Sensitivity of influenza rapid diagnostic tests to H5N1 and 2009 pandemic H1N1 viruses.

PubMed

Sakai-Tagawa, Yuko; Ozawa, Makoto; Tamura, Daisuke; Le, Mai thi Quynh; Nidom, Chairul A; Sugaya, Norio; Kawaoka, Yoshihiro

2010-08-01

Simple and rapid diagnosis of influenza is useful for making treatment decisions in the clinical setting. Although many influenza rapid diagnostic tests (IRDTs) are available for the detection of seasonal influenza virus infections, their sensitivity for other viruses, such as H5N1 viruses and the recently emerged swine origin pandemic (H1N1) 2009 virus, remains largely unknown. Here, we examined the sensitivity of 20 IRDTs to various influenza virus strains, including H5N1 and 2009 pandemic H1N1 viruses. Our results indicate that the detection sensitivity to swine origin H1N1 viruses varies widely among IRDTs, with some tests lacking sufficient sensitivity to detect the early stages of infection when the virus load is low.

Acute Parasitic Infections as a Cause of Fever of Unknown Origin in Egypt

DTIC Science & Technology

1993-10-01

series and included 10 with acute and biliary system (Bassily et al., 1989). fascioliasis , 9 with schistosomiasis and I Diagnosing these patients...Farid et al., 1989). Acute Ilosp., Postal Code 11517, Cairo. Egpt. fascioliasis is treated with bithionol, 88 Table: Diagnostic categories of fcver of...diagnosis Infections 80 57 Tuberculosis (32), Salmonellosis (10), Fascioliasis (10), Schistosomiasis (9). Infective Endocarditis (5), Brucellosis (4

Recurrent fever of unknown origin (FUO): aseptic meningitis, hepatosplenomegaly, pericarditis and a double quotidian fever due to juvenile rheumatoid arthritis (JRA).

PubMed

Cunha, Burke A; Hage, Jean E; Nouri, Yelda

2012-01-01

Fever of unknown origin (FUO) has been defined as a fever of ≥101°F that persists for 3 weeks or more. It is not readily diagnosed after 1 week of intensive in-hospital testing or after intensive outpatient or inpatient testing. Fevers of unknown origin may be caused by infectious diseases, malignancies, collagen vascular diseases, or a variety of miscellaneous disorders. The relative distribution of causes of FUOs is partly age-related. In the elderly, the preponderance of FUOs is attributable to neoplastic and infectious etiologies, whereas in children, collagen vascular diseases, neoplasms, and viral infectious disease predominate. The diagnostic approach to FUOs depends on a careful analysis of the history, physical findings, and laboratory tests. Most patients with FUOs exhibit localizing findings that should direct the diagnostic workup and limit diagnostic possibilities. The most perplexing causes of FUOs involve those without specific diagnostic tests, e.g., juvenile rheumatoid arthritis (JRA) or adult Still's disease. In a young adult with FUO, if all of the cardinal symptoms are present, JRA may present either a straightforward or an elusive diagnosis, if key findings are absent or if the diagnosis goes unsuspected. We present a 19-year-old man with a recurrent FUO. His illness began 3 years before admission and has recurred twice since. In the past, he did not manifest arthralgias, arthritis, or a truncal rash. On admission, he presented with an FUO with hepatosplenomegaly, aseptic meningitis, and pericarditis. An extensive diagnostic workup ruled out lymphoma and leukemia. Moreover, a further extensive workup eliminated infectious causes of FUO appropriate to his clinical presentation, ie, tuberculosis, histoplasmosis, brucellosis, Q fever, typhoid fever, Epstein-Barr virus, infectious mononucleosis, cytomegalovirus, human herpes virus (HHV)-6, babesiosis, ehrlichiosis, viral hepatitis, and Whipple's disease. The diagnosis of JRA was based on the exclusion of infectious and neoplastic disorders in a young adult with hepatosplenomegaly, aseptic meningitis, pericarditis, and a double quotidian fever. With JRA, tests for rheumatic diseases are negative, as they were in this case. The only laboratory abnormalities in this patient included elevated serum transaminases, a mildly elevated erythrocyte sedimentation rate, and a moderately elevated level of serum ferritin. Diagnostic fever curves are most helpful in cases where the diagnosis is most elusive, as was the case here. Relatively few disorders are associated with a double quotidian fever, ie, visceral leishmaniasis, mixed malarial infections, right-sided gonococcal acute bacterial endocarditis, and JRA. Because the patient received antipyretics during the first week of admission, fever was not present. After infectious disease consultation during week 2 of hospitalization, antipyretics were discontinued, and a double quotidian fever was present, which provided the key diagnostic clue in this case. Copyright © 2012 Elsevier Inc. All rights reserved.

Immunohistochemical characterization of neoplastic cells of breast origin.

PubMed

Noriega, Mariadelasmercedes; Paesani, Fernando; Perazzo, Florencia; Lago, Néstor; Krupitzki, Hugo; Nieto, Silvana; Garcia, Alejandro; Avagnina, Alejandra; Elsner, Boris; Denninghoff, Valeria Cecilia

2012-06-22

After skin cancer, breast cancer is the most common malignancy in women. Tumors of unknown origin account for 5-15% of malignant neoplasms, with 1.5% being breast cancer. An immunohistochemical panel with conventional and newer markers, such as mammaglobin, was selected for the detection of neoplastic cells of breast origin. The specific objectives are: 1) to determine the sensitivity and specificity of the panel, with a special emphasis on the inclusion of the mammaglobin marker, and 2) to compare immunohistochemistry performed on whole tissue sections and on tissue micro-array. Twenty-nine metastatic breast tumors were included and assumed as tumors of unknown origin. Other 48 biopsies of diverse tissues were selected and assumed as negative controls. Tissue Micro-Array was performed. Immunohistochemistry for mammaglobin, gross cystic disease fluid protein-15, estrogen receptor, progesterone receptor and cytokeratin 7 was done. Mammaglobin positive staining was observed in 10/29 cases, in 13/29 cases for gross cystic disease fluid protein-15, in 20/29 cases for estrogen receptor, in 9/29 cases for progesterone receptor, and in 25/29 cases for cytokeratin 7. Among the negative controls, mammaglobin was positive in 2/48, and gross cystic disease fluid protein-15 in 4/48. The inclusion of MAG antibody in the immunohistochemical panel for the detection of tumors of unknown origin contributed to the detection of metastasis of breast cancer. The diagnostic strategy with the highest positive predictive value (88%) included hormone receptors and mammaglobin in serial manner.

Utility of bone marrow examination for workup of fever of unknown origin in patients with HIV/AIDS.

PubMed

Quesada, Andrés E; Tholpady, Ashok; Wanger, Audrey; Nguyen, Andy N D; Chen, Lei

2015-03-01

The utility of bone marrow aspiration and biopsy (BMAB) as a diagnostic tool in patients with HIV/AIDS and fever of unknown origin (FUO) is a subject of debate. Because highly active antiretroviral therapy has reduced incidence of opportunistic infections, it is important to reassess the efficacy of BMAB for this diagnostic purpose. To our knowledge, no such studies have been performed in Harris County which has the highest incidence of HIV in the state of Texas. We reviewed all BMABs from patients with HIV/AIDS and FUO or persistent cytopenia(s) from 2007 to 2011. Of 57 evaluable patients, BMAB was positive in 24 samples by acid fast bacilli (AFB) or Gomori methenamine silver (GMS) stains (17.5%), presence of granuloma and/or lymphohistiocytic aggregates (31.6%), culture (21.0%) or a combination. Cultures demonstrated Mycobacterium avium/intracellulare (4), M tuberculosis (2), M gordonae (1), Histoplasma capsulatum (3) and Cryptococcus neoformans (2). There were three cases in which a pathogen was grown in culture but that had a negative of 'direct examination' on tissue sections (negative AFB and GMS special stains, no morphological evidence of granuloma/lymphohistiocytic infiltrates). This study supports the use of diagnostic BMAB as a rapid decision-making tool in patients with HIV and FUO in the proper clinical setting. BMAB demonstrated infection-related evidence prior to positive bone marrow culture in 75% of cases. Special stains and blood cultures had similar diagnostic yield, but BMAB offers faster results. Thus, this procedure assists in clinical decision making and the refinement of treatment in a more timely manner. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Undiagnosed Acute Viral Febrile Illnesses, Sierra Leone

DTIC Science & Technology

2014-07-01

Sierra Leone in West Africa is in a Lassa fever – hyperendemic region that also includes Guinea and Li- beria. Each year...suspected Lassa fever cases result in submission of ≈500–700 samples to the Kenema Govern- ment Hospital Lassa Diagnostic Laboratory in eastern Si- erra...patients have acute diseases of unknown origin. To investigate what other ar- thropod-borne and hemorrhagic fever viral diseases might cause serious

The predictive value of soluble biomarkers (CD14 subtype, interleukin-2 receptor, human leucocyte antigen-G) and procalcitonin in the detection of bacteremia and sepsis in pediatric oncology patients with chemotherapy-induced febrile neutropenia.

PubMed

Urbonas, Vincas; Eidukaitė, Audronė; Tamulienė, Indrė

2013-04-01

Prediction of bacteremia/sepsis in childhood oncology patients with febrile neutropenia still remains a challenge for the medical community due to the lack of reliable biomarkers, especially at the beginning of infectious process. The objective of this study was to evaluate diagnostic value of soluble biomarkers (CD14 subtype, interleukin-2 receptor, HLA-G) and procalcitonin (PCT) in the identification of infectious process at the beginning of a febrile episode in pediatric oncology patients. A total of 62 episodes of febrile neutropenia in 37 childhood oncology patients were enrolled in this study. Serum samples were collected at presentation after confirmation of febrile neutropenia and analyzed according to recommendations of manufacturers. Patients were classified into bacteremia/sepsis and fever of unknown origin groups. Median of PCT and sIL-2R were considerably higher in bacteremia/sepsis group compared to fever of unknown origin group, whereas median of sHLA-G and presepsin levels between investigated groups did not differ sufficiently. PCT and sIL-2R determination might be used as an additional diagnostic tool for the detection of bacteremia/sepsis in childhood oncology patients with febrile neutropenia. Copyright © 2013 Elsevier Ltd. All rights reserved.

Endoscopy as a diagnostic and therapeutic alternative technique of taeniasis.

PubMed

Canaval Zuleta, Héctor Julián; Company Campins, María M; Dolz Abadía, Carlos

2016-06-01

Despite a low incidence in developed countries, gastrointestinal taeniasis should be suspected in patients with abdominal pain, diarrhea, anemia, and/or malabsorption of unknown origin, even more so if they come from endemic regions or areas with poor hygienic and alimentary habits. Diagnosis is traditionally reached by identifying the parasite in stools, but more recently both serological and immunological approaches are also available. Based on a patient diagnosed by gastroscopy, a literature review was undertaken of patients diagnosed by endoscopy. We discuss endoscopy as diagnostic modality, and the effectiveness and safety that endoscopic treatment may provide in view of the potential risk for neurocysticercosis.

Sacroiliac Pain: A Clinical Approach for the Neurosurgeon

PubMed Central

Moscote-Salazar, Luis Rafael; Alvis-Miranda, Hernando Raphael; Joaquim, Andrei Fernandes; Amaya-Quintero, Jessica; Padilla-Zambrano, Huber S.; Agrawal, Amit

2017-01-01

Pain originating from sacroiliac joint may also cause pain in the lumbar and gluteal region in 15% of the population. The clinical manifestation represents a public health problem due to the great implications on the quality of life and health-related costs. However, this is a diagnosis that is usually ignored in the general clinical practice; probably because of the unknown etiology, making harder to rule out the potential etiologies of this pathology, or maybe because the clinical criteria that support this pathology are unknown. By describing several diagnostic techniques, many authors have studied the prevalence of this pathology, finding more positive data than expected; coming to the conclusion that even though there is no diagnostic gold standard yet, an important amount of cases might be detected by properly applying several tests at the physical examination. Thus, it is necessary to have knowledge of the physiopathology and clinical presentation so that diagnosis can be made to those patients that manifest this problem. We present a clinical approach for the neurosurgeon. PMID:29204025

New Aspects in the Differential Diagnosis and Therapy of Bladder Pain Syndrome/Interstitial Cystitis

PubMed Central

Neuhaus, Jochen; Schwalenberg, Thilo; Horn, Lars-Christian; Alexander, Henry; Stolzenburg, Jens-Uwe

2011-01-01

Diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC) is presently based on mainly clinical symptoms. BPS/IC can be considered as a worst-case scenario of bladder overactivity of unknown origin, including bladder pain. Usually, patients are partially or completely resistant to anticholinergic therapy, and therapeutical options are especially restricted in case of BPS/IC. Therefore, early detection of patients prone to develop BPS/IC symptoms is essential for successful therapy. We propose extended diagnostics including molecular markers. Differential diagnosis should be based on three diagnostical “columns”: (i) clinical diagnostics, (ii) histopathology, and (iii) molecular diagnostics. Analysis of molecular alterations of receptor expression in detrusor smooth muscle cells and urothelial integrity is necessary to develop patient-tailored therapeutical concepts. Although more research is needed to elucidate the pathomechanisms involved, extended BPS/IC diagnostics could already be integrated into routine patient care, allowing evidence-based pharmacotherapy of patients with idiopathic bladder overactivity and BPS/IC. PMID:22028706

New aspects in the differential diagnosis and therapy of bladder pain syndrome/interstitial cystitis.

PubMed

Neuhaus, Jochen; Schwalenberg, Thilo; Horn, Lars-Christian; Alexander, Henry; Stolzenburg, Jens-Uwe

2011-01-01

Diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC) is presently based on mainly clinical symptoms. BPS/IC can be considered as a worst-case scenario of bladder overactivity of unknown origin, including bladder pain. Usually, patients are partially or completely resistant to anticholinergic therapy, and therapeutical options are especially restricted in case of BPS/IC. Therefore, early detection of patients prone to develop BPS/IC symptoms is essential for successful therapy. We propose extended diagnostics including molecular markers. Differential diagnosis should be based on three diagnostical "columns": (i) clinical diagnostics, (ii) histopathology, and (iii) molecular diagnostics. Analysis of molecular alterations of receptor expression in detrusor smooth muscle cells and urothelial integrity is necessary to develop patient-tailored therapeutical concepts. Although more research is needed to elucidate the pathomechanisms involved, extended BPS/IC diagnostics could already be integrated into routine patient care, allowing evidence-based pharmacotherapy of patients with idiopathic bladder overactivity and BPS/IC.

[Kawasaki disease in children and adolescents].

PubMed

Neudorf, U

2011-12-01

Kawasaki disease (KD) is a systemic vasculitis of unknown etiology. The diagnostic criteria are fulfilled with fever of unknown origin and 4 of the following 5 criteria: bilateral conjunctival injection, cervical lymphadenopathy, polymorphous rash, oral mucous membrane changes (injected lips, strawberry tongue) and peripheral extremity changes (erythema, edema, desquamation). If less than 4 criteria are found incomplete KD can be diagnosed. The therapy is 2 g/kg body weight single dose intravenous immunoglobulin and acetylsalicylic acid (ASS). In the long-term follow-up the main focus is on the coronary arteries because coronary changes play a key role in the intensity of long-term management. There is some evidence that KD is a risk factor for cardiovascular diseases in adults.

Vertigo in childhood: proposal for a diagnostic algorithm based upon clinical experience.

PubMed

Casani, A P; Dallan, I; Navari, E; Sellari Franceschini, S; Cerchiai, N

2015-06-01

The aim of this paper is to analyse, after clinical experience with a series of patients with established diagnoses and review of the literature, all relevant anamnestic features in order to build a simple diagnostic algorithm for vertigo in childhood. This study is a retrospective chart review. A series of 37 children underwent complete clinical and instrumental vestibular examination. Only neurological disorders or genetic diseases represented exclusion criteria. All diagnoses were reviewed after applying the most recent diagnostic guidelines. In our experience, the most common aetiology for dizziness is vestibular migraine (38%), followed by acute labyrinthitis/neuritis (16%) and somatoform vertigo (16%). Benign paroxysmal vertigo was diagnosed in 4 patients (11%) and paroxysmal torticollis was diagnosed in a 1-year-old child. In 8% (3 patients) of cases, the dizziness had a post-traumatic origin: 1 canalolithiasis of the posterior semicircular canal and 2 labyrinthine concussions, respectively. Menière's disease was diagnosed in 2 cases. A bilateral vestibular failure of unknown origin caused chronic dizziness in 1 patient. In conclusion, this algorithm could represent a good tool for guiding clinical suspicion to correct diagnostic assessment in dizzy children where no neurological findings are detectable. The algorithm has just a few simple steps, based mainly on two aspects to be investigated early: temporal features of vertigo and presence of hearing impairment. A different algorithm has been proposed for cases in which a traumatic origin is suspected.

Fever of unknown origin: analysis of 71 consecutive cases.

PubMed

Colpan, Aylin; Onguru, Pinar; Erbay, Ayse; Akinci, Esragul; Cevik, Mustafa Aydin; Eren, Selim Sirri; Bodur, Hurrem

2007-08-01

Fever of unknown origin (FUO) is still an important problem in clinical practice. Evaluation of patient characteristics may clarify the utility of diagnostic tests and etiologies of FUO. Fever of unknown origin in 71 patients was investigated at Ankara Numune Education and Research Hospital in Turkey between February 2001 and December 2004. Mean hospital stay and fever duration was 20.5 days and 44 days, respectively. Etiologies of FUO were as follows: infections 32 (45.1%), collagen vascular disease 19 (26.8%), neoplasm 10 (14.1%), and miscellaneous diseases 4 (5.6%). Diagnosis remained obscure in 6 patients (8.5 %). Tuberculosis was found to be 40% of the infectious causes of FUO. Mean hospital stay and fever duration were prolonged in infectious cases. Female predominance was observed in collagen vascular diseases (P = 0.047). Splenomegaly and lymphadenopathy were common in the neoplasm group (P = 0.017, P = 0.017, respectively). Erythrocyte sedimentation rate, aspartate aminotransferase, alanine aminotransferase and lactate hydrogenase levels were elevated in patients with collagen vascular diseases. Nine (12.7%) patients died during the follow-up period. Hospital stay and fever duration were prolonged in the infectious group of FUO patients. Infectious diseases, particularly tuberculosis, were the most important cause of FUO in our series. Tuberculosis should be kept in mind as an important etiology of FUO countries where tuberculosis is endemic.

Diagnostic workup for fever of unknown origin: a multicenter collaborative retrospective study

PubMed Central

Naito, Toshio; Mizooka, Masafumi; Mitsumoto, Fujiko; Kanazawa, Kenji; Torikai, Keito; Ohno, Shiro; Morita, Hiroyuki; Ukimura, Akira; Mishima, Nobuhiko; Otsuka, Fumio; Ohyama, Yoshio; Nara, Noriko; Murakami, Kazunari; Mashiba, Kouichi; Akazawa, Kenichiro; Yamamoto, Koji; Senda, Shoichi; Yamanouchi, Masashi; Tazuma, Susumu; Hayashi, Jun

2013-01-01

Objective Fever of unknown origin (FUO) can be caused by many diseases, and varies depending on region and time period. Research on FUO in Japan has been limited to single medical institution or region, and no nationwide study has been conducted. We identified diseases that should be considered and useful diagnostic testing in patients with FUO. Design A nationwide retrospective study. Setting 17 hospitals affiliated with the Japanese Society of Hospital General Medicine. Participants This study included patients ≥18 years diagnosed with ‘classical fever of unknown origin’ (axillary temperature ≥38°C at least twice over a ≥3-week period without elucidation of a cause at three outpatient visits or during 3 days of hospitalisation) between January and December 2011. Results A total of 121 patients with FUO were enrolled. The median age was 59 years (range 19–94 years). Causative diseases were infectious disease in 28 patients (23.1%), non-infectious inflammatory disease in 37 (30.6%), malignancy in 13 (10.7%), other in 15 (12.4%) and unknown in 28 (23.1%). The median interval from fever onset to evaluation at each hospital was 28 days. The longest time required for diagnosis involved a case of familial Mediterranean fever. Tests performed included blood cultures in 86.8%, serum procalcitonin in 43.8% and positron emission tomography in 29.8% of patients. Conclusions With the widespread use of CT, FUO due to deep-seated abscess or solid tumour is decreasing markedly. Owing to the influence of the ageing population, polymyalgia rheumatica was the most frequent cause (9 patients). Four patients had FUO associated with HIV/AIDS, an important cause of FUO in Japan. In a relatively small number of cases, cause remained unclear. This may have been due to bias inherent in a retrospective study. This study identified diseases that should be considered in the differential diagnosis of FUO. PMID:24362014

Fever of unknown origin as initial manifestation of large vessel giant cell arteritis: diagnosis by colour-coded sonography and 18-FDG-PET.

PubMed

Czihal, M; Tatò, F; Förster, S; Rademacher, A; Schulze-Koops, H; Hoffmann, U

2010-01-01

To evaluate the clinical characteristics and imaging results (CDS, 18-FDG-PET) of patients with large vessel giant cell arteritis (LV-GCA) presenting as fever of unknown origin (FUO). From a series of 82 patients with GCA we identified 8 patients with FUO as initial disease manifestation. Clinical characteristics and results of CDS and 18-FDG-PET were analysed. Patients with FUO and those with other clinical manifestations of GCA were compared. 18-FDG-PET-scans were available for 6/8 patients, revealing enhanced tracer uptake of the thoracic aorta and the aortic branches in all patients. CDS was performed in 8/8 patients, with detection of hypoechogenic wall thickening related to LV-GCA in 7/8 patients. Subjects with FUO were significantly younger (60.9 vs. 69.3 years, p<0.01) and had a stronger humoral inflammatory response (CRP 12.6 vs. 7.1 mg/dl, p<0.01; ESR 110 vs. 71 mm/hour, p<0.01), when compared to the other GCA-patients. LV-GCA should be considered as important differential diagnosis in patients with FUO. In addition to 18-FDG-PET, which is known to be a valuable method in the diagnostic work-up of FUO, we recommend CDS of the supraaortal and femoropopliteal arteries for the initial diagnostic work-up.

Aneurysmal bone cyst of the scapula. A case report.

PubMed

Megas, Panagiotis; Papathanassiou, Zafiria G; Kasimatis, George; Papachristou, Dionysios J

2009-10-01

Aneurysmal bone cyst (ABC) is an uncommon, benign but locally destructive bone lesion of unknown origin. Differential diagnosis can be challenging as it shares common radiological and pathological features with other benign and malignant bone lesions. The degree of diagnostic difficulty grows even more when an unusual location has to be taken into account. We report a rare and challenging case of a large primary ABC located at the scapula of a young male, who was surgically treated with subtotal removal of the scapula.

Synchronous Papillary Carcinoma and Hemangiopericytoma with Lung Metastases

PubMed Central

Malagutti, Nicola; Iannini, Valeria; Rocchi, Andrea; Stomeo, Francesco; Frassoldati, Antonio; Borin, Michela; Pelucchi, Stefano

2013-01-01

Hemangiopericytomas (HPC) are uncommon tumors that originate from perivascular cells of capillary vessels. HPC are about 1% of all vascular tumors and can be found in the head-neck region with an incidence between 16% and 33%. HPC is a neoplasm of uncertain malignant potential; it can behave as an aggressive tumor with metastases and increased mitotic activity or as a relatively benign neoplasm with only local development. In this paper we describe a case of hemangiopericytoma with uncertain malignant potential with cervical location associated with a concomitant papillary thyroid carcinoma and lung metastasis of unknown origin; this case led us to follow a specific and uncommon diagnostic and therapeutic strategy. PMID:24368958

[18F-FDG PET/CT diagnosis of liver cyst infection in a patient with autosomal dominant polycystic kidney disease and fever of unknown origin].

PubMed

Banzo, J; Ubieto, M A; Gil, D; Prats, E; Razola, P; Tardín, L; Andrés, A; Rambalde, E F; Ayala, S M; Cáncer, L; Velilla, J

2013-01-01

The diagnosis, localization and treatment of infected cysts in the kidney or liver of patients with autosomal dominant polycystic kidney disease (ADPKD) remain a clinical challenge. We report the findings of (18)F-FDG PET-CT in an ADPKD diagnosed patient who required renal transplantation five years before and in his follow up presented repeated episodes of bacteriemia without known focus on radiological tests performed. The (18)F-FDG PET-CT scan showed numerous hypermetabolic images with focal or ring-shaped morphology related to the content and the wall of some hepatic cysts. The increased metabolic activity was localized on segments VI and VII. We proceeded to drainage of one cyst in segment VI, removing 110 cc of purulent fluid which grew E. Coli BLEE. The (18)F-FDG PET/CT scan should be included in the diagnostic algorithm for detecting infected liver cysts in patients with ADPKD and fever of unknown origin. Copyright © 2012 Elsevier España, S.L. and SEMNIM. All rights reserved.

AB 66. One-year experience of the pulmonary department of Aristotle University of Thessaloniki in thoracoscopy with local anaesthesia (medical thoracoscopy)

PubMed Central

Spyropoulos, George; Kontakiotis, Theodoros; Spyratos, Dionysios; Iakovidis, Dimitrios; Zoglopitis, Fotis; Zarogoulidis, Konstantinos

2012-01-01

Background Thoracoscopy with local anesthesia or medical thoracoscopy is an invasive method which is rather valuable not only for the approach of undiagnosed exudative pleural effusions but also for the treatment of symptomatic malignant effusions with the conduct of pleurodesis. This is a review of those patients who underwent medical thoracoscopy in the period May 2011 to September 2012 in the Pulmonary Department the Aristotle University of Thessaloniki. Patients and methods Thirty nine thoracoscopies were conducted in our Department since May 2011. Twenty nine patients with cytological test negative for malignancy underwent diagnostic thoracoscopy. Eleven of those procedures were diagnostic and positive for malignancy, while 12 were non-diagnostic and 2 with limited evidence of malignancy. The biopsy results of 2 thoracoscopies showed granulomatous infection and other 2 nonspecific chronic inflammation. Out of all the diagnoses which were positive for malignancy, 2 were related to mesothelioma, 5 to adenocarcinoma (4 of them originated from lungs and one of unknown primary origin) while 1 patient was diagnosed with metastatic papillary adenocarcinoma originated from the thyroid and another one with lymphoma. There were also patients carrying diagnosed illness intending pleurodesis in cases of malignant recrudescent pleural effusions in mesothelioma, lung adenocarcinoma and biliary carcinoma who underwent thoracoscopy. Another patient with recrudescent pneumothorax underwent pleurodesis with talc. Results The major complications which emerged either during the procedure or after the thoracoscopy were two: one patient developed allergy in lidocaine intake for the local anesthesia having as a result to quit the procedure while another patient developed an empyema several weeks later. Conclusions Thoracoscopy with local anesthesia is a safe procedure, tolerable for the patient, which has a significant diagnostic value and only a small percentage of complications.

Cost-benefit analysis of introducing next-generation sequencing (metagenomic) pathogen testing in the setting of pyrexia of unknown origin.

PubMed

Chai, Jia Hui; Lee, Chun Kiat; Lee, Hong Kai; Wong, Nicholas; Teo, Kahwee; Tan, Chuen Seng; Thokala, Praveen; Tang, Julian Wei-Tze; Tambyah, Paul Anantharajah; Oh, Vernon Min Sen; Loh, Tze Ping; Yoong, Joanne

2018-01-01

Pyrexia of unknown origin (PUO) is defined as a temperature of >38.3°C that lasts for >3 weeks, where no cause can be found despite appropriate investigation. Existing protocols for the work-up of PUO can be extensive and costly, motivating the application of recent advances in molecular diagnostics to pathogen testing. There have been many reports describing various analytical methods and performance of metagenomic pathogen testing in clinical samples but the economics of it has been less well studied. This study pragmatically evaluates the feasibility of introducing metagenomic testing in this setting by assessing the relative cost of clinically-relevant strategies employing this investigative tool under various cost and performance scenarios using Singapore as a demonstration case, and assessing the price and performance benchmarks, which would need to be achieved for metagenomic testing to be potentially considered financially viable relative to the current diagnostic standard. This study has some important limitations: we examined only impact of introducing the metagenomic test to the overall diagnostic cost and excluded costs associated with hospitalization and makes assumptions about the performance of the routine diagnostic tests, limiting the cost of metagenomic test, and the lack of further work-up after positive pathogen detection by the metagenomic test. However, these assumptions were necessary to keep the model within reasonable limits. In spite of these, the simplified presentation lends itself to the illustration of the key insights of our paper. In general, we find the use of metagenomic testing as second-line investigation is effectively dominated, and that use of metagenomic testing at first-line would typically require higher rates of detection or lower cost than currently available in order to be justifiable purely as a cost-saving measure. We conclude that current conditions do not warrant a widespread rush to deploy metagenomic testing to resolve any and all uncertainty, but rather as a front-line technology that should be used in specific contexts, as a supplement to rather than a replacement for careful clinical judgement.

Bone metastases of unknown origin: epidemiology and principles of management.

PubMed

Piccioli, Andrea; Maccauro, Giulio; Spinelli, Maria Silvia; Biagini, Roberto; Rossi, Barbara

2015-06-01

Metastases are the most common malignancies involving bone; breast, prostate, lung and thyroid are the main sites of primary cancer. However, up to 30 % of patients present with bone metastases of unknown origin, where the site of the primary neoplasm cannot be identified at the time of diagnosis despite a thorough history, physical examination, appropriate laboratory testing and modern imaging technology (CT, MRI, PET). Sometimes only extensive histopathological investigations on bone specimens from biopsy can suggest the primary malignancy. At other times, a bone lesion can have such a highly undifferentiated histological appearance that a precise pathological classification on routine hematoxylin-eosin-stained section is not possible. The authors reviewed the relevant literature in an attempt to investigate the epidemiology of the histological primaries finally identified in patients with bone metastases from occult cancer, and a strategy of management and treatment of bone metastases from occult carcinomas is suggested. Lung, liver, pancreas and gastrointestinal tract are common sites for primary occult tumors. Adenocarcinoma is the main histological type, accounting for 70 % of all cases, while undifferentiated cancer accounts for 20 %. Over the past 30 years, lung cancer is the main causative occult primary for bone metastases and has a poor prognosis with an average survival of 4-8 months. Most relevant literature focuses on the need for standardized diagnostic workup, as surgery for bone lesions should be aggressive only when they are solitary and/or the occult primaries have a good prognosis; in these cases, identification of the primary tumor may be important and warrants special diagnostic efforts. However, in most cases, the primary site remains unknown, even after autopsy. Thus, orthopedic surgery has a mainly palliative role in preventing or stabilizing pathological fractures, relieving pain and facilitating the care of the patient in an attempt to provide the most appropriate therapy for the primary tumor as soon as possible. 5.

Persistent socket pain postenucleation and post evisceration: a systematic review.

PubMed

Hogeboom, Charlotte S E; Mourits, Daphne L; Ket, Johannes C F; Tan, H Stevie; Hartong, Dyonne T; Moll, Annette C

2018-04-06

To investigate causes, diagnostics and treatment modalities for persistent socket pain (PSP) after enucleation and evisceration. A systematic search was undertaken in accordance with the PRISMA Statement, in PubMed, Embase.com and Thomson Reuters/Web of Science. We searched for relevant papers until the 28th of July 2016. Inclusion criteria were (1) patients with a history of enucleation or evisceration, (2) PSP, (3) report of the cause and/or used diagnostics and/or treatment modality, (4) full text in English, Dutch or Spanish language. Excluded were (1) review articles, (2) comments, and publications concerning, (3) nonhumans, (4) exenterated patients, (5) acute postoperative pain, or (6) periorbital pain without pain in the socket. Given the lack of high quality evidence from randomized controlled trials, we examined all available evidence from primary observational studies and assessed quality within this lower level of evidence. A total of 32 studies were included. Causes of PSP found were prosthesis-related (n = 5), dry socket (n = 2), trochleitis (n = 3), compression of the trigeminal nerve (n = 2), implant-related (n = unknown), inflammation (n = 5), surgery-related (n = 4), neuromas (n = 8), malignant tumours (n = 3), psychiatric/psychosocial (n = 2), phantom pain (n = 149), rarer entities (n = 3) or unknown (n = 14). Nonsurgical treatments suffice for conditions as trochleitis, prosthesis-related pain, dry socket and for phantom pain. Other causes of pain may require more invasive treatments such as implant removal. Careful history and examination can give some direction in the diagnostic procedure; however, PSP is probably multifactorial and the specific origin(s) may remain uncertain. Implant replacement can be an effective treatment. Studies to identifiy less invasive procedures are required. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

How much helpful is the capsule endoscopy for the diagnosis of small bowel lesions?

PubMed Central

Ersoy, Osman; Sivri, Bulent; Arslan, Serap; Batman, Figen; Bayraktar, Yusuf

2006-01-01

AIM: To assess the practically usefulness and diagnostic yield of this new method in a group of patients with suspected small bowel lesions. METHODS: Capsule endoscopic (CE) examination by using M2A capsule endoscope TM (Given Imaging, Yoqneam, Israel) was performed in thirty nine patients (26 males, 13 females) with suspected small intestinal lesions. The composing of the patients was as follows: obscure gastrointestinal bleeding in twenty three patients, known Crohn’s disease in 6 patients, in whom CE was used to evaluate the severity and extension of the diseases, chronic diarrhea in 8 patients, abdominal pain in one patient and malignancy in one patient with unknown origin. RESULTS: In two patients CE failed. Different abnormalities were revealed in 26 patients overall. Detection rate of abnormalities was highest among patients with obscure gastrointestinal bleeding and the source of bleeding was demonstrated in 17 of 23 patients with obscure bleeding (73.9%). Entero-Behcet was diagnosed in two patients by CE as a source of obscure gastrointestinal bleeding. In 6 patients with known Crohn's disease, CE revealed better evaluation of the disease extension. In 3 of 8 (37.5%) patients with chronic diarrhea; CE revealed some mucosal abnormalities as the cause of chronic diarrhea. In a patient with unexplained abdominal pain and in a cancer patient with unknown origin, CE examination was normal. CONCLUSION: In our relatively small series, we found that capsule endoscopy is a useful diagnostic tool particularly in diagnosis of obscure gastrointestinal bleeding, chronic diarrhea and in estimating the extension of Crohn’s disease. PMID:16804980

[Giant inflammatory pseudotumor of the cranial base].

PubMed

Carrasco-Moro, Rodrigo; Martínez-San Millán, Juan; Pian, Héctor

The inflammatory pseudotumour (IPT) is a non-neoplastic entity of unknown origin, and is characterised by a proliferation of connective tissue and a polyclonal inflammatory infiltrate. Central nervous system involvement is uncommon, and usually represents a diagnostic and therapeutic challenge even for the experienced clinician. This reports deals with the case of a 56year-old woman diagnosed with a giant, infiltrating mass centred in the left cavernous sinus, who had a rapid clinical and radiological response to steroid therapy. Biopsy specimens were diagnostic for IPT. The progression of a small orbital residual lesion was detected after steroid withdrawal. Treatment with cyclophosphamide induced a complete response that remains stable after six years of follow-up. Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

Cervical lymph node metastases of squamous cell carcinoma of unknown origin: the diagnostic value of FDG PET/CT and clinical outcome.

PubMed

Dale, Einar; Moan, Jon M; Osnes, Terje A; Bogsrud, Trond V

2017-02-01

FDG PET/CT is perceived as a valuable diagnostic tool in addition to the standard diagnostic workup for patients with isolated neck lymph nodes of squamous cell carcinoma of unknown primary (SCCUP). For patients with SCCUP intended for primary radiotherapy, we hypothesize that the previously reported FDG PET/CT detection rates are too high. From 2008 to 2015, 30 SCCUP patients were examined with FDG PET/CT. The objective of the FDG PET/CT examination was twofold: (1) improve the radiotherapy target definition, and (2) identify the primary cancer. Before the FDG PET/CT, the patients had been through a standard workup consisting of CT of the neck and chest, examination with flexible endoscopy with patient awake, panendoscopy and examination under general anesthesia, tonsillectomy and sometimes blind sampling biopsies, and MRI (floor of the mouth). All FDG PET/CTs were performed applying a flat table, head support and fixation mask as part of the radiotherapy treatment planning. Diagnostic CT with contrast was an integrated part of the PET/CT examination. Only 1/30 patients (cancer of the vallecula) had their primary cancer detected by FDG PET/CT. In addition, a non-biopsied patient with high uptake in the ipsilateral palatine tonsil was included, giving a detection rate of ≤7 % (95 % CI 2-21 %). In this retrospective study, we found that the FDG PET/CT detection rate of the primary for SCCUP patients is lower than previously reported. It is questionable whether FDG PET/CT is necessary for these patients when improved, advanced workup is available.

Pathophysiology of Hyperhidrosis.

PubMed

Schick, Christoph H

2016-11-01

Studies and case reports on excessive sweating frequently state that hyperhidrosis is a disease whose origin and mechanism are unknown. However, the term excessive is rarely based on systematic diagnostic measurements, instead being a description of the symptoms from patient histories, which suggests that hyperhidrosis is purely a problem involving the quantity of sweat, whereas it is a change in the control mechanism of sweating in which the need for and production of sweat are strongly disproportionate. This lack of proportion is perceived by those affected to be a limitation of activities of daily living and is thus pathologic. Copyright © 2016 Elsevier Inc. All rights reserved.

Lung Lesions During Fever of Unknown Origin.

PubMed

Krupa, Renata; Zielonka, Tadeusz M; Hadzik-Blaszczyk, Malgorzata; Wardyn, Kazimierz A; Zycinska, Katarzyna

2017-01-01

Fever of unknown origin (FUO) remains one of the most difficult diagnostic challenges. The causes of FUO can be various diseases located in different organs. The aim of the study was to determine the prevalence and nature of pulmonary lesions during FUO. One hundred and sixty one patients with FUO participated in this prospective study. We performed a detailed comprehensive history, physical examination, and a wide spectrum of tests. The most common causes of FUO were infections (39%), autoimmune conditions (28%), and neoplasms (17%). Lung lesions were found in 30% of patients. In this group 35% were infections, 30% autoimmune diseases, and 4% cancer. Among patients with respiratory infections, there were cases of tuberculosis, atypical pneumonia, lung abscess, and bronchiectases. Autoimmune pulmonary lesions were observed during vasculitis and systemic lupus. The causes of FUO in the group of patients with lung lesions were also pulmonary embolism, sarcoidosis, and pulmonary fibrosis. Chest CT played an important role in the diagnosis of the causes of FUO with pulmonary manifestations. Pulmonary lesions are a common cause of FUO. Most FUO with pulmonary lesions are recognized during infections and autoimmune diseases. An important part of diagnosing FUO is a detailed evaluation of the respiratory system.

Chest Radiographic Screening for Sarcoidosis in the Diagnosis of Patients with Active Uveitis.

PubMed

Groen, Fahriye; van Laar, Jan A M; Rothova, Aniki

2017-06-01

Although chest radiography is currently recommended for the initial evaluation of patients with new-onset uveitis, the efficacy of this diagnostic screening modality is not known. To evaluate the diagnostic value of chest radiographs in patients with active uveitis of recent onset in a tertiary center in Western Europe. A retrospective cross-sectional study was conducted by reviewing all chest imaging for adults with new-onset (<1 yr) uveitis of unknown origin undergoing initial evaluation in the Department of Ophthalmology at Erasmus University Medical Center (Rotterdam, the Netherlands). Radiographic findings were related to clinical and other imaging characteristics and to final diagnoses. Screening chest radiographs were abnormal for 30 of 200 patients (15%) included in this study. Twenty-two of the 200 patients (11%) had biopsy-confirmed sarcoidosis, and an additional 12 patients were presumed to have sarcoidosis. The finding of chest radiographic abnormalities interpreted as typical of sarcoidosis was specific (91%; 95% confidence interval, 85.9-94.4%) but not sensitive (64%; 95% confidence interval, 43.0-80.3%) for biopsy-confirmed sarcoidosis. The combination of elevated serum angiotensin-converting enzyme level and chest radiographic findings typical of sarcoidosis increased the sensitivity to 79%. Biopsy-confirmed sarcoidosis was more common in patients with panuveitis (17 of 84; 20%) compared to patients with other anatomical locations of uveitis (5 of 116, 4%; P < 0.001). One patient was diagnosed with active pulmonary and ocular tuberculosis. Abnormal chest radiographs were found in 15% of patients with active uveitis of unknown origin and onset within 1 year of referral to a tertiary center in the Netherlands. A majority of the abnormal chest radiographs showed findings compatible with a diagnosis of sarcoidosis.

Fever of Unknown Origin in Children: A 6 year- Experience in a Tertiary Pediatric Egyptian Hospital

PubMed Central

Hassan, Rasha H; Fouda, Ashraf E; Kandil, Shaimaa M

2014-01-01

Background Fever of unknown origin (FUO) is among the most conditions which poses challenge in diagnosis. The presence of information on regional patterns of FUO will shorten the time for diagnosis and reduces health services costs. There are almost no previous studies describing the etiology of FUO in children of Egypt or nearby countries. Aim of the Study To determine different causes of FUO and the possible diagnostic procedures. Methods Data of patients with FUO, presented to the Infectious Diseases Unit of Mansoura University Children Hospital, were retrospectively collected in a 6 year-period from May 2006 to May 2011. The study included children with a fever of 38.3° C or more documented by a health care provider and for which the cause could not be identified after 3 weeks of evaluation as an outpatient or after a week of evaluation in hospital. Patients were then categorized into 5 groups. Results 127 patients met the diagnostic criteria. Infectious diseases were the commonest causes of FUO in 46 cases (36.22%) followed by the miscellaneous causes in 38 cases (29.9%). Meanwhile, collagen vascular diseases and malignancy were diagnosed in 13 cases (10.2%) and 10 cases (7.87%) respectively. While, 20 cases (15.75%) remained undiagnosed. Conclusions Infectious diseases are the commonest cause of FUO. The delay in diagnosis was due to atypical presentations or inappropriate use of antibiotic prior to the referral. Non infectious causes, malignancy and collagen or vascular disorders were diagnosed in rest of the patients. However, about 15% of our patients remained undiagnosed. The diagnosis was established by non-invasive means in more than two-third of the cases. PMID:24899875

Prevalence and impact on clinicopathological characteristics of human papillomavirus-16 DNA in cervical lymph node metastases of head and neck squamous cell carcinoma.

PubMed

Weiss, Daniel; Koopmann, Mario; Rudack, Claudia

2011-06-01

Human papillomavirus (HPV) is a basic risk factor for head and neck squamous cell carcinoma (HNSCC). Little knowledge exists about the impact of HPV on clinical diagnostic and therapy of patients with HNSCC. We evaluated the evidence of HPV16 in 131 retrospectively collected HNSCC and associated cervical lymph node metastases by HPV16 real-time polymerase chain reaction (PCR) and p16 immunohistochemistry and its impact on clinicopathological characteristics. HPV16-DNA and p16 overexpression were present in 27% of HNSCCs. All cervical lymph node metastases of HPV16-positive HNSCC showed HPV16-DNA. HPV16 was strongly associated with tumors arising from the oropharyngeal site (p < .000001), favorable outcome after standard therapy in univariate (p = .001) and multivariate (p = .0004) analysis, and cervical lymph node metastases before primary detection. HPV16-diagnostic in cervical lymph node metastases can predict the site of tumor origin in case of carcinoma of unknown primary (CUP) and favorable outcome and should, therefore, be included in routine diagnostic workup. Copyright © 2010 Wiley Periodicals, Inc.

Improving the histopathologic diagnosis of pediatric malignancies in a low-resource setting by combining focused training and telepathology strategies.

PubMed

Santiago, Teresa C; Jenkins, Jesse J; Pedrosa, Francisco; Billups, Catherine; Quintana, Yuri; Ribeiro, Raul C; Qaddoumi, Ibrahim

2012-08-01

Accurate diagnosis is critical for optimal management of pediatric cancer. Pathologists with experience in pediatric oncology are in short supply in the developing world. Telepathology is increasingly used for consultations but its overall contribution to diagnostic accuracy is unknown. We developed a strategy to provide a focused training in pediatric cancer and telepathology support to pathologists in the developing world. After the training period, we compared trainee's diagnoses with those of an experienced pathologist. We next compared the effectiveness of static versus dynamic telepathology review in 127 cases. Results were compared by Fisher's exact test. The diagnoses of the trainee and the expert pathologist differed in only 6.5% of cases (95% CI, 1.2-20.0%). The overall concordance between the telepathology and original diagnoses was 90.6% (115/127; 95% CI, 84.1-94.6%). Brief, focused training in pediatric cancer histopathology can improve diagnostic accuracy. Dynamic and static telepathology analyses are equally effective for diagnostic review. Copyright © 2012 Wiley Periodicals, Inc.

Male breast cancer arising in ectopic axillary breast tissue: A diagnostic dilemma.

PubMed

Xie, Yangchun; Huang, Jin; Xiao, Desheng; Zhong, Meizuo

2013-06-01

Male breast cancer arising in ectopic axillary breast tissue is a rare occurrence and few cases have been reported in the literature. Due to its rarity, male axillary breast cancer is easy to misdiagnose. As for adenocarcinoma in the axilla, it is difficult to identify whether the origin is the mammary tissue or the skin appendages, particularly in cases where there is a poor differentiation. The present study reports the case of a male patient with a right axillary lesion that had been present for 6 months. A histological evaluation revealed the features of a poorly-differentiated adenocarcinoma with regards to the pathological report. The patient was diagnosed with a metastatic adenocarcinoma with unknown primary origin. However, following 4 cycles of intensive chemotherapy, the patient experienced bone metastasis while the local lesion was in partial remission. Further immunohistochemistry confirmed its mammary origin. There is limited literature relating to male ectopic axillary breast cancer, and a high probability of misdiagnosis of this disease.

Male breast cancer arising in ectopic axillary breast tissue: A diagnostic dilemma

PubMed Central

XIE, YANGCHUN; HUANG, JIN; XIAO, DESHENG; ZHONG, MEIZUO

2013-01-01

Male breast cancer arising in ectopic axillary breast tissue is a rare occurrence and few cases have been reported in the literature. Due to its rarity, male axillary breast cancer is easy to misdiagnose. As for adenocarcinoma in the axilla, it is difficult to identify whether the origin is the mammary tissue or the skin appendages, particularly in cases where there is a poor differentiation. The present study reports the case of a male patient with a right axillary lesion that had been present for 6 months. A histological evaluation revealed the features of a poorly-differentiated adenocarcinoma with regards to the pathological report. The patient was diagnosed with a metastatic adenocarcinoma with unknown primary origin. However, following 4 cycles of intensive chemotherapy, the patient experienced bone metastasis while the local lesion was in partial remission. Further immunohistochemistry confirmed its mammary origin. There is limited literature relating to male ectopic axillary breast cancer, and a high probability of misdiagnosis of this disease. PMID:23833669

5. Photographic copy of photograph (date unknown, original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. Photographic copy of photograph (date unknown, original print in the possession of the Wisconsin Veterans Museums). SIX COTTAGES. VIEW UNKNOWN. - Wisconsin Home for Veterans, King, Waupaca County, WI

8. Photographic copy of photograph (date unknown, original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Photographic copy of photograph (date unknown, original print in the possession of the Wisconsin Veterans Museums). SEVEN COTTAGES. VIEW UNKNOWN. - Wisconsin Home for Veterans, King, Waupaca County, WI

4. Photographic copy of photograph (date unknown, original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Photographic copy of photograph (date unknown, original print in the possession of the Wisconsin Veterans Museums). COTTAGES WITH DIRT ROAD IN FOREGROUND. LOCATION UNKNOWN. - Wisconsin Home for Veterans, King, Waupaca County, WI

Prospective evaluation of fever of unknown origin in patients infected with the human immunodeficiency virus. Grupo Andaluz para el Estudio de las Enfermedades Infecciosas.

