs RR =24). Accurateness of clinical documentation resulted inadequate especially regarding information at discharge (50% missing information on smoking habit, 83% on previous year reacutizations, 22% on follow-up organization after discharge). This study contributes to the debate on the role of administrative data on the comparative evaluation of health outcomes. Other relevant issues are to promote the collaboration among different health professionals working in the same hospital, and to increase the awareness of the importance of the quality of health and administrative data.

The quantum efficiency of HgCdTe photodiodes in relation to the direction of illumination and to their geometry

NASA Technical Reports Server (NTRS)

Rosenfeld, D.; Bahir, G.

1993-01-01

A theoretical study of the effect of the direction of the incident light on the quantum efficiency of homogeneous HgCdTe photodiodes suitable for sensing infrared radiation in the 8-12 microns atmospheric window is presented. The probability of an excess minority carrier to reach the junction is derived as a function of its distance from the edge of the depletion region. Accordingly, the quantum efficiency of photodiodes is presented for two geometries. In the first, the light is introduced directly to the area in which it is absorbed (opaque region), while in the second, the light passes through a transparent region before it reaches the opaque region. Finally, the performance of the two types of diodes is analyzed with the objective of finding the optimal width of the absorption area. The quantum efficiency depends strongly on the way in which the light is introduced. The structure in which the radiation is absorbed following its crossing the transparent region is associated with both higher quantum efficiency and homogeneity. In addition, for absorption region widths higher than a certain minimum, the quantum efficiency in this case is insensitive to the width of the absorption region.

Primary epithelioid trophoblastic tumor with a synchronous breast carcinoma detected only with FDG-PET/CT Scan.

PubMed

Kara, T; Ozcan Kara, P; Baba, F; Celik, C; Kara Gedik, G

2011-01-01

Epithelioid trophoblastic tumor is a recently described, rare and distinctive type of gestational trophoblastic tumor. We report the case of a 31-year old patient who had a full-term pregnancy 18 months before presentation. She had a right axillary lymph node metastasis and was referred for FDG-PET/CT scan for evaluation of distant metastasis and to detect primary malignancy. The axillary lymph node biopsy revealed metastatic breast carcinoma. FDG-PET/CT revealed increased uptake of right axillary lymph node, soft tissue density lesion with a diameter of 24 mm on left cervical region with increased FDG uptake, increased uptake on cervical region and left inguinal lymph node with increased uptake. Pelvic MRI imaging and ultrasonography were negative for malignancy in cervical region. Biopsy of the lesion was consistent with epithelioid trophoblastic tumor in cervical region. Gestational trophoblastic tumor was not suspected because she had no signs such as abnormal vaginal bleeding. FDG-PET/CT demonstrated the primary lesion in cervical region. We report a rare case of primary epithelioid trophoblastic tumor detected only with FDG-PET/CT scan which synchronized with breast carcinoma. Copyright © 2010 Elsevier España, S.L. and SEMNIM. All rights reserved.

Understanding the rotation of coronal holes

NASA Astrophysics Data System (ADS)

Wang, Y.-M.; Sheeley, N. R., Jr.

1993-09-01

In an earlier study we found that the rotation of coronal holes could be understood on the basis of a nearly current-free coronal field, with the holes representing open magnetic regions. In this paper we illustrate the model by focusing on the case of CH1, the rigidly rotating boot-shaped hole observed by Skylab. We show that the interaction between the polar fields and the flux associated with active regions produces distortions in the coronal field configuration and thus in the polar-hole boundaries; these distortions corotate with the perturbing nonaxisymmetric flux. In the case of CH1, positive-polarity field lines in the northern hemisphere 'collided' with like-polarity field lines fanning out from a decaying active region complex located just below the equator, producing a midlatitude corridor of open field lines rotating at the rate of the active region complex. Sheared coronal holes result when nonaxisymmetric flux is present at high latitudes, or equivalently, when the photospheric neutral line extends to high latitudes. We demonstrate how a small active region, rotating at the local photospheric rate, can drift through a rigidly rotating hole like CH1. Finally, we discuss the role of field-line reconnection in maintaining a quasi-potential coronal configuration.

Evaluation of data quality, timeliness and acceptability of the tuberculosis surveillance system in Brazil's micro-regions.

PubMed

Silva, Gabriela Drummond Marques da; Bartholomay, Patrícia; Cruz, Oswaldo Gonçalves; Garcia, Leila Posenato

2017-10-01

This study aimed to evaluate quality, acceptability and timeliness of the data in the tuberculosis surveillance system in Brazilian micro-regions. An ecological cross-sectional study was carried out, after a qualitative stage for selecting indicators. All 558 Brazilian micro-regions were used as units of analysis. Data available in the National Notifiable Diseases Information System (SINAN), from 2012 to 2014, were used to calculate 14 indicators relating to four attributes: completeness, consistency, timeliness and acceptability. The study made use of cluster analysis to group micro-regions according to acceptability and timeliness. Three clusters were identified among the 473 micro-regions with optimal or regular completeness (70% to 100%) and with over five notifications. Cluster 1 (n = 109) presented mean timeliness of notification and treatment equal to 62.8% and 24.9%, respectively. Cluster 2 (n = 143) had a mean percentage of cases tested for HIV equal to 55.9%. Cluster 3 (n = 221) had the best performing tuberculosis indicators. Results suggest priority areas for improving surveillance of tuberculosis, predominantly in the central-north part of the country. They also point to the need to increase the timeliness of treatment and the percentage of cases tested for HIV.

Rhodotorula fungemia: Report of two cases in Sfax (Tunisia).

PubMed

Guidara, R; Trabelsi, H; Neji, S; Cheikhrouhou, F; Sellami, H; Makni, F; Ayadi, A

2016-06-01

Rhodotorula is emerging as an important cause of nosocomial and opportunistic infections. We present two cases of Rhodotorula mucilaginosa fungemia diagnosed at our hospital during the last decade. The first case was of a term neonate who presented congenital heart disease (interventricular communication) and body dysmorphic disorder. He was admitted for respiratory failure and sepsis. The second case involved in a 33-year-old woman that had Hodgkinien lymphoma associated to tuberculosis. Identification was performed using commercial systems and confirmed by PCR sequencing of internal transcribed spacer, ITS1 and ITS2 regions of rDNA. Antifungal susceptibility tested by sensititre yeast revealed susceptibility to amphotericin B and resistance to fluconazole for the two strains. These cases emphasize the emerging importance of Rhodotorula sp. as a pathogen and it must be considered a potential pathogen in patients with immunosupression and with central venous catheters. Correct identification is mandatory for appropriate management, as Rhodotorula spp. are resistant to antifungal agents, such as fluconazole. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Plasma cell gingivitis - A rare case related to Colocasia (arbi) leaves

PubMed Central

Bali, Deepika; Gill, Sanjeet; Bali, Amit

2012-01-01

Plasma cell gingivitis is an uncommon inflammatory condition of uncertain etiology often flavoured chewing gum, spices, foods, candies, or dentifrices. The diagnosis of plasma cell gingivitis is based on comprehensive history taking, clinical examination, and appropriate diagnostic tests. Here we are presenting a rare case of plasma cell gingivitis caused by consumption of colocasia (arbi) leaves. Colocasia is a kind of vegetable, very commonly consumed in the regions of North India. PMID:23230358

Papillary tumor of the pineal region: Case report and review of the literature.

PubMed

Cañizares Méndez, María de Los Ángeles; Amosa Delgado, Manuel; Álvarez Salgado, Juan Antonio; Villaseñor Ledezma, Jorge Javier; Capilla Cabezuelo, Elena; Díaz Crespo, Francisco

2018-04-22

Papillary tumor of the pineal region is a rare neuroepithelial tumor characterized by papillary architecture and epithelial cytology, immunopositivity for cytokeratin and ependymal differentiation. It is considered grade II-III by the World Health Organization and was first described by Jouvet in 2003. We present a 34-year-old male with headaches, blurred vision and normal examination. Radiological study showed a nodulocystic lesion in the pineal region compatible with pineocytoma. Surgery was performed using an infratentorial supracerebellar approach, finding a cystic tumor in the quadrigeminal cistern which was completely resected. Histopathology reported a papillary tumor of the pineal region. The patient made good progress without adjuvant therapy, and after 57 months of follow-up he remained asymptomatic and free of recurrence. A review of the literature was performed to collect all the cases published with gross total resection and no complementary treatment. In conclusion, there is still much to be learned about the pathogenesis, prognosis and management of this tumor. Copyright © 2018 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

Laguerre-polynomial-weighted squeezed vacuum: generation and its properties of entanglement

NASA Astrophysics Data System (ADS)

Ye, Wei; Zhang, Kuizheng; Zhang, Haoliang; Xu, Xuexiang; Hu, Liyun

2018-02-01

We theoretically prepare a kind of two-mode entangled non-Gaussian state generated by combining quantum catalysis and parametric-down amplifier operated on the two-mode squeezing vacuum state. We then investigate the entanglement properties by examining Von Neumann entropy, EPR correlation, squeezing effect and the fidelity of teleportation. It is shown that only Von Neumann entropy can be enhanced by both single- and two-mode catalysis in a small squeezing region, while the other properties can be enhanced only by two-mode catalysis including symmetrical and asymmetrical cases. A comparison among these properties shows that the squeezing and the EPR correlation definitely lead to the improvement of both the entanglement and the fidelity, and the region of enhanced fidelity can be seen as a sub-region of the enhanced entanglement which indicates that the entanglement is not always beneficial for the fidelity. In addition, the effect of photon-loss after catalysis on the fidelity is considered and the symmetrical two-photon catalysis may present better behavior than the symmetrical single-photon case against the decoherence in a certain region.

Atomic oxygen between 80 and 120 km: Evidence for a rapid spatial variation in vertical transport near the ionosphere

NASA Technical Reports Server (NTRS)

Donahue, T. M.; Wasser, B.

1977-01-01

Analysis of OGO-6 OI green line photometer results was carried out for 8 cases when the alignment of the spacecraft was such that local emission rates could be determined below the altitude of maximum emission and down to about 80 km. Results show a variation on a scale of 6 deg to 8 deg in latitude between regions where the emission rate increases rapidly between 90 and 95 km and regions where it increases slowly from 80 km to 95 km. Latitude-altitude maps of iso-emissivity contours and iso-density contours for oxygen concentration are presented. The latter are computed under 3 assumptions concerning excitation mechanisms. Comparisons of the spatial variations of oxygen density with the results of a time dependent theory suggest the regions of strong downward transport alternate on a scale of about 1000 km with regions of weak transport near 90 km. In the first case conversion of O to O3 at night appears to be overwhelmed by downward transport of O.

Relationship between masseter muscle form and occlusal supports of remaining teeth.

PubMed

Tetsuka, Makoto; Saga, Tsuyoshi; Nakamura, Moriyoshi; Tabira, Yoko; Kusukawa, Jingo; Yamaki, Koh-Ichi

2012-01-01

To chew, it is necessary to maintain harmony between the masseter muscle and other organs. Various studies have been conducted on the masseter muscle, but none has examined the relationships among masseter muscle form, occlusal support of remaining teeth, and maxillofacial morphology. Thus, we conducted the present study using cadavers donated to anatomy practice. After the masseter muscle was extracted, its length, width, thickness, and volume were measured; histological observations were conducted; and the muscle fiber cross-sectional area and muscle density were calculated. In addition, denture use and non-use were examined. The results showed that when regional support loss occurs, muscle fiber thickness and density decrease. This in turn causes masseter muscle thickness and volume to decrease, resulting in muscle atrophy. Furthermore, excluding Eichner class A cases (all regions intact), the thickness of the masseter muscle is greatest when the premolar support region remains. The premolar support region was shown to have the most impact on masseter muscle morphology. These results suggest that atrophy of the masseter muscle can be arrested or improved with the use of dentures in the case of tooth loss.

Electrocardiographic findings in Mexican chagasic subjects living in high and low endemic regions of Trypanosoma cruzi infection.

PubMed

Sosa-Jurado, Francisca; Mazariego-Aranda, Miguel; Hernández-Becerril, Nidia; Garza- Murillo, Verónica; Cárdenas, Manuel; Reyes, Pedro A; Hirayama, Kenji; Monteón, Victor M

2003-07-01

In México the first human chronic chagasic case was recognized in 1940. In spite of an increasing number of cases detected since that time, Chagas disease in México has been poorly documented. In the present work we studied 617 volunteers subjects living in high and low endemic regions of Trypanosoma cruzi infection with seroprevalence of 22% and 4% respectively. Hemoculture performed in those seropositive subjects failed to demonstrate circulating parasites, however polymerase chain reaction identified up to 60% of them as positives. A higher level of anti-T. cruzi antibodies was observed in seropositive residents in high endemic region, in spite of similar parasite persistence (p < 0.05). On standard 12 leads electrocardiogram (ECG) 20% to 22% seropositive individuals from either region showed right bundle branch block or ventricular extrasystoles which were more prevalent in seropositive than in seronegative individuals (p < 0.05). In conclusion, the frequency or type of ECG abnormality was influenced by serologic status but not by endemicity or parasite persistence. Furthermore, Mexican indeterminate patients have a similar ECG pattern to those reported in South America.

