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The diagnostic value of the portable chest radiography obtained with Fuji computed radiography (FCR) was evaluated in comparison with conventional images in 23 patients who were admitted to ICU in Yokohama City University Hospital. On the whole , FCR produced more exellent images than conventional screen-film radiographs. Especially the evaluation for the demonstration of the catheters, the endotracheal tubes and the tracheal shadows obtained high score. We discuss the clinically utility of FCR for the portable chest radiographs in ICU. (author).

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Diabetes, Gestational; Postpartum Period

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ICU telemedicine uses audiovisual conferencing technology to provide critical care from a remote location. Research is needed to best define the optimal use of ICU telemedicine, but efforts are hindered by methodological challenges and the lack of an organized delivery approach. We convened an interdisciplinary working group to develop a research agenda in ICU telemedicine, addressing both methodological and knowledge gaps in the field. To best inform clinical decision-making and health policy, future research should be organized around a conceptual framework that enables consistent descriptions of both the study setting and the telemedicine intervention. The framework should include standardized methods for assessing the preimplementation ICU environment and describing the telemedicine program. This framework will facilitate comparisons across studies and improve generalizability by permitting ...

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To evaluate the usefulness of portable chest radiographs by Fuji computed radiography (FCR) in ICU, FCR radiographs of 56 patients who were admitted to General Intensive Care Unit of Keio University Hospital were compared with the conventional portable images. Because FCR could show two differently processed images in one film and allowed a wide range of image reproduction, visualization of the trachea, bone soft tissues and catheters by FCR was easier than that by the conventional radiography. Repeated radiographs by FCR had similar optical densities and limited exposure errors. Furthermore, radiation was reduced than that of the conventional radiography. In conclusion, FCR is thought to be a useful technique for portable chest radiography in ICU patients. (author).

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Digital information flow within the intensive care unit (ICU) continues to grow, with advances in technology and computational biology. Recent developments in the integration and archiving of these...Full Text Available

UK PubMed Central (United Kingdom)

Quality research, requiring large numbers of participants, in the intensive care unit (ICU) population requires multicentre collaboration. Although logistically challenging, this methodology reduces...Full Text Available

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A 1984 American Association of the Academy of Sciences study of more than 150 successful science in-service programs developed a list of their characteristics, which included: Strong academic component in mathematics, science, and communications, focused on enrichment rather than remediation; academic subjects taught by teachers who are highly competent in the subject matter and believe that students can learn the materials; heavy emphasis on the applications of science and mathematics and careers in these fields; integrative approach to teaching that incorporates all subject areas, hands-on opportunities, and computers; multiyear involvement with students; recruitment of participants from all relevant target populations; opportunities for in-school and out-of-school learning experiences; parental involvement and development of base of community support; specific attention to removing educational inequalities related to race and gender; involvement of professionals ...

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The objective of this article is to evaluate two-year clinical and radiological follow-up results for patients who were treated with microdiscectomy and posterior dynamic transpedicular stabilisation...Full Text Available

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BackgroundLoss to follow-up (LTF) challenges the reporting of antiretroviral treatment (ART) programmes, since it encompasses patients alive but lost to programme and deaths misclassified...Full Text Available

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Purpose: The purpose of this research was to identify the extent and scope of changes to radiography practice. Method: Questionnaires were sent to radiology managers at acute National Health Service (NHS) hospitals in 2000 as a follow-up to an initial survey conducted in 1998. Information was sought on region, teaching/non-teaching status, the nature of extended role tasks undertaken and the year in which these tasks were first undertaken. Results: Some 172 questionnaires were returned from a total of 253 dispatched (68%). In 161 hospitals radiographers administered intravenous injections and performed barium enemas in 119 hospitals, while a red-dot system was in operation in 141 hospitals. Reporting by radiographers had increased since 1998. Replies indicated that, at 124 hospitals, radiographers were reporting in ultrasound. Skeletal reporting was the second most-frequently-reported activity, with 63 hospitals indicating that radiographers ...

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Clinical-HINTS (Health Intelligence System) is a horizontally integrated decision support system (DSS) designed to meet the requirements for intelligent real-time clinical information management in critical care medical environments and to lay the foundation for the development of the next generation of intelligent medical instrumentation. The system presented was developed to refine and complement the information yielded by clinical laboratory investigations, thereby benefiting the management of the intensive care unit (ICU) patient. More specifically, Clinical-HINTS was developed to provide computer-based assistance with the acquisition, organisation and display, storage and retrieval, communication and generation of real-time patient-specific clinical information in an ICU. Clinical-HINTS is an object-oriented system developed in C+2 to run under Microsoft Windows as an embryo intelligent agent. Current generic reasoning skills include ...

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Preterm children born before 32 weeks of gestation represent 1% of the annual births in Switzerland, and are the most at risk of neurodevelopmental disabilities. A neurological surveillance is thus implemented in the neonatal units, and multidisciplinary neurodevelopmental follow-up is offered to all our preterm patients. The follow-up clinics of the University hospitals in Lausanne and Geneva follow the Swiss guidelines for follow-up. An extended history and neurological examination is taken at each appointment, and a standardized test of development is performed. These examinations, which take place between the ages of 3 months and 9 years old, allow the early identification and treatment of developmental disorders frequent in this population, such as motor, cognitive or behavioral disorders, as well as the monitoring of the quality of neonatal care. PMID:21452511

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Background Limited data is available for investigating the long-term safety and effects of intracoronary progenitor cell therapy in patients with acute myocardial infarction (AMI). Objective To assess the clinical course, NT-proBNP and MRI data as objective markers of cardiac function of the TOPCARE-AMI patients at 5-year follow-up. Design The TOPCARE-AMI trial was the first randomized study investigating the effects of intracoronary infusion of circulating (CPC) or bone marrow-derived progenitor cells (BMC) in 59 patients with successfully reperfused AMI. Results Five-year follow-up data were completed in 55 patients, 3 patients were lost to follow-up. None of the patients showed any signs of intramyocardial calcification or tumors at 5?years. One patient died during the initial hospitali...

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Deltombe T, Gustin T. Selective tibial neurotomy in the treatment of spastic equinovarus foot in hemiplegic patients: a 2-year longitudinal follow-up of 30 cases. Objective To assess the long-term efficacy of selective tibial neurotomy in the treatment of spastic equinovarus foot in hemiplegic patients. Design Intervention study (before-after trial) with an observational design and 2-year follow-up. Setting Spasticity group in a university hospital. Participants Hemiplegic patients (N=30) with spastic equinovarus foot. Intervention A selective neurotomy was performed at the level of the motor nerve branches of the tibial nerve. Main Outcome Measures Spasticity (Ashworth scale), muscle strength (Medical Research Council scale), passive ankle dorsiflexion, gait parameters (6 min walking test...

UK PubMed Central (United Kingdom)

Nine patients with renal osteodystrophy were tested for 6.5 to 35 months with 1,25-dihydroxycholecalciferol (1,25-DHCC). A close biochemical follow-up was performed during the first 6 months of treatment,...Full Text Available

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BackgroundWhile physical health has improved considerably over recent decades in Finland, the disease burden of mental health, especially that of depression, has become increasingly...Full Text Available

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BackgroundSymptomatic heterotopic ossification (HO) in multiple trauma patients may lead to follow up surgery, furthermore the long-term outcome can be restricted. Knowledge of the...Full Text Available

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BackgroundPercutaneous endoscopic lumbar discectomy is a relatively new technique. Very few studies have reported the clinical outcome of percutaneous endoscopic discectomy in terms...Full Text Available

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Background The scale-up of treatment for HIV and multidrug-resistant tuberculosis (MDR-TB) in developing countries requires a long-term relationship with the...Full Text Available

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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

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As yet, the role of Computed Tomography (CT) as a routine imaging technique in the staging and follow-up of thoracic Hodgkin's disease has not been assessed. The authors reported the results obtained in 120 patients affected with thoracic Hodgkin's disease, staged and followed by means af chest X-rays and CT. CT better identified intrathoracic involvement of mediastinal nodes, of lung parenchyma, of pleura, and of pericarcial and chest walls in 54/120 patients (45%), with staging modifications in 18 (15%) of them only. Treatment was changed only in 12 patients (19%) where radiation therapy had been planned. The clinical value of the additional information yielded by CT was especially evident in the follow-up: CT allowed the correct evaluation of persistent/ recurrent disease in 51/117 patients (43.5%), a figure high enough to suggest the use of CT in the routive follow-up of patients affected with thoracic Hodgkin's ...

UK PubMed Central (United Kingdom)

Ten coccygectomies were performed. Patients were all females (aged 26-74, average 46). All patients expressed satisfaction after the operation (one was deceased at the time of follow up). The material...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundHip resurfacing arthroplasty (HRA) is considered a bone-preserving procedure and may eliminate proximal femoral stress shielding and osteolysis. However, in addition to...Full Text Available

UK PubMed Central (United Kingdom)

Discrete masses are commonly detected during mammographic screening and most such lesions are benign. For lesions without pathognomonically benign imaging features that are still regarded likely to...Full Text Available

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This case report makes evident that in a 75 years old patient with a (cured) femoral neck fracture 15 years ago a refracture at the same site following a new trauma could not be detected by conventional X-ray. The follow-up of a radionuclide bone study, however, enabled the dignosis of a refracture. From these findings, it is further evident that the decreased bone metabolism in older patients has to be considered. Thus, although the initial bone scan following the trauma is negative, a follow-up scan should be performed within a 4 day-period.

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In order to evaluate the role of Computed Tomography (CT) in prediction of nature, staging and follow-up of soft-tessue tumors, the authors examined by CT 124 patients with soft tissue neoplasms who later underwent surgery (116 cases) or fine needle biopsy (8 cases). Comparison between CT and surgical or anatomical results showed that CT was able to correctly predict the benignancy or malignancy of the masses in 76% of cases but it was very seldom able to allow an hystological prediction. On the contrary CT was found to be a very useful tool for pre-therapeutic staging and follow-up of the tumors, because it gave many diagnostic information which influenced therapeutic choiches and strategies.

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The follow-up system for wastes (JAeSTI), developed at the end of the 1990s, forms a basis for today's followup activities in Finland. JAeSTI relies on an environmental protection database, the compliance monitoring system VAHTI operated by the environmental authorities. Waste followup and waste statistics depend very much on the annual waste quantities recorded in the VAHTI system. In the KYJ-project the coverage and reliability of the data in the VAHTI system was evaluated as for the streams of solid municipal waste. The project also included the compiling of national statistics on municipal waste for the year 2000. The project used other information sources, too, such as statistics compiled when the National Waste Plan and regional waste plans were revised in 2002. In addition, the extent and quantity of in-situ (household) composting and incineration were assessed on the basis of a separate study (Annex 2, In Finnish). In connection with the data ...

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This study examined whether cognitive behavioural therapy (CBT) could prevent the development or worsening of panic-spectrum psychopathology and anxiety symptoms in chronic obstructive pulmonary disease (COPD). 41 patients with COPD, who had undergone pulmonary rehabilitation, were randomised to either a four-session CBT intervention condition (n = 21) or a routine care condition (n = 20). Assessments were at baseline, post-intervention, and at 6-, 12- and 18-month follow-ups. Primary outcomes were the rates of panic attacks, panic disorder and anxiety symptoms. Secondary outcomes were depressive symptoms, catastrophic cognitions about breathing difficulties, disease-specific quality of life and hospital admission rates. There were no significant differences between the groups on outcome measures at baseline. By the 18-month follow-up assessment, 12 (60%) routine care group participants had experienced at least one panic attack in the previous ...

