Serious complications due to coronary artery fistulae have been described. Most authors recommend early intervention at the time of diagnosis. We present a case of a fistula originating from a dilated left coronary artery and draining into the right atrium, which was diagnosed prenatally by color Doppler echocardiography. During pregnancy, the echocardiographic findings remained unchanged, and there were no signs of heart failure. After birth, the fistula was confirmed by angiography. Additionally, a persistent left superior vena cava draining into the coronary sinus and a very small ventricular septal defect were detected. The fistula was closed successfully by transcatheter coil embolization. At 17 months old the child was in good clinical condition. Prenatal diagnosis of coronary artery fistulae may be possible and may improve perinatal management and outcome. PMID:12047543
Atrial septal defect closure is now routinely performed using a percutaneous approach under echocardiographic guidance. Centrally located, secundum defects are ideal for device closure but there is...Full Text Available
Background. The coexistence of neoplasm and abdominal aortic aneurysm (AAA) presents a real management challenge. This paper reviews the literature on the prevalence, diagnosis,...Full Text Available
Hepatocellular carcinoma (hcc) is an uncommon tumour, but its incidence is increasing in Canada and elsewhere. Currently, there are no Canadian recommendations for diagnosis and treatment of...Full Text Available
The early and precise diagnosis, the prognosis, and the clinical management of multiple sclerosis, remain a considerable challenge. In recent years, the development of novel and powerful proteomic...Full Text Available
Percutaneous renal biopsy (PRB) is a safe and effective tool in the diagnosis and management of renal disease. It is the gold standard for evaluating renal parenchymal disease. It is both useful for...Full Text Available
There is considerable evidence to suggest that the identification and treatment of dyslipidaemia will reduce the risk of premature CHD, i.e. before the age of 65. Diagnosis of the cause of raised plasma...Full Text Available
Background/Objectives:Imaging technology is an important part of the diagnosis and management of spinal trauma. Indications and findings in post-traumatic imaging of the vertebral...Full Text Available
Background:In 2007, the American College of Cardiology/American Heart Association (ACC/AHA) published new guidelines for the diagnosis and management of patients with unstable angina/non-ST...Full Text Available
Purpose: To report the detection of con-compacted ventricular myocardium (NVCM) with MRI compared to echocardiography in 8 patients. Material and methods: Non-compaction of the ventricular myocardium is a congenital disorder characterized by an altered structure of the myocardial wall resulting from an intrauterine arrest in endomyocardial embryogenesis. The morphological findings consist of a prominent meshwork of multiple myocardial trabeculations and deep intertrabecular recesses, communicating with the left ventricular cavity. 8 consecutive patients (mean age 7.3 years) with clinical and echocardiographic signs of NCVM were examined by MRI (1.5 T, Vision, Siemens) in short axis and 2- and 4-chamber views, using T_1-weighted TSE and Cine-GRE in 6 patients and true FISP sequences in 2 patients. MRI and echocardiography were evaluated for visibility, signs of NCVM and involvement of myocardial wall segments. Thickness was measured for non-compacted and compacted ...
Ovarian carcinoma is now the leading cause of death among women. Surgery has reached its limits, and further aggressive surgery will result in an inordinate morbidity and mortality. Ovarian carcinoma...Full Text Available
Objective: To highlight the key differences in history, examination, and management of pyoderma gangrenosum and necrotizing fasciitis and to outline the importance of distinguishing these...Full Text Available
Four infants with obstructive hydrocephalus caused by space occupying third ventricle and mesencephalic cysts are reported. Despite immediate shunt insertion in all patients, there was either lack of...Full Text Available
Currently, the outcome of patients with intermediate-and poor-risk germ cell tumors at diagnosis is optimized by the use of risk-appropriate chemotherapy and post-chemotherapy surgical resection of...Full Text Available
Pancreatic cysts are challenging lesions to diagnose and to treat. Determining which of the five most common diagnoses—pancreatic pseudocyst, serous cystic neoplasm (SCN), solid pseudopapillary...Full Text Available
Spontaneous rupture of membranes (ROM) is a normal component of labor and delivery. Premature ROM (PROM) refers to rupture of the fetal membranes prior to the onset of labor irrespective of gestational...Full Text Available
Coronary artery disease (CAD) is the single most common cause of death in the developed world, responsible for about 1 in every 5 deaths. The morbidity, mortality, and socioeconomic importance...Full Text Available
BackgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia with a population prevalence of about 1%. Natriuretic peptide level is elevated in patients with AF with...Full Text Available
OBJECTIVE—To validate the accuracy of the prognostic significance of non-invasive clinical diagnostic indices as predictors of sustained ventricular tachycardia (sVT) or fibrillation...Full Text Available
The aim of this thesis is the design of a faults diagnosis-aiding system in a nuclear facility of the Cea. Actually the existing system allows the optimization of the production processes in regular operating conditions. Meanwhile during accidental events, the alarms, managed by threshold, are bringing no relevant information. To increase the reliability and the safety, the human operator needs a faults diagnosis-aiding system. The developed system, SECAPI, combines problem solving techniques and automatic learning techniques, that allow the diagnosis and the the simulation of various faults happening on nuclear facilities. Its reasoning principle uses case-based and rules-based techniques. SECAPI owns a learning module which reads out knowledge connected with faults. It can then simulate various faults, using the inductive logical computing. SECAPI has been applied on a radioactive tritium treatment ...
Abstract Neurodegenerative and neurometabolic disorders may cause significant morbidity and mortality in children. Imaging is important in early diagnosis of metabolic disorders and in determining the extent of brain injury. Especially after the development of new techniques such as diffusion-weighted magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS), neuroimaging plays more important role in the diagnosis and management of these disorders. In these disorders, usually a mutation causes a clinically significant block in one or more metabolic pathways. This blockage usually results in either a deficiency of the product or in an accumulation of substrate with damage induced by either storage or toxicity. The presenting symptoms are usually nonspecific. In some of the ...
Because of the superior tissue contrast, high spatial resolution, and multiplanar capabilities, fetal magnetic resonance imaging (MRI) can depict fetal brain pathologies with high accuracy. Pathological fetal brain development may result from malformations or acquired conditions. Differentiation of these etiologies is important with respect to managing the actual pregnancy or counseling future pregnancies. As a widened ventricular system is a common hallmark of both maldevelopment and acquired conditions, it may cause problems in the differential diagnosis. Fetal MRI can provide detailed morphological information, which allows refinement of the diagnosis of ventricular enlargement in a large number of cases. Systematic work-up of morphological details that may be recognized on MR images provides an approach for achieving a correct diagnosis in cases of ventricle enlargement. (orig.)
The fault detection and diagnosis system for gas engines was developed to improve the reliability of cogeneration systems (CGS). Most of existing fault detection systems monitor the trend of each part condition of engines and diagnose faults based on trend change, resulting in slow detection. Although early detection systems are available, those are complex, expensive and poor in flexibility and applicability. Since CGSs combined with gas engines increased to 1/3 of the whole CGS, engine troubles cause possible serious faults. The fault diagnosis system was thus developed to prevent serious faults which can early detect, in particular, abnormal conditions of parts around a combustion chamber such as ignition plug, intake valve and exhaust valve by monitoring exhaust pressure waveforms in an exhaust collector. Since this system can detect progressive occurrence frequency of abnormal conditions and degradation of engine parts, it can transfer ...
Intravenous digital subtraction angiography using Fuji computed radiography system (FCR-DSA) was used to evaluate 57 preoperative patients with clinical manifestations of peripheral vascular disease of lower extremity. With its high contrast resolution and good special resolution, image of FCR-DSA could offer optimal information of vascular abnormality in lower extremity distal to midfoot for the diagnosis and the choice of management.
Intravenous digital subtraction angiography using Fuji computed radiography system (FCR-DSA) was used to evaluate 57 preoperative patients with clinical manifestations of peripheral vascular disease of lower extremity. With its high contrast resolution and good special resolution, image of FCR-DSA could offer optimal information of vascular abnormality in lower extremity distal to midfoot for the diagnosis and the choice of management. (orig.).
Radiotherapy has been reported to be of benefit in prolonging the survival of patients with cholangiocarcinoma. This study examined whether radiotherapy in addition to endoscopic stenting improved survival. The survival advantage of radiotherapy in those with a type II/III stricture is seen only in the first 10 months after diagnosis. The costs of radiotherapy and significantly increased time spent in hospital, however, raise doubts over its routine use in the management of non-resectable cholangiocarcinoma. (Author).
AimsTwo-dimensional echocardiographic (2DE) continuity-equation derived aortic valve area (AVA) in aortic stenosis (AS) relies on non-simultaneous measurement of left ventricular...Full Text Available
Gallstone is a common disease with a 10% prevalence in the United States and Western Europe. However, it is only symptomatic in 20-30% of patients, with biliary pain "colic" being the most common symptom. Complications of asymptomatic gallstone disease are generally rare, with an incidence of <1 %/yr. The most common complications of gallstone disease are acute cholecystitis, acute pancreatitis, ascending cholangitis, and gangrenous gallbladder. Less frequent complications include Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Mirizzi syndrome and cholecystocholedochal fistula are two manifestations of the same process that starts with impaction of a gallstone in the gallbladder neck that results in obstruction of the bile duct, causing jaundice. The gallstone may erode into the bile duct, causing cholecystocholedochal fistula. Gallstone ileus refers to small bowel obstruction resulting from the impaction of one or more gallstones after they have migrated ...
A diagnosis of dementia is devastating at any age but diagnosis in younger patients presents a particular challenge. The differential diagnosis is broad as late presentation of metabolic disease...Full Text Available
The purpose of this study is to clarify the confusing nomenclature and pathogenesis of Developmental Facial Paralysis, and how it can be differentiated from other causes of facial paralysis present at birth. Differentiating developmental from traumatic facial paralysis noted at birth is important for determining prognosis, but also for medicolegal reasons. Given the dramatic presentation of this condition, accurate and reliable guidelines are necessary in order to facilitate early diagnosis and initiate appropriate therapy, while providing support and counselling to the family. The 30 years experience of our center in the management of developmental facial paralysis is dependent upon a thorough understanding of facial nerve embryology, anatomy, nerve physiology, and an appreciation of well...
Introduction: The orofacial clefts include 30 variant according to Tessier classification: the number 30 contain mandibular arc damage isolated or associated with damage of surrounding soft tissue. Case report: Our patient was a newborn with median mandibular cleft associated with ankyloglossia, bifid tongue and a top cervical fistula. We have not found polymalformative syndrome. The early surgical management included one time and after-effect were simple within 11months. Discussion: We point up difficulties for antenatal diagnosis and controversy about appropriate time for management of bone defect. The last physiopathologic hypotheses were explicated.
Purpose: To report the detection of con-compacted ventricular myocardium (NVCM) with MRI compared to echocardiography in 8 patients. Material and methods: Non-compaction of the ventricular myocardium is a congenital disorder characterized by an altered structure of the myocardial wall resulting from an intrauterine arrest in endomyocardial embryogenesis. The morphological findings consist of a prominent meshwork of multiple myocardial trabeculations and deep intertrabecular recesses, communicating with the left ventricular cavity. 8 consecutive patients (mean age 7.3 years) with clinical and echocardiographic signs of NCVM were examined by MRI (1.5 T, Vision, Siemens) in short axis and 2- and 4-chamber views, using T{sub 1}-weighted TSE and Cine-GRE in 6 patients and true FISP sequences in 2 patients. MRI and echocardiography were evaluated for visibility, signs of NCVM and involvement of myocardial wall segments. Thickness was measured for non-compacted and ...
Accurate diagnosis of local invasion of hilar cholangiocarcinomas is challenging due to their small size and the anatomic complexity of the hepatic hilar region. On the other hand, the correct diagnosis of local invasion is essential for assuring the possibility of curative surgery. The purpose of this study was to evaluate the feasibility of four-channel multidetector-row computed tomography (MDCT) in the assessment of vascular and bile duct involvement, by which we could obtain useful information for the surgical management of hilar cholangiocarcinoma. The subjects were 18 patients for whom the extent of tumor invasion was surgically and pathologically confirmed. All patients underwent preoperative multiphasic CT scanning by MDCT. Arterial and portal dominant phases were acquired using a detector configuration of 1.25 mm x 4 mm, and both axial and multiplanar reconstructed images were interpreted. Longitudinal extension ...
The authors assess the role of Computed Topography in the diagnosis and management of multiple myeloma (MM) and investigate if Computed Tomography findings can influence the clinical approach, prognosis and treatment. 273 multiple myeloma patients submitted to Computed Tomography June 1994, to December, 1996. The patients were 143 men and 130 women (mean age: 65 years): 143 were stage I, 38 stage II and 92 stage III according to Durie and Salomon's clinical classification. All patients were submitted to blood tests, spinal radiography and Computed Tomography, the latter with serial 5-mm scans on several vertebral bodies. Computed Tomography despicted vertebral arch and process involvement in 3 cases with the vertebral pedicle sign. Moreover, Computed Tomography proved superior to radiography in showing the spread of myelomatous masses into the soft tissues in a case with solitary permeative lesion in the left public bone, which facilitated ...
BackgroundMetastases to the stomach from an extra-gastric neoplasm are an unusual event, identified in less than 2% of cancer patients at autopsy. The stomach may be involved by hematogenous spread from a distant primary (most commonly breast, melanoma or lung), or by contiguous spread from an adjacent malignancy, such as the pancreas, esophagus and gallbladder. These latter sites may also involve the stomach via lymphatic or haematogenous spread. We present three cases of secondary gastric malignancy.Methods/ResultsThe first is a 19-year-old male who received a diagnosis of testicular choriocarcinoma in September 2004. Metastatic malignancy was demonstrated in the stomach after partial gastrectomy was performed to control gastric hemorrhage.The second is a 75-year-old male, generally well, who was diagnosed with adenocarcinoma of the lung in September 2005. Poorly differentiated adenocarcinoma of the lung was demonstrated in a subsequent biopsy of "gastric ...
We used computerized tomography (CT) in the study of eight patients with macronodular splenic tuberculosis prior to the microbiological diagnosis. These patients underwent additional CT controls during and after tuberculostatic therapy. All the patients studed presented the acquired immunodeficiency syndrome (AIDS). Splenomegaly and numerosous round, hypodense lesions that showed no contrast uptake were found in all the subjects. Only three patients presented evidence of tuberculosis in plain radiography and/or chest X-ray. Two patients presented abdominal lymph nodes. None of them showed evidence of hepatic lesions or ascites. follow-up CT scans revealed a progressive reduction of the lesions, which eventually disappeared completely, and splenomegaly was considerably reduced. Anthough it is uncommon, we should suspect splenic involvement in tuberculosis if the clinical and radiological contexts are appropriate. CT provides excellent monitoring of the efficacy of ...
Spinal Ewing's sarcomas are rare and cause problems in differential diagnosis. The radiologic, nuclear medicine and CT findings in two children with histologically proven Ewing's sarcoma are presented and problems in differential diagnosis discussed. Biopsy should be done early. (orig.).
Asymptomatic cholelithiasis is increasingly diagnosed today, mainly as a result of the widespread use of abdominal ultrasonography for the evaluation of patients for unrelated or vague abdominal complaints. About 10-20% of people in most western countries have gallstones, and among them 50-70% are asymptomatic at the time of diagnosis. Asymptomatic gallstone disease has a benign natural course; the progression of asymptomatic to symptomatic disease is relatively low, ranging from 10-25%. The majority of patients rarely develop gallstone-related complications without first having at least one episode of biliary pain ("colic"). In the prelaparoscopy era, (open) cholecystectomy was generally performed for symptomatic disease. The minimally invasive laparoscopic cholecystectomy refueled the discussion about the optimal management of asymptomatic cholelithiasis. Despite some controversy, most authors agree that the vast majority of subjects should ...
Purpose. To examine the impact of residual limb osteomyelitis (RLO) on the rehabilitation of lower limb amputees. Method. Retrospective review of the casenotes of patients with RLO. Information sought included details of amputation, clinical features of investigations for and management of RLO and its effect on rehabilitation. Results. There were seven transfemoral and three transtibial amputees. Indications for amputation were vascular disease in nine cases, trauma in one. In each case, delayed wound healing or residual limb pain prompted radiological, hematological and microbiological investigations. Average time between amputation and diagnosis was 187 days. One patient died before treatment commenced. Two transtibial amputees were treated with intravenous antibiotics while rehabilitati...
Unilateral diaphragmatic paralysis was diagnosed in 2 preterm neonates born at 29 and 25 weeks of gestation, respectively. In both instances, the pathophysiology was phrenic nerve injury after extravasation of parenteral nutrition fluid. Misplacement and infection were predisposing factors. Diaphragmatic movement analysis by time-motion-mode ultrasonography was helpful in achieving a diagnosis. The first neonate required a diaphragmatic placation, whereas the other infant was managed nonoperatively. These cases confirm a rare etiology of diaphragmatic paralysis and possible spontaneous recovery. In neonates with very low birth weight, general anesthesia and thoracic surgery may be associated with a high morbidity, suggesting that nonoperative medical treatment, when possible, is preferable...
Background/Purpose: Congenital esophageal stenosis (CES) is a rare malformation. Endoscopic dilations represent a therapeutic option. This study retrospectively evaluated the efficacy and safety of a conservative treatment of CES. Patients and Methods: Patients diagnosed with CES since 1980 by a barium study or endoscopy were reviewed. Endoscopic ultrasonography (Olympus UM-3R-20-MHz radial miniprobe, Olympus Corporation, Tokyo, Japan), available from 2001, allowed for the differential diagnosis of tracheobronchial remnants (TBR) and fibromuscular hypertrophy (FMH) CES. All children underwent conservative treatment by endoscopic dilations (hydrostatic and Savary). Results: Forty-seven patients (20 men) had CES. Fifteen were associated with esophageal atresia; and 8, with Down syndrome. Mea...
Active contrast material extravasation can be recognized with conventional CT scanners, though it has been considered a rare finding. Helical CT seems to increase the detection rate and especially to boost the radiologist's confidence in this diagnosis. Though active bleeding is defined in severely-injured subjects requiring urgent intervention and may be associated with findings of hypovolaemic shock, it should not be considered itself as a negative prognostic factor. Contrast extravasation is due to ongoing hemorrhage and its detection is critical for urged treatment. Accurate anatomical location permits to choose surgical management or transcatheter embolization and thus decreases time consumption for precis e bleeding site identification.