An improved method for calculating power density in the Fresnel region of circular parabolic reflector antennas

NASA Astrophysics Data System (ADS)

Mize, Johnnie E.

1988-03-01

A computer program is presented which calculates power density in the Fresnel region of circular parabolic reflector antennas. The aperture illumination model is the one-parameter circular distribution developed by Hansen. The program is applicable to the analysis of electrically large, center-fed (or Cassegrain) paraboloids with linearly polarized feeds. The scalar Kirchoff diffraction integral is solved numerically by Romberg integration for points both on and perpendicular to the antenna boresight. Axial results cannot be directly compared to any others obtained with this illumination model, but they are consistent with what is expected in the Fresnel region where a quadratic must be added to the linear phase term of the integral expression. Graphical results are presented for uniform illumination and for cases where the first sidelobe ratio is 20, 25, 30, and 35 dB.

Two novel translocation breakpoints upstream of SOX9 define borders of the proximal and distal breakpoint cluster region in campomelic dysplasia.

PubMed

Leipoldt, M; Erdel, M; Bien-Willner, G A; Smyk, M; Theurl, M; Yatsenko, S A; Lupski, J R; Lane, A H; Shanske, A L; Stankiewicz, P; Scherer, G

2007-01-01

The semilethal skeletal malformation syndrome campomelic dysplasia (CD) with or without XY sex reversal is caused by mutations within the SOX9 gene on 17q24.3 or by chromosomal aberrations (translocations, inversions or deletions) with breakpoints outside the SOX9 coding region. The previously published CD translocation breakpoints upstream of SOX9 fall into two clusters: a proximal cluster with breakpoints between 50-300 kb and a distal cluster with breakpoints between 899-932 kb. Here, we present clinical, cytogenetic and molecular data from two novel CD translocation cases. Case 1 with karyotype 46,XY,t(1;17)(q42.1;q24.3) has characteristic symptoms of CD, including mild tibial bowing, cryptorchidism and hypospadias. By standard fluorescence in situ hybridization (FISH) and by high-resolution fiber FISH, the 17q breakpoint was mapped 375 kb from SOX9, defining the centromeric border of the proximal breakpoint cluster region. Case 2 with karyotype 46,X,t(Y;17)(q11.2;q24.3) has the acampomelic form of CD and complete XY sex reversal. By FISH and somatic cell hybrid analysis, the 17q breakpoint was mapped 789 kb from SOX9, defining the telomeric border of the distal breakpoint cluster region. We discuss the structure of the 1 Mb cis-control region upstream of SOX9 and the correlation between the position of the 14 mapped translocation breakpoints with respect to disease severity and XY sex reversal.

Clarus multi-state regional demonstrations, evaluation of use case #5 : enhanced road weather content for traveler advisories.

DOT National Transportation Integrated Search

2011-05-11

This evaluation report presents an assessment of the benefits of a new road condition forecast tool that offers road weather information to travelers. The tool has been developed by Meridian Environmental Technology, Inc. and has been demonstrated in...

Reemerging threat of epidemic typhus in Algeria.

PubMed

Mokrani, K; Fournier, P E; Dalichaouche, M; Tebbal, S; Aouati, A; Raoult, D

2004-08-01

We report a case of epidemic typhus in a patient from the Batna region of Algeria, who presented with generalized febrile exanthema. The clinical diagnosis was confirmed by serological cross-adsorption followed by Western blotting. Our report emphasizes the threat of epidemic typhus in the highlands of Algeria.

Neurogenic Thoracic Outlet Syndrome Caused by Vascular Compression of the Brachial Plexus: A Report of Two Cases

PubMed Central

Hanna, Amgad; Bodden, Larry O'Neil; Siebiger, Gabriel R. L.

2018-01-01

Thoracic outlet syndrome (TOS) is caused by compression of the brachial plexus and/or subclavian vessels as they pass through the cervicothoracobrachial region, exiting the chest. There are three main types of TOS: neurogenic TOS, arterial TOS, and venous TOS. Neurogenic TOS accounts for approximately 95% of all cases, and it is usually caused by physical trauma (posttraumatic etiology), chronic repetitive motion (functional etiology), or bone or muscle anomalies (congenital etiology). We present two cases in which neurogenic TOS was elicited by vascular compression of the inferior portion of the brachial plexus. PMID:29497457

[HIV infection in the Stavropol' region].

PubMed

Filonenko, N G; Isaev, V P; Pelikh, N L

2001-01-01

The data on the dynamics of HIV infection in the Stavropol Territory beginning with 1987 are given. The situation became aggravated after 1996, and its sharp deterioration occurred in 2000 when 138 cases of HIV infection were detected and the area of this infection increased. In most cases patients became infected beyond the borders of the territory. About a half of the new cases of HIV infection registered in 2000 were detected in Ingushetia and Chechnya. The leading factor in the spread of HIV infection was the use of drugs by injection. The main trends of the prophylactic work are presented.

Chopart's amputation for resection of clear cell sarcoma of the foot: a case report and review of the literature.

PubMed

Berenji, Manijeh; Kwok-Oleksy, Christina; Dang, Binh Nguyen; Trepal, Michael J; Wallack, Marc K

2009-01-01

Clear cell sarcoma (CCS) is a subset of soft tissue sarcoma that occurs mainly in young Caucasians. Although on initial presentation these growths might not appear to be malignant, CCS has a tendency to disseminate to regional lymph nodes and ultimately develop distant metastasis. We report a case of CCS from our institution, discussing the radiological and pathological findings, surgical treatments, and survival prognoses. To our knowledge, this is the first reported case of using a Chopart's amputation technique in the resection of CCS of the foot. 4.

Combination of Face Regions in Forensic Scenarios.

PubMed

Tome, Pedro; Fierrez, Julian; Vera-Rodriguez, Ruben; Ortega-Garcia, Javier

2015-07-01

This article presents an experimental analysis of the combination of different regions of the human face on various forensic scenarios to generate scientific knowledge useful for the forensic experts. Three scenarios of interest at different distances are considered comparing mugshot and CCTV face images using MORPH and SC face databases. One of the main findings is that inner facial regions combine better in mugshot and close CCTV scenarios and outer facial regions combine better in far CCTV scenarios. This means, that depending of the acquisition distance, the discriminative power of the facial regions change, having in some cases better performance than the full face. This effect can be exploited by considering the fusion of facial regions which results in a very significant improvement of the discriminative performance compared to just using the full face. © 2015 American Academy of Forensic Sciences.

Spontaneous cervical epidural hematomas with acute hemiparesis should be considered a contraindication for intravenous thrombolysis: a case report with a literature review of 50 cases.

PubMed

Ito, Hirotaka; Takai, Keisuke; Taniguchi, Makoto

2014-01-01

We herein report the case of a 63-year-old woman with an acute spontaneous cervical epidural hematoma who presented with acute hemiparesis and was successfully managed with surgery. Based on a literature review of 50 cases of spontaneous cervical epidural hematomas, we concluded that the relatively high frequency of hemiparesis (12 of 50 cases, 24%) is the result of the fact that epidural hematomas are predominantly distributed dorsolaterally in the region of the mid and lower cervical spine, leading to unilateral cervical cord compression. Clinicians should keep in mind that acute hemiparesis can be caused by spontaneous cervical epidural hematomas for which intravenous thrombolysis is contraindicated.

Automated coronary artery calcification detection on low-dose chest CT images

NASA Astrophysics Data System (ADS)

Xie, Yiting; Cham, Matthew D.; Henschke, Claudia; Yankelevitz, David; Reeves, Anthony P.

2014-03-01

Coronary artery calcification (CAC) measurement from low-dose CT images can be used to assess the risk of coronary artery disease. A fully automatic algorithm to detect and measure CAC from low-dose non-contrast, non-ECG-gated chest CT scans is presented. Based on the automatically detected CAC, the Agatston score (AS), mass score and volume score were computed. These were compared with scores obtained manually from standard-dose ECG-gated scans and low-dose un-gated scans of the same patient. The automatic algorithm segments the heart region based on other pre-segmented organs to provide a coronary region mask. The mitral valve and aortic valve calcification is identified and excluded. All remaining voxels greater than 180HU within the mask region are considered as CAC candidates. The heart segmentation algorithm was evaluated on 400 non-contrast cases with both low-dose and regular dose CT scans. By visual inspection, 371 (92.8%) of the segmentations were acceptable. The automated CAC detection algorithm was evaluated on 41 low-dose non-contrast CT scans. Manual markings were performed on both low-dose and standard-dose scans for these cases. Using linear regression, the correlation of the automatic AS with the standard-dose manual scores was 0.86; with the low-dose manual scores the correlation was 0.91. Standard risk categories were also computed. The automated method risk category agreed with manual markings of gated scans for 24 cases while 15 cases were 1 category off. For low-dose scans, the automatic method agreed with 33 cases while 7 cases were 1 category off.

Identifying Opportunities for Decision Support Systems in Support of Regional Resource Use Planning: An Approach Through Soft Systems Methodology.

PubMed

Zhu; Dale

2000-10-01

/ Regional resource use planning relies on key regional stakeholder groups using and having equitable access to appropriate social, economic, and environmental information and assessment tools. Decision support systems (DSS) can improve stakeholder access to such information and analysis tools. Regional resource use planning, however, is a complex process involving multiple issues, multiple assessment criteria, multiple stakeholders, and multiple values. There is a need for an approach to DSS development that can assist in understanding and modeling complex problem situations in regional resource use so that areas where DSSs could provide effective support can be identified, and the user requirements can be well established. This paper presents an approach based on the soft systems methodology for identifying DSS opportunities for regional resource use planning, taking the Central Highlands Region of Queensland, Australia, as a case study.

Hints of a rotating spiral structure in the innermost regions around IRC +10216

PubMed Central

Quintana-Lacaci, G.; Cernicharo, J.; Agúndez, M.; Prieto, L. Velilla; Castro-Carrizo, A.; Marcelino, N.; Cabezas, C.; Peña, I.; Alonso, J.L.; Zúñiga, J.; Requena, A.; Bastida, A.; Kalugina, Y.; Lique, F.; Guélin, M.

2016-01-01

The Atacama Large Millimeter/submillimeter Array (ALMA) is allowing us to study the innermost regions of the circumstellar envelopes of evolved stars with un-precedented precision and sensitivity. Key processes in the ejection of matter and dust from these objects occur in their inner zones. In this work, we present sub-arcsecond interferometric maps of transitions of metal-bearing molecules towards the prototypical C-rich evolved star IRC +10216. While Al-bearing molecules seem to be present as a roughly spherical shell, the molecular emission from the salts NaCl and KCl presents an elongation in the inner regions, with a central minimum. In order to accurately analyze the emission from the NaCl rotational lines, we present new calculations of the collisional rates for this molecule based on new spectroscopic constants. The most plausible interpretation for the spatial distribution of the salts is a spiral with a NaCl mass of 0.08M☉. Alternatively, a torus of gas and dust would result in similar structures as those observed. From the torus scenario we derive a mass of ~ 1.1 × 10−4M☉. In both cases, the spiral and the torus, the NaCl structure presents an inner minimum of 27 AU. In the case of the torus, the outer radius is 73 AU. The kinematics of both the spiral and the torus suggests that they are slowly expanding and rotating. Alternative explanations for the presence of the elongation are explored. The presence of these features only in KCl and NaCl might be a result of their comparatively high dipole moment with respect to the Al-bearing species. PMID:26997665

Hints of a rotating spiral structure in the innermost regions around IRC +10216.

PubMed

Quintana-Lacaci, G; Cernicharo, J; Agúndez, M; Prieto, L Velilla; Castro-Carrizo, A; Marcelino, N; Cabezas, C; Peña, I; Alonso, J L; Zúñiga, J; Requena, A; Bastida, A; Kalugina, Y; Lique, F; Guélin, M

2016-02-20

The Atacama Large Millimeter/submillimeter Array (ALMA) is allowing us to study the innermost regions of the circumstellar envelopes of evolved stars with un-precedented precision and sensitivity. Key processes in the ejection of matter and dust from these objects occur in their inner zones. In this work, we present sub-arcsecond interferometric maps of transitions of metal-bearing molecules towards the prototypical C-rich evolved star IRC +10216. While Al-bearing molecules seem to be present as a roughly spherical shell, the molecular emission from the salts NaCl and KCl presents an elongation in the inner regions, with a central minimum. In order to accurately analyze the emission from the NaCl rotational lines, we present new calculations of the collisional rates for this molecule based on new spectroscopic constants. The most plausible interpretation for the spatial distribution of the salts is a spiral with a NaCl mass of 0.08 M ☉ . Alternatively, a torus of gas and dust would result in similar structures as those observed. From the torus scenario we derive a mass of ~ 1.1 × 10 -4 M ☉ . In both cases, the spiral and the torus, the NaCl structure presents an inner minimum of 27 AU. In the case of the torus, the outer radius is 73 AU. The kinematics of both the spiral and the torus suggests that they are slowly expanding and rotating. Alternative explanations for the presence of the elongation are explored. The presence of these features only in KCl and NaCl might be a result of their comparatively high dipole moment with respect to the Al-bearing species.