PubMed

Lozano, F; Torre-Cisneros, J; Bascuñana, A; Polo, J; Viciana, P; García-Ordóñez, M A; Hernández-Quero, J; Márquez, M; Vergara, A; Díez, F; Pujol, E; Torres-Tortosa, M; Pasquau, J; Hernández-Burruezo, J J; Suárez, I

1996-09-01

The aim of this study was to determine the frequency and aetiology of fever of unknown origin (FUO) in patients infected with the human immunodeficiency virus (HIV), to assess the value of the tests used in its diagnosis, and to evaluate possible models of diagnosis for the causes found most frequently. One hundred twenty-eight (3.5%) of 3603 hospitalised HIV-positive patients evaluated from October 1992 to December 1993 had FUO, defined by established criteria. Eighty-six percent of patients with FUO had previously progressed to AIDS. The median CD4+ cell count was 46/mm3. A definite diagnosis was made in 96 (75%) of the 128 patients and a possible diagnosis in 24 (18.7%). whilst no diagnosis was made in eight cases (6.2%). Tuberculosis (48.3%), visceral leishmaniasis (16%), and infection by Mycobacterium avium complex (6.9%) were the diseases found most frequently. The most useful diagnostic tests were liver biopsy (68.9%) and bone marrow aspirate/biopsy (39.7%). It is not possible to predict clinically the cases of FUO due to tuberculosis, whilst thrombocytopaenia < 100,000 cells/mm3 alone is useful for differentiating the cases of visceral leishmaniasis, with a negative predictive value of 95.2%.

Exploring utilitarian and hedonic antecedents for adopting information from a recommendation agent and unplanned purchase behaviour

NASA Astrophysics Data System (ADS)

Huang, Li-Ting

2016-01-01

Research indicated that in order for properly utilizing recommendation agents (RAs), customers must rationally evaluate capability and suggestions of RAs during the interaction process. However, enjoying interactive processes and interface is also important. Methods for increasing user enjoyment of RAs are yet unknown. This study investigated the influences of utilitarian and hedonic factors on intention to adopt RAs suggestions and their antecedents. Involvement influences relative importance of utilitarian and hedonic factors. Contrary to common assumptions, customers may make unplanned purchases, rather than rational purchase. A field experiment with 2 × 2 × 2 factorial design reveals main findings. First, information diagnosticity and enjoyment enhance adoption intention simultaneously. Information diagnosticity is more important than enjoyment. Diagnosticity was determined by outcome similarity, and enjoyment was determined by both outcome similarity and atmospherics. The context of interacting with RAs is important. Outcome similarity even directly affects adoption intention. Second, highly involved users considered enjoyment and diagnosticity when forming adoption intentions, while users with low involvement only considered enjoyment. Third, information cascades altered the relationship between adoption intention and unplanned purchases. Most customers change selection after seeing ratings from other customers, even if they originally strongly want to adoption suggestion from RAs. Theoretical and managerial implications are proposed.

OMOM capsule endoscopy in diagnosis of small bowel disease

PubMed Central

Li, Chen-yi; Zhang, Bing-ling; Chen, Chun-xiao; Li, You-ming

2008-01-01

Objective: To assess the diagnostic efficiency of OMOM capsule endoscopy (CE) in a group of patients with different indications. Methods: Data from 89 consecutive patients (49 males, 40 females) with suspected small bowel disease who underwent OMOM CE (Jinshan Science and Technology Company, Chongqing, China) examination were obtained by retrospective review. The patients’ indications of the disease consisted of the following: obscure gastrointestinal bleeding (OGIB), abdominal pain or diarrhea, partial intestinal obstruction, suspected inflammatory bowel disease, tumor of unknown origin, hypoproteinemia, constipation, weight loss, and elevated tumor markers. Results: CE failed in one patient. Visualization of the entire small bowel was achieved in 75.0%. Capsules were naturally excreted by all patients. The detection rate of abnormalities was 70.5% for patients with suspected small bowel disease, and the diagnostic yield for patients with OGIB was higher than that for patients with abdominal pain or diarrhea (85.7% vs 53.3%, P<0.005). Angiodysplasia was the most common small bowel finding. Active bleeding sites were noted in the small intestine in 11 cases. Conclusion: OMOM CE is a useful diagnostic tool for the diagnosis of variably suspected small bowel disease, whose diagnostic efficiency is similar to that of the Pillcam SB (small bowel) CE (Given Imaging, Yoqneam, Israel). PMID:18988304

The Ability to Diagnose Intrahepatic Cholangiocarcinoma Definitively Using Novel Branched DNA-Enhanced Albumin RNA In Situ Hybridization Technology.

PubMed

Ferrone, Cristina R; Ting, David T; Shahid, Mohammed; Konstantinidis, Ioannis T; Sabbatino, Francesco; Goyal, Lipika; Rice-Stitt, Travis; Mubeen, Ayesha; Arora, Kshitij; Bardeesey, Nabeel; Miura, John; Gamblin, T Clark; Zhu, Andrew X; Borger, Darrell; Lillemoe, Keith D; Rivera, Miguel N; Deshpande, Vikram

2016-01-01

Intrahepatic cholangiocarcinoma (ICC) often is a diagnosis determined by exclusion. Distinguishing ICC from other metastatic adenocarcinomas based on histopathologic or immunohistochemical analysis often is difficult and requires an extensive workup. This study aimed to determine whether albumin, whose expression is restricted to the liver, has potential as a biomarker for ICC using a novel and highly sensitive RNA in situ hybridization (ISH) platform. Modified branched DNA probes were developed for albumin RNA ISH. The study evaluated 467 patient samples of primary and metastatic lesions. Of the 467 samples evaluated, 83 were ICCs, 42 were hepatocellular carcinomas (HCCs), and 332 were nonhepatic carcinomas including tumors arising from the perihilar region and bile duct, pancreas, stomach, esophagus, colon, breast, ovary, endometrium, kidney, and urinary bladder. Albumin RNA ISH was highly sensitive for cancers of liver origin, staining positive in 82 (99 %) of 83 ICCs and in 42 HCCs (100 %). Perihilar and distal bile duct carcinomas as well as carcinomas arising at other sites tested negative for albumin. Notably, 6 (22 %) of 27 intrahepatic tumors previously diagnosed as carcinomas of undetermined origin tested positive for albumin. Albumin RNA ISH is a sensitive and highly specific diagnostic tool for distinguishing ICC from metastatic adenocarcinoma to the liver or carcinoma of unknown origin. Albumin RNA ISH could replace the extensive diagnostic workup, leading to timely confirmation of the ICC diagnosis. Additionally, the assay could serve as a guide to distinguish ICC from perihilar adenocarcinoma.

Evaluation of the prevalence and clinical impact of toxocariasis in patients with eosinophilia of unknown origin

PubMed Central

Kim, Hong-Beum; Seo, Jun-Won; Lee, Jun-Hyung; Choi, Byung-Seok; Park, Sang-Gon

2017-01-01

Background/Aims Eosinophilia has numerous diverse causes, and in many patients, it is not possible to establish the cause of eosinophilia. Recently, toxocariasis was introduced as one cause of eosinophilia. The aims of this study were to evaluate the prevalence of toxocariasis and the clinical impact of albendazole treatment for toxocariasis in patients suspected of eosinophilia of unknown origin. Methods We performed a retrospective chart review. After evaluation of cause of eosinophilia, the patients suspected of eosinophilia of unknown origin performed immunoglobulin G antibody specific assay for the Toxocara canis larval antigen by enzyme-linked immunosorbent assay. Results This study evaluated 113 patients, 69 patients (61%) were suspected of eosinophilia of unknown origin. Among these 69 patients, the frequency of T. canis infection was very high (45 patients, 65.2%), and albendazole treatment for 45 eosinophilia with toxocariasis was highly effective for a cure of eosinophilia than no albendazole group regardless of steroid (82.3%, p = 0.007). Furthermore, among the nonsteroid treated small group (19 patients), albendazole treatment for eosinophilia were more effective than no albendazole group, too (83.3% vs. 28.6 %, p = 0.045). Conclusions The prevalence of toxocariasis was high among patients suspected of eosinophilia of unknown origin; therefore, evaluation for T. canis infection is recommended for patients with eosinophilia of unknown origin. Furthermore, for patients suspected of eosinophilia of unknown origin who have positive results for T. canis, albendazole treatment may be considered a valuable treatment option. PMID:28352060

Evaluation of the prevalence and clinical impact of toxocariasis in patients with eosinophilia of unknown origin.

PubMed

Kim, Hong-Beum; Seo, Jun-Won; Lee, Jun-Hyung; Choi, Byung-Seok; Park, Sang-Gon

2017-05-01

Eosinophilia has numerous diverse causes, and in many patients, it is not possible to establish the cause of eosinophilia. Recently, toxocariasis was introduced as one cause of eosinophilia. The aims of this study were to evaluate the prevalence of toxocariasis and the clinical impact of albendazole treatment for toxocariasis in patients suspected of eosinophilia of unknown origin. We performed a retrospective chart review. After evaluation of cause of eosinophilia, the patients suspected of eosinophilia of unknown origin performed immunoglobulin G antibody specific assay for the Toxocara canis larval antigen by enzyme-linked immunosorbent assay. This study evaluated 113 patients, 69 patients (61%) were suspected of eosinophilia of unknown origin. Among these 69 patients, the frequency of T. canis infection was very high (45 patients, 65.2%), and albendazole treatment for 45 eosinophilia with toxocariasis was highly effective for a cure of eosinophilia than no albendazole group regardless of steroid (82.3%, p = 0.007). Furthermore, among the nonsteroid treated small group (19 patients), albendazole treatment for eosinophilia were more effective than no albendazole group, too (83.3% vs. 28.6 %, p = 0.045). The prevalence of toxocariasis was high among patients suspected of eosinophilia of unknown origin; therefore, evaluation for T. canis infection is recommended for patients with eosinophilia of unknown origin. Furthermore, for patients suspected of eosinophilia of unknown origin who have positive results for T. canis , albendazole treatment may be considered a valuable treatment option.

Effects of memory colour on colour constancy for unknown coloured objects

PubMed Central

Granzier, Jeroen J M; Gegenfurtner, Karl R

2012-01-01

The perception of an object's colour remains constant despite large variations in the chromaticity of the illumination—colour constancy. Hering suggested that memory colours, the typical colours of objects, could help in estimating the illuminant's colour and therefore be an important factor in establishing colour constancy. Here we test whether the presence of objects with diagnostical colours (fruits, vegetables, etc) within a scene influence colour constancy for unknown coloured objects in the scene. Subjects matched one of four Munsell papers placed in a scene illuminated under either a reddish or a greenish lamp with the Munsell book of colour illuminated by a neutral lamp. The Munsell papers were embedded in four different scenes—one scene containing diagnostically coloured objects, one scene containing incongruent coloured objects, a third scene with geometrical objects of the same colour as the diagnostically coloured objects, and one scene containing non-diagnostically coloured objects (eg, a yellow coffee mug). All objects were placed against a black background. Colour constancy was on average significantly higher for the scene containing the diagnostically coloured objects compared with the other scenes tested. We conclude that the colours of familiar objects help in obtaining colour constancy for unknown objects. PMID:23145282

Effects of memory colour on colour constancy for unknown coloured objects.

PubMed

Granzier, Jeroen J M; Gegenfurtner, Karl R

2012-01-01

The perception of an object's colour remains constant despite large variations in the chromaticity of the illumination-colour constancy. Hering suggested that memory colours, the typical colours of objects, could help in estimating the illuminant's colour and therefore be an important factor in establishing colour constancy. Here we test whether the presence of objects with diagnostical colours (fruits, vegetables, etc) within a scene influence colour constancy for unknown coloured objects in the scene. Subjects matched one of four Munsell papers placed in a scene illuminated under either a reddish or a greenish lamp with the Munsell book of colour illuminated by a neutral lamp. The Munsell papers were embedded in four different scenes-one scene containing diagnostically coloured objects, one scene containing incongruent coloured objects, a third scene with geometrical objects of the same colour as the diagnostically coloured objects, and one scene containing non-diagnostically coloured objects (eg, a yellow coffee mug). All objects were placed against a black background. Colour constancy was on average significantly higher for the scene containing the diagnostically coloured objects compared with the other scenes tested. We conclude that the colours of familiar objects help in obtaining colour constancy for unknown objects.

[Diagnosis and differential diagnosis of pancreatitis--diagnostic relevance of clinical and biochemical changes during the course of the disease and of endoscopic retrograde pancreatography (author's transl)].

PubMed

Ammann, R

1976-08-01

In order to classify a patient with pancreatitis according to the Marseille clasiffication the following criteria must be fulfilled: (a) an acute attach of pancreatitis must be observed, (b) the cause of pancreatitis has to be established, (c) the patient has to be followed over longer periods of time in order to find out, whether the process becomes chronic (involving progredient endocrine and exocrine insufficiency). Diagnostic problems of acute pancreatitis, relapsing pancreatitis, and chronic pancreatitis are discussed taking into account the author's own results. It is concluded, that repeated tests of pancreatitis function and demonstration of pancreatic calcification are more important for establishing the diagnosis of chronic pancreatitis than studies of pancreatic morphology including endoscopic retrograde pancreatography (ERP). ERP may help to find the cause of relapsing pancreatitis of unknown origine; it may help as well preoperatively to diagnose local changes of the pancreatic duct system in chronic pancreatitis.

A rare genetic disorder causing persistent severe neonatal hypoglycaemia the diagnostic workup.

PubMed

Francescato, Gaia; Salvatoni, Alessandro; Persani, Luca; Agosti, Massimo

2012-07-19

We report a case of familial glucocorticoid deficiency (FGD), a rare genetic autosomal-recessive disorder with typical hyperpigmentation of the skin and mucous membranes, severe hypoglycaemia, occasionally leading to seizures and coma, feeding difficulties, failure to thrive and infections. A newborn child was admitted, on his second day of life, to our neonatal intensive care unit because of seizures and respiratory insufficiency. Hyperpigmentation was not evident due to his Senegalese origin. The clinical presentation led us to consider a wide range of diagnostic hypothesis. Laboratory findings brought us to the diagnosis of FGD that was confirmed by molecular analysis showing an MC2R:p.Y254C mutation previously reported as causative of type 1 FGD and two novel heterozygous non-synonymous single-nucleotide polymorphisms in exon 2 and 3 of melanocortin 2 receptor accessory protein-α, whose role in the disease is currently unknown. The importance of an early collection and storage of blood samples during hypoglycaemic event is emphasised.

Coma of unknown origin in the emergency department: implementation of an in-house management routine.

PubMed

Braun, Mischa; Schmidt, Wolf Ulrich; Möckel, Martin; Römer, Michael; Ploner, Christoph J; Lindner, Tobias

2016-04-27

Coma of unknown origin is an emergency caused by a variety of possibly life-threatening pathologies. Although lethality is high, there are currently no generally accepted management guidelines. We implemented a new interdisciplinary standard operating procedure (SOP) for patients presenting with non-traumatic coma of unknown origin. It includes a new in-house triage process, a new alert call, a new composition of the clinical response team and a new management algorithm (altogether termed "coma alarm"). It is triggered by two simple criteria to be checked with out-of-hospital emergency response teams before the patient arrives. A neurologist in collaboration with an internal specialist leads the in-hospital team. Collaboration with anaesthesiology, trauma surgery and neurosurgery is organised along structured pathways that include standardised laboratory tests and imaging. Patients were prospectively enrolled. We calculated response times as well as sensitivity and false positive rates, thus proportions of over- and undertriaged patients, as quality measures for the implementation in the SOP. During 24 months after implementation, we identified 325 eligible patients. Sensitivity was 60 % initially (months 1-4), then fluctuated between 84 and 94 % (months 5-24). Overtriage never exceeded 15 % and undertriage could be kept low at a maximum of 11 % after a learning period. We achieved a median door-to-CT time of 20 minutes. 85 % of patients needed subsequent ICU treatment, 40 % of which required specialised neuro-ICUs. Our results indicate that our new simple in-house triage criteria may be sufficient to identify eligible patients before arrival. We aimed at ensuring the fastest possible proceedings given high portions of underlying time-sensitive neurological and medical pathologies while using all available resources as purposefully as possible. Our SOP may provide an appropriate tool for efficient management of patients with non-traumatic coma. Our results justify the assignment of the initial diagnostic workup to neurologists and internal specialists in collaboration with anaesthesiologists.

[Fulminant isolated necrotizing fasciitis of the chest wall, complicating thoracic empyema].

PubMed

Kovács, Ottó; Szántó, Zoltán; Krasznai, Géza

2016-03-01

Authors introduce the case of a 64-year-old male patient with fulminant isolated necrotizing fasciitis of the chest wall, complicating empyema thoracis of unknown origin. The patient's co-morbidities were hypertension, ischaemic heart disease, atrial fibrillation with oral anticoagulation. The real etiology was revealed post mortem, due to the rapid progression. The autopsy demonstrated that the fasciitis was caused by a small blunt thoracic trauma (haematoma), not emerged from patient's history and was not visible during physical examination. Authors review diagnostic pitfalls, leading to delayed recognition in addition to this very case. After quick diagnosis surgical debridement, targeted wide spectrum antibiotics and maximal intensive care are the basic pillars of the management of necrotizing fasciitis.

[Advances in the management of cervical lymphadenopathies of unknown primary: advances in diagnostic imaging and surgical modalities and new international staging system].

PubMed

Troussier, Idriss; Klausner, Guillaume; Morinière, Sylvain; Blais, Eivind; Jean-Christophe Faivre; Champion, Ambroise; Geoffrois, Lionnel; Pflumio, Carole; Babin, Emmanuel; Maingon, Philippe; Thariat, Juliette

2018-02-01

Cervical lymphadenopathies of unknown primary represent 3 % of head and neck cancers. Their diagnostic work up has largely changed in recent years. This review provides an update on diagnostic developments and their potential therapeutic impact. This is a systematic review of the literature. In recent years, changes in epidemiology-based prognostic factors such as human papilloma virus (HPV) cancers, advances in imaging and minimally invasive surgery have been integrated in the management of cervical lymphadenopathies of unknown primary. In particular, systematic use of PET scanner and increasing practice of robotic or laser surgery have contributed to increasing detection rate of primary cancers. These allow more adapted and personalized treatments. The impact of changes in the eighth TNM staging system is discussed. The management of cervical lymphadenopathies of unknown primary cancer has changed significantly in the last 10 years. On the other hand, practice changes will have to be assessed. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Population-based incidence, treatment and survival of patients with peritoneal metastases of unknown origin.

PubMed

Thomassen, Irene; Verhoeven, Rob H A; van Gestel, Yvette R B M; van de Wouw, Agnes J; Lemmens, Valery E P P; de Hingh, Ignace H J T

2014-01-01

Until recently, peritoneal metastases (PM) were regarded as an untreatable condition, regardless of the organ of origin. Currently, promising treatment options are available for selected patients with PM from colorectal, appendiceal, ovarian or gastric carcinoma. The aim of this study was to investigate the incidence, treatment and survival of patients presenting with PM in whom the origin of PM remains unknown. Data from patients diagnosed with PM of unknown origin during 1984-2010 were extracted from the Eindhoven Cancer Registry. European age-standardised incidence rates were calculated and data on treatment and survival were analysed. In total 1051 patients were diagnosed with PM of unknown origin. In 606 patients (58%) the peritoneum was the only site of metastasis, and 445 patients also had other metastases. Chemotherapy usage has increased from 8% in the earliest period to 16% in most recent years (p=.016). Median survival was extremely poor with only 42days (95% confidence interval (CI) 39-47days) and did not change over time. Median survival of patients not receiving chemotherapy was significantly worse than of those receiving chemotherapy (36 versus 218days, p<.0001). The prognosis of PM of unknown origin is extremely poor and did not improve over time. Given the recent progress that has been achieved in selected patients presenting with PM, maximum efforts should be undertaken in order to diagnose the origin of PM as accurately as possible. Potentially effective treatment strategies should be further explored for patients in whom the organ of origin remains unknown. Copyright © 2013 Elsevier Ltd. All rights reserved.

[The changing spectrum of fever of unknown origin: trends and comparison with previous series at the Salvador Zubirán National Institute of Nutrition].

PubMed

Molina-Gamboa, J; Rivera-Morales, I; Camacho-Mezquita, E; Ponce-de-León, S

1994-01-01

We reviewed 400 medical records of patients admitted because of fever at the National Institute of Nutrition Salvador Zubirán between January 1, 1988 to December 31, 1992. Patient characteristics, diagnostic methods, final diagnosis and patient progress were analyzed, comparing these data with the previous series of the institute. We found 77 cases of fever of unknown origin (FUO), 47 males and 30 females, between 14 to 87 years of age. The final diagnosis encountered were: infections (40%), neoplasias (23%), collagen diseases (13%), and other diagnosis (8%). Sixteen percent of the cases remained without a final diagnosis. The most frequent infections were HIV infection (19%), tuberculosis (19%) and endocarditis (13%). The most common neoplasia was lymphoma (55.6%), with 90% of Hodgkin's disease. SLE was the most common autoimmune disease found. The methods to establish a final diagnosis were: biopsies (52%), serology (17%), cultures (12%), image (11%), and clinical (8%). Final diagnosis by serology tests increased from 2 to 17% in comparison with previous reports. Eight laparotomies were done, which is a less frequent practice than previously (10 vs 35%). We saw only one case of amebic hepatic abscess and had no cases of malaria and salmonellosis as final diagnosis of FUO; HIV infection was found to be a new major cause of FUO.

Metastatic Neuroendocrine Carcinoma of Unknown Origin Arising in the Femoral Nerve Sheath.

PubMed

Candy, Nicholas; Young, Adam; Allinson, Kieren; Carr, Oliver; McMillen, Jason; Trivedi, Rikin

2017-08-01

Metastatic neuroendocrine carcinoma of unknown origin is a rare condition, usually presenting with lesions in the liver and/or lung. We present the first reported case of a metastatic neuroendocrine carcinoma of unknown origin arising in the femoral nerve sheath. Magnetic resonance imaging demonstrated what was thought to be a schwannoma in the left femoral nerve sheath in the proximal femoral triangle, immediately inferior to the anterior inferior iliac spine. At the time of operation, the tumor capsule was invading surrounding tissue, as well as three trunks of the femoral nerve. The patient underwent a subtotal resection, preserving the integrity of the residual functioning femoral nerve trunks. Histologic evaluation determined that the tumor had features consistent with a metastatic neuroendocrine carcinoma of unknown primary origin. The patient recovered well postoperatively, and subsequent radiologic evaluation failed to demonstrate a potential primary site. Unfortunately, the patient re-presented with disease progression and was subsequently referred to palliative care. We recommend that there is a definite role for surgery in the management of solitary neuroendocrine carcinoma of unknown origin. Copyright © 2017 Elsevier Inc. All rights reserved.

Is CDX2 immunostaining useful for delineating anorectal from penile/vulvar squamous cancer in the setting of squamous cell carcinoma with clinically unknown primary site presenting with histologically confirmed inguinal lymph node metastasis?

PubMed

Gunia, Sven; Koch, Stefan; May, Matthias

2013-02-01

Penile, vulvar and anal squamous cell carcinomas (SCCs) share histomorphological overlap and are prone to lymphatic dissemination into inguinal nodes. Anal SCCs might derive from the anorectal zone (ARZ), anal transitional zone, squamous zone or from perianal skin. These anatomically distinct zones differ in terms of their embryological development. We sought to investigate the role of caudal-related homeobox 2 (CDX2), a homeobox gene implicated in the development and anterior/posterior pattern specification from duodenum to rectum including the ARZ, in terms of narrowing the possible sites of origin to be considered in the setting of SCC with unknown primary presenting with histologically confirmed inguinal lymph node metastasis. By immunohistochemistry (IHC) employing a panel of antibodies directed against CK5/6, CK7, CK20, p63, p16, CEA and CDX2, we compared 89 penile, 11 vulvar and eight anal SCCs with respect to their staining profiles. Moreover, anal SCCs were subjected to in situ hybridisation (ISH) for high-risk human papillomavirus (HPV) subtypes. By IHC, CDX2 expression was observed in 2/8 anal SCCs (25%) while being absent from all penile and vulvar SCCs examined. High-risk HPV subtypes were detected by ISH in all anal SCCs examined, which were uniformly p16-positive by IHC. CDX2 might be valuable in terms of narrowing the possible sites of origin to be considered in the setting of SCC with unknown primary presenting with inguinal lymph node metastasis. However, despite its favourable specificity, the diagnostic benefit achieved by this observation is limited by the low sensitivity.

Prediction and prevention of the next pandemic zoonosis

PubMed Central

Morse, Stephen S; Mazet, Jonna A K; Woolhouse, Mark; Parrish, Colin R; Carroll, Dennis; Karesh, William B; Zambrana-Torrelio, Carlos; Lipkin, W Ian; Daszak, Peter

2013-01-01

Most pandemics—eg, HIV/AIDS, severe acute respiratory syndrome, pandemic influenza—originate in animals, are caused by viruses, and are driven to emerge by ecological, behavioural, or socioeconomic changes. Despite their substantial effects on global public health and growing understanding of the process by which they emerge, no pandemic has been predicted before infecting human beings. We review what is known about the pathogens that emerge, the hosts that they originate in, and the factors that drive their emergence. We discuss challenges to their control and new efforts to predict pandemics, target surveillance to the most crucial interfaces, and identify prevention strategies. New mathematical modelling, diagnostic, communications, and informatics technologies can identify and report hitherto unknown microbes in other species, and thus new risk assessment approaches are needed to identify microbes most likely to cause human disease. We lay out a series of research and surveillance opportunities and goals that could help to overcome these challenges and move the global pandemic strategy from response to pre-emption. PMID:23200504

Pyrexia of unknown origin 90 years on: a paradigm of modern clinical medicine.

PubMed

Brown, Michael

2015-12-01

In 1925, Sir Thomas Horder, a leading physician of his day, gave a lecture, published in this journal, entitled 'Some cases of pyrexia without physical signs'. The paper highlighted what was already a familiar clinical presentation "which taxes our resources to the utmost". Fast-forward through 90 years of careful clinical description, technological innovation in diagnosis and treatment, emergent infections, novel diagnoses, demographic shifts, and radical changes in the health economy. Sir Thomas would find certain aspects familiar, and others revolutionary, in the differential diagnosis and management of the 21st century patient with pyrexia of unknown origin (PUO). Within high-income settings, the proportion of cases due to infection has declined, albeit unevenly. The era of untreated HIV, and the consequences of iatrogenic intervention and immunosuppression, led to Durack and Street's subclassification of the condition in the early 1990 s into classic, nosocomial, neutropenic and HIV-associated PUO. Shifts towards ambulatory care have driven a change in the definition of many diseases. An era of observant clinicians, who lent their names to eponymous syndromes, followed by meticulous serological, genetic and clinicopathological correlation, generated a battery of diagnoses that, along with malignancy, form a large proportion of diagnoses in more recent clinical care. In the current era, universal access to cross-sectional imaging and an infinite array of laboratory tests has undermined the attention paid to history and examination. In some areas of the clinical assessment, such as assessing the fever pattern, this shift is supported by research evidence. The issues that need to be addressed in the next 90 years of technological innovation, information sharing and health service transformation are likely to include: transcriptomic approaches to diagnosis; the place of positron emission tomography (PET) in the diagnostic pathway; the optimal management of high ferritin states; and the most cost-effective diagnostic environment, in the face of this era of specialisation and fragmentation of care. In the meantime, this review covers some important early 21st century lessons to be shared in avoiding diagnostic pitfalls and choosing empirical therapy. 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/

[Molecular biology for sarcoma: useful or necessary?].

PubMed

Neuville, Agnès; Coindre, Jean-Michel; Chibon, Frédéric

2015-01-01

Sarcomas are a heterogeneous group of tumors. Their diagnosis is based on morphology and immunohistochemical profile, with categories of tumors according to the type of tissue that they resemble. Nevertheless, for several tumors, cellular origin is unknown. Molecular analysis performed in recent years allowed, combining histophenotype and genomics, better classifying such sarcomas, individualizing new entities and grouping some tumors. Simple and recurrent genetic alterations, such as translocation, mutation, amplification, can be identified in one of two sarcomas and appear as new diagnostic markers. Their identification in specialized laboratories in molecular pathology of sarcomas is often useful and sometimes necessary for a good diagnosis, leading to a heavy and multidisciplinary multi-step treatment. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

7. Photographic copy of photograph (date unknown, original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photographic copy of photograph (date unknown, original print in the possession of the Wisconsin Veterans Museums). LAKE IN FOREGROUND, COTTAGES IN BACK. - Wisconsin Home for Veterans, King, Waupaca County, WI

Human Papillomavirus as a Diagnostic and Prognostic Tool in Cancer of Unknown Primary in the Head and Neck Region.

PubMed

Sivars, Lars; Tani, Edneia; Näsman, Anders; Ramqvist, Torbjörn; Munck-Wikland, Eva; Dalianis, Tina

2016-02-01

Human papillomavirus (HPV) is recognized as a risk factor for oropharyngeal squamous cell carcinomas (SCC), especially tonsillar and base of tongue cancer. Furthermore, HPV-positive tonsillar and base of tongue SCC have a significantly better prognosis than their HPV-negative counterparts and head and neck cancer (HNSCC) in general. HPV has recently also been implicated in cancer of unknown primary (CUP) in the head and neck region, where a primary tumour is not found despite extensive workup. Using fine-needle aspiration cytology to determine CUP HPV status in cervical lymph nodes could be of advantage, since it is minimally invasive and it is assumed that an HPV-positive lymph node metastasis likely has an HPV-positive otopharyngeal SCC origin. We review the current knowledge of HPV in HNSCC, with an emphasis on CUP of the head and neck region, its relation to oropharyngeal, tonsillar and base of tongue SCC and implications of HPV status for diagnosis, prognosis and treatment. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Gene expression profiles help identify the tissue of origin for metastatic brain cancers.

PubMed

Wu, Alan H B; Drees, Julia C; Wang, Hangpin; VandenBerg, Scott R; Lal, Anita; Henner, William D; Pillai, Raji

2010-04-26

Metastatic brain cancers are the most common intracranial tumor and occur in about 15% of all cancer patients. In up to 10% of these patients, the primary tumor tissue remains unknown, even after a time consuming and costly workup. The Pathwork Tissue of Origin Test (Pathwork Diagnostics, Redwood City, CA, USA) is a gene expression test to aid in the diagnosis of metastatic, poorly differentiated and undifferentiated tumors. It measures the expression pattern of 1,550 genes in these tumors and compares it to the expression pattern of a panel of 15 known tumor types. The purpose of this study was to evaluate the performance of the Tissue of Origin Test in the diagnosis of primary sites for metastatic brain cancer patients. Fifteen fresh-frozen metastatic brain tumor specimens of known origins met specimen requirements. These specimens were entered into the study and processed using the Tissue of Origin Test. Results were compared to the known primary site and the agreement between the two results was assessed. Fourteen of the fifteen specimens produced microarray data files that passed all quality metrics. One originated from a tissue type that was off-panel. Among the remaining 13 cases, the Tissue of Origin Test accurately predicted the available diagnosis in 12/13 (92.3%) cases. This study demonstrates the accuracy of the Tissue of Origin Test when applied to predict the tissue of origin of metastatic brain tumors. This test could be a very useful tool for pathologists as they classify metastatic brain cancers.

Gene expression profiles help identify the Tissue of Origin for metastatic brain cancers

PubMed Central

2010-01-01

Background Metastatic brain cancers are the most common intracranial tumor and occur in about 15% of all cancer patients. In up to 10% of these patients, the primary tumor tissue remains unknown, even after a time consuming and costly workup. The Pathwork® Tissue of Origin Test (Pathwork Diagnostics, Redwood City, CA, USA) is a gene expression test to aid in the diagnosis of metastatic, poorly differentiated and undifferentiated tumors. It measures the expression pattern of 1,550 genes in these tumors and compares it to the expression pattern of a panel of 15 known tumor types. The purpose of this study was to evaluate the performance of the Tissue of Origin Test in the diagnosis of primary sites for metastatic brain cancer patients. Methods Fifteen fresh-frozen metastatic brain tumor specimens of known origins met specimen requirements. These specimens were entered into the study and processed using the Tissue of Origin Test. Results were compared to the known primary site and the agreement between the two results was assessed. Results Fourteen of the fifteen specimens produced microarray data files that passed all quality metrics. One originated from a tissue type that was off-panel. Among the remaining 13 cases, the Tissue of Origin Test accurately predicted the available diagnosis in 12/13 (92.3%) cases. Discussion This study demonstrates the accuracy of the Tissue of Origin Test when applied to predict the tissue of origin of metastatic brain tumors. This test could be a very useful tool for pathologists as they classify metastatic brain cancers. PMID:20420692

15. Photocopy of photograph (original in WACC), photographer unknown, c. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

15. Photocopy of photograph (original in WACC), photographer unknown, c. 1917 BEN ERICKSON IN WWI UNIFORM STANDING IN FRONT OF SOUTH LIVING ROOM WINDOW (ADOBE WALLS) - Faraway Ranch, Willcox, Cochise County, AZ

3. Photocopy of photograph (location of original unknown) Mary Mather, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. Photocopy of photograph (location of original unknown) Mary Mather, photographer, ca. 1920 PARTIAL EAST ELEVATION, OBSCURED BY FOLIAGE - Bagatelle Plantation, East River Road (moved to Iberville Parish), Donaldsonville, Ascension Parish, LA

The sense of the body in the dream: Diagnostic capacity in the meanings of dreams.

PubMed

Giordo, Gianfranco

2016-04-01

The author investigates the oneiric representation of somatic states and the diagnostic capacity of dreams. He draws on Freud's hypotheses on the procedures by which somatic stimuli insert themselves in oneiric elaboration and restructures them according to the recent neurobiological discoveries and to analytical experiences. In the representations of certain dreams, with a psychic interpretation agreed upon by the patients, somatic alterations unknown to the analytical couple were discriminated and confirmed by radiological investigations. These representations were linked to the manifestation of one aspect of the bodily Self, neglected in the precocious maternal relation, that entered the organization of the Self consolidated in the relation with the paternal figure. This conjunction gave origin to the double meaning (somatic and psychic) of the dream. The entering of the somatic representation in the oneiric one did not appear to be the figurative effect, but of a condensation of diagnostic capacity into the meaning of the dream. This characteristic manifested itself in the particular styles of the dreamers, interpretable by an analyst countertransferentially oriented. The perception or scotomization of the condensation in the interpretation of the dream and of the moment had an effect on the evolution of the analysis. Copyright © 2015 Institute of Psychoanalysis.

[Fever of unknown origin (febris continua e causa ignota)].

PubMed

Hansen, T H; Seidenfaden-Lassen, M

1992-02-10

Fever can be recognized as a higher set-point of the normal temperature regulation which is controlled by the center in the anterior part of hypothalamus. The change in this set-point is induced by interleukin-1 (IL-1) which is the common mediator of exogenic and endogenic pyrogenic factors. IL-1 is believed to act through an induction of a prostaglandin E cascade. The normal diurnal variation in temperature can often be recognized in infectious diseases but not always in non-infectious conditions. Four different fever curves can be defined but are without differential diagnostic importance, however, septic fever curves are more likely to occur in bacteremic patients. Comparison of the most important investigations about PUO since 1960 shows that the follow-up investigations revealed a high percentage of undiagnosed cases and that the mortality due to conditions related to PUO was 6-8%. Among the other investigations, a total of 83% were diagnosed: 23% had cancer, 33% had infections, 11% had collagenic diseases, 17% had other causes and 16% were undiagnosed. To establish the diagnosis in cases of PUO, liver biopsy can be of diagnostic value especially in patients with hepatomegaly. Abdominal CT-scan, ultrasonography and Gallium 67 scintigraphy are equal in sensitivity and specificity and can supplement each other with diagnostic information. Leucocyte scintigraphy can detect local inflammatory processes. Laparotomy or laparoscopy have high diagnostic values and can be considered in patients with signs of involvement of abdominal organs if no diagnosis has been established after noninvasive investigations. Lymphography gives only limited diagnostic information in cases of PUO.

Consensus guidelines for the use of empiric and diagnostic-driven antifungal treatment strategies in haematological malignancy, 2014.

PubMed

Morrissey, C O; Gilroy, N M; Macesic, N; Walker, P; Ananda-Rajah, M; May, M; Heath, C H; Grigg, A; Bardy, P G; Kwan, J; Kirsa, S W; Slavin, M; Gottlieb, T; Chen, S

2014-12-01

Invasive fungal disease (IFD) causes significant morbidity and mortality in patients undergoing allogeneic haemopoietic stem cell transplantation or chemotherapy for haematological malignancy. Much of these adverse outcomes are due to the limited ability of traditional diagnostic tests (i.e. culture and histology) to make an early and accurate diagnosis. As persistent or recurrent fevers of unknown origin (PFUO) in neutropenic patients despite broad-spectrum antibiotics have been associated with the development of IFD, most centres have traditionally administered empiric antifungal therapy (EAFT) to patients with PFUO. However, use of an EAFT strategy has not been shown to have an overall survival benefit and is associated with excessive antifungal therapy use. As a result, the focus has shifted to developing more sensitive and specific diagnostic tests for early and more targeted antifungal treatment. These tests, including the galactomannan enzyme-linked immunosorbent assay and Aspergillus polymerase chain reaction (PCR), have enabled the development of diagnostic-driven antifungal treatment (DDAT) strategies, which have been shown to be safe and feasible, reducing antifungal usage. In addition, the development of effective antifungal prophylactic strategies has changed the landscape in terms of the incidence and types of IFD that clinicians have encountered. In this review, we examine the current role of EAFT and provide up-to-date data on the newer diagnostic tests and algorithms available for use in EAFT and DDAT strategies, within the context of patient risk and type of antifungal prophylaxis used. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

Polycystic ovarian syndrome: clinical and biological diagnosis.

PubMed

Bachelot, Anne

2016-12-01

Polycystic ovary syndrome (PCOS) is the most common ovarian disorder associated with androgen excess in women, which justifies the growing interest of endocrinologists. This syndrome leads to clinical hyperandrogenism and/or a biological dysovulation and infertility. Its diagnosis is based on consensual diagnostic criteria, but which are likely to change in the near future with the rise of the interest of new markers such as AMH. Diagnostic tools of PCOS are also discussed, with emphasis on the laboratory evaluation of androgens and other potential biomarkers of ovarian and metabolic dysfunctions. The exact etiology of PCOS is unknown and is likely multifactorial. Many studies indicate that PCOS results from originally ovarian abnormalities. In some patients, secondary hyperinsulinemia with insulin resistance plays a role in the pathophysiology. In addition, the relevant impact of metabolic issues, specifically insulin resistance and obesity, on the pathogenesis of PCOS, and the susceptibility to develop earlier than expected glucose intolerance states, including type 2 diabetes, has supported the notion that these aspects should be considered when defining the PCOS phenotype and planning potential therapeutic strategies in an affected subject.

Assessment, origin, and implementation of breath volatile cancer markers

PubMed Central

Haick, Hossam; Broza, Yoav Y.; Mochalski, Pawel; Ruzsanyi, Vera; Amann, Anton

2016-01-01

A new non-invasive and potentially inexpensive frontier in the diagnosis of cancer relies on the detection of volatile organic compounds (VOCs) in exhaled breath samples. Breath can be sampled and analyzed in real-time, leading to fascinating and cost-effective clinical diagnostic procedures. Nevertheless, breath analysis is a very young field of research and faces challenges, mainly because the biochemical mechanisms behind the cancer-related VOCs are largely unknown. In this review, we present a list of 115 validated cancer-related VOCs published in the literature during the past decade, and classify them with respect to their “fat-to-blood” and “blood-to-air” partition coefficients. These partition coefficients provide an estimation of the relative concentrations of VOCs in alveolar breath, in blood and in the fat compartments of the human body. Additionally, we try to clarify controversial issues concerning possible experimental malpractice in the field, and propose ways to translate the basic science results as well as the mechanistic understanding to tools (sensors) that could serve as point-of-care diagnostics of cancer. We end this review with a conclusion and a future perspective. PMID:24305596

Presumed lupus erythematosus cells identified in bronchoalveolar lavage fluid from a Mexican Hairless dog.

PubMed

Black, Laura J; Hechler, Ashley C; Duffy, Maura E; Beatty, Sarah S K

2017-06-01

A neutered male Mexican Hairless dog was presented for generalized weight loss and weakness. Initial laboratory testing and diagnostic imaging revealed thrombocytopenia and an interstitial to miliary lung pattern affecting all lung fields. Mild joint effusion was found on physical examination affecting the stifle, tarsal, carpal, and elbow joints. Examination of synovial fluid demonstrated an inflammatory polyarthropathy in 3 joints. Cytocentrifuged and direct preparations of the bronchoalveolar lavage (BAL) fluid sample were made and cells consistent with lupus erythematosus (LE) cells and ragocytes were found. Based on these findings, the anti-nuclear antibody (ANA) titer was determined as 1:640. A clinical diagnosis of systemic LE was made based on the satisfaction of 2 major criteria (thrombocytopenia and inflammatory polyarthritis), 4 minor criteria (central nervous system signs, lymphadenopathy, fever of unknown origin, and pleuritis), positive ANA titer, and the identification of presumed LE cells in BAL fluid. This case report highlights a novel finding of LE cells in respiratory secretions and provides a review of diagnostic criteria of systemic LE. © 2017 American Society for Veterinary Clinical Pathology.

1. Photocopy of photograph (original print located in Pope & ...

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1. Photocopy of photograph (original print located in Pope & Talbot Archives. Port Gamble, WA.) Unknown Photographer, Unknown Date. View of Walker-Ames House, house no. 1, facing southwest. - Walker-Ames House, Rainier Avenue, Port Gamble, Kitsap County, WA

43. Photocopy of photograph, photographer unknown, ca January 1929 (original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

43. Photocopy of photograph, photographer unknown, ca January 1929 (original print located at Arizona Department of Transportation, Phoenix AZ). COMPLETED BRIDGE. - Navajo Bridge, Spanning Colorado River at U.S. Highway 89 Alternate, Page, Coconino County, AZ

13. Photocopy of photograph (original print at Riveside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Photocopy of photograph (original print at Riveside Library, Local History Collection), photographer and date unknown. VIEW OF JAPANESE WORKER HOUSING, ARLINGTON HEIGHTS FRUIT COMPANY, EXACT LOCATION UNKNOWN - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

9. Photocopy of drawing (Original in possession of National Archives ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photocopy of drawing (Original in possession of National Archives and Record Service, Record Group 92) Delineator unknown, Date unknown FIRST FLOOR PLAN - Omaha Quartermaster Depot Historic District, Twenty-second & Woolworth Streets, Omaha, Douglas County, NE

8. Photocopy of drawing (Original in possession of National Archives ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Photocopy of drawing (Original in possession of National Archives and Record Service, Record Group 92) Delineator unknown, Date unknown BASEMENT FLOOR PLAN - Omaha Quartermaster Depot Historic District, Twenty-second & Woolworth Streets, Omaha, Douglas County, NE

10. Photocopy of drawing (Original in possession of National Archives ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Photocopy of drawing (Original in possession of National Archives and Record Service, Record Group 92) Delineator unknown, Date unknown SECOND FLOOR PLAN - Omaha Quartermaster Depot Historic District, Twenty-second & Woolworth Streets, Omaha, Douglas County, NE

6. Photographic copy of photograph (date unknown, original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. Photographic copy of photograph (date unknown, original print in the possession of the Wisconsin Veterans Museums). COTTAGES, INCLUDING 'J.P. McPHERSON POST NO. 27 CAFE GENEVA'. - Wisconsin Home for Veterans, King, Waupaca County, WI

[Coma in the emergency room].

PubMed

Braun, M; Ploner, C J; Lindner, T; Möckel, M; Schmidt, W U

2017-06-01

Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO. We propose an interdisciplinary standard operating procedure (SOP) for patients with acute CUO as has been established in our maximum care hospital. The SOP is triggered by simple triage criteria that are sufficient to identify CUO patients before arrival in hospital. The in-hospital response team is led by a neurologist. Collaboration with nursing staff, internal medicine, anesthesiology, neurosurgery and trauma surgery is organized along structured pathways that include standardized laboratory tests, including cerebrospinal fluid (CSF), toxicology, computed tomography (CT) and CT angiography imaging (CTA). Our data suggest that neurologists and internists need to be placed at the beginning of the diagnostic work-up. Imaging should not just be carried out depending on the clinical syndrome because sensitivity, specificity and inter-rater reliability of the latter are not sufficient and because in many cases, multiple pathologies can be detected that could each explain CUO alone. Clinical examination, imaging and laboratory testing should be regarded as components of an integrative diagnostic approach and the final aetiological classification should only be made after the diagnostic work-up is complete.

15. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

15. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer and date unknown. VIEW OF BARNS, STABLE AND FIELD EQUIPMENT, ARLINGTON HEIGHTS FRUIT COMPANY, EXACT LOCATION UNKNOWN - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

2. Photocopy of photograph (location of original unknown) Mary Mather, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. Photocopy of photograph (location of original unknown) Mary Mather, photographer, ca. 1920 GENERAL VIEW OF WEST (LEFT) AND SOUTH (RIGHT) FACADES, TAKEN FROM LEVEE - Bagatelle Plantation, East River Road (moved to Iberville Parish), Donaldsonville, Ascension Parish, LA

47. Photocopy of a photograph (original print in the collection ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

47. Photocopy of a photograph (original print in the collection of the Claremont Historical Society) photographer unknown, no date INTERIOR OF OFFICE AND EMPLOYEES IN AN UNKNOWN BUILDING - Claremont Village Industrial District, Between B, Claremont, Sullivan County, NH

Protracted fever of unknown origin as the presenting symptom of Behçet's disease. Report of a case.

PubMed

Niamane, Radouane; Karim Moudden, Mohamed; Zyani, Mahamed; Hda, Ali

2005-03-01

We report a case of Behçet's disease that presented as protracted fever of unknown origin. The diagnosis was established when a thromboembolic event and ora3l aphthous ulcers occurred simultaneously. Antibiotics had no effect on the fever, which resolved when glucocorticoid and anticoagulant therapy was given. Among causes of protracted fever of unknown origin, Behçet's disease is exceedingly rare but should be considered together with the other vasculitides. Above all, the presence of a fever should prompt a search for a thromboembolic complication.

The Scientific Method, Diagnostic Bayes, and How to Detect Epistemic Errors

NASA Astrophysics Data System (ADS)

Vrugt, J. A.

2015-12-01

In the past decades, Bayesian methods have found widespread application and use in environmental systems modeling. Bayes theorem states that the posterior probability, P(H|D) of a hypothesis, H is proportional to the product of the prior probability, P(H) of this hypothesis and the likelihood, L(H|hat{D}) of the same hypothesis given the new/incoming observations, \\hat {D}. In science and engineering, H often constitutes some numerical simulation model, D = F(x,.) which summarizes using algebraic, empirical, and differential equations, state variables and fluxes, all our theoretical and/or practical knowledge of the system of interest, and x are the d unknown parameters which are subject to inference using some data, \\hat {D} of the observed system response. The Bayesian approach is intimately related to the scientific method and uses an iterative cycle of hypothesis formulation (model), experimentation and data collection, and theory/hypothesis refinement to elucidate the rules that govern the natural world. Unfortunately, model refinement has proven to be very difficult in large part because of the poor diagnostic power of residual based likelihood functions tep{gupta2008}. This has inspired te{vrugt2013} to advocate the use of 'likelihood-free' inference using approximate Bayesian computation (ABC). This approach uses one or more summary statistics, S(\\hat {D}) of the original data, \\hat {D} designed ideally to be sensitive only to one particular process in the model. Any mismatch between the observed and simulated summary metrics is then easily linked to a specific model component. A recurrent issue with the application of ABC is self-sufficiency of the summary statistics. In theory, S(.) should contain as much information as the original data itself, yet complex systems rarely admit sufficient statistics. In this article, we propose to combine the ideas of ABC and regular Bayesian inference to guarantee that no information is lost in diagnostic model evaluation. This hybrid approach, coined diagnostic Bayes, uses the summary metrics as prior distribution and original data in the likelihood function, or P(x|\\hat {D}) ∝ P(x|S(\\hat {D})) L(x|\\hat {D}). A case study illustrates the ability of the proposed methodology to diagnose epistemic errors and provide guidance on model refinement.