In recent years, Obesity (defined as Body Mass Index > 30 kg/m2) has increased its prevalence reaching epidemic levels in countries such as The United States where it has became a national health issue. In Colombia the Obesity prevalence is figured around 14%. Treatment options for Obesity include life style modifications, pharmacologist management and surgical approach (Bariatric Surgery). This article describes a patient with previous bariatric surgery, who presents abdominal pain and melena owed to isquemic process of the alimentary limb caused by an internal hernia which is a potentially lethal condition if it is not highly suspected allowing its early diagnosis and treatment
Background Adrenal incidentaloma remains a diagnostic challenge. Despite well-established management guidelines, the long-term results of following these guidelines are unknown. We sought to determine how accurately these guidelines identify functioning incidentalomas and how often these guidelines result in adrenalectomy for benign tumors. Methods We catalogued adrenal incidentalomas from a retrospective review of 500 consecutive adrenalectomies at a single institution. The outcome measures studied were patient demographics, preoperative biochemical analysis, imaging characteristics, tumor size, type of operation performed, and postoperative histologic diagnosis. Results Eighty-one of the 500 adrenalectomies performed were for incidentalomas. Size was the only significant characteristic t...
Hepatocellular carcinoma (HCC) represents a major health problem as it afflicts an increasing number of patients worldwide. Albeit most of the risk factors for HCC are known, this is a deadly syndrome with a life expectancy at the time of diagnosis of less than 1?year. Definition of the molecular principles governing the neoplastic transformation of the liver is an urgent need to facilitate the clinical management of patients, based on innovative methods to detect the disease in its early stages and on more efficient therapies. In the present study, we have combined the analysis of a murine model and human samples of HCC to identify genes differentially expressed early in the process of hepatocarcinogenesis, using a microarray-based approach. Expression of 190 genes was impaired in murine ...
Background: Incidence, characteristics and predictive factors of transient ST-segment changes after DC shock are poorly known. Methods: 91 consecutive pts referred for external cardioversion of atrial fibrillation (AF) (61 men, 69+/-10yo) were prospectively included. The presence of ST elevation or depression was assessed on 12 lead-ECG immediately after the first DC shock. Correlations with DC shock characteristics (monophasic/biphasic and energy), clinical variables, echocardiographic parameters, biological parameters, medications, anesthesic drugs as well with morphological features were made. Results: 18 and 20 pts underwent 200J or 300J monophasic and 53 pts 200J biphasic DC shocks. We found an incidence of 48% for ST-segment changes: 35% for ST elevation and 13% for ST depression. ST...
Feline heartworm disease is a very different clinical entity from canine heartworm disease. In cats, the arrival and death of immature heartworms in the pulmonary arteries can cause coughing and dyspnea as early as 3 months postinfection. Adult heartworms suppress the function of pulmonary intravascular macrophages and thus reduce clinical disease in chronic feline heartworm infection. Approximately 80% of asymptomatic cats self-cure. Median survival time for symptomatic cats is 1.5 years, or 4 years if only cats living beyond the day of presentation are considered. Aberrant worm migration is more frequent than it is in dogs, and sudden death can occur with no prior clinical signs. The bacterial endosymbiont Wolbachia likely contributes to the inflammatory pathology of heartworm disease, but its role is not yet fully clear. Unfortunately, the diagnosis, treatment, and management of feline heartworm disease are far from simple. Antemortem ...
The currently available methods for the diagnosis of dry eye are still far from being perfect for a variety of reasons. This review attempts to highlight the advantages and disadvantages of both traditional...Full Text Available
A case of intrathoracic lipoma in a child is presented. The diagnosis was made before operation by means of computer-assisted tomography, a non-interventional procedure.
Malformations of the cerebral cortex are recognized as a common cause of developmental delay, neurological deficits, mental retardation and epilepsy. Currently, the diagnosis of cerebral cortical...Full Text Available
Acute vertebrobasilar occlusion (VBO) is associated with a high risk of stroke and death. Although local thrombolysis may achieve recanalization and improve outcome, mortality is still between 35% and 75%. However, without recanalization the chance of a good outcome is extremely poor, with mortality rates of 80-90%. Early treatment is a fundamental factor, but detailed studies of the exact time management of the diagnostic and interventional workflow are still lacking. Data on 18 patients were retrospectively evaluated. Time periods between symptom onset, admission to hospital, time of diagnosis, and beginning of intervention were correlated with postinterventional neurological status. The Glasgow Coma Scale and National Institute of Health Stroke Scale (NIHSS) were used to examine patients before and after local thrombolysis. Additionally, multivariate statistics were applied to reveal similarities between patients with neurological ...
Laparoscopic orchiopexy has gained popularity in recent years. However, the decision when to perform one-stage laparoscopic orchiopexy without division of the spermatic vessels versus initial ligation of the spermatic vessels followed later by orchiopexy is not clear. A new laparoscopic classification to facilitate decision-making during laparoscopy, according to the position of the impalpable testis and the relation of the spermatic vessels and vas deferens to the internal ring, with a management protocol based on this classification is presented. Over a 2-year period, a total of 37 boys with 52 impalpable gonads underwent a laparoscopic procedure. Four laparoscopic types of testis were noted: type I: no testis visualized; type II: a testis seen at the internal ring with the vas and vessels looping to the internal ring; type III: testis at the internal ring, with vas and vessels going to the testis directly; and type IV: intra-abdominal testis not related to the ...
Antiquitin (ATQ) deficiency is the main cause of pyridoxine dependent epilepsy characterized by early onset epileptic encephalopathy responsive to large dosages of pyridoxine. Despite seizure control most patients have intellectual disability. Folinic acid responsive seizures (FARS) are genetically identical to ATQ deficiency. ATQ functions as an aldehyde dehydrogenase (ALDH7A1) in the lysine degradation pathway. Its deficiency results in accumulation of ?-aminoadipic semialdehyde (AASA), piperideine-6-carboxylate (P6C) and pipecolic acid, which serve as diagnostic markers in urine, plasma, and CSF. To interrupt seizures a dose of 100mg of pyridoxine-HCl is given intravenously, or orally/enterally with 30mg/kg/day. First administration may result in respiratory arrest in responders, and thus treatment should be performed with support of respiratory management. To make sure that late and masked response is not missed, treatment with oral/enteral pyridoxine should be ...
The diagnostic imaging findings in hepatic amoebiasis and the capabilities of percutaneous drainage have already been described but some debate is open on both diagnosis and treatment. It is reported the experience with the ultrasound (US) and Computed Tomography (CT) studies of the hepatic amoebic abscess and its management. [Italian] I reperti con diagnostica per immagini nell'amebiasi epatica e le possibilita' del drenaggio percutaneo sono stati gia' illustrati; esistono tuttavia controversie sul piano sia diagnostico che terapeutico. Obiettivo di questo lavoro e' quello di riportare l'esperienza personale nella diagnostica con ecografia e tomografia computerizzata (TC) e nel trattamento degli ascessi amebici del fegato.
Experience in the diagnosis and treatment of infertility has led to an increased understanding of the prominent role male factors play in many couples' inability to conceive. While many forms of male factor infertility are amenable to treatment, for some patients there is no corrective therapy available. For this reason, a great deal of attention has been focused on developing technologies for semen processing and sperm utilization in cases of decreased semen quality. One area of research is the development of more sophisticated methods of assessing sperm function, as well as methods of sperm preparation. Progress is also being made in the application of technologies such as intrauterine insemination and in vitro fertilization in the treatment of male factor infertility. Such developments have improved prospects for fertility among patients suffering from decreased semen quality, as well as those suffering from such disorders as ejaculatory failure and congenital ...
Computer tomography used in the diagnosis of tumours is described in the light of particularly great diagnostic difficulties in children. Computer tomography was applied in 12 cases. A high diagnostic value of this method was demonstrated, which makes possible a more accurate diagnosis of the position of the tumour, its size, and expanding tendency. The possibility of estimating healthy tissues and organs, and those with pathological changes on the basis of differences in their density with a detection threshold at 0.5% density difference facilitates not infrequently preoperative diagnosis raising the value of the method.
Twenty-two out of 31 patients with chronic renal failure and secondary hyperparathyroidism who underwent parathyroidectomy before operation underwent non-invasive image diagnosis of parathyroid glands by computed tomography (CT), scintigraphy with /sup 201/TlCl and /sup 99m/TcO/sup 4 +/, and/or ultrasonography. CT visualized 39 of 45 parathyroid glands (86.7%), weighing more than 500 mg. Scintigraphy with a subtraction method using a computer performed the diagnosis in 19 of 27 glands (70.4%). Ultrasonography detected 21 of 27 glands (77.8%). Image diagnosis was also useful in the postoperative follow-up study. The non-invasive image diagnosis of parathyroid glands in patients with chronic renal failure is thus valuable for 1) definite diagnosis of secondary hyperparathyroidism, 2) localization, and 3) diagnosis for effectiveness of conservative treatment.
The method, use and results of computer-aided diagnosis of bone tumours and tumour-like skeletal abnormalities in childhood are described. One hundred and twentyone histologically verified cases were analysed and subjected to computer-aided diagnosis. Statistical methods were used, resulting in an accuracy of 96.7% and 91.7% respectively. In order to obtain additional confirmation of the diagnosis, a so-called growth rate was calculated by the computer. This proved to be a reliable criterion for evaluating the biological behaviour of tumours, irrespective of the histological diagnosis. The reasons for misdiagnosis were discussed. Attention is drawn to the importance of an accurate analysis of the radiographs and its input into the computer.
Aim: To evaluate the role of computed tomography (CT) in needle placement for ganglion impar blocks, and to determine the efficacy of CT-guided ganglion impar blocks in the management of coccydynia. Materials and methods: The results of ganglion impar blockade in eight patients with coccydynia secondary to trauma or unknown cause were reviewed. The diagnosis of coccydynia was based on clinical history, location of pain, and response to previous diagnostic and therapeutic procedures. The eight patients were treated with CT-guided ganglion impar blocks to manage their coccyx pain after conservative procedures, including oral medication and cushions, failed to provide relief. All patients were subjected to ganglion impar blocks under a thin-section CT-guided technique for needle placement, using a mixture of bupivacaine and triamcinolone. The patients were followed-up for a period of 6-months. Results: Eight patients were ...
The OASIS Registry started annual collection of longitudinal data on patients on home parenteral nutrition (HPN) in 1984. This report describes outcome profiles on 1594 HPN patients in seven disease categories. Analysis showed clinical outcome was principally a reflection of the underlying diagnosis. Patients with Crohn's disease, ischemic bowel disease, motility disorders, radiation enteritis, and congenital bowel dysfunction all had a fairly long-term clinical outcome, whereas those with active cancer and acquired immunodeficiency syndrome (AIDS) had a short-term outcome. The long-term group had a 3-year survival rate of 65 to 80%, they averaged 2.6 complications requiring hospitalization per year, and 49% experienced complete rehabilitation. The short-term group had a mean survival of 6 months; they averaged 4.6 complications per year and about 15% experienced complete rehabilitation. The registry data also indicated HPN was used for 19,700 patients in 1987 with ...
Program Plans, Implementation, & Results Energy Management at Federal Facilities Energy Management at DOE Fleet Management Interagency Coordination Interagency Energy...
Borrelial infection may manifest with a wide range of clinical signs, and in many cases, microbiological findings are essential for a proper diagnosis. This study included 48 patients with a working...Full Text Available
A 65-year-old woman who was diagnosed as having psoitis by CT findings, which disclosed non-symmetrical dilation of the psoas muscle and gaseous image. Pus from the psoas muscle seen at surgery corresponded to CT findings. Preoperative CT examination was useful in the establishment of diagnosis. (Namekawa, K.).
Between 1946 and 1976 over 9,000 women with breast cancer were seen within one year of diagnosis at the A. Maxwell Evans Clinic (AMEC) in Vancouver, British Columbia. By 1978, 275 had a subsequent diagnosis...Full Text Available
Prenatal diagnosis of junctional epidermolysis bullosa associated with pyloric atresia was carried out in a couple at risk. Their two previous children had died during the first months of life of the...Full Text Available
In the course of a prenatal diagnosis for beta thalassaemia by linkage analysis of restriction fragment length polymorphisms, a homozygous beta thalassaemia fetus was misdiagnosed as beta thalassaemia...Full Text Available
BackgroundThe diagnosis of typhoid fever is confirmed by culture of Salmonella enterica serotype Typhi (S. typhi). However, a more rapid, simpler,...Full Text Available
AIM: To improve the diagnosis of heterotopic pancreas by the use of contrast-enhanced computed tomography (CT) imaging and CT virtual endoscopy (CTVE).METHODS: A total of six patients with heterotopic...Full Text Available
A case of multifocal Langerhans cell histiocytosis in a two-year-old child is presented where fine needle aspiration was helpful in achieving a rapid and accurate diagnosis in an appropriate clinical...Full Text Available
Realization that dental caries is a reversible, dynamic biochemical event at a micron level has changed the way the profession recognizes the caries disease and the caries lesion. The diagnosis of dental...Full Text Available
Fast and efficient high-throughput techniques are essential for the molecular diagnosis of highly heterogeneous hereditary diseases, such as retinitis pigmentosa (RP). We had previously approached RP...Full Text Available
A commercial multiplex real-time PCR assay (Cepheid Xpert C. difficile assay) for the diagnosis of Clostridium difficile infection was evaluated. The sensitivity and...Full Text Available
New developments in the field of thoracic oncology have challenged the way pathologists approach the diagnosis of pulmonary carcinoma. Nonsmall cell carcinoma is no longer an adequate diagnostic category....Full Text Available
Seeking effective methods is one of the most important goals in machinery fault diagnosis. The effective methods for gear fault diagnosis have been successively developed in our Institute. This paper is a comprehensive treatise based on our research work of recent years. A mathematical model of vibration signals for defective gears is physically described. Five effective new methods for gear fault diagnosis, such as zoom complex envelope analysis, wideband demodulation technique, bispectrum analysis, correlative spectrum analysis, and maximum entropy spectrum analysis for phase modulated signals, are summarily presented. The listed illustrations prove sufficiently the validation of these methods.
This paper deals with the indications for prostatectomy; the differential diagnosis of the symptomatology of bladder neck obstruction; and the factors influencing the choice of operation....Full Text Available
... negative diplooocci, to determine the type of pneumococi, to study staphylococa proteas, ehigla, sallmnefla, pasteurella, brucela, linters, leptosp ,s ...
Herein we present an impact of diagnosis by enhanced multidetector-row computed tomography and magnetic resonance imaging for extrahepatic cholangiocarcinoma (ECC). Although the diagnosis against the longitudinal stromal extension and surrounding tissue invasion of ECC by multi detector row CT (MDCT) and MRI was very strict, we could not detect any superficial mucosal spread (SMS). Furthermore, the diagnosis of lymphnode metastasis by MDCT/MRI was miserable. We believe that misdiagnosis of SMS is permissible since positive mucosal but not stromal surgical margin was not a significant factor influencing the postoperative prognosis. However, further advances in imaging diagnosis for ECC is needed. (author)
The growth of a middle ear cholesteatoma behind a normal tympanic membrane is a rate though possible event. In such cases, CT may provide useful information for diagnosis. The results are presented of a CT study carried out on 14 patients affected with unilateral conductive hearing loss and with normal tympanic membrane. CT allowed the diagnosis of meddle ear cholesteatoma to be made in all cases. All patients were treated with surgery: 8 of them underwent tympanoplasty and 6 explorative tympanotomy. While the diagnosis of cholesteatoma was confirmed in 13 patients, in 1 case tympanosclerosis was diagnosed. CT diagnosis of middle ear cholesteatoma is based on the demonstration of a low-density soft-tissue mass, in association with bone erosion or ossicular dislocation. The author emphasizes the difficulty of a CT diagnosis of cholesteatoma in the patients with middle ear soft-tissue ...
Exposure to crystalline silica dust causes multiple diseases, but silicosis and silica dust-associated tuberculosis (TB), in particular, are the two diseases that remain high on the list of occupational health priorities in low-income countries and that still occur in some high-income countries. The prevalence of silica-related TB is exacerbated by the human immunodeficiency virus (HIV) epidemic in low-income countries. This review describes the morphology of silica and the variable potency of the different forms. Sources of crystalline silica are discussed, with emphasis on less commonly recognised sources, such as small-scale mining operations and agriculture. Trends in the prevalence of silicosis are also presented. Although efforts have been made for many years in most countries to reduce silica dust levels, silicosis continues to occur even in young people. The clinical and pathological features and diagnosis of silicosis, with emphasis on chest radiography, ...
As semiconductor device density and wafer area continue to increase, the volume of in-line and off-line data required to diagnose yield-limiting conditions is growing exponentially. To manage this data in the future, analysis tools will be required that can automatically reduce this data to useful information, e.g., by assisting the engineer in rapid root-cause diagnosis of defect generating mechanisms. In this paper, the authors describe a technology known as Spatial Signature Analysis (SSA) and its application to both optically-detected defect data as well as electrical test (e-test) bin data. The results of a validation study are summarized that demonstrate the effectiveness of the SSA approach on optical defect wafermaps through field-testing at three semiconductor manufacturing sites on ASIC, DRAM and SRAM products. This method has been extended to analyze and interpret electrical test data and to provide a pathway for correlation of this ...
Purpose: A retrospective analysis was undertaken to determine the indications for, the efficacy of, and the long-term complications of two courses of total skin electron beam therapy for mycosis fungoides. Methods and Materials: A retrospective analysis of 15 patients with the pathologic diagnosis of mycosis fungoides treated in the Department of Radiation Oncology at Stanford University Medical Center between 1968 and 1990 was performed. All patients received two courses of high-dose electron beam therapy to the skin. The mean dose for the total skin treatment for the first course was 32.6 Gy and 23.4 Gy for the second course of treatment. Results: Following the first course of total skin electron beam therapy, 11 of 15 had a complete response, with a mean duration of 11.6 months. All patients received adjuvant therapies between the first and second courses of high-dose total skin electron beam therapy. The mean interval between the first and the second courses of ...
This report was prepared in response to a request from the Nuclear Energy Research Advisory Committee (NERAC) subcommittee on ''Long-Term Isotope Research and Production Plans.'' The NERAC subcommittee has asked for a reply to a number of questions regarding (1) ''How well does the Department of Energy (DOE) infrastructure sme the need for commercial and medical isotopes?'' and (2) ''What should be the long-term role of the federal government in providing commercial and medical isotopes?' Our report addresses the questions raised by the NERAC subcommittee, and especially the 10 issues that were raised under the first of the above questions (see Appendix). These issues are related to the isotope products offered by the DOE Isotope Production Sites, the capabilities and condition of the facilities used to produce these products, the management of the isotope production ...