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Introduction: Previous studies have published the correlation between myocardial perfusion SPECT (MP) during cold pressor test (CPT) and intracoronary acetylcholine and its usefulness as independent marker of endothelial dysfunction (ED). Objective: To analyze the incidence of positivization of MP exercise studies in the follow up of asymptomatic patients with moderate cardiovascular risk (CV) and ED detected by PF. Material and Methods: Of 301 patients of the PARADIGMA Registry (normal exercise MP SPECT and clinical probability < 20% of events at 10 years [moderate risk by Framingham index]) 55 had positive PF (+) (18.3%). Prospectively and consecutively, 15 asymptomatic patients with PF (+), and a control group (CG) of 15 patients with negative PF, with paired sex, age and coronary risk factors (CRF), that accomplished a 12 #+-# 2 months follow up, and that underwent a new exercise and resting MP ...

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Abstract Background: This study involves a multicentre surveillance of tigecycline and tetracycline activity against Gram-negative and Gram-positive bacteria from primary care centres (PCCs), general hospital wards (GHWs) and intensive care units (ICUs) in Denmark (n == 9), Finland (n == 10), Norway (n == 7) and Sweden (n == 19). Methods: The hospitals were each asked to test 30 consecutive Gram-positive and 30 Gram-negative clinical isolates. Supportive information accompanying each isolate included the study centre, ward level (PCC, GHW, or ICU), patient identification and source of the isolate. Minimum inhibitory concentrations (MICs) for tetracycline and tigecycline were determined with the Etest. Results: The isolates collected comprised 1610 Gram-negative and 1767 Gram-positive clini...

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... directed the transformation of designated Service operational headquarters into effective and scalable Joint Task Force headquarters capable of ...

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The need for noninvasive sensitive techniques for the diagnosis and follow-up of metabolic bone disease in dialysis patients has stimulated the author's interest in the efficacy of more detailed quantitative bone scintigraphy. Using hemodialysis to reduce elevated soft-tissue activity at scintigraphy, an attempt was made to assess the diagnostic sensitivity of quantitative bone scintigraphy as compared to qualitative bone scintigraphic, biochemical, radiographic and bone histologic studies. The second aim of these studies was to determine if one of the two major components of renal osteodystrophy is a major determinant for skeletal radiotracer uptake. The clinical observations on the efficacy and possible specificity of quantitative bone scintigraphy in the diagnosis and follow-up during treatment of renal osteodystrophy are presented briefly in this chapter. Thus, the use of scintigraphy for the routine detection and ...

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A retrospective study was made of all radionuclide (RN) bone images performed at our institution over a two-year period to evaluate femoral head viability after nonpathologic fracture of the femoral neck. Twelve patients had avascular femoral heads during the perioperative period, of which nine had adequate follow-up. Seven of these nine patients had follow-up bone images. Revascularization occurred in four patients, while three had persistent absence of femoral head uptake. With clinical follow-up ranging from four to 29 months (median: 14 months), only two of these nine patients developed clinical or radiographic evidence of osteonecrosis. RN bone imaging performed in the perioperative period does not reliably predict the development of post-traumatic osteonecrosis of the femoral head and, at present, should not be used to determine prospectively method of treatment of femoral neck fracture.

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This paper is concerned with the fracture analysis of thin cylindrical shells subject to secondary bending stresses with some degree of elastic follow-up. A P.Y.F.M. failure assessment route is utilised for an initial investigation. Results are presented graphically and indicate the differences obtained by considering the stresses as primary or secondary in nature. The Jsup(*) contour integral is computed from the results of a non-linear finite element analysis of a thermally loaded cracked cylinder. Comparison is made between Jsup(*) and the P.Y.F.M. failure criteria demonstrating the degree of conservatism in the latter. It is observed that LEFM may be appropriate for moderate load levels but that the elastic follow-up of the structure causes enhancement of Jsup(*) for higher loads, at which stage LEFM becomes non-conservative. (orig.).

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Summary Objective- To evaluate the role of prophylactic trimethoprim-sulfamethoxazole (co-trimoxazole) antibacterial prophylaxis in reducing morbidity and mortality in HIV-infected post-natal women in southern Africa. Methods- Double-blind placebo-controlled trial. HIV-infected women with WHO stage 2 or 3 HIV disease who had recently delivered in the Department of Obstetrics and Gynaecology at the University Teaching Hospital, Lusaka, Zambia were randomised to receive daily co-trimoxazole (cotox) or matched placebo daily for the duration of the trial. Participants were followed up for a minimum of 1-year. Primary outcome measures were mortality from any cause or hospital admission and serious adverse events. Results- Of 600 women randomised, follow-up information was available from 355 (18...

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Summary Penile injury is common as an emergency and should be accurately diagnosed and treated. We analysed 22 patients with penile injury admitted to the emergency unit of Dubrava University Hospital during a 4-year period. According to the American Association for the Surgery of Trauma five-grade classification of penile injuries, there were 14 grade I, 6 grade II and 2 grade III cases. Diagnosis was mainly based on clinical and ultrasonography findings, and in some cases on cavernosography. Nineteen patients underwent immediate surgery and three patients received conservative therapy. On outpatient follow up, sexual function was assessed by use of the 5-item International Index of Erectile Function (IIEF-5) test at 3 and 12-months of injury. At 3-month follow up, moderate, mild and no e...

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In a retrospective single-centre study 170 consecutive patients were included who received a Kotz modular prosthesis after resection of bone tumours of the proximal femur to evaluate the management of prosthetic infection. Infection occurred in 12 of 166 patients available for follow-up (six males; six females; mean age, 47?years; range, ten to 75?years) after a mean of 39?months (range, one to 166?months; infection rate, 7.2%). Mean follow-up was 54?months (range, four to 200?months). One patient died of septic shock. Two patients were treated by wound revision only. Treatment of infection in the remaining patients was one-stage revision in eight and hip disarticulation in one. Infection control by one-stage revision was achieved in five of eight patients; re-infection occurred in three p...

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The purpose of this study was to validate through natural exposure a cut-off level of varicella zoster IgG as protective against infection with varicella zoster virus (VZV). Laboratory testing to determine VZV immune status of pregnant women exposed to varicella is recommended. Quantitative assays are now available which are sensitive and specific. More than 200 consecutive requests for screening in pregnant patients with recent varicella contacts were followed-up by questionnaire. DiaSorin LIAISON and VZV time resolved fluorescence immuno assay (VZV TRFIA) were used to measure VZV antibody level. One hundred fifty out of 209 (72%) questionnaires were returned; 14 patients developed varicella, 129 did not and seven were not known. Patients who had been given VZIG and developed varicella on...

British Library Electronic Table of Contents (United Kingdom)

Aims To study the effect of fish consumption on the risk of acute coronary syndrome (ACS) in healthy subjects. Methods and results This Danish follow-up study included 57 053 men and women between 50 and 64 years. Intake of lean and fatty fish was estimated from a detailed and validated food frequency questionnaire. Potential cases of ACS were identified through nationwide medical databases. A total of 1122 cases of ACS were verified during a mean follow-up period of 7.6 years. Among men, intake of fatty fish was associated with a lower risk of ACS. For men in the highest quintile of fish intake compared with the lowest quintile, the hazard ratio was 0.67 (95% confidence interval: 0.53-0.85). The inverse association was observed for intakes >6 g of fatty fish per day with no obvious additi...

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The RECH-1 MTR reactor has been converted from HEU to MEU (45% enrichment) and the decision to a LEU (20% enrichment) conversion was taken some years ago. This LEU conversion decision involved a local fuel development and fabrication based on U{sub 3}Si{sub 2}-Al dispersion fuel, and a fabrication qualification stage that resulted in four fuel elements fully complying with established fabrication standards for this type of fuel. This report-presents relevant points of these four leaders fuel elements fabrication, in particular a fuel plate core homogeneity control development. A summary of the intended in core follow-up studies for the leaders fuel elements is also presented here. (author)

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Abstract Objective:- This study explored 12-month outcome and its associations to social adjustment-related variables in patients with first-episode non-affective psychosis in Finland and Spain. Methods:- Forty-nine Finnish and 37 Spanish patients were evaluated at admission on various characteristics of social adjustment. Outcome was measured for 68 (79%) patients by the Brief Psychiatric Rating Scale, Global Assessment Scale, and Grip on Life. Results:- One-fourth of the patients experienced psychotic symptoms at follow-up. Sixty per-cent of the patients showed good global functioning and Grip on Life. In both patient groups, poor earlier global functioning, weak social network, poor Grip on Life, and psychological dependence on family of origin were associated with poor outcome. In the ...

UK PubMed Central (United Kingdom)

INTRODUCTIONLevel T4 video-assisted thoracoscopic sympathectomy proved superior to T3-T4 treatment for controlling axillary hyperhidrosis at the initial and six-month follow-ups...Full Text Available

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Altogether 99 029 men aged 40-59, employed on the Italian railroad system, were classified in three levels of physical activity at work and three levels of job responsibility and then followed up for...Full Text Available

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Authors describe diagnostic dilemma of differentiating pyelonephritis with lymphomatous involvement of kidney in a known case of lymphoma. FDG uptake pattern was non-discriminatory and pyelonephritis diagnosed retrospectively on follow up study. Authors emphasize the importance of recognition of features and subtle clues of infection evident on CT component of PET-CT. (author)

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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

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(1) Most ancillary services needed for real-time control of the transmission grid and to meet operating criteria can be competitively supplied and competitively procured. (2) The independent service operator (ISO) must directly control the generators and loads, which supply ancillary services. (3) Comparability of access to ancillary services is achievable through the ISO-based competitive market structure.

UK PubMed Central (United Kingdom)

BackgroundMany interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services...Full Text Available

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42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...

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Orchestration Layer. Service Delivery . Datacenter. Infrastructure. Systems call API. E2E automated. Automate service-levels. Analyze & ...

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... WHS- Washington Headquarters Service. ... ie, Army, Navy, Air Force) service publications ... The Case of the Rapid Deployment Joint Task Force. ...

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Currently many service providers offer their services on a private and proprietary hard- and software infrastructure. These infrastructures often share many similarities. Hence we believe a generic service management architecture, that allows service providers to offer a large array of different services on a single infrastructure or multiple providers to offer their services cooperatively, would provide many advantages over current silo-based approaches. Additionally, by allowing the distributed service management components to cooperate in a peer-to-peer overlay network, scalability and resilience of the system could be greatly improved. In this paper we propose an optimal algorithm, based on an integer linear programming (ILP) formulation, and several heuristics to support such a generi...

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... Joint Meritorious Award to DLA," Dimnsions Vol. ... recently the Defense Finance Accounting Services (DFAS ... gmbAt Service SUoDort Field Manual. ...

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May 25, 2007 ... This form will generate a bibliography of cost estimating references. The form will search the NASA Technical Report Service (NTRS) database ...

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18 months service for FERS; 60 months service for CSRS employees. the period covered by your accrued, donated, and advanced sick leave & accrued and ...