Esophageal achalasia: current diagnosis and treatment.

PubMed

Schlottmann, Francisco; Patti, Marco G

2018-05-27

Esophageal achalasia is a primary esophageal motility disorder of unknown origin, characterized by lack of peristalsis and by incomplete or absent relaxation of the lower esophageal sphincter in response to swallowing. The goal of treatment is to eliminate the functional obstruction at the level of the gastroesophageal junction Areas covered: This comprehensive review will evaluate the current literature, illustrating the diagnostic evaluation and providing an evidence-based treatment algorithm for this disease Expert commentary: Today we have three very effective therapeutic modalities to treat patients with achalasia - pneumatic dilatation, per-oral endoscopic myotomy and laparoscopic Heller myotomy with fundoplication. Treatment should be tailored to the individual patient, in centers where a multidisciplinary approach is available. Esophageal resection should be considered as a last resort for patients who have failed prior therapeutic attempts.

42. Photocopy of photograph, photographer unknown, 12 September 1928 (original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

42. Photocopy of photograph, photographer unknown, 12 September 1928 (original print located at Arizona Department of Transportation, Phoenix AZ). BRIDGE IMMEDIATELY AFTER INSERTION OF CENTER PIN. - Navajo Bridge, Spanning Colorado River at U.S. Highway 89 Alternate, Page, Coconino County, AZ

44. Photocopy of photograph, photographer unknown, 1415 June 1929 (original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

44. Photocopy of photograph, photographer unknown, 14-15 June 1929 (original print located at Utah State Historical Society Photograph Collection, Salt Lake City UT). DEDICATION CEREMONY AT BRIDGE. - Navajo Bridge, Spanning Colorado River at U.S. Highway 89 Alternate, Page, Coconino County, AZ

Photographic copy of photograph, photographer unknown, 1942 (original print located ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photographic copy of photograph, photographer unknown, 1942 (original print located at Southern UTE Agency, Bureau of Indian Affairs Office, Ignacio, Colorado). West front and south side of boy's dormitory. - Southern Ute Boarding School, Boy's Dormitory, Ouray & Capote Drives, Ignacio, La Plata County, CO

Photographic copy of photograph, photographer unknown, 1942 (original print located ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photographic copy of photograph, photographer unknown, 1942 (original print located at Southern UTE Agency, Bureau of Indian Affairs Office, Ignacio, Colorado). East rear and north side of boy's dormitory. - Southern Ute Boarding School, Boy's Dormitory, Ouray & Capote Drives, Ignacio, La Plata County, CO

45. Photocopy of photograph, photographer unknown, 1415 June 1929 (original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

45. Photocopy of photograph, photographer unknown, 14-15 June 1929 (original print located at Arizona Department of Transportation, Phoenix AZ). AIRPLANE STUNT DURING DEDICATION CEREMONY AT BRIDGE. - Navajo Bridge, Spanning Colorado River at U.S. Highway 89 Alternate, Page, Coconino County, AZ

14. Photocopy of historic photograph (original photograph on file at ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. Photocopy of historic photograph (original photograph on file at Fairchild Air Force Museum, Spokane, WA) Photographer unknown, date unknown BOMBER ALERT FACILITY, INTERIOR, SLEEPING QUARTERS - Fairchild Air Force Base, Bomber Alert Facility, 803G South Taxi Way, Spokane, Spokane County, WA

21 CFR 864.9160 - Blood group substances of nonhuman origin for in vitro diagnostic use.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Blood group substances of nonhuman origin for in... Used In Establishments That Manufacture Blood and Blood Products § 864.9160 Blood group substances of nonhuman origin for in vitro diagnostic use. (a) Identification. Blood group substances of nonhuman origin...

21 CFR 864.9160 - Blood group substances of nonhuman origin for in vitro diagnostic use.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Blood group substances of nonhuman origin for in... Used In Establishments That Manufacture Blood and Blood Products § 864.9160 Blood group substances of nonhuman origin for in vitro diagnostic use. (a) Identification. Blood group substances of nonhuman origin...

21 CFR 864.9160 - Blood group substances of nonhuman origin for in vitro diagnostic use.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Blood group substances of nonhuman origin for in... Used In Establishments That Manufacture Blood and Blood Products § 864.9160 Blood group substances of nonhuman origin for in vitro diagnostic use. (a) Identification. Blood group substances of nonhuman origin...

Photographic copy of photograph, photographer unknown, August 1912 (original print ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photographic copy of photograph, photographer unknown, August 1912 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "A VIEW OF METHOD OF DAM CONSTRUCTION" - Kachess Dam, Kachess River, 1.5 miles north of Interstate 90, Easton, Kittitas County, WA

Photographic copy of photograph, photographer unknown, ca. 1930 (original print ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photographic copy of photograph, photographer unknown, ca. 1930 (original print located at Colorado Historical Society, Denver, Colorado). Overall view of Southern UTE Agency Boarding School, with boys dormitory at center. - Southern Ute Boarding School, Boy's Dormitory, Ouray & Capote Drives, Ignacio, La Plata County, CO

An 8-month history of meningitis in an extremely low birth weight infant? - Long-lasting Infection with Ureaplasma parvum.

PubMed

Glaser, K; Wohlleben, M; Speer, C P

2015-02-01

Ureaplasma spp. have been implicated in the pathogenesis of both preterm labor and neonatal morbidity including pneumonia and sepsis and the development of chronic lung disease of prematurity. Data on Ureaplasma meningitis are limited and partly controversially discussed. We report the unique case of a 9-month-old infant with progressive internal hydrocephalus of unknown origin and developmental delay due to a history of>200 days of inflammation of the central nervous system. The female extremely low birth weight infant had been referred to our hospital for ventriculoperitoneal shunt implantation. She had been born at 26+3 weeks of gestation with a birth weight of 940 g. With the exception of a moderate respiratory distress syndrome, postnatal period had been reported uneventful. However, internal hydrocephalus had become manifest at 4 weeks of postnatal age. Intraventricular hemorrhage had not been documented by cranial ultrasound and magnetic resonance imaging. Cerebrospinal fluid (CSF) analysis had repetitively revealed pronounced inflammation reflected by pleocytosis (50-86 leukocytes/μL, 60% lymphocytes), CSF protein levels of 578-1,026 mg/dL and undetectable CSF glucose. Although suggesting bacterial meningitis, microbial diagnostics had not been indicative, and empirical antibiotics had not affected the CSF findings. On admission to our hospital, CSF analysis still documented significant inflammation (125 leukocytes/μL, CSF protein 565 mg/dL, CSF glucose<2 mg/dL). Due to a prenatal history of cerclage, we initiated microbial diagnostics on Ureaplasma spp. and Mycoplasma hominis. U. parvum was detected in CSF by culture and PCR, no other pathogens were isolated. On intravenous treatment with chloramphenicol, CSF profile continuously normalized, and cultures and PCR became negative. Treatment was continued for 3 weeks, and the infant was discharged after uncomplicated ventriculoperitoneal shunt placement. During a 12-month observation period she has shown encouraging recovery. In preterm infants, in particular, internal hydrocephalus of unknown origin and sustained CSF inflammation are highly suggestive of Ureaplasma meningitis. Our case highlights that infection may escape detection if not explicitly considered, since microbial diagnosis requires complex media and PCR. © Georg Thieme Verlag KG Stuttgart · New York.

Photographic copy of photograph, photographer unknown, August 1912 (original print ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photographic copy of photograph, photographer unknown, August 1912 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "METHOD OF CONSTRUCTING DAM AFTER REMOVING OF TRESTLE" - Kachess Dam, Kachess River, 1.5 miles north of Interstate 90, Easton, Kittitas County, WA

Photographic copy of photograph, photographer unknown, ca. 1930 (original print ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photographic copy of photograph, photographer unknown, ca. 1930 (original print located at Colorado Historical Society, Denver, Colorado). Overall views of Southern Ute Agency Boarding School, with boys' dormitory at left of lower view. - Southern Ute Boarding School, Boy's Dormitory, Ouray & Capote Drives, Ignacio, La Plata County, CO

Photographic copy of photograph, date unknown (original print located at ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photographic copy of photograph, date unknown (original print located at the History Office, U.S. Army South, Fort Clayton, Republic of Panama). Early view of Fort Sherman from boat dock with theater in background, facing southwest. - Fort Sherman, Toro Point on Limon Bay, Colon, Former Panama Canal Zone, CZ

Clinical pictures of unknown origin in neurology: past, present and future usefulness of artificial intelligence.

PubMed

Conti, Andrea A; Conti, Antonio; Masoni, Marco; Gensini, Gian Franco

2005-01-01

Although, in the course of the last 50 years, the achievements in the medical field have been astonishing, at the beginning of the third millennium a number of clinical pictures are still left without a precise nosographic origin. In the past, the delay in scientific communication was the main explanation presented for the lack of understanding of clinical pictures of unknown nosographic origin. The history of medicine provides excellent examples of this dispersion of human capital, even if the history of clinical neurology presents "exceptions" (the pictures that we now call de la Tourette's syndrome and Parkinson's disease) that indicate that major clinical syndromes could be clearly detected and relatively rapidly diffused even in the 19th century. Contrary to the past, the delay in scientific communication no longer seems an obstacle to the sharing of medical knowledge. Nevertheless, the problem of the in-depth comprehension of clinical pictures of unknown nosographic origin still remains dominant, mainly because of the limited spread of ample and flexible online accessible databases of unknown nosographic origin clinical syndromes. The need for interactive electronic archives and other artificial intelligence resources in order to promote progress in clinical knowledge is discussed in this paper.

[Erythema nodosum during the course of idiopathic granulomatous mastitis].

PubMed

Fahmy, J; Halabi-Tawil, M; Bagot, M; Tournant, B; Petit, A

2015-01-01

Idiopathic granulomatous mastitis (IGM) is a benign, aseptic inflammatory disease of unknown origin, which must be distinguished from tumoral and infectious processes that affect the breast, including tuberculosis. IGM is a rare cause of erythema nodosum, but it is useful for dermatologists to be aware of this association. A 32-year-old nulliparous woman presented with erythema nodosum, arthralgia and fever. On examination, she had a firm and painful mass of 5cm in the right breast with retraction and axillary adenopathy. The breast lump developed gradually over the preceding 4 months. Although two biopsies showed no evidence of atypical cells, inflammatory areas and a granulomatous process were seen. Culture of breast tissue for mycobacteria was negative. A diagnostic of idiopathic granulomatous mastitis was made. Systemic corticosteroids led to a reduction in size of the mass, but relapse occurred in the contralateral breast on dose-reduction of the corticosteroids. IGM is a rare disease of unknown aetiology. Diagnosis is based on characteristic histological features and exclusion of other granulomatous diseases. Extra-mammary signs are rare and include erythema nodosum, arthralgia and episcleritis. Management is poorly codified. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Photographic copy of photograph, photographer unknown, ca. 1915 (original print ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photographic copy of photograph, photographer unknown, ca. 1915 (original print located at Southern Ute Agency, Bureau of Indian Affairs Office, Ignacio, Colorado). Overall view of Southern Ute Agency Boarding School, with main building (boy's dormitory) at right. - Southern Ute Boarding School, Boy's Dormitory, Ouray & Capote Drives, Ignacio, La Plata County, CO

Hemlock woolly adelgid biological control: molecular methods to distinguish Laricobius nigrinus, L. rubidus, and their hybrids

Treesearch

Nathan P. Havill; Gina Davis; Joanne Klein; Adalgisa Caccone; Scott Salom

2011-01-01

Molecular diagnostics use DNA-based methods to assign unknown organisms to species. As such, they rely on a priori species designation by taxonomists and require validation with enough samples to capture the variation within species for accurately selecting diagnostic characters.

[Many faces of sarcoidosis].

PubMed

Prosch, H; Vonbank, K; Loewe, C; Beitzke, D

2016-01-01

Sarcoidosis is a systemic, inflammatory, granulomatous disease of unknown origin that can involve any organ. More than 90% of patients have thoracic sarcoidosis, which most frequently presents with bilateral hilar lymphadenopathy. In approximately 20% of patients with thoracic sarcoidosis there is involvement of the lung parenchyma as well as mostly asymptomatic cardiac sarcoidosis in up to 55% of patients. Most patients are asymptomatic and the diagnosis is an incidental finding on chest X-ray or during clarification of unspecific symptoms, such as fatigue or cough. In approximately two thirds of patients the disease undergoes spontaneous remission and in one third the disease follows a chronic or even progressive course. Furthermore, sarcoidosis can also be manifested in the abdominal organs, the central nervous system (CNS) and the musculoskeletal system. These manifestations are frequently subclinical and require targeted diagnostics when sarcoidosis is clinically suspected.

A revision of the Anthaxia (Anthaxia) midas Kiesenwetter, 1857 species-group (Coleoptera: Buprestidae: Anthaxiini).

PubMed

Baiocchi, Daniele; Magnani, Gianluca

2018-01-10

The Anthaxia (Anthaxia) midas Kiesenwetter, 1857 species-group is defined and revised. A new species from Turkey, A. (A.) cebecii sp. nov., is described and compared to its most similar species. A. midas oberthuri Schaefer, 1938 is elevated to the rank of species, and a lectotype is designated. A. (A.) spathuligera Obenberger, 1924 and A. (A.) midas muelleri Obenberger, 1925 are reconfirmed synonyms of A. midas Kiesenwetter, 1857.All species of the new species-group are illustrated, including the hitherto unknown male of A. (A.) patsyae Baiocchi, 2008, all type specimens and original data labels. In addition to diagnostic characters, informations on the distribution, biology and taxonomic position of each species are also presented, together with a short definition of the new species-group, and a key to its species.

Molecular diagnosis of microbial aetiologies using SepsiTest™ in the daily routine of a diagnostic laboratory.

PubMed

Haag, Heike; Locher, Franziska; Nolte, Oliver

2013-08-01

A universal PCR and sequencing test, SepsiTest™ (Molzym, Germany) was evaluated for its applicability during daily diagnostic routine in a privately operated laboratory. In total, 96 specimens originating from 66 patients under suspect of infectious endocarditis, infections of joints, encephalitis/meningitis, systemic infections and infections of unknown genesis were PCR analysed and compared to culture results. Samples comprised cultured and non-cultured blood, synovial fluid, synovial tissue, heart valves, pacemakers, spinal tissue, cerebrospinal fluid, and swabs. PCR and culture were concordant in 26 negative and 8 positive cases (51.5%). A group of 25 patients was culture-negative but PCR-positive (37.9%). In at least 14 of these, common and/or rare aetiologies were identified, while for 4 patients the results of 16S PCR could not be unequivocally linked with the underlying disease. Benefits and limitations of the molecular test are discussed with special emphasis on technical and economic issues. In conclusion, SepsiTest™ proved to be a valuable tool for the diagnosis of aetiologies, particularly in cases of culture-negative patients who are under strong suspicion for an infection. Copyright © 2013 Elsevier Inc. All rights reserved.

[Use of high frequency cinematography in diagnosis of globus sensation].

PubMed

Alberty, J; Oelerich, M

1996-09-01

Globus pharyngis is a frequent symptom in patients who consult an otolaryngologist. In many cases, routine diagnostic work-up including history, clinical examination, and barium swallow fail to revealing the underlying pathogenesis. In a retrospective study, we present 51 selected patients suffering from globus pharyngis of unknown origin who were investigated by high-speed cineradiography in a standardized manner. Twenty-four of the patients enrolled in the study (47.1%) showed functional and/or structural swallowing disorders. In 13 cases (25.5%) dyskinesias of the superior esophagus sphincter muscle were found. Five of these patients (9.8%) also had an inconstant hypopharyngeal diverticulum. Six cases (11.8%) showed laryngeal penetration or tracheal aspiration. In four cases (7.8%) functional disorders of pharyngeal, and in three cases (5.9%) functional disorders of oral bolus transport were found. Furthermore one hypopharyngeal web (1.9%) and two benign tumors (3.9%) were detected. In many cases, varying combinations of these findings occurred. Using high-speed cineradiography for evaluation of globus pharyngis results in an increased incidence of pathologic findings, and thus is an important method for interdisciplinary diagnostic work up of patients suffering from this symptom.

The Diagnostic and Prognostic Role of microRNA in Colorectal Cancer - a Comprehensive review.

PubMed

Mazeh, Haggi; Mizrahi, Ido; Ilyayev, Nadia; Halle, David; Brücher, Bjoern; Bilchik, Anton; Protic, Mladjan; Daumer, Martin; Stojadinovic, Alexander; Itzhak, Avital; Nissan, Aviram

2013-01-01

The discovery of microRNA, a group of regulatory short RNA fragments, has added a new dimension to the diagnosis and management of neoplastic diseases. Differential expression of microRNA in a unique pattern in a wide range of tumor types enables researches to develop a microRNA-based assay for source identification of metastatic disease of unknown origin. This is just one example of many microRNA-based cancer diagnostic and prognostic assays in various phases of clinical research.Since colorectal cancer (CRC) is a phenotypic expression of multiple molecular pathways including chromosomal instability (CIN), micro-satellite instability (MIS) and CpG islands promoter hypermethylation (CIMP), there is no one-unique pattern of microRNA expression expected in this disease and indeed, there are multiple reports published, describing different patterns of microRNA expression in CRC.The scope of this manuscript is to provide a comprehensive review of the scientific literature describing the dysregulation of and the potential role for microRNA in the management of CRC. A Pubmed search was conducted using the following MeSH terms, "microRNA" and "colorectal cancer". Of the 493 publications screened, there were 57 papers describing dysregulation of microRNA in CRC.

Still's Disease in a Pediatric Patient after Liver Transplantation.

PubMed

Meza, Juan-Carlos; Muñoz-Buitrón, Evelyn; Bonilla-Abadía, Fabio; Cañas, Carlos Alberto; Tobón, Gabriel J

2013-01-01

Still's disease (SD) is a multisystemic inflammatory disease characterized by persistent arthritis and in many cases with fever of unknown origin. Diagnosis of SD is challenging because of nonspecific characteristics and especially in the case of a patient with solid organ transplantation and immunosuppressive therapy where multiple causes of fever are possible. There is no diagnostic test for SD, even though some useful diagnostic criteria or laboratory findings, such as serum ferritin levels, have been proposed, and useful imaging studies for the diagnosis or followup of SD have not been developed. We report the case of a 9-year-old child who presented with high grade fever associated with joint pain after a history of liver transplantation and immunosuppressive therapy. Laboratory tests showed increased acute phase reactants, elevated ferritin, and leukocytosis. An 18 F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) was performed identifying abnormal hypermetabolic areas localized in spleen, transplanted liver, and bone marrow secondary to inflammatory process. All infectious, autoimmune, and malignant causes were ruled out. A diagnosis of SD was performed and a steroid-based regimen was initiated with adequate response and no evidence of recurrence. To our knowledge this is the first case of SD following a solid organ transplant.

Merkel Cell Carcinoma of Unknown Primary Origin

PubMed Central

Deneve, Jeremiah L.; Messina, Jane L.; Marzban, Suroosh S.; Gonzalez, Ricardo J.; Walls, Brooke M.; Fisher, Kate J.; Ann Chen, Y.; Wayne Cruse, C.; Sondak, Vernon K.; Zager, Jonathan S.

2015-01-01

Background Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin. MCC from an unknown primary origin (MCCUP) can present a diagnostic and therapeutic challenge. We describe our single-institution experience with the diagnosis and management of MCCUP presenting as metastases to lymph nodes. Methods After institutional review board approval, our institutional database spanning the years 1998–2010 was queried for patients with MCCUP. Clinicopathologic variables and outcomes were assessed. Results From a database of 321 patients with MCC, 38 (12%) were identified as having nodal MCCUP. Median age was 67 years, and 79% were men. Nodal basins involved at presentation were cervical (58%), axillary/epitrochlear (21%), or inguinal/iliac (21%). CK20 staining was positive in 93% of tumors tested, and all were negative for thyroid transcription factor-1. Twenty-nine patients (76%) underwent complete regional lymph node dissection (LND): 3 had LND alone, ten had LND and adjuvant radiotherapy, and 16 underwent LND followed by chemoradiotherapy. Definitive chemoradiotherapy without surgery was provided to six patients (16%), while radiotherapy alone was provided to three (8%). Recurrence was observed in 34% of patients. Median recurrence-free survival was 35 months. Ten patients (26%) died, five of disease and five of other causes. The median overall survival was 104 months. Conclusions Nodal MCCUP is a rare disease affecting primarily elderly white men. Recurrence is observed in approximately one-third of patients, with a 104 month median overall survival after a multimodal treatment approach consisting of surgery along with adjuvant chemotherapy and radiotherapy in the majority of patients. PMID:22271206

An Evidence-Based Review Literature About Risk Indicators and Management of Unknown-Origin Xerostomia

PubMed Central

Agha-Hosseini, Farzaneh; Moosavi, Mahdieh-Sadat

2013-01-01

This evidence-based article reviews risk indicators and management of unknown-origin xerostomia. Xerostomia and hyposalivation refer to different aspects of dry mouth. Xerostomia is a subjective sensation of dry mouth, whilst hyposalivation is defined as an objective assessment of reduced salivary flow rate. About 30% of the elderly (65 years and older) experience xerostomia and hyposalivation. Structural and functional factors, or both may lead to salivary gland dysfunction. The EBM literature search was conducted by using the medical literature database MEDLINE via PubMed and OvidMedline search engines. Results were limited to English language articles (1965 to present) including clinical trials (CT), randomized controlled trials (RCT), systematic reviews and review articles. Case control or cohort studies were included for the etiology. Neuropathic etiology such as localized oral alteration of thermal sensations, saliva composition change (for example higher levels of K, Cl, Ca, IgA, amylase, calcium, PTH and cortisol), lower levels of estrogen and progesterone, smaller salivary gland size, and illnesses such as lichen planus, are risk indicators for unknown-origin xerostomia. The management is palliative and preventative. Management of symptoms includes drug administration (systemic secretogogues, saliva substitutes and bile secretion-stimulator), night guard, diet and habit modifications. Other managements may be indicated to treat adverse effects. Neuropathic etiology, saliva composition change, smaller salivary gland size, and illnesses such as oral lichen planus can be suggestive causes for unknown-origin xerostomia. However, longitudinal studies will be important to elucidate the causes of unknown-origin xerostomia. PMID:25512755

Pulpal perio relations: Interdisciplinary diagnostic approach - I

PubMed Central

Nirola, Ashutosh; Grover, Sunanda; Sharma, Ajay; Kaur, Damanjeet

2011-01-01

Lesions of pulpal and periodontal origin may perpetuate from either the infections of dental pulp or periodontium or alveolar bone. This review focuses on interdisciplinary diagnostic approach towards lesions of periodontal or endodontic origin. PMID:21772729

High-throughput cell analysis and sorting technologies for clinical diagnostics and therapeutics

NASA Astrophysics Data System (ADS)

Leary, James F.; Reece, Lisa M.; Szaniszlo, Peter; Prow, Tarl W.; Wang, Nan

2001-05-01

A number of theoretical and practical limits of high-speed flow cytometry/cell sorting are important for clinical diagnostics and therapeutics. Three applications include: (1) stem cell isolation with tumor purging for minimal residual disease monitoring and treatment, (2) identification and isolation of human fetal cells from maternal blood for prenatal diagnostics and in-vitro therapeutics, and (3) high-speed library screening for recombinant vaccine production against unknown pathogens.

Photographic copy of photograph, photographer unknown, 18 February 1908 (original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photographic copy of photograph, photographer unknown, 18 February 1908 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "LAKE KACHESS CRIB DAM. TAKEN FROM UPSTREAM SIDE. 4 FEET OF SNOW" - Kachess Dam, 1904 Cascade Canal Company Crib Dam, Kachess River, 1.5 miles north of Interstate 90, Easton, Kittitas County, WA

28. Photocopy of photograph dated ca. 1940; photographer unknown; original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

28. Photocopy of photograph dated ca. 1940; photographer unknown; original filed as MR2.9/SP8/r373 in Audio-Visual Collection of Minnesota Historical Society, St. Paul; WEST SIDE AFTER SECOND-STORY ADDITION; LOOKING EAST - Northwest Airways Hangar & Administration Building, 590 Bayfield Street, St. Paul Downtown Airport (Holman), Saint Paul, Ramsey County, MN

24. Photographic copy of undated photo; Photographer unknown; Original in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

24. Photographic copy of undated photo; Photographer unknown; Original in Rath collection at Iowa State University Libraries, Ames, Iowa; Filed under: Rath Packing Company, Printed Photographs, Symbol M, Box 2; REMOVING HIDES ON THE MOVING SKINNING TABLE; LOOKING NORTH - Rath Packing Company, Beef Killing Building, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

Photocopy of photograph (original located at Mare Island Archives). Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph (original located at Mare Island Archives). Original photographer unknown. View of building 133 being moved; 1933. - Mare Island Naval Shipyard, East of Nave Drive, Vallejo, Solano County, CA

Photocopy of photograph (original located at Mare Island Archives). Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph (original located at Mare Island Archives). Original photographer unknown. View of sawmill after earthquake of 1898. - Mare Island Naval Shipyard, East of Nave Drive, Vallejo, Solano County, CA

Does Sex Influence the Diagnostic Evaluation of Autism Spectrum Disorder in Adults?

ERIC Educational Resources Information Center

Wilson, C. Ellie; Murphy, Clodagh M.; McAlonan, Grainne; Robertson, Dene M.; Spain, Debbie; Hayward, Hannah; Woodhouse, Emma; Deeley, P. Quinton; Gillan, Nicola; Ohlsen, J. Chris; Zinkstok, Janneke; Stoencheva, Vladimira; Faulkner, Jessica; Yildiran, Hatice; Bell, Vaughan; Hammond, Neil; Craig, Michael C.; Murphy, Declan G. M.

2016-01-01

It is unknown whether sex influences the diagnostic evaluation of autism spectrum disorder, or whether male and female adults within the spectrum have different symptom profiles. This study reports sex differences in clinical outcomes for 1,244 adults (935 males and 309 females) referred for autism spectrum disorder assessment. Significantly, more…

Photocopy of photograph (original located at Mare Island Archives). Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph (original located at Mare Island Archives). Original photographer unknown. View of waterfront during World War II; N.D. - Mare Island Naval Shipyard, East of Nave Drive, Vallejo, Solano County, CA

Photocopy of photograph (original located at Mare Island Archives). Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph (original located at Mare Island Archives). Original photographer unknown. Isometric drawing, "early plan for Mare Island", 1870. - Mare Island Naval Shipyard, East of Nave Drive, Vallejo, Solano County, CA

41. Photocopy of progress photograph ca. 1974, photographer unknown. Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

41. Photocopy of progress photograph ca. 1974, photographer unknown. Original photograph Property of United States Air Force, 21" Space Command. This is the source for views 41 to 47. CAPE COD AIR STATION PAVE PAWS FACILITY - SHOWING BUILDING "RED IRON" STEEL STRUCTURE NEARING COMPLETION. - Cape Cod Air Station, Technical Facility-Scanner Building & Power Plant, Massachusetts Military Reservation, Sandwich, Barnstable County, MA

26. Photocopy of photograph dated 1930; photographer unknown; original filed ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

26. Photocopy of photograph dated 1930; photographer unknown; original filed as MR2.9/SP8/p343 in Audio-Visual Collection of Minnesota Historical Society, St. Paul; THREE-QUARTER VIEW SHOWING WEST SIDE AND SOUTH FRONT SHORTLY AFTER COMPLETION; LOOKING NORTHEAST - Northwest Airways Hangar & Administration Building, 590 Bayfield Street, St. Paul Downtown Airport (Holman), Saint Paul, Ramsey County, MN

27. Photocopy of photograph dated ca. 1940; photographer unknown; original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

27. Photocopy of photograph dated ca. 1940; photographer unknown; original filed as MR2.9/SP8/r374 in Audio-Visual Collection Minnesota Historical Society, St. Paul; THREE-QUARTER VIEW SHOWING WEST SIDE AND SOUTH FRONT AFTER SECOND-STORY ADDITION; LOOKING NORTHEAST - Northwest Airways Hangar & Administration Building, 590 Bayfield Street, St. Paul Downtown Airport (Holman), Saint Paul, Ramsey County, MN

25. Photographic copy of undated photo; Photographer unknown; Original in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

25. Photographic copy of undated photo; Photographer unknown; Original in Rath collection at Iowa State University Libraries, Ames, Iowa; Filed under: Rath Packing Company, Printed Photographs, Symbol M, Box 2; REMOVING HIDES ON THE SKINNING TABLE; CARCASSES IN HALF-HOIST POSITION; LOOKING SOUTH - Rath Packing Company, Beef Killing Building, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

Photocopy of photograph (original located at Mare Island Archives). Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph (original located at Mare Island Archives). Original photographer unknown. View of ammunition depot from across Mare Island Strait; 1961. - Mare Island Naval Shipyard, East of Nave Drive, Vallejo, Solano County, CA

[Chronic lymphocytic leukaemia: current management].

PubMed

Aurran-Schleinitz, T; Arnoulet, C; Ivanov, V; Coso, D; Rey, J; Schiano, J-M; Stoppa, A-M; Bouabdallah, R; Gastaut, J-A

2008-05-01

Chronic lymphocytic leukemia (CLL) is the most common leukaemia in the Western world. Recent advancement in the aetiology, pathophysiology and the development of new therapeutics tools have significantly modified the current management of CLL. The cellular origin of CLL is still unknown. The current main hypothesis will be first briefly described. This review will then focus on the newly defined prognostic factors and the development and use of new drugs for the treatment of CLL. To describe the modern and practical management of CLL, we will compare classical and new prognostic markers. Then, we will discuss the various therapeutic options including chemotherapy and immunotherapy (monoclonal antibodies, allogenic transplantation), and define their current respective indications. These new diagnostic and prognostic markers will allow the characterization of new prognostic subgroups of patients. This will lead to a targeted and individualized therapeutic approach. We will present the first results of clinical trials and the on-going studies conducted in this disease.

Evidence from animal models on the pathogenesis of PCOS.

PubMed

Walters, K A; Bertoldo, M J; Handelsman, D J

2018-06-01

Polycystic ovarian syndrome (PCOS) is the most common endocrine condition in women, and is characterized by reproductive, endocrine and metabolic features. However, there is no simple unequivocal diagnostic test for PCOS, its etiology remains unknown and there is no cure. Hence, the management of PCOS is suboptimal as it relies on the ad hoc empirical management of its symptoms only. Decisive studies are required to unravel the origins of PCOS, but due to ethical and logistical reasons these are not possible in humans. Experimental animal models for PCOS have been established which have enhanced our understanding of the mechanisms underlying PCOS and propose novel mechanism-based therapies to treat the condition. This review examines the findings from various animal models to reveal the current knowledge of the mechanisms underpinning the development of PCOS, and also provides insights into the implications from these studies for improved clinical management of this disorder. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Burning sensation in oral cavity--burning mouth syndrome in everyday medical practice].

PubMed

Gerlinger, Imre

2012-09-30

Burning mouth syndrome (BMS) refers to chronic orofacial pain, unaccompanied by mucosal lesions or other evident clinical signs. It is observed principally in middle-aged patients and postmenopausal women. BMS is characterized by an intense burning or stinging sensation, typically on the tongue or in other areas of the oral mucosa. It can be accompanied by other sensory disorders such as dry mouth or taste alterations. Probably of multifactorial origin, and often idiopathic, with a still unknown etiopathogenesis in which local, systemic and psychological factors are implicated. Currently there is no consensus on the diagnosis and classification of BMS. This study reviews the literature on this syndrome, with special reference to the etiological factors that may be involved and the clinical aspects they present. The diagnostic criteria that should be followed and the therapeutic management are discussed with reference to the most recent studies.

Airport malaria: report of four cases in Tunisia.

PubMed

Siala, Emna; Gamara, Dhikrayet; Kallel, Kalthoum; Daaboub, Jabeur; Zouiten, Faiçal; Houzé, Sandrine; Bouratbine, Aïda; Aoun, Karim

2015-01-28

Four cases of airport malaria were notified for the first time in Tunisia during the summer of 2013. All patients were neighbours living within 2 km of Tunis International Airport. They had no history of travel to malarious countries, of blood transfusion or of intravenous drug use. Although malaria transmission had ceased in Tunisia since 1980, autochthonous infection by local Anopheles mosquitoes was initially considered. However, this diagnostic hypothesis was ruled out due to negative entomological survey and the absence of additional cases.All cases were caused by Plasmodium falciparum. Clinical presentation was severe (important thrombocytopaenia and parasitaemia), because of relatively important delay in diagnosis (average of seven days). This indicates the need to consider malaria while examining airport employees or people living near international airports presenting with fever of unknown origin. It also stresses the need for effective spraying of aircrafts coming from malarious areas.

TH-A-BRF-11: Image Intensity Non-Uniformities Between MRI Simulation and Diagnostic MRI

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

Paulson, E

2014-06-15

Purpose: MRI simulation for MRI-based radiotherapy demands that patients be setup in treatment position, which frequently involves use of alternative radiofrequency (RF) coil configurations to accommodate immobilized patients. However, alternative RF coil geometries may exacerbate image intensity non-uniformities (IINU) beyond those observed in diagnostic MRI, which may challenge image segmentation and registration accuracy as well as confound studies assessing radiotherapy response when MR simulation images are used as baselines for evaluation. The goal of this work was to determine whether differences in IINU exist between MR simulation and diagnostic MR images. Methods: ACR-MRI phantom images were acquired at 3T usingmore » a spin-echo sequence (TE/TR:20/500ms, rBW:62.5kHz, TH/skip:5/5mm). MR simulation images were obtained by wrapping two flexible phased-array RF coils around the phantom. Diagnostic MR images were obtained by placing the phantom into a commercial phased-array head coil. Pre-scan normalization was enabled in both cases. Images were transferred offline and corrected for IINU using the MNI N3 algorithm. Coefficients of variation (CV=σ/μ) were calculated for each slice. Wilcoxon matched-pairs and Mann-Whitney tests compared CV values between original and N3 images and between MR simulation and diagnostic MR images. Results: Significant differences in CV were detected between original and N3 images in both MRI simulation and diagnostic MRI groups (p=0.010, p=0.010). In addition, significant differences in CV were detected between original MR simulation and original and N3 diagnostic MR images (p=0.0256, p=0.0016). However, no significant differences in CV were detected between N3 MR simulation images and original or N3 diagnostic MR images, demonstrating the importance of correcting MR simulation images beyond pre-scan normalization prior to use in radiotherapy. Conclusions: Alternative RF coil configurations used in MRI simulation can Result in significant IINU differences compared to diagnostic MR images. The MNI N3 algorithm reduced MR simulation IINU to levels observed in diagnostic MR images. Funding provided by Advancing a Healthier Wisconsin.« less

29. Photocopy of photograph dated 1930; photographer unknown; original filed ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

29. Photocopy of photograph dated 1930; photographer unknown; original filed as HE17/p7 in Audio-Visual Collection of Minnesota Historical Society, St. Paul; HANGAR AREA, INTERIOR, SHOWING LONGITUDINAL 'CARRYING' TRUSS AND CANTILEVERED SECTION OF ROOF TRUSSES; LOOKING NORTHWEST FROM SOUTHEAST FRONT CORNER - Northwest Airways Hangar & Administration Building, 590 Bayfield Street, St. Paul Downtown Airport (Holman), Saint Paul, Ramsey County, MN

8. Photocopy of photograph, date unknown (original print on file ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Photocopy of photograph, date unknown (original print on file at U.S. Army Intelligence Security Command, Fort Belvoir, Virginia). VIEW OF SULLINS COLLEGE, BRISTOL, VIRGINIA. SULLINS COLLEGE PRESIDENT WILLIAM MARTIN FOUNDED ARLINGTON HALL JUNIOR COLLEGE, AND APPEARS TO HAVE LOOSELY BASED THE DESIGN OF THE NEW SCHOOL'S BUILDINGS UPON THOSE AT SULLINS. - Arlington Hall Station, 4000 Arlington Boulevard, Arlington, Arlington County, VA

Risk Factors for Speech Delay of Unknown Origin in Three-Year-Old Children.

ERIC Educational Resources Information Center

Campbell, Thomas F.; Dollaghan, Christine A.; Rockette, Howard E.; Paradise, Jack L.; Feldman, Heidi M.; Shriberg, Lawrence D.; Sabo, Diane L.; Kurs-Lasky, Marcia

2003-01-01

Compared 100 three-year-olds with speech delay of unknown origin and 539 same-age peers with respect to 6 speech disorder variables; also examined abnormal hearing in a subset of 279 children. Found significant odds ratios only for low maternal education, male sex, and positive family history; a child with all 3 factors was 7.71 times as likely to…

Photocopy of photograph (original located at Mare Island Archives). Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph (original located at Mare Island Archives). Original photographer unknown. Coal sheds with coals; 1906. - Mare Island Naval Shipyard, Coal Sheds, Waterfront Avenue, northwest corner of Waterfront Avenue & Fourth Street, Vallejo, Solano County, CA

Photocopy of photograph (original located at Mare Island Archives). Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph (original located at Mare Island Archives). Original photographer unknown. Building H1; 1920. - Mare Island Naval Shipyard, Hospital Headquarters, Johnson Lane, west side at intersection of Johnson Lane & Cossey Street, Vallejo, Solano County, CA

Cytologic evaluation of cervical lymph node metastases from cancers of unknown primary origin.

PubMed

Pusztaszeri, Marc P; Faquin, William C

2015-01-01

Fine-needle aspiration biopsy (FNAB) is often the first diagnostic procedure performed in patients with head and neck (HN) masses. Metastatic squamous cell carcinoma (SCC) to cervical lymph nodes is by far the most common malignancy aspirated in the HN, but in approximately 3-10% of patients, a primary tumor will not be found even after complete clinico-radiological workup. Several HN cancers are associated with oncogenic viruses, including HPV-associated SCC and EBV-associated nasopharyngeal carcinoma (NPC). While the primary tumor is sometimes small or undetectable, patients often present initially with cervical lymph node metastases. HPV-associated SCC and EBV-associated NPC are typically non-keratinizing carcinomas that can mimic several other poorly differentiated HN cancers by FNAB but have a significantly better prognosis. Therefore, the precise classification of the metastatic disease in the FNAB material is very useful since it can facilitate the subsequent location of the primary tumor, and it can provide prognostic and therapeutic information as well. In this review, we discuss the major entities that can present as a metastatic cancer of unknown primary in cervical lymph node other than supraclavicular, including their cytologic features and the role of ancillary studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Fluorescence cytology with 5-aminolevulinic acid in EUS-guided FNA as a method for differentiating between malignant and benign lesions (with video).

PubMed

Ikeura, Tsukasa; Takaoka, Makoto; Uchida, Kazushige; Shimatani, Masaaki; Miyoshi, Hideaki; Kato, Kota; Ohe, Chisato; Uemura, Yoshiko; Kaibori, Masaki; Kwon, A-Hon; Okazaki, Kazuichi

2015-01-01

EUS-guided FNA (EUS-FNA) has been increasingly performed to obtain specimens for the pathological evaluation of patients with GI and pancreaticobiliary masses as well as lymphadenopathies of unknown origin. Photodynamic diagnosis by using 5-aminolebulinic acid (ALA) has been reported to be useful for enabling the visual differentiation between malignant and normal tissue in various cancers. To evaluate the diagnostic accuracy of fluorescence cytology with ALA in EUS-FNA. A prospective study. A single center. A total of 28 consecutive patients who underwent EUS-FNA for the pathological diagnosis of a pancreaticobiliary mass lesion or intra-abdominal lymphadenopathy of unknown origin. Patients were orally administered ALA 3 to 6 hours before EUS-FNA. The sample was obtained via EUS-FNA for fluorescence cytology and conventional cytology. A single gastroenterologist performed the fluorescence cytology by using fluorescence microscopy after the procedure, independently of the conventional cytology by pathologists. The accuracy of fluorescence cytology with ALA in the differentiation between benign and malignant lesions by comparing the results of fluorescence cytology with the final diagnosis. Of the 28 patients included in the study, 22 were considered as having malignant lesions and 6 patients as having benign lesions. Fluorescence cytology could correctly discriminate between benign and malignant lesions in all patients. Therefore, both the sensitivity and specificity of fluorescence cytology were 100% in our study. Fluorescence cytology was performed by only 1 gastroenterologist with a small number of patients. Fluorescence cytology with ALA in EUS-FNA may be an effective and simple method for differentiating between benign and malignant lesions. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

9 CFR 93.406 - Diagnostic tests.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.406 Diagnostic tests. (a) Tuberculosis and brucellosis...; and (2) Tuberculosis. (i) For steers and spayed heifers, the cattle originated from a herd of origin that tested negative to a whole herd test for tuberculosis within 1 year prior to the date of...

9 CFR 93.406 - Diagnostic tests.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.406 Diagnostic tests. (a) Tuberculosis and brucellosis...; and (2) Tuberculosis. (i) For steers and spayed heifers, the cattle originated from a herd of origin that tested negative to a whole herd test for tuberculosis within 1 year prior to the date of...

Cryptococcal meningitis in an immunocompetent child: a case report and literature review.

PubMed

Othman, Norlijah; Abdullah, Nor Atiqah Ng; Wahab, Zubaidah Abdul

2004-12-01

An immunocompetent 5 year-old girl presented with pyrexia of unknown origin associated with headache. Initial investigations showed leukocytosis and an increased erythrocyte sedimentation rate. A Widal-Weil Felix test, blood film for malarial parasites, mycoplasma IgM antibody, cultures from blood and urine, full blood picture, Mantoux test, and chest x-ray were all negative. A lumbar puncture was done as part of a work-up for pyrexia of unknown origin. Cryptococcus neoformans was seen on India ink examination and confirmed on culture. She was treated with 10 weeks of intravenous amphotericin B and 8 weeks of fluconazole. Further immunological tests did not reveal any defect in the cell-mediated immune system. C. neoformans meningitis may present with non-specific symptoms and should be considered in a work-up for pyrexia of unknown origin.

Characterization of two familial cases presenting with a syndromic specific learning disorder and carrying (17q;21q) unbalanced translocations.

PubMed

Coton, Julie; Labalme, Audrey; Till, Marianne; Bussy, Gerald; Krifi Papoz, Sonia; Lesca, Gaetan; Heron, Delphine; Sanlaville, Damien; Edery, Patrick; des Portes, Vincent; Rossi, Massimiliano

2018-05-01

Chromosomal microarray (CMA) can detect pathogenic copy number variations in 15-20% of individuals with intellectual disability and in 10% of patients with autism spectrum disorders. The diagnostic rate in specific learning disorders (SLD) is unknown. Our study emphasizes the usefulness of CMA in the diagnostic workout assessment of familial SLD.

Using a web-based application to define the accuracy of diagnostic tests when the gold standard is imperfect.

PubMed

Lim, Cherry; Wannapinij, Prapass; White, Lisa; Day, Nicholas P J; Cooper, Ben S; Peacock, Sharon J; Limmathurotsakul, Direk

2013-01-01

Estimates of the sensitivity and specificity for new diagnostic tests based on evaluation against a known gold standard are imprecise when the accuracy of the gold standard is imperfect. Bayesian latent class models (LCMs) can be helpful under these circumstances, but the necessary analysis requires expertise in computational programming. Here, we describe open-access web-based applications that allow non-experts to apply Bayesian LCMs to their own data sets via a user-friendly interface. Applications for Bayesian LCMs were constructed on a web server using R and WinBUGS programs. The models provided (http://mice.tropmedres.ac) include two Bayesian LCMs: the two-tests in two-population model (Hui and Walter model) and the three-tests in one-population model (Walter and Irwig model). Both models are available with simplified and advanced interfaces. In the former, all settings for Bayesian statistics are fixed as defaults. Users input their data set into a table provided on the webpage. Disease prevalence and accuracy of diagnostic tests are then estimated using the Bayesian LCM, and provided on the web page within a few minutes. With the advanced interfaces, experienced researchers can modify all settings in the models as needed. These settings include correlation among diagnostic test results and prior distributions for all unknown parameters. The web pages provide worked examples with both models using the original data sets presented by Hui and Walter in 1980, and by Walter and Irwig in 1988. We also illustrate the utility of the advanced interface using the Walter and Irwig model on a data set from a recent melioidosis study. The results obtained from the web-based applications were comparable to those published previously. The newly developed web-based applications are open-access and provide an important new resource for researchers worldwide to evaluate new diagnostic tests.

13. Photocopy of photograph. Photographer unknown, circa 1940. Original photograph ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Photocopy of photograph. Photographer unknown, circa 1940. Original photograph can be found in Marvine Colliery folder in the archives of the Lackawanna Historical Society, Scranton, Pennsylvania. VIEW SHOWING SOUTH AND EAST FACADES OF BREAKER, WITH OVERHEAD PIPING IN FOREGROUND AND RETAIL SCALES OFFICE AT FAR RIGHT, LOOKING NORTHWEST - Marvine Colliery, Breaker No. 2, West side Boulevard Avenue, between East Parker Street & Route 380, Scranton, Lackawanna County, PA

Ante- and postmortem diagnostic techniques for anthrax: rethinking pathogen exposure and the geographic extent of the disease in wildlife.

PubMed

Bagamian, Karoun H; Alexander, Kathleen A; Hadfield, Ted L; Blackburn, Jason K

2013-10-01

Although antemortem approaches in wildlife disease surveillance are common for most zoonoses, they have been used infrequently in anthrax surveillance. Classically, anthrax is considered a disease with extremely high mortality. This is because anthrax outbreaks are often detected ex post facto through wildlife or livestock fatalities or spillover transmission to humans. As a result, the natural prevalence of anthrax infection in animal populations is largely unknown. However, in the past 20 yr, antemortem serologic surveillance in wildlife has indicated that not all species exposed succumb to infection, and anthrax exposure may be more widespread than originally appreciated. These studies brought about a multitude of new questions, many of which can be addressed by increased antemortem serologic surveillance in wildlife populations. To fully understand anthrax transmission dynamics and geographic extent, it is important to identify exposure in wildlife hosts and associated factors and, in turn, understand how these influences may drive environmental reservoir dynamics and concurrent disease risk in livestock and humans. Here we review our current understanding of the serologic response to anthrax among wildlife hosts and serologic diagnostic assays used to augment traditional postmortem anthrax surveillance strategies. We also provide recommendations for the use of serology and sentinel species surveillance approaches in anthrax research and management.

The Diagnostic and Prognostic Role of microRNA in Colorectal Cancer - a Comprehensive review

PubMed Central

Mazeh, Haggi; Mizrahi, Ido; Ilyayev, Nadia; Halle, David; Brücher, Björn LDM; Bilchik, Anton; Protic, Mladjan; Daumer, Martin; Stojadinovic, Alexander; Avital, Itzhak; Nissan, Aviram

2013-01-01

The discovery of microRNA, a group of regulatory short RNA fragments, has added a new dimension to the diagnosis and management of neoplastic diseases. Differential expression of microRNA in a unique pattern in a wide range of tumor types enables researches to develop a microRNA-based assay for source identification of metastatic disease of unknown origin. This is just one example of many microRNA-based cancer diagnostic and prognostic assays in various phases of clinical research. Since colorectal cancer (CRC) is a phenotypic expression of multiple molecular pathways including chromosomal instability (CIN), micro-satellite instability (MIS) and CpG islands promoter hypermethylation (CIMP), there is no one-unique pattern of microRNA expression expected in this disease and indeed, there are multiple reports published, describing different patterns of microRNA expression in CRC. The scope of this manuscript is to provide a comprehensive review of the scientific literature describing the dysregulation of and the potential role for microRNA in the management of CRC. A Pubmed search was conducted using the following MeSH terms, "microRNA" and "colorectal cancer". Of the 493 publications screened, there were 57 papers describing dysregulation of microRNA in CRC. PMID:23459799

Clinical and epidemiological correlates of the neurohistology of cases of histologically unconfirmed, clinically suspect bovine spongiform encephalopathy.