ObjectiveHIV and type 2 diabetes are known risk factors for albuminuria, but no previous reports have characterized albuminuria in HIV-infected patients with diabetes.Research Design and MethodsWe performed a cross-sectional study including 73 HIV-infected adults with type 2 diabetes, 82 HIV-infected non-diabetics, and 61 diabetic control subjects without HIV. Serum creatinine >1.5 mg/dL was exclusionary. Albuminuria was defined as urinary albumin/creatinine ratio >30 mg/g.ResultsThe prevalence of albuminuria was significantly increased among HIV-infected diabetics (34% vs. 13% of HIV non-diabetic vs. 16% diabetic control, p?=?0.005). HIV status and diabetes remained significant predictors of albuminuria after adjusting for age, race, BMI, and blood pressure. Albumin/creatinine ratio correlated significantly with HIV viral load (r?=?0.28, p?=?0.0005) and HIV-infected subjects with albuminuria had significantly greater cumulative exposure to abacavir (p?=?0.01). In an adjusted ...
"1"8F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan has been found to reflect tumor aggressiveness and prognosis in various types of cancer. However, pattern of FDG uptake in biliary malignancies and its clinical significance have not been studied well. The purpose of this study was to assess the additional value of "1"8F-FDG PET in differential diagnosis and prognosis of cholangiocarcinoma (CC) according to the tumor location and tumor morphology. From April 2005 to May 2008, eighty two patients (M:F=55:27, age 66.2#+-#9.6 yrs) with CC underwent "1"8F-FDG PET. For semiquantitative analysis, the maximum standardized uptake value (SUV_m_a_x) was obtained from the primary tumor. The difference of SUV_m_a_x according to the tumor location and tumor growth pattern, such as scirrhous type, nodular type, polypoid type were compared. Overall sensitivity of PET scan was 81.7% in CC. SUV_m_a_x on PET scan in intrahepatic CC was significantly ...
Active contrast material extravasation can be recognized with conventional CT scanners, though it has been considered a rare finding. Helical CT seems to increase the detection rate and especially to boost the radiologist's confidence in this diagnosis. Though active bleeding is defined in severely-injured subjects requiring urgent intervention and may be associated with findings of hypovolaemic shock, it should not be considered itself as a negative prognostic factor. Contrast extravasation is due to ongoing hemorrhage and its detection is critical for urged treatment. Accurate anatomical location permits to choose surgical management or transcatheter embolization and thus decreases time consumption for precis e bleeding site identification. [Italian] Lo stravaso attivo del mdc e' rilevabile anche con appropriate apparecchiature TC tradizionali, sebbene sia stato considerato raro. La TC sprirale sembra aumentare la frequanza ...
Respiratory allergy affects all age groups but the children are the worst affected by the respiratory allergy. Bioparticles from different biological sources are the main cause of allergy. Pollen grains, fungal spores, insect and other materials of biological origin form the most important allergen load in the air. For the efficient diagnosis of the allergy and its effective treatment it is very important to know about the prevalence, seasonal and annual variations of aeroallergens of the area. India being the climatically diversed country, there is diversity in the flora and fauna of different parts of the country. Atmospheric surveys carried out in different parts of India reveal that, Alanus nitida, Amarantus spinosus, Argemone mexicana Cocos nucifera, Betula utilis, Borasus flabellifer, Caraica papaya, Cedrus deodara, Cassia fistula, Parthenium, Chenopodium album, Dodonaea viscosa, Malotus phillipensis, Plantago ovata, Prosopis juliflora, Ricinus communis, ...
The management of risks of explosives are described. Administrative and procedural controls are considered. The safety management plan involves hazard identification, risk analysis, assessment and control. The current position of explosives safety is considered. 4 tabs.
The publication presents an outline of the subject of energy management and attempts to test the hypotheses that targeted knowledge management may result in new developments and potentials, and if these are at all desirable. On this basis, a knowledge management system will be developed that may effectively promote developments and potentials in the field of energy management. The tools and fundamentals of energy management are looked into, and the given situation and desired goals are identified by means of an enquiry. This is a scientific study that aims at providing empirical information on the situation and views on the subject of energy management. The analysis, which is supported by an enquiry sheet, is to provide a basis for testing the assumed hypothesis. Further, the potential acceptance and utilization potential of decisive knowledge ...
Advances in the diagnosis of Ewing's sarcoma of the rib were considered and retrospective analysis of the treatment of 32 patients (76% of them were children at the age of 10-15 y.o.) in the clinic of children oncology was performed. It was shown that the diagnosis of Ewing's sarcoma of the rib in children ought to be combined taking into account the course, morphology and radiation examination techniques. Most optimum treatment consisted of combined therapy (cyclic polychemotherapy, lesion focus irradiation at the summary focus dose of 57 Gy, surgery with subsequent polychemotherapy for not less than 1.5 years
Contributions to the population dose due to medical applications of ionising radiation are presented. It appears that contributions due to radiotherapy and X ray diagnosis are of comparable magnitude. To account for the age dependency of the radiation risks, contributions in terms of somatically significant dose equivalent are calculated as 0.3 mSv per caput per annum for X ray diagnosis and as 0.2 mSv per caput per annum for radiotherapy, the latter referring to only doses to organs outside the target volume. (author).
This paper presents the status of development of Korea standard method for Human Reliability Analysis (HRA), and proposed a standard procedure and rules for the evaluation of diagnosis error probability. The quality of KSNP HRA was evaluated using the requirement of ASME PRA standard guideline, and the design requirement for the standard HRA method was defined. Analysis procedure and rules, developed so far, to analyze diagnosis error probability was suggested as a part of the standard method. And also a study of comprehensive application was performed to evaluate the suitability of the proposed rules.
Three cases of primitive suprasellar germinomas are reported: the tumors show typical clinical signs (diabetes insipidus, disfunctions), but CT findings are not so specific. It is very important to reach a correct diagnosis based on clinical and radiological findings, because of very high radiosensibility of the tumor. The accuracy of preoparative diagnosis has been enhanced by CT in addition to conventional neuroradiological examinations. Due to the possible risk of meningeal spreading following biopsy, some authors prefer to avoid biopsy and to treat directly the patient by radiotherapy; a rapid reduction of the tumor size at the dose of 30 Gy suggest a possible germinoma.
Full text: Immunoassays for prostate-specific antigen (PSA) are used to detect early-stage prostate cancer, monitor disease progress, and evaluate therapeutic response. At least two forms of PSA, free PSA (F-PSA) and PSA complexed to alpha-1 anti-chymotrypsin (PSA-ACT) are detected by commercial PSA assays. The fraction of F-PSA is shown to be smaller in patients with untreated prostate cancer than in patients with benign prostate hyperplasia (BPH). Thus, combined measurements of both total and free PSA are used for a better discrimination between BPH and prostate cancer. Detection of PSA for screening of prostate cancer has been a subject of debate for many years. The reason of this debate is mainly because screening for prostate cancer is not cost-effective, as was shown by studies undertaken in Europe and United States. In Lebanon, no previous programs of screening for prostate cancer were done and so the incidence of this cancer is not known. Recently, the cancer registry in ...
Development and deployment of small-scale nuclear power reactors and their maintenance, monitoring, and control are part of the mission under the Small Modular Reactor (SMR) program. The objectives of this NERI-consortium research project are to investigate, develop, and validate advanced methods for sensing, controlling, monitoring, diagnosis, and prognosis of these reactors, and to demonstrate the methods with application to one of the proposed integral pressurized water reactors (IPWR). For this project, the IPWR design by Westinghouse, the International Reactor Secure and Innovative (IRIS), has been used to demonstrate the techniques developed under this project. The research focuses on three topical areas with the following objectives. Objective 1 - Develop and apply simulation capabilities and sensitivity/uncertainty analysis methods to address sensor deployment analysis and small grid stability issues. Objective 2 - Develop and test an autonomous and ...
This revision of the APT Waste Management Plan details the waste management requirements and issues specific to the APT plant for design considerations, construction, and operation. The APT Waste Management Plan is by its nature a living document and will be reviewed at least annually and revised as required.
Environmental Protection Agency Energy Management and Conservation Program ...Environmental Protection Agency Office of Administration and Resources Management 1200 Pennsylvania Avenue, NW (3101A) ...MANAGEMENT AND ADMINISTRATION 7 Energy Management Infrastructure 7 Senior Agency Official and Energy Team 7
OBJECTIVE: To examine primary care physicians' management of rheumatoid arthritis, ascertain the determinants of management and compare management with that recommended by a current practice panel....Full Text Available
Title: FY 2004 Energy Management and Conservation Program Annual Report ...Energy Management and Conservation Program ...Environmental Protection Agency Office of Administration and Resources Management 1200 Pennsylvania Avenue, NW (3101A)
Keywords: energy, management, conservation, program, fiscal, year, 2005, annual, ...S Environmental Protection Agency Energy Management and Conservation Program ...ENVIRONMENTAL P ROTECTION AGENCY Energy Management and Conservation Program Fiscal Year 2005 Annual Report
Anomalies of the urethra are uncommon. Urethrorectal fistula in horses has only been reported in foals and only in conjunction with other congenital anomalies. This report describes the diagnosis, surgical...Full Text Available
Bone mineral density is considered to be the standard measure for the diagnosis of osteoporosis and the assessment of fracture risk. The majority of fragility fractures occur in patients with bone mineral...Full Text Available
Background:Solid pseudopapillary tumor is a rare pancreatic neoplasm with uncertain to low malignant potential. This is an uncommon neoplasm with many pseudonyms, occurring...Full Text Available
IntroductionShoulder pain covers a wide range of problems and affects up to 20% of the population. It is not a specific diagnosis. Shoulder pain can be caused by problems with the...Full Text Available
We report a 55-year-old woman with coccydynia due to a sacral mass. The histological diagnosis was haemangioma. The MRI findings and the unusual location of this lesion are discussed. (orig.)
A single enhancing lesion in the brain parenchyma, also called an inflammatory granuloma, is a frequent neurologic diagnosis. One of the commonest causes of this lesion is human neurocysticercosis,...Full Text Available
... with the symptoms of MS have MS. Diagnosis Physical examination and medical history are very important in diagnosing MS. Physical exams include a variety of tests to check ...
BACKGROUNDNew diagnostic tools are urgently needed to interrupt the transmission of tuberculosis and multidrug-resistant tuberculosis. Rapid,...Full Text Available
The invention of the microscope disclosed a whole new world, that of the hitherto invisibly small. Histologic evidence as revealed by the microscope has become a cornerstone of medical diagnosis, and...Full Text Available
A new approach of gear fault diagnosis based on continuous wavelet transform is presented. Continuous wavelet transform can provide a finer scale resolution than orthogonal wavelet transform. It is more suitable for extracting mechanical fault information. In this paper, the concept of time-averaged wavelet spectrum (TAWS) based on Morlet continuous wavelet transform is proposed. Two fault diagnosis methods named spectrum comparison method (SCM) and feature energy method (FEM) based on TAWS are established. The results of the application to gearbox gear fault diagnosis show that TAWS can effectively extract gear fault information. The feature energy of the TAWS features the gear fault advancement very well and is conically proportional to the gear fault advancement.
In a prospective study, patients with the diagnosis of chronic ethmoid sinusitis were evaluated microbiologically by using biopsy specimens of the ethmoid sinus mucosa. Microbiology cultures were performed...Full Text Available
Cryptococcosis is a systemic fungal disease and meningitis is the most serious complication. The purpose of this study is to define problems related to its diagnosis and treatment. This is a retrospective...Full Text Available
The importance of designating criteria for diagnosing dementia lies in its implications for clinical treatment, research, caregiving, and decision-making. Dementia diagnosis in Huntington's...Full Text Available
Primary cardiac angiosarcoma is a rare cardiac tumor. The initial clinical course is often asymptomatic, and metastatic disease is present in a majority of affected patients at diagnosis. We present...Full Text Available
In eight patients with Ewing's sarcoma bone scans were performed using "9"9"mTc-MDP. This procedure rendered possible the diagnosis of clinically or radiologically silent metastases. (orig.).
The aim of the study was to assess the usefulness of artificial neural networks (ANN) application in evaluation of scintimammography in the context of clinical data in the diagnosis of breast cancer. The results produced by ANN were compared with the diagnosis of two independent observers, nuclear medicine specialists. Material and methods: The clinical data and the numerical values derived from scintimammograms of 103 patients were the material for the study. The reference method was the result of histopathology study (core biopsy and /or FNB). Results: The overall sensitivity of physician diagnosis was 78% with specificity of 72%. The ANN produced 71% sensitivity and specificity of 73%. The physicians and ANN results were not significantly different (p=0.4619). Conclusions: Artificial neutral networks are useful tool in clinical diagnosis of breast cancer. (authors)
Flow cytometry (FCM) is widely used in health research and in treatment for a variety of tasks, such as in the diagnosis and monitoring of leukemia and lymphoma patients, providing the counts of helper-T...Full Text Available
The purpose of this document is to describe the NIF Project Organization and the roles and responsibilities of the managers charged with executing the Project.
Sep 2, 2008 ... Abstract: This tutorial is intended to serve as a guide towards proper hazardous waste management. Knowing the regulations, different ...
This document deals with energy management in buildings. It presents the conditions for a good implementation of energy management. These conditions include the total involvement of the management and the training of the staff. The structure of this implementation is presented together with the tools for an efficient energy management. Eventually, information on air quality and comfort in buildings is provided, as well as the management of complaints linked to them. (TEC). 1 tab.
The clinical manifestation of wounds of the heart is determined by the mode, site and size of the injury as well as the structure of the pericardial and myocardial lesion. Diagnosis can be confirmed by ECG and echocardiography. Only 20% of the patients with penetrating wounds of the heart live for more than 30 minutes. Pericardio-centesis should be used only to gain time for a safe sternotomy, cardiac decompression and suture of the wound of the heart. An aggressive surgical approach is mandatory. Cardiopulmonary bypass is necessary only to correct of concomitant lesions. PMID:1983618
The author reports 10 studies concerning the diagnosis of renal osteodystrophy and extraskeletal calcification in patients on maintenance hemodialysis as well as some aspects of persistent hyperparathyroidism after renal transplantation. The majority of the studies focus on the value of bone scintigraphy with Tc-99m HEDP in the diagnosis of these disorders. (Auth.).
This opinion presents an overview of recent developments in the diagnosis and treatment of hepatocellular carcinoma (HCC) in Japan. The use of Ethiodol (iodized ethyl ester of the fatty acid of poppyseed oil) for hepatic angiography in diagnosing and treating (combined with chemotherapeutic agents) HCC has been reported. Ethiodol has been found to localize in HCC and remain there for long periods. The implications of these findings are discussed.
Based on a literature study an actual summary of the risk-utility problems in X-ray diagnosis is outlined due to the Recommendations of the International Commission for Radiation Protection (ICRP publication 26/1977). Papers demonstrating quantitative assessment of the somatic and genetical risk in X-ray examination are preferably cited and evaluated. It is concluded that the somatic and genetical risk is low in diagnostic ratiology. However, it must not be neglected and has always to be compared to the utility of an examination as well as to other risks of the examination. (author).
The paper considered the vibration signals of rotating equipment as cyclo stationary signals through analyzing the features of this kind of signals. Based on the analytic method of cyclic spectrum density, the paper pointed out that the impact frequency could be extracted effectively with the help of scanning cyclic frequency domain. The validity of the method of cyclic spectrum density is proved by simulating signals and the method is applied to the diagnosis of rolling bearings. (authors)
This case report presents the prenatal diagnosis of conjoined twins at 7 weeks and 6 days’ gestation according to the last menstrual period and 6 weeks and 4 days’ gestation according...Full Text Available
Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity ...
Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity ...
Identification of factors that determine individual patient risk for recurrence and progression in superficial papillary carcinoma of the bladder is a subject of extensive research as it would be a major outcome in patient management. It has been well recognized that traditional prognostic markers as tumor grade and stage are not accurate enough in predicting biological behavior. A large number of markers have been investigated as potential prognostic factors and relatively few can help in predicting outcome. Material and Methods: Forty-nine cases undergoing complete transurethral resection for primary superficial papillary transitional cell carcinoma were subjected to clinicopathologic evaluation as well as immunohistochemical staining for p53, bcl-2, cytokeratin 20 and Ki-67. The CAS-200 image analyzer was used to estimate the Ki-67 labeling index. Results: Recurrence was observed in 19 cases (38.8%) and progression in 7 cases (14.3%) with a median followup of 49 ...
This report is a compilation of worksheets from the waste management units of Savannah River Plant. Information is presented on the following: Solid Waste Management Units having received hazardous waste or hazardous constituents with a known release to the environment; Solid Waste Management Units having received hazardous waste or hazardous constituents with no known release to the environment; Solid Waste Management Units having received no hazardous waste or hazardous constituents; Waste Management Units having received source; and special nuclear, or byproduct material only.
The importance of radiation management for nuclear facilities including nuclear power plants has increased as the general public understanding has progressed, and necessary information for management must be processed exactly and quickly. In nuclear power plants, radiation management is performed by each individual operation, and collected information is managed by the system of each operation. The distributed-processing radiation management system has been developed aiming to use a general-purpose LAN and make quick and efficient use of information managed by individual operations. This paper describes the system configuration and functions. (author)
The role of MRT in the prebiopsy diagnosis of muscular and vascular inflammatory conditions was evaluated prospectively and an optimal method of examination was investigated. 92 patients with a suspected diagnosis of myositis (60 cases) or vasculitis (32 cases) were examined, in each case two extremities were studied using transverse T_1 and T_2 weighted SE sequences and double echo STIR sequences on a 0.5 Tesla (56 patients) or 1.5 Tesla magnet (36 patients; T5/S15 Gyroscan, Philips). The site of the biopsy depended on the MRT findings. In 41 patients the suspected diagnosis was confirmed histologically, in two patients an infective myositis was diagnosed on clinical grounds despite negative histology. MRT demonstrated muscle oedema in 86% of patients. There were negative findings after immuno-suppressive therapy (two patients), in focal myositis (3 out of 4 patients) and in one of 7 patients with untreated vasculitis. ...