Hints of a Rotating Spiral Structure in the Innermost Regions around IRC+10216

NASA Astrophysics Data System (ADS)

Quintana-Lacaci, G.; Cernicharo, J.; Agúndez, M.; Velilla Prieto, L.; Castro-Carrizo, A.; Marcelino, N.; Cabezas, C.; Peña, I.; Alonso, J. L.; Zúñiga, J.; Requena, A.; Bastida, A.; Kalugina, Y.; Lique, F.; Guélin, M.

2016-02-01

The Atacama Large Millimeter/submillimeter Array is allowing us to study the innermost regions of the circumstellar envelopes of evolved stars with unprecedented precision and sensitivity. Key processes in the ejection of matter and dust from these objects occur in their inner zones. In this work, we present sub-arcsecond interferometric maps of transitions of metal-bearing molecules toward the prototypical C-rich evolved star IRC +10216. While Al-bearing molecules seem to be present as a roughly spherical shell, the molecular emission from the salts NaCl and KCl presents an elongation in the inner regions with a central minimum. In order to accurately analyze the emission from the NaCl rotational lines, we present new calculations of the collisional rates for this molecule based on new spectroscopic constants. The most plausible interpretation for the spatial distribution of the salts is a spiral with a NaCl mass of 0.08 {M}⊙ . Alternatively, a torus of gas and dust would result in structures similar to those observed. From the torus scenario we derive a mass of ˜1.1 × 10-4 {M}⊙ . In both cases, the spiral and the torus, the NaCl structure presents an inner minimum of 27 AU. In the case of the torus, the outer radius is 73 AU. The kinematics of both the spiral and the torus suggests that they are slowly expanding and rotating. Alternative explanations for the presence of the elongation are explored. The presence of these features only in KCl and NaCl might be a result of their comparatively high dipole moment with respect to the Al-bearing species.

Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya

PubMed Central

Al-Dwibe, Hamida; Gashout, Aisha; Moskalenko, Olga; Galafin, Marlena; Hamarsheh, Omar; Frohme, Marcus; Jaeschke, Anja; Schönian, Gabriele; Kuhls, Katrin

2017-01-01

Background Cutaneous leishmaniasis (CL) is a major public health problem in Libya. In this paper, we describe the eco-epidemiological parameters of CL during the armed conflict period from January 2011 till December 2012. Current spatiotemporal distributions of CL cases were explored and projected to the future using a correlative modelling approach. In addition the present results were compared with our previous data obtained for the time period 1995–2008. Methodology/Principal findings We investigated 312 CL patients who presented to the Dermatology Department at the Tripoli Central Hospital and came from 81 endemic areas distributed in 10 districts. The patients presented with typical localized lesions which appeared commonly on the face, arms and legs. Molecular identification of parasites by a PCR-RFLP approach targeting the ITS1 region of the rDNA was successful for 81 patients with two causative species identified: L. major and L. tropica comprised 59 (72.8%) and 22 (27.2%) cases, respectively. Around 77.3% of L. tropica CL and 57.7% of L. major CL caused single lesions. Five CL patients among our data set were seropositive for HIV. L. tropica was found mainly in three districts, Murqub (27.3%), Jabal al Gharbi (27.3%) and Misrata (13.7%) while L. major was found in two districts, in Jabal al Gharbi (61%) and Jafara (20.3%). Seasonal occurrence of CL cases showed that most cases (74.2%) admitted to the hospital between November and March, L. major cases from November till January (69.4%), and L. tropica cases mainly in January and February (41%). Two risk factors were identified for the two species; the presence of previously infected household members, and the presence of rodents and sandflies in patient’s neighborhoods. Spatiotemporal projections using correlative distribution models based on current case data and climatic conditions showed that coastal regions have a higher level of risk due to more favourable conditions for the transmitting vectors. Conclusion Future projection of CL until 2060 showed a trend of increasing incidence of CL in the north-western part of Libya, a spread along the coastal region and a possible emergence of new endemics in the north-eastern districts of Libya. These results should be considered for control programs to prevent the emergence of new endemic areas taking also into consideration changes in socio-economical factors such as migration, conflicts, urbanization, land use and access to health care. PMID:28880944

Female children with ambiguous genitalia in awareness-poor subregion.

PubMed

Osifo, Osarumwense D; Amusan, Taiwo I

2009-12-01

Congenital aberrations of female children's external genitalia are common worldwide with varied mode of presentation especially in regions with poor awareness. This prospective experience between July 2004 and June 2008 at two Nigerian healthcare facilities is on the mode of presentation and challenges of management of female children with ambiguous genitalia. Congenital adrenal hyperplasia (CAH) 19 (47.5%), female pseudohermaphroditism 20 (50%) and vaginal atresia 1 (2.5%) manifested as aberrations of external genitalia of 40 female children who presented between the ages of 3 months and 16 years (average 9 years). Cultural influence, lack of awareness, inadequate examination of external genitalia at birth and lack of diagnostic facilities resulted in late presentation and diagnosis with all the cases of CAH and pseudohermaphroditism raised as males. Five cases who developed female secondary sexual characteristics at puberty attempted suicide before presentation. Gender reassignment and feminizing genitoplasty were major challenges, but outcomes were encouraging.

On optimal soft-decision demodulation. [in digital communication system

NASA Technical Reports Server (NTRS)

Lee, L.-N.

1976-01-01

A necessary condition is derived for optimal J-ary coherent demodulation of M-ary (M greater than 2) signals. Optimality is defined as maximality of the symmetric cutoff rate of the resulting discrete memoryless channel. Using a counterexample, it is shown that the condition derived is generally not sufficient for optimality. This condition is employed as the basis for an iterative optimization method to find the optimal demodulator decision regions from an initial 'good guess'. In general, these regions are found to be bounded by hyperplanes in likelihood space; the corresponding regions in signal space are found to have hyperplane asymptotes for the important case of additive white Gaussian noise. Some examples are presented, showing that the regions in signal space bounded by these asymptotic hyperplanes define demodulator decision regions that are virtually optimal.

Calculation of oblique-shock-wave laminar-boundary-layer interaction on a flat plate

NASA Technical Reports Server (NTRS)

Goldberg, U.; Reshotko, E.

1980-01-01

A finite difference solution to the problem of the interaction between an impinging oblique shock wave and the laminar boundary layer on a flat plate is presented. The boundary layer equations coupled with the Prandtl-Meyer relation for the external flow are used to calculate the flow field. A method for the calculation of the separated flow region is presented and discussed. Comparisons between this theory and the experimental results of other investigators show fairly good agreement. Results are presented for the case of a cooled wall with an oncoming flow at Mach number 2.0 without and with suction. The results show that a small amount of suction greatly reduces the extent of the separated region in the vicinity of the shock impingement location.

MODFLOW-LGR: Practical application to a large regional dataset

NASA Astrophysics Data System (ADS)

Barnes, D.; Coulibaly, K. M.

2011-12-01

In many areas of the US, including southwest Florida, large regional-scale groundwater models have been developed to aid in decision making and water resources management. These models are subsequently used as a basis for site-specific investigations. Because the large scale of these regional models is not appropriate for local application, refinement is necessary to analyze the local effects of pumping wells and groundwater related projects at specific sites. The most commonly used approach to date is Telescopic Mesh Refinement or TMR. It allows the extraction of a subset of the large regional model with boundary conditions derived from the regional model results. The extracted model is then updated and refined for local use using a variable sized grid focused on the area of interest. MODFLOW-LGR, local grid refinement, is an alternative approach which allows model discretization at a finer resolution in areas of interest and provides coupling between the larger "parent" model and the locally refined "child." In the present work, these two approaches are tested on a mining impact assessment case in southwest Florida using a large regional dataset (The Lower West Coast Surficial Aquifer System Model). Various metrics for performance are considered. They include: computation time, water balance (as compared to the variable sized grid), calibration, implementation effort, and application advantages and limitations. The results indicate that MODFLOW-LGR is a useful tool to improve local resolution of regional scale models. While performance metrics, such as computation time, are case-dependent (model size, refinement level, stresses involved), implementation effort, particularly when regional models of suitable scale are available, can be minimized. The creation of multiple child models within a larger scale parent model makes it possible to reuse the same calibrated regional dataset with minimal modification. In cases similar to the Lower West Coast model, where a model is larger than optimal for direct application as a parent grid, a combination of TMR and LGR approaches should be used to develop a suitable parent grid.

Snakebites notified to the poison control center of Morocco between 2009 and 2013.

PubMed

Chafiq, Fouad; El Hattimy, Faiçal; Rhalem, Naima; Chippaux, Jean-Philippe; Soulaymani, Abdelmajid; Mokhtari, Abdelrhani; Soulaymani-Bencheikh, Rachida

2016-01-01

Snakebites cause considerable death and injury throughout the globe, particularly in tropical regions, and pose an important yet neglected threat to public health. In 2008, the Centre Anti Poison et de Parmacovigilance du Maroc (CAPM) started to set up a specific strategy for the control of snakebites that was formalized in 2012. The aim of the present study is to describe and update the epidemiological characteristics of snakebites notified to CAPM between 2009 and 2013. This retrospective five-year study included all cases of snakebites notified to CAPM by mail or phone. During the study period, 873 snakebite cases were reported to CAPM, an average incidence of 2.65 cases per 100,000 inhabitants with 218 cases each year. The highest incidence was found in Tangier-Tetouan region with 357 cases (40.9 %) followed by Souss Massa Draa region with 128 cases (14.6 %). The average age of patients was 26.8 ± 17.2 years. The male to female sex ratio was 1.67:1 and 77 % of cases occurred in rural areas. The bites occurred mainly in spring (44 %) followed by summer (42 %). Snake species was identified in 54 cases (6.2 %): colubrids represented 31 % (n = 18) and vipers 67 % (n = 36), mainly Daboia mauritanica, Bitis arietans and Cerastes cerastes. In 311 cases (35.6 %), the patients showed viper syndrome. Thrombocytopenia was observed in 23.5 % of viper syndrome cases, whereas, compartment syndrome was observed in 7.6 % patients. FAV-Afrique® was administered in 41 patients (5 %). In patients treated with antivenom, 38 patients recovered and three died. Twenty-seven deaths were reported (3.9 %). Despite specific efforts to better understand the epidemiology of snakebites in Morocco (incidence, severity, snake species involved), it remains underestimated. Therefore, further work is still necessary to ensure accessibility of appropriate antivenom against venomous species and to improve the management of envenomation in Morocco.

Ophthalmoparesis, papillitis and premacular hemorrhage in a case with endocarditis: A rare presentation of brucellosis

PubMed Central

Sahin, Özlem Gürses; Pelit, Aysel; Turunc, Tuğba; Akova, Yonca Aydin

2010-01-01

We report a rare presentation of brucellosis as bilateral optic nerve and right abducent nerve involvement, and endocarditis complicated by right premacular hemorrhage in a 28-year-old white female. The patient showed improvement with both medical and surgical therapy. Brucellosis should be considered in the differential diagnosis of papillitis, gaze palsy and endocarditis complicated with premacular hemorrhage in endemic regions. PMID:20195047

Metastatic hidradenocarcinoma: Surgery and chemotherapy.

PubMed

Amel, Trabelsi; Olfa, Gharbi; Faten, Hammedi; Makrem, Hochlef; Slim, Ben Ahmed; Moncef, Mokni

2009-12-01

Hidradenocarcinoma is a rare carcinoma of high malignant potential. It most metastasizes to regional lymph nodes and distant viscera. We report a case of 52-year-old woman who presented with an invasive hidradenocarcinoma of the finger, treated with surgical excision. The patient presented with skin and lymph node metastases four years after, treated by chemotherapy. Hidradenocarcinoma is an aggressive tumor. It seems important to use adjuvant therapies particularly for recurrent and metastatic forms.

Impact of the lower third molar presence and position on the fragility of mandibular angle and condyle: A Three-dimensional finite element study.

PubMed

Antic, Svetlana; Vukicevic, Arso M; Milasinovic, Marko; Saveljic, Igor; Jovicic, Gordana; Filipovic, Nenad; Rakocevic, Zoran; Djuric, Marija

2015-07-01

The aim of the present study was to investigate the influences of the presence and position of a lower third molar (M3) on the fragility of mandibular angle and condyle, using finite element analysis. From computed tomographic scans of a human mandible with normally erupted M3, two additional virtual models were generated: a mandibular model with partially impacted M3 and a model without M3. Two cases of impact were considered: a frontal and a lateral blow. The results are based on the chromatic analysis of the distributed von Mises and principal stresses, and calculation of their failure indices. In the frontal blow, the angle region showed the highest stress in the case with partially impacted M3, and the condylar region in the case without M3. Compressive stresses were dominant but caused no failure. Tensile stresses were recorded in the retromolar areas, but caused failure only in the case with partially impacted M3. In the lateral blow, the stress concentrated at the point of impact, in the ipsilateral and contralateral angle and condylar regions. The highest stresses were recorded in the case with partially impacted M3. Tensile stresses caused the failure on the ipsilateral side, whereas compressive stresses on the contralateral side. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

A two-year follow-up study of temporomandibular disorders in a female Sami population: validation of cases and controls as predicted by questionnaire.