PubMed

Wells, G A; Sayers, A R; Wilesmith, J W

1995-03-04

The associations between three major categories of the neurohistological diagnoses and the epidemiological data were examined in unconfirmed cases of clinically suspect bovine spongiform encephalopathy (BSE). The diagnostic categories were focal spongiosis of white matter (37 cases), encephalic listeriosis (13 cases) and no significant lesions (78 cases). An additional control category of 200 confirmed cases of BSE were included for comparison. Epidemiological variables were the frequencies of specific clinical signs, the season of clinical onset, the age, the duration of the clinical signs and the geographical origin of the cases. Discriminant analysis was used to assess the contribution of these variables to the distinction between the diagnostic categories. The analyses characterised the cases of listeriosis by their shortest clinical duration, the greater prevalences of certain clinical signs and their occurrence mainly in winter and spring, consistent with current understanding of the disease. Cases of focal spongiosis, a lesion of unknown significance, but potentially with a metabolic causation, were tentatively separable from cases with no significant lesions by their winter onset. The results also confirmed that among the categories, the cases of BSE had the longest clinical duration. Despite their statistical significance, the findings do not have sufficient predictive power to be of value in making clinical decisions.

Photocopy of photograph (original located at Mare Island Archives). Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph (original located at Mare Island Archives). Original photographer unknown. Lithograph of Mare Island, "showing the works already completed in the Navy Yard and the US. Frigate "Independence"; 1855. - Mare Island Naval Shipyard, East of Nave Drive, Vallejo, Solano County, CA

A naive Bayes algorithm for tissue origin diagnosis (TOD-Bayes) of synchronous multifocal tumors in the hepatobiliary and pancreatic system.

PubMed

Jiang, Weiqin; Shen, Yifei; Ding, Yongfeng; Ye, Chuyu; Zheng, Yi; Zhao, Peng; Liu, Lulu; Tong, Zhou; Zhou, Linfu; Sun, Shuo; Zhang, Xingchen; Teng, Lisong; Timko, Michael P; Fan, Longjiang; Fang, Weijia

2018-01-15

Synchronous multifocal tumors are common in the hepatobiliary and pancreatic system but because of similarities in their histological features, oncologists have difficulty in identifying their precise tissue clonal origin through routine histopathological methods. To address this problem and assist in more precise diagnosis, we developed a computational approach for tissue origin diagnosis based on naive Bayes algorithm (TOD-Bayes) using ubiquitous RNA-Seq data. Massive tissue-specific RNA-Seq data sets were first obtained from The Cancer Genome Atlas (TCGA) and ∼1,000 feature genes were used to train and validate the TOD-Bayes algorithm. The accuracy of the model was >95% based on tenfold cross validation by the data from TCGA. A total of 18 clinical cancer samples (including six negative controls) with definitive tissue origin were subsequently used for external validation and 17 of the 18 samples were classified correctly in our study (94.4%). Furthermore, we included as cases studies seven tumor samples, taken from two individuals who suffered from synchronous multifocal tumors across tissues, where the efforts to make a definitive primary cancer diagnosis by traditional diagnostic methods had failed. Using our TOD-Bayes analysis, the two clinical test cases were successfully diagnosed as pancreatic cancer (PC) and cholangiocarcinoma (CC), respectively, in agreement with their clinical outcomes. Based on our findings, we believe that the TOD-Bayes algorithm is a powerful novel methodology to accurately identify the tissue origin of synchronous multifocal tumors of unknown primary cancers using RNA-Seq data and an important step toward more precision-based medicine in cancer diagnosis and treatment. © 2017 UICC.

11. Photocopy of photograph. Photographer unknown, circa 1955. Original photograph ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Photocopy of photograph. Photographer unknown, circa 1955. Original photograph can be found in Marvine Colliery folder in the archives of the Lackawanna Historical Society, Scranton, Pennsylvania. VIEW SHOWING EAST AND NORTH FACADES OF BREAKER, WITH BOILER HOUSE AT FAR LEFT AND RETAIL SCALES OFFICE DIRECTLY EAST OF BREAKER, LOOKING SOUTHWEST - Marvine Colliery, Breaker No. 2, West side Boulevard Avenue, between East Parker Street & Route 380, Scranton, Lackawanna County, PA

Fever of unknown origin as the first manifestation of colonic pathology.

PubMed

Belhassen-García, Moncef; Velasco-Tirado, Virginia; López-Bernus, Amparo; Alonso-Sardón, Montserrat; Carpio-Pérez, Adela; Fuentes-Pardo, Lucía; Pardo-Lledías, Javier; Alvela-Suárez, Lucia; Romero-Alegría, Angela; Iglesias-Gomez, Alicia; Sánchez, Miguel Cordero

2013-04-01

Fever of unknown origin (FUO) is an entity caused by more than 200 diseases. Haematologic neoplasms are the most common malignant cause of FUO. Fever as a first symptom of colonic tumour pathology, both benign and malignant, is a rare form of presentation. Our work is a descriptive study of a series of 23 patients with colonic tumoral pathology who presented with fever of unknown origin. The mean age was 67.6 years; 56.5% of patients were men and 43.5% were women. Primary malignant neoplasia was the most common diagnosis. Blood cultures were positive in 45% of the samples. Coagulase-negative staphylococci were the most common cause of bacteraemia. Nine of 10 faecal occult blood tests performed were positive. Fever secondary to colon neoplasms, both benign and malignant, usually presents with a bacteraemic pattern, with positive results for blood-culture tests in a high percentage of cases.

Two similar cases of elderly women with moderate abdominal pain and pneumoperitoneum of unknown origin: a surgeon's successful conservative management.

PubMed

Vinzens, Fabrizio; Zumstein, Valentin; Bieg, Christian; Ackermann, Christoph

2016-05-26

Patients presenting with abdominal pain and pneumoperitoneum in radiological examination usually require emergency explorative laparoscopy or laparotomy. Pneumoperitoneum mostly associates with gastrointestinal perforation. There are very few cases where surgery can be avoided. We present 2 cases of pneumoperitoneum with unknown origin and successful conservative treatment. Both patients were elderly women presenting to our emergency unit, with moderate abdominal pain. There was neither medical intervention nor trauma in their medical history. Physical examination revealed mild abdominal tenderness, but no clinical sign of peritonitis. Cardiopulmonary examination remained unremarkable. Blood studies showed only slight abnormalities, in particular, inflammation parameters were not significantly increased. Finally, obtained CTs showed free abdominal gas of unknown origin in both cases. We performed conservative management with nil per os, nasogastric tube, total parenteral nutrition and prophylactic antibiotics. After 2 weeks, both were discharged home. 2016 BMJ Publishing Group Ltd.

Diagnostic labelling influences self-rated health. A prospective cohort study: the HUNT Study, Norway

PubMed Central

Jørgensen, Pål; Langhammer, Arnulf; Krokstad, Steinar; Forsmo, Siri

2015-01-01

Background. Studies have shown an independent association between poor self-rated health (SRH) and increased mortality. Few studies, however, have investigated any possible impact on SRH of diagnostic labelling. Objective. To test whether SRH differed in persons with known and unknown hypothyroidism, diabetes mellitus (DM) or hypertension, opposed to persons without these conditions, after 11-year follow-up. Methods. Prospective population-based cohort study in North-Trøndelag County, Norway, HUNT2 (1995–97) to HUNT3 (2006–08). All inhabitants aged 20 years and older were invited. The response rate was 69.5% in HUNT2 and 54.1% in HUNT3. In total, 34144 persons aged 20–70 years were included in the study population. The outcome was poor SRH. Results. Persons with known disease had an increased odds ratio (OR) to report poor SRH at follow-up; figures ranging from 1.11 (0.68–1.79) to 2.52 (1.46–4.34) (men with hypothyroidism kept out owing to too few numbers). However, in persons not reporting, but having laboratory results indicating these diseases (unknown disease), no corresponding associations with SRH were found. Contrary, the OR for poor SRH in women with unknown hypothyroidism and unknown hypertension was 0.64 (0.38–1.06) and 0.89 (0.79–1.01), respectively. Conclusions. Awareness opposed to ignorance of hypothyroidism, DM and hypertension seemed to be associated with poor perceived health, suggesting that diagnostic labelling could have a negative effect on SRH. This relationship needs to be tested more thoroughly in future research but should be kept in mind regarding the benefits of early diagnosing of diseases. PMID:26240089

Diagnostic labelling influences self-rated health. A prospective cohort study: the HUNT Study, Norway.

PubMed

Jørgensen, Pål; Langhammer, Arnulf; Krokstad, Steinar; Forsmo, Siri

2015-10-01

Studies have shown an independent association between poor self-rated health (SRH) and increased mortality. Few studies, however, have investigated any possible impact on SRH of diagnostic labelling. To test whether SRH differed in persons with known and unknown hypothyroidism, diabetes mellitus (DM) or hypertension, opposed to persons without these conditions, after 11-year follow-up. Prospective population-based cohort study in North-Trøndelag County, Norway, HUNT2 (1995-97) to HUNT3 (2006-08). All inhabitants aged 20 years and older were invited. The response rate was 69.5% in HUNT2 and 54.1% in HUNT3. In total, 34144 persons aged 20-70 years were included in the study population. The outcome was poor SRH. Persons with known disease had an increased odds ratio (OR) to report poor SRH at follow-up; figures ranging from 1.11 (0.68-1.79) to 2.52 (1.46-4.34) (men with hypothyroidism kept out owing to too few numbers). However, in persons not reporting, but having laboratory results indicating these diseases (unknown disease), no corresponding associations with SRH were found. Contrary, the OR for poor SRH in women with unknown hypothyroidism and unknown hypertension was 0.64 (0.38-1.06) and 0.89 (0.79-1.01), respectively. Awareness opposed to ignorance of hypothyroidism, DM and hypertension seemed to be associated with poor perceived health, suggesting that diagnostic labelling could have a negative effect on SRH. This relationship needs to be tested more thoroughly in future research but should be kept in mind regarding the benefits of early diagnosing of diseases. © The Author 2015. Published by Oxford University Press.

New system for digital to analog transformation and reconstruction of 12-lead ECGs.

PubMed

Kothadia, Roshni; Kulecz, Walter B; Kofman, Igor S; Black, Adam J; Grier, James W; Schlegel, Todd T

2013-01-01

We describe initial validation of a new system for digital to analog conversion (DAC) and reconstruction of 12-lead ECGs. The system utilizes an open and optimized software format with a commensurately optimized DAC hardware configuration to accurately reproduce, from digital files, the original analog electrocardiographic signals of previously instrumented patients. By doing so, the system also ultimately allows for transmission of data collected on one manufacturer's 12-lead ECG hardware/software into that of any other. To initially validate the system, we compared original and post-DAC re-digitized 12-lead ECG data files (∼5-minutes long) in two types of validation studies in 10 patients. The first type quantitatively compared the total waveform voltage differences between the original and re-digitized data while the second type qualitatively compared the automated electrocardiographic diagnostic statements generated by the original versus re-digitized data. The grand-averaged difference in root mean squared voltage between the original and re-digitized data was 20.8 µV per channel when re-digitization involved the same manufacturer's analog to digital converter (ADC) as the original digitization, and 28.4 µV per channel when it involved a different manufacturer's ADC. Automated diagnostic statements generated by the original versus reconstructed data did not differ when using the diagnostic algorithm from the same manufacturer on whose device the original data were collected, and differed only slightly for just 1 of 10 patients when using a third-party diagnostic algorithm throughout. Original analog 12-lead ECG signals can be reconstructed from digital data files with accuracy sufficient for clinical use. Such reconstructions can readily enable automated second opinions for difficult-to-interpret 12-lead ECGs, either locally or remotely through the use of dedicated or cloud-based servers.

New diagnostic pathways urgently needed. Protocol of PET Guidance I pilot study: positron emission tomography in suspected cardiac implantable electronic device-related infection.

PubMed

Marciniak-Emmons, Marta Barbara; Sterliński, Maciej; Syska, Paweł; Maciąg, Aleksander; Farkowski, Michał Mirosław; Firek, Bohdan; Dziuk, Mirosław; Zając, Dariusz; Pytkowski, Mariusz; Szwed, Hanna

2016-01-01

Cardiovascular implantable electronic device (CIED) infection is a complication of increasing incidence. We present a protocol of an observational case control clinical trial "Positron Emission Tomography Combined With Computed Tomography (PET CT) in Suspected Cardiac Implantable Electronic Device Infection, a Pilot Study - PET Guidance I" (NCT02196753). The aim of this observational clinical trial is to assess and standardise diagnostic algorithms for CIED infections (lead-dependent infective endocarditis, generator pocket infection, fever of unknown origin) with PET CT in Poland. Study group will consist of 20 patients with initial diagnosis of CIED-related infection paired with a control group of 20 patients with implanted CIEDs, who underwent PET CT due to other non-infectious indications and have no data for infectious process in follow-up. All patients included in the study will undergo standard diagnostic pro-cess. Conventional/standard diagnostic and therapeutic process will consist of: medical interview, physical examination, laboratory tests, blood cultures; imaging studies: echocardiography: transthoracic (TTE), and, if there are no contraindications transoesophageal, computed tomography scan for pulmonary embolism if indicated; if there are abnormalities in other systems, decisions concerning further diagnostics will be made at the physician's discretion. As well as standard diagnostic procedures, patients will undergo whole body PET CT scan to localise infection or inflammation. Diagnosis and therapeutic decision will be obtained from the Study Committee. Follow-up will be held within six months with control visits at three and six months. During each follow-up visit, all patients will undergo laboratory tests, two blood cultures collected 1 h apart, and TTE. In case of actual clinical suspicion of infective endocarditis or local generator pocket infection, patients will be referred for further diagnostics. Endpoints for the results assessment - primary endpoints are to standardise PET CT in the diagnostic process: sensitivity, specificity, positive predictive value, and negative predictive value of the diagnosis made by PET CT; secondary endpoints are: assessment of usefulness of PET CT for detection of remote infective complications (metastatic abscesses, infected pulmonary emboli), incidence of particular localisations of infection, influence of PET CT on therapeutic decision: confirmation or change of decision based on PET CT, safety and complications of diagnostic process of CIED-related infections with PET CT. Evaluation of PET CT use for device-related infections in a case control study may be conclusive and improve diagnostic pathway.

Ten questions about terminology for children with unexplained language problems

PubMed Central

Bishop, D V M

2014-01-01

Background In domains other than language, there is fairly consistent diagnostic terminology to refer to children's developmental difficulties. For instance, the terms ‘dyslexia’, ‘attention deficit hyperactivity disorder’ and ‘autistic spectrum disorder’ are used for difficulties with reading, attention or social cognition, respectively. There is no agreed label, however, for children with unexplained language problems. Aims To consider whether we need labels for unexplained language problems in children, and if so, what terminology is appropriate. Main Contribution There are both advantages and disadvantages to labels, but they are important to ensure children receive services, and to increase our knowledge of the nature and causes of such problems. A survey of labels in current use found 132 different terms, 33 of which had 600 or more returns on Google Scholar between 1994 and 2013. Many of these labels were too general to be useful. Of the remainder, the term ‘specific language impairment’ was the most commonly used. Conclusions The current mayhem in diagnostic labels is unsustainable; it causes confusion and impedes research progress and access to appropriate services. We need to achieve consensus on diagnostic criteria and terminology. The DSM-5 term ‘language disorder’ is problematic because it identifies too wide a range of conditions on an internet search. One solution is to retain specific language impairment, with the understanding that ‘specific’ means idiopathic (i.e., of unknown origin) rather than implying there are no other problems beyond language. Other options are the terms ‘primary language impairment’, ‘developmental language disorder’ or ‘language learning impairment’. PMID:25142090

Incidence of chronic obstructive pulmonary disease based on three spirometric diagnostic criteria in Sao Paulo, Brazil: a nine-year follow-up since the PLATINO prevalence study.

PubMed

Moreira, Graciane Laender; Gazzotti, Mariana Rodrigues; Manzano, Beatriz Martins; Nascimento, Oliver; Perez-Padilla, Rogelio; Menezes, Ana Maria Baptista; Jardim, José Roberto

2015-01-01

Chronic obstructive pulmonary disease (COPD) is a respiratory disease of high prevalence and socioeconomic impact worldwide. It affects approximately 16% of the population of São Paulo. The incidence of COPD is still unknown in Brazil. The aim of this study was to estimate new cases of COPD in a population-based sample in São Paulo, Brazil, using three different spirometric diagnostic criteria, and to assess the concordance between these criteria. Prospective cohort study, in the city of São Paulo, Brazil. A questionnaire was applied and anthropometry and pre and post-bronchodilator spirometry were performed on the same subjects as in the initial PLATINO study (2003) in São Paulo. Data from this follow-up study were added to the original database of the initial phase. Incident COPD cases refer to subjects who developed the disease in accordance with each spirometric criterion during the nine-year follow-up period. The Statistical Package for the Social Sciences, version 17.0 (SPSS Inc., Chicago, IL, USA) was used in the analysis and the significance level was set at P < 0.05. 613 subjects participated in the follow-up. New COPD cases ranged in frequency from 1.4% to 4.0%, depending on the diagnostic criterion used. The concordance between the criteria ranged from 35% to 60%. The incidence of COPD after a nine-year follow-up was high, but varied according to the spirometric criterion used. The agreement between the criteria for identifying new cases of the disease ranged from 35% to 60%.

16. Photocopy of original USRS photograph (from original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

16. Photocopy of original USRS photograph (from original print in the Umatilla Project History 1918, on file at National Archives, Rocky Mountain Region, Denver, Colorado) Photographer unknown, ca. 1918. Office of U.S. Reclamation Service - Hermiston, Umatilla Project, Oregon - Former Umatilla Project Headquarters Buildings, Office, Hermiston, Umatilla County, OR

The Utility of Diagnostic Laparoscopy in Post-Bariatric Surgery Patients with Chronic Abdominal Pain of Unknown Etiology.

PubMed

Alsulaimy, Mohammad; Punchai, Suriya; Ali, Fouzeyah A; Kroh, Matthew; Schauer, Philip R; Brethauer, Stacy A; Aminian, Ali

2017-08-01

Chronic abdominal pain after bariatric surgery is associated with diagnostic and therapeutic challenges. The aim of this study was to evaluate the yield of laparoscopy as a diagnostic and therapeutic tool in post-bariatric surgery patients with chronic abdominal pain who had negative imaging and endoscopic studies. A retrospective analysis was performed on post-bariatric surgery patients who underwent laparoscopy for diagnosis and treatment of chronic abdominal pain at a single academic center. Only patients with both negative preoperative CT scan and upper endoscopy were included. Total of 35 post-bariatric surgery patients met the inclusion criteria, and all had history of Roux-en-Y gastric bypass. Twenty out of 35 patients (57%) had positive findings on diagnostic laparoscopy including presence of adhesions (n = 12), chronic cholecystitis (n = 4), mesenteric defect (n = 2), internal hernia (n = 1), and necrotic omentum (n = 1). Two patients developed post-operative complications including a pelvic abscess and an abdominal wall abscess. Overall, 15 patients (43%) had symptomatic improvement after laparoscopy; 14 of these patients had positive laparoscopic findings requiring intervention (70% of the patients with positive laparoscopy). Conversely, 20 (57%) patients required long-term medical treatment for management of chronic abdominal pain. Diagnostic laparoscopy, which is a safe procedure, can detect pathological findings in more than half of post-bariatric surgery patients with chronic abdominal pain of unknown etiology. About 40% of patients who undergo diagnostic laparoscopy and 70% of patients with positive findings on laparoscopy experience significant symptom improvement. Patients should be informed that diagnostic laparoscopy is associated with no symptom improvement in about half of cases.

Marked improvement of vulvovaginitis of unknown origin in a pediatric patient--case report.

PubMed

Check, J H; Cohen, R

2014-01-01

To present a novel therapy for pediatric vulvovaginitis. An eight-year-old girl with persistent severe vulvovaginitis of unknown origin also complained of unexplained weight gain and sudden academic difficulties. She was treated with dextroamphetamine sulfate. She not only showed very quick and excellent relief from her vulvovaginitis but she also lost weight and improved her mentality. Sympathomimetic amine therapy may benefit pediatric vulvovaginitis when an infectious cause cannot be ascertained.

Fever of unknown origin (FUO) due to Legionnaire's disease.

PubMed

Muñoz-Gómez, Sigridh; Cunha, Burke A

2015-01-01

Fevers of unknown origin (FUOs) may be due to any of over 200 different disorders. We present a most unusual case of an FUO in a returning traveler from the Dominican Republic. Work-up for Q fever, Brucellosis, Bartonella, malaria and HIV were negative, but very highly elevated ESRs and ferritin levels suggested possible Legionnaire's disease. This is the third reported case of Legionnaire's disease presenting as an FUO. Copyright © 2015 Elsevier Inc. All rights reserved.

21 CFR 864.9160 - Blood group substances of nonhuman origin for in vitro diagnostic use.

Code of Federal Regulations, 2011 CFR

2011-04-01

... licensed by the Center for Biologics Evaluation and Research of the Food and Drug Administration. (b... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Blood group substances of nonhuman origin for in vitro diagnostic use. 864.9160 Section 864.9160 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...

21 CFR 864.9160 - Blood group substances of nonhuman origin for in vitro diagnostic use.

Code of Federal Regulations, 2010 CFR

2010-04-01

... licensed by the Center for Biologics Evaluation and Research of the Food and Drug Administration. (b... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood group substances of nonhuman origin for in vitro diagnostic use. 864.9160 Section 864.9160 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...

10. Photocopy of photograph (original print from Southern Pacific Transportation ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Photocopy of photograph (original print from Southern Pacific Transportation Company) ca. 1916, photographer unknown VIEW OF ORIGINAL PACIFIC ELECTRIC RAILWAY LYNWOOD SHELTER SHED - Lynwood Pacific Electric Railway Depot, 11453 Long Beach Boulevard, Lynwood, Los Angeles County, CA

Prediction of Tubal Ectopic Pregnancy Using Offline Analysis of 3-Dimensional Transvaginal Ultrasonographic Data Sets: An Interobserver and Diagnostic Accuracy Study.

PubMed

Infante, Fernando; Espada Vaquero, Mercedes; Bignardi, Tommaso; Lu, Chuan; Testa, Antonia C; Fauchon, David; Epstein, Elisabeth; Leone, Francesco P G; Van den Bosch, Thierry; Martins, Wellington P; Condous, George

2018-06-01

To assess interobserver reproducibility in detecting tubal ectopic pregnancies by reading data sets from 3-dimensional (3D) transvaginal ultrasonography (TVUS) and comparing it with real-time 2-dimensional (2D) TVUS. Images were initially classified as showing pregnancies of unknown location or tubal ectopic pregnancies on real time 2D TVUS by an experienced sonologist, who acquired 5 3D volumes. Data sets were analyzed offline by 5 observers who had to classify each case as ectopic pregnancy or pregnancy of unknown location. The interobserver reproducibility was evaluated by the Fleiss κ statistic. The performance of each observer in predicting ectopic pregnancies was compared to that of the experienced sonologist. Women were followed until they were reclassified as follows: (1) failed pregnancy of unknown location; (2) intrauterine pregnancy; (3) ectopic pregnancy; or (4) persistent pregnancy of unknown location. Sixty-one women were included. The agreement between reading offline 3D data sets and the first real-time 2D TVUS was very good (80%-82%; κ = 0.89). The overall interobserver agreement among observers reading offline 3D data sets was moderate (κ = 0.52). The diagnostic performance of experienced observers reading offline 3D data sets had accuracy of 78.3% to 85.0%, sensitivity of 66.7% to 81.3%, specificity of 79.5% to 88.4%, positive predictive value of 57.1% to 72.2%, and negative predictive value of 87.5% to 91.3%, compared to the experienced sonologist's real-time 2D TVUS: accuracy of 94.5%, sensitivity of 94.4%, specificity of 94.5%, positive predictive value of 85.0%, and negative predictive value of 98.1%. The diagnostic accuracy of 3D TVUS by reading offline data sets for predicting ectopic pregnancies is dependent on experience. Reading only static 3D data sets without clinical information does not match the diagnostic performance of real time 2D TVUS combined with clinical information obtained during the scan. © 2017 by the American Institute of Ultrasound in Medicine.

Enhanced CT images by the wavelet transform improving diagnostic accuracy of chest nodules.

PubMed

Guo, Xiuhua; Liu, Xiangye; Wang, Huan; Liang, Zhigang; Wu, Wei; He, Qian; Li, Kuncheng; Wang, Wei

2011-02-01

The objective of this study was to compare the diagnostic accuracy in the interpretation of chest nodules using original CT images versus enhanced CT images based on the wavelet transform. The CT images of 118 patients with cancers and 60 with benign nodules were used in this study. All images were enhanced through an algorithm based on the wavelet transform. Two experienced radiologists interpreted all the images in two reading sessions. The reading sessions were separated by a minimum of 1 month in order to minimize the effect of observer's recall. The Mann-Whitney U nonparametric test was used to analyze the interpretation results between original and enhanced images. The Kruskal-Wallis H nonparametric test of K independent samples was used to investigate the related factors which could affect the diagnostic accuracy of observers. The area under the ROC curves for the original and enhanced images was 0.681 and 0.736, respectively. There is significant difference in diagnosing the malignant nodules between the original and enhanced images (z = 7.122, P < 0.001), whereas there is no significant difference in diagnosing the benign nodules (z = 0.894, P = 0.371). The results showed that there is significant difference between original and enhancement images when the size of nodules was larger than 2 cm (Z = -2.509, P = 0.012, indicating the size of the nodules is a critical evaluating factor of the diagnostic accuracy of observers). This study indicated that the image enhancement based on wavelet transform could improve the diagnostic accuracy of radiologists for the malignant chest nodules.

[Risk on bias assessment: (6) A Revised Tool for the Quality Assessment on Diagnostic Accuracy Studies (QUADAS-2)].

PubMed

Qu, Y J; Yang, Z R; Sun, F; Zhan, S Y

2018-04-10

This paper introduced the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2), including the development and comparison with the original QUADAS, and illustrated the application of QUADAS-2 in a published paper related to the study on diagnostic accuracy which was included in systematic review and Meta-analysis. QUADAS-2 presented considerable improvement over the original tool. Confused items that included in QUADAS had disappeared and the quality assessment of the original study replaced by the rating of risk on bias and applicability. This was implemented through the description on the four main domains with minimal overlapping and answering the signal questions in each domain. The risk of bias and applicability with 'high','low' or 'unclear' was in line with the risk of bias assessment of intervention studies in Cochrane, so to replace the total score of quality assessment in QUADAS. Meanwhile, QUADAS-2 was also applicable to assess the diagnostic accuracy studies in which follow-up without prognosis was involved in golden standard. It was useful to assess the overall methodological quality of the study despite more time consuming than the original QUADAS. However, QUADAS-2 needs to be modified to apply in comparative studies on diagnostic accuracy and we hope the users would follow the updates and give their feedbacks on line.

7. Photographic copy of photograph, date unknown (original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photographic copy of photograph, date unknown (original print in possession of James E. Zielinski Earth Tech, Huntsville, AL). Pan American World Airways, photographer. Aerial view (north to south) of missile launch area. Warhead handling building can be seen at the bottom center of the picture and the universal missile building in the middle right. In the distance can be seen the missile site control building and related structures - Stanley R. Mickelsen Safeguard Complex, Missile Launch Area, Within Exclusion Area, Nekoma, Cavalier County, ND

Metastatic brain tumor

MedlinePlus

... the brain, the type of tissue involved, the original location of the tumor, and other factors. In rare cases, doctors do not know the original location. This is called cancer of unknown primary ( ...

Transmission electron microscopy analysis of the origin and incidence of sperm intranuclear cytoplasmic retention in fertile and teratozoospermia men.

PubMed

Zhu, W-J

2018-03-01

The human sperm nucleus contains cytoplasm. However, the origin and incidence of human sperm intranuclear cytoplasmic retention (INCR) remain unknown. The objectives of this study were to observe the morphological origin of INCR within the seminiferous epithelium and investigate the incidence of INCR in fertile and teratozoospermia men using transmission electron microscopy (TEM). By TEM, INCR initially appeared in elongating round spermatid nuclei and varied in size, number, shape, content, location and distribution within sperm nuclei. The teratozoospermia group (n = 16) demonstrated a higher incidence of INCR than did the fertile group (n = 16) (17.6 ± 5.2% vs. 9.7 ± 3.4%; p = 0.000). In the fertile group, no correlations were found between the incidence of INCR and abnormal sperm morphology, nuclear vacuole, acrosome integrity, motility or concentration (p > 0.05). However, the incidence of INCR exhibited a positive relationship with sperm abnormal morphology in the teratozoospermia group (r = 0.616, p = 0.011). These results demonstrate that INCR occurs in the early process of spermatogenesis and is an alteration found in the nucleus. Spermatozoa from teratozoospermia men contained more INCRs than those from fertile males. More attention should be paid to the possibility of spermatozoa containing INCR when using spermatozoa with abnormal head morphology for clinical or diagnostic purposes. © 2018 American Society of Andrology and European Academy of Andrology.

18. Photocopy of original postcard, (original in Forest Service Office, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

18. Photocopy of original postcard, (original in Forest Service Office, Elkins, WV, 'U. S. Forest Nursery with CCC Camp in Background-Parsons, W. Va.'), photographer unknown, ca. 1936. AERIAL VIEW EAST, ORIGINAL WASH HOUSE, WORKSHOP/WAREHOUSE, TWO EQUIPMENT BUILDINGS (DEMOLISHED) IN FOREGROUND, CCC CAMP PARSONS IN BACKGROUND. - Parsons Nursery, South side of U.S. Route 219, Parsons, Tucker County, WV

Causes of permanent childhood hearing impairment.

PubMed

Korver, Anna M H; Admiraal, Ronald J C; Kant, Sarina G; Dekker, Friedo W; Wever, Capi C; Kunst, Henricus P M; Frijns, Johan H M; Oudesluys-Murphy, Anne Marie

2011-02-01

The causes of Permanent Childhood Hearing Impairment (PCHI) are often quoted as being hereditary in 50%, acquired in 25%, and unknown in 25% of cases. Interest in the causes of PCHI has grown recently due to increasing diagnostic possibilities. We investigated the evidence for the reported distribution of these causes. Population-based study and a systematic review. Inclusion criteria for population-based study: children born between 2003 and 2005, resident in The Netherlands at birth, known at an Audiology Center with PCHI at the age of 3-5 years. The causes of PCHI were determined prospectively by detection of congenital cytomegalovirus on dried blood spots and/or genetic diagnostic investigations in addition to reviewing data from medical records. A systematic review was carried out using three terms (hearing loss, infant, and etiology) and limited to articles published between January 1997 and July 2009. Main outcome measures were: the (weighted) proportions of the various causes of PCHI following diagnostic investigations. In the study-population (n = 185) a hereditary cause was found in 38.9%, acquired cause in 29.7%, miscellaneous cause in 7.1%, and the cause remained unknown in 24.3%. The systematic review of the literature (n = 9 articles) resulted in a weighted mean of 30.4% hereditary, 19.2% acquired, and 48.3% unknown causes of PCHI. The systematic review and the results of the population-based study provided little support for the generally accepted distribution of causes of PCHI. Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.

Archaeology Through Computational Linguistics: Inscription Statistics Predict Excavation Sites of Indus Valley Artifacts.

PubMed

Recchia, Gabriel L; Louwerse, Max M

2016-11-01

Computational techniques comparing co-occurrences of city names in texts allow the relative longitudes and latitudes of cities to be estimated algorithmically. However, these techniques have not been applied to estimate the provenance of artifacts with unknown origins. Here, we estimate the geographic origin of artifacts from the Indus Valley Civilization, applying methods commonly used in cognitive science to the Indus script. We show that these methods can accurately predict the relative locations of archeological sites on the basis of artifacts of known provenance, and we further apply these techniques to determine the most probable excavation sites of four sealings of unknown provenance. These findings suggest that inscription statistics reflect historical interactions among locations in the Indus Valley region, and they illustrate how computational methods can help localize inscribed archeological artifacts of unknown origin. The success of this method offers opportunities for the cognitive sciences in general and for computational anthropology specifically. Copyright © 2015 Cognitive Science Society, Inc.

31. Photocopy of photograph (original print in Helgesen Collection) Photographer ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

31. Photocopy of photograph (original print in Helgesen Collection) Photographer unknown 1928 MEN'S MEZZANINE SMOKING ROOM - B. F. Keith Memorial Theatre, 539 Washington Street, Boston, Suffolk County, MA

Undiagnosed Acute Viral Febrile Illnesses, Sierra Leone

PubMed Central

Rossi, Cynthia A.; Khan, Sheik H.; Goba, Augustine; Fair, Joseph N.

2014-01-01

Sierra Leone in West Africa is in a Lassa fever–hyperendemic region that also includes Guinea and Liberia. Each year, suspected Lassa fever cases result in submission of ≈500–700 samples to the Kenema Government Hospital Lassa Diagnostic Laboratory in eastern Sierra Leone. Generally only 30%–40% of samples tested are positive for Lassa virus (LASV) antigen and/or LASV-specific IgM; thus, 60%–70% of these patients have acute diseases of unknown origin. To investigate what other arthropod-borne and hemorrhagic fever viral diseases might cause serious illness in this region and mimic Lassa fever, we tested patient serum samples that were negative for malaria parasites and LASV. Using IgM-capture ELISAs, we evaluated samples for antibodies to arthropod-borne and other hemorrhagic fever viruses. Approximately 25% of LASV-negative patients had IgM to dengue, West Nile, yellow fever, Rift Valley fever, chikungunya, Ebola, and Marburg viruses but not to Crimean-Congo hemorrhagic fever virus. PMID:24959946

Dracunculiasis in oral and maxillofacial surgery.

PubMed

Kim, Soung Min

2016-04-01

Dracunculiasis, otherwise known as guinea worm disease (GWD), is caused by infection with the nematode Dracunculus medinensis. This nematode is transmitted to humans exclusively via contaminated drinking water. The transmitting vectors are Cyclops copepods (water fleas), which are tiny free-swimming crustaceans usually found abundantly in freshwater ponds. Humans can acquire GWD by drinking water that contains vectors infected with guinea worm larvae. This disease is prevalent in some of the most deprived areas of the world, and no vaccine or medicine is currently available. International efforts to eradicate dracunculiasis began in the early 1980s. Most dentists and maxillofacial surgeons have neglected this kind of parasite infection. However, when performing charitable work in developing countries near the tropic lines or other regions where GWD is endemic, it is important to consider GWD in cases of swelling or tumors of unknown origin. This paper reviews the pathogenesis, epidemiology, clinical criteria, diagnostic criteria, treatment, and prevention of dracunculiasis. It also summarizes important factors for maxillofacial surgeons to consider.

[Antegrade visualization of the billiary duct system by percutaneous transjugular cholangiography (author's transl)].

PubMed

Huchzermeyer, H; Luska, G; Freuschmidt, J

1976-01-01

Percutaneous transjugular cholangiography (PTJC) is a new technique for visualization of the biliary duct system and for diagnosis of obstructive jaundice. First experiences of the authors in 22 patients are described. The advantages and disadvantages of this procedure, which at the present time is used rather rarely, are discussed and compared to various other cholangiographic methods. The endoscopic retrograde cholangiography (ERC) was used for patients with obstructive jaundice of unknown origine in the first place. If the biliary duct system could not be visualized by ERC (failure of complete obstruction of the common bile duct), the antegrade technique (PTJC) was performed. The peritoneoscopic and the transjugular cholangiography yield about the same percentage of positive results (90%), as far as visualization of the biliary tree is concerned. However in contrast to the peritoneoscopic methods PTJC seems to bear a smaller risk of complications. Some further diagnostic and therapeutical advantages, which might result from the use of PTJC are pointed out.

Active Solid State Dosimetry for Lunar EVA

NASA Technical Reports Server (NTRS)

Wrbanek, John D.; Fralick, Gustave C.; Wrbanek, Susan Y.; Chen, Liang-Yu.

2006-01-01

The primary threat to astronauts from space radiation is high-energy charged particles, such as electrons, protons, alpha and heavier particles, originating from galactic cosmic radiation (GCR), solar particle events (SPEs) and trapped radiation belts in Earth orbit. There is also the added threat of secondary neutrons generated as the space radiation interacts with atmosphere, soil and structural materials.[1] For Lunar exploration missions, the habitats and transfer vehicles are expected to provide shielding from standard background radiation. Unfortunately, the Lunar Extravehicular Activity (EVA) suit is not expected to afford such shielding. Astronauts need to be aware of potentially hazardous conditions in their immediate area on EVA before a health and hardware risk arises. These conditions would include fluctuations of the local radiation field due to changes in the space radiation field and unknown variations in the local surface composition. Should undue exposure occur, knowledge of the dynamic intensity conditions during the exposure will allow more precise diagnostic assessment of the potential health risk to the exposed individual.[2

Desmoplastic fibroma of the distal tibia: A case report of a minimally invasive histological diagnosis

PubMed Central

Levrini, Gabriele; Pattacini, Pierpaolo

2016-01-01

Desmoplastic fibroma (DF) is a benign, rare fibroblastic intraosseous neoplasm histologically resembling a desmoid soft tissue tumor. Although classified as benign, DF frequently exhibits an aggressive behavior, has a moderate-to-high recurrence rate, and often causes pathological fractures and extensive bone destruction. This case report presents an incidentally detected DF of the tibia, which was diagnosed using a minimally invasive approach. A 36-year-old African female patient was referred to the Department of Diagnostic Imaging of Arcispedale Santa Maria Nuova-IRCCS (Reggio Emilia, Italy), to be examined by a computed tomography scan on an outpatient basis, after an x-ray examination of the tibia, which was performed after an injury to exclude the presence of a fracture, revealed a hyperlucency of unknown origin. The aim of this study was to discuss the clinical, histological, immunohistochemical and radiographic characteristics of this rare neoplasm, with a focus on image-guided bone biopsy. PMID:27882239

Notes from the Field: Baseline Assessment of the Use of Ebola Rapid Diagnostic Tests--Forécariah, Guinea, October-November 2015.

PubMed

Huang, Jennifer Y; Louis, Frantz Jean; Dixon, Meredith G; Sefu, Marcel; Kightlinger, Lon; Martel, Lise D; Jayaraman, Gayatri C; Gueye, Abdou Salam

2016-04-01

The Ebola virus disease (Ebola) epidemic in West Africa began in Guinea in early 2014. The reemergence of Ebola and risk of ongoing, undetected transmission continues because of the potential for sexual transmission and other as yet unknown transmission pathways. On March 17, 2016, two new cases of Ebola in Guinea were confirmed by the World Health Organization. This reemergence of Ebola in Guinea is the first since the original outbreak in the country was declared over on December 29, 2015. The prefecture of Forécariah, in western Guinea, was considerably affected by Ebola in 2015, with an incidence rate of 159 cases per 100,000 persons. Guinea also has a high prevalence of malaria; in a nationwide 2012 survey, malaria prevalence was reported to be 44% among healthy children aged ≤5 years. Malaria is an important reason for seeking health care; during 2014, 34% of outpatient consultations were related to malaria.

Dracunculiasis in oral and maxillofacial surgery

PubMed Central

2016-01-01

Dracunculiasis, otherwise known as guinea worm disease (GWD), is caused by infection with the nematode Dracunculus medinensis. This nematode is transmitted to humans exclusively via contaminated drinking water. The transmitting vectors are Cyclops copepods (water fleas), which are tiny free-swimming crustaceans usually found abundantly in freshwater ponds. Humans can acquire GWD by drinking water that contains vectors infected with guinea worm larvae. This disease is prevalent in some of the most deprived areas of the world, and no vaccine or medicine is currently available. International efforts to eradicate dracunculiasis began in the early 1980s. Most dentists and maxillofacial surgeons have neglected this kind of parasite infection. However, when performing charitable work in developing countries near the tropic lines or other regions where GWD is endemic, it is important to consider GWD in cases of swelling or tumors of unknown origin. This paper reviews the pathogenesis, epidemiology, clinical criteria, diagnostic criteria, treatment, and prevention of dracunculiasis. It also summarizes important factors for maxillofacial surgeons to consider. PMID:27162746

Cerebral magnetic resonance changes associated with fibromyalgia syndrome.

PubMed

Murga, Iñigo; Guillen, Virginia; Lafuente, José-Vicente

2017-06-07

Fibromyalgia syndrome is a chronic disease, of unknown origin, whose diagnostic criteria were established in 1990 by the American College of Rheumatology. New criteria were proposed in 2010 that have not yet been validated. It is characterized by a generalized chronic musculoskeletal pain, accompanied by hyperalgesia and allodynia, as well as other motor, vegetative, cognitive and affective symptoms and signs. We have reviewed a set of studies with cerebral magnetic resonance (morphometry, connectivity and spectroscopy) that refer to changes in areas involved in pain processing. Modifications in gray and white matter volume, as well as in levels of N-acetylaspartate, choline or glutamate, among other metabolites, have been observed in the hippocampus, insula, prefrontal and cingular cortex. Neuroradiological findings are nonspecific and similar to those found in other examples of chronic pain. An increase in the sample size and a standardized methodology would facilitate comparison, allowing the drawing of general conclusions. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

New System for Digital to Analog Transformation and Reconstruction of 12-Lead ECGs

PubMed Central

Kothadia, Roshni; Kulecz, Walter B.; Kofman, Igor S.; Black, Adam J.; Grier, James W.; Schlegel, Todd T.

2013-01-01

Introduction We describe initial validation of a new system for digital to analog conversion (DAC) and reconstruction of 12-lead ECGs. The system utilizes an open and optimized software format with a commensurately optimized DAC hardware configuration to accurately reproduce, from digital files, the original analog electrocardiographic signals of previously instrumented patients. By doing so, the system also ultimately allows for transmission of data collected on one manufacturer's 12-lead ECG hardware/software into that of any other. Materials and Methods To initially validate the system, we compared original and post-DAC re-digitized 12-lead ECG data files (∼5-minutes long) in two types of validation studies in 10 patients. The first type quantitatively compared the total waveform voltage differences between the original and re-digitized data while the second type qualitatively compared the automated electrocardiographic diagnostic statements generated by the original versus re-digitized data. Results The grand-averaged difference in root mean squared voltage between the original and re-digitized data was 20.8 µV per channel when re-digitization involved the same manufacturer's analog to digital converter (ADC) as the original digitization, and 28.4 µV per channel when it involved a different manufacturer's ADC. Automated diagnostic statements generated by the original versus reconstructed data did not differ when using the diagnostic algorithm from the same manufacturer on whose device the original data were collected, and differed only slightly for just 1 of 10 patients when using a third-party diagnostic algorithm throughout. Conclusion Original analog 12-lead ECG signals can be reconstructed from digital data files with accuracy sufficient for clinical use. Such reconstructions can readily enable automated second opinions for difficult-to-interpret 12-lead ECGs, either locally or remotely through the use of dedicated or cloud-based servers. PMID:23613787

45. Photocopy of negative (original in possession of Chiricahua National ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

45. Photocopy of negative (original in possession of Chiricahua National Monument), photographer unknown, undated RANCH HOUSE - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

40. Photocopy of negative (original in possession of Chiricahua National ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

40. Photocopy of negative (original in possession of Chiricahua National Monument), photographer unknown, 1935 RANCH HOUSE - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

42. Photocopy of negative (original in possession of Chiricahua National ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

42. Photocopy of negative (original in possession of Chiricahua National Monument), photographer unknown, 1942 RANCH HOUSE - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

43. Photocopy of negative (original in possession of Chiricahua National ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

43. Photocopy of negative (original in possession of Chiricahua National Monument), photographer unknown, 1950 RANCH HOUSE - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

46. Photocopy of negative (original in possession of Chiricahua National ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

46. Photocopy of negative (original in possession of Chiricahua National Monument), photographer unknown, undated RANCH HOUSE - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

17. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer and date unknown. VIEW OF MAGNOLIA AVENUE - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

51. Ground floor, southeast corner, looking southeast in mezzanine (original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

51. Ground floor, southeast corner, looking southeast in mezzanine (original function unknown) - Sheffield Farms Milk Plant, 1075 Webster Avenue (southwest corner of 166th Street), Bronx, Bronx County, NY

ATF1 and RAS in exosomes are potential clinical diagnostic markers for cervical cancer.

PubMed

Shi, Yanhua; Wang, Wei; Yang, Baozhi; Tian, Hongge

2017-10-01

Cervical cancer is one of the most common cancers among women worldwide. It is highly lethal yet can be treated when found in early stage. Thus, early detection is of significant important for early diagnosis of cervical cancer. Exosomes have been used as biomarkers in clinical diagnosis. It is unknown that whether blood exosomes associated with cervical cancer can be detected and if these exosomes can accurately represent the developmental stage of cervical cancer. Mouse models were made out of a relapsed cervical cancer patient's tumour sample for original and recurrent cervical cancer, and gene analysis in both tumours and exosomes in these mouse models were performed. We found that activating transcription factor 1 (ATF1) and RAS genes were significantly up-regulated in tumours of both primary and recurrent cervical cancer mouse model, and they can also be detected in the blood exosomes of the mouse model. Our results indicated that ATF1 and RAS could be potential candidate biomarkers for cervical cancer in early diagnosis. ATF1 and RAS genes were found significantly elevated in tumours of primary and recurrent cervical cancer mouse model, and they were also detected in the blood exosomes. Therefore, ATF1 and RAS could be used as a diagnostic marker for cervical cancer in the future. Copyright © 2017 John Wiley & Sons, Ltd.

12. Photocopy of photograph, (original in Forest Service Office, Elkins, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. Photocopy of photograph, (original in Forest Service Office, Elkins, WV, photo #305568, 'show me tour'), photographer and date unknown. VIEW SOUTHWEST, NURSERY MANAGER'S RESIDENCE, NURSERY OFFICE, WORKSHOP/WAREHOUSE, ORIGINAL WASH HOUSE. - Parsons Nursery, South side of U.S. Route 219, Parsons, Tucker County, WV

16. Photocopy of photograph (original in possession of Chiricahua National ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

16. Photocopy of photograph (original in possession of Chiricahua National Monument), photographer unknown, c.1917 LILLIANA AND HILDEGARD ERICKSON IN FRONT OF RANCH HOUSE - Faraway Ranch, Willcox, Cochise County, AZ

19. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

19. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer and date unknown. VIEW OF CITRUS EXPERIMENT STATION - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

5. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer and date unknown. VIEW OF ARLINGTON HEIGHTS CITRUS GROVES - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

10. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer and date unknown. VIEW OF DUFFERIN AVENUE AND VEHICLE - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

Diagnostic pitfalls in sporadic transthyretin familial amyloid polyneuropathy (TTR-FAP).

PubMed

Planté-Bordeneuve, V; Ferreira, A; Lalu, T; Zaros, C; Lacroix, C; Adams, D; Said, G

2007-08-14

Transthyretin familial amyloid polyneuropathies (TTR-FAPs) are autosomal dominant neuropathies of fatal outcome within 10 years after inaugural symptoms. Late diagnosis in patients who present as nonfamilial cases delays adequate management and genetic counseling. Clinical data of the 90 patients who presented as nonfamilial cases of the 300 patients of our cohort of patients with TTR-FAP were reviewed. They were 21 women and 69 men with a mean age at onset of 61 (extremes: 38 to 78 years) and 17 different mutations of the TTR gene including Val30Met (38 cases), Ser77Tyr (16 cases), Ile107Val (15 cases), and Ser77Phe (5 cases). Initial manifestations included mainly limb paresthesias (49 patients) or pain (17 patients). Walking difficulty and weakness (five patients) and cardiac or gastrointestinal manifestations (five patients), were less common at onset. Mean interval to diagnosis was 4 years (range 1 to 10 years); 18 cases were mistaken for chronic inflammatory demyelinating polyneuropathy, which was the most common diagnostic error. At referral a length-dependent sensory loss affected the lower limbs in 2, all four limbs in 20, and four limbs and anterior trunk in 77 patients. All sensations were affected in 60 patients (67%), while small fiber dysfunction predominated in the others. Severe dysautonomia affected 80 patients (90%), with postural hypotension in 52, gastrointestinal dysfunction in 50, impotence in 58 of 69 men, and sphincter disturbance in 31. Twelve patients required a cardiac pacemaker. Nerve biopsy was diagnostic in 54 of 65 patients and salivary gland biopsy in 20 of 30. Decreased nerve conduction velocity, increased CSF protein, negative biopsy findings, and false immunolabeling of amyloid deposits were the main causes of diagnostic errors. We conclude that DNA testing, which is the most reliable test for TTR-FAP, should be performed in patients with a progressive length-dependent small fiber polyneuropathy of unknown origin, especially when associated with autonomic dysfunction.