Described is the diagnosis for the cancer extension of cholangiocarcinoma by various imaging techniques and processes to support the current surgical procedure based on preoperative biliary drainage. The cancer tends to locally extend horizontally and/or vertically and its diagnosis is important for surgical indication. For the indication, multi-detector raw CT (MDCT) and MR cholangio-pancreatography (MRCP) are useful and particularly, the former can give multi-phase (arterial, portal and delayed) images to reconstruct multiplanar (MPR) and CT angiographic 3D images, which have made the previous invasive examinations like angiography and percutaneous transportal contrasting unnecessary. MDCT and MRCP can almost complete the diagnosis of the extension. The operative procedure is decided dependently on the site of the lesion, and of which diagnosis, whether it is hepatic hilar/on upper bile duct or ...
Japan`s coke industry was developed as the basic part for iron and steel industry. The paper addresses two factors as a characteristic of Japan-unique management. One topic is operation management and equipment management of coke factory; the second topic is human resource training in a company that lies under each management. The concepts and actual methods of these topics are introduced by showing examples. The paper discusses the improvement of the working environment and measures for future employment caused by the aging problem in Japan. 5 figs.
DOE`s Office of Environmental Management (EM) is responsible for managing waste and cleaning up contamination at DOE sites across the United States. A substantial fraction of the work performed for EM includes sampling and analysis activities. This paper outlines the Sample Management Programs, achievements to date, and future directions.
U.S. Department of Energy (DOE) Policy 450.4, Safety Management System Policy commits to institutionalizing an Integrated Safety Management System (ISMS) throughout the DOE complex as a means of accomplishing its missions safely. DOE Acquisition Regulation 970.5204-2 requires that contractors manage and perform work in accordance with a documented safety management system.
The Joint Convention on the Safety of Spent Fuel management and on the Safety of Radioactive Waste Management is the first legal instrument to directly address the safety of spent fuel and radioactive waste management on a global scale. The Joint Convention entered into force in 2001. This paper describes its process and its main achievements to date. The perspectives to establish of a Global Waste Safety Regime based on the Joint Convention are also discussed. (authors)
Following the executive summary, this document contains the following: (1) waste management facilities design objectives; (2) AVLIS production plant wastes; (3) waste management design criteria; (4) waste management plan description; and (5) waste management plan implementation. 17 figures, 18 tables.
Problems and solutions in the diagnosis and operative treatment were clarified by retrospective evaluation of cases of intramedullary tumor in which MRI and surgery had been performed. The subjects were 16 patients (21-75 years old, mean age: 45 years) whose tumor was surgically removed between 1991 and 1998. MRI was performed preoperatively, and T1-weighted images, T2-weighted images, and enhanced images were obtained. Angiography was also performed in some cases. The histological diagnosis based on the MRI findings before surgery were compared with the pathological diagnosis after the operation. In 9/16 cases (56%), the preoperative histological diagnosis based on the MR images was the same as the pathological diagnosis after the operation. In 8 of the 11 cases (73%) whose images showed clear tumor margins and well shaped the tumor, the tumors were completely removed. The ...
Monitoring nuclear plants components enable to save on operation and maintenance costs by reducing incidents gravity and casual plant stoppages thank to early detection and fast diagnosis. Improving the knowledge of the behaviour of the plant will also allow to optimize maintenance and to increase plant life. In order to improve monitoring and diagnosis capabilities in nuclear power plants. Electricite de France (EDF) is extending the existing data processing chains towards automatic aided interpretation and diagnosis. Therefore, EDF has designed an integrated monitoring and diagnosis assistance system: PSAD-Poste de Surveillance et d'Aide au Diagnostic, including several monitoring functions of the main components. It integrates on-line monitoring, off-line diagnosis and knowledge based systems. PSAD stations provide homogeneous aids to diagnosis which enable ...
Leakage after oesophageal anastomosis or perforation remains a challenge for the surgeon. Traditional management has been operative repair or intensive conservative management. Both treatments are...Full Text Available
This book chapter discusses sugarcane culture and history, describes arthropod biologies and injury, and identifies sugarcane pest management factors to consider for people interested in commercial sugarcane production. Arthropod groups include 10 orders and 40 families. Sugarcane pest management ...
... POSITION VACANT: Program Manager (Advance Materials and Manufacturing), AD-340-4. Salary ranges from ... POTENTIAL: Program Manager (Advanced Materials and Manufacturing), AD-340-4. LOCATION: Directorate ...
Over the past 10 years, the original partnership of clinician and statistician for the running of clinical research projects, especially clinical trials, has come to be supplemented by the data manager...Full Text Available
The scope of our problems with nuclear waste management is outlined. Present and future inventories of nuclear wastes are assessed for risk. A discussion of what is presently being done to solve waste management problems and what might be done in the future are presented. (DC)
BackgroundResearch has shown that the long term management of food allergy is suboptimal. Our study aims to provide direction for improvement, by evaluating food allergy management...Full Text Available
The DOE strategy recognizes that public perception of low-level waste management practices is not positive. Actions are included that are aimed at opening the system to the public. A better informed public will be able to better assess the performance of the low-level waste management system.
This paper presents a prescriptive account of diagnostic problem solving, or diagnosis, in quality and process control. This paper identifies a general strategy, named branch-and-prune, whose manifestations can be found in disciplines such as medical diagnosis, troubleshooting of devices, and model-based diagnosis in artificial intelligence. The work aims to offer a clear conceptualization of this strategy, based on the notions of structures for the search space, and constraints to the cause's nature.The idea is to treat the search space of candidate explanations as a tree structure, in which general and high-level causal directions are branched into more specific and detailed explanations. Constraints eliminate all but a few branches (pruning), which are explored in more detail. We enumer...
Contradictory reports in the literature on the reliability of lymphography stimulated the authors to test the diagnostic accuracy, employing methods which are approximately analogous to practice, using carcinoma of the cervix as the model on which the study was carried out. Using 21 observers it was found that there was no correlation between their experience and on-target accuracy of the diagnosis. Good observers obtained an accuracy of 85% with good proportions between sensitivity in the recognition of detail, specificity and readiness to arrive at a decision on the basis of discriminatory ability. With the help of the concept of the ROC curves, the position taken up by the observers in respect of diagnostic decisions, and a complex manner of assessing the various characteristic factors determining diagnostic accuracy, are demonstrated. This form of test, which permits manipulation of different variants of diagnosis, is recommended, among ...
In spite of the improved imaging techniques currently available, mortality for pancreatic cancer is still high, and pancreatics is often diagnosed only in its advanced stages. The authors investigated the value of different imaging techniques - i.e., US, CT, and ERCP - for an early diagnosis, when a more effective (curative?) treatment can be suggested. Fifty-six cases of pancreatic cancer and 36 cases of chronic pancreatitis were evaluated. The results indicate that ERCP, with the help of statistical methods, is superior to US and CT not only in evaluating early neoplastic or inflammatory lesions, but also for their differential diagnosis. In the letter case, ERCP can sometimes be used as a valid alternative to fine-needle aspiration biopsy.
MRI diagnosis for malignant tumors are made possible by direct comparison to the results obtained by the brain and it seems possible to differentiate malignant tumors from other benign lesions. Cystic lesions, and mycotic sinusitis sometimes resemble malignant tumors in MR Image. In the present report, we investigated the relationships between the biochemical contents of cystic lesions and NMR-parameters to clarify why some inflammatory lesions appeared similar to malignant tumors in MRI. The variation of relaxation time depends upon the amount of protein in the cystic contents and the amount of glucose affects the relaxation time. We conclude that NMR-parameters are useful for the differential diagnosis of malignant tumors, cystic lesions and mycositic sinusitis by using the multiple variation analysis.
Abstract In this brief report, we have described the fine-needle aspiration cytology (FNAC) of a hepatosplenic T-cell lymphoma (HSTCL) in a 60-year-old female patient. The patient complained of fever and heaviness of left upper abdomen. Ultrasound-guided FNAC of the spleen showed immature lymphoid cells, and a diagnosis of primary non-Hodgkin lymphoma of spleen was offered. Subsequently, the patient underwent splenectomy and wedge biopsy of liver that confirmed the cytological diagnosis. The lymphoma cells were positive for CD3 immunostain. Primary hepatosplenic T-cell lymphoma is a rare entity and may often pose diagnostic problems on FNAC. Diagn. Cytopathol. 2010. 2010 Wiley-Liss, Inc.
A marine propulsion system is a very complicated system composed of many mechanical components. As a result, the vibration signal of a gearbox in the system is strongly coupled with the vibration signatures of other components including a diesel engine and main shaft. It is therefore imperative to assess the coupling effect on diagnostic reliability in the process of gear fault diagnosis. For this reason, a fault detection and diagnosis method based on bispectrum analysis and artificial neural networks (ANNs) was proposed for the gearbox with consideration given to the impact of the other components in marine propulsion systems. To monitor the gear conditions, the bispectrum analysis was first employed to detect gear faults. The amplitude-frequency plots containing gear characteristic sign...
Varying load can cause changes in a measured gearbox vibration signal. However, conventional techniques for fault diagnosis are based on the assumption that changes in vibration signal are only caused by deterioration of the gearbox. There is a need to develop a technique to provide accurate state indicator of gearbox under fluctuating load conditions. This paper presents an approach to gear fault diagnosis based on complex Morlet continuous wavelet transform under this condition. Gear motion residual signal, which represents the departure of time synchronously averaged signal from the average tooth-meshing vibration, is analyzed as source data due to its lower sensitiveness to the alternating load condition. A fault growth parameter based on the amplitude of wavelet transform is proposed ...
Identifying gear damage categories, especially for early faults and combined faults, is a challenging task in gear fault diagnosis. This paper proposes a new multidimensional hybrid intelligent diagnosis method to identify different categories and levels of gear damage automatically. In this method, Hilbert transform, wavelet packet transform (WPT) and empirical mode decomposition (EMD) are performed on gear vibration signals to extract additional fault characteristic information. Then, multidimensional feature sets including time-domain, frequency-domain and time-frequency-domain features are generated to reveal gear health conditions. Multiple classifiers based on several classification algorithms and input features are combined with genetic algorithm (GA). Because of the use of multidim...
The Waste Management Project manages and integrates (non-TWRS) waste management activities at the site. Activities include management of Hanford wastes as well as waste transferred to Hanford from other DOE, Department of Defense, or other facilities. This work includes handling, treatment, storage, and disposal of radioactive, nonradioactive, hazardous, and mixed solid and liquid wastes. Major Waste Management Projects are the Solid Waste Project, Liquid Effluents Project, and Analytical Services. Existing facilities (e.g., grout vaults and canyons) shall be evaluated for reuse for these purposes to the maximum extent possible.
The primary purpose of the Waste Management Program Plan is to provide an annual report of how Waste Management's operations are conducted, what facilities are being used to manage wastes, what forces are acting to change current waste management systems, and what plans are in store for the coming fiscal year. In addition, this document projects activities for several years beyond the coming fiscal year in order to adequately plan for safe handling, storage, and disposal of radioactive wastes generated at the Savannah River Site and for developing technology for improved management of wastes. In this document, work descriptions and milestone schedules are current as of December 1991.
The main objective of this paper is to demonstrate that it makes good business sense to identify risks and hazards of an operation and take appropriate steps to manage them effectively. Developing and implementing an effective risk and hazard management plan also contibutes to other industry requirements and standards. Development of a risk management system, key elements of a risk management plan, and hazards and risk analysis methods are outlined. Comparing potential risk to the cost of prevention is also discussed. It is estimated that the cost of developing and preparing the first risk management plan varies between $50,000 to $200,000. 3 refs., 2 figs., 1 tab.
This Waste Management Plan functions as a management and planning tool for managing waste streams generated as a result of operations at the Idaho CERCLA Disposal Facility (ICDF) Complex. The waste management activities described in this plan support the selected remedy presented in the Waste Area Group 3, Operable Unit 3-13 Final Record of Decision for the operation of the Idaho CERCLA Disposal Facility Complex. This plan identifies the types of waste that are anticipated during operations at the Idaho CERCLA Disposal Facility Complex. In addition, this plan presents management strategies and disposition for these anticipated waste streams.
Westinghouse Electric Corporation is aggressively applying cost-time management to bolster timely, cost-effective cleanup and waste management activities at sites it manages for the U.S. Department of Energy (DOE). Cost-time management is a diagnostic technique which is applicable to virtually any process. It identifies opportunities to reduce cycle-times and costs. When applied to cleanup and waste management at DOE facilities, cost-time profile analysis helps identify actions to improve productivity and quality. Moreover, by reducing cycle-times and costs, it achieves significant savings to taxpayers. (author)
... of waste food generated at McMurdo Station. Some of the difficulties of disposing of waste food ... change waste generation or management at the site? Yes. This will be a temporary waste management ...
AbstractObjective: This study examined the effectiveness of a telephone-based referral-care management (TBR-CM) intervention on psychiatric health...Full Text Available
Objectives: To evaluate the training of pharmacists in Accra, Ghana, in the syndromic management of STIs. Methods: We randomly selected 50 pharmacy outlets that had...Full Text Available
The Directive establishes a single manager for the Department of Defense Military Working Dog Program, provides policy, prescribes procedures, and assigns responsibilities.
In the last two decades rectal cancer has changed from a surgically managed disease into a multidisciplinary treatment model resulting in considerable improvements in the survival and outcome. This...Full Text Available
This guide is intended to provide the necessary guidance to successfully manage the NAVMED Navy Occupational Health Information Management System (NOHIMS) at NAVMED sites and the NAVSEA Occupational Safety and Health Record Keeping System (OSHRKS) at NAVSEA sites. Outlines procedures to manage system operations, procedures to resolve hardware, software and communications problems, and procedures outside the realm of system operations that are required for a successful system. This guide is intended for the System and Functional Managers use. The System Manager is the individual designated to provide overall ADP management to the entire local configuration. Usually responsible for file backup, daily operations of the CPU, security, supplies, equipment, operating software and technical ADP guidance to the local functional users.
Primary sclerosing cholangitis (PSC) is a rare cholestatic liver disease with major morbidity and mortality. Therapeutic management is difficult, due to lack of conclusive data and individual disease...Full Text Available
Background: Contamination of autologous grafts unfortunately occurs in plastic surgery, but the literature provides no guidance for management of such incidents. Methods: American...Full Text Available
... Advances in Complex Systems ( ACS) 413 (413) 2001-2011 Springer Advances in Data Analysis and Classification 59 (59) 2008-2011 Advances in Management Advances In Management ...
... In this manner, a JBI-enabled COI would have the full suite of JBI information management capabilities, but would still be based on and have full ...
The purpose of this report is to provide management with performance data on key performance indicators selected from the FFTF Early Warning System performance indicators.
The organizational structure of medical record departments in Iran is not appropriate for the efficient management of healthcare information. In addition, there is no strong information management division...Full Text Available
A set of computer programs is described which constitutes a clone database management system. Maintenance of the database and the stocks of material is designed to be under the control of one person...Full Text Available
The diagnosis of viral causes of many infectious diseases is difficult due to the inherent sequence diversity of viruses as well as the ongoing emergence of novel viral pathogens, such as SARS coronavirus...Full Text Available
Neurofibromatosis type I (NF1) is one of the most common inheritable disorders and is associated with an increased risk of gastrointestinal stromal tumours (GISTs). However, the predominant location...Full Text Available
The authors report a case of a cephalopagus conjoined twin that was diagnosed at 29 weeks of gestation despite the mother having had two ultrasounds done previously. The fetus had one head and face,...Full Text Available
1. We have studied determinants of outcome of 7 day courses of treatment in 77 middle aged and elderly patients, in whom the general practitioner's diagnosis of urinary tract infections had been confirmed...Full Text Available
BACKGROUND: A number of studies have shown that the early mortality following TURP is higher for patients with prostate cancer than those with benign disease. This study examines the effect of the histological...Full Text Available
The University of North Carolina Comprehensive Pain Center, which has been in existence since 1972, is a pain evaluation, treatment and research program based upon individual diagnosis, comprehensive...Full Text Available
The aim of this study was to assess the possibility of digital image analysis of pit-and-fissure discoloration in order to diagnose caries. Digital images showing pit-and-fissure discoloration in 100...Full Text Available
BackgroundAcute lower respiratory infection (ALRI) is a major cause of hospitalization for children in China, while the etiological diagnosis of ALRI remains a challenge. This study...Full Text Available
We describe the interactions of two benzimidazole derivatives, astemizole (AST) and lansoprazole (LNS), with anomalous aggregates of tau protein (neurofibrillary tangles). Interestingly, these...Full Text Available
The noninvasive assessment of cardiac function is of first importance for the diagnosis of cardiovascular diseases. Among all medical scanners only a few enables radiologists to evaluate the local cardiac...Full Text Available
Prostate biopsy is the current gold-standard procedure for prostate cancer diagnosis. Existing prostate biopsy procedures have been mostly focusing on detecting cancer presence. However, they...Full Text Available
Reliable characterization of locomotor dynamics of human walking is vital to understanding the neuromuscular control of human locomotion and disease diagnosis. However, the inherent oscillation and...Full Text Available
Disseminated intravascular coagulation (DIC) is a disorder characterized by both acute generalized, widespread activation of coagulation, which results in thrombotic complications due to the intravascular...Full Text Available
The introduction of prenatal screening requires rapid high-throughput diagnosis of common aneuploidies. Multiplex ligation-dependent probe amplification (MLPA) allows for quick, easily automated multiplex...Full Text Available
Radionuclide angiocardiography provides a noninvasive assessment of cardiac function and blood flow through the heart and lungs. During the past three years, this procedure has been used at the Duke...Full Text Available
In this chart review the authors describe 51 cases of PSOAS abscess treated at Hospital Universitario del Valle in Cali, Colombia in the last 10 years. It is not a rare condition and require high index of suspicion. epidemiology, bacteriology, diagnosis and treatment are discussed.
Computer-aided diagnosis of neural diseases from EEG signals (or other physiological signals that can be treated as time series, e.g., MEG) is an emerging field that has gained much attention in past...Full Text Available
Breast cancer is a progressive and potentially fatal disease that affects women of all ages. Like all progressive diseases, early and reliable diagnosis is the key for successful treatment and annihilation....Full Text Available
BackgroundLung cancer diagnosis in tissue material with commonly used histological techniques is sometimes inconvenient and in a number of cases leads to ambiguous conclusions. Frequently...Full Text Available
... based, disease treatment remains promising, the emphasis for stem cell research from the biomedical research community is clear, and ... diagnosis as a novel source of embryos for stem cell research. Repr...