PubMed

Storm, Christina; Wänman, Anders

2007-11-01

The first aim of this study was to validate persistent, severe symptoms of temporomandibular disorders (TMD) among Sami females, as predicted by questionnaire. The second aim was to establish diagnoses according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis 1 among predicted cases and controls. The third aim was to compare subjects with severe TMD to controls in regard to dental occlusion, general health, and parafunctions. The subjects, Sami females living in the Arctic region of northern Sweden, all with long-standing (>or=1 year), intense (>or=5 on NS), and frequent (>or=once a week) symptoms of pain and dysfunction in the jaw-face region, were invited for clinical examination; 22 (63%) agreed to participate. Forty-six subjects with no symptoms in the jaw-face region were matched to these cases in accordance with five age groups. The examiner was blind to subject affiliation. The positive predictive value of presenting with signs and symptoms of TMD at follow-up was 0.82; the negative value was 0.87. Cases reported impaired general health and awareness of parafunctions significantly more frequently than did controls. Registered dental occlusion factors did not distinguish cases from controls. Long-standing, intense, and frequent TMD symptoms remained essentially unchanged over the 2-year follow-up of females in a Sami population. Presence of severe TMD was related to impaired general health and awareness of oral parafunctions.

South Asia river-flow projections and their implications for water resources

NASA Astrophysics Data System (ADS)

Mathison, C.; Wiltshire, A. J.; Falloon, P.; Challinor, A. J.

2015-12-01

South Asia is a region with a large and rising population, a high dependence on water intense industries, such as agriculture and a highly variable climate. In recent years, fears over the changing Asian summer monsoon (ASM) and rapidly retreating glaciers together with increasing demands for water resources have caused concern over the reliability of water resources and the potential impact on intensely irrigated crops in this region. Despite these concerns, there is a lack of climate simulations with a high enough resolution to capture the complex orography, and water resource analysis is limited by a lack of observations of the water cycle for the region. In this paper we present the first 25 km resolution regional climate projections of river flow for the South Asia region. Two global climate models (GCMs), which represent the ASM reasonably well are downscaled (1960-2100) using a regional climate model (RCM). In the absence of robust observations, ERA-Interim reanalysis is also downscaled providing a constrained estimate of the water balance for the region for comparison against the GCMs (1990-2006). The RCM river flow is routed using a river-routing model to allow analysis of present-day and future river flows through comparison with available river gauge observations. We examine how useful these simulations are for understanding potential changes in water resources for the South Asia region. In general the downscaled GCMs capture the seasonality of the river flows but overestimate the maximum river flows compared to the observations probably due to a positive rainfall bias and a lack of abstraction in the model. The simulations suggest an increasing trend in annual mean river flows for some of the river gauges in this analysis, in some cases almost doubling by the end of the century. The future maximum river-flow rates still occur during the ASM period, with a magnitude in some cases, greater than the present-day natural variability. Increases in river flow could mean additional water resources for irrigation, the largest usage of water in this region, but has implications in terms of inundation risk. These projected increases could be more than countered by changes in demand due to depleted groundwater, increases in domestic use or expansion of water intense industries. Including missing hydrological processes in the model would make these projections more robust but could also change the sign of the projections.

An alternative subspace approach to EEG dipole source localization

NASA Astrophysics Data System (ADS)

Xu, Xiao-Liang; Xu, Bobby; He, Bin

2004-01-01

In the present study, we investigate a new approach to electroencephalography (EEG) three-dimensional (3D) dipole source localization by using a non-recursive subspace algorithm called FINES. In estimating source dipole locations, the present approach employs projections onto a subspace spanned by a small set of particular vectors (FINES vector set) in the estimated noise-only subspace instead of the entire estimated noise-only subspace in the case of classic MUSIC. The subspace spanned by this vector set is, in the sense of principal angle, closest to the subspace spanned by the array manifold associated with a particular brain region. By incorporating knowledge of the array manifold in identifying FINES vector sets in the estimated noise-only subspace for different brain regions, the present approach is able to estimate sources with enhanced accuracy and spatial resolution, thus enhancing the capability of resolving closely spaced sources and reducing estimation errors. The present computer simulations show, in EEG 3D dipole source localization, that compared to classic MUSIC, FINES has (1) better resolvability of two closely spaced dipolar sources and (2) better estimation accuracy of source locations. In comparison with RAP-MUSIC, FINES' performance is also better for the cases studied when the noise level is high and/or correlations among dipole sources exist.

Working memory, reasoning, and expertise in medicine-insights into their relationship using functional neuroimaging.

PubMed

Hruska, Pam; Krigolson, Olav; Coderre, Sylvain; McLaughlin, Kevin; Cortese, Filomeno; Doig, Christopher; Beran, Tanya; Wright, Bruce; Hecker, Kent G

2016-12-01

Clinical reasoning is dependent upon working memory (WM). More precisely, during the clinical reasoning process stored information within long-term memory is brought into WM to facilitate the internal deliberation that affords a clinician the ability to reason through a case. In the present study, we examined the relationship between clinical reasoning and WM while participants read clinical cases with functional magnetic resonance imaging (fMRI). More specifically, we examined the impact of clinical case difficulty (easy, hard) and clinician level of expertise (2nd year medical students, senior gastroenterologists) on neural activity within regions of cortex associated with WM (i.e., the prefrontal cortex) during the reasoning process. fMRI was used to scan ten second-year medical students and ten practicing gastroenterologists while they reasoned through sixteen clinical cases [eight straight forward (easy) and eight complex (hard)] during a single 1-h scanning session. Within-group analyses contrasted the easy and hard cases which were then subsequently utilized for a between-group analysis to examine effects of expertise (novice > expert, expert > novice). Reading clinical cases evoked multiple neural activations in occipital, prefrontal, parietal, and temporal cortical regions in both groups. Importantly, increased activation in the prefrontal cortex in novices for both easy and hard clinical cases suggests novices utilize WM more so than experts during clinical reasoning. We found that clinician level of expertise elicited differential activation of regions of the human prefrontal cortex associated with WM during clinical reasoning. This suggests there is an important relationship between clinical reasoning and human WM. As such, we suggest future models of clinical reasoning take into account that the use of WM is not consistent throughout all clinical reasoning tasks, and that memory structure may be utilized differently based on level of expertise.

Effect of Mesoscale and Multiscale Modeling on the Performance of Kevlar Woven Fabric Subjected to Ballistic Impact: A Numerical Study

NASA Astrophysics Data System (ADS)

Jia, Xin; Huang, Zhengxiang; Zu, Xudong; Gu, Xiaohui; Xiao, Qiangqiang

2013-12-01

In this study, an optimal finite element model of Kevlar woven fabric that is more computational efficient compared with existing models was developed to simulate ballistic impact onto fabric. Kevlar woven fabric was modeled to yarn level architecture by using the hybrid elements analysis (HEA), which uses solid elements in modeling the yarns at the impact region and uses shell elements in modeling the yarns away from the impact region. Three HEA configurations were constructed, in which the solid element region was set as about one, two, and three times that of the projectile's diameter with impact velocities of 30 m/s (non-perforation case) and 200 m/s (perforation case) to determine the optimal ratio between the solid element region and the shell element region. To further reduce computational time and to maintain the necessary accuracy, three multiscale models were presented also. These multiscale models combine the local region with the yarn level architecture by using the HEA approach and the global region with homogenous level architecture. The effect of the varying ratios of the local and global area on the ballistic performance of fabric was discussed. The deformation and damage mechanisms of fabric were analyzed and compared among numerical models. Simulation results indicate that the multiscale model based on HEA accurately reproduces the baseline results and obviously decreases computational time.

Achondroplasia with 47, XXY karyotype: a case report of the neonatal diagnosis of an extremely unusual association.

PubMed

Ros-Pérez, Purificación; Regidor, Francisco J; Colino, Esmeralda; Martínez-Payo, Cristina; Barroso, Eva; Heath, Karen E

2012-06-29

The association of achondroplasia and Klinefelter syndrome is extremely rare. To date, five cases have been previously reported, all of them diagnosed beyond the postnatal period, and only one was molecularly characterized. We describe the first case of this unusual association diagnosed in the neonatal period, the clinical findings and the molecular studies undertaken. The boy was born at term with clinical and radiological features indicating the diagnosis of achondroplasia or hypochondroplasia combined with the prenatal karyotype of Klinefelter syndrome (47,XXY). Neonatal FGFR3 mutation screening showed that the newborn was heterozygous for the classic achondroplasia G340R mutation. Microsatellite marker analysis showed that the sex chromosome aneuploidy had arisen from a non-disjunction error in paternal meiosis I, with a recombination event in the pseudoautosomal region 1 (PAR1). Specific mutation analysis is appropriate to confirm the clinical diagnosis of achondroplasia for appropriate diagnosis, prognosis, and genetic counseling, especially when the karyotype does not explain the abnormal prenatal sonographic findings. In the present case, a recombination event was observed in the PAR1 region, although recombinational events in paternally derived Klinefelter syndrome cases are much rarer than expected.

Short report of an unusual ballistic trauma

PubMed Central

Inchingolo, Francesco; Tatullo, Marco; Marrelli, Massimo; Inchingolo, Alessio D.; Pinto, Giorgia; Inchingolo, Angelo M.; Dipalma, Gianna

2011-01-01

INTRODUCTION Portable firearms have a relevant medico-legal interest, being a major cause of injury. Bullet entry wounds generally have a particular appearance, including contusion, skin introflection, and simple or excoriated ecchymosis. The skin wound is typically a hole with frayed margins, whose diameter is smaller than that of the bullet. PRESENTATION OF CASE We report the case of a 19-year-old man with ballistic trauma. Examination of the patient's lesions indicated that the bullet had entered from the left mandibular parasymphysis, creating a small hole without the typical bullet wipe and blackening. Subsequently, the bullet seemed to have fractured the left chin region immediately below the lower alveolar process, and it finally stopped in the submandibular area in the suprahyoid region of the neck. DISCUSSION This case is peculiar because the distinctive features of a firearm injury were absent; the lack of bleeding and edema made the case difficult to interpret without additional diagnostic investigations. CONCLUSION Ballistic trauma can manifest in different ways; therefore, internal trauma should be suspected even in the absence of clear external signs. This case report shows how an unusual bullet entry hole can mask quite serious injuries. PMID:22096751

A study of X-ray multiple diffraction by means of section topography.

PubMed

Kohn, V G; Smirnova, I A

2015-09-01

The results of theoretical and experimental study are presented for the question of how the X-ray multiple diffraction in a silicon single crystal influences the interference fringes of section topography for the 400 reflection in the Laue case. Two different cases of multiple diffraction are discovered for zero and very small values of the azimuthal angle for the sample in the form of a plate with the surface normal to the 001 direction. The cases are seen on the same topogram without rotation of the crystal. Accurate computer simulations of the section topogram for the case of X-ray multiple diffraction are performed for the first time. It is shown that the structure of interference fringes on the section topogram in the region of multiple diffraction becomes more complicated. It has a very sharp dependence on the azimuthal angle. The experiment is carried out using a laboratory source under conditions of low resolution over the azimuthal angle. Nevertheless, the characteristic inclination of the interference fringes on the tails of the multiple diffraction region is easily seen. This phenomenon corresponds completely to the computer simulations.

Addison's disease as a presentation of metastatic malignant melanoma.

PubMed

Srinivasan, B; Patel, M; Ethunandan, M; Ilankovan, V

2016-01-01

Melanoma accounts for 5% of all skin cancers. The risk of metastasis is related to the thickness of the tumour, and can affect local, regional and distant sites. Adrenal metastasis from melanoma of the head and neck is uncommon and often asymptomatic. Addison's disease as a presentation of metastatic melanoma is extremely rare and we are unaware of previous reports in the world literature. We report a case of a patient with metastatic melanoma presenting with signs and symptoms of Addison's disease.

Vulvar Pyogenic Granuloma in a Postmenopausal Woman: Case Report and Review of the Literature

PubMed Central

Arikan, Deniz Cemgil; Kiran, Gurkan; Sayar, Hamide; Kostu, Bulent; Coskun, Ayhan; Kiran, Hakan

2011-01-01

Introduction. Although pyogenic granulomas (PG) are common and benign vascular proliferations of the skin and mucous membranes, they are relatively rare on the vulva. Case Presentation. A 57-year-old G7P7 postmenopausal woman presented with a 3-year history of a foul smell and bleeding lesions in the genital region. A gynecologic examination revealed multiple large papillomatous, pedunculated, and lobulated lesions that were cherry-red and infective in appearance. There was a 2-cm lesion at the upper intersection of the labia majora, a 2-cm lesion on the right labium majus, and a 4-cm lesion on the clitoris. The patient complained of itching, and the lesions were asymptomatic, except for occasional bleeding. All lesions were excised and sent for histopathological examination, which revealed an ulcerated polypoidal structure with extensive proliferation of vascular channels lined by a single layer of endothelium. The histopathological features were consistent with PG. Conclusion. The present case is the first case of multiple pyogenic granulomas on the vulva in a postmenopausal woman. PMID:21912553

Methods for Solving Gas Damping Problems in Perforated Microstructures Using a 2D Finite-Element Solver

PubMed Central

Veijola, Timo; Råback, Peter

2007-01-01

We present a straightforward method to solve gas damping problems for perforated structures in two dimensions (2D) utilising a Perforation Profile Reynolds (PPR) solver. The PPR equation is an extended Reynolds equation that includes additional terms modelling the leakage flow through the perforations, and variable diffusivity and compressibility profiles. The solution method consists of two phases: 1) determination of the specific admittance profile and relative diffusivity (and relative compressibility) profiles due to the perforation, and 2) solution of the PPR equation with a FEM solver in 2D. Rarefied gas corrections in the slip-flow region are also included. Analytic profiles for circular and square holes with slip conditions are presented in the paper. To verify the method, square perforated dampers with 16–64 holes were simulated with a three-dimensional (3D) Navier-Stokes solver, a homogenised extended Reynolds solver, and a 2D PPR solver. Cases for both translational (in normal to the surfaces) and torsional motion were simulated. The presented method extends the region of accurate simulation of perforated structures to cases where the homogenisation method is inaccurate and the full 3D Navier-Stokes simulation is too time-consuming.