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Web Services and mobile data services are the newest trends in information systems engineering in wired and wireless domains, respectively. Web Services have a broad range of service distributions while mobile phones have large and expanding user base. To address the confluence of Web Services and pervasive mobile devices and communication environments, a basic mobile Web Service provider was developed for smart phones. The performance of this Mobile Host was also analyzed in detail. Further analysis of the Mobile Host to provide proper QoS and to check Mobile Host's feasibility in the P2P networks, identified the necessity of a mediation framework. The paper describes the research conducted with the Mobile Host, identifies the tasks of the mediation framework and then discusses the feasible realization details of such a mobile Web Services ...

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The family of natriuretic peptides consists of the atria natriuretic peptide (ANP), the cerebral natriuretic peptide (BNP), the type C natriuretic peptide (CNP) and the peptide isolated from the dendroaspis snakes' poison (DNP), whose presence in humans has not been confirmed. The physiological function of ANP is in the control of arterial blood pressure by regulation of systemic vascular resistance of blood vessels. BNP is produced as one of the factors in the acute response to inflammatory tissue damage, mainly in coronary vessels. Increased serum concentrations of natriuretic peptides have been found in stress situations, such as trauma or major surgery, systemic hypotension, and in intrinsic myocardial dysfunction. High concentrations of natriuretic peptides were observed in severe sepsis, septic shock and in multiple organ failure, probably due to increased secretion by mediators of the inflammatory process.The highest concentrations of ANP and BNP were found in lethal conditions. ...

Scientific Electronic Library Online (English)

Abstract in english We hypothesized that chronic oral administration of the phosphodiesterase-5 inhibitor sildenafil could improve the exercise capacity and pulmonary hemodynamics in patients with pulmonary arterial hypertension (PAH) on the basis of previous short-term studies. We tested this hypothesis in 14 subjects with PAH, including seven patients with the idiopathic form and seven patients with atrial septal defects, but no other congenital heart abnormalities. Patients were subjected (more) to a 6-min walk test and dyspnea was graded according to the Borg scale. Pulmonary flow and pressures were measured by Doppler echocardiography. Patients were given sildenafil, 75 mg orally three times a day, and followed up for 1 year. Sildenafil therapy resulted in the following changes: increase in the 6-min walk distance from a median value of 387 m (range 0 to 484 m) to 462 m (range 408 to 588 m; P

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Ewing's sarcoma is a highly malignant neoplasm of the bone whose origin is still uncertain. A strong relationship exists between Ewing's sarcoma and tumors of neural origin (Ewing family of tumors). Ewing's sarcoma must be distinguished from other round-cell tumors like lymphoma and neuroblastoma and also must be differentiated from osteogenic sarcomas. On plain radiographs, Ewing's sarcoma appears as a lytic or mixed lytic-sclerotic, rarely as predominantly sclerotic lesion with margins Lodwick grade III. It is located primarily in the diaphyseal and metadiaphyseal regions of the long bones of the lower extremities. A large soft tissue tumor is usually present. Magnetic resonance imaging is the imaging modality of choice to evaluate the extent of the primary lesion, to monitor the response to neoadjuvant chemotherapy and to follow up non-resected Ewing's sarcomas. Bone scintigraphy is necessary to detect skeletal metastasis, and "2"0"1thallium ...

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In the paper six cases of facial osteomyelitis as a complication of chronic sinusitis in hemophiliac-AIDS patients are reported. Osteomyelitis was suggested by an increasing of erythrocyte sedimentation rate. The diagnosis was confirmed by a positive {sup 99m} Tc MDP scintigraphy. The patients were submitted to clinical treatment. The erythrocyte sedimentation rate and 67-gallium citrate scans were used in the follow-up of the therapy. Three patients had negative gallium after three weeks of organism-specific antibiotic therapy; in two patients the gallium scintigraphy remained positive. One patient did not undergo the radionuclide scan for this clinical conditions. These results suggest that MDP scans showed higher sensitivity and specificity in detection of bone disease in chronic sinusitis. Gallium scans appeared to be valuable tool in the follow-up of the infection. There are no reports in the literature of osteomyelitis as a complication ...

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The University of Georgia, in collaboration with GE Global Research, has investigated the relevant quenching mechanism of phosphor coatings used in white light devices based on UV LEDs. The final goal of the project was the design and fabrication of a high-efficacy white light UV-LED device through improved geometry and optimized phosphor coatings. At the end of the research period, which was extended to seamlessly carry over the research to a follow-up program, we have demonstrated a two-fold improvement in the conversion efficiency of a white light LED device, where the increase efficacy is due to both improved phosphor quantum efficiency and lamp geometry. Working prototypes have been displayed at DOE sponsored meetings and during the final presentation at the DOE Headquarters in Washington, DC. During the first phase of the project, a fundamental understanding of quenching processes in UV-LEDs was obtained, and the relationships that describe the performance of ...

British Library Electronic Table of Contents (United Kingdom)

Blomqvist M, Ahadi S, Fernell E, Ek U, Dahllf G. Dental caries in adolescents with attention deficit hyperactivity disorder: a population-based follow-up study. Eur J Oral Sci 2011; 119: 381-385. 2011 Eur J Oral Sci This study tested the hypothesis that adolescents with attention deficit hyperactivity disorder (ADHD) exhibit a higher prevalence of caries than adolescents in a control group. Thirty-two adolescents with ADHD and a control group of 55 adolescents from a population-based sample, all 17-yr of age, underwent a clinical and radiographic dental examination. The mean--SD number of decayed surfaces (DS) was 2.0--2.2 in adolescents with ADHD and 0.9--1.4 in adolescents of the control group. Thirty-one per cent of the adolescents in the ADHD group had no new caries lesions (DS-=-0) co...

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Sirio is a computerized application to manage the hydroelectric system in a short time. This management is implemented as a real time tool in the Control Department. SIRIO has many modules, independent and integrated to operate and perform the data acquisition, optimization, planning simulation and planning optimization. This article presents the SIRIO System and its applications to the Iberdrola system in Tajo river.

Science.gov (United States)

Spinal cord stimulation (SCS) is frequently used for relief of chronic benign pain resistant to conservative therapies. Clinical practice suggests, at least in patients with failed back surgery syndrome (FBSS), the possibility that SCS significantly improves motor performances. We present here the case of a 41-years-old female patient with FBSS, who showed a clear improvement in muscle strength after SCS, persisting at 6-months follow-up. We speculate that the electrical stimulation of posterior columns could potentiate the caudal, segmental spinal reflexes resulting in a facilitation of motoneurons activation. PMID:16175150

International Nuclear Information System (INIS)

Computerized tomography of the adrenal glands was performed in 10 patients with Cushing's syndrome using a G.E. 8800 CT/T Body Scanner. The tomographic findings of unilateral adrenal masses in 4 patients were confirmed by surgery. In the remaining 6 patients, computerized tomography did not identify any masses, and both glands were well visualized and showed normal shape. In these patients, measurement of the adrenal glands revealed both normal (n=1) and enlarged glands (n=5). The findings of adrenalectomy (n=4) or transphenoidal surgery and follow-up (n=2) established the diagnosis of adrenal phyperplasia in all patients. (Author).

International Nuclear Information System (INIS)

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.).

Energy Technology Data Exchange (ETDEWEB)

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

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We report here the imaging findings of a rare case of a lethal form of Gorham disease in a young female patient. Multimodality imaging findings over 13 year-follow-up demonstrated progressive wide spread skeletal and soft tissue abnormalities with permeative osteolysis, pathological fractures and severe skeletal deformities. Unusual extensive osseous and soft tissue pneumatosis was illustrated on cross-sectional studies. The progressive nature of this form of Gorham disease and the subsequent complications eventually culminated in patient's death. (orig.)

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Abstract We provide the first firm-level evidence of the impact of the trade in producer services (-offshoring-) on the labour market. Using a new data set from the UK that measures trade in services at the firm level, we find no evidence that importing intermediate services is associated with job losses or greater worker turnover. Using regression to control for observable differences between firms that import service inputs and those that do not, we show that firms that start importing intermediate services experience faster employment growth than equivalent firms that do not. This seems likely to be the result of positive demand shocks, which cause a simultaneous increase in employment, output, and use of imported service inputs.

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The difficulty in information communication and sharing are major problems for forest fire monitoring and early warning in China. As authors, we applied web service technology to a personal digital assistant (PDA) forest fire monitoring system and propose the framework of a monitoring system based on service-oriented architecture (SOA). At the same time, we describe the composition and function of web services from a server side and a client side. The method for developing a web service invocation engine on the PDA is introduced in detail. Finally, an example of a fire danger rating and fire weather services system are established, based on the Beijing Forest Fire Control System. The results show that the PDA forest fire monitoring system based on web services can effectively take advantag...

International Nuclear Information System (INIS)

Objective: To evaluate the diagnostic value of 64 multidetector-row CT angiography for internal carotid artery (ICA) stenosis and the application in the follow-up of carotid endarterectomy and percutaneous transluminal stenting. Methods: Forty transient ischemic attack (TIA) patients with interpretable CTA and DSA of the cervical carotid arteries were selected from May 2005 to December 2005. This yielded a total of 80 vessels. The CTA curved planar reformations (CPR) and DSA images referenced to the distal cervical internal carotid were graded by two senior neuroradiologists blindly, according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) guidelines. The paired-t test was used to verify the statistical significant difference between pre-operating and post-operating of carotid endarterectomy or percutaneous transluminal stenting in measuring the vascular diameter and area of cross section using CTA. Results: When the 70% stenosis was used ...

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Objective: To evaluate technical feasibility and acute and subacute radiotolerance of a self-expandable stent loaded with {sup 125}I seeds in the rabbit esophagus. Methods: A self-expandable stent designed for esophageal application was made of 0.16 mm nitinol wire and loaded with {sup 125}I seeds (CIAE-6711). Twenty-seven stents with three different radioactive dosages (n = 9 in each dosage group) were implanted in the esophagus of healthy rabbits, while nine stents alone were used as controls. The stents were perorally deployed into the esophagus under fluoroscopic guidance. Radiological follow-up included plain chest film, CT scan, and barium esophagography which were undertaken in all rabbits of each group at 2, 4, and 8 weeks, respectively, which were correlated to histopathological findings. The stented esophageal segments along with their adjacent tissues were harvested for histopathological examinations. Results: The stent was successfully deployed into the ...

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Coiling or infusion of embolic materials into a wide necked aneurysm can be performed with stenting. The purpose of our study is to assess the technical feasibility of aneurysm treatment with glue embolization after stenting. We used four Wallstents for surgically repairing eight canine carotid aneurysms. After confirmation of the aneurysms on the angiogram, we introduced a 6-7 F guiding catheter in order to deploy the stents. After stenting, we passed a microcatheter into the aneurysm lumen through the stent mesh. 28% glue was slowly injected until the glue cast completely filled the lumen. We evaluated the passage of a microcatheter through the stent meshwork, formation of the glue cast and the stents' ability to protection for any leakage of glue. The follow-up angiogram was obtained for two dogs, one to three times until 8 weeks, and then we sacrificed the dogs and performed pathologic examinations. Stenting was successful in all cases except one in which the ...

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Purpose - To study the optimization of a randomized control problem in an M/G/1 queue in which a removable and unreliable server may provide two phases of heterogeneous service to arriving customers. Design/methodology/approach - Arriving customers follow a Poisson process and require the first essential service (FES). As soon as FES of a customer is completed, the customer may leave the system or opt for the second optional service (SOS). The service times of FES channel and SOS channel are assumed to be general distribution functions. The server requires a startup time with random length before starting service. When the server is working, he may meet unpredictable breakdowns but is immediately repaired. The inter-breakdown time and repair time of the removable server are exponentially r...