In the past decade, we have witnessed a revolution in osteoporosis diagnosis and therapeutics. This includes enhanced understanding of basic bone biology, recognizing the severe consequences of fractures...Full Text Available
BACKGROUND: Epidermolysis bullosa (EB) is a group of heritable diseases that manifest as blistering and erosions of the skin and mucous membranes. In the dystrophic forms of EB (DEB), the diagnostic...Full Text Available
Patients with histopathologically proved sarcoidosis were studied serially by means of bronchoalveolar lavage, initially at the time of diagnosis and then six and 12 months later. Two years later they...Full Text Available
BackgroundIdentification of urinary biomarkers for detection of bladder cancer recurrence would be beneficial to minimize the frequency of cystoscopy. Our objective was to determine...Full Text Available
Idiopathic frozen shoulder is a common medical diagnosis for patients seeking physical therapy. Radiographic and surgical evidence exists that describes the coracohumeral ligament (CHL) as a major contributor...Full Text Available
We report the first case of human infection by Phaeoisaria clematidis. This fungus caused a corneal ulcer in a Brazilian man who had previously suffered an eye injury. Diagnosis was...Full Text Available
We present a case of cardiac tamponade following umbilical venous catheterization in a neonate, an uncommon, yet potentially fatal complication. Timely diagnosis by echocardiography and urgent pericardiocentesis proved lifesaving. PMID:21654008
BackgroundRapid and correct diagnosis of malaria is considered an important strategy in the control of the disease. However, it remains to be determined how well these tests can...Full Text Available
Peak expiratory flow rate (PEFR) has been measured hourly from waking to sleeping in 29 workers with respiratory symptoms exposed to the fumes of soft soldering fluxes containing colophony (pine resin)....Full Text Available
AIM: To investigate differential points of solid-pseudopapillary neoplasm (SPN) of the pancreas and pancreatic endocrine tumor (PET).METHODS: Ten cases of SPN and fourteen cases of PET were studied...Full Text Available
The outcome of patients admitted to intensive care units is known to be influenced by such factors as age, previous health status, severity of disease, and diagnosis. To estimate the outcome of such...Full Text Available
Erythrovirus (formerly parvovirus) B19 causes a wide range of diseases in humans, including anemia due to aplastic crisis. Diagnosis of B19 infection relies on serology and the detection of viral DNA...Full Text Available
SummaryBecause increasing numbers of HIV vaccine candidates are being tested globally, it is essential to differentiate vaccine-from virus-induced antibodies. Most of the currently...Full Text Available
Arriving at a firm diagnosis of neurosarcoidosis continues to pose serious problems, particularly when evidence of granulomatous disease outside the nervous system is lacking. The commonest mode of...Full Text Available
A case of neurocysticercosis with progressive severe neurological symptoms is described. The patient was a Turkish girl aged 4 1/2 years who had experienced intermittent neurological symptoms for two years. Rapid diagnosis and treatment with praziquantel and corticosteroid resulted in complete restitution.
Neurodegenerative and infectious disorders including Alzheimer’s and Parkinson’s diseases, amyotrophic lateral sclerosis, and stroke are rapidly increasing as population’s...Full Text Available
BackgroundThe precise mechanisms involved in the initiation and progression of rheumatoid arthritis (RA) are not known. Early stages of RA often have non-specific symptoms, delaying...Full Text Available
Breath analysis is a powerful noninvasive technique for the diagnosis and monitoring of respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). Nitric oxide...Full Text Available
A bladder neck obstruction was suspected after ultrasound investigation at 16 weeks' gestation. Evaluation of protein content in the amniotic fluid, fetal ascites, and fluid from the overdistended bladder...Full Text Available
BackgroundGastrointestinal stromal tumors (GISTs) are mesenchymal tumors that develop in the wall of the gastrointestinal tract and their diagnosis during pregnancy or puerperium...Full Text Available
In this paper we report a case with primarily unspecific arthralgia after surgical therapy of hallux valgus deformity and consecutive reflex sympathetic dystrophy in which MR led to the diagnosis of Lyme disease. (orig.)
Blunt chest-wall trauma is common; however, resultant tricuspid valve rupture is rare and can be subtle in its presentation. Transthoracic echocardiography plays a key role in diagnosis.Herein,...Full Text Available
BackgroundCavernous hemangiomas are the most frequent neoplasms of the liver and in routine clinical practice they often need to be differentiated from malignant tumors and other...Full Text Available
The major activities of the various Institute's departments are highlighted. The following departments are included: (i) Tokamak; (ii) Pulse plasma systems; (iii) Thermal plasma; (iv) Materials engineering; (v) Laser plasma; and (vi) Optical diagnosis. (P.A.)
Dementia with Lewy bodies (DLB) is the second most common cause of degenerative dementia after Alzheimer's disease (AD), and is clinically characterized by the progressive cognitive decline with fluctuations...Full Text Available
Acute myocardial infarction (AMI) is a common cause of death for which effective treatments are available provided that diagnosis is rapid. The current diagnostic gold standards are circulating cardiac...Full Text Available
Previous studies have documented diagnostic bias and noted that its reduction could eliminate misdiagnosis and improve mental health service delivery. Few studies have investigated clinicians'...Full Text Available
The accelerating development of biochemical and DNA-based diagnostic tests for human genetic conditions in the last decade has engendered a revolution in genetic diagnosis. Both genetic testing and...Full Text Available
BackgroundDue to the high morbidity and mortality of fulminant hepatitis, early diagnosis followed by early effective treatment is the key for prognosis improvement. So far, little...Full Text Available
This book provides differential diagnostic possibilities of specific scan abnormalities in one volume for easy reference. This book is organized by organ systems and covers the central nervous system, the endocrine, skeletal, pulmonary, gastrointestinal, genitourinary, and cardiovascular systems. The gamuts are designed to teach differential diagnosis and to assist in the actual interpretation of patient slides.
Assessment of subtle changes in the primary macromolecular components of cartilage, proteoglycan (PG) and collagen, is critical for the diagnosis of early stages of osteoarthritis (OA), but...Full Text Available
Currently, accurate diagnosis of breast lesions depends on a triple assessment approach comprising clinical, imaging and pathologic examinations. Fine needle aspiration cytology (FNAC) is widely adopted...Full Text Available
Thirteen fetuses (five twin, one triplet) were compromised by fetofetal transfusion syndrome in six pregnancies, five in the mid trimester, and one in the third trimester. This diagnosis, which was...Full Text Available
Extraosseous Ewing's sarcoma (EES) is an uncommon lesion included in the group of soft tissue tumors. We present a case in a 19-year-old woman in which the diagnosis was not initially suspected because of the absence of clinical and radiological evidence. (Author).
Rotazyme II, which is a shorter version of Rotazyme (less than 3 h), was compared with electron microscopy and Rotazyme for sensitivity and specificity on 229 human stool specimens. Compared with electron...Full Text Available
This case describes a 10-year-old girl who developed a Ewing's sarcoma in her proximal fibula. The radiologic features mimicked those of a unicameral bone cyst. The presence of pain and the atypical location led to a prompt biopsy and the correct diagnosis. The mechanism of this unusual radiographic presentation is discussed. (orig.)
The development of rapid and specific diagnostic tests to identify individuals infected with malaria is of paramount importance in efforts to control the severe public health impact of this disease....Full Text Available
The recombinant product (rK39) of the 39-amino-acid repeats encoded by a kinesin-like protein-encoding gene of Leishmania chagasi was evaluated by enzyme-linked immunosorbent assay...Full Text Available
BackgroundBlood spots collected onto filter paper are an established and convenient source of antibodies for serological diagnosis and epidemiological surveys. Although recommendations...Full Text Available
A serodiagnostic test has been developed for the detection of Plasmodium falciparum in infected blood. Using parasite antigens and infected red blood cells from in vitro...Full Text Available
Examples are used to demonstrate that a shift in the point of emphasis is necessary with regard to radiation hazard in medicinal X-ray diagnosis. The parameters employed in this study to calculate somatic dose (SD) and somatically significant dose (SSD) m...
A 23-year-old woman presented to our hospital with nonspecific pain in the abdomen. She underwent radiological investigations, which revealed a solid and cystic mass in the tail end of the pancreas....Full Text Available
BackgroundOptimal blood culture performance is critical for successful diagnosis and treatment of sepsis. To understand the status of blood culture, we investigated several aspects...Full Text Available
Objective:To estimate the prevalence of insulin resistant syndrome (IRS) among newly diagnosed patients with type 2 diabetes and to test their validity against two indices...Full Text Available
IntroductionColonoscopic perforation is a rare but serious complication of colonoscopy. Factors known to increase the risk of perforation include colonic strictures, extensive diverticulosis,...Full Text Available
Urethral and endocervical swabs and self-collected vaginal swabs (SCVSs) and urine specimens are all used as samples for diagnosis of urogenital infection with Chlamydia trachomatis....Full Text Available
Fifteen related dogs were studied for susceptibility to malignant hyperthermia using halothane challenge and caffeine contracture tests. These dogs had hypertrophied muscles, were of a nervous temperament...Full Text Available
BackgroundBiomarkers play a key role in risk assessment, assessing treatment response, and detecting recurrence and the investigation of multiple biomarkers may also prove useful...Full Text Available
...2 Resource type: documents Mesothelioma Information HON-code certified resource, covering the main aspects of asbestos exposure: diagnosis, diseases caused by asbestos, treatment options, prevention and legal options. Diagrams are included in articles, and links are provided to the references used. Also contains a listing of ...
BACKGROUND: DNA prenatal diagnosis for cystic fibrosis (CF) has been available for parents of affected children since late 1985. METHODS: Using anonymous questionnaires, we surveyed 395 parents of children...Full Text Available
The objective of this retrospective field study was to associate the type and smell of discharge, the size of the uterus, the ovarian and treatment status, and the time to diagnosis of animals with...Full Text Available
BackgroundMost analyses of spatial clustering of disease have been based on either residence at the time of diagnosis or current residence. An underlying assumption in these analyses...Full Text Available
We report an unusual patient with primary adenocarcinoma of lung causing malignant pleural and pericardial effusions. The diagnosis was made only at autopsy as his staging computed tomography scan of...Full Text Available
We report an unusual case of strangulated diaphragmatic (Morgagni) hernia resulting in ischaemia of the small and large bowel, which was initially diagnosed as a pneumonia. This case highlights the...Full Text Available
To diagnose asymptomatic bacterial vaginosis (BV), self-sampled vaginal smears were collected during a study of risk factors for preterm birth in African American women. More than 90% of those...Full Text Available
BackgroundCow's milk is the most common food allergen in infants and the diagnosis of cow's milk allergy is difficult, even with the use of several diagnostic tests. Therefore, elimination...Full Text Available
A form for the clinical evaluation of bovine digital disease was developed. In this article, each section of the resulting Digit Evaluation Form is discussed and justified. By following the...Full Text Available
Significant research has been devoted to predicting diagnosis, prognosis, and response to treatment using high-throughput assays. Rapid translation into clinical results hinges upon efficient access...Full Text Available
Sixty-six cases of histologically proven hepatocellular carcinomas (HCC) were studied by MRI. Detectability was better by MRI than by CT, especially in the tumor under 2 cm in diameter. The capsule was detected in all cases of HCC over 3 cm in diameter. The capsule was able to be diagnosed only by dynamic MRI study in some cases. High intensity on the T1-weighted image and iso or low intensity on the T2-weighted image suggested that the nodule was adenomatous hyperplasi (AH) or well differentiated HCC. MRI is concluded to be an essential modality in the diagnosis of HCC. (author).
Snapping or grating scapula is a condition of the shoulder girdle in which the patient complains of pain and an audible snapping sound which may be associated with pain. We evaluated the diagnostic value of the computed tomography (CT) scans using the clinical diagnosis of a grating scapula as the gold standard. This retrospective study reports the sensitivity, specificity, likelihood ratio and receiver operator characteristic curve for the CT scans and the k value as a measure of the interobserver agreement. None of the parameters validated the examination. We therefore concluded that CT scans are inappropriate for differentiation between a grating scapula and a normally functioning shoulder except in cases where bony abnormalities are present. (orig.)
The aortovenous fistulas are rare, most of them are aortocaval fistula. The non-caval communication of the fistula is sparse. Herein we report a 47-year-old female diagnosed as traumatic aorto-superior mesenteric vein (Ao-SMV) fistula. The abdominal pain, fullness, and frank bruit on abdominal auscultation suggested the diagnosis of an intra-abdominal arteriovenous fistula. The diagnosis of Ao-SMV was further confirmed by the computed tomography (CT) and aortography. The fistula was successfully treated with transcatheter coil embolization. This is the first case of Ao-SMV fistula. It provides an alternative option of treatment other than conventional surgery. PMID:19327940
The value of CT in respect of preoperative determination of tumour status and of tumour classification was studied using 127 histologically identified ovarial tumours as basis in a blind study via mutual image classification by the two participating institutes. The medium accuracy of diagnosis was 82%, but the results were found to be greatly dependent on tumour histology. Quotas of more than 90% were obtained in case of functional cysts, cystomas, cystadeno-carcinomas and dermoids, whereas classification was less successful with the other types of tumours such as germ cell tumours, tumours of the sexually differentiated stroma, metastases and tubo-ovarial abscesses.
Cross-sectional imaging has revolutionised the radiological diagnosis of pleural collections. Not only can the precise location and volume of a pleural effusion be established, but also features specific for the aetiology of the effusion can be demonstrated. Increasingly, radiologists are called upon to perform image-guided biopsies, aspirations and small bore chest drain placement, all of which have been shown to be safe and efficacious. Pneumothoraces occurring due to acute trauma and in an intensive care setting can also benefit from radiological input, both in terms of diagnosis and image-guided treatment. (orig.)
As part of the evolution of computer technology, Fuji Computed Radiography (FCR) has been developed as a new system for radiographical diagnosis. In this system, the X-ray energy is stored on the imaging plate and then converted into digital signals utilizing scanning laser-stimulated luminence. After proper image processing, it offers much more improved information for diagnosis than the conventional film system does. Since April, 1986, we have principally used FCR (System 101) for neurosurgical practice. In this article, we present our recent experience and evaluate its usefulness.
As part of the evolution of computer technology, Fuji Computed Radiography (FCR) has been developed as a new system for radiographical diagnosis. In this system, the X-ray energy is stored on the imaging plate and then converted into digital signals utilizing scanning laser-stimulated luminence. After proper image processing, it offers much more improved information for diagnosis than the conventional film system does. Since April, 1986, we have principally used FCR (System 101) for neurosurgical practice. In this article, we present our recent experience and evaluate its usefulness. (author).
Brucela serology using ELISA and standard agglutination test was performed on 23 patients with prolonged fever where the test was requested, on 26 randomly chosen patients with prolonged fever where it was not requested and on 17 controls. ELISA was positive in 39.1, 26.9 and 0 per cent respectively in these groups. Brucellosis may often be unsuspected because of its varied clinical manifestations and may be a more important cause of fever than previously considered. Our data reaffirm that ELISA is superior to the standard agglutination test for the diagnosis of brucellosis. PMID:8707374
We describe a 16-month-old boy presenting with stridor and fever. The chest X-ray suggested inhalation of a foreign body but here was no history of this. A high spot a T_1-weighted chest MRI was due to a peanut which was seen to have moved from the right main bronchus to the left inferior bronchus, between the two MRI studies. MRI can provide information on position and size of the peanut, the conditons of the surrounding tissues and may be also useful in treatment. We consider MRI to be a valuable new method for the diagnosis of peanut inhalation. (orig./GDG).
Computed tomography (CT) has already proved extremely effective both in cerebral and abdominal pathology. Several recent publications describing first heterogeneous series [1, 2, 7, 11-17], then studies of a single type of lesion [3-6, 8] have illustrated its usefulness in the study of bone lesions. This report deals with 41 cases of Ewing's sarcoma studied by CT at the Institut Gustave Roussy from October 1977 to July 1981, and tries to show both the limitations and indications of this technique for the diagnosis, treatment, and follow-up of Ewing's sarcoma as well as in the diagnosis of any eventual recurrence. (orig.).
We report the cranial CT and MRI findings in three children with Lyme disease (neuroborreliosis). The neuroimaging findings in children have been rarely reported. We found cranial MRI far superior to cranial CT. Ring-enhancing lesions have been described in acute disseminating encephalomyelitis and multiple sclerosis but not in neuroborreliosis. Although other infectious and inflammatory diseases cannot be excluded, Lyme disease should be included in the differential diagnosis and put forward as being the most likely diagnosis in the appropriate clinical setting. Gadopentetate dimeglumine is helpful in assessing the response to antibiotic treatment. (orig.)
A diagnosis of the refrigerant flows in a refrigerator was carried out by real-time neutron radiography. The thermal neutron radiography system of JRR-3M in Japan Atomic Energy Research Institute and the real-time image processing system developed by Musashi Institute of Technology were used. Freon evaporating flows in the evaporator, condensing flows in the condenser, flashing flows in the capillary tube and flows in the accumulator were visualized and the dynamic behaviors under practical conditions were clarified. In the case of the capillary tube of 0.8 mm i.d., a cooled-CCD camera was utilized. (orig.).
Cell voltage monitoring (CVM) systems are essential for the operation of fuel cell stacks and some battery systems, in the field as well as in the laboratory, because they allow the diagnosis and correction of problems that would otherwise go unnoticed and cause impaired performance or even permanent damage. A robust, safe, and low-cost design for a CVM unit is presented, using electromechanical relays as multiplexing switches. Some examples from the application of the unit on the University of Delaware's fuel cell battery hybrid buses are presented, including its use in automatically correcting anode flooding and diagnosing air channel blockage. (author)
Purpose: To assess the benefit and the effect of intraarterial lipiodol application on histological analysis of patients suspected of having HCC. To determine whether lipiodol marking leads to a better biopsy result and how lipiodol or a transarterial chemoembolization influences the histological diagnosis. Materials and Methods: Two groups of patients were examined. Group A included 14 patients highly suspected of having an HCC which had previously been unsuccessfully biopsied. A transarterial embolization with lipiodol was performed in these patients to mark intrahepatic tumors which could not otherwise be defined in unenhanced CT. A biopsy was then repeated. Group B included 22 patients undergoing therapy using transarterial chemoembolization (TACE). A biopsy was performed to support the diagnosis of a multifocal HCC before changing the therapy. Results: The transversal diameters of the biopsied tumors were similar in both groups (A: 22 mm; ...
... MUNICIPAL SOLID WASTES (MANAGEMENT AND HANDLING) RULES, 2000 Plastic Bag ban in Dhaka City, Bangladesh Private Sector Participation in Municipal Solid Waste Management SKAT 2000 TECHNICAL GUIDELINES ON MUNICIPAL SOLID WASTE MANAGEMENT Hazardous Waste Management Unit, Environmental Pollution Control Division, Central Environmental Authority, Sri Lanka 2004 Subregional ...