Bilateral Mandibular Paramolars

PubMed Central

Dhull, Rachita Singh; Panda, Swagatika; Acharya, Sonu; Yadav, Shweta; Mohanty, Gatha

2014-01-01

ABSTRACT Supernumerary tooth is a developmental anomaly and has been argued to arise from multiple etiologies. These teeth may remain embedded in the alveolar bone or can erupt into the oral cavity. They can cause a variety of complications in the develo­ping dentition. Supernumerary teeth can present in various forms and in any region of the mandible or maxilla, but have a predisposition for the anterior maxilla. Here is the presentation of a case of unusual location of supernumerary teeth located in between mandibular first and second molar region bilaterally. How to cite this article: Dhull KS, Dhull RS, Panda S, Acharya S, Yadav S, Mohanty G. Bilateral Mandibular Paramolars. Int J Clin Pediatr Dent 2014;7(1):40-42. PMID:25206236

Bilateral mandibular paramolars.

PubMed

Dhull, Kanika Singh; Dhull, Rachita Singh; Panda, Swagatika; Acharya, Sonu; Yadav, Shweta; Mohanty, Gatha

2014-01-01

Supernumerary tooth is a developmental anomaly and has been argued to arise from multiple etiologies. These teeth may remain embedded in the alveolar bone or can erupt into the oral cavity. They can cause a variety of complications in the develo-ping dentition. Supernumerary teeth can present in various forms and in any region of the mandible or maxilla, but have a predisposition for the anterior maxilla. Here is the presentation of a case of unusual location of supernumerary teeth located in between mandibular first and second molar region bilaterally. How to cite this article: Dhull KS, Dhull RS, Panda S, Acharya S, Yadav S, Mohanty G. Bilateral Mandibular Paramolars. Int J Clin Pediatr Dent 2014;7(1):40-42.

A case of temporal lobe epilepsy with improvement of clinical symptoms and single photon emission computed tomography findings after treatment with clonazepam.

PubMed

Ide, M; Mizukami, K; Suzuki, T; Shiraishi, H

2000-10-01

A 26-year-old female presented psychomotor seizures, deja vu and amnestic syndrome after meningitis at the age of 14 years. Repeated electroencephalograms (EEG) demonstrated occasional spikes localized in the right temporal region in addition to a considerable amount of theta waves mainly in the right fronto-temporal region. Single photon emission computed tomography (SPECT) showed a marked hypoperfusion corresponding to the region in which the EEG showed abnormal findings, although magnetic resonance imaging (MRI) demonstrated no abnormal findings associated with the clinical features. Treatment with clonazepam in addition to sodium valproate resulted in a remarkable improvement of clinical symptoms (i.e. psychomotor seizures and deja vu), as well as of the EEG and SPECT findings. The present study suggests that SPECT is a useful method not only to determine the localization of regions associated with temporal lobe epilepsy but also to evaluate the effect of treatment in temporal lobe epilepsy.

Computation of multi-dimensional viscous supersonic jet flow

NASA Technical Reports Server (NTRS)

Kim, Y. N.; Buggeln, R. C.; Mcdonald, H.

1986-01-01

A new method has been developed for two- and three-dimensional computations of viscous supersonic flows with embedded subsonic regions adjacent to solid boundaries. The approach employs a reduced form of the Navier-Stokes equations which allows solution as an initial-boundary value problem in space, using an efficient noniterative forward marching algorithm. Numerical instability associated with forward marching algorithms for flows with embedded subsonic regions is avoided by approximation of the reduced form of the Navier-Stokes equations in the subsonic regions of the boundary layers. Supersonic and subsonic portions of the flow field are simultaneously calculated by a consistently split linearized block implicit computational algorithm. The results of computations for a series of test cases relevant to internal supersonic flow is presented and compared with data. Comparison between data and computation are in general excellent thus indicating that the computational technique has great promise as a tool for calculating supersonic flow with embedded subsonic regions. Finally, a User's Manual is presented for the computer code used to perform the calculations.

A new case of partial trisomy 19q (q13.2-->qter) owing to an unusual maternal translocation.

PubMed Central

Valerio, D; Lavorgna, F; Scalona, M; Conte, A

1993-01-01

A new case of trisomy 19q13.2-->qter is described in a male child which was caused by a maternal balanced translocation (13;19)(p13;q13.2). The major clinical features detected in the patient included the following: facial dysmorphism, bilateral coloboma, narrow and hypoplastic nails, cardiac malformations (Fallot's tetralogy), genitourinary and gastrointestinal anomalies, and agenesis of the corpus callosum. A comparison with other reported cases of partial trisomy 19q is presented. A hypothesis is proposed to account for the involvement of p13 regions of different acrocentrics in some cases of familial translocations involving a chromosome 19. Images PMID:8411060

Superfund Record of Decision (EPA Region 3): Voortman Farm Site, Lehigh County, Pennsylvania (first remedial action) June 1988. Final report

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

Not Available

1988-06-30

The 43-acre Voortman Farm site is located in Upper Salucon Township, Lehigh County, Pennsylvania. The site consists of a sinkhole that contained empty battery casings disposed of in late 1979 and early 1980. Citizen complaints in 1980 prompted the prohibition of dumping and subsequent site investigation. In September 1986, the battery casings in the sinkhole caught on fire. Since the battery casings were burning underground, attempts to extinguish the fire remained unsuccessful. There does not appear to be any leaching from any residual metals, contaminated soils or battery casings present. The selected remedial action for the site is included.

[Systemic paracoccidioidomycosis with central nervous system involvement].

PubMed

Duarte, A L; Baruffa, G; Terra, H B; Renck, D V; de Moura, D; Petrucci, C

1999-01-01

A clinical case of a patient bearing systemic paracoccidioidomycosis with regional ganglionic and oral exposure and later pulmonary involvement is presented. The patient was treated with specific drugs (amphotericin B, itraconazole, sulfamethoxazole-trimethoprim) and followed throughout a 6-year period and eventually died showing an extensive involvement of the central nervous system.

FISH SPECIES OCCURRENCE DENSITIES IN NORTHEASTERN LAKES AND THE EXTENT OF NON-NATIVES

EPA Science Inventory

A species' occurrence density is the proportion or number of habitat units (lakes in this case) in a region in which it is present. Reliable estimates of occurrence density should be useful to discussions and decisions about biodiversity, rare species, and non-native invasions. T...

Impaired Verbal Associative Learning after Resection of Left Perirhinal Cortex

ERIC Educational Resources Information Center

Weintrob, David L.; Saling, Michael M.; Berkovic, Samuel F.; Reutens, David C.

2007-01-01

Some patients considered for left temporal lobectomy for epilepsy present with normal verbal learning and no MRI evidence of hippocampal pathology. In order to preserve learning function, the surgical approach in these cases often aims at sparing the hippocampus. Parahippocampal structures, including the left perirhinal region, however, also…

Spectrum of phenotypic anomalies in four families with deletion of the SHOX enhancer region

PubMed Central

2014-01-01

Background SHOX alterations have been reported in 67% of patients affected by Léri-Weill dyschondrosteosis (LWD), with a larger prevalence of gene deletions than point mutations. It has been recently demonstrated that these deletions can involve the SHOX enhancer region, rather that the coding region, with variable phenotype of the affected patients. Here, we report a SHOX gene analysis carried out by MLPA in 14 LWD patients from 4 families with variable phenotype. Case presentation All patients presented a SHOX enhancer deletion. In particular, a patient with a severe bilateral Madelung deformity without short stature showed a homozygous alteration identical to the recently described 47.5 kb PAR1 deletion. Moreover, we identified, for the first time, in three related patients with a severe bilateral Madelung deformity, a smaller deletion than the 47.5 kb PAR1 deletion encompassing the same enhancer region (ECR1/CNE7). Conclusions Data reported in this study provide new information about the spectrum of phenotypic alterations showed by LWD patients with different deletions of the SHOX enhancer region. PMID:25056248

[Impact of a new regional management for postpartum hemorrhages by an audit of severe cases: a before and after study (2002-2005)].

PubMed

Lefèvre, P; Brucato, S; Mayaud, A; Morello, R; Deneux-Tharaux, C; Bouvier-Colle, M-H; Dreyfus, M

2009-05-01

Postpartum haemorrhage (PPH) is still the first cause of maternal mortality in France. Most of these cases include inappropriate management. In 2004, regional guidelines were diffused to all the birthplaces in Basse-Normandie. To assess the impact of this regional management, an epidemiological study "before-after" (2002-2005) has been performed. Part of this study was the evaluation of the management of severe PPH. This study assessed the quality of care for major PPH and the correct follow-up of the guidelines before and after 2004. A clinical audit has been conducted in all the birthplaces from the region to assess the management of all severe PPH identified during 2002 and 2005. PPH were considered as severe when they presented one or more of the following: blood transfusion, uterine embolisation, hemostatic surgery, difference in hemoglobin rates greater than 4 g / dl, or maternal death. All of these cases have been analysed except those defined by hemoglobin difference. Assessment has been carried out by pairs of practitioners (obstetrician and anesthetist) blinded to the origin of the case. Criteria assessed were the quality of care for major PPH, the correct follow-up of the guidelines and the degree of severity of the PPH which was estimated as moderate or severe on clinical arguments. The number of severe PPH was 34 in 2002 and 63 in 2005. The quality of care was increased with rates of inadequate management falling from 32 to 13% (p < 0,02), respectively. The follow-up of the guidelines was correct in the whole area, most of the criteria having been respected in about 90% of cases in 2005. However, active management of the third stage of delivery was only conducted in 71% of cases. The rates of severe PPH were not significantly different between 2002 (44%) and 2005 (38%). The originality from this study is that the modifications of the practices were conducted at a regional level in order to enhance the management of PPH. The assessment which was performed showed that quality of care was improved all over the area but that there is still place to progress.

An anatomical study of arcuate foramen and its clinical implications: a case report.

PubMed

Afsharpour, Salman; Hoiriis, Kathryn T; Fox, R Bruce; Demons, Samuel

2016-01-01

The objective of this paper is to describe the relationship of the vertebral artery (VA) to the Atlas (C1) in the sub-occipital region in the presence of arcuate foramen; and discuss the clinical implications related to manual therapies and surgical implications related to screw placement. This study is an anatomical cadaveric case report of symmetrical bilateral lateral and dorsal arcuate foramina on the C1 dorsal arch. Out of 40 cadavers that were available for use in teaching anatomy in the university setting, three presented with anomalies of the C1 dorsal arch. The sub-occipital regions were skillfully prosected to preserve related structures, especially VAs, sub-occipital and greater occipital nerves. Visual observations, photographs, measurements, and radiographic examinations were performed between January 15, 2014 and August 25, 2014. One cadaver (Specimen A) presented with complete bilateral ossified arcuate foramina, and two presented with partial ossification of the atlanto-occipital membrane. Specimen A presented the bilateral anomaly which is almost symmetrical. The VAs were found passing through double foramina (lateral and dorsal) on each side. Arcuate foramina have been shown to be commonly found anomalies with highly variable shapes and sizes, even in the same individual with a bilateral condition. This study found a rare type of the anomaly associated with the C1 dorsal arch, which protected the VA against manual pressure. However, VA, in this case, would be more susceptible to dissection. The presence of the arcuate foramen would also complicate screw placement during surgery. Clinical pre-screening for signs of vertebrobasilar insufficiency is important for chiropractic and manual therapies.

Detection and sequencing of measles virus from peripheral mononuclear cells from patients with inflammatory bowel disease and autism.