Science.gov (United States)

Understanding Center for Medicare and Medicaid Services (CMS) documentation and coding rules is challenging for most physicians. To accurately bill for clinical services, physicians must learn a system that may initially seem daunting, but is in fact governed by a small number of straightforward rules. The Evaluation and Management (E/M) guidelines for all service codes specify 3 components: history, examination, and medical decision-making, each with a defined set of elements or characteristics. Service coding is based on the level of care supported by the number of history and examination elements and the complexity of decision-making. This article will clarify the guidelines for outpatient clinical services and suggest a practical method of selecting appropriate E/M codes. Because physicians must often choose between billing codes 99213 and 99214 for a visit by an established ...

UK PubMed Central (United Kingdom)

BackgroundHIV/AIDS is a major public health concern in Uganda. There is widespread consensus that weak health systems hamper the effective provision of HIV/AIDS services. In recent...Full Text Available

UK PubMed Central (United Kingdom)

The objectives of this study were to evaluate the current fitness of an area ambulance service based in Belfast and to quantify the physiological demands of accident and emergency work. From a total...Full Text Available

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Officers receive service-specific education and undergo experiences within their components that provide the expert knowledge that enables them to operate in their respective military departments. Given the Department of Defense (DoD) emphasis on service ...

CERN Document Server

Distributed denial of service attacks are often considered a security problem. While this may be the way to view the problem with today's Internet, new network architectures attempting to address the issue should view it as a scalability problem. In addition, they need to address the problem based on a rigorous foundation.

UK PubMed Central (United Kingdom)

Scoping studies have been used across a range of disciplines for a wide variety of purposes. However, their value is increasingly limited by a lack of definition and clarity of purpose. The UK's Service...Full Text Available

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42 Public Health 1 2010-10-01 2010-10-01 false 2-Health Professions Recruitment Program for Indians J Subdivision J Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

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... values and unless special precautions and equipment are used, it would be very difficult to service and maintain operational jet-fuel systems with ...

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Repair and maintenance for equipment used in the Belchatow brown coal mine and organizational models of repair services in the mine are discussed. Maintenance of earthmoving equipment, spreaders, bucket wheel excavators, loaders and other coal handling equipment, belt conveyors and drive systems for belt conveyors is discussed. Repair shops in the mine also manufacture about 35% of spare parts and elements for equipment used in the mine. Reliability of mining equipment, repairs and repair capacity of the shops are discussed. Organizational models of repair services, equipment used by these services and repair personnel are described. Effects of repair services on operation of the mine are evaluated.

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(1974). United States Ramsett, LO Wisconsin Public Service Corp., Green

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... Release/Receipt Document I&S Interchangeability and Substitutability ISSP Inter-Service Supply Support Procedures JANAP J

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... The total hemispherical emittance rig has been returned to service and the quality of temperature measurement has been investigated. ...

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This volume provides the subject index for the annual input to the Biomass Information Service of the IEA. (DT)

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The purpose of this presentation is to provide an in-depth discussion of the possible evolution of unbundling of services in a competitive environment. The author discusses unbundling from both a technical/engineering and an economic perspective. The main thrust of the talk is threefold: (a) that in the long run the potential for unbundling of services is extremely large from an engineering perspective; (b) that the form of the initial industry structure will have an important impact on the extent of service unbundling; and (c) that unbundling of wholesale related services is where most of the initial demand will be. (A) Engineering Perspectives on Unbundling: A large proportion of ancillary services can be provided in a competitive framework with current technologies. The author discusses those that current technologies may not facilitate such a decentralized approach. (B) The ...

International Nuclear Information System (INIS)

A century of technical development put steam turbines on a high level regarding efficiency and reliability. This procedure is still ongoing. The technological-commercial point of view - influenced intensively by liberalisation of the energy-market - makes great demands on field services. Well suited concepts in service and modernization are the solutions, as shown in NPP Emsland upgrade.

International Nuclear Information System (INIS)

Requirements and guidelines are provided for the control of activities to be exercised during procurement of items and services which affect the quality of nuclear facilities. These requirements and guidelines apply to procurement activities for items and services such as designing, purchasing, fabricating, handling, shipping, storing, cleaning, constructing, erecting, installing, inspecting, texting, maintaining and modifying.

Wastenet

... Most of the received offers were ecolabelled cleaning products and were not more expensive than conventional products. Case 3: The procurement of sustainable cleaning services 104kB Eight cooperating municipalities in the Netherlands needed a new contractor for cleaning services. They wanted to use SPP criteria as well as finding a social employment organisation. SPP criteria for cleaning services were used to set minimum requirements in ...

International Nuclear Information System (INIS)

Purpose of this work is to investigate the role of Helical CT and the usefulness of three-dimensional (3D) imaging for pre-operative planning and follow-up of reconstructive maxillofacial surgery with alloplastic material in neoplastic disease involving this region. From 1996 to 1999 eleven patients were examined with Helical CT and 3D images for planning of maxillofacial plastic and reconstructive surgery for advanced cancer of this anatomically complex region. A 3D-modulated titanium mesh (100%) or micro nets was used to rebuild the anterior surface of maxillary bone and the orbital floor. The mesh was cut to the appropriate size and shape and curved where necessary. Within the residual sinusal cavity a siliconed filling was used surmounting an acrylic prosthesis with dental arch to rebuild the palate. A rehydrated bovine pericardium was affixed and moduled on the borders in two cases only. Three-dimensionally reconstructed CT images were obtained preoperatively ...

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PurposeTo evaluate the effect of vitrectomy timing on outcomes for patients with crystalline retained lens fragments receiving vitrectomy 3+ days after cataract surgery. DesignSystematic review and meta-analysis of retrospective interventional cases series. MethodsSearches of MEDLINE (English, 1/1/85 through 7/30/2010) and article reference lists. Articles were screened for patients with crystalline retained lens fragments after surgery for age-related cataracts, discussion of vitrectomy timing, and, for the meta-analysis, patient totals for at least 1 outcome and multiple time periods, 10+ patients, and mean follow-up ?3 months. Outcomes included visual acuity, retinal detachment, increased intraocular pressure, intraocular infection/inflammation, cystoid macular edema, and corneal...

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An asymptomatic pink discoloration of a maxillary right fourth premolar tooth was discovered during a routine oral examination on a 9 year-old Belgian Malinois dog. A radiolucent lesion was seen in the pulpal chamber on radiographic examination. The lesion had perforated the mesiobuccal root of the tooth. The primary differential diagnosis was idiopathic internal resorption. The tooth was treated by partial resection (removal of the mesiobuccal root and associated crown). A vital pulpotomy and amalgam restoration was performed on the remaining tooth structure. A follow-up 1 year later demonstrated a successful treatment outcome. The animal was asymptomatic and able to perform military duties. Clinical and radiographic signs of healing were evident and the tooth was functional. PMID:10518874

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Background The crucial role of cigarette smoking in the development of pneumothorax is unclear because nonsmokers can also develop primary spontaneous pneumothorax. The purpose of this study was to clarify the pathophysiologic effects of cigarette smoking and its clinical correlations in primary spontaneous pneumothorax. Methods Included were 115 specimens of lung tissue from patients with primary spontaneous pneumothorax who underwent video-assisted thoracoscopic surgery from January 2001 to December 2002. We reviewed the clinical features of 56 smokers and 59 nonsmokers with an average follow-up of 67 months. The pathologic findings of resected lung specimens were analyzed retrospectively. Results There were no statistical differences in sex, age, body height, body weight, body mass inde...

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Three adolescents (ages 14-17) with emotional and behavioral disorders displayed chronic disruptive behavior in their self-contained classrooms at a self-contained alternative school. A descriptive functional behavioral assessment was conducted for each student. Data from file review, structured interviews, and direct observations were used to identify the functions of their disruptive behaviors. Then, function-based interventions were systematically constructed for each student and implemented for an extended period (nearly 6 weeks) within the most problematic situation in their classrooms. The interventions improved each student's behavior and the effects maintained during follow-up and generalized to instruction in a nonintervention classroom. Social validity data comparing the interventions to baseline practices revealed the function-based intervention had moderately higher social validity among teachers and substantially higher social validity among students. ...

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The aims of this study were to quantify the severity and extent of subclinical interstitial lung disease as depicted on HRCT and to study the relationship between the patterns of lung disease quantified by HRCT and the functional parameters and bronchoalveolar lavage findings in patients with rheumatic diseases. The results confirm that HRCT is a sensitive tool in detecting interstitial lung disease in patients with rheumatic diseases with no signs and symptoms of pulmonary involvement. The relationship between the different HRCT patterns and bronchoalveolar lavage cell profiles can identify patients at higher risk of developing irreversible lung fibrosis. A long-term, prospective follow-up study is needed to determine whether these patients will develop over pulmonary disease.

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Spastic equinovarus foot deformity commonly occurs after stroke or head trauma. Management by split anterior tibial tendon transfer to the lateral border of the foot was chosen by the authors. The purpose of that work was to assess the reliability of this method to improve patient's functional autonomy and investigate the relationship between the initial clinical examination findings and the quality of the functional results. 84 feet, operated in 82 patients out of 130, of mean age 46 years, were reviewed at a mean follow-up of 65 months. Very few complications were observed. Toe deformities remain a commonly associated problem. 80 patients were able to walk barefoot, 74 reported an increase in their walking distance, and 73 could regularly wear normal shoes. There is a strong relationship...

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Paraquat is a nonselective contact herbicide of great toxicological importance, being associated with high mortality rates, mainly due to respiratory failure. We report the case of a 22-year-old male admitted to the emergency room with a sore throat, dysphagia, hemoptysis, and retrosternal pain after the ingestion of 50 mL of a paraquat solution, four days prior to admission. Chest CT scans revealed pulmonary opacities, pneumomediastinum, pneumothorax, and subcutaneous emphysema. The patient was submitted to two cycles of immunosuppressive therapy with cyclophosphamide, methylprednisolone, and dexamethasone. The pulmonary gas exchange parameters gradually improved, and the patient was discharged four weeks later. The clinical and tomographic follow-up evaluations performed at four months after discharge showed that there had been further clinical improvement. We also present a brief review of the literature, as well as a discussion of the therapeutic algorithm for ...

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It is not clear whether males in all mammalian species adjust their copulatory behavior when faced with risk of sperm competition (RSC). Previous work on meadow voles, Microtus pennsylvanicus, indicated that males increase their sperm expenditure but not the number of ejaculations in the presence of odors of a conspecific male. The present study follows up on this work and asks whether male meadow voles modify any aspect of their copulatory behavior when they face a RSC. We examined 46 variables of copulatory behavior and found that the presence of odors from a conspecific male did not affect any of these variables. Thus, male meadow voles, unlike some other species of mammals, do not adjust their copulatory behavior when exposed to cues associated with an elevated RSC.

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Abstract Aim- Conventional outcomes such as survival, tumour recurrence and complication rates after surgery for rectal cancer have been rigorously assessed, but the importance of maintaining quality of life (QOL) after surgery for rectal cancer has received less attention. The aim of the current study was to analyse QOL and the occurrence of pelvic dysfunction after the surgical treatment of rectal cancer. Method- Between May 2005 and May 2008, 150 patients with rectal cancer underwent abdominoperineal resection (APR) or anterior resection (AR). Seventy-four answered two preoperative questionnaires. At a follow up of 1-year, 65 were alive without sign of recurrence and answered the same questionnaires: (a) validated RAND 36-item health survey QOL questionnaire; and (b) self-administered d...