Admixture analysis of the diagnostic subtypes of social anxiety disorder: implications for the DSM-V.

PubMed

Aderka, Idan M; Nickerson, Angela; Hofmann, Stefan G

2012-06-01

Much controversy exists regarding diagnostic subtypes of social anxiety disorder (SAD). The present study used admixture analysis to examine whether individuals with generalized and nongeneralized SAD belong to the same or different populations of origin. This can inform diagnostic subtyping of SAD in the forthcoming DSM-V. Treatment-seeking individuals with generalized SAD (n = 154) and nongeneralized SAD (n = 48) completed a battery of questionnaires. Based on participants' responses to the Liebowitz Social Anxiety Scale (LSAS), we estimated log likelihood and chi-square goodness-of-fit for models with 1, 2, 3, or 4 populations of origin, and compared models using forward stepwise estimation and maximum likelihood ratio tests. Admixture analyses suggested that the two diagnostic subtypes of SAD belong to the same underlying population of origin. In addition, observable differences in depression, general anxiety, and comorbidity were no longer significant when controlling for social anxiety severity. Our sample was recruited in the U.S. and was a treatment-seeking sample. Future studies should examine whether our results generalize to different cultures, and community samples. Support for qualitative differences between SAD subtypes was not found. Rather, our findings support the notion that the diagnostic subtypes of SAD differ quantitatively, and that SAD exists on a continuum of severity. This finding informs diagnostic subtyping of SAD in the forthcoming DSM-V. Copyright © 2011 Elsevier Ltd. All rights reserved.

How to conduct a high-quality original study on a diagnostic research topic.

PubMed

Yao, Xiaomei; Vella, Emily

2017-09-01

As health research methodologists and journal reviewers, we noticed that the methodological rigor of many publications on diagnostic or prognostic topics in the medical literature could be improved. We present a concise and clear series of reviews to help clinicians and health researchers to master the basic key components of how to conduct a high-quality original study or systematic review on a diagnostic or prognostic research topic from a methodological perspective. This is the first review of the series, which focuses on how to conduct a high-quality diagnostic study. We are introducing four aspects: clarifying the objectives; generating an appropriate research question; planning the study design; and reporting and analyzing data. This review highlights that diagnostic test accuracy outcomes are surrogates for patient outcomes, a diagnostic test has three roles, the "PIRO" components should be included in a diagnostic research question, a new study should be registered, multiple index tests can be compared in one study, and prevalence affects test accuracy outcomes. This review also emphasizes reporting any thresholds, calculating sample size, and performing a two-by-three table to calculate diagnostic outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Non-alcoholic beverages, unknown influence on cell proliferation - an in vitro study.

PubMed

Nowacki, Maciej; Adamowicz, Jan; Olkowska, Joanna; Pietkun, Katarzyna; Kloskowski, Tomasz; Bajek, Anna; Drewa, Tomasz

2014-01-01

The aim of the presented study was to check differences between 'Diet' and 'non-Diet' soft drinks on cell proliferation. Coca Cola and Pepsi Cola of different origin and their dietetic versions were examined at concentrations of 2% and 4%. Fructose and glucose as well as medium alone (control) were examined. Cell number was higher in media supplemented with soft drinks, compared to control. Proliferation depended on the soft drink concentration and its origin, but not on sugar and calorific content. An unknown factor is responsible for the increase in proliferation.

Should fine needle aspiration biopsy be the first pathological investigation in the diagnosis of a bone lesion? An algorithmic approach with review of literature

PubMed Central

Mehrotra, Ravi; Singh, Mamta; Singh, Premala A; Mannan, Rahul; Ojha, Vinod K; Singh, Pradumyn

2007-01-01

Background Fine needle aspiration biopsy (FNAB) is gaining increasing popularity in the diagnosis of musculoskeletal lesions; and in many patients, a definitive diagnosis can be rendered from aspiration smears alone. Its applicability in bone pathology, however, has been controversial due to a high percentage of inadequate smears, difficulty in evaluation of tissue architecture and nonspecific results in the diagnosis of primary bone lesions. In this study, the value of aspiration as the first pathological investigation in the diagnosis of a bone lesion was evaluated. Methods 91 cases of clinically suspected cases of bone lesions were aspirated over a period of two years. Direct or cytospin smears were fixed in 95% alcohol and stained by Hematoxylin and Eosin or air-dried and later fixed in methanol for May Grŭnwald Giemsa staining. Results Of the 91 patients who were subjected to FNAB, 81 were considered satisfactory and 10.9 % (10) were inadequate\\inconclusive for diagnosis. Cyto-histological concordance was obtained in 78.5 % (51/65) patients. Positive and negative predictive values were 87.5% and 97.2 % respectively. Sensitivity as a preliminary diagnostic technique was 93.3%, whereas specificity was 94.5 %. Overall, diagnostic accuracy was 94.2 %. Metastatic lesions were detected with 100% accuracy. Two cases were reported as false positive and one case as false negative. Conclusion Cytology provides valuable information to the clinician to make an informed decision regarding appropriate therapy. We conclude that time-consuming and costly investigations may be reduced by choosing FNAB as the initial pathological diagnostic method for skeletal lesions of unknown origin. The choice of radiological examinations, laboratory tests and surgical biopsies can be determined after the FNAB diagnosis. PMID:17439659

Interstitial pneumonia with autoimmune features: an additional risk factor for ARDS?

PubMed

Grasselli, Giacomo; Vergnano, Beatrice; Pozzi, Maria Rosa; Sala, Vittoria; D'Andrea, Gabriele; Scaravilli, Vittorio; Mantero, Marco; Pesci, Alberto; Pesenti, Antonio

2017-09-18

Interstitial pneumonia with autoimmune features (IPAF) identifies a recently recognized autoimmune syndrome characterized by interstitial lung disease and autoantibodies positivity, but absence of a specific connective tissue disease diagnosis or alternative etiology. We retrospectively reviewed the clinical presentation, diagnostic workup and management of seven critically ill patients who met diagnostic criteria for IPAF. We compared baseline characteristics and clinical outcome of IPAF patients with those of the population of ARDS patients admitted in the same period. Seven consecutive patients with IPAF admitted to intensive care unit for acute respiratory distress syndrome (ARDS) were compared with 78 patients with ARDS secondary to a known risk factor and with eight ARDS patients without recognized risk factors. Five IPAF patients (71%) survived and were discharged alive from ICU: Their survival rate was equal to that of patients with a known risk factor (71%), while the subgroup of patients without risk factors had a markedly lower survival (38%). According to the Berlin definition criteria, ARDS was severe in four IPAF patients and moderate in the remaining three. All had multiple organ dysfunction at presentation. The most frequent autoantibody detected was anti-SSA/Ro52. All patients required prolonged mechanical ventilation (median duration 49 days, range 10-88); four received extracorporeal membrane oxygenation and one received low-flow extracorporeal CO 2 removal. All patients received immunosuppressive therapy. This is the first description of a cohort of critical patients meeting the diagnostic criteria for IPAF presenting with ARDS. This diagnosis should be considered in any critically ill patient with interstitial lung disease of unknown origin. While management is challenging and level of support high, survival appears to be good and comparable to that of patients with ARDS associated with a known clinical insult.

Oral vs. salivary diagnostics

NASA Astrophysics Data System (ADS)

Marques, Joana; Corby, Patricia M.; Barber, Cheryl A.; Abrams, William R.; Malamud, Daniel

2015-05-01

The field of "salivary diagnostics" includes studies utilizing samples obtained from a variety of sources within the oral cavity. These samples include; whole unstimulated saliva, stimulated whole saliva, duct saliva collected directly from the parotid, submandibular/sublingual glands or minor salivary glands, swabs of the buccal mucosa, tongue or tonsils, and gingival crevicular fluid. Many publications state "we collected saliva from subjects" without fully describing the process or source of the oral fluid. Factors that need to be documented in any study include the time of day of the collection, the method used to stimulate and collect the fluid, and how much fluid is being collected and for how long. The handling of the oral fluid during and post-collection is also critical and may include addition of protease or nuclease inhibitors, centrifugation, and cold or frozen storage prior to assay. In an effort to create a standard protocol for determining a biomarker's origin we carried out a pilot study collecting oral fluid from 5 different sites in the mouth and monitoring the concentrations of pro- and anti-inflammatory cytokines detected using MesoScaleDiscovery (MSD) electrochemiluminesence assays. Our data suggested that 3 of the cytokines are primarily derived from the submandibular gland, while 7 of the cytokines come from a source other than the major salivary glands such as the minor salivary glands or cells in the oral mucosae. Here we review the literature on monitoring biomarkers in oral samples and stress the need for determining the blood/saliva ratio when a quantitative determination is needed and suggest that the term oral diagnostic be used if the source of an analyte in the oral cavity is unknown.

[Cardiac sarcoidosis - clinical manifestation and diagnosis].

PubMed

Błaut-Jurkowska, Justyna; Podolec, Piotr; Olszowska, Maria

2016-08-01

Sarcoidosis is a multisystem inflammatory disease defined histologically by the formation of noncaseating granulomas. The etiology of sarcoidosis remains unknown. Heart involvement in the course of sarcoidosis concerns about 5% of patients. The most common manifestation of cardiac sarcoidosis are conduction abnormalities, arrhythmias and heart failure. The diagnostic algorithm includes performing a clinical history, a 12-lead electrocardiogram (ECG) and an echocardiogram. If any of the initial screening investigations yields an abnormality, diagnostics should be continue using advanced imaging techniques: cardiovascular magnetic resonance (CMR) or fluorodeoxyglucose positron emission tomography (FDG-PET). Nowadays endomyocardial biopsy is not performed routinely.The clinical picture of cardiac sarcoidosis is highly variable. Screening for cardiac sarcoidosis should be performed in all patients diagnosed with extracardiac sarcoidosis. Cardiac sarcoidosis should also be suspected in young patients without a diagnosis of sarcoidosis who present with conduction abnormalities of unknown etiology, because cardiac sarcoidosis may be the first or the only manifestation of the disease. © 2016 MEDPRESS.

Investigating portable fluorescent microscopy (CyScope) as an alternative rapid diagnostic test for malaria in children and women of child-bearing age.

PubMed

Sousa-Figueiredo, José Carlos; Oguttu, David; Adriko, Moses; Besigye, Fred; Nankasi, Andrina; Arinaitwe, Moses; Namukuta, Annet; Betson, Martha; Kabatereine, Narcis B; Stothard, J Russell

2010-08-27

Prompt and correct diagnosis of malaria is crucial for accurate epidemiological assessment and better case management, and while the gold standard of light microscopy is often available, it requires both expertise and time. Portable fluorescent microscopy using the CyScope offers a potentially quicker, easier and more field-applicable alternative. This article reports on the strengths, limitations of this methodology and its diagnostic performance in cross-sectional surveys on young children and women of child-bearing age. 552 adults (99% women of child-bearing age) and 980 children (99% ≤ 5 years of age) from rural and peri-urban regions of Ugandan were examined for malaria using light microscopy (Giemsa-stain), a lateral-flow test (Paracheck-Pf) and the CyScope. Results from the surveys were used to calculate diagnostic performance (sensitivity and specificity) as well as to perform a receiver operating characteristics (ROC) analyses, using light microscopy as the gold-standard. Fluorescent microscopy (qualitative reads) showed reduced specificity (<40%), resulting in higher community prevalence levels than those reported by light microscopy, particularly in adults (+180% in adults and +20% in children). Diagnostic sensitivity was 92.1% in adults and 86.7% in children, with an area under the ROC curve of 0.63. Importantly, optimum performance was achieved for higher parasitaemia (>400 parasites/μL blood): sensitivity of 64.2% and specificity of 86.0%. Overall, the diagnostic performance of the CyScope was found inferior to that of Paracheck-Pf. Fluorescent microscopy using the CyScope is certainly a field-applicable and relatively affordable solution for malaria diagnoses especially in areas where electrical supplies may be lacking. While it is unlikely to miss higher parasitaemia, its application in cross-sectional community-based studies leads to many false positives (i.e. small fluorescent bodies of presently unknown origin mistaken as malaria parasites). Without recourse to other technologies, arbitration of these false positives is presently equivocal, which could ultimately lead to over-treatment; something that should be further explored in future investigations if the CyScope is to be more widely implemented.

4. Photocopy of photograph, JANE MOSELEY (VESSEL 53) TIED UP ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Photocopy of photograph, JANE MOSELEY (VESSEL 53) TIED UP AT DOCK IN UNKNOWN LOCATION. Date and photographer unknown. (Original in Mariners Museum, Newport News, Virginia, negative #625) - Shooters Island, Ships Graveyard, Vessel No. 53, Newark Bay, Staten Island (subdivision), Richmond County, NY

37. Photocopy of photograph (original in possession of WACC), photographer ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

37. Photocopy of photograph (original in possession of WACC), photographer unknown, c.1930 VIEW OF MAIN HOUSE LOOKING NORTHEAST - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

47. Photocopy of negative (original in possession of Chiricahua National ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

47. Photocopy of negative (original in possession of Chiricahua National Monument) photographer unknown, undated RANCH HOUSE AND ORCHARD IN SNOW - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

1. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, M 3810) Photographer unknown, 1923-25 GRANADA PLAZA AND GRANADA BOULEVARD - Granada Plaza, Coral Gables, Miami-Dade County, FL

16. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

16. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer and date unknown. VIEW OF MAGNOLIA AVENUE WITH ELECTRIC STREET CAR - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

19. Photocopy of photograph (original in possession of NYC Economic ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

19. Photocopy of photograph (original in possession of NYC Economic Development Corp.) Photographer and date unknown PIER 4 CONNECTING BRIDGE AND WAREHOUSE A - Brooklyn Army Supply Base, Pier 4, Brooklyn, Kings County, NY

11. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer and date unknown. VIEW OF WORKERS HARVESTING ORANGES IN GROVES - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

18. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

18. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer and date unknown. VIEW OF MISSION INN, SEVENTH STREET ENTRANCE - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

Diagnostic approach to cardiac amyloidosis: A case report.

PubMed

Fernandes, Andreia; Caetano, Francisca; Almeida, Inês; Paiva, Luís; Gomes, Pedro; Mota, Paula; Trigo, Joana; Botelho, Ana; Cachulo, Maria do Carmo; Alves, Joana; Francisco, Luís; Leitão Marques, António

2016-05-01

The authors present a case of systemic amyloidosis with cardiac involvement. We discuss the need for a high level of suspicion to establish a diagnosis, diagnostic techniques and treatment options. Our patient was a 78-year-old man with chronic renal disease and atrial fibrillation admitted with acute decompensated heart failure of unknown cause. The transthoracic echocardiogram revealed severely impaired left ventricular function with phenotypic overlap between hypertrophic and restrictive cardiomyopathy. After an extensive diagnostic workup, which included an abdominal fat pad biopsy, the final diagnosis was amyloidosis. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Whole-Exome Sequencing in Adults With Chronic Kidney Disease: A Pilot Study.

PubMed

Lata, Sneh; Marasa, Maddalena; Li, Yifu; Fasel, David A; Groopman, Emily; Jobanputra, Vaidehi; Rasouly, Hila; Mitrotti, Adele; Westland, Rik; Verbitsky, Miguel; Nestor, Jordan; Slater, Lindsey M; D'Agati, Vivette; Zaniew, Marcin; Materna-Kiryluk, Anna; Lugani, Francesca; Caridi, Gianluca; Rampoldi, Luca; Mattoo, Aditya; Newton, Chad A; Rao, Maya K; Radhakrishnan, Jai; Ahn, Wooin; Canetta, Pietro A; Bomback, Andrew S; Appel, Gerald B; Antignac, Corinne; Markowitz, Glen S; Garcia, Christine K; Kiryluk, Krzysztof; Sanna-Cherchi, Simone; Gharavi, Ali G

2018-01-16

The utility of whole-exome sequencing (WES) for the diagnosis and management of adult-onset constitutional disorders has not been adequately studied. Genetic diagnostics may be advantageous in adults with chronic kidney disease (CKD), in whom the cause of kidney failure often remains unknown. To study the diagnostic utility of WES in a selected referral population of adults with CKD. Observational cohort. A major academic medical center. 92 adults with CKD of unknown cause or familial nephropathy or hypertension. The diagnostic yield of WES and its potential effect on clinical management. Whole-exome sequencing provided a diagnosis in 22 of 92 patients (24%), including 9 probands with CKD of unknown cause and encompassing 13 distinct genetic disorders. Among these, loss-of-function mutations were identified in PARN in 2 probands with tubulointerstitial fibrosis. PARN mutations have been implicated in a short telomere syndrome characterized by lung, bone marrow, and liver fibrosis; these findings extend the phenotype of PARN mutations to renal fibrosis. In addition, review of the American College of Medical Genetics actionable genes identified a pathogenic BRCA2 mutation in a proband who was diagnosed with breast cancer on follow-up. The results affected clinical management in most identified cases, including initiation of targeted surveillance, familial screening to guide donor selection for transplantation, and changes in therapy. The small sample size and recruitment at a tertiary care academic center limit generalizability of findings among the broader CKD population. Whole-exome sequencing identified diagnostic mutations in a substantial number of adults with CKD of many causes. Further study of the utility of WES in the evaluation and care of patients with CKD in additional settings is warranted. New York State Empire Clinical Research Investigator Program, Renal Research Institute, and National Human Genome Research Institute of the National Institutes of Health.

Diagnostic Strategy Used To Establish Etiologies of Encephalitis in a Prospective Cohort of Patients in England▿

PubMed Central

Ambrose, H. E.; Granerod, J.; Clewley, J. P.; Davies, N. W. S.; Keir, G.; Cunningham, R.; Zuckerman, M.; Mutton, K. J.; Ward, K. N.; Ijaz, S.; Crowcroft, N. S.; Brown, D. W. G.

2011-01-01

The laboratory diagnostic strategy used to determine the etiology of encephalitis in 203 patients is reported. An etiological diagnosis was made by first-line laboratory testing for 111 (55%) patients. Subsequent testing, based on individual case reviews, resulted in 17 (8%) further diagnoses, of which 12 (71%) were immune-mediated and 5 (29%) were due to infection. Seventy-five cases were of unknown etiology. Sixteen (8%) of 203 samples were found to be associated with either N-methyl-d-aspartate receptor or voltage-gated potassium channel complex antibodies. The most common viral causes identified were herpes simplex virus (HSV) (19%) and varicella-zoster virus (5%), while the most important bacterial cause was Mycobacterium tuberculosis (5%). The diagnostic value of testing cerebrospinal fluid (CSF) for antibody was assessed using 139 samples from 99 patients, and antibody was detected in 46 samples from 37 patients. Samples collected at 14 to 28 days were more likely to be positive than samples taken 0 to 6 days postadmission. Three PCR-negative HSV cases were diagnosed by the presence of virus-specific antibody in the central nervous system (CNS). It was not possible to make an etiological diagnosis for one-third of the cases; these were therefore considered to be due to unknown causes. Delayed sampling did not contribute to these cases. Twenty percent of the patients with infections with an unknown etiology showed evidence of localized immune activation within the CNS, but no novel viral DNA or RNA sequences were found. We conclude that a good standard of clinical investigation and thorough first-line laboratory testing allows the diagnosis of most cases of infectious encephalitis; testing for CSF antibodies allows further cases to be diagnosed. It is important that testing for immune-mediated causes also be included in a diagnostic algorithm. PMID:21865429

38. Photographic copy of photograph, photographer unknown, 26 March 1915 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

38. Photographic copy of photograph, photographer unknown, 26 March 1915 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). " Dredge after failure of control dam." - Keechelus Dam, Yakima River, 10 miles northwest of Easton, Easton, Kittitas County, WA

39. Photographic copy of photograph, photographer unknown, 26 March 1915 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

39. Photographic copy of photograph, photographer unknown, 26 March 1915 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "View of control dam after failure." - Keechelus Dam, Yakima River, 10 miles northwest of Easton, Easton, Kittitas County, WA

44. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

44. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. May 4, 1949. PERSPECTIVE DRAWING, BIRD'S-EYE VIEW - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

38. Photocopy of photograph (original in possession of WACC) photographer ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

38. Photocopy of photograph (original in possession of WACC) photographer unknown, c.1930 'GARFIELD' FIREPLACE AND PART OF NORTH BACK WALL - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

39. Photocopy of photograph (original in possession of WACC), photographer ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

39. Photocopy of photograph (original in possession of WACC), photographer unknown, c.1930's GUEST DINING ROOM WITH TABLE LAID FOR GUESTS - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

14. Photocopy of negative (original in possession of WACC), photographer ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. Photocopy of negative (original in possession of WACC), photographer unknown, c.1908 EMMA AND NEIL ERICKSON IN FRONT OF BOARD AND BATTEN SOUTH WALL OF MAIN HOUSE - Faraway Ranch, Willcox, Cochise County, AZ

34. Photocopy of photograph (original in possession of Western Archeological ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

34. Photocopy of photograph (original in possession of Western Archeological and Conservation Center, (WACC), Tucson, Arizona), photographer unknown, c.1910 MAIN HOUSE - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

7. Photocopy of photograph (original in possession of NYC Economic ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photocopy of photograph (original in possession of NYC Economic Development Corp.) Photographer unknown, circa 1983) OVERALL VIEW OF THE BROOKLYN ARMY TERMINAL, LOOKING NORTHEAST - Brooklyn Army Supply Base, Pier 2, Brooklyn, Kings County, NY

9. Photocopy of photograph (original print at Riveside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photocopy of photograph (original print at Riveside Library, Local History Collection), photographer unknown, ca. 1916. VIEW OF MAUDE STREET AT VICTORIA AVENUE LOOKING SOUTH - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

14. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer and date unknown. VIEW OF OSBORNE CAMP AND STABLES, ARLINGTON HEIGHTS FRUIT COMPANY - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

7. Photocopy of drawing (Original in collection of the Department ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photocopy of drawing (Original in collection of the Department of Treasury) William Martin Aiken, Supervising architect, date unknown TOWER - U.S. Post Office Department, 1100 Pennsylvania Avenue Northwest, Washington, District of Columbia, DC

7. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, M 3828) Photographer unknown, 1923-25 SEGOVIA PLAZA - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

9. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, M 3812) Photographer unknown, 1923-25 DESOTO PLAZA FOUNTAIN - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

14. Photocopy of photograph (Original in the collection of Baltimore ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. Photocopy of photograph (Original in the collection of Baltimore and Ohio Railroad) Unknown, Photographer, November 1956 PERSPECTIVE VIEW OF EAST (FRONT) AND SOUTH SIDE - John Brown Fort, Shenandoah Street, Harpers Ferry, Jefferson County, WV

Patients with community-acquired bacteremia of unknown origin: clinical characteristics and usefulness of microbiological results for therapeutic issues: a single-center cohort study.

PubMed

Courjon, Johan; Demonchy, Elisa; Degand, Nicolas; Risso, Karine; Ruimy, Raymond; Roger, Pierre-Marie

2017-05-19

Bacteremia of unknown origin (BUO) are associated with increased mortality compared to those with identified sources. Microbiological data of those patients could help to characterize an appropriate empirical antibiotic treatment before bloodcultures results are available during sepsis of unknown origin. Based on the dashboard of our ward that prospectively records several parameters from each hospitalization, we report 101 community-acquired BUO selected among 1989 bacteremic patients from July 2005 to April 2016, BUO being defined by the absence of clinical and paraclinical infectious focus and no other microbiological samples retrieving the bacteria isolated from blood cultures. The in-hospital mortality rate was 9%. We retrospectively tested two antibiotic associations: amoxicillin-clavulanic acid + gentamicin (AMC/GM) and 3rd generation cephalosporin + gentamicin (3GC/GM) considered as active if the causative bacteria was susceptible to at least one of the two drugs. The mean age was 71 years with 67% of male, 31 (31%) were immunocompromised and 52 (51%) had severe sepsis. Eleven patients had polymicrobial infections. The leading bacterial species involved were Escherichia coli 25/115 (22%), group D Streptococci 12/115 (10%), viridans Streptococci 12/115 (10%) and Staphylococcus aureus 11/115 (9%). AMC/GM displayed a higher rate of effectiveness compared to 3GC/GM: 100/101 (99%) vs 94/101 (93%) (p = 0.04): one Enterococcus faecium strain impaired the first association, Bacteroides spp. and Enterococcus spp. the second. In case of community-acquired sepsis of unknown origin, AMC + GM should be considered.

14. Photographic copy of original Survey Data drawing of the ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. Photographic copy of original Survey Data drawing of the Loleta Dams, date and engineer unknown (original in possession of United States Department of Agriculture-Forest Service-Allegheny National Forest). - Loleta Recreation Area, Lower Dam, 6 miles Southeast of interesection of State Route 24041 & State Route 66, Loleta, Elk County, PA

13. Photographic copy of original Design For New Sluice Gate ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Photographic copy of original Design For New Sluice Gate drawing, date and engineer unknown (original in possession of United States Department of Agriculture-Forest Service-Allegheny National Forest). - Loleta Recreation Area, Lower Dam, 6 miles Southeast of interesection of State Route 24041 & State Route 66, Loleta, Elk County, PA

An evidence-based diagnostic classification system for low back pain

PubMed Central

Vining, Robert; Potocki, Eric; Seidman, Michael; Morgenthal, A. Paige

2013-01-01

Introduction: While clinicians generally accept that musculoskeletal low back pain (LBP) can arise from specific tissues, it remains difficult to confirm specific sources. Methods: Based on evidence supported by diagnostic utility studies, doctors of chiropractic functioning as members of a research clinic created a diagnostic classification system, corresponding exam and checklist based on strength of evidence, and in-office efficiency. Results: The diagnostic classification system contains one screening category, two pain categories: Nociceptive, Neuropathic, one functional evaluation category, and one category for unknown or poorly defined diagnoses. Nociceptive and neuropathic pain categories are each divided into 4 subcategories. Conclusion: This article describes and discusses the strength of evidence surrounding diagnostic categories for an in-office, clinical exam and checklist tool for LBP diagnosis. The use of a standardized tool for diagnosing low back pain in clinical and research settings is encouraged. PMID:23997245

Relapsed neuroblastomas show frequent RAS-MAPK pathway mutations | Office of Cancer Genomics

Cancer.gov

The majority of patients with neuroblastoma have tumors that initially respond to chemotherapy, but a large proportion will experience therapy-resistant relapses. The molecular basis of this aggressive phenotype is unknown. Whole-genome sequencing of 23 paired diagnostic and relapse neuroblastomas showed clonal evolution from the diagnostic tumor, with a median of 29 somatic mutations unique to the relapse sample. Eighteen of the 23 relapse tumors (78%) showed mutations predicted to activate the RAS-MAPK pathway.

Atypical sarcoidosis-associated uveitis: diagnostic challenges.

PubMed

Cehajic Kapetanovic, Jasmina; Jones, Nicholas P; Steeples, Laura R

2018-05-30

Sarcoidosis is a multisystem disease of unknown aetiology with pulmonary involvement in most patients. Uveitis is common and often characteristic. We report a case of ocular sarcoidosis with grossly atypical contiguous optic neuropathy and choroiditis and describe the diagnostic challenges in this highly unusual presentation. High-dose systemic corticosteroid and immunosuppressive treatment was required for sustained control of intraocular inflammation. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

30. Photocopy of blueprint. PLAN, ELEVATION, END SECTION, DETAIL OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

30. Photocopy of blueprint. PLAN, ELEVATION, END SECTION, DETAIL OF DECK SYSTEM AND LOAD COMPUTATION. Preparer unknown, date unknown, but probably ca. 1932. (Original in possession of the Washington County Highway Department.) - Hegeman-Hill Street Bridge, Spanning Batten Kill, .65 mile West of Greenwich, Easton, Washington County, NY

46. Photographic copy of photograph, photographer unknown, 24 July 1916 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

46. Photographic copy of photograph, photographer unknown, 24 July 1916 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "Scheme for shelter for cransemen on bucyrus steam shovel." - Keechelus Dam, Yakima River, 10 miles northwest of Easton, Easton, Kittitas County, WA

Gene expression profile and immunological evaluation of unique hypothetical unknown proteins of Mycobacterium leprae by using quantitative real-time PCR.

PubMed

Kim, Hee Jin; Prithiviraj, Kalyani; Groathouse, Nathan; Brennan, Patrick J; Spencer, John S

2013-02-01

The cell-mediated immunity (CMI)-based in vitro gamma interferon release assay (IGRA) of Mycobacterium leprae-specific antigens has potential as a promising diagnostic means to detect those individuals in the early stages of M. leprae infection. Diagnosis of leprosy is a major obstacle toward ultimate disease control and has been compromised in the past by the lack of specific markers. Comparative bioinformatic analysis among mycobacterial genomes identified potential M. leprae-specific proteins called "hypothetical unknowns." Due to massive gene decay and the prevalence of pseudogenes, it is unclear whether any of these proteins are expressed or are immunologically relevant. In this study, we performed cDNA-based quantitative real-time PCR to investigate the expression status of 131 putative open reading frames (ORFs) encoding hypothetical unknowns. Twenty-six of the M. leprae-specific antigen candidates showed significant levels of gene expression compared to that of ESAT-6 (ML0049), which is an important T cell antigen of low abundance in M. leprae. Fifteen of 26 selected antigen candidates were expressed and purified in Escherichia coli. The seroreactivity to these proteins of pooled sera from lepromatous leprosy patients and cavitary tuberculosis patients revealed that 9 of 15 recombinant hypothetical unknowns elicited M. leprae-specific immune responses. These nine proteins may be good diagnostic reagents to improve both the sensitivity and specificity of detection of individuals with asymptomatic leprosy.

Gene Expression Profile and Immunological Evaluation of Unique Hypothetical Unknown Proteins of Mycobacterium leprae by Using Quantitative Real-Time PCR

PubMed Central

Prithiviraj, Kalyani; Groathouse, Nathan; Brennan, Patrick J.; Spencer, John S.

2013-01-01

The cell-mediated immunity (CMI)-based in vitro gamma interferon release assay (IGRA) of Mycobacterium leprae-specific antigens has potential as a promising diagnostic means to detect those individuals in the early stages of M. leprae infection. Diagnosis of leprosy is a major obstacle toward ultimate disease control and has been compromised in the past by the lack of specific markers. Comparative bioinformatic analysis among mycobacterial genomes identified potential M. leprae-specific proteins called “hypothetical unknowns.” Due to massive gene decay and the prevalence of pseudogenes, it is unclear whether any of these proteins are expressed or are immunologically relevant. In this study, we performed cDNA-based quantitative real-time PCR to investigate the expression status of 131 putative open reading frames (ORFs) encoding hypothetical unknowns. Twenty-six of the M. leprae-specific antigen candidates showed significant levels of gene expression compared to that of ESAT-6 (ML0049), which is an important T cell antigen of low abundance in M. leprae. Fifteen of 26 selected antigen candidates were expressed and purified in Escherichia coli. The seroreactivity to these proteins of pooled sera from lepromatous leprosy patients and cavitary tuberculosis patients revealed that 9 of 15 recombinant hypothetical unknowns elicited M. leprae-specific immune responses. These nine proteins may be good diagnostic reagents to improve both the sensitivity and specificity of detection of individuals with asymptomatic leprosy. PMID:23239802

Serotonin, ATRX, and DAXX Expression in Pituitary Adenomas: Markers in the Differential Diagnosis of Neuroendocrine Tumors of the Sellar Region.

PubMed

Casar-Borota, Olivera; Botling, Johan; Granberg, Dan; Stigare, Jerker; Wikström, Johan; Boldt, Henning Bünsow; Kristensen, Bjarne Winther; Pontén, Fredrik; Trouillas, Jacqueline

2017-09-01

Differential diagnosis based on morphology and immunohistochemistry between a clinically nonfunctioning pituitary neuroendocrine tumor (NET)/pituitary adenoma and a primary or secondary NET of nonpituitary origin in the sellar region may be difficult. Serotonin, a frequently expressed marker in the NETs, has not been systematically evaluated in pituitary NETs. Although mutations in ATRX or DAXX have been reported in a significant proportion of pancreatic NETs, the mutational status of ATRX and DAXX and their possible pathogenetic role in pituitary NETs are unknown. Facing a difficult diagnostic case of an invasive serotonin and adrenocorticotroph hormone immunoreactive NET in the sellar region, we explored the immunohistochemical expression of serotonin, ATRX, and DAXX in a large series of pituitary endocrine tumors of different types from 246 patients and in 2 corticotroph carcinomas. None of the pituitary tumors expressed serotonin, suggesting that serotonin immunoreactive sellar tumors represent primary or secondary NETs of nonpituitary origin. Normal expression of ATRX and DAXX in pituitary tumors suggests that ATRX and DAXX do not play a role in the pathogenesis of pituitary endocrine tumors that remain localized to the sellar and perisellar region. A lack of ATRX or DAXX in a sellar NET suggests a nonpituitary NET, probably of pancreatic origin. One of the 2 examined corticotroph carcinomas, however, demonstrated negative ATRX immunolabeling due to an ATRX gene mutation. Further studies on a larger cohort of pituitary carcinomas are needed to clarify whether ATRX mutations may contribute to the metastatic potential in a subset of pituitary NETs.

A deep convolutional neural network model to classify heartbeats.

PubMed

Acharya, U Rajendra; Oh, Shu Lih; Hagiwara, Yuki; Tan, Jen Hong; Adam, Muhammad; Gertych, Arkadiusz; Tan, Ru San

2017-10-01

The electrocardiogram (ECG) is a standard test used to monitor the activity of the heart. Many cardiac abnormalities will be manifested in the ECG including arrhythmia which is a general term that refers to an abnormal heart rhythm. The basis of arrhythmia diagnosis is the identification of normal versus abnormal individual heart beats, and their correct classification into different diagnoses, based on ECG morphology. Heartbeats can be sub-divided into five categories namely non-ectopic, supraventricular ectopic, ventricular ectopic, fusion, and unknown beats. It is challenging and time-consuming to distinguish these heartbeats on ECG as these signals are typically corrupted by noise. We developed a 9-layer deep convolutional neural network (CNN) to automatically identify 5 different categories of heartbeats in ECG signals. Our experiment was conducted in original and noise attenuated sets of ECG signals derived from a publicly available database. This set was artificially augmented to even out the number of instances the 5 classes of heartbeats and filtered to remove high-frequency noise. The CNN was trained using the augmented data and achieved an accuracy of 94.03% and 93.47% in the diagnostic classification of heartbeats in original and noise free ECGs, respectively. When the CNN was trained with highly imbalanced data (original dataset), the accuracy of the CNN reduced to 89.07%% and 89.3% in noisy and noise-free ECGs. When properly trained, the proposed CNN model can serve as a tool for screening of ECG to quickly identify different types and frequency of arrhythmic heartbeats. Copyright © 2017 Elsevier Ltd. All rights reserved.

6. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. October 31, 1950. BEV-331. MAGNET ROOM. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

18. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

18. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. January 12, 1950. BEV-195. ION GUN INJECTOR. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

43. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

43. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. March 28, 1950. BEV-226. BEVATRON BUILDING CONSTRUCTION. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

27. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

27. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. August 18, 1958. Bubble Chamber 605. BUBBLE CHAMBER ASSEMBLY - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

14. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. November 22, 1963. BEV-3467. ACCELERATION DIAGRAM. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

13. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. April 4, 1957. BEV-128. PROGRESS--MAGNET REPAIR. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

56. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

56. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. December 4, 1953. BEV-627. OVERALL VIEW OF BEVATRON - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

40. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

40. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. March, 1949. BEV 4903-00020. GRADING-SITE WORK FOR BEVATRON - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

30. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

30. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. October 6, 1955. BEV-943. ANTI-PROTON EXPERIMENT. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

5. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. August 25, 1950. BEV-307. BEVATRON MAGNET FOUNDATION. B-51 - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

4. Photocopy of photograph (original in possession of Western Archeological ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Photocopy of photograph (original in possession of Western Archeological and Conservation Center (WACC), Tucson, Arizona), photographer unknown, undated NEIL ERICKSON WORKING OUTSIDE OFFICE/GARAGE WHEN IT WAS NEW - Faraway Ranch, Office-Garage, Willcox, Cochise County, AZ

4. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, M 3686) Photographer unknown, 1923-25 GRANADA ENTRANCE, TAMIAMI TRAIL - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

9. Photocopy of photograph (original in possession of NYC Economic ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photocopy of photograph (original in possession of NYC Economic Development Corp.) Photographer and date unknown VIEW BETWEEN PIERS 2 AND 3, LOOKING FROM WAREHOUSE ROOF - Brooklyn Army Supply Base, Pier 2, Brooklyn, Kings County, NY

8. Photocopy of photograph (original photograph in possession of Coronado ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Photocopy of photograph (original photograph in possession of Coronado Historical Association). Photographer Unknown, circa 1922. HEILMAN VILLAS FROM ORANGE AVENUE - Heilman Villas, 706-720 Orange Avenue & 1060-1090 Seventh Street, Coronado, San Diego County, CA

12. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, M 3110) Photographer unknown, 1923-25 BALBOA PLAZA, DESOTO BOULVARD - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

6. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, M 3791) Photographer unknown, 1923-25 ALHAMBRA ENTRANCE (COMMERCIAL ENTRANCE) - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

Systematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints.

PubMed

Maas, E T; Juch, J N S; Ostelo, R W J G; Groeneweg, J G; Kallewaard, J W; Koes, B W; Verhagen, A P; Huygen, F J P M; van Tulder, M W

2017-03-01

Patient history and physical examination are frequently used procedures to diagnose chronic low back pain (CLBP) originating from the facet joints, although the diagnostic accuracy is controversial. The aim of this systematic review is to determine the diagnostic accuracy of patient history and/or physical examination to identify CLBP originating from the facet joints using diagnostic blocks as reference standard. We searched MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Collaboration database from inception until June 2016. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias. We calculated sensitivity and specificity values, with 95% confidence intervals (95% CI). Twelve studies were included, in which 129 combinations of index tests and reference standards were presented. Most of these index tests have only been evaluated in single studies with a high risk of bias. Four studies evaluated the diagnostic accuracy of the Revel's criteria combination. Because of the clinical heterogeneity, results were not pooled. The published sensitivities ranged from 0.11 (95% CI 0.02-0.29) to 1.00 (95% CI 0.75-1.00), and the specificities ranged from 0.66 (95% CI 0.46-0.82) to 0.91 (95% CI 0.83-0.96). Due to clinical heterogeneity, the evidence for the diagnostic accuracy of patient history and/or physical examination to identify facet joint pain is inconclusive. Patient history and physical examination cannot be used to limit the need of a diagnostic block. The validity of the diagnostic facet joint block should be studied, and high quality studies are required to confirm the results of single studies. Patient history and physical examination cannot be used to limit the need of a diagnostic block. The validity of the diagnostic facet joint block should be studied, and high quality studies are required to confirm the results of single studies. © 2016 European Pain Federation - EFIC®.

[Value of interleukin-27 as a diagnostic biomarker of sepsis in critically ill adults].

PubMed

Fu, Junjing; Wang, Yongtao; Zeng, Ping; Niu, Shanshan

2015-06-01

To evaluate interleukin-27 (IL-27) as a sepsis diagnostic biomarker in critically ill adults with sepsis. A retrospetive study was conducted. A total of 176 systemic inflammatory response syndrome (SIRS) patients in Department of Critical Care Medicine of Xinxiang Medical College First Affiliated Hospital from March to November in 2014 were enrolled. The patients were divided into no sepsis group (n=66), pulmonary originated sepsis group (n=65), and non-pulmonary originated sepsis group (n=45). Plasma IL-27 and procalcitonin (PCT) were determined with enzyme linked immunosorbent assay (ELISA). Receiver operating characteristic curve (ROC) and classification and regression tree methodology was used to evaluate diagnostic biomarker performance. The proportion of patients in pulmonary original sepsis group whose body temperature in line with SIRS criteria was significantly higher than no sepsis group (66.2% vs. 44.5%, P<0.05), and they were easy to suffer from tumor (44.6% vs. 22.7%, P<0.05). The proportion of patients in non-pulmonary originated sepsis group whose white blood cell count in line with SIRS criteria was significantly higher than no sepsis group (68.9% vs. 42.7%, P<0.05). It indicated that patients in pulmonary originated sepsis group and non-pulmonary originated sepsis group were more in line with SIRS criteria compared with no sepsis group. It was shown by ROC curve that IL-27 and PCT was not effective in discriminating sepsis among unselected patients showing symptoms and signs of SIRS. The area under the curve (AUC) was 0.59 [95% confidence interval (95%CI)=0.49-0.65] and 0.61 (95%CI=0.55-0.71). According to the further analysis from different infection sources, the highest AUC was 0.71 (95%CI=0.59-0.79) for IL-27 in patients with a non-pulmonary originated sepsis. A decision tree incorporating IL-27, PCT, and age had an AUC of 0.78 (95%CI=0.71-0.87) in patients with a non-pulmonary originated sepsis, which was higher than IL-27 [0.71(95%CI=0.59-0.79)] or PCT [0.65 (95%CI=0.57-0.78)]. Compared to that of pediatric cohort with sepsis, lower expression of IL-27 was found in adult patients. IL-27 performed overall poorly as a sepsis diagnostic biomarker in adults. IL-27 may be a more reliable diagnostic biomarker for sepsis in children than in adults. The combination of IL-27 and PCT can reasonably estimate the risk of sepsis in subjects with a non-pulmonary originated sepsis.

42. Photocopy of photograph (original photograph in possession of Sacramento ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

42. Photocopy of photograph (original photograph in possession of Sacramento Archives and Museum Collection Center, Sacramento, California) Original photographer and year unknown. BEANS GROWING ON THE PHILIP S. DRIVER ESTATE LANDS IN NATOMAS DISTRICT NO. 1000. - Reclamation District 1000, Northwest Sacramento County & southwest Sutter County, bisected by State Highway No. 99, Sacramento, Sacramento County, CA

36. Photocopy of Photograph (original print located in the Twin ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

36. Photocopy of Photograph (original print located in the Twin Falls Library, Twin Falls, Idaho). Original Photograph, Bisbee Photo, William H. Eaton, Photographer, date unknown. COTTONWOOD FLUME SOUTH OF KIMBERLY, IDAHO. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

61. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

61. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. April 1994. CBB 944-3190. AERIAL VIEW OF B-51 BEVATRON - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

23. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

23. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. March 26, 1953. BEV-551. OVERALL VIEW OF ION GUN. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

57. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

57. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. December 29, 1953. BEV-657. WEST TANK OPEN, CLOSE-UP. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

58. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

58. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. December 11, 1956. BEV-1206. PUMP ROOM WITH W. CHUPP IN BACKGROUND - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

8. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. July 2, 1953. BEV-574. QUADRANT POLE TIP INSTALLATION. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

12. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. February 5, 1954. BEV-681. GENERATOR ROOM FOR BEVATRON MAGNET. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

17. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. October 20, 1958. BEV-1654. OVERALL VIEW WITH PROTON INJECTOR. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

51. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

51. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. April 22, 1950. BEV-248. INTERIOR OF BEVATRON BUILDING. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

3. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. November 22, 1963. BEV-3470 INTERNAL BEAM EXPERIMENT DIAGRAM. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

16. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

16. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. December 29, 1953. BEV-654. INJECTOR, INJECTOR TANK-WIDE ANGLE; MARIO CAROTTA. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

55. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

55. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. November 29, 1950. BEV-359. GENERATOR ROOM, LOOKING SOUTH, B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

45. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

45. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. April 28, 1954. BEV-733. MAIN CONTROL ROOM; BOB RICHTER. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

54. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

54. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. September 29, 1950. BEV-328. NORTH SIDE OF BEVATRON BUILDING. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

2. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. November 22, 1963. BEV-3469 EXTERNAL BEAM EXPERIMENT DIAGRAM. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

20. Photocopy of negative (original in possession of WACC), photographer ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

20. Photocopy of negative (original in possession of WACC), photographer unknown, c.1920's BOY WITH DEER STANDING IN EAST YARD OF MAIN HOUSE WITH WELL AND SCREENED PORCH PICTURED IN LEFT BACKGROUND - Faraway Ranch, Willcox, Cochise County, AZ

41. Photocopy of negative (original in possession of WACC), photographer ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

41. Photocopy of negative (original in possession of WACC), photographer unknown, 1935 NEIL ERICKSON IN FRONT OF 'GARFIELD' FIREPLACE/CHIMNEY (NOTE: REAR PORCH IS ENCLOSED) - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

36. Photocopy of photograph (original in possession of Chiricahua National ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

36. Photocopy of photograph (original in possession of Chiricahua National Monument), photographer unknown, c.1915 EMMA ERICKSON AND MRS. COLLINS ON BALCONY OF RANCH HOUSE - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

35. Photocopy of negative (original in possession of WACC), photographer ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

35. Photocopy of negative (original in possession of WACC), photographer unknown, c.1915 FARAWAY RANCH AS COMPLETED WITH ADOBE BRICK WALLS AND WOOD SHINGLE ROOF - Faraway Ranch, Erickson-Riggs Ranch House, State Highway 181, Willcox, Cochise County, AZ

1. Photocopy of measured drawing (original delineated by the Royal ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Photocopy of measured drawing (original delineated by the Royal Danish Academy of Fine Arts (Kunstakademiets), Copenhagen, Denmark, 1961) Photographer and date of photograph unknown HOSPITALSGADE (FRONT) ELEVATION - Hospitalsgade 23 (House), 23 Hospital Street, Christiansted, St. Croix, VI

14. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, CK 109) Photographer unknown, 1923-25 ALHANBRA CIRCLE, VIEW TOWARDS GRANADA PLAZA - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

6. Photo copy of photograph, (original in Forest Service Office, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. Photo copy of photograph, (original in Forest Service Office, Elkins, WV, photo #246860), photographer unknown, ca. 1935. EQUIPMENT DETAIL, SEED WING REMOVER. - Parsons Nursery, Seed Extractor Building, South side of U.S. Route 219, Parsons, Tucker County, WV

9. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer unknown, ca. 1903-04. VIEW OF WORKERS AND BRIDGE UNDER CONSTRUCTION - Union Pacific Railroad Bridge, Spanning Santa Anna River, west of Riverside, Riverside, Riverside County, CA

30. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

30. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer and date unknown. VIEW OF SANTA FE RAILROAD TRACKS AND PACHAPPA AVENUE (COMMERCE STREET) LOOKING NORTH - California Citrus Heritage Recording Project, Riverside, Riverside County, CA

41. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

41. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. August 29, 1949. BEV-101. BEVATRON AREA LOOKING SOUTHEAST. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

15. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

15. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, M 3872) Photographer unknown, 1923-25 VIEW OF COUNTRY CLUB PRADO BOULEVARD - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

5. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, M 3292) Photographer unknown, 1923-25 AERIAL VIEW OF CORAL GABLES BUSINESS SECTION - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

13. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, M 3327) Photographer unknown, 1923-25 LE JEUNE PLAZA, VIEW FROM CORAL WAY - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

8. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, M 3829) Photographer unknown, 1923-25 SEGOVIA PLAZA AT NORTH GREENWAY DRIVE - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

Registration of 'Hidden Valley' meadow fescue

USDA-ARS?s Scientific Manuscript database

'Hidden Valley' (Reg. No. CV-xxxx, PI xxxxxx) meadow fescue [Schedonorus pratensis (Huds.) P. Beauv.; syn. Festuca pratensis Huds.; syn. Lolium pratense (Huds.) Darbysh.] is a synthetic population originating from 561 parental genotypes. The original germplasm is of unknown central or northern Europ...