'Small radioactive source results in big accident' have occurred repeatedly in China and worldwide alike. Radioactive source management is one of the key activities for a nuclear power plant to maintain its good safety record and image to the public. From aspects of establishing the management system, centralized storage, periodic accounting, performing whole process control to the source usage and experience feedback etc., the author reports the practice and experience of radioactive source management in Daya Bay Nuclear Power Plant
This Radioactive and Mixed Waste Management Plan for the Hazardous Waste Handling Facility at Lawrence Berkeley Laboratory is written to meet the requirements for an annual report of radioactive and mixed waste management activities outlined in DOE Order 5820.2A. Radioactive and mixed waste management activities during FY 1994 listed here include principal regulatory and environmental issues and the degree to which planned activities were accomplished.
The philosophy of work management in radiation protection puts emphasis on the following up and management of overall process from work selection, planning, preparation, implementation till experience feedback, and overall optimization of production and safety management. This paper reports practices and experiences of Daya Bay nuclear power plant in the implementation of the philosophy during operational radiation protection through the practical examples
The complex aspects of high energy physics work are briefly described, and approaches to managing them are discussed. Management of software and data are covered. For managing complexity in experimental physics, the choice of building or buying processor systems is addressed and the issues of compatibility and standardization are discussed. (LEW)
Purpose - This paper aims to explore the links between revenue management and business-to-business (B2B) relationships and explains how revenue management can both support and damage B2B relationships. Design/methodology/approach - A single case study method was employed to conduct qualitative research into a company and its key accounts. In-depth data were collected from three divergent sources (company revenue managers, company account managers and nine of the company's key accounts) through semi-structured interviews, observations and document studies. Findings - The research findings reveal that from the company's perspective, managers acknowledge that revenue management has positively influenced the process of identifying and analysing key account activities and conducting contractual...
Waste is a cost of doing business. This cost can be considered in terms of the potential adverse health and environmental impacts, or the waste management costs associated with avoiding, minimizing, and controlling those impacts. There is an anticipated increase in the cost of waste management as a result of the increasing requirements for regulatory compliance. To meet the total waste management capacity needs of the organization and the compliance requirements, low-level radioactive, hazardous, and mixed waste management will need demonstrated technologies strategically managed as a technology portfolio. The role of the decision maker is to select the optimum mix of technologies and facilities to provide the waste management capacity needed for the next twenty years. The waste management system resulting from this mix includes multiple ...
Purpose - The purpose of the paper is to draw together the salient issues surrounding customer loyalty and customer relationship management (CRM) into a single coherent discussion. Various schools of academic thought are examined. The paper concludes with practical implications for managers. Design/methodology/approach - The literature surrounding customer loyalty, customer satisfaction, effective CRM and managing loyalty in a profitable manner are all reviewed. The paper allows managers to consider a wide range of material in the context of their business. Findings - The need for businesses to retain customers is an important issue in today's global marketplace. To retain customers, a business must forge loyal and long-term relationships with profitable customers. Reasons why customers le...
The United States Department of Energy (DOE) is committed to providing high quality products that satisfy customer needs and are the associated with this goal, DOE personnel must possess the knowledge, skills, and abilities to ensure successful job performance. In addition, there must be recognition that the greatest obstacle to proper project performance is inadequate project definition. Without strong project definition, DOE environmental management efforts are vulnerable to fragmented solutions, duplication of effort, and wastes resources. The primary means of ensuring environmental management projects meet cost and schedule milestones is through a structured and graded approach to project definition, which is the focus of this handbook.
Project management mode plays a key role in project construction, especially in nuclear power field. From the aspects of right, responsibility and benefit, this paper discussed the differences among the common used project management modes. Also the main kinds of the construction management modes used in China's nuclear power plants were summarized. At last, considering the experience of Ningde nuclear power plant, this paper put forward several perspectives about the selection of project management mode in nuclear power plant construction. (authors)
The purpose of-this planning guide is to present the process used to identify, document, and control PFP Stabilization and Deactivation Project interfaces. Revisions to this document will include, as attachments, the most recent version of the Project Interface Management List. A preliminary Interface Management List is included in Appendix A. This document is intended be a Project owned management tool. As such, this document will periodically require revisions resulting from improvements of the information, processes, and techniques as now described. For most revisions that suggest improved processes, PFP management approval is all that will be required.
The demand for energy management in teaching packages of Higher Vocational schools in the Netherlands and the possibilities to implement energy management into the different sectors of this school type have been investigated. The results are based on interviews with representative of the above-mentioned school types. Recommendations are made for a follow-up of this investigation in order to set up an energy management teaching module. 1 tab., 1 appendix
The population growth, changing consumption patterns, and rapid urbanization contribute significantly to the growing volumes of solid waste that are generated in urban settings. As the rate of urbanization increases, demand on the services of solid waste management increases. The rapid urban growth in Langkawi Island, Malaysia, combined with the increasing rates of solid waste production has provided evidence that the traditional solid waste management practices, particularly the methods of waste collection and disposal, are inefficient and quite nonsustainable. Accordingly, municipal managers and planners in Langkawi need to look for and adopt a model ...
US Department of Energy (DOE) Order 5820.2A was promulgated in final form on September 26, 1988. The order requires heads of field organizations to prepare and to submit updates on the waste management plans for all operations under their purview according to the format in Chap. 6, {open_quotes}Waste Management Plan Outline.{close_quotes} These plans are to be submitted by the DOE Oak Ridge Operations Office (DOE-ORO) in December of each year and distributed to the DP-12, ES&H-1, and other appropriate DOE Headquarters (DOE-HQ) organizations for review and comment. This document was prepared in response to this requirement for fiscal year (FY) 1994. The Oak Ridge National Laboratory (ORNL) waste management mission is reduction, collection, storage, treatment, and disposal of DOE wastes, generated primarily in pursuit of ORNL missions, in order to protect human health and safety and the environment. In carrying out this ...
Background: Pleural biopsy and cytology are standard procedures for the investigation of pleural disease. Recent medical literature has suggested that image-guided pleural biopsy shows improved sensitivity for the diagnosis of pleural malignancy, when compared with the more commonly performed reverse bevel needle biopsy such as Abrams' needle. In our centre there has been an increasing trend towards performing image-guided pleural biopsies, and to our knowledge there is no large published series documenting the complication rate and diagnostic yield. Methods: The radiology and pathology databases were searched for all image-guided [computed tomography (CT) and ultrasound (US)] pleural biopsies from January 2001 to December 2004. All imaging and histology were reviewed, and final diagnostic information about patients was obtained from the respiratory multidisciplinary team database and patient notes. A record was made of complications following biopsy, presence of ...
The required introduction of on board diagnosis II in the USA from the 94 models onward has led vehicle manufacturers and system suppliers to develop corresponding diagnosis processes at the beginning of the 1990`s. These systems are now in mass production for TLEV and partly for LEV requirements. Based on experience from the wide use of these functions, new knowledge has been obtained, which must be taken into account in the development of future systems. The additionally more severe emission and diagnosis requirements make further minimisation of the overall tolerances on the one hand, and a revision of the existing diagnosis algorithms necessary. In parallel with this, the Law must create the necessary outline conditions, where the requirements for the vehicle manufacturer and system suppliers must also be met. The OBD II development must therefore certainly not be regarded as complete. [Deutsch] Die ...
Radioactive waste for legal and regulatory purposes may be defined as material that contains or is contaminated with radio-nuclides at concentrations or activities greater than clearance levels as established by the regulatory body, and for which no use is foreseen. Safe management of radioactive waste is essential to ensure protection of humans and environment. Radioactive waste management policy is a guideline for the safe management of radioactive waste. It expresses the commitment of the country towards the goal. Government should initiate investigation into best long-term option for management of spent nuclear fuels. Process of selecting option and eventual site should involve comprehensive public participation within set time frames (with deep geological disposal as preferred management option).
The Superconducting super Collider Laboratory is a complex of particle accelerators being built in Ellis County, Texas. It will have a dedicated global communications network that will deliver control messages and provide for general data acquisition. This network will connect thousands of computer nodes over a very large geographic area. In order to meet the demanding availability requirements being levied on the system, it will need comprehensive network management. A large number of the computer nodes are embedded systems that traditionally do not support network management services. This presents unique challenges to standard network management practices. The Simple Network Management Protocol, SNMP, is widely accepted by industry as a tool to manage network devices. In this paper the authors examine the performance characteristics and usefulness of an SNMP agent in a real-time ...
Purpose - This paper seeks to deal with the history of Research and Development (R&D) management. It takes the history of the R&D Department of the Royal Philips Electronics of The Netherlands as an example to unravel the dynamics behind industrial R&D management. Design/methodology/approach - This paper is based upon historical and theoretical studies on industrial R&D institutions and research cultures. Findings - The paper proposes that the directors of the Philips R&D Department continually shaped and reshaped the organization in order to retain researchers with creative ideas, and to stimulate innovativeness. The R&D-management was the outcome of a search process that comprehended a mixture of scientific and industrial (management) skills, knowledge and experti...
The body of knowledge known as ''management'' has evolved incrementally over the past 100 years through a variety of innovators, including: Frederick Taylor, Max Weber, Mary Parker Follett, Chester Barnard, William Ouchi and Tom Peters. While the miracle of management - its structures, processes and techniques - has provided humankind with quantum advances in standard of living, there is an emerging theme in the literature to suggest that ''Management 1.0'' founded within the industrial age paradigm has reached the limits of its relevance. This paper proposes that it is time to consider a new conceptualization - ''Management 2.0'' - based on the global, information age paradigm in which modern businesses compete. This paper examines six forces which are currently redefining the future of m...
How do police respond to and manage complaints of stalking? To answer this question, we conducted a 3-phase study. First, we reviewed the literature to identify risk management tactics used to combat stalking. Second, we asked a group of police officers to review those tactics for completeness and group them into categories reflecting more general risk management strategies. The result was 22 categories of strategies. Finally, we used qualitative methods to evaluate the files of 32 cases referred to the specialized anti-stalking unit of a metropolitan police department. We coded specific risk management tactics and strategies used by police. Results indicated that a median number of 19 specific tactics from 7 general strategies were used to manage risk. Also, the implementation of strategi...
Without administrative terminologies there is no revenue to manage. The use of healthcare IT to capture the codes for administrative and financial support functions will impact the revenue cycle and the management of it. This is presumed to occur because clinical data coded at the point of care becomes the source for claims data. Thus, as electronic health record system applications utilizing terminologies are implemented, healthcare providers need to systematically consider the effect on the coding function and management of the revenue cycle. A key factor is the sequence of events changes, i.e., instead of a health information management professional selecting billing codes at the conclusion of an encounter based on the review of the record, clinical data generates the claims data via mapping. Efficiencies and management challenges result. PMID:19267004
The overall objective of the study in this report was to gather data on waste management technologies to allow comparison of various alternatives for managing municipal solid waste (MSW). The specific objectives of the study were to: 1. Compile detailed data for existing waste management technologies on costs, environmental releases, energy requirements and production, and coproducts such as recycled materials and compost. Identify missing information necessary to make energy, economic, and environmental comparisons of various MSW management technologies, and define needed research that could enhance the usefulness of the technology. 3. Develop a data base that can be used to identify the technology that best meets specific criteria defined by a user of the data base. Volume I contains the report text. Volume II contains supporting exhibits. Volumes III through X are appendices, each addressing a ...
Even before Egyptian times, fiber and paper-based methods were used to manage time, tasks, and priorities. Papyrus and paper were effective in their time, but now is the time for the even more effective computer-based methods of time management. This study compares paper and computer methods of the management of time, tasks, and priorities. Discussed are recommended strengths of off-the-shelf software for time management. Integrated software is recommended. A case study of the use of idea processing software to manage publication tasks and priorities is examined. Illustrated--for classroom-style training--are uses of a computer to enhance the quality and increase the efficiency of the coordination of publications from conception and research to printing and issuance. 3 refs., 43 figs.
Background:The validity of dementia diagnoses in the Danish nationwide hospital registers was evaluated to determine the value of these registers in epidemiological research about dementia. Methods: Two hundred patients were randomly selected from 4,682 patients registered for the first time with a dementia diagnosis in the last 6 months of 2003. The patients' medical journals were reviewed to evaluate if they fulfilled ICD-10 and/or DSM-IV criteria for dementia and specific dementia subtypes. The patients who were still alive in 2006 were invited to an interview. Results: One hundred and ninety-seven journals were available for review and 51 patients were interviewed. A registered diagnosis of dementia was found to be correct in 169 (85.8%) cases. Regarding dementia subtypes, the degree of agreement between the registers and the results of the validating process was low with a kappa of 0.36 (95% CI 0.24-0.48). Conclusion: The validity of ...
The diagnosis of idiopathic pulmonary hemosiderosis (IPH) may be elusive. A 6-year-old boy had microcytic hypochromic anemia and a hemolytic component. Hemosiderin-laden macrophages were not found in the gastric aspirate. He had no pulmonary signs or symptoms. Extensive hematologic and roentgenologic investigations failed to reveal the cause of the anemia. Quantitative serial scintigraphic scanning showed significant (35%) pulmonary sequestration of autologous erythrocytes labeled with sodium chromate Cr51. The half-life of the RBCs was moderately decreased (half-life, 15 days; normal, 25 to 35 days). An open-lung biopsy spece Cr51. The half-life of the RBCs was moderately decreased (half-life, 15 days; normal, 25 to 35 days). An open-lung biopsy specimen confirmed the diagnosis of IPH. A diagnosis of IPH should be considered when children have iron deficiency anemia and pulmonary signs or symptoms. Organ sequestration ...
Non-destructive methods of diagnosis for detecting cable degradation by aging are being studied recently for improvement of electric wires and cables. This study examines degradation behaviors of cable sheath and insulation by combined accelerated aging tests applying thermal and radiation stresses simultaneously using a typical low voltage cable. According to experiments, elongation of cross-linked polyethylene insulation deteriorated at a faster rate than PVC sheath did under low doses below 50 Gy/h. Therefore, measurements using a time domain dielectric spectrometer (TDS) were carried out for the purpose of developing a method of degradation diagnosis of insulation. It was found that values of tan#delta# measured at very low frequencies below 0.1 Hz increase in pace with degradation of insulation reflecting the level of degradation more effectively than those measured at frequencies around the commercial frequency. In order to consider ...
The aim of this study was to evaluate typical magnetic resonance imaging (MRI) findings in early rheumatic diseases manifesting at the soft tissues of the hand using a retrospective analysis. A total of 186 MRI examinations of patients with clinical suspicion of a rheumatic disease were evaluated in a consensus reading by two experienced radiologists. All imaging patterns were assessed with respect to their type and localization. Under blinded and non-blinded conditions diagnoses were correlated with final clinical diagnosis. The most frequent diagnoses were rheumatoid arthritis (RA, 45.7%) and psoriatic arthritis (PsA, 15.6%). The mean correlation between clinical and MRI diagnosis (r) was 0.75 in blinded and 0.853 in non-blinded reading (p <0.001). The following extra-articular imaging patterns were found: synovitis (59.1%), tendovaginitis (91.4%), dactylitis (14.5%), and bone marrow edema (18.3%). Only dactylitis was specific for a ...
Purpose: To evaluate a T_2-weighted URSE sequence for the assessment of pulmonary infiltrations in comparison to CT. Methods: 28 MRT scans of 22 patients with confirmed pneumonia were recorded on a 1.5 Tesla apparatus with an expiratory and diastolic triggered, T_2-weighted ultrafast-spin-echo sequence in axial slice mode with the following parameters: TR_e_f_f/T_E/Turbofactor 2000-4000/90 ms/21-23; slice thickness/separation 6/0.6 mm; FOV 360 mm; 24 slices. 24 spiral CTs (sice thickness/table advance: 1-2 mm/10 mm) were available for comparison. The separate evaluation of MRTs and CTs was performed by three radiologists in a consensus procedure with regard to pulmonary lesions (e.g., infiltration, round foci, net patterns) and image quality of the MRTs (4-step scale). Results: In 71% of the cases the CTs and MRTs agreed with the diagnosis and representation of the lesions, in 25% MRT was superior. MRT was better for the detection of pulmonary abscesses. In 93% the ...
Abstract in english INTRODUCTION: Treatment of the cryptorchid testicle is justified due to the increased risk of infertility and malignancy as well as the risk of testicular trauma and psychological stigma on patients and their parents. Approximately 20% of cryptorchid testicles are nonpalpable. In these cases, the videolaparoscopic technique is a useful alternative method for diagnosis and treatment. MATERIALS AND METHODS: We present data concerning 90 patients submitted to diagnostic lapa (more) roscopy for impalpable testicles. Forty-six patients (51.1%) had intra-abdominal gonads. In 25 testicles of 19 patients, we performed a two stage laparoscopic Fowler-Stephens orchiopexy. The other 27 patients underwent primary laparoscopic orchiopexy, in a total of 29 testicles. RESULTS: We obtained an overall 88% success rate with the 2 stage Fowler-Stephens approach and only 33% rate success using one stage Fowler-Stephens surgery with primary vascular ligature. There ...
Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis is a rare entity, sometimes referred to as Herlyn-Werner-Wunderlich syndrome (HWW). It usually presents after menarche with progressive pelvic pain, sometimes with regular menses, and a palpable mass due to hemihaematocolpos. The diagnosis is generally made only if the suspicion of this genitourinary syndrome is raised. To highlight the imaging diagnostic clues in this rare condition. We report on 11 adolescents with this condition. Sonography mostly allowed the correct diagnosis by showing uterovaginal duplication, haematocolpos or haematometrocolpos, and the absence of the ipsilateral kidney. MRI provided more detailed information regarding uterine morphology, the continuity with each vaginal channel (obstructed and nonobstructed), and the bloody nature of the contents. Early and accurate diagnosis of this syndrome is important so that adequate and ...
Fault symptoms of running gearboxes must be detected as early as possible to avoid serious accidents. Diverse advanced methods are developed for this challenging task. However, for multiwavelet transforms, the fixed basis functions independent of the input dynamic response signals will possibly reduce the accuracy of fault diagnosis. Meanwhile, for multiwavelet denoising technique, the universal threshold denoising tends to overkill important but weak features in gear fault diagnosis. To overcome the shortcoming, a novel method incorporating customized (i.e., signal-based) multiwavelet lifting schemes with sliding window denoising is proposed in this paper. On the basis of Hermite spline interpolation, various vector prediction and update operators with the desirable properties of biorthogonality, symmetry, short support and vanishing moments are constructed. The customized lifting-based multiwavelets for feature matching are chosen by the ...