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Abstract Tumor necrosis factor (TNF)- is a pro-inflammatory cytokine associated with psoriasis pathogenesis. Anti-TNF- therapies are effective in psoriasis. A significant weight gain has been reported in patients treated with anti-TNF- agents. The aim of the present study was to evaluate the body composition changes in psoriatic patients receiving anti-TNF- therapies according with disease phenotype. Forty patients affected with psoriasis were followed up for 24 weeks and divided into two groups: psoriasis vulgaris (PsO) and psoriatic arthritis (PsA). Anthropometric, blood biochemical, body composition parameters, resting metabolic rate, and disease activity indexes were measured at baseline and at week 24. After 24 weeks of anti-TNF- administration, the disease activity indexes and concen...

International Nuclear Information System (INIS)

Computed tomography (CT) of the neck and mediastinum was performed in 16 patients with renal osteodystrophy. Thirty out of 34 excised parathyroid glands weighing more than 500mg were diagnosed preoperatively (88.2%). Scintigraphy of the neck with _2_0_1TlCl and sup(99m)TcOsub(4-) was also performed in 15 patients. The introduction of subtraction method with a mini-computor in the scintigraphy has remarkably improved the visualization rate of parathyroid glands. Ultrasonic echography (US) of the neck which is able to obtain not only transverse butalso longitudinal imaging was done in 7 patients. It has about same detection rate of the glands with CT. The visualization of enlarged parathyroid glands is valuable not only for localization but also for undeniable evidence of hyperparathyroidism. Also, repeated follow-up examination can determine the effectiveness of conservative treatment. (author).

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When evaluating the risks of oncogenesis and cancer mortality following exposure to the radiations of the atomic bombs (A-bombs), the medical X-ray doses received by the A-bomb survivors must also be estimated and considered. Using a human phantom, dosimetry was performed to estimate the X-ray doses received by A-bomb survivors during medical examinations at the Radiation Effects Foundation (RERF) as part of the long-term follow-up on the Adult Health Study (AHS). These examinations have been estimated to represent nearly 45% of the survivors' cumulative medical irradiation dose. Doses to the salivary glands, thyroid gland, lung, breast, stomach and colon were measured using thermoluminescent dosemeters. The results, which are reported here, will aid in estimating organ doses received by individual AHS participants. (Author).

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The aim of this study is to clarify the relation among developmental outcome, nutritional state during the neonatal period, maturational electroencephalographic changes. Thirteen extremely low birth weight infants who completed 6- or 9-year follow-up were a subject of this study. Undernutrition was defined as enteral feeding below 100mL/kg/day at 3weeks of age. Dysmature patterns were defined as the persistence of EEG patterns 2weeks or more immature for post-conceptional age. IQ was examined at 6 and 9years of age. Body height and weight, and head circumference at 6years of age were stratified by the percentile grades. Full and verbal IQ was significantly lower in infants with undernutrition than those with normal nutrition. Among infants with undernutrition, those with persistent dysmatu...

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17 patients with chronic aortic dissection were examined by MRI. In 12 patients, comparison between gradient echo sequences and SE sequences was possible. Gradient echo sequences, unlike SE sequences, permitted evaluation of flow in the true and false lumen, reliable differentiation between thrombus and flowing blood and clear delination of the intimal flap. An additional comparison between transoesophageal ultrasound and MRT in 15 patients showed significant advantages in favour of MRI. In three patients MRI was able to detect more proximal origins of the dissection. Moreover, MRI allowed evaluation of the major aortic branches and their relation to the dissection; this was not possible with ultrasound. MRI plays an important role in the follow-up of chronic aortic dissections. (orig.).

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Ex vivo expanded peripheral blood progenitor cells (PBPC) have been shown to provide rapid neutrophil engraftment, and in some patients, to eliminate neutropenia after transplantation to support high-dose chemotherapy. However, the effect of expansion culture on stem cell content and potential loss of stem cells caused by induction of differentiation remains a concern. We have transplanted 21 patients with breast cancer with expanded autologous PBPC, with 11 patients receiving expanded PBPC as their sole hematopoietic cell source. In these studies, the CD34+ cells were selected and cultured for 10 days in defined media containing 100 ng/mL each of recombinant human stem cell factor (rhSCF), recombinant human granulocyte colony stimulating factor (rhG-CSF), and recombinant human megakaryocy...

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Purpose Elective laparoscopic sigmoid resection (LSR) for symptomatic diverticular disease is supposed to have significant short-term advantages compared to open surgery (open sigmoid resection (OSR)). This opinion is rather based on inferences from trials on colonic resections for malignant diseases or minor laparoscopic surgery. This randomized controlled trial was conducted to compare quality of life as well as morbidity and clinical outcome after LSR vs. OSR following a midterm follow-up period. Methods Patients presenting with a symptomatic sigmoid diverticular disease stage II/III (Stock/Hansen) were randomly allocated to LSR or OSR in a prospective multicenter trial. Endpoints included the quality of life assessed with a standardized questionnaire, postoperative mortality, and compl...

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Global supply chain practices and their effects have received considerable attention over the last two decades. In the recent past, the need for integration across supply chains has been identified as a key for effective and efficient operations of supply chains. This is observed with the increasing trend of collaborative partnerships among supply chain partners. This paper presents an integrated approach for manufacturing and distribution networks within the supply chain system of a global car company. The paper shows that the integration of manufacturing and distribution networks creates the environment for effective planning of many components and execution/follow-up of those plans. These components include materials, resources, operations/activities, suppliers and customers. The main f...

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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.

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Background This study aimed to evaluate the feasibility, safety, and follow-up results of endoscopic papilletomy (ESP) with pancreatic and biliary duct stent placement for ampullary tumors. The therapeutic approach to benign ampullary tumors remains unsettled. The ESP procedure is a curative treatment option for benign papillary tumors, but ESP raises concerns about a relatively high risk for procedure-related complications such as pancreatitis. A pancreatic stent may protect against complications. Methods Between September 2000 and June 2008, 36 patients with ampullary tumors confined to the mucosa and no intraductal tumor growth underwent ESP. The preprocedural diagnostic tools included endoscopic ultrasound, transpapillary intraductal ultrasound, and endoscopic retrograde cholangiopancr...

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Abstract The glycosylation profile of therapeutic antibodies is routinely analyzed throughout development to monitor the impact of process parameters and to ensure consistency, efficacy, and safety for clinical and commercial batches of therapeutic products. In this study, unusually high levels of the mannose-5 (Man5) glycoform were observed during the early development of a therapeutic antibody produced from a Chinese hamster ovary (CHO) cell line, model cell line A. Follow up studies indicated that the antibody Man5 level was increased throughout the course of cell culture production as a result of increasing cell culture medium osmolality levels and extending culture duration. With model cell line A, Man5 glycosylation increased more than twofold from 12% to 28% in the fed-batch process...

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The present study consisted of two experiments to compare new word learning in healthy young (N = 11) and older (N = 17) adults within an explicit learning paradigm. Experiment 1 investigated the new name learning for familiar objects, while Experiment 2 investigated learning names and descriptions for unfamiliar objects. Participants attended five learning sessions over 5 consecutive days, during which they viewed objects with novel names with/without descriptions. The older adults were as accurate as the young adults when recalling and recognizing new names during the learning sessions. With respect to response times, the older adults were as rapid as the young adults at recognizing the new names for the familiar objects, but were slower during the follow-up sessions. The older adults we...

International Nuclear Information System (INIS)

Dynamic CT and MRT were performed in 21 patients who had undergone prosthetic replacement of the aorta because of dissection of the thoracic aorta. There is no difference between MRI and dynamic CT in the demonstration of a persistent intimal flap, the formation of a thrombus and the assessment of the aortic diameter in patients who underwent surgery for thoraco-abdominal aortic dissection. MRI, however, is superior in the identification of the true and false lumen and the demonstration of the distal anastomotic site. The major advantages of MRI are that there is no need for intravenous contrast agents, that it is high sensitive to flow phenomena, and that it can demonstrate the aortic arch and the ascending aorta on sagittal oblique sections. The major disadvantages of MRI are the limited access to the patient during the procedure, and the inability to examine patients fitted with pacemakers or who are on assisted ventilation. Today, MRI is considered the method of first choice for ...

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Abstract Routinely used prognostic factors fail to predict clinical outcome in a significant proportion of breast cancer patients, implying that they can not detect some important biological characteristics. Chromosomal changes have been described in breast carcinomas for many years but their significance is not clear. We compared chromosomal changes with clinico-pathological characteristics and clinical outcome in 203 breast cancer patients with a follow-up of 9-18 years. Combining data from classical cytogenetics and flow cytometry revealed chromosomal abnormalities in 142 cases (70%). Of these, 51 (35.9%) contained two or more cytogenetically abnormal clones. Polyclonality was significantly associated with poor breast-cancer-specific survival (P = 0.03) within 5 years, independent of tu...

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Background Despite potentially relevant chemical differences between filtered and boiled coffee, this study is the first to investigate consumption in relation to the risk of incident cancer. Methods Subjects were from the V?sterbotten Intervention Project (64,603 participants, including 3,034 cases), with up to 15?years of follow-up. Hazard ratios (HR) were calculated by multivariate Cox regression. Results No associations were found for all cancer sites combined, or for prostate or colorectal cancer. For breast cancer, boiled coffee ?4 versus <1 occasions/day was associated with a reduced risk (HR?=?0.52, CI?=?0.30?0.88, p trend?=?0.247). An increased risk of premenopausal and a reduced risk of postmenopausal breast cancer were found for both total (HRpremenopausal?=?1.69, CI?=?0.96?2.98...

International Nuclear Information System (INIS)

The Commissariat a l'Energie Atomique (CEA, French Atomic Energy Commission) has set up over the last 10 years an innovative methodology aiming at characterizing radiological contaminations. The application of the latter relies on various tools such as expertise vehicles with impressive detection performances (VEgAS) and recently developed software platform called Kartotrak. A Geographic Information System tailored to radiological needs constitutes the heart of the platform; it is surrounded by several modules aiming at sampling optimization (Stratege), data analysis and geostatistical modeling (Krigeo), real-time monitoring (Kartotrak- RT) and validation of cleaning efficiency (Pescar). This paper presents the different tools which provide exhaustive instruments for the follow-up of decontamination projects, from doubt removal to the verification of the decontamination process. (authors)

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AbstractBACKGROUND: The authors chose to examine the association between body mass index (BMI) and incident colorectal cancer across the spectrum of BMI, including underweight persons, because detailed prospective cohort data on this topic in Asians is scarce, as is data on underweight persons (BMI, <18.5 kg/m2) in any population. METHODS: Analysis of the Singapore Chinese Health Study included 51,251 men and women aged 45-74 years enrolled in 1993-1998 and followed through 2007. Incident cancer cases and deaths among cohort members were identified through record linkage, and 980 cases were identified. Cox regression models were used to investigate the association of baseline BMI with risk of incident colorectal cancer during a mean of 11.5 years of follow-up. RESULTS: A significant, U-sha...