44. Photocopy of a photograph (original print in the collection ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

44. Photocopy of a photograph (original print in the collection of the Claremont Historical Society) No date, photographer unknown HORSE TEAM HAULING A T-CONNECTION FOR A PENSTOCK. - Claremont Village Industrial District, Between B, Claremont, Sullivan County, NH

13. Photocopy of photograph (original in Documents Collection, College of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Photocopy of photograph (original in Documents Collection, College of Environmental Design, University of California, Berkeley, CA) Circa 1910, photographer unknown VIEW LOOKING NORTHEAST - Howard B. Gates House, 62 South Thirteenth Street, San Jose, Santa Clara County, CA

Multiple Origins of the Pathogenic Yeast Candida orthopsilosis by Separate Hybridizations between Two Parental Species.

PubMed

Schröder, Markus S; Martinez de San Vicente, Kontxi; Prandini, Tâmara H R; Hammel, Stephen; Higgins, Desmond G; Bagagli, Eduardo; Wolfe, Kenneth H; Butler, Geraldine

2016-11-01

Mating between different species produces hybrids that are usually asexual and stuck as diploids, but can also lead to the formation of new species. Here, we report the genome sequences of 27 isolates of the pathogenic yeast Candida orthopsilosis. We find that most isolates are diploid hybrids, products of mating between two unknown parental species (A and B) that are 5% divergent in sequence. Isolates vary greatly in the extent of homogenization between A and B, making their genomes a mosaic of highly heterozygous regions interspersed with homozygous regions. Separate phylogenetic analyses of SNPs in the A- and B-derived portions of the genome produces almost identical trees of the isolates with four major clades. However, the presence of two mutually exclusive genotype combinations at the mating type locus, and recombinant mitochondrial genomes diagnostic of inter-clade mating, shows that the species C. orthopsilosis does not have a single evolutionary origin but was created at least four times by separate interspecies hybridizations between parents A and B. Older hybrids have lost more heterozygosity. We also identify two isolates with homozygous genomes derived exclusively from parent A, which are pure non-hybrid strains. The parallel emergence of the same hybrid species from multiple independent hybridization events is common in plant evolution, but is much less documented in pathogenic fungi.

Human enteroviruses are not the cause of neurological impairments in children at the Korle-Bu Teaching Hospital.

PubMed

Tettey, Prudence; Badoe, Ebenezer; Adiku, Theophilus; Obodai, Eva; Odoom, John Kofi

2014-01-01

Convulsions associated with fever and acute onset of unknown aetiology with case fatalities have become a long observed medical condition at the Child Health Department of the Korle-Bu Teaching Hospital. Children admitted to the department with seizures of undetermined origin and fever has been a source of diagnostic confusion. Studies from the Asia Pacific region suggest a link with non-polio enteroviruses. The aim of the study was to investigate the association between non-polio enterovirus and acute encephalopathy causing neurological morbidity in children. One hundred and fifty cerebrospinal fluid (CSF), throat swab and serum samples were collected from participants at the Child Health Department of the Korle-Bu Teaching Hospital for virus isolation and characterization. Samples were cultured on cells and positive culture assayed by microneutralisation. Direct PCR as well as multiplex PCR were used to detect other viral agents present. Enterovirus isolation rate was approximately 0.67%. Intratypic differentiation by molecular characterization identified a poliovirus from vaccine origin. Further screening by real-time RT-PCR identified the virus as normal Sabin and not vaccine-derive poliovirus. No arbovirus was however detected. Non-polio enteroviruses and chikugunya virus were found not to be the etiologic agent responsible for the convulsion with neurologic morbidity observed in the Ghanaian children. Investigation for other viral agents is recommended.

Concurrent BRAF and PTEN mutations in melanoma of unknown origin presenting as a breast mass

PubMed Central

Agosto-Arroyo, Emmanuel; Rosa, Marilin; Chau, Alec; Khazai, Laila

2017-01-01

Background: Metastases represent a small percentage of the malignancies affecting the breast, and only 5% of melanomas originate from non-cutaneous sites. Multiple genetic aberrations have been associated with the development of melanocytic lesions, including BRAF V600E mutation. Mutations in PTEN gene have also been related to the pathogenesis of multiple malignancies. Purpose/Method: This is the case of a 28-year-old female who presented with a tender, palpable mass in the upper outer quadrant of the right breast. Ultrasound showed a 1-cm solid mass, initially diagnosed as invasive ductal carcinoma on biopsy. During pre-operative workup, a second mass was identified and biopsied. Immunohistochemical stains performed on the second mass biopsy demonstrated that the neoplastic cells were positive for cytokeratin AE1/3, pan-melanoma, tyrosinase, and SOX-10 and negative for CK7, CAM5.2, and GATA-3. Subsequent workup showed widespread metastatic disease involving the liver, lungs, bones, and brain. The brain metastasis tested positive for BRAF p.V600E and PTEN p.R130Efs*4 mutations. Thorough skin and eye examination did not reveal a primary melanoma. Conclusion: Only few reports have been published of melanoma presenting as a breast mass. This is an interesting case due to the clinical presentation, diagnostic challenges, and genetic mutations profile. PMID:28607685

17. Photocopy of original USRS photograph (from original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. Photocopy of original USRS photograph (from original print in the Umatilla Project History 1920, on file at National Archives, Rocky Mountain Region, Denver, Colorado) Photographer unknown, ca. 1920. Project office and employees - reading from left to right: Una H. Keck, Geo. C. Patterson, H.M. Schilling, Maurice D. Scroggs, Carl M. Voyen, Chas. Taylor, C.D. Porter - Former Umatilla Project Headquarters Buildings, Office, Hermiston, Umatilla County, OR

Chromosomal Microarray Testing in 42 Korean Patients with Unexplained Developmental Delay, Intellectual Disability, Autism Spectrum Disorders, and Multiple Congenital Anomalies.

PubMed

Lee, Sun Ho; Song, Wung Joo

2017-09-01

Chromosomal microarray (CMA) is a high-resolution, high-throughput method of identifying submicroscopic genomic copy number variations (CNVs). CMA has been established as the first-line diagnostic test for individuals with developmental delay (DD), intellectual disability (ID), autism spectrum disorders (ASDs), and multiple congenital anomalies (MCAs). CMA analysis was performed in 42 Korean patients who had been diagnosed with unexplained DD, ID, ASDs, and MCAs. Clinically relevant CNVs were discovered in 28 patients. Variants of unknown significance were detected in 13 patients. The diagnostic yield was high (66.7%). CMA is a superior diagnostic tool compared with conventional karyotyping and fluorescent in situ hybridization.

Evaluation and management of head and neck squamous cell carcinoma of unknown primary.

PubMed

Martin, Jeffrey M; Galloway, Thomas J

2015-07-01

The diagnostic evaluation and therapeutic management of a patient with squamous cell carcinoma of an unknown primary (SCCUP) has considerably evolved over recent decades and will likely continue to change as a result of the improving ability to identify small primary tumors and better tailor the implementation of multimodality therapy. By application of the general principles of head and neck oncology, physicians and surgeons are often able to achieve satisfactory control of the disease in patients with SCCUP. Copyright © 2015 Elsevier Inc. All rights reserved.

Biomarkers and Brain Mechanisms of Gulf War Illness

DTIC Science & Technology

Gulf War illness (GWI), a chronic and debilitating pain, headaches, impaired memory and thinking, fatigue, respiratory and gastrointestinal symptoms...believed to be causative of the illness . The pathobiological mechanisms of GWI are unknown; there are no validated diagnostic tests, nor are there effective

The role of liquid-based cytology and ancillary techniques in pleural and pericardic effusions: an institutional experience.

PubMed

Rossi, Esther Diana; Bizzarro, Tommaso; Schmitt, Fernando; Longatto-Filho, Adhemar

2015-04-01

Fine-needle aspiration cytology (FNAC) of serous membrane effusions may fulfil a challenging role in the diagnostic analysis of both primary and metastatic disease. From this perspective, liquid-based cytology (LBC) represents a feasible and reliable method for empowering the performance of ancillary techniques (ie, immunocytochemistry and molecular testing) with high diagnostic accuracy. In total, 3171 LBC pleural and pericardic effusions were appraised between January 2000 and December 2013. They were classified as negative for malignancy (NM), suspicious for malignancy (SM), or positive for malignancy (PM). The cytologic diagnoses included 2721 NM effusions (2505 pleural and 216 pericardic), 104 SM effusions (93 pleural and 11 pericardic), and 346 PM effusions (321 pleural and 25 pericardic). The malignant pleural series included 76 unknown malignancies (36 SM and 40 PM effusions), 174 metastatic lesions (85 SM and 89 PM effusions), 14 lymphomas (3 SM and 11 PM effusions), 16 mesotheliomas (5 SM and 11 SM effusions), and 3 myelomas (all SM effusions). The malignant pericardic category included 20 unknown malignancies (5 SM and 15 PM effusions), 15 metastatic lesions (1 SM and 14 PM effusions), and 1 lymphoma (1 PM effusion). There were 411 conclusive immunocytochemical analyses and 47 molecular analyses, and the authors documented 88% sensitivity, 100% specificity, 98% diagnostic accuracy, 98% negative predictive value, and 100% positive predictive value for FNAC. FNAC represents a primary diagnostic tool for effusions and a reliable approach with which to determine the correct follow-up. Furthermore, LBC is useful for ancillary techniques, such as immunocytochemistry and molecular analysis, with feasible diagnostic and predictive utility. © 2015 American Cancer Society.

40. Photocopy of building model photograph, ca., 1974, photographer unknown. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

40. Photocopy of building model photograph, ca., 1974, photographer unknown. Original photograph property of United States Air Force, 21" Space Command. CAPE COD AIR STATION PAVE PAWS FACILITY MODEL - ELEVATION SHOWING FLOOR AND EQUIPMENT LAYOUT. - Cape Cod Air Station, Technical Facility-Scanner Building & Power Plant, Massachusetts Military Reservation, Sandwich, Barnstable County, MA

39. Photocopy of building model photograph, ca. 1974, photographer unknown. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

39. Photocopy of building model photograph, ca. 1974, photographer unknown. Original photograph property of United States Air Force, 21" Space Command. CAPE COD AIR STATION PAVE PAWS FACILITY MODEL - SHOWING "A" AND "B" FACES. - Cape Cod Air Station, Technical Facility-Scanner Building & Power Plant, Massachusetts Military Reservation, Sandwich, Barnstable County, MA

6. Photographic copy of historic photograph (date and photograph unknown) ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. Photographic copy of historic photograph (date and photograph unknown) of upper dam showing retaining walls (original in possession of United States Department of Agriculture-Forest Service-Allegheny National Forest). VIEW WEST - Loleta Recreation Area, Upper Dam, 6 miles Southeast of interesection of State Route 24041 & State Route 66, Loleta, Elk County, PA

[Factitious fevers as a cause of prolonged fevers. Apropos of 5 clinical cases].

PubMed

Potin, M; Regamey, C; Glauser, M P

1983-10-22

Among the numerous causes of prolonged fever of unknown origin, the factitious fevers are frequently considered last after much diagnostic and therapeutic effort. Five observations of factitious fever are presented including 2 cases of thermometer manipulation in men aged 45 and 80. The latter patient is the oldest in whom such a case has been reported. In the first case the prolonged fever led to exploratory laparotomy with splenectomy followed by antilymphoma chemotherapy before the thermometer manipulation was discovered. This patient had previously been treated successfully for stage Ib Hodgkin lymphoma. In the other case hospitalization had lasted several weeks, and much antibiotic and steroid treatment had been administered, before the manipulation was suspected. A third case of thermometer manipulation was observed in a 57-year-old woman who had been presenting with factitious symptoms for over 10 years. Two other cases of factitious fever due to self-induced infections have been observed in two young women aged 23 and 27, both in paramedical professions. These self-induced infections led to polymicrobial bacteremia, exploratory laparotomy and hemicolectomy in one case, and to probable bacterial meningitis in the other. Certain aspects of these cases agree well with the diagnostic criteria of factitious fever described in the literature. We feel it is important to recognize this cause of febrile states, even if there is an apparent etiology, in order to avoid much vain investigation and prolonged hospitalization.

7. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. November 29, 1950. BEV-360. GENERAL VIEW, MAGNET ROOM, LOOKING SOUTHWEST. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

42. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

42. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. September 29, 1949. BEV-132. LOOKING NORTHWEST AT INITIAL STAGES OF CONSTRUCTION. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

35. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

35. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. April 27, 1960. BEV-2050. CLYDE WIEGAND; ANTI-PROTON SET-UP. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

48. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

48. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. February 10, 1960. BEV-2003. COAXIAL, MAIN CONTROL ROOM CONSOLE MODIFICATIONS. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

52. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

52. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. June 28, 1950. BEV-267. INTERIOR OF BEVATRON BUILDING LOOKING WEST. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

32. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

32. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. October 6, 1955. BEV-937. ANTI-PROTON SET-UP, EXTERIOR VIEW. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

31. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

31. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. October 6, 1955. BEV-933. ANTI-PROTON SET-UP, INTERIOR VIEW. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

11. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. December 17, 1952. BEV-517. MOVING CURVE TANK INTO MAGNET FOR STORAGE. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

53. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

53. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. June 28, 1950. BEV-268. EXTERIOR OF SOUTHWEST CORNER OF BEVATRON BUILDING. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

10. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. November 11, 1950. BEV-336. MAGNET CORE SHOWING FOUNDATION AND SUPPORTS. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

48. Photocopy of photograph (original print in possession of Historic ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

48. Photocopy of photograph (original print in possession of Historic Bethlehem, Inc., Bethlehem, PA) photographer unknown, 1922. Concrete handling method along the main street ramp - Hill to Hill Bridge, Spans Lehigh River at State Route 378, Bethlehem, Northampton County, PA

7. Photograph is copy of historic photo (original print located ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photograph is copy of historic photo (original print located in Ogden Air Logistics Center, Hill Air Force Base, Utah). Photographer unknown. - Ogden Arsenal, Primer Loading Building for 37mm Shell Loading, 7726 North Carolina Way, Layton, Davis County, UT

1. Photocopy of photograph (original print #17 located in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Photocopy of photograph (original print #17 - located in Pope & Talbot Archives. Port Gamble, WA). Unknown Photographer, September 1906. View of St. Paul's Episcopal Church, facing southwest from Rainier Avenue. - St. Paul's Episcopal Church, Rainier Avenue, Port Gamble, Kitsap County, WA

9. Photocopy of photograph (original photograph in possession of Coronado ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photocopy of photograph (original photograph in possession of Coronado Historical Association). Photographer Unknown, circa 1922. HEILMAN VILLAS FROM CORNER OF ORANGE AVENUE AND SEVENTH STREET - Heilman Villas, 706-720 Orange Avenue & 1060-1090 Seventh Street, Coronado, San Diego County, CA

10. Photocopy of Photograph (original print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Photocopy of Photograph (original print in the Coral Gables Public Library, Fishbaugh Collection, M 3109) Photographer unknown, 1923-25 COLUMBUS PLAZA, COLUMBUS STREET AND INDIAN MOUNTAIN TRAIL - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

22. Photocopy of photograph (original print in files of Theatre ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

22. Photocopy of photograph (original print in files of Theatre Historical Society, P.O. Box 101, Notre Dame, IN 46556) Photographer unknown 1938 TREMONT STREET ANNEX, LOOKING SOUTHEAST - B. F. Keith Memorial Theatre, 539 Washington Street, Boston, Suffolk County, MA

Photocopy of original blackandwhite silver gelatin print, AERIAL VIEW OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of original black-and-white silver gelatin print, AERIAL VIEW OF FEDERAL TRIANGLE, IRS BUILDING EAST SIDE OF THE OLD POST OFFICE BUILDING, 1936, photographer unknown - Internal Revenue Service Headquarters Building, 1111 Constitution Avenue Northwest, Washington, District of Columbia, DC

A novel technique to identify the nerve of origin in head and neck schwannomas.

PubMed

Ching, H H; Spinner, A G; Reeve, N H; Wang, R C

2018-04-18

Identifying the nerve of origin in head and neck schwannomas is a diagnostic challenge. Surgical management leads to a risk of permanent deficit. Accurate identification of the nerve would improve operative planning and patient counselling. Three patients with head and neck schwannomas underwent a diagnostic procedure hypothesised to identify the nerve of origin. The masses were infiltrated with 1 per cent lidocaine solution, and the patients were observed for neurological deficits. All three patients experienced temporary loss of nerve function after lidocaine injection. Facial nerve palsy, voice changes with documented unilateral same-side vocal fold paralysis, and numbness in the distribution of the maxillary nerve (V2), respectively, led to a likely identification of the nerve of origin. Injection of lidocaine into a schwannoma is a safe, in-office procedure that produces a temporary nerve deficit, which may enable accurate identification of the nerve of origin of a schwannoma. Identifying the nerve of origin enhances operative planning and patient counselling.

Chromosomal microarray analysis of consecutive individuals with autism spectrum disorders or learning disability presenting for genetic services.

PubMed

Roberts, Jennifer L; Hovanes, Karine; Dasouki, Majed; Manzardo, Ann M; Butler, Merlin G

2014-02-01

Chromosomal microarray analysis is now commonly used in clinical practice to identify copy number variants (CNVs) in the human genome. We report our experience with the use of the 105 K and 180K oligonucleotide microarrays in 215 consecutive patients referred with either autism or autism spectrum disorders (ASD) or developmental delay/learning disability for genetic services at the University of Kansas Medical Center during the past 4 years (2009-2012). Of the 215 patients [140 males and 75 females (male/female ratio=1.87); 65 with ASD and 150 with learning disability], abnormal microarray results were seen in 45 individuals (21%) with a total of 49 CNVs. Of these findings, 32 represented a known diagnostic CNV contributing to the clinical presentation and 17 represented non-diagnostic CNVs (variants of unknown significance). Thirteen patients with ASD had a total of 14 CNVs, 6 CNVs recognized as diagnostic and 8 as non-diagnostic. The most common chromosome involved in the ASD group was chromosome 15. For those with a learning disability, 32 patients had a total of 35 CNVs. Twenty-six of the 35 CNVs were classified as a known diagnostic CNV, usually a deletion (n=20). Nine CNVs were classified as an unknown non-diagnostic CNV, usually a duplication (n=8). For the learning disability subgroup, chromosomes 2 and 22 were most involved. Thirteen out of 65 patients (20%) with ASD had a CNV compared with 32 out of 150 patients (21%) with a learning disability. The frequency of chromosomal microarray abnormalities compared by subject group or gender was not statistically different. A higher percentage of individuals with a learning disability had clinical findings of seizures, dysmorphic features and microcephaly, but not statistically significant. While both groups contained more males than females, a significantly higher percentage of males were present in the ASD group. © 2013 Elsevier B.V. All rights reserved.

Application of MALDI-TOF MS Systems in the Rapid Identification of Campylobacter spp. of Public Health Importance.

PubMed

Hsieh, Ying-Hsin; Wang, Yun F; Moura, Hercules; Miranda, Nancy; Simpson, Steven; Gowrishankar, Ramnath; Barr, John; Kerdahi, Khalil; Sulaiman, Irshad M

2018-05-01

Campylobacteriosis is an infectious gastrointestinal disease caused by Campylobacter spp. In most cases, it is either underdiagnosed or underreported due to poor diagnostics and limited databases. Several DNA-based molecular diagnostic techniques, including 16S ribosomal RNA (rRNA) sequence typing, have been widely used in the species identification of Campylobacter. Nevertheless, these assays are time-consuming and require a high quality of bacterial DNA. Matrix-assisted laser desorption ionization (MALDI) time-of-flight (TOF) MS is an emerging diagnostic technology that can provide the rapid identification of microorganisms by using their intact cells without extraction or purification. In this study, we analyzed 24 American Type Culture Collection reference isolates of 16 Campylobacter spp. and five unknown clinical bacterial isolates for rapid identification utilizing two commercially available MADI-TOF MS platforms, namely the bioMérieux VITEK® MS and Bruker Biotyper systems. In addition, 16S rRNA sequencing was performed to confirm the species-level identification of the unknown clinical isolates. Both MALDI-TOF MS systems identified the isolates of C. jejuni, C. coli, C. lari, and C. fetus. The results of this study suggest that the MALDI-TOF MS technique can be used in the identification of Campylobacter spp. of public health importance.

Taxonomic notes on American heriades spinola, 1808 and leioproctus smith, 1853 (hymenoptera: megachilidae colletidae)

USDA-ARS?s Scientific Manuscript database

The previously unknown males of Leioproctus rosellae and Heriades tayrona, two recently discovered bees from northern Colombia, are described and diagnostic characters illustrated. The additional material of Heriades confirms that the megachilid tribe Osmiini does reach northern South America....

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

Grover, S.; Lorton, L.

The impacted tooth and its associated pathology provides the most diagnostic challenges to the dentist. Impactions can occur because of mal-positioning of the tooth bud and obstruction in the path of eruption. However, the exact mechanism is still unknown. Four unusual and uncommon cases of impacted permanent molars are being described.

A clinical utility study of exome sequencing versus conventional genetic testing in pediatric neurology.

PubMed

Vissers, Lisenka E L M; van Nimwegen, Kirsten J M; Schieving, Jolanda H; Kamsteeg, Erik-Jan; Kleefstra, Tjitske; Yntema, Helger G; Pfundt, Rolph; van der Wilt, Gert Jan; Krabbenborg, Lotte; Brunner, Han G; van der Burg, Simone; Grutters, Janneke; Veltman, Joris A; Willemsen, Michèl A A P

2017-09-01

Implementation of novel genetic diagnostic tests is generally driven by technological advances because they promise shorter turnaround times and/or higher diagnostic yields. Other aspects, including impact on clinical management or cost-effectiveness, are often not assessed in detail prior to implementation. We studied the clinical utility of whole-exome sequencing (WES) in complex pediatric neurology in terms of diagnostic yield and costs. We analyzed 150 patients (and their parents) presenting with complex neurological disorders of suspected genetic origin. In a parallel study, all patients received both the standard diagnostic workup (e.g., cerebral imaging, muscle biopsies or lumbar punctures, and sequential gene-by-gene-based testing) and WES simultaneously. Our unique study design allowed direct comparison of diagnostic yield of both trajectories and provided insight into the economic implications of implementing WES in this diagnostic trajectory. We showed that WES identified significantly more conclusive diagnoses (29.3%) than the standard care pathway (7.3%) without incurring higher costs. Exploratory analysis of WES as a first-tier diagnostic test indicates that WES may even be cost-saving, depending on the extent of other tests being omitted. Our data support such a use of WES in pediatric neurology for disorders of presumed genetic origin.Genet Med advance online publication 23 March 2017.

A clinical utility study of exome sequencing versus conventional genetic testing in pediatric neurology

PubMed Central

Vissers, Lisenka E.L.M.; van Nimwegen, Kirsten J.M.; Schieving, Jolanda H.; Kamsteeg, Erik-Jan; Kleefstra, Tjitske; Yntema, Helger G.; Pfundt, Rolph; van der Wilt, Gert Jan; Krabbenborg, Lotte; Brunner, Han G.; van der Burg, Simone; Grutters, Janneke; Veltman, Joris A.; Willemsen, Michèl A.A.P.

2017-01-01

Purpose: Implementation of novel genetic diagnostic tests is generally driven by technological advances because they promise shorter turnaround times and/or higher diagnostic yields. Other aspects, including impact on clinical management or cost-effectiveness, are often not assessed in detail prior to implementation. Methods: We studied the clinical utility of whole-exome sequencing (WES) in complex pediatric neurology in terms of diagnostic yield and costs. We analyzed 150 patients (and their parents) presenting with complex neurological disorders of suspected genetic origin. In a parallel study, all patients received both the standard diagnostic workup (e.g., cerebral imaging, muscle biopsies or lumbar punctures, and sequential gene-by-gene–based testing) and WES simultaneously. Results: Our unique study design allowed direct comparison of diagnostic yield of both trajectories and provided insight into the economic implications of implementing WES in this diagnostic trajectory. We showed that WES identified significantly more conclusive diagnoses (29.3%) than the standard care pathway (7.3%) without incurring higher costs. Exploratory analysis of WES as a first-tier diagnostic test indicates that WES may even be cost-saving, depending on the extent of other tests being omitted. Conclusion: Our data support such a use of WES in pediatric neurology for disorders of presumed genetic origin. Genet Med advance online publication 23 March 2017 PMID:28333917

Electromigration techniques--a fast and economical tool for differentiation of similar strains of microorganisms.

PubMed

Horká, Marie; Horký, Jaroslav; Kubesová, Anna; Mazanec, Karel; Matousková, Hana; Slais, Karel

2010-07-01

The detection and identification of pathogens currently relies upon a very diverse range of techniques and skills, from traditional cultivation and taxonomic procedures to modern rapid and sensitive diagnostic methods. Real-time PCR is now exploited as a front line diagnostic screening tool in human, animal and plant health as well as bio-security. Nevertheless, new techniques for pathogen identification, particularly of unknown samples, are needed. In this study we propose the combination of electrophoresis-based procedures for the fast differentiation of microorganisms. The method feasibility is proved on the model of seven similar strains of Pseudomonas syringae pathovars from 37 sources, identified by gas chromatography of fatty acid methyl esters. The results from the routine laboratory were compared with results of the combination of the developed capillary and gel electrophoresis as well as mass spectrometry. According to our experiments appropriate combination of electromigration techniques appears to be useful for the fast and economical differentiation of unknown microorganisms.

Anomalous aortic origin of a coronary artery: toward a standardized approach.

PubMed

Mery, Carlos M; Lawrence, Silvana M; Krishnamurthy, Rajesh; Sexson-Tejtel, S Kristen; Carberry, Kathleen E; McKenzie, E Dean; Fraser, Charles D

2014-01-01

Anomalous aortic origin of a coronary artery (AAOCA) is a congenital abnormality of the origin or course of a coronary artery that arises from the aorta. It is the second most common cause of sudden cardiac death in young athletes. Its exact prevalence, the pathophysiological mechanisms that cause sudden cardiac death, the actual risk of death for the different types of AAOCA, the optimal way to evaluate these patients, and whether any treatment strategies decrease the risk of sudden cardiac death in patients diagnosed with AAOCA are unknown. This article analyzes what is currently known and unknown about this disease. It also describes the creation of a dedicated multidisciplinary coronary anomalies program and the development of a framework in an initial attempt to standardize the evaluation and management of these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

28. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

28. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. April 1, 1959. Bubble Chamber 722. BUBBLE CHAMBER, WIDE-ANGLE INTERIOR VIEW OF BUILDING 59 - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

33. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

33. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. April 10, 1958. BEV-1515. ANTI-PROTON SET-UP; BRUCE CORK, GLENN LAMBERTSON. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

Photocopy of a photograph (original taken for the Edison Co.) ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of a photograph (original taken for the Edison Co.) Unknown, Photographer, 1939 AERIAL VIEW (SOUTH) SHOWING NORTH ELEVATION AND OTHER LABORATORY BUILDINGS AROUND THE COURTYARD - Thomas A. Edison Laboratories, Machine Shop & Library, Main Street & Lakeside Avenue, West Orange, Essex County, NJ

9. Photocopy of photograph (original print in possession of WACC), ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photocopy of photograph (original print in possession of WACC), photographer unknown, c.1900's NEIL ERICKSON ON LEDGE OVERLOOKING BONITA CANYON WITH STAFFORD CABIN IN FOREGROUND AND ERICKSON HOUSE IN DISTANCE (BOARD AND BATTEN PERIOD) - Faraway Ranch, Willcox, Cochise County, AZ

11. Photocopy of Photograph (original Print in the Coral Gables ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Photocopy of Photograph (original Print in the Coral Gables Public Library, Fishbaugh Collection, M 3809) Photographer unknown, 1923-25 PONCE DE LEON PLAZA, FROM CORAL WAY AND GRANADA BOULEVARD - Coral Gables (Entrances, Streets, Gates, & Squares), Coral Gables, Miami-Dade County, FL

59. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

59. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. April 25, 1957. BEV-1311. VACUUM SNOUT IN NORTH TARGET AREA; BOB RICHTER. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

Isolated muscular sarcoidosis causing fever of unknown origin: The value of gallium-67 imaging

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

Patel, N.; Krasnow, A.; Sebastian, J.L.

1991-02-01

An unusual case of a patient with a long-standing fever of unknown origin (FUO) is presented whose gallium-67 ({sup 67}Ga) images revealed increased activity only in the calf muscles bilaterally. Other imaging modalities also failed to show chest or other abnormal findings. Subsequent biopsy of the right gastrocnemius muscle revealed noncaseating granulomas consistent with the diagnosis of sarcoidosis. When using {sup 67}Ga to evaluate a patient with a FUO, imaging of the extremities should always be included. Also, when abnormal Ga-67 uptake is present in the extremities, sarcoidosis should be included in the differential diagnosis.

Diagnostic Approaches to Metastatic Hepatocellular Carcinoma of the Orbit.

PubMed

Geske, Michael J; Bloomer, Michele M; Kersten, Robert C; Vagefi, M Reza

Orbital metastasis of hepatocellular carcinoma is exceedingly rare and caries a grave prognosis. Three cases of metastatic orbital hepatocellular carcinoma in which the primary tumor was initially unknown and the diagnostic challenges encountered are presented. With hepatocellular carcinoma, open biopsy and palliative tumor debulking has an increased bleeding risk due to the highly vascular nature of the tumor and coagulopathy associated with chronic liver disease. As an alternative, fine needle aspiration biopsy should be considered for hepatocellular carcinoma with a readily accessible mass and the availability of an experienced cytopathologist.

[Atypical subacute thyroiditis in combination with Grave's disease:Diagnostic difficulties in a case report].

PubMed

Koutouridou, Emmanouela; Planck, Tereza; Uddman, Erik; Lantz, Mikael

2018-04-13

Subacute thyroiditis is a common inflammatory disorder of the thyroid gland, possibly of viral etiology, that typically presents with neck pain, fever and tenderness on palpation of the thyroid gland. Graves' disease is an autoimmune thyroid disorder caused by stimulation of the thyroid gland by thyrotropin receptor antibodies (TRAb). The development of Graves´ disease and subacute thyroiditis simultaneously is an uncommon condition and only a few cases have been reported. In this article we present a case of a 46-year old woman diagnosed with Graves´ disease who was started on thiamazole and weeks later developed high fever. Several differential diagnoses were considered such as infection, lymphoma and vasculitis due to thiamazole. Finally, the fine needle aspiration of the thyroid gland displayed histopathological features of subacute thyroiditis. Remarkably, our patient did not have neck pain or tenderness on palpation of the thyroid gland and overall the clinical presentation of subacute thyroiditis was atypical. Thus, subacute thyroiditis may be considered as a potential cause of fever of unknown origin.

Strategy for the elucidation of elemental compositions of trace analytes based on a mass resolution of 100,000 full width at half maximum.

PubMed

Kaufmann, Anton

2010-07-30

Elemental compositions (ECs) can be elucidated by evaluating the high-resolution mass spectra of unknown or suspected unfragmented analyte ions. Classical approaches utilize the exact mass of the monoisotopic peak (M + 0) and the relative abundance of isotope peaks (M + 1 and M + 2). The availability of high-resolution instruments like the Orbitrap currently permits mass resolutions up to 100,000 full width at half maximum. This not only allows the determination of relative isotopic abundances (RIAs), but also the extraction of other diagnostic information from the spectra, such as fully resolved signals originating from (34)S isotopes and fully or partially resolved signals related to (15)N isotopes (isotopic fine structure). Fully and partially resolved peaks can be evaluated by visual inspection of the measured peak profiles. This approach is shown to be capable of correctly discarding many of the EC candidates which were proposed by commercial EC calculating algorithms. Using this intuitive strategy significantly extends the upper mass range for the successful elucidation of ECs. Copyright 2010 John Wiley & Sons, Ltd.

The diagnostic utility of Merkel cell polyomavirus immunohistochemistry in a fine needle aspirate of metastatic Merkel cell carcinoma of unknown primary to the pancreas.

PubMed

Li, Long; Molberg, Kyle; Cheedella, Naga; Thibodeaux, Joel; Hinson, Stacy; Lucas, Elena

2018-01-01

Merkel cell carcinoma (MCC) is an aggressive skin tumor with a high tendency for metastases. We report a case of MCC initially presenting as axillary and pancreatic metastases. A 33-year-old HIV-positive Hispanic male presented with a history of a rapidly growing axillary mass. A needle core biopsy demonstrated an epithelioid neoplasm composed of small to medium-sized cells with high nuclear-cytoplasmic ratio, nuclear molding, and frequent mitotic figures. A subsequent PET scan revealed a 1.5 cm FDG avid mass in the pancreas. Endoscopic ultrasound-guided FNA of the pancreatic mass showed neoplastic cells with similar morphology to those of the axillary mass. The tumor cells were positive with pancytokeratin AE1/AE3, CK20, CD56, synatophysin, chromogranin, and Merkel cell polyomavirus (MCPyV). This case of MCC most likely originated from a resolved primary skin lesion drained by the involved axillary lymph node with subsequent metastases to the pancreas and distant lymph nodes. © 2017 Wiley Periodicals, Inc.

Terrorist Group Profiles

DTIC Science & Technology

1988-11-01

Formed 1975. Estimated Membership Unknown. Headquarters Unknown. Area of Operations Worldwide. Leadership ASALA-RM: Monte Melkonian. ASALA-M: Hagop...release. Black Sea are. Stan ulSOVIEIT UNION ®ANKARA ~ Ararat TURKEY Moditerroneen Sea LES- BEIRUT ’ . Historic area claimed by Armenian terrorists...Lima, Peru. - Leadership Ernesto Montes Aliaga (AKA Raul Perez). Other Names Movimiento Revolucionario Tupac Amaru (original language). Armed members of

29. Photocopy of photograph. VIEW, LOOKING NORTHEAST, OF NORTHEAST SECTION ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

29. Photocopy of photograph. VIEW, LOOKING NORTHEAST, OF NORTHEAST SECTION OF THE STRUCTURE, SHOWING ORIGINAL WOOD DECK, RAILING AND EARLY 1930'S PACKARD AUTOMOBILE IN BACKGROUND. Photographer unknown, date unknown. (Print in possession of the Washington County Highway Department). - Hegeman-Hill Street Bridge, Spanning Batten Kill, .65 mile West of Greenwich, Easton, Washington County, NY

7. Photocopy of photograph, date unknown. VIEW OF WEST HIGH ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photocopy of photograph, date unknown. VIEW OF WEST HIGH STREET BRIDGE OVER SOUTH BRANCH OF FRENCH CREEK, WITH PENN RAILROAD BRIDGE IN BACKGROUND. (Original in Union City Historical Museum.) 8'x10' enlargement from 4'x5' negative. - Bridge Street Bridge, Spanning Little French Creek at Bridge Street, Union City, Erie County, PA

[Diagnostic performance of biliary ultrasound vs. magnetic resonance cholangiogram in patients with recurrent biliary obstruction.].

PubMed

Chávez-Valencia, V; Espinosa-Ortega, H F; Espinoza-Peralta, D; Arce-Salinas, C A

2009-01-01

Obstructive jaundice in patients with previous cholecystectomy requires a precise diagnosis. In the diagnostic algorithm, biliary ultrasound (BUS) and magnetic resonance cholangiogram (MRC) are used, although the accuracy of each method is unknown in our setting. No previous comparison of US and MRC in subjects with cholecystectomy has been made. To determine diagnostic accuracy of BUS and MRC in patients with recurrent biliary obstruction. Patients with endoscopic retrograde cholangiopacreatography (ERCP) demonstrating recurrent biliary obstruction by stones were included. All patients underwent BUS and MRC. We determined the diagnostic performance of each image study compared with ERCP. Twenty-seven patients with a mean age of 62.9 +/- 17.3 years-old were included. Sensitivity and specificity of BUS were 0.12 and 0.58, respectively. Figures for MRC were 0.88 and 0.82. Diagnostic agreement between ERCP and MRC was k= 0.66 whereas BUS had a k of only 0.26. MRC had good diagnostic performance for recurrent choledocolithiasis. BUS demonstrated lower accuracy compared with previous reports, so should not be considered in the initial approach of recurrent choledocus obstruction.

7. Photocopy of photograph (original in possession of NYC Economic ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photocopy of photograph (original in possession of NYC Economic Development Corp.) Photographer unknown, circa 1983) OVERALL VIEW OF THE BROOKLYN ARMY TERMINAL, LOOKING NORTHEAST - Wood's Grist Mill, South bank of Indian River, 1 mile east of Breached Mill Dam, Antwerp, Jefferson County, NY

9. Photocopy of photograph (original print at Riverside Library, Local ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photocopy of photograph (original print at Riverside Library, Local History Collection), photographer unknown, October 1916. FORMER 'VICTORIA BRIDGE' (HOWE DECK TRUSS SUPPORTED BY TRESTLE) LOOKING SOUTHWEST, SHOWING STREETCAR AND THATCH-ROOFED, CANTILEVERED PEDESTRIAN PLATFORM - Victoria Bridge, Spanning Tequesquite Arroyo, Riverside, Riverside County, CA

36. Photographic copy of historic photo, c1915 (original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

36. Photographic copy of historic photo, c1915 (original print in Still Photo Branch of the National Archives, RG-155-JC, Washington, DC; photographer unknown). VIEW OF NORTH SIDE OF BOISE PROJECT OFFICE. - Boise Project, Boise Project Office, 214 Broadway, Boise, Ada County, ID

20. Photo copy of photograph, (original owned by John King, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

20. Photo copy of photograph, (original owned by John King, Berea, KY), photographer unknown, ca. 1935. VIEW SOUTH, CCC CAMP PARSONS IN BACKGROUND, BLACKSMITH SHOP ON LEFT, TRUCK STORAGE GARAGE IN FOREGROUND. - Parsons Nursery, South side of U.S. Route 219, Parsons, Tucker County, WV

11. Photocopy of photograph (original copy in Edison collection). Photographer ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Photocopy of photograph (original copy in Edison collection). Photographer and date unknown, although photo taken prior to 1930 reconstruction of Project flumes. VIEW OF ORIGINAL SOUTH FORK OF THE TULE RIVER MIDDLE FORK "BOX" WOOD FLUME BRANCH SHOWING NORTH FORK OF TULE RIVER MIDDLE FORK CROSSING. VIEW TO NORTHWEST. - Tule River Hydroelectric Project, Water Conveyance System, Middle Fork Tule River, Springville, Tulare County, CA

Magnetic resonance appearance of monoclonal gammopathies of unknown significance and multiple myeloma. The GRI Study Group.

PubMed

Bellaïche, L; Laredo, J D; Lioté, F; Koeger, A C; Hamze, B; Ziza, J M; Pertuiset, E; Bardin, T; Tubiana, J M

1997-11-01

A prospective multicenter study. To evaluate the use of magnetic resonance imaging, in the differentiation between monoclonal gammopathies of unknown significance and multiple myeloma. Although multiple myeloma has been studied extensively with magnetic resonance imaging, to the authors' knowledge, no study has evaluated the clinical interest of magnetic resonance imaging in the differentiation between monoclonal gammopathies of unknown significance and multiple myeloma. The magnetic resonance examinations of the thoracolumbar spine in 24 patients with newly diagnosed monoclonal gammopathies of unknown significance were compared with those performed in 44 patients with newly diagnosed nontreated multiple myeloma. All findings on magnetic resonance examination performed in patients with monoclonal gammopathies of unknown significance were normal, whereas findings on 38 (86%) of the 44 magnetic resonance examinations performed in patients with multiple myeloma were abnormal. Magnetic resonance imaging can be considered as an additional diagnostic tool in differentiating between monoclonal gammopathies of unknown significance and multiple myeloma, which may be helpful when routine criteria are not sufficient. An abnormal finding on magnetic resonance examination in a patient with monoclonal gammopathies of unknown significance should suggest the diagnosis of multiple myeloma after other causes of marrow signal abnormalities are excluded. Magnetic resonance imaging also may be proposed in the long-term follow-up of monoclonal gammopathies of unknown significance when a new biologic or clinical event suggests the diagnosis of malignant monoclonal gammopathy.

Tularemia without lesions in grey tree squirrels: A diagnostic challenge

USDA-ARS?s Scientific Manuscript database

Fifteen cases of Francisella tularenesis infection (tularemia) were identified in western grey (Sciurus griseus) and eastern grey (Sciurus carolinesis) squirrels submitted to the Washington Animal Disease Diagnostic Laboratory between 2008 and 2011. All of the squirrels originated in Washington stat...

Being smart or getting smarter: Implicit theory of intelligence moderates stereotype threat and stereotype lift effects.

PubMed

Froehlich, Laura; Martiny, Sarah E; Deaux, Kay; Goetz, Thomas; Mok, Sog Yee

2016-09-01

This research explores implicit theory of intelligence (TOI) as a moderator of stereotype activation effects on test performance for members of negatively stereotyped and of favourably stereotyped groups. In Germany, Turkish-origin migrants are stereotyped as low in verbal ability. We predicted that on a test diagnostic of verbal intelligence, endorsement of an entity TOI predicts stereotype threat effects for Turkish-origin students and stereotype lift effects for German students. This effect could account for some of the performance gap between immigrants and host society members after stereotype activation. Study 1 (N = 107) established structural equivalence of implicit theories across the ethnic groups. In two experimental studies (Study 2: N = 182, Study 3: N = 190), we tested the moderating effect of TOI in a 2 (stereotype activation: diagnostic vs. non-diagnostic test) × 2 (ethnicity: German vs. Turkish migration background) experimental design. The results showed that when the test was described as diagnostic of verbal intelligence, higher entity theory endorsement predicted stereotype threat effects for Turkish-origin students (Study 2 and Study 3) and stereotype lift effects for German students (Study 3). The results are discussed in terms of practical implications for educational settings and theoretical implications for processes underlying stereotype activation effects. © 2016 The British Psychological Society.

4. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. August, 1955. XBB 689-5508. BEVATRON MODEL (L. TO R.) WITH L. SMITH, McMILLAN, E.O. LAWRENCE, LOFGREN, BROBECK, AND SEWELL - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

29. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

29. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. July, 1959. Morgue 1959-46 (P-1). ALVAREZ BUBBLE CHAMBER GROUP (L. TO R.) HERNANDEZ, McMILLAN, ALVAREZ, GOW - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

Iatrogenic Buschke's disease (Michelin man syndrome)

PubMed

Ahmad, N; Lawrence, J R; Macdonald, J W

1988-02-01

Scleredema [corrected] adultorum as originally described by Buschke in 1900, is cutaneous thickening of unknown aetiology. Since then several cases have been reported which have illustrated different aspects of the disease but the exact aetiology, pathogenesis and prognosis remain uncertain. Disease of possible iatrogenic origin appears not to have been described previously.

47. Photocopy of photograph (negative made from original photograph property ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

47. Photocopy of photograph (negative made from original photograph property of The Wichita Eagle newspaper, Wichita, Kansas), photographer unknown, date on photograph 1948. View of southeast, Building 8 - Veterans Administration Center, Officers Duplex Quarters, 5302 East Kellogg (Legal Address); 5500 East Kellogg (Common Address), Wichita, Sedgwick County, KS

13. Photocopy of photograph (original print in the private collection ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Photocopy of photograph (original print in the private collection of Mr. Orton Camp, Waterbury, Connecticut) ca. 1890, photographer unknown DEXTER'S DRUG STORE IN SOUTHWEST CORNER OF HOTCHKISS BLOCK ON EAST MAIN STREET - Hotchkiss Block (Irving Block), 11 East Main Street, Waterbury, New Haven County, CT

Cocos nucifera L

Treesearch

James A. Allen

2002-01-01

The genus Cocos is monotypic. Cocos nucifera is believed to have originated in the Old World tropics, but the natural range is unknown and the origin of the species is the subject of considerable debate (Harries 1978, Parrotta 1993). Dispersal by humans has played a major role in the naturalization of the species on tropical...

[A fever of finally known origin].

PubMed

Jenni, Stefan; Kositz, Christian; Diethelm, Markus; Albrich, Werner

2014-05-21

We present the case of a 77 year old man with fever of unknown origin. Despite a thorough assessment in hospital the diagnosis could only be made after discharge when positive results for C. burnetii serology revealed acute Q-fever. However, retrospectively history and clinical findings matched well with acute Q-fever.

26. Photo copy of photograph, (original in Forest Service Office, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

26. Photo copy of photograph, (original in Forest Service Office, Elkins, WV), photographer unknown, ca. 1936. VIEW NORTHWEST, GARAGE (DEMOLISHED), NURSERY MANAGER'S GARAGE AND RESIDENCE, AND PACKING BUILDING, TRANSPLANT SHEDS AND PLOW IN FOREGROUND. - Parsons Nursery, South side of U.S. Route 219, Parsons, Tucker County, WV

20. Photocopy of a photograph (original print in the collection ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

20. Photocopy of a photograph (original print in the collection of the New Hampshire Water Resources Board, Concord, New Hampshire) 1927, photographer unknown 2 3/8 X 4 inch negative BUILDING OF DAM No. 3, LOOKING SOUTH - Claremont Village Industrial District, Between B, Claremont, Sullivan County, NH

19. Photocopy of a photograph (original print in the collection ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

19. Photocopy of a photograph (original print in the collection of the New Hampshire Water Resources Board, Concord, New Hampshire) 1927, photographer unknown 2 3/8 X 4 inch negative BUILDING OF DAM No. 3, FROM THE NORTH - Claremont Village Industrial District, Between B, Claremont, Sullivan County, NH

22. Photocopy of a photograph (original print in the collection ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

22. Photocopy of a photograph (original print in the collection of the New Hampshire Water Resources Board, Concord, New Hampshire) 1927, photographer unknown 2 3/8 X 4 inch negative BUILDING OF DAM NO. 3, LOOKING SOUTH - Claremont Village Industrial District, Between B, Claremont, Sullivan County, NH

4. Photocopy of an engraving (original in the collection of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Photocopy of an engraving (original in the collection of the Claremont Historical Society) artist unknown, no date FIRST COAL CUTTER MANUFACTURED BY THE SULLIVAN MACHINERY COMPANY. THIS DEVICE WAS POWERED BY HAND. - Sullivan Machinery Company, Main Street between Pearl & Water Streets, Claremont, Sullivan County, NH

17. Photocopy of drawing (original 8 x 101/2 inch plate ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. Photocopy of drawing (original 8 x 10-1/2 inch plate located in: USDA Forest Service, North Pacific Region, recreation handbook, date unknown). COMMUNITY BLDG., PLATE A-9 (enlarged from a 4x5 negative) - Austin Pass Warming Hut, Washington Highway 542, Glacier, Whatcom County, WA

4. Photocopy of photograph, original negative in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Photocopy of photograph, original negative in the possession of John R. Morison, Peterborough, New Hampshire. Photographer unknown, 14 September 1888. INSIDE CAISSON PIER IV, 60 FEET BELOW WATER LINE, 25 POUNDS AIR PRESSURE - Sioux City Bridge, Spanning the Missouri River, Sioux City, Woodbury County, IA

Photocopy of photograph (original in collection of U.S. Coast Guard ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph (original in collection of U.S. Coast Guard Civil Engineering Unit Providence, Warwick, RI) photographer unknown, 1975 Aerial view directly above - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

Photocopy of photograph (original in collection of U.S. Coast Guard ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph (original in collection of U.S. Coast Guard Civil Engineering Unit Providence, Warwick, RI) photographer unknown, 1977 Aerial view looking northeast - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

Focus on the Social Aspect of Autism

ERIC Educational Resources Information Center

Kaluzna-Czaplinska, Joanna; Zurawicz, Ewa; Józwik-Pruska, Jagoda

2018-01-01

Autism spectrum disorder (ASD) describes a set of neurodevelopmental disorders. Despite extensive ASD research lasting more than 60 years, its causes are still unknown. Without indicating the etiology, its development cannot be stopped. Over the years, both the definition and diagnostic criteria have developed. The number of ASD incidence is…

Participation Bias among Suicidal Adults in a Randomized Controlled Trial

ERIC Educational Resources Information Center

Stirman, Shannon Wiltsey; Brown, Gregory K.; Ghahramanlou-Holloway, Marjan; Fox, Allison J.; Chohan, Mariam Zahid; Beck, Aaron T.