Purpose: The aim of this study was to demonstrate the typical appearance of ganglioneuromas in computer-assisted tomography (CT), and magnetic resonance imaging (MRI). Material and methods: Retrospective analysis of diagnostic imaging (9 CT, 6 MRI) in 9 children aged 3 to 15 years with the histological diagnosis of ganglioneuroma. Results: The tomographies showed large (max. 13.4 cm in diameter) round or oval tumors with sharp delineation. The sites of the tumors were the retroperitoneum (5), the mediastinum (3), and the adrenal gland (1). Intraspinal tumor involvement occurred in 4 cases. On comparing CT with MRI, MRI was more accurate in defining the intraspinal involvement. The ganglioneuromas were of hypodense appearance in the native CT scan and showed moderate enhancement upon administration of contrast media. In five patients tumor calcifications with a disseminated sprinkled pattern were seen in CT. In MRI T_1-weighted scans the tumors were homogeneous and ...
Forty resected cases of intrahepatic cholangiocarcinoma were classified into four types according to the gross appearance; type I: mass forming type (n=8), type II: mass forming with periductal infiltrating type (n=20), type III: periductal infiltrating type (n=9) and type IV: intraductal growth type (n=3). Diagnostic features of these four types were studied. Peripheral enhancement was a common angiographic feature and tumor stains were recognized in 88%, 20%, 0%, 33%, respectively. Angiography and dynamic computed tomography (D-CT) were useful in differential diagnosis with hepatocellular carcinoma. Accuracy rate in diagnosis of portal vein involvement by angiography and D-CT was 82% and 91%, respectively. MRI was more useful in tumor detection than D-CT in cases with attenuation difference, in 55% of type II and in 75% of type III. Increase of arterial involvement, biliary tract involvement and portal vein involvement, incidence of lymph ...
The microelectronic cable diagnosis is a substantial tool to determine destruction free the residual strength and the lifetime of laid PE/XLPE medium voltage cables. Fundamentals of the ageing diagnosis and a cost reduced inspection concept are the `Isothermal-Relaxation-Current` Analysis and the Neuro-Fuzzy evaluation software. These new tools are able to determine the ageing status of the investigated cable without any references. The authors also show that the test breakdown during the assessment of the ageing status of criterial systems can be reduced by this approach. The cable diagnosis equipment KDA is also useful for the steering of investment as well as for preventive maintenance. (orig.) [Deutsch] Die zerstoerungsfreie dielektrische Kabeldiagnostik kann heute einen wesentlichen Beitrag zur Bestimmung der Restfestigkeit und der Restlebensdauer eines PE/VPE-isolierten Mittelspannungskabels leisten. Basis der ...
Varying load can cause changes in a measured gearbox vibration signal. However, conventional techniques for fault diagnosis are based on the assumption that changes in vibration signal are only caused by deterioration of the gearbox. There is a need to develop a technique to provide accurate state indicator of gearbox under fluctuating load conditions. This paper presents an approach to gear fault diagnosis based on complex Morlet continuous wavelet transform under this condition. Gear motion residual signal, which represents the departure of time synchronously averaged signal from the average tooth-meshing vibration, is analyzed as source data due to its lower sensitiveness to the alternating load condition. A fault growth parameter based on the amplitude of wavelet transform is proposed to evaluate gear fault advancement quantitatively. We found that this parameter is insensitive to varying load and can correctly indicate early gear fault. ...
Using observational and interview approaches, we evaluated the usability of a web-based communication tool that allows managers to announce open work shifts and staff to request work shifts....Full Text Available
Successful management of a patient with tracheo-innominate artery erosion requires the rapid institution of specific resuscitative and operative measures. Ten patients seen at the Charity Hospital of...Full Text Available
BackgroundMost studies on children with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) have been undertaken in tertiary care and little is known about their management...Full Text Available
The management of the interim phase of a complete oral rehabilitation in patients with severely worn dentition is often challenging due to the loss of occlusal vertical dimension, loss of tooth structure,...Full Text Available
The clinical management of adults with low-grade gliomas (LGGs) remains a challenge. There is no curative treatment, and management of individual patients is a matter of deciding optimal timing as well...Full Text Available
To assess the merits of currently available treatment options in the management of patients with low rectal cancer, a review of the medical literature pertaining to the operative and non-operative management...Full Text Available
The main aspects of the present WWER-440 reactors spent fuel management are described in the paper. Experimental results of fuel integrity studies which are carried out under conditions of a long-term storage are also presented. (author). 5 refs, 5 figs.
This document establishers the Software Configuration Management Plan (SCMP) for the software associated with the control system of the Sodium Removal System (SRS) located in the Interim Examination and Maintenance (IEM Cell) Facility of the FFTF Flux Test.
This article reports on an exploratory study of hospice social workers’ assessment and collaborative practices related to pain management; especially caregiver concerns about patient...Full Text Available
ObjectivesTo investigate the effect of group cognitive behavioural therapy (CBT) for fatigue self-management, compared with groups receiving fatigue information alone, on fatigue...Full Text Available
The United States Virgin Islands (USVI) is facing a diabetes epidemic similar to the one on the U.S. mainland, yet little is known regarding the cultural context relevant to self-management...Full Text Available
This report highlights the Pipeline integrity Management methods being implemented by gas companies. These aim at maintaining the current high safety level, prevent major hazards, ensure the integrity of the pipeline and protect people and environment in the vicinity of the pipeline in the most cost effective way. It should be noticed that Pipeline Integrity Management aspects, technical and organisational, are included in the more general framework of the Safety Management System. Currently, more and more gas companies implement such a system on the basis of standards like ISO 9000 and so on. In this way, the report shows how practices of Pipeline Integrity Management are continually developing in order to adapt to their environment, and to improve performance. Past experience and imminent developments show that Pipeline Integrity Management is a flexible and efficient approach to ...
This report documents site remediation at ORNL, including ORNL site characterization technologies, waste management and robotics and automation of the laboratory for waste processing and analysis.
Research progress is reported in 20 activities under the headings: spent fuels, defense waste management, commercial waste management, remedial action, and conventional reactors. Separate entries were prepared for each activity.
This document presents the way which the 8th principle of the quality management system 'Process approach' is applied, the principle that is identified and used by international standard ISO 9000. In order to understand the evolution of the management system requirements, as used today in different activities namely, industry, services, and nuclear activities, the authors present an evolution of the quality concept and its traceability to different standards, applicable in time. There are described the requirements of ISO 9001 standard, that represents the most widely spread model for modern organization management and the IAEA concerns related to integration of the above standard requirements into the most recent safety IAEA standard 'The Management System for facilities and activities'. The IAEA Safety Standard GS-R-3 describes a management model considering both the evolution of ...
The prognosis for patients with newly diagnosed malignant gliomas remains poor; however there have been some recent advances in treatment that have generated optimism. Medical management usually includes...Full Text Available
OBJECTIVE: The management and outcome of 138 abdominal shotgun wounds were examined over a 5-year period. SUMMARY BACKGROUND DATA: It has been proposed that exploratory laparotomy may be unnecessary...Full Text Available
...The Political Evolution of the Landfill Tax in the UK wm-1996-03 Green Taxes, Waste Management and Political Economy 1995 ^ Top ...on civil engineering Lifecycle assessment - an overlooked opportunity Refereed Journal Articles: Green taxes, waste management and political economy Reports: Environmental cost benefit ...
Disorders of the adrenal gland are rare and complex, with many potential pitfalls in their management. An understanding of embryology, anatomy, physiology and biochemistry is crucial. Surgical treatment may be required for syndromes of hormonal excess and/or suspicion of neoplasia.
The University of Cincinnati (UC) has been active in the National Library of Medicine's Integrated Advanced Information Management Systems (IAIMS) program since IAIMS' inception in 1984. UC received...Full Text Available
A microcomputer-based herd management information system was implemented as part of the herd health program provided to 13 dairy clients by the Ontario Veterinary College, University of Guelph. The...Full Text Available
Purpose:The oral chemotherapy cycle management program (CMP) provides clinical management support to patients receiving certain oral chemotherapies. The CMP includes a dose-monitoring...Full Text Available
On 12 July the Audit Commission published For Your Information, a well researched report about information and its management in acute hospitals in Britain, how and why it is failing, and steps that...Full Text Available
OBJECTIVES: To describe the immediate reported management, by general practitioners (GPs), of men presenting with symptoms of urethral discharge, or dysuria only. SUBJECTS: All 692 GPs in practice in...Full Text Available
BackgroundManagement of benign tracheal stenosis (BTS) varies with the type and extent of the disease and influenced by the patient's age and general health status, hence we sought...Full Text Available
Esophageal perforation is associated with a significant risk of morbidity and mortality. We report herein a case of lye-induced esophageal perforation managed successfully by employing endoscopic T-tube...Full Text Available
Hemoptysis in patients with lung cancer is not uncommon and sometimes have dangerous consequences. Hemoptysis has been managed with various treatment options other than surgery and medicine, such as...Full Text Available
We report herein a case of thoraco diaphragmatico biliary fistula in a 24-year-old male who was managed conservatively with antibiotics and tube thoracostomy and had complete radiological clearance.
This paper describes the development of an interactive internet-based cost-estimating tool for commonly used urban storm runoff best management practices (BMP), including: retention and detention ponds, grassed swales, and constructed wetlands. The paper presents the cost data, c...
The attitudes and expectations of producers toward the use of a microcomputer-based herd management information system were assessed. The study was conducted over a two-year period, beginning in January...Full Text Available
Many Pacific Basin countries rely on oil for electricity production. Alternative fuel sources such as coal, which is available in the Pacific Basin, can help mitigate adverse impacts of sudden price increases or supply disruptions. Coal combustion produces solid and potentially hazardous wastes of concern to environmental regulators and utility managers. This paper identifies issues associated with managing coal combustion wastes in the Pacific Basin, using the state of Hawaii as a case study. Hawaii is typical of many Pacific Basin locations in that it depends on oil, has limited sites, for waste management operations, and is subject to domestic and international waste management regulations. The paper discusses coal-fired utility wastes, environmental impacts of coal combustion waste disposal, and regulatory requirements that impact coal waste management. From this baseline, ...
BackgroundTraumatic pneumothoraces are common. Many are managed with tube thoracostomy. However, there is a high complication rate from chest tube placement, particularly in patients...Full Text Available
Until recent years, those involved in the design, operation and regulation of nuclear power systems devoted more resources to forward movement than to the back end of the fuel cycle. Now, though, concerted thought and international cooperation have been devoted to the question of nuclear waste management. The expert consensus is that sufficient knowledge exists to make e.g. disposal decisions with an acceptable level of confidence. In the first phases of research, decision processes were adapted to the tasks at hand. However, at some point in each nuclearized country, there came a time when waste management implied finding repository sites. At that time management abruptly entered the social sphere - where unfortunate experience has shown time and time again that classical decision processes are not adapted to facilitating societal acceptance of management solutions. This paper recounts the various ...
This article describes the design and implementation of an online diabetes self-management intervention for a sample of inner-city African Americans with diabetes. Study participants were randomly assigned...Full Text Available
Based on the Morlet wavelet transformation and Wigner-Ville distribution (WVD), we present a wind turbine fault diagnosis method in this paper. Wind turbine can be damaged by moisture absorption, fatigue, wind gusts or lightening strikes. Due to this reason, there is an increasing need to monitor the health of these structures. Vibration analysis is the best-known technology applied in wind turbine condition monitoring, in which the time-frequency analysis techniques such as Wigner-Ville distribution (WVD) are widely used. Theoretically WVD has an infinite resolution in time-frequency domain. For early wind turbine fault signals, however, there are two main difficulties in WVD analysis. One is strong noise signals in the background and the other is cross terms in WVD itself. In this paper,...
Aim.- To identify what determinants influence the prevalence and accuracy of nursing diagnosis documentation in clinical practice. Background.- Nursing diagnoses guide and direct nursing care. They are the foundation for goal setting and provide the basis for interventions. The literature mentions several factors that influences nurses- documentation of diagnoses, such as a nurse-s level of education, patient-s condition and the ward environment. Design.- Systematic review. Method.- MEDLINE and CINAHL databases were searched using the following headings and keywords: nursing diagnosis, nursing documentation, hospitals, influence, utilisation, quality, implementation and accuracy. The search was limited to articles published between 1995-October 2009. Studies were only selected if they were...
Objective To investigate value of magnetic resonance cholangiopancreatography (MRCP) using oral diluted gadolinium (Gd)-diethylenetriamine penta-acetic acid (DTPA) as negative contrast materials in diagnosis of juxtapapillary duodenal diverticulum with atypical imaging features. Methods Nineteen patients with juxtapapillary duodenal diverticula of which imaging findings were atypical underwent MRCP using oral diluted Gd-DTPA as negative contrast materials after conventional MRCP without any oral contrast materials. Results Twenty diverticula were revealed in the 19 patients. At conventional MRCP, the diverticula appeared as rounded lesion with high signal intensity. After oral administration of diluted Gd-DTPA, they disappeared at MRCP. These entities were diagnosed as duodenal diverticula...
The use of magnetic resonance imaging for diagnosis and the preoperative staging of renal cell carconoma was evaluated in 79 patients with 88 tumors. Gradient-echo and spin-echo images before and after intravenous administration of Gadolinium DTPA were compared with the results of computed tomography (CT) and histologic staging. The two imaging techniques had comparable results: T-stage was predicted correctly with CT in 78%.4% and with MRI in 84.0% of the cases, while the N-stage was accurately assessed in 81.8% and 79.5%, respectively. MRI had some advantages in diagnosing perirental tumor spread and in excluding an infiltration beyond Gerota's fascia. Therefore, MRI is a true alternative to CT for staging large renal cell carcinomas and especially for patients with contraindications for iodinated contrast agents. (orig.).
MRI (Magnetic resonance imaging) has been widely used in the diagnosis of primary carpal tunnel syndrome (CTS). However, it has had limited clinical application in diagnosing persistent or recurrent CTS. We aimed to investigate the efficacy of this imaging modality in patients who had previously undergone open carpal tunnel release without relief of symptoms, and assess the correlation of MRI with intra-operative findings upon re-exploration. MRI studies were performed on 17 wrists (16 patients) presenting with recurrent/persistent symptoms and signs of CTS in whom repeat nerve conduction studies were also performed. Surgical re-exploration was undertaken on 16 wrists in which a 100% correlation was noted between MRI and intra-operative findings of an incompletely released or re-grown tran...
The generalized demodulation time-frequency analysis is a novel signal processing method, which is particularly suitable for the processing of multi-component amplitude-modulated and frequency-modulated (AM-FM) signals as it can decompose a multi-component signal into a set of single-component signals whose instantaneous frequencies own physical meaning. While fault occurs in gear, the vibration signals measured from gearbox would exactly display AM-FM characteristics. Therefore, targeting the modulation feature of gear vibration signal in run-ups and run-downs, a fault diagnosis method in which generalized demodulation time-frequency analysis and envelope order spectrum technique are combined is put forward and applied to the transient analysis of gear vibration signal. Firstly the multi-...
This study was developed as part of the project ?Studies for Environmental and Cultural Sustainability of the Fulni-? Medical System: Office on handling medicinal plants?. The Fulni-? people are located in Pernambuco State, Northeastern Brazil. One of the components of this project was an ethnobotanical diagnosis of the indigenous land, where a phytosociological survey was performed in an area of Caatinga vegetation, located at Ouricuri settlement. Based on these ethnobotanical data, we calculated a conservation priority index aiming to rank species that should receive immediate attention from the Fulni-? people. We identified 44 woody plants, 50% of which have a medicinal use. Among these, six plants were considered highly vulnerable and in need of immediate conservationist attention, in ...
Between 1983 and 1986, 35 of 90 patients with acquired immunodeficiency syndrome (AIDS) had double-contrast esophagograms to rule out opportunistic esophagitis. The radiographs were reviewed without knowledge of the clinical or endoscopic findings. Candida esophagitis was diagnosed radiographically in 17 patients who had varying degrees of plaque formation and viral esophagitis in three who had discrete ulcers without plaques. All three patients with viral esophagitis (herpes in 2 and cytomegalo virus in one) and 15 of 17 with Candida esophagitis had endoscopic and/or clinical corroboration of the radiographic diagnosis. Thus, the authors' experience suggests that fungal and viral esophagitis can often be differentiated on double-contrast esophagography, so that appropriate antifungal or antiviral therapy can be instituted without need for endoscopic intervention.
PURPOSE.- The study aims to clinically validate the defining characteristics (DCs) of the nursing diagnosis (ND) of Activity Intolerance for patients with ischemic heart disease and refractory angina. METHODS.- Cross-sectional study was used, involving 22 patients with ND of Activity Intolerance. The Fehring method was used to validate the ND. FINDINGS.- Most DCs presented reliability indexes between 0.5 and 0.79. Three DCs presented reliability indexes - 0.8. CONCLUSION.- All DCs were validated, and electrocardiographic changes indicating ischemia, verbal report of fatigue, and abnormal rate response to activity were considered as DC major. IMPLICATIONS FOR NURSING PRACTICE.- This study is relevant in daily nursing practice for guidance in establishing the care plan and describing the ass...
A novel approach to fault diagnosis is proposed using multiscale morphology analysis to extract impulsive features from the signals with strong background noise. Multiscale morphology is applied to one-dimensional signal by defining both the length and height scales of structuring elements (SEs). A local-peak-value based adaptive algorithm is also introduced. The new approach makes the selection of SEs more transparent and is independent of empirical rules. Both simulated impulsive and vibration signals of two defective roller bearings are employed to validate the proposed algorithm. The roller bearing faults presented in the validation include both inner and outer race faults. The test results show that the multiscale morphology analysis is effective and robust to extract morphological features.
Magnetic resonance imaging has proven an invaluable method in the diagnosis of joint diseases associated with osteonecrotic, inflammatory, traumatic and degenerative processes. At the clinical level, it has an important role in decisions about the method of treatment and evaluations of the therapeutic success. When the merits of MRT are balanced against those of conventional radiography including tomography and CT, which both ensure better spatial resolution in the visualisation of cortical and spongy bone structures, it becomes quite evident that MRT must not be regarded as an alternative method of imaging but as one that can be used additionally to obtain the most information for the diagnosis of arthropathy. The question as to whether new pulse sequences (snap shots) or invasive techniques like intra-articular injection of paramagnetic substances (MR arthrography) are likely to become routine procedures in the detection of joint diseases ...