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SNAP25 occurs on chromosome 20p12.2, which has been linked to schizophrenia in some samples, and recently linked to latent classes of psychotic illness in our sample. SNAP25 is crucial to synaptic functioning, may be involved in axonal growth and dendritic sprouting, and its expression may be decreased in schizophrenia. We genotyped 18 haplotype-tagging SNPs in SNAP25 in a sample of 270 Irish high-density families. Single marker and haplotype analyses were performed in FBAT and PDT. We adjusted for multiple testing by computing q values. Association was followed up in an independent sample of 657 cases and 411 controls. We tested for allelic effects on the clinical phenotype by using the method of sequential addition and 5 factor-derived scores of the OPCRIT. Nine of 18 SNPs had P values <...

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A 21-year-old woman developed midesophageal stricture two weeks after ingestion of aluminium phosphide (AlP) tablets. Aluminium phosphide is a lethal protoplasmic toxin and is also the most common cause of suicidal poisoning in northern India. Upper gastrointestinal endoscopy (UGIE) showed a tight esophageal stricture 29?cm from the incisors with a circumferential ulcer. Dilatation up to 17?mm was done using Savary-Gilliard dilators. She had repeated dilatations three times at nearly two-week intervals. In view of the resistant stricture, a silicone Polyflex stent was placed across the stricture and removed after 3?months; there was no recurrence of stricture even after three months of follow-up. Patients with recurrent esophageal stricture and those with fistula may benefit from silicone ...

Energy Technology Data Exchange (ETDEWEB)

The rapid pace of competitive change in the generation sector has pushed electric utilities to rethink the concept of being obligated to serve all customers and with this change, the notion of measuring customer profitability is also being redefined. Traditionally, uniform services were provided to all customers. Rates were based on each customer classes` contribution to average costs, and consequently return was equally allocated across all customer segments. Profitability was defined strictly on an aggregate basis. The increasing demand for choice by electric customers will require electricity providers to redefine if not who they serve, than certainly how they provide differentiated services tailored to specific customer segments. Utilities are beginning to analyze the value, or profitability, of offering these services. Aggregate data no longer provides an accurate assessment of how resources should be allocated most ...

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We wanted to determine the technical and clinical efficacy of using a PTFE-covered self-expandable nitinol stent for the palliative treatment of malignant biliary obstruction. Thirty-seven patients with common bile duct strictures caused by malignant disease were treated by placing a total of 37 nitinol PTFE stents. These stents were covered with PTFE with the exception of the last 5 mm at each end; the stent had an unconstrained diameter of 10 mm and a total length of 50 80 mm. The patient survival rate and stent patency rate were calculated by performing Kaplan-Meier survival analysis. The bilirubin, serum amylase and lipase levels before and after stent placement were measured and then compared using a Wilcoxon signed-rank test. The average follow-up duration was 27.9 weeks (range: 2 81 weeks). Placement was successful in all cases. Seventy-six percent of the patients (28/37) experienced adequate palliative drainage for the remainder of their lives. There were ...

International Nuclear Information System (INIS)

This paper presents a group's efforts to introduce national newborn screening in Lebanon. Tandem mass spectrometry (MS) technology offers the prospect of utilizing filter paper blood specimens to screen newborns for several metabolic disorders. In order to be cost-effective, it is necessary to have a mandatory newborn screening policy. At present such a policy is not available in Lebanon. A national screening survey for congenital hypothyroidism (CH) was carried out to assess the incidence of this anomaly in the Lebanese population. Such an initiative is essential as a first step for assessing the feasibility and cost of a national screening programme. Coated beads, blood spot standards for quality control and buffer solutions used for assays were prepared in-house to minimize costs. At first, samples of umbilical cord blood spots were assayed for TSH using IRMA technique. Those samples showing borderline or high values of TSH were then assayed for total T4 (TT4) using radioimmunoassay ...

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Ewing's sarcoma is the most common malignant bone tumour occurring in children and adolescents and exists in two different clinico pathological entities: osseous Ewing's sarcoma (OES) and extraosseous Ewing's sarcoma (EES). Five cases of primary epidural EES are described, which presented with non-specific symptoms leading to a long diagnostic delay. The median age at diagnosis was 22 years (range 13-36 years). The median diagnostic delay was 3 months. All patients had one or more neurological deficits. All underwent surgical exploration with a laminectomy and partial resection followed by adjuvant radiotherapy to a dose of 46-50 Gy and chemotherapy with VAC (vincristine, adriamycin and cyclophosphamide) alternating with ICE (ifosphamide, cisplatin and etoposide) for at least six cycles. The mean follow-up period is 21.2 months (range 11-32 months). Four of the five patients achieved a complete remission and are disease free at the time of writing this report. Two ...

DEFF Research Database (Denmark)

A few studies have found poor semen quality in sons whose mothers have received fertility treatment, but it is unknown whether the poor semen quality is related to the infertility treatment or to infertility per se, for example, whether it is caused by hereditable factors. Using data from a population-based, Danish follow-up study conducted in 2005-2006, the authors of the present study examined whether sons of subfertile couples who had not received fertility treatment had poorer semen quality than sons of fertile couples. Among the 311 participants, an inverse association between parental waiting time to pregnancy and both semen volume and total sperm count was observed (p trend = 0.04 and p trend = 0.046, respectively). Semen volume in sons of subfertile parents (pregnant after > or =1 years) was 19% lower in comparison with that in sons ofparents whose waiting time to pregnancy was 0-6 months (p = 0.02). Additionally, sperm concentration and percentage of ...

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The results of 144 previously untreated cases of primary Ewing's sarcoma of bone are reported with a minimum follow-up of 5 years. This series was treated between 1972 and 1982 at Istituto Ortopedico Rizzoli with a combined therapy. The local control of the disease consisted of amputation (ten cases), resection followed by radiation therapy (35-45 Gy) (48 cases) and radiation therapy alone (40-60 Gy) (86 cases). Adjuvant chemotherapy, rigorously standardized, was performed according two different protocols: the first (85 cases treated in the period 1972-1978) consisted of vincristine (VCR) Adriamycin (doxorubicin) (ADM), and cyclophosphamide (EDX); the second (59 cases treated in the period 1979-1982) of VCR, ADM, EDX and dactinomycin (DACT). At a follow-up of 5 to 16 years (median, 9), 59 patients (41%) are continuously disease-free (CDF), 81 (56%) developed metastatic disease and/or local recurrence, and four (3%) had a second malignancy. ...

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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 internal ring. Of the ...

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Objective: Solid pseudopapillary tumor of the pancreas (SPTP tumor) is a rare pancreatic neoplasm with low malignant potential, which usually affects female patients in the second or third decades of life. It is a non-functional, slow-growing neoplasm that very often reaches considerable size before the first symptoms appear. Symptomatology is frequently related to tumor size. Surgical excision is usually curative in most cases. Infrequently the tumor can appear in male patients or in aged women, which can make the diagnosis more difficult. Some patients develop liver metastases in the follow-up that can be resected. Our purpose is to review the radiological and pathological findings of SPTP with emphasis on these infrequent cases. Subjects and methods: The medical records and radiological findings of patients who underwent surgery for SPTP between 2000 and 2005 were retrospectively reviewed. Study eligibility required that patients had undergone surgical resection ...

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The first Brazilian historical mortality cohort study on miners was conducted. The cohort consisted of 3224 workers in the underground coal mining industry in southern Brazil. This industry has been operating since 1942 without compliance with any regulatory standards, since there were no relevant national regulations. Over almost 60 years, about 5000 workers were exposed to high levels of radiation. However, later radiation exposure was significantly reduced, particularly that due to radon exposure. Recent radon concentration measurements indicated an average annual exposure to radon progeny of 2.1 WLM, ranging from 0.2 to 7.2 WLM. As radon exposure in the past was unknown, it can be suggested that mine workers have not been working safely as regards the health hazard related to radon and radon progeny exposure. The cohort inclusion criteria are as follows: (a) all male employees who had worked for at least one year at the coal mine; (b) workers with complete workplace information ...

DEFF Research Database (Denmark)

OBJECTIVE: To evaluate the association between fatty acid (alpha-linolenic acid (ALA), EPA, DHA, palmitic, stearic, oleic, linoleic and arachidonic acids) intake and prospective weight change in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition. DESIGN: Prospective cohort study with mean follow-up time of 6.5 years. In a total of 9182 men and 10867 women aged 35 to 64 years, from body weight measurement at recruitment and calibrated body weight during follow-up, weight change was expressed as mean annual weight change relative to baseline weight (%/year) and categorised into four groups (weight loss, or =2.5 to or =7.5%/5 years). Energy-adjusted dietary fatty acid intake data were estimated from the FFQ completed at baseline. Multivariate linear regression models as well as multinomial logistic regression analyses (carbohydrate replacement models) were conducted. RESULTS: Stearic acid intake was linearly ...

International Nuclear Information System (INIS)

Background and purpose: stereotactic radiosurgery (SRS) and also fractionated stereotactic radiotherapy (SRT) offer high local control (LC) rates (> 90%). This study aimed to evaluate three-dimensional (3-D) tumor volume (TV) shrinkage and to assess quality of life (QoL) after SRS/SRT. Patients and methods: from 1999 to 2005, 35/74 patients were treated with SRS, and 39/74 with SRT. Median age was 60 years. Treatment was delivered by a linear accelerator. Median single dose was 13 Gy (SRS) or 54 Gy (SRT). Patients were followed up ? 12 months after SRS/SRT. LC and toxicity were evaluated by clinical examinations and magnetic resonance imaging. 3-D TV shrinkage was evaluated with the planning system. QoL was assessed using the questionnaire Short Form-36. Results: Median follow-up was 50/36 months (SRS/SRT). Actuarial 5-year freedom from progression/overall survival was 88.1%/100% (SRS), and 87.5%/87.2% (SRT). TV ...

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We wanted to evaluate the correlation of mild renal pelvic dilatation (RPD) that is observed to be less than 10 mm on ultrasound (US) with urinary tract infection (UTI) and vesicoureteral reflux (VUR) in neonates. We reviewed 137 kidneys of 107 neonates who had RPD less than 10 mm on US. All the kidneys were divided into two groups: Group I (RPD <= 5.0 mm) and Group II (RPD > 5.0 mm), and we statistically analyzed the RPD change according to UTI and VUR. Seven neonates had VUR (5.1%), and there was no statistical significance between Group I (6 neonates, 5.6%) and Group II (1 neonate, 3.3%). Thirty seven cases (27%) had UTI and there was no statistical significance between Group I (30 cases, 28.0%) and Group II (7 cases, 23.3%). The RPD did not change in 81.8% of the cases, it increased in 4.4% of the cases and it decreased in 13.9% of the cases on follow up US. The incidence of VUR and UTI were not different according to the ...

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The influence of carbon monoxide (CO) exposure on regional cerebral blood flow (r-CBF) in rat brain was studied using autoradiography and {sup 125}I-IMP. Fuji computed radiography (FCR) was used to obtain improved autoradiograms in this study. R-CBF was determined in a relative measure by calculating hippocampus/cortex and putamen/cortex ratios of RI accumulation from the autoradiogram using a densitometer. Comparison of autoradiograms with pathological findings in the area of the hippocampus and putamen yield the following results. In the animals that were exposed to 6400 ppm or 10000 ppm of CO for 30 minutes, and then were followed up for 2 weeks without further exposure, r-CBF was decreased but no pathological changes occurred. In the animals that were exposed to 6400 ppm or 10000 ppm of CO, and then were followed up for 4 weeks without further exposure, pathological changes appeared. In animals ...