PubMed

Kawashima, H; Mori, T; Kashiwagi, Y; Takekuma, K; Hoshika, A; Wakefield, A

2000-04-01

It has been reported that measles virus may be present in the intestine of patients with Crohn's disease. Additionally, a new syndrome has been reported in children with autism who exhibited developmental regression and gastrointestinal symptoms (autistic enterocolitis), in some cases soon after MMR vaccine. It is not known whether the virus, if confirmed to be present in these patients, derives from either wild strains or vaccine strains. In order to characterize the strains that may be present, we have carried out the detection of measles genomic RNA in peripheral mononuclear cells (PBMC) in eight patients with Crohn's disease, three patients with ulcerative colitis, and nine children with autistic enterocolitis. As controls, we examined healthy children and patients with SSPE, SLE, HIV-1 (a total of eight cases). RNA was purified from PBMC by Ficoll-paque, followed by reverse transcription using AMV; cDNAs were subjected to nested PCR for detection of specific regions of the hemagglutinin (H) and fusion (F) gene regions. Positive samples were sequenced directly, in nucleotides 8393-8676 (H region) or 5325-5465 (from noncoding F to coding F region). One of eight patients with Crohn disease, one of three patients with ulcerative colitis, and three of nine children with autism, were positive. Controls were all negative. The sequences obtained from the patients with Crohn's disease shared the characteristics with wild-strain virus. The sequences obtained from the patients with ulcerative colitis and children with autism were consistent with being vaccine strains. The results were concordant with the exposure history of the patients. Persistence of measles virus was confirmed in PBMC in some patients with chronic intestinal inflammation.

Carcinoma in ectopic breast: a cytological diagnosis.

PubMed

Shukla, Shailaja; Sehgal, Shivali; Rai, Preeti; Agarwal, Kiran

2015-01-01

Ectopic breast carcinoma in the axillary region is rare with an incidence ranging from 0.3-6%. We report a case of infiltrating duct carcinoma in an adult female arising in aberrant breast tissue in the axilla diagnosed on fine needle aspiration cytology. There was history of recent increase in size of the lump which was otherwise present for the past 5 years. This case highlights the role fine needle aspiration cytology can play in the early diagnosis of malignant transformation of lumps.

Bounds of the error of Gauss-Turan-type quadratures

NASA Astrophysics Data System (ADS)

Milovanovic, Gradimir V.; Spalevic, Miodrag M.

2005-06-01

We consider the remainder term of the Gauss-Turan quadrature formulaefor analytic functions in some region of the complex plane containing the interval [-1,1] in its interior. The remainder term is presented in the form of a contour integral over confocal ellipses or circles. A strong error analysis is given for the case with a generalized class of weight functions, introduced recently by Gori and Micchelli. Also, we discuss a general case with an even weight function defined on [-1,1]. Numerical results are included.

Intracranial, intradural aneurysmal bone cyst.

PubMed

Afnan, Jalil; Snuderl, Matija; Small, Juan

2015-01-01

Aneurysmal bone cysts (ABCs) are benign, expansile, blood-filled, osteolytic lesions with internal septations that may be intraosseous or extraosseous. The cysts may cause local mass effect, and changes in the regional vascular supply necessitating intervention. A case of an intracranial, intradural ABC in a young male patient with progressively severe headaches is presented. This is only the third recorded intradural case, the majority of these rare lesions being extracranial and only a minute fraction intracranial. Copyright © 2015 Elsevier Inc. All rights reserved.

Leptospirosis in Greece.

PubMed

Papa, Anna; Kotrotsiou, Tzimoula

2015-09-01

Leptospirosis is a zoonotic disease with increased public health concern worldwide. The disease occurs more often in temperate and tropical regions. The present study analyzes the demographic, epidemiological and clinical data of 168 leptospirosis cases laboratory diagnosed in northern Greece during 1998-2014. Most patients were males, aged 50-69 years, working in animal husbandry or farming. Cases were observed more frequently in summer and autumn. Severity of the disease was correlated with presence of pulmonary involvement and hemorrhagic manifestations. Copyright © 2015 Elsevier B.V. All rights reserved.

[Recurrent herpes zoster with neuralgia].

PubMed

Schwickert, Myriam; Saha, Joyonto

2006-06-01

We present the case of a 40-year-old female patient suffering from recurrent herpes zoster and postherpetic neuralgia. Herpes zoster has recurred several times per year for more than 15 years. At admission, rash localised on the right sacral region and accompanied by neuralgia had lasted for 3 months. Standard out-patient treatment remained unsuccessful. A multimodal integrative therapy regimen including fasting, hydrotherapy, leech application and treatment with autologous blood led to rapid healing of herpetic lesions and persistent pain relief. The case is discussed.

Planning for the baby boomers' healthcare needs: a case study.

PubMed

Albert, Terri C; Johnson, Edward; Gasperino, Daniel; Tokatli, Pinar

2003-01-01

Will the impact of baby boomers, as they age, be a bonanza or a bust for the healthcare system? A range of perspectives prevail, from increasing in-patient admissions capacity to accommodate the sheer numbers, to the creation of a variety of healthcare services and delivery channels that address their unique requirements. This case study presents a top 100, regional hospital's approach to this dilemma. The strategic marketing process using segmentation, targeting, and positioning (STP) was employed to guide the administration's planning and decision making.

Three eyelid localized cutaneous anthrax cases.

PubMed

Esmer, Oktay; Karadag, Remzi; Bilgili, Serap Gunes; Gultepe, Bilge; Bayramlar, Huseyin; Karadag, Ayse Serap

2014-12-01

Anthrax is primarily seen in the developing countries, but it can be a worldwide medical concern due to bioterrorism threats. Palpebral anthrax is a rare form of cutaneous anthrax. Untreated cutaneous anthrax can be lethal. Patients with palpebral anthrax can develop complications including cicatrisation and ectropion. Thus, anthrax should be considered in differential diagnosis for patients presenting with preseptal cellulitis in high-risk regions. Herein, we report three anthrax cases (with different age) involving eyelids that were cured without any complications due to early diagnosis and treatment.

The initiation of coronal mass ejections by newly emerging magnetic flux

NASA Technical Reports Server (NTRS)

Feynman, J.; Martin, S. F.

1995-01-01

We present observational evidence that eruptions of quiescent filaments and associated coronal mass ejections (CMEs) occur as a consequence of the destabilization of large-scale coronal arcades due to interactions between these structures and new and growing active regions. Both statistical and case studies have been carried out. In a case study of a 'bulge' observed by the High-Altitude Observatory Solar Maximum Mission coronagraph, the high-resolution magnetograms from the Big Bear Solar Observatory show newly emerging and rapidly changing flux in the magnetic fields that apparently underlie the bugle. For other case studies and in the statistical work the eruption of major quiescent filaments was taken as a proxy for CME eruption. We have found that two thirds of the quiescent-filament-associated CMEs occurred after substantial amounts of new magnetic flux emerged in the vicinity of the filament. In addition, in a study of all major quiescent filaments and active regions appearing in a 2-month period we found that 17 of the 22 filaments that were associated with new active regions erupted and 26 of the 31 filaments that were not associated with new flux did not erupt. In all cases in which the new flux was oriented favorably for reconnection with the preexisting large-scale coronal arcades; the filament was observed to erupt. The appearance of the new flux in the form of new active regions begins a few days before the eruption and typically is still occurring at the time of the eruption. A CME initiation scenario taking account of these observational results is proposed.

Masking of central diabetes insipidus and hypogonadotrophic hypogonadism by germ cell tumour in suprasellar--pineal region.

PubMed

Isa, S H Md; Wong, M; Khalid, B A K

2006-12-01

A patient with beta hCG-secreting germ cell carcinoma of the pineal and suprasellar regions presented with hydrocephalus, Parinaud's syndrome, hypopituitarism and polyuria. Central diabetes insipidus was strongly suspected although the water deprivation test was not diagnostic. The polyuria however, responded to ADH analogue when the hypothyroidism and hypocortisolism were treated. Pubertal development was evident and serum testosterone was normal despite the low FSH/LH, suggesting hCG stimulation of Leydig cells. This case illustrates that a beta hCG-germ cell tumour of the suprasellar region causing hypopituitarism can mask the presence of central diabetes insipidus and hypogonadotrophic hypogonadism.

Analyzing the presentation and the stigma of schizophrenia in French newspapers.

PubMed

Lampropoulos, Dimitrios; Wolman, Angelika; Apostolidis, Thémis

2017-12-01

It has been suggested that the stigmatizing presentation of people with schizophrenia by newspapers is an example of structural stigma. In this study, we explore how French newspapers contribute to the stigma of people with schizophrenia. All the articles of eight major newspapers (four national and four regional) that include the term schizophr* and that were published in 2015 were therefore analyzed using a coding scheme that we developed inductively. This analysis showed that among the identified themes, 40.4% of the articles used the term schizophrenia metaphorically and 28.3% referred to dangerousness. The first concerned mostly national newspapers, while the second were mostly published by regional newspapers. A more selective analysis was also carried out on these major themes in order to investigate how the "us" against "them" distinction is created and how negative stereotypes are associated with this distinction. In the case of the metaphorical use of the term, schizophrenia was presented as a "split personality" disorder and the label used in order to devalue the political opposition. Schizophrenia was presented either as a deterministic cause of dangerousness or as a potential cause of crime. In either case, the question of control was clearly present in these articles. These results are discussed in terms of the "us" against "them" distinction as a double process of stigmatization of people with schizophrenia and of reinforcement of one's own identity and security.

Parathyroid cysts: the Latin-American experience

PubMed Central

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

2016-01-01

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

Jet stability and wall impingement flow field in a thermal striping experiment

DOE PAGES

Lomperski, S.; Obabko, A.; Merzari, E.; ...

2017-08-10

We present velocity and temperature field measurements for a 0.9 x 0.9 x 1.7 m glass tank in which two air jets at Re=10000 mix and impinge upon the lid at ambient temperature and pressure. Flow patterns are characterized across a 350 x 200 mm plane located 3 mm below the lid for two inlet geometries: 1) “extended”, in which inlet channels protrude above the tank base, and 2) “flush”, a flat base without protrusions. This minor geometry variation produced distinct changes in the lid flow field, appearing as three stagnant regions for the extended case and only one formore » flush. The dichotomy is attributed to system stability characteristics: jets are stable in the extended case and unstable for flush. In a separate set of nonisothermal tests, the impingement temperature field was measured for inlet temperature mismatches of 4 oC and jets near Re=10000. A 50 m-long fiber optic distributed temperature sensor positioned 2 mm below the lid measured at 1350 locations. Like the velocity fields, the temperature fields differ for the two inlet geometries: good thermal mixing for the flush case and subdued mixing for the extended case. Simulations with the spectral element code Nek5000 replicated the observed stability dichotomy, duplicating the number of stagnant regions observed in the experiment and matching their locations within ±10 mm. Simulation data suggests that flush case instability is due to interactions between jets and wall flows at the bottom of the tank. The clear flow dichotomy exhibited by this two-jet setup presents an unambiguous case to test the ability of CFD tools to predict subtle flow field changes driven by minor modifications in geometry in the context of thermal striping.« less

Jet stability and wall impingement flow field in a thermal striping experiment

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

Lomperski, S.; Obabko, A.; Merzari, E.

We present velocity and temperature field measurements for a 0.9 x 0.9 x 1.7 m glass tank in which two air jets at Re=10000 mix and impinge upon the lid at ambient temperature and pressure. Flow patterns are characterized across a 350 x 200 mm plane located 3 mm below the lid for two inlet geometries: 1) “extended”, in which inlet channels protrude above the tank base, and 2) “flush”, a flat base without protrusions. This minor geometry variation produced distinct changes in the lid flow field, appearing as three stagnant regions for the extended case and only one formore » flush. The dichotomy is attributed to system stability characteristics: jets are stable in the extended case and unstable for flush. In a separate set of nonisothermal tests, the impingement temperature field was measured for inlet temperature mismatches of 4 oC and jets near Re=10000. A 50 m-long fiber optic distributed temperature sensor positioned 2 mm below the lid measured at 1350 locations. Like the velocity fields, the temperature fields differ for the two inlet geometries: good thermal mixing for the flush case and subdued mixing for the extended case. Simulations with the spectral element code Nek5000 replicated the observed stability dichotomy, duplicating the number of stagnant regions observed in the experiment and matching their locations within ±10 mm. Simulation data suggests that flush case instability is due to interactions between jets and wall flows at the bottom of the tank. The clear flow dichotomy exhibited by this two-jet setup presents an unambiguous case to test the ability of CFD tools to predict subtle flow field changes driven by minor modifications in geometry in the context of thermal striping.« less

Atomic oxygen between 80 and 120 km - Evidence for a latitudinal variation in vertical transport near the mesopause

NASA Technical Reports Server (NTRS)

Wasser, B.; Donahue, T. M.

1979-01-01

Analysis of the OGO 6 OI green line nightglow photometer experiment has been carried out for eight cases when the alignment of the spacecraft was such that local emission rates could be determined below the altitude of maximum emission and down to about 80 km. The results obtained show that the vertical gradient of the emission rate between 95 and 80 km alternates between regions of very rapid variation and very slow variation spaced on a scale of 5-10 deg of latitude. Maps showing isoemissivity contours and isodensity contours for atomic oxygen concentration in vertical meridional planes are presented. The densities are computed under three assumptions concerning excitation mechanisms. Comparisons of the vertical variations of oxygen density with the results of a time dependent theory suggest the regions of strong downward transport alternate in latitude with regions of weak transport near 90 km. In the first case, conversion of O to O3 at night appears to be overwhelmed by downward transport of O.