2011-01-01

Although individuals who attempt suicide have poor compliance rates with treatment recommendations, the nature and degree of participation bias in clinical treatment research among these individuals is virtually unknown. The purpose of this study was to examine participation bias by comparing the demographic and diagnostic characteristics of adult…

11. Photocopy of photograph in the collection of Photographic Branch, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Photocopy of photograph in the collection of Photographic Branch, Puget Sound Naval Shipyard, Bremerton, WA. Original is labelled: Yard Photo 42. Date unknown, probably 1940's. Photographer unknown. HABS negative is a 4x5' copy negative. Perspective view of NE corner of Building 78. - Puget Sound Naval Shipyard, Administration Building, Farragut Avenue, Bremerton, Kitsap County, WA

The Complex Biogeography of the Plant Pathogen Xylella fastidiosa: Genetic Evidence of Introductions and Subspecific Introgression in Central America

PubMed Central

Nunney, Leonard; Ortiz, Beatriz; Russell, Stephanie A.; Ruiz Sánchez, Rebeca; Stouthamer, Richard

2014-01-01

The bacterium Xylella fastidiosa is a plant pathogen with a history of economically damaging introductions of subspecies to regions where its other subspecies are native. Genetic evidence is presented demonstrating the introduction of two new taxa into Central America and their introgression into the native subspecies, X. fastidiosa subsp. fastidiosa. The data are from 10 genetic outliers detected by multilocus sequence typing (MLST) of isolates from Costa Rica. Six (five from oleander, one from coffee) defined a new sequence type (ST53) that carried alleles at six of the eight loci sequenced (five of the seven MLST loci) diagnostic of the South American subspecies Xylella fastidiosa subsp. pauca which causes two economically damaging plant diseases, citrus variegated chlorosis and coffee leaf scorch. The two remaining loci of ST53 carried alleles from what appears to be a new South American form of X. fastidiosa. Four isolates, classified as X. fastidiosa subsp. fastidiosa, showed a low level of introgression of non-native DNA. One grapevine isolate showed introgression of an allele from X. fastidiosa subsp. pauca while the other three (from citrus and coffee) showed introgression of an allele with similar ancestry to the alleles of unknown origin in ST53. The presence of X. fastidiosa subsp. pauca in Central America is troubling given its disease potential, and establishes another route for the introduction of this economically damaging subspecies into the US or elsewhere, a threat potentially compounded by the presence of a previously unknown form of X. fastidiosa. PMID:25379725

The complex biogeography of the plant pathogen Xylella fastidiosa: genetic evidence of introductions and Subspecific introgression in Central America.

PubMed

Nunney, Leonard; Ortiz, Beatriz; Russell, Stephanie A; Ruiz Sánchez, Rebeca; Stouthamer, Richard

2014-01-01

The bacterium Xylella fastidiosa is a plant pathogen with a history of economically damaging introductions of subspecies to regions where its other subspecies are native. Genetic evidence is presented demonstrating the introduction of two new taxa into Central America and their introgression into the native subspecies, X. fastidiosa subsp. fastidiosa. The data are from 10 genetic outliers detected by multilocus sequence typing (MLST) of isolates from Costa Rica. Six (five from oleander, one from coffee) defined a new sequence type (ST53) that carried alleles at six of the eight loci sequenced (five of the seven MLST loci) diagnostic of the South American subspecies Xylella fastidiosa subsp. pauca which causes two economically damaging plant diseases, citrus variegated chlorosis and coffee leaf scorch. The two remaining loci of ST53 carried alleles from what appears to be a new South American form of X. fastidiosa. Four isolates, classified as X. fastidiosa subsp. fastidiosa, showed a low level of introgression of non-native DNA. One grapevine isolate showed introgression of an allele from X. fastidiosa subsp. pauca while the other three (from citrus and coffee) showed introgression of an allele with similar ancestry to the alleles of unknown origin in ST53. The presence of X. fastidiosa subsp. pauca in Central America is troubling given its disease potential, and establishes another route for the introduction of this economically damaging subspecies into the US or elsewhere, a threat potentially compounded by the presence of a previously unknown form of X. fastidiosa.

[Usefulness of FDG-PET/CT for the diagnosis of intravascular large B-cell lymphoma presenting with fever of unknown origin and renal dysfunction].

PubMed

Yago, Kazuhiro; Yanagita, Soshi; Aono, Maki; Matsuo, Ken; Shimada, Hideto

2009-06-01

A 76-year-old man presented with fever of unknown origin and renal dysfunction. Laboratory examination revealed anemia, thrombocytopenia, hypoalbuminemia, proteinuria, and elevations of C-reactive protein, lactic dehydrogenase, creatinine and ferritin. (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging showed FDG accumulation in the renal cortex and spleen. Based on the imaging study, renal biopsy was performed and histological diagnosis of intravascular large B-cell lymphoma (IVLBCL) was made. Renal impairment due to IVLBCL is uncommon and is often difficult to diagnose early. FDG-PET/CT may be a useful tool for the early diagnosis of IVLBCL.

The origin of aliphatic hydrocarbons in olive oil.

PubMed

Pineda, Manuel; Rojas, María; Gálvez-Valdivieso, Gregorio; Aguilar, Miguel

2017-11-01

There are many substances that can interfere with olive oil quality. Some of them are well characterized, but many others have an unknown origin. Saturated hydrocarbons make an extraordinary complex family of numerous molecules, some of them present naturally in vegetable oils. When major natural saturated hydrocarbons are analyzed by standard chromatographic methods, this complex mixture of saturated hydrocarbons appears as a hump in the chromatogram and is commonly named as unresolved complex mixture (UCM), whose origin remains unknown. In this work we studied the occurrence and the origin of aliphatic saturated hydrocarbons in olive oil. Hydrocarbons were analyzed in olive oil and along the industrial process of oil extraction. We also analyzed n-alkanes and the UCM fraction of hydrocarbons in leaf, fruit and oil from different varieties and different locations, and we also analyzed the soils at these locations. We conclude that the hydrocarbons present in olive oil do not necessarily have their origin in a contamination during olive oil elaboration; they seem to have a natural origin, as a result of olive tree metabolism and/or as the result of an intake and accumulation by the olive tree directly from the environment during its entire life cycle. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Subjective ultrasound assessment, the ADNEX model and ultrasound-guided tru-cut biopsy to differentiate disseminated primary ovarian cancer from metastatic non-ovarian cancer.

PubMed

Epstein, E; Van Calster, B; Timmerman, D; Nikman, S

2016-01-01

To compare subjective ultrasound assessment and the ADNEX model with ultrasound-guided tru-cut biopsy to differentiate disseminated primary ovarian cancer from metastatic non-ovarian cancer. This was a prospective study including 143 consecutive women with disseminated malignancy of unknown primary origin, with a pelvic tumor/carcinosis. Women underwent either transvaginal or transrectal ultrasound as well as transabdominal ultrasound examination followed by tru-cut biopsy. The ultrasound examiner assessed tumor morphology, spread in the pelvis and abdomen, and predicted tumor origin as primary ovarian or metastatic using both subjective assessment and the ADNEX model. Histology from tru-cut biopsy served as the gold standard for assessment of diagnostic accuracy. Biopsy adequacy and the complication rate were assessed. Tru-cut biopsy was performed transvaginally in 131/143 (92%) women. Two women needed inpatient care (one had abdominal wall hematoma, and one infection). Biopsy resulted in a conclusive diagnosis in 126/143 (88%) women, amongst whom cytoreductive surgery was performed in 30/126 confirming the diagnosis in all cases. Non-ovarian metastatic cancer was found in 37/126 (29%) women and primary ovarian cancer in 89/126 (71%) women. Subjective ultrasound evaluation had a sensitivity of 82% (73/89) and a specificity of 70% (26/37) in predicting primary ovarian cancer. The ADNEX model had an area under the receiver-operating characteristics curve of 0.891 (95% CI, 0.794-0.946) (in women with an ovarian lesion, n = 104). Tumor origin was associated with age, CA 125, previous neoplasia, presence of omental cake and tumor mobility. Subjective ultrasound assessment and the ADNEX model can both be used to predict whether a pelvic tumor is metastatic and of non-ovarian origin, indicating the need for tru-cut biopsy, which is associated with very few complications and will provide a conclusive diagnosis in nine out of 10 women. Copyright © 2015 ISUOG. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Spatial enhancement of ECG using diagnostic similarity score based lead selective multi-scale linear model.

PubMed

Nallikuzhy, Jiss J; Dandapat, S

2017-06-01

In this work, a new patient-specific approach to enhance the spatial resolution of ECG is proposed and evaluated. The proposed model transforms a three-lead ECG into a standard twelve-lead ECG thereby enhancing its spatial resolution. The three leads used for prediction are obtained from the standard twelve-lead ECG. The proposed model takes advantage of the improved inter-lead correlation in wavelet domain. Since the model is patient-specific, it also selects the optimal predictor leads for a given patient using a lead selection algorithm. The lead selection algorithm is based on a new diagnostic similarity score which computes the diagnostic closeness between the original and the spatially enhanced leads. Standard closeness measures are used to assess the performance of the model. The similarity in diagnostic information between the original and the spatially enhanced leads are evaluated using various diagnostic measures. Repeatability and diagnosability are performed to quantify the applicability of the model. A comparison of the proposed model is performed with existing models that transform a subset of standard twelve-lead ECG into the standard twelve-lead ECG. From the analysis of the results, it is evident that the proposed model preserves diagnostic information better compared to other models. Copyright © 2017 Elsevier Ltd. All rights reserved.

Anomalous Origin of the Right Vertebral Artery: Incidence and Significance.

PubMed

Maiti, Tanmoy Kumar; Konar, Subhas Kanti; Bir, Shyamal; Nanda, Anil; Cuellar, Hugo

2016-05-01

Detailed knowledge about anatomic variations of the aortic arch and its multiple branches is extremely important to endovascular and diagnostic radiologists. It is often hypothesized that anomalous origin and distribution of large aortic vessels may alter the cerebral hemodynamics and potentially lead to a vascular pathology. In this article, we describe a case of anomalous origin of the right vertebral artery, which was detected during an intervention. We further reviewed the available literature of anomalous origin of the right vertebral artery. The probable embryologic development and clinical significance are discussed. The incidence of anomalous origin of a vertebral artery seems to be underestimated in recent literature. A careful review of the literature shows more than 100 such cases. The right vertebral artery can arise from the aortic arch or one of its branches. Dual origin of the vertebral artery is not uncommon. The embryologic developmental hypotheses are contradictory and complex. Anomalous origin of the right vertebral artery may not be the sole reason behind a disease process. However, it can certainly lead to a misdiagnosis during diagnostic vascular studies. Detailed information is essential for any surgery or endovascular intervention in this location. Copyright © 2015 Elsevier Inc. All rights reserved.

Cystic Fibrosis Related Liver Disease—Another Black Box in Hepatology

PubMed Central

Staufer, Katharina; Halilbasic, Emina; Trauner, Michael; Kazemi-Shirazi, Lili

2014-01-01

Due to improved medical care, life expectancy in patients with cystic fibrosis (CF) has veritably improved over the last decades. Importantly, cystic fibrosis related liver disease (CFLD) has become one of the leading causes of morbidity and mortality in CF patients. However, CFLD might be largely underdiagnosed and diagnostic criteria need to be refined. The underlying pathomechanisms are largely unknown, and treatment strategies with proven efficacy are lacking. This review focuses on current invasive and non-invasive diagnostic standards, the current knowledge on the pathophysiology of CFLD, treatment strategies, and possible future developments. PMID:25093717

Absence of histopathological changes of ileum and colon in functional chronic diarrhea associated with bile acid malabsorption, assessed by SeHCAT test: a prospective study.

PubMed

Sciarretta, G; Furno, A; Morrone, B; Malaguti, P

1994-07-01

Chronic diarrhea of unknown origin is often associated with bile acid malabsorption, the pathogenetic role of which is uncertain. The aim of this study was to identify morphological abnormalities in the ileal and colonic mucosa in patients with this disorder. We performed a prospective and blinded histopathological study (between June 1991 and November 1992) of endoscopic biopsies of the distal ileum and colon of 23 patients suffering from chronic diarrhea of unknown origin. In 14, the SeHCAT (75-selena-homo-cholic acid taurine) test was abnormal owing to bile acid malabsorption; in the other nine, the diarrhea control group, the test results were normal. A detailed evaluation of surface epithelium, immune response and inflammatory changes was made. in two patients and two controls, mild villous atrophy was observed; there was also slight inflammation of the ileal and colonic mucosa occurring with the same frequency in both groups. A slight replacement of goblet cells was more evident in the diarrhea control group. Chronic diarrhea of unknown origin associated with bile acid malabsorption does not involve specific morphological changes of ileal or colonic mucosa, and its pathogenesis must be looked for in dysfunction of the ileum and/or colon.

An apodized Kepler periodogram for separating planetary and stellar activity signals

PubMed Central

Gregory, Philip C.

2016-01-01

A new apodized Keplerian (AK) model is proposed for the analysis of precision radial velocity (RV) data to model both planetary and stellar activity (SA) induced RV signals. A symmetrical Gaussian apodization function with unknown width and centre can distinguish planetary signals from SA signals on the basis of the span of the apodization window. The general model for m AK signals includes a linear regression term between RV and the SA diagnostic log (R′hk), as well as an extra Gaussian noise term with unknown standard deviation. The model parameters are explored using a Bayesian fusion Markov chain Monte Carlo code. A differential version of the generalized Lomb–Scargle periodogram that employs a control diagnostic provides an additional way of distinguishing SA signals and helps guide the choice of new periods. Results are reported for a recent international RV blind challenge which included multiple state-of-the-art simulated data sets supported by a variety of SA diagnostics. In the current implementation, the AK method achieved a reduction in SA noise by a factor of approximately 6. Final parameter estimates for the planetary candidates are derived from fits that include AK signals to model the SA components and simple Keplerians to model the planetary candidates. Preliminary results are also reported for AK models augmented by a moving average component that allows for correlations in the residuals. PMID:27346979

Diagnostic accuracy of the MMSE in detecting probable and possible Alzheimer's disease in ethnically diverse highly educated individuals: an analysis of the NACC database.

PubMed

Spering, Cynthia C; Hobson, Valerie; Lucas, John A; Menon, Chloe V; Hall, James R; O'Bryant, Sid E

2012-08-01

To validate and extend the findings of a raised cut score of O'Bryant and colleagues (O'Bryant SE, Humphreys JD, Smith GE, et al. Detecting dementia with the mini-mental state examination in highly educated individuals. Arch Neurol. 2008;65(7):963-967.) for the Mini-Mental State Examination in detecting cognitive dysfunction in a bilingual sample of highly educated ethnically diverse individuals. Archival data were reviewed from participants enrolled in the National Alzheimer's Coordinating Center minimum data set. Data on 7,093 individuals with 16 or more years of education were analyzed, including 2,337 cases with probable and possible Alzheimer's disease, 1,418 mild cognitive impairment patients, and 3,088 nondemented controls. Ethnic composition was characterized as follows: 6,296 Caucasians, 581 African Americans, 4 American Indians or Alaska natives, 2 native Hawaiians or Pacific Islanders, 149 Asians, 43 "Other," and 18 of unknown origin. Diagnostic accuracy estimates (sensitivity, specificity, and likelihood ratio) of Mini-Mental State Examination cut scores in detecting probable and possible Alzheimer's disease were examined. A standard Mini-Mental State Examination cut score of 24 (≤23) yielded a sensitivity of 0.58 and a specificity of 0.98 in detecting probable and possible Alzheimer's disease across ethnicities. A cut score of 27 (≤26) resulted in an improved balance of sensitivity and specificity (0.79 and 0.90, respectively). In the cognitively impaired group (mild cognitive impairment and probable and possible Alzheimer's disease), the standard cut score yielded a sensitivity of 0.38 and a specificity of 1.00 while raising the cut score to 27 resulted in an improved balance of 0.59 and 0.96 of sensitivity and specificity, respectively. These findings cross-validate our previous work and extend them to an ethnically diverse cohort. A higher cut score is needed to maximize diagnostic accuracy of the Mini-Mental State Examination in individuals with college degrees.

Identification of HIV Mutation as Diagnostic Biomarker through Next Generation Sequencing.

PubMed

Shaw, Wen Hui; Lin, Qianqian; Muhammad, Zikry Zhiwei Bin Roslee; Lee, Jia Jun; Khong, Wei Xin; Ng, Oon Tek; Tan, Eng Lee; Li, Peng

2016-07-01

Current clinical detection of Human immunodeficiency virus 1 (HIV-1) is used to target viral genes and proteins. However, the immunoassay, such as viral culture or Polymerase Chain Reaction (PCR), lacks accuracy in the diagnosis, as these conventional assays rely on the stable genome and HIV-1 is a highly-mutated virus. Next generation sequencing (NGS) promises to be transformative for the practice of infectious disease, and the rapidly reducing cost and processing time mean that this will become a feasible technology in diagnostic and research laboratories in the near future. The technology offers the superior sensitivity to detect the pathogenic viruses, including unknown and unexpected strains. To leverage the NGS technology in order to improve current HIV-1 diagnosis and genotyping methods. Ten blood samples were collected from HIV-1 infected patients which were diagnosed by RT PCR at Singapore Communicable Disease Centre, Tan Tock Seng Hospital from October 2014 to March 2015. Viral RNAs were extracted from blood plasma and reversed into cDNA. The HIV-1 cDNA samples were cleaned up using a PCR purification kit and the sequencing library was prepared and identified through MiSeq. Two common mutations were observed in all ten samples. The common mutations were identified at genome locations 1908 and 2104 as missense and silent mutations respectively, conferring S37N and S3S found on aspartic protease and reverse transcriptase subunits. The common mutations identified in this study were not previously reported, therefore suggesting the potential for them to be used for identification of viral infection, disease transmission and drug resistance. This was especially the case for, missense mutation S37N which could cause an amino acid change in viral proteases thus reducing the binding affinity of some protease inhibitors. Thus, the unique common mutations identified in this study could be used as diagnostic biomarkers to indicate the origin of infection as being from Singapore.

Archaeology through Computational Linguistics: Inscription Statistics Predict Excavation Sites of Indus Valley Artifacts

ERIC Educational Resources Information Center

Recchia, Gabriel L.; Louwerse, Max M.

2016-01-01

Computational techniques comparing co-occurrences of city names in texts allow the relative longitudes and latitudes of cities to be estimated algorithmically. However, these techniques have not been applied to estimate the provenance of artifacts with unknown origins. Here, we estimate the geographic origin of artifacts from the Indus Valley…

36. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

36. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. September 21, 1956. BEV-1154. DISCOVERERS OF ANTI-NEUTRON--(L. to R.) W. WENZEL, B. CORK, G. LAMBERTSON, AND O. PICCIONI, WITH FOCUS MAGNET. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

34. Photocopy of photograph (original print located in LBNL Photo ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

34. Photocopy of photograph (original print located in LBNL Photo Lab Collection). Photographer unknown. October 6, 1955. BEV-938. ANTI-PROTON SET-UP WITH WORK GROUP; E. SEGRE, C. WIEGAND, E. LOFGREN, O. CHAMBERLAIN, T. YPSILANTIS. B-51. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

13. Photocopy of photograph (original photograph in possession of 30th ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Photocopy of photograph (original photograph in possession of 30th Audiovisual Squadron, Vandenberg Air Force Base, California). Photography by United States Air Force, date unknown. THRUST AUGMENTED THOR PREPARED FOR LAUNCH FROM SLC-3W. - Vandenberg Air Force Base, Space Launch Complex 3, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

3. Photographic copy of historic photograph. JulyDec. 1947 OAMA. (Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. Photographic copy of historic photograph. July-Dec. 1947 OAMA. (Original print located at Ogden Air Logistics Center, Hill Air Force Base, Utah). Photographer unknown. - Hill Field, North of State Highway 193, East of Interstate 15, South of Davis-Weber Canal, West of Wherry Road, Layton, Davis County, UT

4. Photographic copy of historic photograph. Jan.June 1948 OAMA. (Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Photographic copy of historic photograph. Jan.-June 1948 OAMA. (Original print located at Ogden Air Logistics Center, Hill Air Force Base, Utah). Photographer unknown. - Hill Field, North of State Highway 193, East of Interstate 15, South of Davis-Weber Canal, West of Wherry Road, Layton, Davis County, UT

10. Photographic copy of historic photograph. Jan.June 1954 OAMA. (Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Photographic copy of historic photograph. Jan.-June 1954 OAMA. (Original print located at Ogden Air Logistics Center, Hill Air Force Base, Utah). Photographer unknown. - Hill Field, North of State Highway 193, East of Interstate 15, South of Davis-Weber Canal, West of Wherry Road, Layton, Davis County, UT

7. Photographic copy of historic photograph. Jan.June 1951 OAMA. (Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photographic copy of historic photograph. Jan.-June 1951 OAMA. (Original print located at Ogden Air Logistics Center, Hill Air Force Base, Utah). Photographer unknown. - Hill Field, North of State Highway 193, East of Interstate 15, South of Davis-Weber Canal, West of Wherry Road, Layton, Davis County, UT

8. Photographic copy of historic photograph. JulyDec. 1951 OAMA. (Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Photographic copy of historic photograph. July-Dec. 1951 OAMA. (Original print located at Ogden Air Logistics Center, Hill Air Force Base, Utah). Photographer unknown. - Hill Field, North of State Highway 193, East of Interstate 15, South of Davis-Weber Canal, West of Wherry Road, Layton, Davis County, UT

6. Photographic copy of historic photograph. Jan.June 1951 OAMA. (Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. Photographic copy of historic photograph. Jan.-June 1951 OAMA. (Original print located at Ogden Air Logistics Center, Hill Air Force Base, Utah). Photographer unknown. - Hill Field, North of State Highway 193, East of Interstate 15, South of Davis-Weber Canal, West of Wherry Road, Layton, Davis County, UT

5. Photographic copy of historic photograph. JulyDec. 1950 OAMA. (Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. Photographic copy of historic photograph. July-Dec. 1950 OAMA. (Original print located at Ogden Air Logistics Center, Hill Air Force Base, Utah). Photographer unknown. - Hill Field, North of State Highway 193, East of Interstate 15, South of Davis-Weber Canal, West of Wherry Road, Layton, Davis County, UT

2. Photographic copy of historic photograph. JulyDec. 1947 OAMA. (Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. Photographic copy of historic photograph. July-Dec. 1947 OAMA. (Original print located at Ogden Air Logistics Center, Hill Air Force Base, Utah). Photographer unknown. - Hill Field, North of State Highway 193, East of Interstate 15, South of Davis-Weber Canal, West of Wherry Road, Layton, Davis County, UT

1. Photographic copy of historic photograph. JulySept. 1946 OAMA. (Original ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Photographic copy of historic photograph. July-Sept. 1946 OAMA. (Original print located at Ogden Air Logistics Center, Hill Air Force Base, Utah). Photographer unknown. - Hill Field, North of State Highway 193, East of Interstate 15, South of Davis-Weber Canal, West of Wherry Road, Layton, Davis County, UT

3. Photocopy of photograph (Original print, Phillip McCracken, courtesy of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. Photocopy of photograph (Original print, Phillip McCracken, courtesy of Bill Mitchell.) Photographer unknown, 1924. Cold Storage Warehouse on the left, north and west facades. On the right, north facade of the Hay and Grain Warehouse. - Curtis Wharf, Cold Storage Warehouse, O & Second Streets, Anacortes, Skagit County, WA

46. Photocopy of photograph (negative made from original photograph property ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

46. Photocopy of photograph (negative made from original photograph property of The Wichita Eagle newspaper, Wichita, Kansas), photographer unknown, date on photograph 1943. View southeast, Building 8 is first structure on right - Veterans Administration Center, Officers Duplex Quarters, 5302 East Kellogg (Legal Address); 5500 East Kellogg (Common Address), Wichita, Sedgwick County, KS

10. Photographic copy of photograph (original print in possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Photographic copy of photograph (original print in possession of CSSD-HO, Huntsville, AL). Photographer unknown. Comparison of Spartan and sprint missiles. The sprint missile is on the left; the Spartan missile is on the right - Stanley R. Mickelsen Safeguard Complex, Missile Launch Area, Within Exclusion Area, Nekoma, Cavalier County, ND

14. Photocopy of photograph original print located at University Archives, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. Photocopy of photograph original print located at University Archives, Hayden Library, Arizona State University, Tempe, Arizona. Photographer unknown, 1902 VIEW SHOWING TRAIN WRECK ON MARICOPA AND PHOENIX RAILROAD CAUSED BY BRIDGE FAILURE RESULTING FROM FLOOD DAMAGE - Ash Avenue Bridge, Spanning Salt River at Foot of Ash Avenue, Tempe, Maricopa County, AZ

34. Photographic copy of photograph (ca. 1962, original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

34. Photographic copy of photograph (ca. 1962, original print in possession of Army Corps of Engineers, Ft. Belvoir, Virginia) Photographer unknown. View of launch control facility under construction, security gate at left - Ellsworth Air Force Base, Delta Flight, 10 mile radius around Exit 127 off Interstate 90, Interior, Jackson County, SD

2. Photocopy of photograph (original photograph in possession of Atlanta ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. Photocopy of photograph (original photograph in possession of Atlanta Housing Authority, Atlanta, GA). Photographer unknown, circa 1940. Aerial view of Clark Howell Homes, center, Techwood Homes, left, Georgia Institute of Technology, bottom. - Clark Howell Homes (Public Housing), Bounded by North Avenue, Lovejoy Street, Mills Street & Luckie Street, Atlanta, Fulton County, GA

1. Photocopy of photograph (original photograph in possession of Atlanta ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Photocopy of photograph (original photograph in possession of Atlanta Housing Authority, Atlanta, GA). Photographer unknown, circa 1940. Aerial view, Clark Howell Homes, left, Techwood Homes, right, Georgia Institute of Technology, top, right. - Clark Howell Homes (Public Housing), Bounded by North Avenue, Lovejoy Street, Mills Street & Luckie Street, Atlanta, Fulton County, GA

The origin of Ceratocystis fagacearum, the oak wilt fungus

Treesearch

Jennifer Juzwik; Thomas C. Harrington; William L. MacDonald; David N. Appel

2008-01-01

The oak wilt pathogen, Ceratocystis fagacearum, may be another example of a damaging, exotic species in forest ecosystems in the United States. Though C. fagacearum has received much research attention, the origin of the fungus is unknown. The pathogen may have been endemic at a low incidence until increased disturbances, changes...

24. Photocopy of a photograph (original print in the collection ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

24. Photocopy of a photograph (original print in the collection of the New Hampshire Water Resources Board, Concord, New Hampshire) 1927, photographer unknown 2 3/8 X 4 inch negative VIEW OF THE OLD TIMBER CRIB DAM, LOOKING EAST FROM THE NORTH BANK - Claremont Village Industrial District, Between B, Claremont, Sullivan County, NH

11. Photographic copy of photograph (original print in possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Photographic copy of photograph (original print in possession of CSSD-HO, Huntsville, AL). Photographer unknown. View of rocket models, allowing a comparison of the Spartan, galosh (USSR), minute man III, and SS-9 (USSR) missiles - Stanley R. Mickelsen Safeguard Complex, Missile Launch Area, Within Exclusion Area, Nekoma, Cavalier County, ND

23. Photocopy of original photo from Corps of Engineers, Los ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

23. Photocopy of original photo from Corps of Engineers, Los Angeles District, 'Report on Salinas Dam, Salinas River, California,' June 15, 1943. (Photographer unknown; report located at City of San Luis Obispo.) CONSTRUCTION PHOTO SHOWING CURVED CONCRETE CHUTE SPILLWAY. - Salinas Dam, Salinas River near Pozo Road, Santa Margarita, San Luis Obispo County, CA

21. Photocopy of original photo from Corps of Engineers, Los ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

21. Photocopy of original photo from Corps of Engineers, Los Angeles District, 'Report on Salinas Dam, Salinas River, California,' June 15, 1943. (Photographer unknown; report located at City of San Luis Obispo.) SALINAS DAM UNDER CONSTRUCTION IN 1941. - Salinas Dam, Salinas River near Pozo Road, Santa Margarita, San Luis Obispo County, CA

24. Photocopy of original photo from Corps of Engineers, Los ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

24. Photocopy of original photo from Corps of Engineers, Los Angeles District, 'Report on Salinas Dam, Salinas River, California,' June 15, 1943. (Photographer unknown, report located at City of San Luis Obispo.) SALINAS DAM COMPLETION PHOTO. - Salinas Dam, Salinas River near Pozo Road, Santa Margarita, San Luis Obispo County, CA

76. Photocopy of Photograph (original located in Univ. of Denver ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

76. Photocopy of Photograph (original located in Univ. of Denver collection). C.R. Savage, Photographer, date unknown. DISASSEMBLING CRANE TOWER FROM SOUTH ISLAND SPILLWAY. REMOVING CABLE TOWER. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

Photocopy of photograph (original in collection of U.S. Coast Guard ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph (original in collection of U.S. Coast Guard Civil Engineering Unit Providence, Warwich, RI), photographer unknown, 1977 view south, showing western docking structure and ordnance wharf - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

Characterization of a low-level unknown isomeric degradation product using an integrated online-offline top-down tandem mass spectrometry platform.

PubMed

Yu, Xiang; Warme, Christopher; Lee, Dinah; Zhang, Jing; Zhong, Wendy

2013-10-01

An integrated online-offline platform was developed combining automated online LC-MS fraction collection, continuous accumulation of selected ions (CASI), and offline top-down electron capture dissociation (ECD) tandem mass spectrometry experiments to identify a low-level, unknown isomeric degradant in a formulated drug product during an accelerated stability study. By identifying the diagnostic ions of the isoaspartic acid (isoAsp), the top-down ECD experiment showed that the Asp9 in exenatide was converted to isoAsp9 to form the unknown isomeric degradant. The platform described here provides an accurate, straightforward, and low limit of detection method for the analysis of Asp isomerization as well as other potential low-level degradants in therapeutic polypeptides and proteins. It is especially useful for unstable and time-sensitive degradants and impurities.

Globally Convergent Numerical Methods for Coefficient Inverse Problems

DTIC Science & Technology

2008-09-23

backgrounds. Probing radiations are usually thought as electric and acoustic waves for the first two applications and light originated by lasers in...fundamental laws of physics. Electric , acoustic or light scattering properties of both unknown targets and the backgrounds are described by coefficients of...with the back-reflected data here, Army applications are quite feasible. The 2-D inverse problem of the determination of the unknown electric

15. Photographic copy of photograph dated ca. 1929; Photographer unknown; ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

15. Photographic copy of photograph dated ca. 1929; Photographer unknown; Original in Rath collection at Grout Museum, Waterloo, Iowa; Filed under: Rath Packing Company, Box 4; THE RATH COMPLEX IN THE LATE 1920S; LOOKING WEST FROM 18TH STREET; LARGE BUILDING AT CENTER IS HOG KILL (BUILDING 40) - Rath Packing Company, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

"A Marriage on the Rocks": An Unknown Letter by William H. Kilpatrick about His Project Method

ERIC Educational Resources Information Center

Knoll, Michael

2010-01-01

William H. Kilpatrick is worldwide known as "Mr. Project Method." But the origin of his celebrated paper of 1918 has never been explored. The discovery of a hitherto unknown letter reveals that Kilpatrick was an educational entrepreneur who, without regard for language and tradition, adopted the term "project" and used it in a provocative new way…

Extensions to the Speech Disorders Classification System (SDCS)

PubMed Central

Shriberg, Lawrence D.; Fourakis, Marios; Hall, Sheryl D.; Karlsson, Heather B.; Lohmeier, Heather L.; McSweeny, Jane L.; Potter, Nancy L.; Scheer-Cohen, Alison R.; Strand, Edythe A.; Tilkens, Christie M.; Wilson, David L.

2010-01-01

This report describes three extensions to a classification system for pediatric speech sound disorders termed the Speech Disorders Classification System (SDCS). Part I describes a classification extension to the SDCS to differentiate motor speech disorders from speech delay and to differentiate among three subtypes of motor speech disorders. Part II describes the Madison Speech Assessment Protocol (MSAP), an approximately two-hour battery of 25 measures that includes 15 speech tests and tasks. Part III describes the Competence, Precision, and Stability Analytics (CPSA) framework, a current set of approximately 90 perceptual- and acoustic-based indices of speech, prosody, and voice used to quantify and classify subtypes of Speech Sound Disorders (SSD). A companion paper, Shriberg, Fourakis, et al. (2010) provides reliability estimates for the perceptual and acoustic data reduction methods used in the SDCS. The agreement estimates in the companion paper support the reliability of SDCS methods and illustrate the complementary roles of perceptual and acoustic methods in diagnostic analyses of SSD of unknown origin. Examples of research using the extensions to the SDCS described in the present report include diagnostic findings for a sample of youth with motor speech disorders associated with galactosemia (Shriberg, Potter, & Strand, 2010) and a test of the hypothesis of apraxia of speech in a group of children with autism spectrum disorders (Shriberg, Paul, Black, & van Santen, 2010). All SDCS methods and reference databases running in the PEPPER (Programs to Examine Phonetic and Phonologic Evaluation Records; [Shriberg, Allen, McSweeny, & Wilson, 2001]) environment will be disseminated without cost when complete. PMID:20831378

Review: Occult hepatitis C virus infection: still remains a controversy.

PubMed

Vidimliski, Pavlina Dzekova; Nikolov, Igor; Geshkovska, Nadica Matevska; Dimovski, Aleksandar; Rostaing, Lionel; Sikole, Aleksandar

2014-09-01

Occult hepatitis C virus (HCV) infection is characterized by the presence of HCV RNA in the liver cells or peripheral blood mononuclear cells of the patients whose serum samples test negative for HCV RNA, with or without presence of HCV antibodies. The present study reviews the existing literature on the persistence of occult hepatitis C virus infection, with description of the clinical characteristics and methods for identification of occult hepatitis C. Occult hepatitis C virus infection was detected in patients with abnormal results of liver function tests of unknown origin, with HCV antibodies and HCV RNA negativity in serum, and also in patients with spontaneous or treatment-induced recovery from hepatitis C. The viral replication in the liver cells and/or peripheral blood mononuclear cells was present in all clinical presentations of occult hepatitis C. The peripheral blood mononuclear cells represent an extra-hepatic site of HCV replication. The reason why HCV RNA was not detectable in the serum of patients with occult hepatitis C, could be the low number of circulating viral particles not detectable by the diagnostic tests with low sensitivity. It is uncertain whether occult hepatitis C is a different clinical entity or just a form of chronic hepatitis C virus infection. Data accumulated over the last decade demonstrated that an effective approach to the diagnosis of HCV infection would be the implementation of more sensitive HCV RNA diagnostic assays, and also, examination of the presence of viral particles in the cells of the immune system. © 2014 Wiley Periodicals, Inc.

Accentuated Virchow-Robin spaces in the centrum semiovale in children with autistic disorder.

PubMed

Taber, Katherine H; Shaw, J Bryant; Loveland, Katherine A; Pearson, Deborah A; Lane, David M; Hayman, L Anne

2004-01-01

The purpose of this study was to assess the incidence of abnormal Virchow-Robin (VR) spaces in children and adolescents with an autistic disorder (AD). An increased incidence of enlarged VR spaces in children has been reported in several developmental disorders. Sixteen children and adolescents (13 male, 3 female; mean age = 143.5 months; mean IQ = 95.1) with an AD, verified by use of standardized procedures (Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule-Revised), received cranial magnetic resonance (MR) imaging. Sixteen children and adolescents (13 male, 3 female; mean age = 160.7 months; mean IQ = 111.6) without AD, as determined using the same procedures, were scanned as a comparison group. The MR scans were performed using a 1.5-T scanner. Two T1-weighted spoiled GRASS sequences (0.7-mm coronal thin-slice, 0-mm gap; 1.5-mm sagittal, 0-mm gap) and a complementary T2-weighted fast spin echo sequence (1.5-mm, 0-mm gap) were obtained. A neuroradiologist and a neurobiologist without clinical information determined the incidence of normal, accentuated, and/or dilated VR spaces. Seven of 16 subjects with AD (approximately 44%) had dilated VR spaces in the centrum semiovale. No grossly abnormal spaces were present in the control subjects. Unusually large VR spaces are seen in at most 22% to 27% of MR scans in children with tension headaches and other psychiatric disorders, suggesting that the incidence of spaces of this type is greater in AD than in other abnormal populations. The origin and significance of this phenomenon remain unknown.

Optical Measurements of Air Plasma

DTIC Science & Technology

2008-05-05

beam impact ionization of air was studied in the context of optical diagnostics . The electron beam originates in a pulsed 100 keV 20-mA source and...range of 636 Torr to 1 mTorr with pulse durations from 1 ms to 10 ms. Microwave diagnostics were used to quantify electron density and power; and an...optical diagnostic was used to quantify ozone production. An additional effort to quantify byproducts of electron impact ionization, that are

Diagnostic ultrasound exposure in man.

PubMed

Gramiak, R

1975-09-01

In his review of the AAPM statement on ultrasound, the author feels that allowing "some" research or demonstration on normal persons in the face of cautionary statements on as yet unknown side effects is an inconsistent position. The use of videotapes and the development of simulators hacked by data banks are offered in place of tissue phantoms.

Unpacking the Complex Nature of the Autism Epidemic

ERIC Educational Resources Information Center

Leonard, Helen; Dixon, Glenys; Whitehouse, Andrew J. O.; Bourke, Jenny; Aiberti, Karina; Nassar, Natasha; Bower, Carol; Glasson, Emma J.

2010-01-01

The etiology of autism spectrum disorders is unknown but there are claims of increasing prevalence in many countries. Despite more than a decade of epidemiological investigation, it is still unclear whether the rising trend in prevalence reflects a true increase or changes in diagnostic trends and improvements in case ascertainment. This paper…

Histone acetylation regulates the time of replication origin firing.

PubMed

Vogelauer, Maria; Rubbi, Liudmilla; Lucas, Isabelle; Brewer, Bonita J; Grunstein, Michael

2002-11-01

The temporal firing of replication origins throughout S phase in yeast depends on unknown determinants within the adjacent chromosomal environment. We demonstrate here that the state of histone acetylation of surrounding chromatin is an important regulator of temporal firing. Deletion of RPD3 histone deacetylase causes earlier origin firing and concurrent binding of the replication factor Cdc45p to origins. In addition, increased acetylation of histones in the vicinity of the late origin ARS1412 by recruitment of the histone acetyltransferase Gcn5p causes ARS1412 alone to fire earlier. These data indicate that histone acetylation is a direct determinant of the timing of origin firing.

Diagnostic Examination for Students Entering Graduate Study in Soil Science.

ERIC Educational Resources Information Center

Loynachan, T. E.

1988-01-01

Reports that students with soil science background performed better on a diagnostic examination; no relationship existed between exam performance and country of origin, degree sought, or undergraduate class quartile. Concludes that exam results, the grade received in a beginning graduate-level course and the cumulative graduate grade-point average…

Molecular aspects of development and regulation of endometriosis

PubMed Central

2014-01-01

Endometriosis is a common and painful condition affecting women of reproductive age. While the underlying pathophysiology is still largely unknown, much advancement has been made in understanding the progression of the disease. In recent years, a great deal of research has focused on non-invasive diagnostic tools, such as biomarkers, as well as identification of potential therapeutic targets. In this article, we will review the etiology and cellular mechanisms associated with endometriosis as well as the current diagnostic tools and therapies. We will then discuss the more recent genomic and proteomic studies and how these data may guide development of novel diagnostics and therapeutics. The current diagnostic tools are invasive and current therapies primarily treat the symptoms of endometriosis. Optimally, the advancement of “-omic” data will facilitate the development of non-invasive diagnostic biomarkers as well as therapeutics that target the pathophysiology of the disease and halt, or even reverse, progression. However, the amount of data generated by these types of studies is vast and bioinformatics analysis, such as we present here, will be critical to identification of appropriate targets for further study. PMID:24927773

Evaluation of two commercially available chromogenic media for confirmation of methicillin-resistant Staphylococcus aureus from human, animal, and food samples.

PubMed

Ariza-Miguel, Jaime; Oniciuc, Elena-Alexandra; Sanz, Iván; Fernández-Natal, Isabel; Hernández, Marta; Rodríguez-Lázaro, David

2015-09-16

We compared the diagnostic performance of two chromogenic media, Brilliance MRSA 2 agar (Thermo Fisher Scientific) and ChromID MRSA agar (bioMérieux), for MRSA confirmation of 239 Staphylococcus aureus isolates from clinical, animal and food samples. Statistically significant differences were not observed between MRSA confirmation by mecA/mecC PCR, and by culture in both chromogenic media. However, a statistically significant difference was observed between the results obtained by both chromogenic media (p = 0.003). Segregated analysis of the results depending on the origin of the isolates (clinical, animal, and food) revealed a significant lower performance in the MRSA confirmation of food-derived isolates by using Brilliance MRSA 2 agar in comparison to PCR confirmation (p = 0.003) or ChromID MRSA agar (p<0.001). Both chromogenic media provided a good diagnostic performance for detection of MRSA isolates of human and animal origin. In conclusion, the use of chromogenic agar plates for MRSA confirmation of S. aureus isolates can provide a good diagnostic performance (sensitivity >92% and specificity >89%) regardless of the type of chromogenic media used or the origin of the S. aureus isolates. However, our results revealed a lower diagnostic performance for MRSA confirmation of S. aureus isolates from food samples by using Brilliance MRSA 2 agar. Copyright © 2015 Elsevier B.V. All rights reserved.

Clinical review: Current state and future perspectives in the diagnosis of diabetes insipidus: a clinical review.

PubMed

Fenske, Wiebke; Allolio, Bruno

2012-10-01

The differential diagnosis of diabetes insipidus (DI) is often challenging but essential, because treatment may vary substantially. This article analyzes the database and performance of currently used differential diagnostic tests for DI and discusses future perspectives for diagnostic improvement. A review of electronic and print data comprising original and review articles retrieved from the PubMed or Cochrane Library database up to January 2012 was conducted. The search term "polyuria polydipsia syndrome" was cross-referenced with underlying forms of disease and associated clinical, diagnostic, and therapeutic MeSH terms. In addition, references from review articles and textbook chapters were screened for papers containing original data. Search results were narrowed to articles containing primary data with a description of criteria for the differential diagnosis of DI. Fifteen articles on differential diagnosis of DI were identified, mainly consisting of small series of patients, and mostly covering only part of the differential diagnostic spectrum of DI. Test protocols differed, and prospective validation of diagnostic criteria was consistently missing. Inconsistent data were reported on the diagnostic superiority of direct plasma arginine vasopressin determination over the indirect water deprivation test. Both test methods revealed limitations, especially in the differentiation of disorders with a milder phenotype. The available data demonstrate limitations of current biochemical tests for the differential diagnosis of DI, potentially leading to incorrect diagnosis and treatment. The newly available assay for copeptin, the C terminus of the vasopressin precursor, holds promise for a higher diagnostic specificity and simplification of the differential diagnostic protocol in DI.

Selection of Atypia/Follicular Lesion of Unknown Significance Patients for Surgery Versus Active Surveillance, Without Using Genetic Testing: A Single Institute Experience, Prospective Analysis, and Recommendations.

PubMed

Cohen, Oded; Tzelnick, Sharon; Lahav, Yonatan; Schindel, Doron; Halperin, Doron; Yehuda, Moshe

2017-07-01

Atypia/follicular lesion of unknown significance (AUS/FLUS) has variable rates of malignancy. The recommended management includes active surveillance (AS), repeated fine-needle aspiration (RFNA), diagnostic surgery, or genetic testing for malignancy. The objective of this study was to assess the management of AUS/FLUS patients in a dedicated thyroid clinic without implementing genetic testing. This was a single institute cohort study of all patients aged ≥18 years who underwent ultrasound-guided FNA thyroid biopsies between January 2009 and January 2013 and were followed until January 2016. The median follow-up time was 4.6 years (range 3.2-6.8 years). Forty-eight (57%) patients were referred to AS, and 36 (43%) patients were referred for diagnostic surgery. Thirty-six (75%) patients from the AS group underwent RFNA. An additional eight patients from the AS group subsequently underwent diagnostic surgery. Malignancies were found in 15/44 (34%) diagnostic surgical samples, and benign cytologies were found in 61.1% of the RFNAs. Analysis of adherence to follow-up in the 36 AS patients showed an adherence rate of only 53%, with males tending to comply better than females did (31.6% vs. 5.8%, respectively; p = 0.052), especially males in their sixth decade of life. Genetic tests for AUS/FLUS patients are accepted today as complementary evaluations in many well-developed health systems. Yet, when these tests are not feasible due to financial or availability issues, careful management of AUS/FLUS patients may still offer good results in the selection of patients for surgery or AS. The present results also indicate that compliance to follow-up schedules is a major consideration when selecting patients for AS.

Diagnostic imaging in paraneoplastic autoimmune multiorgan syndrome: retrospective single site study and literature review of 225 patients.

PubMed

Lehman, Vance T; Barrick, Benjamin J; Pittelkow, Mark R; Peller, Patrick J; Camilleri, Michael J; Lehman, Julia S

2015-04-01

The utility of diagnostic imaging in paraneoplastic autoimmune multiorgan syndrome (PAMS) is unknown. We examined the role of diagnostic imaging in patients with PAMS evaluated at our tertiary referral center (at Mayo Clinic, Rochester, MN, USA) and in the English literature between January 1, 1996, and August 31, 2012. We included 17 patients from our institution and 208 patients from the literature review. Of these 225 patients, 113 (50.2%) were not known to have a malignancy diagnosis at the time of PAMS diagnosis. Of the 123 patients from our institution and from the literature reported to undergo imaging studies, conventional computed tomography (CT) was the predominant imaging modality (n = 110; 89.4%); 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT was also used, albeit infrequently (n = 12; 9.8%). When CT was included in imaging to identify or confirm the presence of a malignancy, imaging was successful in all patients who ultimately were diagnosed with an associated malignancy. At our institution, a relatively high percentage (n = 7; 41%) of patients had 18F-FDG PET/CT, which not only identified all tumors found on CT but also facilitated staging of lymphoma and guided biopsy procedures. Diagnostic imaging is frequently utilized in PAMS with unknown malignancy. Both conventional CT and 18F-FDG PET/CT are likely to detect the typical underlying neoplasms. Relative to conventional CT, 18F-FDG PET/CT may provide additional useful information regarding prognosis for the likely underlying malignancies, although there is a paucity of reports describing the use of this modality for this purpose. © 2014 The International Society of Dermatology.

Metabolic screening and metabolomics analysis in the Intellectual Developmental Disorders Mexico Study.

PubMed

Ibarra-González, Isabel; Rodríguez-Valentín, Rocío; Lazcano-Ponce, Eduardo; Vela-Amieva, Marcela

2017-01-01

Inborn errors of metabolism (IEM) are genetic conditions that are sometimes associated with intellectual developmental disorders (IDD). The aim of this study is to contribute to the metabolic characterization of IDD of unknown etiology in Mexico. Metabolic screening using tandem mass spectrometry and fluorometry will be performed to rule out IEM. In addition, target metabolomic analysis will be done to characterize the metabolomic profile of patients with IDD. Identification of new metabolomic profiles associated with IDD of unknown etiology and comorbidities will contribute to the development of novel diagnostic and therapeutic schemes for the prevention and treatment of IDD in Mexico.

Malignant Melanoma Presenting as a Mediastinal Malignant Melanoma Presenting as a Mediastinal Unknown Primary Origin?

PubMed

Pujani, Mukta; Hassan, Mohd Jaseem; Jetley, Sujata; Raina, Prabhat Kumar; Kumar, Mukesh

2017-01-01

The most common site of primary malignant melanoma is the skin, however, virtually any organ system may be involved. Metastatic melanoma of unknown primary origin accounts for approximately 2-6% of all melanoma cases. The mediastinum as the site for malignant melanoma is extremely rare, both as a primary or metastatic lesion. Primary malignant melanoma of mediastinum is very rare with only a handful of reports in the literature. We hereby report a rare case of malignant melanoma of mediastinum in a 31 year old male who was initially misdiagnosed on fine needle aspiration cytology as adenocarcinoma for which he received chemotherapy with clinical deterioration. Even on extensive meticulous search, no primary was discovered.