International Nuclear Information System (INIS)

The Food Safety and Inspection Service (FSIS) of the United States Department of Agriculture (USDA) inspects domestic and imported meat and poultry food products to assure the public that they are safe, wholesome, not economically adulterated and properly labeled. The Service also monitors the activities of meat and poultry plants and related activities in allied industries, and establishes standards and approves labels for meat and poultry products. As part of its responsibility, shortly after the Chernobyl accident occurred, FSIS developed a plan to assess this accident's impact on domestically produced and imported meat and poultry

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This document defines the services the Waste Sampling and Characterization Facility (WSCF) shall provide Effluent Monitoring (EM) throughout the calendar year for analysis. The internal memo contained in Appendix A identifies the samples Em plans to submit for analysis in CY-1995. Analysis of effluent (liquid and air discharges) and environmental (air, liquid, animal, and vegetative) samples is required using standard laboratory procedures, in accordance with regulatory and control requirements. This report describes regulatory reporting requirements and WSCF services and data quality objectives.

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The Dental Investigation Service, USAFSAM, Brooks AFB, has outlined the need for a vacuum unit to be used in the Air Force dental clinics. The unit must be capable of effectively picking up mercury and at the same time not redistribute mercury vapors throughout the dental clinic during normal operations or mercury-spill situations. The Dental Investigation Service selected the MRS-3, Minuteman Mercury Recovery System, product of American Cleaning Equipment Corporation as the mercury vacuum to be used for T E. The USAF OEHL/ECH was requested by the Dental Investigation Service to perform the T E on the MRS-3 for possible health hazards due to exposures of mercury vapors.

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Huntsville, Alabama Utilities has successfully provided services for over 53 years. However, the quality of service demands from customers are changing every day! Part of this demand is due to updated digital appliances, home and business computers, and automated systems. A quality program was initiated in 1992 as a result of an internal assessment. The Malcolm Baldrige approach was selected which includes seven areas: (1) Leadership; (2) Information and Analysis; (3) Strategic Planning; (4) Human Resource Utilization; (5) Quality Assurance of Products and Services: (6) Quality Results: (7) Customer Satisfaction. Training for and implementation of the Quality program is discussed in detail.

CERN Document Server

Ubiquitous computing based on small mobile devices using wireless communication links is becoming very attractive. The computational power and storage capacities provided allow the execution of sophisticated applications. Due to the fact that sharing of information is a central problem for distributed applications, the development of self organizing middleware services providing high level interfaces for information managing is essential. ADS is a directory service for mobile ad-hoc networks dealing with local and nearby information as well as providing access to distant information. The approach discussed throughout this paper is based upon the concept of information markets.

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If you are a FERS employee (the current retirement system), you lose your sick leave if you do not return to Federal service. If you separate from the Federal ...

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... Defense Finance and Accounting Service DID Data Item Descriptions DLA Defense Logistics Agency DLAM Defense Logistics Agency Manual ...

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... This coordinated proposal was presented to the Threat System Working Group (TSWG) (then called the Threat System Investment Working Group ...

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As competition in the service industry grows, delivering high-quality service to meet customers' needs and expectations becomes paramount. In order to achieve a thorough understanding of customers, companies are increasingly adopting Customer Relationship Management (CRM) initiatives. However, CRM does not have the process vision necessary to cope with complex and cross-functional processes. This problem is better handled by Business Process Management (BPM) initiatives, which, by their turn, struggle to built-in customer intelligence in their systems. Based upon systems theory, we discuss the roles of CRM and BPM in an integrated approach to deliver customer fulfillment. As the evolution of service-oriented approaches requires us to consider both customer interactions and experiences as k...

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... WHS- Washington Headquarters Service ... paper will advocate assignment of a Commander, Air Force Forces for all Joint Task Forces conducting ...

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... P ) FERS 4 ... i 25. Opportunity for better fringe benefits 1 outside of the Federal Sector (eg, sick leave, _ annual leave, health or life insurance) .... ...

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... Title : The Numerical Weather Prediction System at the Italian Air Force Weather Service: Impact of Non-Conventional Observations and Increased ...

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The spectre of exclusionary medical service provision, restricted clinic access and physician targeting in sectarian-divided Iraq underscores the crucial and timely need for qualitative research into the inter-relationship between conflict, identity and health. In response, this paper provides a critical ethnography of obstetric service provision and patient access during Shia-Sunni hostilities in Gilgit Town, capital of Pakistans Northern Areas (2005). I analyse how services were embedded in and constrained by sectarian affiliation in ways that detrimentally impacted Sunni women patients and hospital staff, resulting in profoundly diminished clinic access, reduced physician coverage and a higher observed incidence of maternal morbidity and mortality. The paper first situates obstetric med...

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The purpose of this statement of work (SOW) is to establish laboratory analytical criteria and requirements for radioactive airborne emissions measurement sample and/or analysis activities.

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Programs & Services Technical Resources Land Use Soils Water Snow Survey & Water Supply Water Management Water Quality Watersheds Wetlands Air Plants & Animals Energy Climate...

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Four low activation alloy classes, two austenitic and two ferritic, have been incorporated into the MOTA-1B experiment in the FFTF reactor to provide an early assessment of the suitability of such alloys for reactor service.

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Recent Reviews in Carcinogenesis is a service of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute, intended to facilitate and promote the exchange of information between cancer scientists. It contains abstracts ...

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Sick Leave: Receives 13 days paid leave per year. ... Under the FERS, the Government contributes 11.4% of the employees' base ...

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voluntarily provided by you. Network Traffic Logs In the course of ensuring network security and consistent service for all users, the University employs software programs to...

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17F0B270 MUSCOOT RIVER AT BALDWIN PLACE, N 41° 20' 17", W 73 ° 46' 07" (41.338055 , -73.768608) Disclaimer...

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Milstar is a flexible, robust satellite communications ... of the Milstar system includes services capable of supporting status reporting, ...

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... WHS- Washington Headquarters Service ... but also with respect to other Joint, National and ... unit of action (UA) combat team or task force is organized ...

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Mangroves are disappearing rapidly worldwide despite their well documented biodiversity and the ecosystem services they provide. Failure to link ecological processes and their societal benefits has...Full Text Available

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Apr 18, 2011 ... TOA period, sick leave may be granted for the period of ..... civil service retirement under the CSRS and FERS retirement programs. ...

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Jan 31, 2006 ... Sick leave accrues at the rate of 1 hour for each 20 hour in a pay status. ... FERS: All periods of service are used in determining the FERS ...

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... WHS- Washington Headquarters Service ... present a framework based on political campaigns theory for both the Joint Task Force Commander down ...

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... Masatsune IHI Technology Service Co., Ltd., Yokohama, Kanagawa (Japan)

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... content of the environment) are significant factors affecting the useful service life of adhesive bonded plastic composite sandwich panels at 650 F ...

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Online District Residents Businesses Visitors Media Online Services DC Home > DPW > Education and Outreach accordian interface begins About DPW Who We Are News Room FOIA Requests...

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... WHS- Washington Headquarters Service. ... The standing Joint Task Force concept should be used more to provide warfighter forces and ...

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... Exercise Preps 82nd Airborne Division Staff for Afghanistan Deployment. By Donna Miles American Forces Press Service. WASHINGTON, Nov. ...

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pumped storage plants; but these must be built as well since there is no correspondence with the pump and turbine operating times governed by normal network ...

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Dec 20, 2007 ... Process 5b Federal Employee Retirement System (FERS) Deposits and ..... CSRS, CSRS Offset, or FERS ..... Advanced Sick Leave and ...

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within the United States for the benefit of present and future generations of Americans Kenai National Wildlife Refuge. Photo Credit: USFWS/Steve Hillebrand Kenai National Wildlife...

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This paper presents a new mathematical model for designing distribution networks in a supply chain system considering service level constraint optimizing strategic decisions (location), tactical decisions (inventory), and assigning decisions. In real-world cases, demand, traveling time or any parameters in classical models may change over the period of time. So, considering uncertainty yields more flexibility for the results and the proposed model. In our study, environmental uncertainty is described by discrete scenarios. In this model, we have service level constraint in order to prevent inventory lost in distribution centers (DCs). Also, we assume that customer's demand is stochastic with Poisson distribution function and DCs have coverage radius constraints thus any DC cannot service a...

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... Our primary work to date in this area has been with the Automated Transport and Retrieval System (ATRS) [1]. ATRS enables independent mobility ...

International Nuclear Information System (INIS)

Purpose: During recent years, more intensified systemic and local treatment regimens have increased the 5-year survival figures in localized Ewing's sarcoma to more than 60%. There is, however, concern about the risk of second malignancies (SM) in long-term survivors. We have analyzed the second malignancies in patients treated in the German Ewing's Sarcoma Studies CESS 81 and CESS 86. Materials and Methods: From January 1981 through June 1991, 674 patients were registered in the two sequential multicentric Ewing's sarcoma trials CESS 81 (recruitment period 1981-1985) and CESS 86 (1986-1991). The systemic treatment in both studies consisted of a four-drug-regimen (VACA = vincristine, actinomycin D, cyclophosphamide, and adriamycin; or VAIA = vincristine, actinomycin D, ifosfamide, and adriamycin) and a total number of four courses, each lasting nine weeks, was recommended by the protocol. Local therapy in curative patients was either complete surgery (n = 162), surgery plus ...

Science.gov (United States)

Basal cell carcinoma (BCC) is the most frequent cutaneous neoplasm, with a generally favorable clinical behavior. Sometimes, indeed, it recurs after therapy and/or metastasizes. As point mutations in the coding sequence of the p53 tumor suppressor gene have been implicated in the progression of many human tumors, we studied the expression of p53 protein on this neoplasia. We tested immunohistochemically the positivity for p53 protein (NCL-p53-CM1, YLEM) on 19 cases of morphologically "non aggressive" BCC (BCC1) and on 19 "aggressive" BCC (BCC2), all with one or more relapses and 3 with distant metastases also. Results were related to clinico-pathological and follow-up data. All but one BCC2 were found positive for p53 protein. Conversely, only 2 cases of BCC1 exhibited low immunoreactivity for p53 protein, with high statistical differences between the two groups. No correlation was found between the immunoreactivity, age of patients, and site of the lesions. The ...

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The waterjet technique enables precise tissue dissection without thermal damage and with preservation of vessels in general surgery. In neurosurgery, these qualities could help to avoid damage of intact brain parenchyma in tumour resections. The present study reports our first results with this technique in brain metastases. Ten patients with intracranial metastases underwent surgery with the aid of the waterjet. Resection was performed in combination with conventional neurosurgical methods. The follow-up consisted of neurological examination and MRI studies. Intraoperatively, the device was easy to handle. No complications due to the device were observed. Vessels were preserved at pressures below 20 bars. Six of the tumours consisted of soft tissue which was poorly demarcated from the surrounding brain. In these tumours, the waterjet was very helpful. It enabled tumour debulking by aspiration and - more important - precise separation of tumour and brain ...