Ectopic Thyroid Tissue in Submandibular and Infrahyoid Region

PubMed Central

Mutlu, Vahit

2014-01-01

The thyroid is the first endocrine gland to form during embryogenesis. At this stage, incomplete or anomalous migration of thyroid tissue causes ectopic localization of the gland. Submandibular ectopic thyroid tissue with a coexisting normally located thyroid gland is extremely rare. In this case aimed to present the findings of the 65-years-old female patient who is bilateral subtotal thyroidectomy operation performed for multinodular goiter of 12 years ago. Case, painless mass in the right submandibular and infrahyoid region for 6 months was admitted to our clinic with complaints. Result of contrast-enhanced neck computed tomography, ultrasound-guided fine-needle aspiration biopsy and thyroid scintigraphy were found of functional residual thyroid tissue in the normal localization as well as 2×3 cm mass in the submandibular area and 1×2 cm mass lesion in the infrahyoid region. The patient referred to excisional biopsy. Normal thyroid follicules and no evidence of malignancy were found in specimen pathologically. Postoperative follow-up of thyroid function tests were normal. PMID:25610328

Using hybrid implicit Monte Carlo diffusion to simulate gray radiation hydrodynamics

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

Cleveland, Mathew A., E-mail: cleveland7@llnl.gov; Gentile, Nick

This work describes how to couple a hybrid Implicit Monte Carlo Diffusion (HIMCD) method with a Lagrangian hydrodynamics code to evaluate the coupled radiation hydrodynamics equations. This HIMCD method dynamically applies Implicit Monte Carlo Diffusion (IMD) [1] to regions of a problem that are opaque and diffusive while applying standard Implicit Monte Carlo (IMC) [2] to regions where the diffusion approximation is invalid. We show that this method significantly improves the computational efficiency as compared to a standard IMC/Hydrodynamics solver, when optically thick diffusive material is present, while maintaining accuracy. Two test cases are used to demonstrate the accuracy andmore » performance of HIMCD as compared to IMC and IMD. The first is the Lowrie semi-analytic diffusive shock [3]. The second is a simple test case where the source radiation streams through optically thin material and heats a thick diffusive region of material causing it to rapidly expand. We found that HIMCD proves to be accurate, robust, and computationally efficient for these test problems.« less

Primary mucosal sinonasal melanoma—Case report and review of the literature. The role of complex treatment-surgery and adjuvant radiotherapy

PubMed Central

Marinova, Lena; Yordanov, Kaloyan; Sapundgiev, Nikolay

2010-01-01

Aim The place of adjuvant radiotherapy in the treatment of sinonasal melanoma. Background Sinonasal mucosal melanoma is a rare disease with poor prognosis and requires a complex treatment. Elective neck dissection in patients with N0 and adjuvant radiotherapy has been a source of controversy. High late regional recurrence rates rise questions about elective irradiation of the neck nodes in patients with N0 stage disease. Methods We present our two years’ follow up in a case of locally advanced sinonasal melanoma and literature review of the treatment options for mucosal melanoma. Results In locally advanced sinonasal melanoma treated with surgical resection, postoperative radiotherapy and chemotherapy we had local tumor control. Two years later, a regional contralateral recurrence without distant metastasis occurred. Conclusions Literature data for frequent neck lymph nodes recurrences justify elective neck dissection. Postoperative elective neck radiotherapy for patients with locally advanced sinonasal melanoma and clinically N0 appears to decrease the rate of late regional recurrences. PMID:24376954

The Dynamics of Traded Industries In Between 2008-2014

NASA Astrophysics Data System (ADS)

Török, Ibolya; Török, Gergely

2016-10-01

During the last two decades a great number of studies have analyzed the industrial specialization and spatial concentration of specific industries, considering that the two phenomena closely interrelated: the geographic concentration of economic activities representing a territorial approach that describes the distribution of economic activities within a well-defined geographical area, while regional specialization expresses the weight of a certain sector in the regional economy. At the same time regional specialization is a good indicator of the competitive advantages a region possesses in producing different goods or services, making the best use of the local resources compared to other territories. The present study will analyze the importance and perspectives of traded- vs. local industries in the case of Romania during the 2008-2014 period.

Unusual injury pattern in a case of postmortem animal depredation by a domestic German shepherd.

PubMed

Tsokos, M; Schulz, F; Püschel, K

1999-09-01

A case is presented of a 38-year-old woman with skeletization of the head, neck, and collar region and a circumscribed 26-cm x 19-cm defect on the left chest with sole removal of the heart through the opened pericardium but undamaged mediastinum and lungs. The injuries showed V-shaped puncture wounds and superficial claw-induced scratches adjacent to the wound margins that have been described as typical for postmortem animal depredation of carnivore origin and derived from postmortem animal damage by the woman's domestic German shepherd. The circumscribed destruction of the left chest with unusual opening of the pericardium is explained by the physiognomy of the muzzle of the German shepherd and differs from previous reports. Any case presented as postmortem animal mutilation should be viewed with skepticism and undergo a full autopsy.

CHOROIDAL MELANOMA IN A PATIENT WITH WAARDENBURG SYNDROME.

PubMed

Itty, Sujit; Richter, Elizabeth R; McCannel, Tara A

2015-01-01

To report a case of choroidal malignant melanoma in a patient with Waardenburg syndrome and bilateral choroidal pigmentary abnormalities. Clinical examination and multimodal imaging of the case. A 45-year-old woman presented with asymptomatic flat choroidal pigmentation abnormalities in both eyes. A choroidal lesion was identified in the inferotemporal periphery of the left eye arising from an area of hyperpigmentation; ultrasonography findings were consistent with a choroidal melanoma. The patient endorsed a personal and family history of premature graying of hair and was identified to have dystopia canthorum consistent with the diagnosis of Waardenburg syndrome. The authors present the first reported case of concurrent Waardenburg syndrome and choroidal malignant melanoma. This cooccurrence may suggest that the relative hyperpigmented regions in affected fundi may be abnormal and should be monitored closely for the development of choroidal melanoma.

Prairie rattlesnake envenomation in 27 New World camelids.

PubMed

Sonis, J M; Hackett, E S; Callan, R J; Holt, T N; Hackett, T B

2013-01-01

Morbidity and case fatality from rattlesnake envenomation is regionally specific because of variability in relative toxicity of the species of snake encountered. A previous report of rattlesnake envenomation in New World camelids (NWC) from the western coastal United States documented high case fatality rates and guarded prognosis for survival. To describe clinical findings, treatments, and outcome of NWC with prairie rattlesnake (Crotalus viridis viridis) envenomation in the Rocky Mountain region of the United States. Twenty-seven NWC admitted to the Colorado State University Veterinary Teaching Hospital for evaluation of acute rattlesnake envenomation between 1992 and 2012. Medical records of NWC evaluated for rattlesnake envenomation as coded by the attending clinician and identified by a database search were reviewed retrospectively. Month of admission, signalment, area of bite, clinical and clinicopathologic data, treatments, and outcome were recorded. Twenty-five llamas and 2 alpacas were admitted for envenomation. Llamas were overrepresented compared to hospital caseload. The face was the most common site of envenomation, observed in 96% of recorded cases. Presenting clinical signs included fever, tachypnea, tachycardia, and respiratory distress. Nine animals required a tracheotomy. Median hospitalization time was 3 days and overall survival rate was 69%. Case fatality rate for prairie rattlesnake envenomation in NWC was lower than that reported in the Western coastal region of the United States and similar to that reported for prairie rattlesnake envenomation in horses. Copyright © 2013 by the American College of Veterinary Internal Medicine.

Dirofilaria repens: emergence of autochthonous human infections in the Czech Republic (case reports).

PubMed

Matějů, Jana; Chanová, Marta; Modrý, David; Mitková, Barbora; Hrazdilová, Kristýna; Žampachová, Víta; Kolářová, Libuše

2016-04-19

Human dirofilariasis is a zoonotic infection that continues to spread to previously unaffected areas of Europe. In the South Moravian Region of the Czech Republic (CR), imported as well as autochthonous canine infections were recorded in the last decade, and parasite DNA was detected in mosquitoes of Aedes vexans. In the present paper, human Dirofilaria infections are reported from the country for the first time. The samples from five patients with suspected tissue helminthiases were investigated. In particular cases, nematodes were isolated from various tissues including skin of lower leg, soft tissues of finger, subcutaneous tissue of hypogastrium, lymph node and peritoneum. The diagnosis was based on light microscopic morphology and/or DNA analysis of the worms. In addition, ELISA examination of patients' sera for anti-filaria IgG antibodies was performed. In the CR, five cases of human dirofilariasis caused by Dirofilaria repens were recorded during 2010-2014 (species determination for three of them was confirmed besides morphological also by DNA analysis). At least, three of the cases were of autochthonous origin (the patients are Czech citizens residing in South Moravian Region who have never travelled abroad). The findings confirm the natural setting of D. repens in South Moravian Region of the CR. Dirofilariasis should be therefore considered as endemic in this area where it may represent a significant risk factor for public health.

Unilateral subfrontal approach to anterior communicating artery aneurysms: A review of 28 patients

PubMed Central

Petraglia, Anthony L.; Srinivasan, Vasisht; Moravan, Michael J.; Coriddi, Michelle; Jahromi, Babak S.; Vates, G Edward; Maurer, Paul K.

2011-01-01

Background: The pterional approach is the most common for AComm aneurysms, but we present a unilateral approach to a midline region for addressing the AComm complex. The pure subfrontal approach eliminates the lateral anatomic dissection requirements without sacrificing exposure. The subfrontal approach is not favored in the US compared to Asia and Europe. We describe our experience with the subfrontal approach for AComm aneurysms treated at a single institution. Methods: We identified 28 patients treated for AComm aneurysms through the subfrontal approach. Patient records and imaging studies were reviewed. Demographics and case data, as well as clinical outcome at 6 weeks and 1 year were collected. Results: Mean patient age was 48 (range 21–75) years and 64% suffered subarachnoid hemorrhage (SAH). All aneurysms were successfully clipped. Gyrus rectus was resected in 57% of cases, more commonly in ruptured cases. Intraoperative rupture occurred in 11% of cases. The average operative time was 171 minutes. There were two patient deaths. Ninety-two percent of patients had a Glasgow Outcome Scale (GOS) of 5 at 6 weeks. All unruptured patients had a GOS of 5. At 12 months, 96% of all patients had a GOS of 5. Conclusions: The subfrontal approach provides an efficient avenue to the AComm region, which reduces opening and closing friction but still yields a comprehensive operative window for access to the anterior communicating region. PMID:22059119

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.

Asymptomatic Presentation of Large Cardiac Hydatid.

PubMed

Beedkar, Amey; Parikh, Rohan; Deshmukh, Pradeep

2017-02-01

Hydatid cyst is a tissue parasitic infection caused by tapeworm Echinococcus granulosus. Common location for hydatid cysts are the liver (65%) and the lungs (25%). Cardiac hydatid cyst is seen rarely, occurring in about 0.5-2% of all cases of hydatid disease. We present this case of 45 years female who presented with short duration of dry cough and atypical chest pain. Chest X ray showed cardiomegaly with round bulge at the right heart border and curvilinear calcification in left upper abdomen in the region of spleen. Transthoracic echocardiography (TTE) depicted cystic lesion in Right Ventricle free wall causing compression of right atrial and ventricular cavity. Cardiac CT confirmed this cyst as hydatid cyst. Patient underwent successful excision of right ventricular hydatid cyst. © Journal of the Association of Physicians of India 2011.

Oral and maxillofacial sclerosing epithelioid fibrosarcoma: report of five cases.

PubMed

Folk, Gretchen S; Williams, Stephen B; Foss, Robert B; Fanburg-Smith, Julie C

2007-09-01

Sclerosing epithelioid fibrosarcoma (SEF) has distinctive morphology and occurs mainly in deep soft tissue of adult extremities. Approximately 59 cases of SEF have been reported, with only 12 previously described in head and neck locations. Lesions involving the oral and maxillofacial region (OMFR) and intraosseous examples are rare. We present five cases of OMFRSEF. The OMF Pathology Department Registry was searched for cases coded from 1990 to the present as "SEF," "fibrosarcoma not otherwise specified" or "neoplasm of uncertain histiogenesis." Inclusion required OMFR location, an abundantly sclerotic sarcoma with epithelioid features, and lack of other phenotype by immunohistochemistry. Five cases of SEF included 3 males and 2 females. The age of the patients were: 19, 22, 35, 47 and 47 years. Tumor location included the infra-temporal fossa, buccal mucosa (recurrence extending into bone), anterior mandible (intraosseous primary, focally extending into soft tissue), and left parotid and submandibular gland (with metaplastic bone) regions. Tumor sizes ranged from 1.0 to 5.7 cm, median 3.5 cm. Histologically, the tumors were well delineated and multinodular, separated by fibrous septae. The spindled to primarily epithelioid tumor cells formed moderately cellular sheets and cords of irregularly contoured medium to large, round to oval, occasionally overlapping nuclei, indistinct nucleoli, wispy eosinophilic (retracting) cytoplasm, and distinctive cytoplasmic borders, embedded in osteoid-like stroma. Hemangiopericytoid (HPC-like) vessels were observed. Despite numerous apoptotic cells, mitoses were generally low; necrosis was present in two cases. Three tumors were graded as 2/3 and two 1/3. Immunohistochemically, the tumor cells were positive for vimentin, 1 case focally for CD34, whereas all cases were negative for S100 protein, keratins, EMA, desmin, and SMA. Wide or radical excision was performed with no adjuvant therapy. Follow-up revealed that 4 cases recurred at a range of 12-120 months. One case had no recurrent/residual disease at 3 months. Metastatic disease was present in 2 cases, to chest wall and lumbar/thoracic spine at 12 and 21 months, respectively. One patient died of disease complications at 15 months. OMFRSEF occur in adults in various locations, but with a common propensity to involve bone; there is recurrent potential and morbidity with higher grade lesions. The differential diagnosis for these tumors in this site includes sclerosing carcinoma, Ewing/PNET, osteosarcoma, osteoblastoma, and benign and malignant myoepithelial salivary gland tumors. The collagen, focal spindle cell features, HPC-like vasculature, and weak focal CD34 reactivity in one case might have raised a possible relationship between OMFRSEF and low grade malignant solitary fibrous tumor, but the intraosseous propensity, epithelioid features and relative lack of CD34 make this a distinctive entity.