Diagnostic Value of the Serum Anti-Toxocara IgG Titer for Ocular Toxocariasis in Patients with Uveitis at a Tertiary Hospital in Korea

PubMed Central

Bae, Ki Woong; Ahn, Seong Joon; Park, Kyu Hyung

2016-01-01

Purpose This study evaluated the prevalence of ocular toxocariasis (OT) in patients with uveitis of unknown etiology who visited a tertiary hospital in South Korea and assessed the success of serum anti-Toxocara immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) as a diagnostic test for OT. Methods The records of consecutive patients with intraocular inflammation of unknown etiology were reviewed. All participants underwent clinical and laboratory investigations, including ELISA for serum anti-Toxocara IgG. OT was diagnosed based on typical clinical findings. Clinical characteristics, seropositivity, and IgG titers were compared between patients diagnosed with OT and non-OT uveitis. The seropositivity and the diagnostic value of anti-Toxocara IgG was investigated among patients with different types of uveitis. Results Of 238 patients with uveitis of unknown etiology, 71 (29.8%) were diagnosed with OT, and 80 (33.6%) had positive ELISA results for serum anti-Toxocara IgG. The sensitivity and specificity of the ELISA test were 91.5% (65 / 71) and 91.0% (152 / 167), respectively. The positive predictive value of the serum anti-Toxocara IgG assay was 81.3%. Among patients with anterior, intermediate, posterior, and panuveitis, the prevalence rates of OT were 8.3%, 47.1%, 44.8%, and 7.1%, respectively; the seropositivity percentages were 18.1%, 47.1%, 43.7%, and 17.9%; and the positive predictive values were 38.5%, 95.8%, 92.1%, and 40.0%. The serum anti-Toxocara IgG titer also significantly decreased following albendazole treatment. Conclusions OT is a common cause of intraocular inflammation in the tertiary hospital setting. Considering that OT is more prevalent in intermediate and posterior uveitis, and that the positive predictive value of the anti-Toxocara IgG assay is high, a routine test for anti-Toxocara IgG might be necessary for Korean patients with intermediate and posterior uveitis. PMID:27478352

Diagnostic Value of the Serum Anti-Toxocara IgG Titer for Ocular Toxocariasis in Patients with Uveitis at a Tertiary Hospital in Korea.

PubMed

Bae, Ki Woong; Ahn, Seong Joon; Park, Kyu Hyung; Woo, Se Joon

2016-08-01

This study evaluated the prevalence of ocular toxocariasis (OT) in patients with uveitis of unknown etiology who visited a tertiary hospital in South Korea and assessed the success of serum anti-Toxocara immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) as a diagnostic test for OT. The records of consecutive patients with intraocular inflammation of unknown etiology were reviewed. All participants underwent clinical and laboratory investigations, including ELISA for serum anti-Toxocara IgG. OT was diagnosed based on typical clinical findings. Clinical characteristics, seropositivity, and IgG titers were compared between patients diagnosed with OT and non-OT uveitis. The seropositivity and the diagnostic value of anti-Toxocara IgG was investigated among patients with different types of uveitis. Of 238 patients with uveitis of unknown etiology, 71 (29.8%) were diagnosed with OT, and 80 (33.6%) had positive ELISA results for serum anti-Toxocara IgG. The sensitivity and specificity of the ELISA test were 91.5% (65 / 71) and 91.0% (152 / 167), respectively. The positive predictive value of the serum anti-Toxocara IgG assay was 81.3%. Among patients with anterior, intermediate, posterior, and panuveitis, the prevalence rates of OT were 8.3%, 47.1%, 44.8%, and 7.1%, respectively; the seropositivity percentages were 18.1%, 47.1%, 43.7%, and 17.9%; and the positive predictive values were 38.5%, 95.8%, 92.1%, and 40.0%. The serum anti-Toxocara IgG titer also significantly decreased following albendazole treatment. OT is a common cause of intraocular inflammation in the tertiary hospital setting. Considering that OT is more prevalent in intermediate and posterior uveitis, and that the positive predictive value of the anti-Toxocara IgG assay is high, a routine test for anti-Toxocara IgG might be necessary for Korean patients with intermediate and posterior uveitis.

11. Photographic copy of photograph, photographer unknown, 2 July 1938 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Photographic copy of photograph, photographer unknown, 2 July 1938 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "Inspecting concrete on upstream face of Keechelus Dam spillway. Joseph Jacobs, consulting engineer; M.B. Lemon, Gatetender; Paul Taylor, assistant engineer; and C.H. Paul, consulting engineer." - Keechelus Dam, Spillway, Yakim River, 10 miles northwest of Easton, Easton, Kittitas County, WA

Iron overload patients with unknown etiology from national survey in Japan.

PubMed

Ikuta, Katsuya; Hatayama, Mayumi; Addo, Lynda; Toki, Yasumichi; Sasaki, Katsunori; Tatsumi, Yasuaki; Hattori, Ai; Kato, Ayako; Kato, Koichi; Hayashi, Hisao; Suzuki, Takahiro; Kobune, Masayoshi; Tsutsui, Miyuki; Gotoh, Akihiko; Aota, Yasuo; Matsuura, Motoo; Hamada, Yuzuru; Tokuda, Takahiro; Komatsu, Norio; Kohgo, Yutaka

2017-03-01

Transfusion is believed to be the main cause of iron overload in Japan. A nationwide survey on post-transfusional iron overload subsequently led to the establishment of guidelines for iron chelation therapy in this country. To date, however, detailed clinical information on the entire iron overload population in Japan has not been fully investigated. In the present study, we obtained and studied detailed clinical information on the iron overload patient population in Japan. Of 1109 iron overload cases, 93.1% were considered to have occurred post-transfusion. There were, however, 76 cases of iron overload of unknown origin, which suggest that many clinicians in Japan may encounter some difficulty in correctly diagnosing and treating iron overload. Further clinical data were obtained for 32 cases of iron overload of unknown origin; median of serum ferritin was 1860.5 ng/mL. As occurs in post-transfusional iron overload, liver dysfunction was found to be as high as 95.7% when serum ferritin levels exceeded 1000 ng/mL in these patients. Gene mutation analysis of the iron metabolism-related genes in 27 cases of iron overload with unknown etiology revealed mutations in the gene coding hemojuvelin, transferrin receptor 2, and ferroportin; this indicates that although rare, hereditary hemochromatosis does occur in Japan.

Leaping into the Unknown: Developing Thinking in the Primary Science Classroom

ERIC Educational Resources Information Center

Serret, Natasha

2004-01-01

The original project, the foundation for all subsequent work, was set up in 1981 by Michael Shayer, with Philip Adey and Carolyn Yates, and became known as CASE @ KS3 (Adey and Shayer, 1994). CASE stands for Cognitive Acceleration through Science Education. The original CASE project drew on Piaget's work on the stage theory of cognitive…

12. Photocopy of photograph (original photograph in possession of 30th ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. Photocopy of photograph (original photograph in possession of 30th Audiovisual Squadron, Vandenberg Air Force Base, California). Photography by United States Air Force, date unknown. LAUNCH OF AN ATLAS FROM SLC-3. MOBILE SERVICE TOWER (MST) IN PARKED POSITION. - Vandenberg Air Force Base, Space Launch Complex 3, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

42. Photocopy of photograph (negative made from original photograph displayed ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

42. Photocopy of photograph (negative made from original photograph displayed in office at Veterans Administration in Wichita, Kansas), photographer unknown, ca. 1935. Panoramic of campus, view of north and east, Building 8 is first structure on right - Veterans Administration Center, Officers Duplex Quarters, 5302 East Kellogg (Legal Address); 5500 East Kellogg (Common Address), Wichita, Sedgwick County, KS

43. Photographic copy of photograph (ca. 1962, original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

43. Photographic copy of photograph (ca. 1962, original print in possession of Peter Kiewit Sons' Co., Omaha, Nebraska) Photographer unknown. View of launch closure, launch closure apron at left, personnel access hatch open at right - Ellsworth Air Force Base, Delta Flight, 10 mile radius around Exit 127 off Interstate 90, Interior, Jackson County, SD

84. Photocopy of Photograph (original located in Univ. of Denver ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

84. Photocopy of Photograph (original located in Univ. of Denver collection). C.R. Savage, Photographer, date unknown. ROCK CREEK SIPHON, TWIN FALLS COUNTY, SOUTH OF KIMBERLY, IDAHO; WEST VIEW OF SIPHON PIPE. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

85. Photocopy of Photograph (original located in Univ. of Denver ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

85. Photocopy of Photograph (original located in Univ. of Denver collection). C.R. Savage, Photographer, date unknown. ROCK CREEK SIPHON, TWIN FALLS COUNTY, SOUTH OF KIMBERLY, IDAHO; EAST VIEW OF SIPHON PIPE. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

83. Photocopy of Photograph (original located in Univ. of Denver ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

83. Photocopy of Photograph (original located in Univ. of Denver collection). C.R. Savage, Photographer, date unknown. DRY CREEK GATES, TWIN FALLS COUNTY, SOUTH OF MURTAUGH, IDAHO; GATES FROM THE LOWER SIDE. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

12. Photocopy of photograph (original photograph in possession of Atlanta ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. Photocopy of photograph (original photograph in possession of Atlanta Housing Authority, Atlanta, GA). Photographer unknown, circa 1945. View across park and playground between Techwood Homes and Clark Howell Homes, facing west with Clark Howell Homes in background. - Clark Howell Homes (Public Housing), Bounded by North Avenue, Lovejoy Street, Mills Street & Luckie Street, Atlanta, Fulton County, GA

12. Photocopy of antique postcard. (Original postcard is in the ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. Photocopy of antique postcard. (Original postcard is in the possession of the Venice Branch of the Los Angeles Public Library, publisher/photographer unknown.) VIEW OF PRE-EXISTING GRAND CANAL COURT PEDESTRIAN BRIDGE OVER CARROLL CANAL, LOOKING EAST TOWARD DELL AVENUE VEHICULAR BRIDGE - Venice Canals, Community of Venice, Los Angeles, Los Angeles County, CA

9. Photographic copy of photograph (circa 1908, original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photographic copy of photograph (circa 1908, original print in Archives, Public Affairs Department, Sears Merchandise Group, Hoffman Estates, Illinois), Photographer unknown. OVERALL VIEW OF PRINTING AND ADVERTISING BUILDING, ADMINISTRATION BUILDING, AND MERCHANDISE BUILDING, VIEW TO WEST-SOUTHWEST - Sears Roebuck & Company Mail Order Plant, Bounded by Lexington & Grenshaw Streets, Kedzie Avenue & Independence Boulevard, Chicago, Cook County, IL

130. Photographic copy of drawing (undated, original drawing in Archives, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

130. Photographic copy of drawing (undated, original drawing in Archives, Public Affairs Department, Sears Merchandise Group, Hoffman Estates, Illinois). Engineer unknown. Full size. Pneumatic tube cartridges used at the time of the Plant closing. 4' PNEUMATIC TUBE SYSTEM - 11' LEATHER CARRIER - Sears Roebuck & Company Mail Order Plant, Merchandise Building, 924 South Homan Avenue, Chicago, Cook County, IL

131. Photographic copy of drawing (undated, original drawing in Archives, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

131. Photographic copy of drawing (undated, original drawing in Archives, Public Affairs Department, Sears Merchandise Group, Hoffman Estates, Illinois). Engineer unknown. Full size. Pneumatic tube cartridges used at the time of the Plant closing. 4' PNEUMATIC TUBE SYSTEM - 11' LEATHER CARRIER - Sears Roebuck & Company Mail Order Plant, Merchandise Building, 924 South Homan Avenue, Chicago, Cook County, IL

Earth observations taken by the STS-9 crew

NASA Image and Video Library

2009-06-25

STS009-35-1622 (28 Nov-8 Dec 1983) --- In the Coral Sea to the last of Australia?s Great Barrier Reed, a massive area is covered with floating material. Its origin is presently unknown nor is it known to be of biological origin or man-made. However, it covers thousands of square miles, thus massive, and is unreported.

25. Photocopy of a photograph (original print in the collection ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

25. Photocopy of a photograph (original print in the collection of the New Hampshire Water Resources Board, Concord, New Hampshire) 1927, photographer unknown 2 3/8 X 4 inch negative VIEW OF THE NORTH END OF THE OLD TIMBER DAM AT DAM SITE No. 3 - Claremont Village Industrial District, Between B, Claremont, Sullivan County, NH

15. Photocopy of photograph (original 43/4 x 33/4 inch print ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

15. Photocopy of photograph (original 4-3/4 x 3-3/4 inch print located in the Recreation files, Mt. Baker-Snoqualmie N. F.). Photographer unknown, ca. 1941 SKI WARMING HUT, AUSTIN PASS, GLACIER DISTRICT. (NOTE PLANK SPANNING GAP BETWEEN KNOLL AND PORCH) - Austin Pass Warming Hut, Washington Highway 542, Glacier, Whatcom County, WA

The avian-origin H3N2 canine influenza virus has limited replication in swine

USDA-ARS?s Scientific Manuscript database

A genetically and antigenically distinct H3N2 canine influenza of avian-origin was detected in March of 2015 in Chicago, Illinois. A subsequent outbreak was reported with over 1,000 dogs in the Midwest affected. The potential for canine-to-swine transmission was unknown. Experimental infection in pi...

35. Photographic copy of historic photo, c1915 (original print in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

35. Photographic copy of historic photo, c1915 (original print in Still Photo Branch of the National Archives, RG-155-JC, Washington, DC; photographer unknown). FRONT VIEW OF BOISE PROJECT OFFICE SHOWING UNITED STATES RECLAMATION SERVICE BOISE PROJECT CLERICAL AND ENGINEERING STAFF. - Boise Project, Boise Project Office, 214 Broadway, Boise, Ada County, ID

Radiation therapy in the management of head-and-neck cancer of unknown primary origin: how does the addition of concurrent chemotherapy affect the therapeutic ratio?

PubMed

Chen, Allen M; Farwell, D Gregory; Lau, Derick H; Li, Bao-Qing; Luu, Quang; Donald, Paul J

2011-10-01

To determine how the addition of cisplatin-based concurrent chemotherapy to radiation therapy influences outcomes among a cohort of patients treated for head-and-neck cancer of unknown primary origin. The medical records of 60 consecutive patients treated by radiation therapy for squamous cell carcinoma of the head and neck presenting as cervical lymph node metastasis of occult primary origin were reviewed. Thirty-two patients (53%) were treated by concurrent chemoradiation, and 28 patients (47%) were treated by radiation therapy alone. Forty-five patients (75%) received radiation therapy after surgical resection, and 15 patients (25%) received primary radiation therapy. Thirty-five patients (58%) were treated by intensity-modulated radiotherapy. The 2-year estimates of overall survival, local-regional control, and progression-free survival were 89%, 89%, and 79%, respectively, among patients treated by chemoradiation, compared to 90%, 92%, and 83%, respectively, among patients treated by radiation therapy alone (p > 0.05, for all). Exploratory analysis failed to identify any subset of patients who benefited from the addition of concurrent chemotherapy to radiation therapy. The use of concurrent chemotherapy was associated with a significantly increased incidence of Grade 3+ acute and late toxicity (p < 0.001, for both). Concurrent chemoradiation is associated with significant toxicity without a clear advantage to overall survival, local-regional control, and progression-free survival in the treatment of head-and-neck cancer of unknown primary origin. Although selection bias cannot be ignored, prospective data are needed to further address this question. Copyright © 2011 Elsevier Inc. All rights reserved.

The Right Place at the Right Time: Priming Facial Expressions with Emotional Face Components in Developmental Visual Agnosia

PubMed Central

Aviezer, Hillel; Hassin, Ran. R.; Perry, Anat; Dudarev, Veronica; Bentin, Shlomo

2012-01-01

The current study examined the nature of deficits in emotion recognition from facial expressions in case LG, an individual with a rare form of developmental visual agnosia (DVA). LG presents with profoundly impaired recognition of facial expressions, yet the underlying nature of his deficit remains unknown. During typical face processing, normal sighted individuals extract information about expressed emotions from face regions with activity diagnostic for specific emotion categories. Given LG’s impairment, we sought to shed light on his emotion perception by examining if priming facial expressions with diagnostic emotional face components would facilitate his recognition of the emotion expressed by the face. LG and control participants matched isolated face components with components appearing in a subsequently presented full-face and then categorized the face’s emotion. Critically, the matched components were from regions which were diagnostic or non-diagnostic of the emotion portrayed by the full face. In experiment 1, when the full faces were briefly presented (150 ms), LG’s performance was strongly influenced by the diagnosticity of the components: His emotion recognition was boosted within normal limits when diagnostic components were used and was obliterated when non-diagnostic components were used. By contrast, in experiment 2, when the face-exposure duration was extended (2000 ms), the beneficial effect of the diagnostic matching was diminished as was the detrimental effect of the non-diagnostic matching. These data highlight the impact of diagnostic facial features in normal expression recognition and suggest that impaired emotion recognition in DVA results from deficient visual integration across diagnostic face components. PMID:22349446

Benefits and Costs of Context Reinstatement in Episodic Memory: An ERP Study.

PubMed

Bramão, Inês; Johansson, Mikael

2017-01-01

This study investigated context-dependent episodic memory retrieval. An influential idea in the memory literature is that performance benefits when the retrieval context overlaps with the original encoding context. However, such memory facilitation may not be driven by the encoding-retrieval overlap per se but by the presence of diagnostic features in the reinstated context that discriminate the target episode from competing episodes. To test this prediction, the encoding-retrieval overlap and the diagnostic value of the context were manipulated in a novel associative recognition memory task. Participants were asked to memorize word pairs presented together with diagnostic (unique) and nondiagnostic (shared) background scenes. At test, participants recognized the word pairs in the presence and absence of the previously encoded contexts. Behavioral data show facilitated memory performance in the presence of the original context but, importantly, only when the context was diagnostic of the target episode. The electrophysiological data reveal an early anterior ERP encoding-retrieval overlap effect that tracks the cost associated with having nondiagnostic contexts present at retrieval, that is, shared by multiple previous episodes, and a later posterior encoding-retrieval overlap effect that reflects facilitated access to the target episode during retrieval in diagnostic contexts. Taken together, our results underscore the importance of the diagnostic value of the context and suggest that context-dependent episodic memory effects are multiple determined.

Psychometric properties of the Generalized Anxiety Disorder Inventory in a Canadian sample.

PubMed

Henderson, Leigh C; Antony, Martin M; Koerner, Naomi

2014-05-01

The Generalized Anxiety Disorder Inventory is a recently developed self-report measure that assesses symptoms of generalized anxiety disorder. Its psychometric properties have not been investigated further since its original development. The current study investigated its psychometric properties in a Canadian student/community sample. Exploratory principal component analysis replicated the original three-component structure. The total scale and subscales demonstrated excellent internal consistency reliability (α = 0.84-0.94) and correlated strongly with the Penn State Worry Questionnaire (r = 0.41-0.74, all ps <0.001) and Generalized Anxiety Disorder-7 (r = 0.55-0.84, all ps <0.001). However, only the total scale and cognitive subscale (r = 0.48-0.49, all ps <0.05) significantly predicted generalized anxiety disorder diagnosis established by diagnostic interview. The somatic subscale in particular may require revision to improve predictive validity. Revision may also be necessary given changes in required somatic symptoms for generalized anxiety disorder diagnostic criteria in more recent versions of the Diagnostic and Statistical Manual of Mental Disorders (i.e. although major changes occurred from Diagnostic and Statistical Manual of Mental Disorders-III-R to Diagnostic and Statistical Manual of Mental Disorders-IV, changes in Diagnostic and Statistical Manual of Mental Disorders-5 were minimal) and the possibility of changes in the upcoming 11th revision of the International Classification of Diseases.

Guidelines for the diagnosis and treatment of idiopathic pulmonary fibrosis. Sociedad Española de Neumología y Cirugía Torácica (SEPAR) Research Group on Diffuse Pulmonary Diseases.

PubMed

Xaubet, Antoni; Ancochea, Julio; Bollo, Elena; Fernández-Fabrellas, Estrella; Franquet, Tomás; Molina-Molina, Maria; Montero, Maria Angeles; Serrano-Mollar, Anna

2013-08-01

Idiopathic pulmonary fibrosis is defined as a chronic fibrosing interstitial pneumonia limited to the lung, of unknown cause, with poor prognosis and few treatment options. In recent years there has been an increase in their prevalence, probably due to the optimization of diagnostic methods and increased life expectancy. The ATS/ERS Consensus (2000) established the diagnostic criteria and recommendations for the assessment of the disease course and treatment. Later studies have helped to redefine diagnostic criteria and treatment options. In 2011, an international consensus was published, establishing diagnostic criteria and new treatment strategies. These guidelines have been updated with the newest aspects of diagnosis and treatment of idiopathic pulmonary fibrosis. A level of evidence has been identified for the most relevant questions, particularly with regard to treatment options. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

The Etiologies and Clinical Characteristics of Patients Hospitalized with an Acute Febrile Illness and Central Nervous System Sydromes in Indonesia

PubMed Central

Aman, Abu Tholib; Gasem, Muhammad Hussein; Tjitra, Emiliana; Alisjahbana, Bachti; Kosasih, Herman; Merati, Ketut Tuti; Arif, Mansyur; Karyana, Muhammad; Sudarmono, Pratiwi; Suharto, Suharto; Lisdawati, Vivi; Neal, Aaron; Siddiqui, Sophia

2017-01-01

Abstract Background Acute febrile illness is a common reason for hospitalization in many developing countries, including Indonesia. While patients can often be categorized and managed based on clinical presentations, diagnostic capacity in these countries remains limited, leading to poor patient outcomes. For patients with central nervous system (CNS) infections, identifying the underlying etiologies is particularly important to prevent lifelong neurological complications and death. Methods As part of a study conducted at 8 top-referral hospitals across Indonesia from 2013 to 2016, 114 of 1,486 enrolled subjects presented with an acute fever and a CNS syndrome. To identify the etiologies and clinical manifestations of these infections, as well as the management of febrile patients at the hospitals, demographic and clinical data were collected at enrollment, and blood samples were collected for diagnostic testing at enrollment, once during days 14–28, and at 3 months after enrollment. Results Subject ages ranged from 1 to 63.2 years old (median of 4.9 years old), and underlying diseases were reported in 35 (30.7%) subjects. Standard-of-care, molecular, and serological testing identified pathogens in 56 (49.1%) cases, as detailed in the table. Of the 19 subjects who died, 18 presented with decreased consciousness and 5 were infected with Rickettsia typhi, which was clinically misdiagnosed in each case. Conclusion The findings from this study will improve the diagnosis and treatment of patients presenting with CNS syndromes in Indonesia. Additionally, the discovery of misdiagnosed, fatal etiologies highlights the general need for greater diagnostic testing capacity to aid clinicians and inform public health policy makers. Acute febrile patients with neurological signs and symptoms Consciousness status (n) Normal (61) Decreased (53) Mortality (%) 1.6 34 End-of-study status (n) Discharged (60) Died (1) Discharged (35) Died (18) Etiology (n) Unknown (32) Unknown (1) Unknown (16) Unknown (9) HHV-6 (9) Dengue (5) R. typhi (5) Dengue (8) HHV-6 (3) Dengue (1) Chikungunya (5) Influenza (2) Influenza (1) Influenza (3) E. faecalis (2) Salmonella spp. (1) K. pneumoniae 
(1) Chikungunya 
(1) S. pneumoniae 
(1) Amoeba (1) Leptospira spp. (1) S. Typhi (1) E. coli (1) S. Aureus (1) Seoul Virus (1) S.Typhi (1) RSV (1) Disclosures All authors: No reported disclosures.

First among Equals: Hybridization of Cognitive Diagnostic Assessment and Evidence-Centered Game Design

ERIC Educational Resources Information Center

Leighton, Jacqueline P.; Chu, Man-Wai

2016-01-01

The objective of the present article is to explore differences and similarities between cognitive diagnostic assessment (CDA) and evidence-centered game design (ECgD) in the service of intentional hybridization. Although some testing specialists might argue that both are essentially the same given their origins in principled assessment design and…

Use and Misuse of Speech Diagnostics for African American Students

ERIC Educational Resources Information Center

Baugh, John

2015-01-01

Many African American students have been tested using speech pathology diagnostics that are ill suited to their distinctive linguistic circumstances. Slave descendants of African origin share a unique linguistic heritage in contrast and comparison to every other immigrant group residing within America. In an effort to overcome the legacy of…

Sliding Mode Observer-Based Current Sensor Fault Reconstruction and Unknown Load Disturbance Estimation for PMSM Driven System.

PubMed

Zhao, Kaihui; Li, Peng; Zhang, Changfan; Li, Xiangfei; He, Jing; Lin, Yuliang

2017-12-06

This paper proposes a new scheme of reconstructing current sensor faults and estimating unknown load disturbance for a permanent magnet synchronous motor (PMSM)-driven system. First, the original PMSM system is transformed into two subsystems; the first subsystem has unknown system load disturbances, which are unrelated to sensor faults, and the second subsystem has sensor faults, but is free from unknown load disturbances. Introducing a new state variable, the augmented subsystem that has sensor faults can be transformed into having actuator faults. Second, two sliding mode observers (SMOs) are designed: the unknown load disturbance is estimated by the first SMO in the subsystem, which has unknown load disturbance, and the sensor faults can be reconstructed using the second SMO in the augmented subsystem, which has sensor faults. The gains of the proposed SMOs and their stability analysis are developed via the solution of linear matrix inequality (LMI). Finally, the effectiveness of the proposed scheme was verified by simulations and experiments. The results demonstrate that the proposed scheme can reconstruct current sensor faults and estimate unknown load disturbance for the PMSM-driven system.

Autism Spectrum Disorder Reclassified: A Second Look at the 1980s Utah/UCLA Autism Epidemiologic Study

PubMed Central

Miller, Judith S.; Farley, Megan; Coon, Hilary; Pinborough-Zimmerman, Judith; Jenson, William; Rice, Catherine E.; Fombonne, Eric; Pingree, Carmen B.; Ritvo, Edward; Ritvo, Riva-Ariella; McMahon, William M.

2015-01-01

The purpose of the present study was to re-examine diagnostic data from a state-wide autism prevalence study (n = 489) conducted in the 1980s to investigate the impact of broader diagnostic criteria on autism spectrum disorder (ASD) case status. Sixty-four (59 %) of the 108 originally “Diagnosed Not Autistic” met the current ASD case definition. The average IQ estimate in the newly identified group (IQ = 35.58; SD = 23.01) was significantly lower than in the original group (IQ = 56.19 SD = 21.21; t = 5.75; p < .0001). Today’s diagnostic criteria applied to participants ascertained in the 1980s identified more cases of autism with intellectual disability. The current analysis puts this historic work into context and highlights differences in ascertainment between epidemiological studies performed decades ago and those of today. PMID:22696195

Clarification of radiation-control regulations for diagnostic x-ray equipment

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

Not Available

The Office of Compliance and Surveillance of the Center for Devices and Radiological Health (CDRH) has received many requests for interpretation of the Federal regulations that relate to diagnostic x-ray equipment. Responses to these requests were originally issued as FDA Compliance Policy Guides, industry-wide letters, and letters to individuals. The document is a compilation of those responses that remain applicable. Guides or opinions that have been withdrawn or are now obsolete because they have been incorporated into the regulations are not included. The document consists of two sections: the General section, which contains information of a general nature; and themore » Specific section, which contains information specific to particular sections of the Federal Performance Standard for Diagnostic X-ray Equipment (21 CFR 1020.30-32). When the term 'Revised Language' appears in an item heading, it indicates English grammar correction; the term 'Revised' indicates an updated version of the original clarification.« less

Clinical, morphological, and molecular characterization of Penicillium canis, sp. nov., isolated from a dog with osteomyelitis

USDA-ARS?s Scientific Manuscript database

Infections caused by Penicillium spp. are rare in dogs, and the prognosis in these cases is poor. An unknown species of Penicillium was isolated from a bone lesion in a young dog with osteomyelitis of the right ilium. Extensive diagnostic evaluation did not reveal evidence of dissemination. Resoluti...

The Accuracy of the ADOS-2 in Identifying Autism among Adults with Complex Psychiatric Conditions

ERIC Educational Resources Information Center

Maddox, Brenna B.; Brodkin, Edward S.; Calkins, Monica E.; Shea, Kathleen; Mullan, Katherine; Hostager, Jack; Mandell, David S.; Miller, Judith S.

2017-01-01

The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), Module 4 is considered a "gold-standard" instrument for diagnosing autism spectrum disorder (ASD) in adults. Although the ADOS-2 shows good sensitivity and specificity in lab-based settings, it is unknown whether these results hold in community clinics that serve a more…

Resolution of an immunodiagnostic dilemma: Heavy chain chimeric antibodies for species in which plasmocytomas are unknown

USDA-ARS?s Scientific Manuscript database

The immunoglobulin (Ig) genes of many vertebrates have been characterized but IgG subclasses, IgD and IgE proteins are only available for three species in which plasmacytomas occur. This creates a major problem in the production and specificity verification of diagnostic anti-Ig reagents for the vas...

Does magnetic resonance imaging produce further benefit for detecting a bleeding source in subarachnoid hemorrhage of unknown origin?

PubMed

Maslehaty, Homajoun; Petridis, Athanassios K; Barth, Harald; Doukas, Alexandros; Mehdorn, Hubertus Maximilian

2011-01-01

Spontaneous subarachnoid hemorrhage (SAH) without evidence of a bleeding source on the first digital subtraction angiogram (DSA) - also called SAH of unknown origin - is observed in up to 27% of all cases. Depending on the bleeding pattern on CT scanning, SAH can be differentiated into perimesencephalic (PM-SAH) and non-perimesencephalic SAH (NON-PM-SAH). The aim of our study was to investigate the effectiveness of magnetic resonance imaging (MRI) for detecting a bleeding source in SAH of unknown origin. We retrospectively reviewed 1,226 patients with spontaneous SAH between January 1991 and December 2008 in our department. DSA was performed in 1,068 patients, with negative results in 179 patients. Forty-seven patients were categorized as having PM-SAH and 132 patients as having NON-PM-SAH. MRI of the brain and the craniocervical region was performed within 72 h after diagnosis of SAH and demonstrated no bleeding sources in any of the PM-SAH and NON-PM-SAH patients (100% negative). In our experience MRI did not produce any additional benefit for detecting a bleeding source after SAH with a negative angiogram. The costs of this examination exceeded the clinical value. Despite our results MRI should be discussed on a case-by-case basis because rare bleeding sources are periodically diagnosed in cases of NON-PM-SAH.

Unintentional drinking-water contamination events of unknown origin: surrogate for terrorism preparedness.

PubMed

Winston, Gary; Leventhal, Alex

2008-01-01

Drinking-water is a direct conduit to many human receptors. An intentional attack (e.g. terrorism) on drinking-water systems can shock and disrupt elements of national infrastructures. We report on an unintentional drinking-water contamination event that occurred in Tel Aviv, Israel in July, 2001. Initially of unknown origin, this event involved risk management strategies used by the Ministry of Health for abating a potential public health crisis as might be envisaged of water contamination due to terrorism. In an abrupt event of unknown origin, public health officials need to be responsible for the same level of preparedness and risk communication. This is emphasized by comparison of management strategies between the Tel Aviv event and one of dire consequences that occurred in Camelford, England in 1988. From the onset of the Tel Aviv incident, the public health strategy was to employ the precautionary principle by warning residents of the affected region to not drink tap water, even if boiled. This strategy was in contrast to an earlier crisis that occurred in Camelford, England in 1988. An outcome of this event was heightened awareness that a water crisis can occur in peacetime and not only in association with terrorism. No matter how minor the contamination event or short-term the disruption of delivery of safe drinking-water, psychological, medical and public health impact could be significant.

Diagnostic Value of Transthoracic Echocardiography in Patients With Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

PubMed Central

Li, Rong-Juan; Sun, Zhonghua; Yang, Jiao; Yang, Ya; Li, Yi-Jia; Leng, Zhao-Ting; Liu, Guo-Wen; Pu, Li-Hong

2016-01-01

Abstract Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality associated with early infant mortality and sudden death in adults. Transthoracic echocardiography (TTE) plays an important role in early detection and diagnosis of ALCAPA as a noninvasive modality. However, its diagnostic value is not well studied. The purpose of this study is to determine the performance of TTE in the diagnostic assessment of ALCAPA as compared with coronary CT and invasive coronary angiography. A total of 22 patients (13 women and 9 men, mean age, 12.9 ± 19.5 years) with ALCAPA who underwent echocardiographic examination for clinical diagnosis were retrospectively reviewed and analyzed. Transthoracic echocardiographic features of ALCAPA were analyzed and its diagnostic value was compared with invasive coronary angiography and coronary CT angiography (CTA) with surgical findings serving as the gold standard. Surgery was performed in all of the patients to establish the dual coronary artery system. Five underwent the Takeuchi procedure and 17 had re-implantation of the anomalous left coronary artery. Of 20 patients, echocardiographic diagnoses were in good agreement with findings at surgery, resulting in the diagnostic accuracy of 90.9%. Two cases were misdiagnosed—one as the right coronary artery to pulmonary artery fistula and the other as rheumatic heart disease. The echocardiographic features of these patients with ALCAPA included: abnormal left coronary ostium arising from the pulmonary trunk with retrograde coronary artery flow in 20 patients; enlargement of the right coronary artery in 17 patients; abundant intercoronary septal collaterals in 17 patients; and moderate and significant mitral regurgitation in 14 patients. The diagnostic accuracy of invasive coronary angiography (in 17 patients) and coronary CTA (in 9 patients) was 100%. This study shows that TTE is an accurate, noninvasive imaging modality for displaying the origin of coronary arteries and demonstrating the coronary courses as well as other associated abnormalities in patients with ALCAPA. PMID:27082616

Nuclear Species-Diagnostic SNP Markers Mined from 454 Amplicon Sequencing Reveal Admixture Genomic Structure of Modern Citrus Varieties

PubMed Central

Curk, Franck; Ancillo, Gema; Ollitrault, Frédérique; Perrier, Xavier; Jacquemoud-Collet, Jean-Pierre; Garcia-Lor, Andres; Navarro, Luis; Ollitrault, Patrick

2015-01-01

Most cultivated Citrus species originated from interspecific hybridisation between four ancestral taxa (C. reticulata, C. maxima, C. medica, and C. micrantha) with limited further interspecific recombination due to vegetative propagation. This evolution resulted in admixture genomes with frequent interspecific heterozygosity. Moreover, a major part of the phenotypic diversity of edible citrus results from the initial differentiation between these taxa. Deciphering the phylogenomic structure of citrus germplasm is therefore essential for an efficient utilization of citrus biodiversity in breeding schemes. The objective of this work was to develop a set of species-diagnostic single nucleotide polymorphism (SNP) markers for the four Citrus ancestral taxa covering the nine chromosomes, and to use these markers to infer the phylogenomic structure of secondary species and modern cultivars. Species-diagnostic SNPs were mined from 454 amplicon sequencing of 57 gene fragments from 26 genotypes of the four basic taxa. Of the 1,053 SNPs mined from 28,507 kb sequence, 273 were found to be highly diagnostic for a single basic taxon. Species-diagnostic SNP markers (105) were used to analyse the admixture structure of varieties and rootstocks. This revealed C. maxima introgressions in most of the old and in all recent selections of mandarins, and suggested that C. reticulata × C. maxima reticulation and introgression processes were important in edible mandarin domestication. The large range of phylogenomic constitutions between C. reticulata and C. maxima revealed in mandarins, tangelos, tangors, sweet oranges, sour oranges, grapefruits, and orangelos is favourable for genetic association studies based on phylogenomic structures of the germplasm. Inferred admixture structures were in agreement with previous hypotheses regarding the origin of several secondary species and also revealed the probable origin of several acid citrus varieties. The developed species-diagnostic SNP marker set will be useful for systematic estimation of admixture structure of citrus germplasm and for diverse genetic studies. PMID:25973611

Nuclear species-diagnostic SNP markers mined from 454 amplicon sequencing reveal admixture genomic structure of modern citrus varieties.

PubMed

Curk, Franck; Ancillo, Gema; Ollitrault, Frédérique; Perrier, Xavier; Jacquemoud-Collet, Jean-Pierre; Garcia-Lor, Andres; Navarro, Luis; Ollitrault, Patrick

2015-01-01

Most cultivated Citrus species originated from interspecific hybridisation between four ancestral taxa (C. reticulata, C. maxima, C. medica, and C. micrantha) with limited further interspecific recombination due to vegetative propagation. This evolution resulted in admixture genomes with frequent interspecific heterozygosity. Moreover, a major part of the phenotypic diversity of edible citrus results from the initial differentiation between these taxa. Deciphering the phylogenomic structure of citrus germplasm is therefore essential for an efficient utilization of citrus biodiversity in breeding schemes. The objective of this work was to develop a set of species-diagnostic single nucleotide polymorphism (SNP) markers for the four Citrus ancestral taxa covering the nine chromosomes, and to use these markers to infer the phylogenomic structure of secondary species and modern cultivars. Species-diagnostic SNPs were mined from 454 amplicon sequencing of 57 gene fragments from 26 genotypes of the four basic taxa. Of the 1,053 SNPs mined from 28,507 kb sequence, 273 were found to be highly diagnostic for a single basic taxon. Species-diagnostic SNP markers (105) were used to analyse the admixture structure of varieties and rootstocks. This revealed C. maxima introgressions in most of the old and in all recent selections of mandarins, and suggested that C. reticulata × C. maxima reticulation and introgression processes were important in edible mandarin domestication. The large range of phylogenomic constitutions between C. reticulata and C. maxima revealed in mandarins, tangelos, tangors, sweet oranges, sour oranges, grapefruits, and orangelos is favourable for genetic association studies based on phylogenomic structures of the germplasm. Inferred admixture structures were in agreement with previous hypotheses regarding the origin of several secondary species and also revealed the probable origin of several acid citrus varieties. The developed species-diagnostic SNP marker set will be useful for systematic estimation of admixture structure of citrus germplasm and for diverse genetic studies.

[Tracing investigation and diagnosis of one transfusion-transmitted malaria case in Zhejiang Province].

PubMed

Ruan, Wei; Lei, Yong-Liang; Yao, Li-Nong; Zhang, Ling-Ling; Liu, Xiao-Hong; Xiang, Xiao-Qing; Mei, Jian-Hua; Zhu, Hai-Bo; Yu, Yang; Zeng, Chang-You

2014-02-01

To identify the sources of infection and the mode of transmission of a malaria case with unknown origin. Clinical data of the case were collected and the epidemiological investigation was conducted. The blood samples of the patient and the suspected infection source (blood donor) were detected by microscopy, rapid diagnostic test strip (RDT) and nested PCR. The patient did not visited malaria endemic areas. After a blood transfusion, the patient had chills and fever, and was confirmed as falciparum malaria by microscopy with bone marrow and peripheral blood smears and RDT. The blood donor was a worker returned from Africa. Before blood donation she was sick like malaria carrier, and took anti-malarial drug. She was then confirmed as falciparum malaria by RDT and microscopy. The blood samples from the patient and the blood donor were diagnosed as falciparum malaria by nested PCR, and the similarity of the small subunit rRNA (SSU rRNA) sequence was 100%, showing they were mix-infected with K1 and MAD20 genotypes of Plasmodium falciparum. This patient is confirmed P. falciparum infection via blood transfusion from a donor who returned from Africa.

NUP160-SLC43A3 is a novel recurrent fusion oncogene in angiosarcoma.

PubMed

Shimozono, Naoki; Jinnin, Masatoshi; Masuzawa, Mamiko; Masuzawa, Mikio; Wang, Zhongzhi; Hirano, Ayaka; Tomizawa, Yukiko; Etoh-Kira, Tomomi; Kajihara, Ikko; Harada, Miho; Fukushima, Satoshi; Ihn, Hironobu

2015-11-01

Angiosarcoma is a malignant vascular tumor originating from endothelial cells of blood vessels or lymphatic vessels. The specific driver mutations in angiosarcoma remain unknown. In this study, we investigated this issue by transcriptome sequencing of patient-derived angiosarcoma cells (ISO-HAS), identifying a novel fusion gene NUP160-SLC43A3 found to be expressed in 9 of 25 human angiosarcoma specimens that were examined. In tumors harboring the fusion gene, the duration between the onset of symptoms and the first hospital visit was significantly shorter, suggesting more rapid tumor progression. Stable expression of the fusion gene in nontransformed human dermal microvascular endothelial cells elicited a gene-expression pattern mimicking ISO-HAS cells and increased cell proliferation, an effect traced in part to NUP160 truncation. Conversely, RNAi-mediated attenuation of NUP160 in ISO-HAS cells decreased cell number. Confirming the oncogenic effects of the fusion protein, subcutaneous implantation of NUP160-SLC43A3-expressing fibroblasts induced tumors resembling human angiosarcoma. Collectively, our findings advance knowledge concerning the genetic causes of angiosarcoma, with potential implications for new diagnostic and therapeutic approaches. ©2015 American Association for Cancer Research.

Soft Tissue Tumours of the Retroperitoneum

PubMed Central

Van Roggen, J. Frans Graadt

2000-01-01

Purpose. This review summarizes the more prevalent soft tissue tumours arising in the retroperitoneum and highlights some recent fundamental and diagnostic developments relevant to mesenchymal tumours. Discussion. The retroperitoneum is an underestimated site for benign and malignant neoplastic disease, and represents the second most common site of origin of primary malignant soft tissue tumours (sarcomas) after the deep tissues of the lower extremity. In contrast to the predominance of benign soft tissue lesions over malignant sarcomas elsewhere, retroperitoneal mesenchymal lesions are far more likely to be malignant. The differential diagnosis is primarily with the more common lymphoproliferative and parenchymatous epithelial lesions arising in this area, and with metastatic disease from known or unknown primary sites elsewhere.The most prevalent mesenchymal tumours at this site are of a lipomatous, myogenic or neural nature.Their generally late clinical presentation and poorly accessible location provides numerous clinical challenges; optimal radiological imaging and a properly performed biopsy are essential cogs in the management route. Histopathological diagnosis may be complicated, but has been aided by developments in the fields of immunohistochemistry and tumour (cyto)genetics. Despite significant advances in oncological management protocols, the prognosis remains generally less favourable than for similar tumours at more accessible sites. PMID:18521430

The `TTIME' Package: Performance Evaluation in a Cluster Computing Environment

NASA Astrophysics Data System (ADS)

Howe, Marico; Berleant, Daniel; Everett, Albert

2011-06-01

The objective of translating developmental event time across mammalian species is to gain an understanding of the timing of human developmental events based on known time of those events in animals. The potential benefits include improvements to diagnostic and intervention capabilities. The CRAN `ttime' package provides the functionality to infer unknown event timings and investigate phylogenetic proximity utilizing hierarchical clustering of both known and predicted event timings. The original generic mammalian model included nine eutherian mammals: Felis domestica (cat), Mustela putorius furo (ferret), Mesocricetus auratus (hamster), Macaca mulatta (monkey), Homo sapiens (humans), Mus musculus (mouse), Oryctolagus cuniculus (rabbit), Rattus norvegicus (rat), and Acomys cahirinus (spiny mouse). However, the data for this model is expected to grow as more data about developmental events is identified and incorporated into the analysis. Performance evaluation of the `ttime' package across a cluster computing environment versus a comparative analysis in a serial computing environment provides an important computational performance assessment. A theoretical analysis is the first stage of a process in which the second stage, if justified by the theoretical analysis, is to investigate an actual implementation of the `ttime' package in a cluster computing environment and to understand the parallelization process that underlies implementation.

Rotating plasma structures in the cross-field discharge of Hall thrusters

NASA Astrophysics Data System (ADS)

Mazouffre, Stephane; Grimaud, Lou; Tsikata, Sedina; Matyash, Konstantin

2016-09-01

Rotating plasma structures, also termed rotating spokes, are observed in various types of low-pressure discharges with crossed electric and magnetic field configurations, such as Penning sources, magnetron discharges, negative ion sources and Hall thrusters. Such structures correspond to large-scale high-density plasma blocks that rotate in the E×B drift direction with a typical frequency on the order of a few kHz. Although such structures have been extensively studied in many communities, the mechanism at their origin and their role in electron transport across the magnetic field remain unknown. Here, we will present insights into the nature of spokes, gained from a combination of experiments and advanced particle-in-cell numerical simulations that aim at better understanding the physics and the impact of rotating plasma structures in the ExB discharge of the Hall thruster. As rotating spokes appear in the ionization region of such thrusters, and are therefore difficult to probe with diagnostics, experiments have been performed with a wall-less Hall thruster. In this configuration, the entire plasma discharge is pushed outside the dielectric cavity, through which the gas is injected, using the combination of specific magnetic field topology with appropriate anode geometry.

Ligand-Sensitive But Not Ligand-Diagnostic: Evaluating Cr Valence-to-Core X-ray Emission Spectroscopy as a Probe of Inner-Sphere Coordination

PubMed Central

2015-01-01

This paper explores the strengths and limitations of valence-to-core X-ray emission spectroscopy (V2C XES) as a probe of coordination environments. A library was assembled from spectra obtained for 12 diverse Cr complexes and used to calibrate density functional theory (DFT) calculations of V2C XES band energies. A functional dependence study was undertaken to benchmark predictive accuracy. All 7 functionals tested reproduce experimental V2C XES energies with an accuracy of 0.5 eV. Experimentally calibrated, DFT calculated V2C XES spectra of 90 Cr compounds were used to produce a quantitative spectrochemical series showing the V2C XES band energy ranges for ligands comprising 18 distinct classes. Substantial overlaps are detected in these ranges, which complicates the use of V2C XES to identify ligands in the coordination spheres of unknown Cr compounds. The ligand-dependent origins of V2C intensity are explored for a homologous series of [CrIII(NH3)5X]2+ (X = F, Cl, Br, and I) to rationalize the variable intensity contributions of these ligand classes. PMID:25496512

The diagnostic value of interleukin-6 and interleukin-8 for early prediction of bacteremia and sepsis in children with febrile neutropenia and cancer.

PubMed

Urbonas, Vincas; Eidukaitė, Audronė; Tamulienė, Indrė

2012-03-01

Early diagnosis of sepsis in children with febrile neutropenia and cancer still remains a challenge for modern medicine because of lack of specific laboratory markers and clinical signs especially at the beginning of the infection. The objective of this study was to evaluate the ability of interleukin-6 and interleukin-8 to predict bacteremia and sepsis during the first 2 days in oncohematologic patients with febrile neutropenia. A total of 61 febrile neutropenic episodes in 37 children were studied. Serum samples were collected on day 1 and day 2 from the onset of fever and analyzed using an automated random access analyzer. Neutropenic children with febrile episodes were classified into the following 2 groups: (1) fever of unknown origin group--patients with a negative blood culture--and (2) bacteremia/sepsis group--patients with a positive blood culture or clinical sepsis. High negative predictive values were found on day 1 for interleukin-6 and interleukin-8 (89% and 82%, respectively) for exclusion of bacteremia/sepsis. These interleukins could be used as a screening tool for the rejection of sepsis or bacteremia on the first day of fever in neutropenic children with cancer.

Tenebrio beetles use magnetic inclination compass

NASA Astrophysics Data System (ADS)

Vácha, Martin; Drštková, Dana; Půžová, Tereza

2008-08-01

Animals that guide directions of their locomotion or their migration routes by the lines of the geomagnetic field use either polarity or inclination compasses to determine the field polarity (the north or south direction). Distinguishing the two compass types is a guideline for estimation of the molecular principle of reception and has been achieved for a number of animal groups, with the exception of insects. A standard diagnostic method to distinguish a compass type is based on reversing the vertical component of the geomagnetic field, which leads to the opposite reactions of animals with two different compass types. In the present study, adults of the mealworm beetle Tenebrio molitor were tested by means of a two-step laboratory test of magnetoreception. Beetles that were initially trained to memorize the magnetic position of the light source preferred, during the subsequent test, this same direction, pursuant geomagnetic cues only. In the following step, the vertical component was reversed between the training and the test. The beetles significantly turned their preferred direction by 180°. Our results brought until then unknown original findings that insects, represented here by the T. molitor species, use—in contrast to another previously researched Arthropod, spiny lobster—the inclination compass.