Fault symptoms of running gearboxes must be detected as early as possible to avoid serious accidents. Diverse advanced methods are developed for this challenging task. However, for multiwavelet transforms, the fixed basis functions independent of the input dynamic response signals will possibly reduce the accuracy of fault diagnosis. Meanwhile, for multiwavelet denoising technique, the universal threshold denoising tends to overkill important but weak features in gear fault diagnosis. To overcome the shortcoming, a novel method incorporating customized (i.e., signal-based) multiwavelet lifting schemes with sliding window denoising is proposed in this paper. On the basis of Hermite spline interpolation, various vector prediction and update operators with the desirable properties of biorthog...
339 CT und 95 MRT examinations in 210 partients were evaluated retrospectively to determine the value of CT and MRT for follow-up of head and neck tumors and for diagnosing recurrences. Semi-quantitative evaluation of tumor extent during and after radiotherapy showed advantages for MRT since changes induced by treatment, particularly oedema, produced less contrast loss in the images. CT had a sensitivity of 81% for the recognition of recurrences; this was 92% for MRT. Specificity for CT was 76% and for MRT 86%. Concerning the reliability of individual diagnostic criteria, space occupying lesions were the most valuable in CT diagnosis. For MRT, space occupying lesions and infiltration into neighbouring structures were of equal value. Because of differences in the nature of the signals, MRT proved better than CT in characterising recurrent masses and this improved the differentiation between scarring and local tumour recurrence. (orig.).
Roller bearing is one of the most widely used elements in rotary machines. Condition monitoring of such elements is conceived as pattern recognition problem. Pattern recognition has three main phases: feature extraction, feature selection and feature classification. Histogram features can be used for fault diagnosis of roller bearing. This paper presents the use of decision tree for selecting best few histogram features (bin ranges) that will discriminate the fault conditions of the bearing from given train samples. These features are extracted from vibration signals. A rule set is formed from the extracted features and fed to a fuzzy classifier. The rule set necessary for building the fuzzy classifier is obtained largely by intuition and domain knowledge. This paper also presents the usag...
Digital radiography for diagnosis of chest diseases using Fuji Computed Radiography (FCR) was evaluated. The results were as follows; 1. Compared to the conventional chest X-ray films, various types of image enhancement could be made by manipulation of the digital information such as tone conversion, spatial frequency modification etc. 2. Digital radiography lessens the X-ray exposure dose and will ultimately permit speedy transmission of image data from outlying clinics to central processing hospitals. 3. Digital radiographic images are useful in chest X-ray diagnosis especially in mass surveys for lung cancer and in primary care medicine because of its full imaging capability. (author).
The aim of this article is to report our experience in the diagnosis of two cases of iliac artery endofibrosis or arteriopathy, a rare entity occurring in high-performance athletes, presenting with intermittent claudication (right-sided in both) after maximal exercise. External iliac artery endofibrosis or arteriopathy is a likely diagnosis in competitive athletes free of cardiovascular risk factors who present with leg claudication. Arteriography and a papaverine-assisted mean pressure gradient across the iliac arteries of more than 10 mmHg is a useful diagnostic approach. Moreover, balloon angioplasty of the iliac artery in that patient, in whom a pressure gradient was detected, resulted in symptomatic relief for 2 months followed by mild symptom recurrence. Thus, although balloon angioplasty is feasible and safe, it might not be adequate to treat this entity and, thus, its value remains undefined.
The early diagnosis of such disorders is of major importance because, in most cases, severe consequences can only be averted by early treatment. The value of magnetic resonance imaging (MRI) in many orthopaedic and traumatological conditions is generally accepted. The value of MRI in this particular field is illustrated by typical case reports on common clinical problems [Deutsch] Der Fruehdiagnose von Erkrankungen des Kindes- und Jugendalters kommt grosse Bedeutung zu, da oftmals nur durch eine daraus resultierende Fruehbehandlung schwerwiegende Folgen vermieden werden koennen. Die Kernspintomographie (Magnetresonanztomographie=MRT) ist in zahlreichen orthopaedischen-traumatologischen Fragestellungen bereits etabliert. An ausgewaehlten Fallbeispielen haeufiger klinischer Problemstellungen soll in der vorliegenden Arbeit der Stellenwert der MRT dargestellt werden. (orig.)
The ensemble empirical mode decomposition (EEMD) can overcome the mode mixing problem of the empirical mode decomposition (EMD) and therefore provide more precise decomposition results. Wavelet neural network (WNN) possesses the advantages of both wavelet transform and artificial neural networks. This paper combines the merits of EEMD and WNN to propose an automated and effective fault diagnosis method of locomotive roller bearings. First, the vibration signals captured from the locomotive roller bearings are preprocessed by EEMD method and intrinsic mode functions (IMFs) are produced. Second, a kurtosis based method is presented and used to select the sensitive IMF. Third, time- and frequency-domain features are extracted from the sensitive IMF, its frequency spectrum and its envelope spe...
Cognitive decline has been described in elderly patients with schizophrenia, but the underlying pathology remains unknown. Some studies report increases in plaques and neurofibrillary tangles, but there is no evidence for an increased risk for Alzheimer's disease (AD) in elderly schizophrenics. Models of a decreased cerebral reserve suggest that increases in AD-related neuropathology below the threshold for a neuropathological diagnosis could be related to dementia severity in elderly schizophrenia patients. We tested this hypothesis in 110 autopsy specimens of schizophrenia patients, without a neuropathological diagnosis of AD or other neurodegenerative disorders. Furthermore, we assessed the effects of apolipoprotein E (ApoE) status, a known genetic risk factor for AD. Measures of densit...
Fuji Computed Radiography (FCR) is a new system of digital radiography that is based on the latest computer technologies. We applied this FCR system to the X-ray diagnosis of the laryngeal disease. Twenty patients with various laryngeal diseases were evaluated by both FCR frontal tomography and conventional screen-film frontal tomography under the same exposure condition. Both tomograms were then compared on the subject of the clarity of delineation of laryngeal structures. As the result, FCR tomograms revealed the feature of the laryngeal lumen and cartilages more clearly than conventional tomograms. In addition, energy subtraction method, which is one of FCR image processing systems, was presented as a new technical procedure to extinguish cervical spine shadows in plain anteroposterior laryngeal X-photograph. We stress that FCR system is the suitable procedure for X-ray analysis of laryngeal diseases, especially in the region related with the phono-surgery. ...
Anaphylaxis is a serious allergic reaction that is rapid in onset and sometimes leads to death. Understanding mechanisms, triggers, and patient-specific risk factors for severe or fatal anaphylaxis is critically important. Diagnosis of anaphylaxis is currently based on established clinical criteria. Epinephrine (adrenaline) is the first-line medication for anaphylaxis treatment and delay in injecting it contributes to biphasic reactions, hypoxic-ischemic encephalopathy, and fatality. Here, we focus on four important areas of translational research in anaphylaxis: studies of potential new biomarkers to support the clinical diagnosis of anaphylaxis, laboratory tests to distinguish allergen sensitization from clinical risk of anaphylaxis, the primary role of epinephrine (adrenaline) in anaphylaxis treatment, and strengthening the overall evidence base for anaphylaxis treatment. PMID:21668849
Pyogenic sacroiliitis is a rare entity in children. Diagnosis is often delayed because of its variable clinical presentation, low suspicion by the examining physician, and rare findings on radiographs. Delayed diagnosis, however, results in complications such as iliopsoas abscess. We report the case of a 12-year-old girl hospitalized with a 21-day history of fever, pain in the left iliac fossa, and flexion contracture of the hip. On examination, she had fever (38.9 ^oC), psoitis, localized tenderness at the left sacroiliac joint, and pain elicited by lateral compression of the pelvis. The abdominal examination was normal. The erythrocyte sedimentation rate was 130mm in the first hour, C-reactive protein was 186mg/l, and the white blood cell count was 18,400/mm^3, with 79% neutrophils. Urin...
When gear fault occurs, the vibration signals always display non-stationary behavior. Therefore time-frequency analysis has become the well-accepted technique for vibration-based gear fault diagnosis. This paper presents the application of a new time-frequency signal processing technique, the Hilbert spectrum based on the maximal overlap discrete wavelet packet transform (MODWPT), to the analysis of simulation signals and gear fault vibration signals measured by the acceleration sensor fixed on the bearing house. As long as the decomposition scale and disjoint dyadic decomposition are chosen suitably, the original signal could be decomposed into a set of monocomponent signals whose instantaneous amplitude and instantaneous frequency own physical meaning. After the instantaneous amplitude a...
Abstract: HARVEST was designed as a strategic research and planning tool, allowing assessment of the spatial pattern consequences of broad timber management ...
... due to the evolving nature of the Strategy Maps and the changing priority roles, it was decided not to link the SMSP directly with any Strategic Plans. ...
The paper takes as its starting point the diffusion of ICT applications associated with so-called 'customer relationship management' (CRM). CRM encourages organisations to shift their understanding of customers from an episodic and transaction-based perspective to one that emphasises continuous 'relationship management'. CRM applications thus promise to deliver more, real-time accurate information about consumer habits and behaviours therefore allowing organisations to maximise their extraction of business value. This paper explores the ways in which such inscriptive technologies are not merely referential but also constitutive of contemporary re-presentations and ideals of the consuming subject. Focusing on what we might call the 'digital doubles' of customer relationship management the a...
Customer knowledge has become an important topic for both academicians and practitioners in recent years. However, there has been little academic research on the utilization of customer-specific knowledge. This study adds to our understanding in focusing on the relationships between various intra-organizational factors and customer knowledge utilization in the context of key account management. The results of the study show, that the use of teams, top management involvement, KAM formalization and CRM technology enhance the utilization of customer knowledge in the management of large industrial key account customers.
The Department of Defense is making significant investments to construct systems, built upon web services and their supporting technologies, that strive to achieve the goals of net-centricity. While these technologies address several of the traditional stumbling blocks to integration and interoperability, they leave issues of information management largely unaddressed. Indeed, the broad availability of these systems exacerbates, rather than reduces, stresses on our information management capabilities. This paper discusses the enterprise-level information management infrastructure objectives for providing net-centric military capabilities and more fundamental technical challenges derived from them.
... a way to model a munition's terminal effects in a ... following attributes are handled in a stochastic fashion ... be improved by managing a queue of buffers ...
... military medical education, environmental security activities, and provides e-mail capabilities and other basic information management capabilities. ...
Prior to this at TRW, Mr. Schier managed flight software development on the MILSTAR Communications Payload and led integration and verification work on ...
According to the Principles of Radioactive Waste Management, the IAEA SAFETY SERIES NO-111-F, IAEA declared 9 doctrines. The IAEA advised a country that operates nuclear power plant to adopt the principles. As a member of the IAEA, Korea has also discussed about a unified policy and enacting law for radioactive waste management to follow the doctrines. This study analyzed the recently enacted Korea Radioactive Waste Management Act and verified whether the Act successfully follows the doctrine or not
... CJCSI 3141.01C, Responsibilities for the Management and ... of a multivolume set of CJCS unclassified and ... (1) CJCSM 3122.01A, Joint Operation ...
Information glut is one of the primary characteristics of the electronic age. Managing such large volumes of information (e.g., keeping track of the types, where they are, their relationships, who controls them, etc.) can be done efficiently with an intelligent, user-oriented information management system. The purpose of this paper is to describe a concept for managing information resources based on an intelligent information technology system developed by the Argonne National Laboratory for managing digital libraries. The Argonne system, Intelligent Query (IQ), enables users to query digital libraries and view the holdings that match the query from different perspectives.
... POVs) overseas when space was available. ... information management system launched in 2004. ... Personally Procured Transportation (PPT) system ...
Jet Propulsion Laboratory. California Institute of Technology. Pasadena, California. Energy and Water Conservation. Steve Rigdon. Facilities Energy Manager ...
Knowledge management is controlling the transfer, distribution, and availability of knowledge. Traditionally, knowledge management processes are predefined; e.g. it is laid out in detail which document template, data structure, system, or work flow steps have to be used in order to manage knowledge. But knowledge management itself is complex. It is simply not possible to predefine the typical flow of work in knowledge intensive processes in advance. So rather than trying to determine the procedures it is more promising to analyze which factors can be used in order to control the outcome of t
This document presents a detailed schedule for the implementation of the strategy for managing defense remote-handled (RH) transuranic (TRU) waste. The baseline management strategy was defined in the Defense Remote-Handled Transuranic Waste Cost/Schedule Optimization Study and is summarized in this document. Also included are revised RH TRU waste inventory projections, current site management plans, a list of key decision points and milestones, and a discussion of uncertainties associated with management of RH TRU waste. The plans are summarized in a detailed schedule diagram and in an RH TRU waste work off diagram. 9 refs., 5 figs., 4 tabs.
Data from many measuring devices throughout the Savannah River Site (SRS) is transmitted to a central location for processing as a vital component in the SRS emergency preparedness and response program. The data processing is currently accomplished using VAX-based FORTRAN programs with the data stored in Digital's Record Management System (RMS) files which is shared using global COMMON. A program is underway to store and process this data using a Structured Query Language (SQL)-based Database Management System (DBMS). The advantages of replacing the current system with one using an SQL-based DBMS are discussed.
... geographically flexible rapid- deployment forecasting system that directly leverages the CORIE modeling and information management capabilities. ...
This paper experimentally evaluates the effects of applying autonomic management to the scheduling of maintenance operations in a deployed Chord network, for various membership churn and workload patterns. Two versions of an autonomic management policy were compared with a static configuration. The autonomic policies varied with respect to the aggressiveness with which they responded to peer access error rates and to wasted maintenance operations. In most experiments, significant improvements due to autonomic management were observed in the performance of routing operations and the quantity of data transmitted between network members. Of the autonomic policies, the more aggressive version gave slightly better results.
In today's business environment, strong forces of competition and globalization have created an urgency to focus how an organization controls and nurtures its intellectual capital. The concept of knowledge and its management has gained currency and momentum as technology has enabled thoughts and ideas to be more easily generated and distributed. With increased application of technologies such as the Internet, Customer Relationship Management (CRM), and advanced software capabilities, it has been suggested the time has come for discussion of a new paradigm for knowledge management. Toward that end, this article examines the knowledge literature and reviews the experience of a leading private healthcare group, with the objective of gaining a better understanding of the issues that confront e...
This report contains preconceptual designs and planning level life-cycle cost estimates for managing hazardous waste. The report`s information on treatment, storage, and disposal modules can be integrated to develop total life-cycle costs for various waste management options. A procedure to guide the US Department of Energy and its contractor personnel in the use of cost estimation data is also summarized in this report.
This report consists of a broad overview of activities at Los Alamos National Laboratory (LANL). The following topics are discussed: The growth of the waste management group; what we do today; the mission of the waste management group; the liquid waste treatment section; the radioactive liquid waste project office; the chemical waste section; the radioactive waste section; and the technical support section.
Little recent research is available about where specific types of farm managers search for information about better production practices. The objective of this study was to investigate what information sources managers used and how they rated the usefulness of each source. The authors administered mail questionnaires to probability samples from sampling frames they developed for four groups: dairy and fresh market vegetable producers from Wisconsin and berry and nursery producers from a multistate region. Questionnaire items asked operation managers to check off, from a list of information sources, those that they used in the last year to learn about new equipment or procedures to improve their operations and then to rate the usefulness of each source. In the last year, nursery, dairy, and berry managers most often used information from print media (63% to 84%), followed by other farmers (50% to 80%). ...
The authors report the individual monitoring data management system (IDOSE) at Daya Bay Nuclear Power Station. The components of the individual monitoring system, the design requirements of IDOSE, the characteristics and application of this computerized management system are mainly presented. Its application shows that IDOSE meets the requirements of the concerning occupational standards of the state and matches with the requirements of IAEA/ISOE.
During its jubilee, the French building technical and scientific centre (CSTB) has organized a colloquium about the future tendencies of buildings evolution in the 20 forthcoming years: autonomy in energy production and wastes or effluents management, reduction of water consumption and management of water, hot water production and space heating, bio-sensors for the management of indoor air-quality, control of noise environment using active acoustic systems etc.. (J.S.)
A range of lessons have been identified from previous attempts to implement long term radioactive waste management policy in the UK and internationally. Many of these relate to the way the decision-making process is undertaken and the fact that there needs to be an open, transparent process that enables continuous stakeholder involvement. Nirex believes that using the SEA and EIA frameworks will help to incorporate the lessons learned into the future decision-making process relating to long-term radioactive waste management.
The management procedure of a large PRISE (Primary-to-Secondary) leakage accident at Loviisa nuclear power plant taking into account the plant modifications which are expected to be realized during 1995-96 is described. The management procedure has been validated by performing thermal hydraulic analyses with the computer code RELAP5/MOD3 and the results from these analyses are also shortly discussed. (4 refs., 6 figs., 1 tab.).
The mission of the Waste Management Institute is two-fold: (1) to enhance awareness and understanding of waste problems and their management in our society and, (2) to provide leadership in research, instruction and outreach to improve the quality of life on a global scale and protect the environment.
This report is an Implementation Guide for Hanford Tanks Initiative C-106 heel retrieval contract management HNF-2511 to provide a set of uniform instructions for managing the two contractors selected. The primary objective is to produce the necessary deliverables and services for the HTI project within schedule and budget.
The fuel management study on 18-months fuel cycle project is introduced for Daya Bay Nuclear Power Station. Station from the selection of the objective of fuel management for 18-months cycle, the method used and the analysis done are explained in detail to reach the final loading pattern chosen
In the market economy, Daya Bay Nuclear Power Station needs to out source or allow to suppliers among industries, while concentrating its core competitive capability, for safely and stable operation. By evaluating the features of contract management in Daya Bay Nuclear Power Station, set up the organization and process of the supply management
This paper describes New York State Electric and Gas Corporation`s concept for a comprehensive, centrally located data system for management of their continuous emission monitoring systems (CEMS) data. The topics of the paper include the power system`s mix of generating units; data reporting requirements; data base management; nitrogen oxides compliance tracking; sulfur dioxide, nitrogen oxides, carbon dioxide and flow monitoring; and allowance tracking.
Implementation of a plan to charge waste management costs to the facility that generates such waste requires a long-term commitment and consistent administration. The benefit is that generators are provided the incentive to optimize waste management practices if the charges are appropriately applied. This paper summarizes (1) a plan to charge waste generators, (2) the administrative structure of the plan, (3) a comparison between the rate structure and changes in waste disposal operations, and (4) issues that have surfaced as the plan is implemented. 2 refs., 1 fig., 1 tab.