Previous Employment and Job Satisfaction Conditions: The Case of Regional Administration

NASA Astrophysics Data System (ADS)

Amalia, Myronaki; Nikolaos, Antonakas

2009-08-01

In the present work we study the different dimensions of satisfaction and the way of constitution of satisfaction of an important sample of the employees in the Regional administration of Crete and in their connection with the variable of the previous employment. We found statistically important differences for the components of satisfaction from the life, collaboration in and outside from the department, in the social satisfaction and the variable of the years in the service (labour group with <5 years in the service, group with 5-9 years in the service and labour group with 10-15 years in the service). The group with total few years in the work <5, presented smaller social and labour satisfaction than the other previous employment groups. In the other hand the group with many years in the service presents bigger satisfaction than the other groups. Finally, is important to note that the sample present some interesting characteristics.

Assaults from corrosive substances and medico legal considerations in a large regional burn centre in the United Kingdom: calls for increased vigilance and enforced legislation

PubMed Central

Tan, Alethea; Bharj, Amrit Kaur; Nizamoglu, Metin; Barnes, David; Dziewulski, Peter

2015-01-01

Burn injuries from corrosive substances have been recognised as a common method of assault in low and middle income countries (LMICs) motivated by various factors. Such injuries often leave survivors with severely debilitating physical and psychological injuries and scars. The number of reported cases of acid assaults within the United Kingdom (UK) appears to be on the rise. As one of the largest regional burn centres in the UK, we have reviewed our experience of chemical burns from assault. This study aims to: (1) review the demographics, incidence and patient outcomes; (2) evaluate the long-term psychosocial support provided; and (3) review current criminal litigation proceedings and preventative legislations in the UK specific to assault by corrosive substances. A 15-year retrospective review of 21 burn injuries from assault with corrosive substances presenting to a regional burn unit was conducted. Victims were mostly young men; male perpetrators were more common. The most common motive cited was assault. The most common anatomical region affected was the face and neck. The number of victims who pursue litigation is disproportionately lower than the number of total cases at presentation. In an effort to better understand the legal considerations surrounding such assaults, we also collaborated with lawyers experienced in this particular field. We hope that our work will help educate healthcare professionals regarding the legal assistance and existing laws available to protect these patients. PMID:29799575

Biomass universal district heating systems

NASA Astrophysics Data System (ADS)

Soltero, Victor Manuel; Rodríguez-Artacho, Salvador; Velázquez, Ramón; Chacartegui, Ricardo

2017-11-01

In mild climate regions Directive 27/2012 EU application for developing sustainable district heating networks in consolidated urban nucleus is a challenge. In Spain most of the municipalities above 5,000 inhabitants have a reliable natural gas network and individual heating systems at homes. In this work a new heating network paradigm is proposed, the biomass universal heating network in rural areas. This model involves all the economic, legal and technical aspects and interactions between the different agents of the systems: provider company, individual and collective end-users and local and regional administration. The continental region in Spain has 588 municipalities with a population above 1,500 inhabitants close to forest biomass with renewable use. In many of these cases the regulation identifies the ownership of the forest resources use. The universal heating networks are a great opportunity for energy saving of 2,000 GWh, avoiding 2.7 million tons of CO2 emissions and with a global annual savings for end users of 61.8 million of euros. The presented model is easily extrapolated to other small municipalities in Europe. The real application of the model is presented for three municipalities in different locations of Spain where Universal Heating Networks are under development. The analysis show the interest of the integrated model for the three cases with different structural agents and relationships between them. The use of sustainable forest resources, extracted and managed by local companies, strengths circular economy in the region with a potential global economic impact above 200 M€.

Human migration, railways and the geographic distribution of leprosy in Rio Grande do Norte State – Brazil

PubMed Central

Nobre, Mauricio Lisboa; Dupnik, Kathryn Margaret; Nobre, Paulo José Lisboa; De Souza, Márcia Célia Freitas; Dűppre, Nádia Cristina; Sarno, Euzenir Nunes; Jerŏnimo, Selma Maria Bezerra

2016-01-01

Summary Introduction Leprosy is a public health problem in Brazil where 31,044 new cases were detected in 2013. Rio Grande do Norte is a small Brazilian state with a rate of leprosy lower than other areas in the same region, for unknown reasons. Objectives We present here a review based on the analysis of a database of registered leprosy cases in Rio Grande do Norte state, comparing leprosy's geographic distribution among municipalities with local socio-economic and public health indicators and with historical documents about human migration in this Brazilian region. Results The current distribution of leprosy in Rio Grande do Norte did not show correlation with socio-economic or public health indicators at the municipal level, but it appears related to economically emerging municipalities 100 years ago, with spread facilitated by railroads and train stations. Drought-related migratory movements which occurred from this state to leprosy endemic areas within the same period may be involved in the introduction of leprosy and with its present distribution within Rio Grande do Norte. Conclusions Leprosy may disseminate slowly, over many decades in certain circumstances, such as in small cities with few cases. This is a very unusual situation currently and a unique opportunity for epidemiologic studies of leprosy as an emerging disease. PMID:26964429

Pseudomamma of the inguinal region in a female patient: A case report

PubMed Central

Marinopoulos, Spyridon; Arampatzis, Ioannis; Zagouri, Flora; Dimitrakakis, Constantine

2015-01-01

Introduction Supernumerary breasts are relative common benign congenital anomalies. General population occurrence rates vary up to 6% according to ethnicity and gender. Higher incidence is recorded in Asian individuals, especially Japanese. Embryonic breast development of the mammary ridge (milk line) is explained and supernumerary breast tissue resulting from involution failure of any portion of the embryonic mammary folds is described. Presentation of case We report a case of supernumerary breast (pseudomamma) in a female occupying her right inguinal region that was treated in the breast unit of our hospital. Differential diagnosis, imaging methods, operative approach, surgical treatment and histological verification are specified. Discussion Classification system for supernumerary breast tissue is presented, high risk population is identified and congenital malformations linked to it are outlined. Evaluation of diagnostic workup and limitations are stated. Cancerous degeneration and justification for surgical removal of the accessory gland is discussed. Conclusion Differential diagnosis of lesions along the milk line should always be inclusive of developmental abnormalities such as any type of supernumerary breast, often overlooked due to small size, although carrying a malignant potential equal to normally positioned breasts. Surgical correction is a sensible approach, often encouraged by the patients. Additional evaluation is recommended due to the frequent accompanying urinary tract and cardiac anomalies. PMID:26011805

Initiating Transdisciplinarity in Academic Case Study Teaching: Experiences from a Regional Development Project in Salzburg, Austria

ERIC Educational Resources Information Center

Muhar, Andreas; Vilsmaier, Ulli; Glanzer, Michaela; Freyer, Bernhard

2006-01-01

Purpose: The purpose of this paper is to describe experiences with the initiation of transdisciplinarity in academic case study teaching with special reference to regional planning, based on the case study "Leben 2014 (Life 2014)--perspectives for regional development in the national park region Ober-pinz-gau, Salzburg".…

Multiple compound odontomas in mandible: A rarity

PubMed Central

Vaid, Sanjeev; Ram, Rangeela; Bhardwaj, Vinay Kumar; Chandel, Mohinder; Jhingta, Pravesh; Negi, Nishant; Sharma, Deepak

2012-01-01

Odontomas are benign odontogenic tumors composed of enamel, dentine, and cementum and pulp tissue. They are usually clinically asymptomatic, but often associated with tooth eruption disturbances. The present study reports an unusual case of eleven odontomas in the left lateral incisor-canine region of lower jaw. A 26 years old female presented to the department of orthodontics and dentofacial orthopedics in H.P. Govt. Dental College and Hospital Shimla for the treatment of misaligned teeth. Clinical examination revealed that the lower left lateral incisor was missing. Patient was advised for radiographs, which revealed a mixed radiopaque lesion associated to impacted lower left canine. The histological report in this case indicated a compound odontoma. PMID:23293496

[Successful electroconvulsive therapy of Cotard syndrome with bitemporal hypoperfusion].

PubMed

Lohmann, T; Nishimura, K; Sabri, O; Klosterkötter, J

1996-05-01

A case study is presented to illustrate a rare condition described by Cotard as "délire de négation". The central symptom is a nihilistic delusion with denial of one's own existence of oneself and that of the external world. In the present case, the syndrome became manifest as an escalation of a recurrent depressive disorder late in life. After initial resistance to therapy, the syndrome was successfully treated with electroconvulsive therapy. For the first time, we report the regional cerebral blood flow measured by 99mTc-HMPAO-SPECT before and after therapy. Before treatment, significant bitemporal hypoperfusion relative to the cerebellum was found, which was no longer demonstrable on remission.

Proximal-type epithelioid sarcoma - Case report*

PubMed Central

dos Santos, Luciana Mendes; Nogueira, Lisiane; Matsuo, Christiane Yuri; Talhari, Carolina; Santos, Mônica

2013-01-01

Epithelioid sarcoma, first described by Enzinger in 1970, is a rare soft-tissue sarcoma typically presenting as a subcutaneous or deep dermal mass in distal portions of the extremities of adolescents and young adults. In 1997, Guillou et al. described a different type of epithelioid sarcoma, called proximal-type epithelioid sarcoma, which is found mostly in the pelvic and perineal regions and genital tracts of young to middle-aged adults. It is characterized by a proliferation of epithelioid-like cells with rhabdoid features and the absence of a granuloma-like pattern. In this paper we present a case of proximal-type epithelioid sarcoma with an aggressive clinical course, including distant metastasis and death nine months after diagnosis. PMID:23793215

Synovial sarcoma: a rare presentation of parapharyngeal mass.

PubMed

Shaariyah, Mohd Mokhtar; Mazita, Ami; Masaany, Mansor; Razif, Mohd Yunus; Isa, Mohamed Rose; Asma, Abdullah

2010-06-01

Synovial sarcoma is a rare soft tissue sarcoma of the head and neck region involving the parapharyngeal space. The diagnosis of synovial sarcoma can be very challenging to the pathologists. We present a rare case of parapharyngeal synovial sarcoma in a young female patient who had a two-month history of left cervical intumescent mass at level II. The fine needle aspiration cytology of the mass was proved inconclusive. Transcervical excision of the mass was performed and the first case of parapharyngeal sarcoma was identified in our center by fluorescence in situ hybridization (FISH) technique. Repeat imaging revealed residual tumor. The patient successfully underwent a second excision of the residual tumor and received adjuvant radiotherapy.

A Rare Bilateral Presentation of Multiple Dens Invaginatus, Shovel-Shaped Incisor and Talon Cusp With Mesiodens.

PubMed

Hegde, S; Jain, M; Shubha, A B

2014-01-01

The aim of this paper is to describe a unique and unusual case of concomitant appearance of morphological dental anomalies in the maxillary anterior region, along with its management in a patient with no systemic abnormality. This case report describes the clinical and radiographic features of talon cusp, dens invaginatus, shovel-shaped incisors and a supernumerary tooth occurring in a single patient, which is a rare presentation. All 4 permanent maxillary incisors had dens invaginatus, the permanent maxillary canines showed the presence of talon cusps, the permanent maxillary central incisors were shovel-shaped and an erupted mesiodens was also observed. Treatment included restorative, surgical and orthodontic approaches.

Depletion of solar wind plasma near a planetary boundary

NASA Technical Reports Server (NTRS)

Zwan, B. J.; Wolf, R. A.

1976-01-01

A mathematical model is presented that describes the squeezing of solar wind plasma out along interplanetary magnetic field lines in the region between the bow shock and the effective planetary boundary (in the case of the earth, the magnetopause). In the absence of local magnetic merging the squeezing process should create a 'depletion layer', a region of very low plasma density just outside the magnetopause. Numerical solutions are obtained for the dimensionless magnetohydrodynamic equations describing this depletion process for the case where the solar wind magnetic field is perpendicular to the solar wind flow direction. For the case of the earth, the theory predicts that the density should be reduced by a factor exceeding 2 in a layer about 700-1300 km thick if the Alfven Mach number in the solar wind, is equal to 8. Scaling of the model calculations to Venus and Mars suggests layer thicknesses about 1/10 and 1/15 those of the earth, respectively, neglecting diffusion and ionospheric effects.