International Nuclear Information System (INIS)

Radioactive iron is used to follow up some haematologic indices in birds infected with irradiated spirochetes of the Borrelia anderina species. Use is made of a total of 90 cockerels, aged two months, divided into three groups: 1st group - cockerels inoculated with spirochetes that had been gamma-irradiated at the rate of 40000 R; 2nd group - cockerels inoculated with untreated spirochetes; and 3rd group - normal cockerels. The infective material consisted of strain Rouen spirochetes of the Pamoukchii serotype. Radiometric studies were also carried out for establishing to what extent radioactive iron is incorporated in the erythrocytes and is deposited in the liver, spleen, and marrow of the investigated birds. Classical methods of investigation were employed to determine the erythrocyte, leukocyte, and thrombocyte counts, the haemoglobin content (after Sahli) as well as the erythrocyte pack after the method of Todorov. It is found that the ...

International Nuclear Information System (INIS)

Purpose: To assess the prevalence, significance and practical value of two recently described CT signs of instable aneurysm: the crescent sign and the periluminal halo (a low-attenuating internal layer of the thrombus around the patent lumen). Material and methods: Among the CT examination performed in the last 5 years, they retrospectively selected the nonruptured aneurysms with a diameter exceeding 4 cm (no. = 93 average diameter 5.1 cm, unenhanced images in 28 cases and enhanced in 84) and the ruptured aneurysms (no. = 16, average diameter 6.7 cm, unenhanced images in 9 cases and enhanced in 9). They studied the prevalence of the crescent and halo sing, their relationship with the aneurysm diameter, and the effect of contrast enhancement. Results: The crescent sign was identified with a statistically significant prevalence in ruptured ( 37.5 % or cases) over asymptomatic aneurysms (5.5 %); the halo had the same frequency in the 2 groups (12.5 % and 9.5 %). Both signs were more ...

CERN Document Server

We report on recent inter-calibration studies featuring Swift's Burst Alert Telescope (BAT) and Fermi's Gamma-ray Burst Monitor (GBM) based upon correlated observations of GRBs 080804 and 080810, via their resultant joint spectral analysis. Swift's intrinsic multi-wavelength instrumentation and dynamical response complement Fermi's superior energy range. The addition of BAT's spectral response will (i) facilitate in-orbit GBM detector response calibration, (ii) augment Fermi's low energy sensitivity, (iii) enable ground-based follow-up efforts of Fermi GRBs, and (iv) help identify a subset of GRBs discovered via off-line GBM data analysis, for an annual estimate of ~30 GRBs. The synergy of BAT and GBM augments previous successful joint spectral fit efforts by enabling the study of peak photon energies (Epeak), while leveraging the over eleven energy decades afforded by Fermi's Large Area Telescope (LAT), in conjunction with Swift's X-Ray (XRT) and ...

International Nuclear Information System (INIS)

Purpose: To report outcomes of a single institution study of stereotactic body radiotherapy (SBRT) for unresectable cholangiocarcinoma. The dose-volume dependency of the observed gastrointestinal toxicity is explored. Methods and materials: Twenty-seven patients with unresectable cholangiocarcinoma (n = 26 Klatskin tumours and one intrahepatic cholangiocarcinoma (IHCC)) were treated by linac-based SBRT. The dose schedule was 45 Gy in three fractions prescribed to the isocenter. Results: The median progression-free survival and overall survival were 6.7 and 10.6 months, respectively. With a median follow-up of 5.4 years, 6 patients had severe duodenal/pyloric ulceration and 3 patients developed duodenal stenosis. Duodenal radiation exposure was higher in patients developing moderate to high-grade gastrointestinal toxicity with the difference in mean maximum dose to 1 cm"3 of duodenum reaching statistical significance. A statistically significant association between ...

Energy Technology Data Exchange (ETDEWEB)

Thermal gradients and thermal conductivities were obtained in real time using an in situ heat-flow technique in 15 shallow (90 to 150 m) wells drilled between Brawley and Glamis in the Imperial Valley, Southern California. The in situ measurements were supplemented by follow-up conventional temperature logs in seven of the wells and by laboratory measurements of thermal conductivity on drill cuttings. The deltaic sedimentary material comprising the upper approx. 100 m of the Salton Trough generally is poorly sorted and high in quartz resulting in quite high thermal conductivities (averaging 2.0 Wm/sup -1/ K/sup -1/ as opposed to 1.2 to 1.7 for typical alluvium). A broad heat-flow anomaly with maximum of about 200 mWm/sup -2/ (approx. 5 HFU) is centered between Glamis and East Brawley and is superimposed on a regional heat-flow high in excess of 100 mWm/sup -2/ (> 2.5 HFU). The heat-flow high corresponds with a gravity maximum and partially with a minimum in ...

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Objective: To analyze the early response of uveal melanomas in patients treated with ruthenium-106 brachytherapy. Materials And Methods: In the period between April 2002 and July 2003, 20 patients diagnosed with uveal melanoma were submitted to ruthenium-106 brachytherapy. The calculated dose delivered at the apex of the tumor ranged between 55 Gy and 100 Gy. Patients with lesions greater than 5 mm were submitted to transpupillary thermotherapy concomitantly with ophthalmic plaque insertion. Results: As regards the lesions site, 75% of the lesions were located in the choroid, 15% in the iris, and the remainder 10% in the ciliary body. In a median 19-month-follow-up, the progression-free survival for brachytherapy was 69%, and 87% for associated brachytherapy and transpupillary thermotherapy. A significant tumor height reduction was observed after treatment. No patient was submitted to enucleation. Conclusion: Our preliminary results show that ruthenium-106 ...

International Nuclear Information System (INIS)

Over the five year period of performance, thirteen task assignments were issued by the DOE to ARINC Research. During the two year base period seven tasks were assigned. Two task assignments were issued for each of the three consecutive one year option periods. Associated with all task assignments were multiple subtasks, some of which required significant effort. These subtasks are appropriately cited in this report under their respective task assignments as principal work activities or deliverables. The technical and management support provided to the DOE under this contract focused on two general areas: (1) appraisal activities and (2) non-appraisal activities. Support to appraisals included planning, document review, developing lines-of-inquiry, interviewing, data collection, report writing, and follow-up. Such work was executed both on-site at the DOE facility under review and off-site. Non-appraisal support was varied and included such areas as document review, ...

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The present study answers at the request of the Inspection of the classified installations to see the operator of the G.I.P. Cyceron setting up a plan of environmental radiological surveillance around its installations and including, at a minimal level, the following data: Measures of radioactivity on representative biological indicators and measures of dose rate in the environment close to installations in functioning. Further to the radiological assessment of the terrestrial environment of the G.I.P. Cyceron installations realized at the end of 2003, within the framework of a project of the installations extension, the A.C.R.O. was again required for the implementation of this radiological surveillance for year 2005. The first purpose is to supply elements of appreciation about the impact of these installations on environment and persons. This evaluation participates in radiation protection and allows to make sure that the G.I.P. operator respects the required regulatory thresholds. ...

Science.gov (United States)

The visual outcomes of Acanthamoeba keratitis, a rare cause of corneal infection, can be devastating. This paper reports two contact lens wearers with severe pain and photophobia who presented to the emergency room. Biomicroscopy revealed radial keratoneuritis in both individuals. Tissue culture on a nonnutrient agar plate with Escherichia coli overlay resulted in a heavy growth of Acanthamoeba. The inpatient treatment included 0.02% polyhexamethylene biguanide, chlorhexidine, neomycin/polymyxin B/bacitracin (Neosporin), and oral fluconazole, which successfully controlled the corneal infection and improvement in the best corrected visual acuity in both patients. Infection did not recur during the 12-month follow-up period. Acanthamoeba keratitis can present as radial keratoneuritis, mimicking other common corneal infections resulting in diagnostic and treatment delays. Early diagnosis and prudent treatment of Acanthamoeba keratitis are the keys to restoring vision ...

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A new microdensitometry method for quantitative assessment of bone mineral content using Fuji computed radiography (FCR) was developed and the results were compared with those obtained by the conventional film-screen method. Using both methods, X-ray pictures of the 2nd metacarpal bone were taken with a reference aluminum step wedge in nine normal subjects and nine parameters representing the width and density of bone marrow and cortex were calculated in middle of the bone shaft. Interobserver reproducibility assessed for three parameters was significantly higher in the FCR method than the conventional one. The value of #SIGMA#GS computed by the FCR method, that is equivalent to the net bone density of the transverse section of the shaft, showed higher correlation with the one obtained by computed tomography in comparison with the conventional method. In our FCR method, moreover, interobserver reproducibility and accuracy was improved by employing automatic manipulation as much as ...

International Nuclear Information System (INIS)

A 2-year follow-up regarding healing complications, such as redisplacement, nonunion, and segmental collapse of the femoral head, was performed in 306 patients operated on for femoral neck fracture and examined with "9"9"mTechnetium-MDP scintimetry within 2 weeks postoperatively. Scintimetric evaluation was performed by selecting regions of interest over the femoral head on the fracture side and the intact side and by comparing the uptake. A femoral head ratio fractured/intact side thus was obtained. Of 199 patients with an intact femoral head uptake (ratio #<=# 1.0), 181 showed no signs of healing complications at 2 years, whereas 18 had developed healing complications. Of 107 cases with a deficient femoral-head uptake (ratio < 1.0), 96 had developed healing complications within 2 years from the operation, while 11 cases had no signs of radiographic complications. We conclude that "9"9"mTc-MDP scintimetry performed within 2 weeks from femoral neck fracture ...

Energy Technology Data Exchange (ETDEWEB)

The Plasma Science Committee (PLSC) of the National Research Council (NRC) is charged with monitoring the health of the field of plasma science in the United States and identifies and examines both broad and specific issues affecting the field. Regular meetings, teleconferences, briefings from agencies and the scientific community, the formation of study panels to prepare reports, and special symposia are among the mechanisms used by the PLSC to meet its charge. During July 1992, the PLSC sponsored a workshop on nonneutral plasmas in traps. Although no written report on the workshop results, was prepared for public distribution, a summary of highlights was provided to the OPST Subpanel on Nonneutral Plasmas. The PLSC also continued its follow-up briefings and discussions on the results of the results of the report Plasma Processing of materials. Scientific and Technological Opportunities. As a result of these activities, the Committee is now working with the NRC ...

International Nuclear Information System (INIS)

Eight patients who had received megavoltage therapy for Cushings' disease 5-12 years previously have been reviewed. The long term response to this therapy was assessed with respect to efficacy of treatment in inducing continued remission and disturbance of hypothalamic-pituitary function. One patient showed clear evidence of relapse of Cushings' disease. One patient had unequivocal hypopituitarism. Basal levels of growth hormone (GH), TSH, LH, and FSH were not statistically different from controls, but provocative testing revealed significant abnormalities of response of cortisol/ACTH, GH, prolactin and LH. Six out of eight patients had absent diurnal cortisol variation and five patients had elevated serum prolactin levels. Thus, in this group of patients normal pituitary-adrenal function has not been satisfactorily restored. It is clear that significant disturbances of hypothalamic-pituitary function follow megavoltage therapy and these may progress to overt hypopituitarism. (author).

International Nuclear Information System (INIS)

To compare clinical effectiveness of Viabil-covered stents versus uncovered metallic Wallstents, for palliation of malignant jaundice due to extrahepatic cholangiocarcinoma, 60 patients were enrolled in a prospective and randomized study. In half of the patients a bare Wallstent was used, and in the other half a Viabil biliary stent. Patients were followed up until death. Primary patency, survival, complication rates, and mean cost were calculated in both groups. Stent dysfunction occurred in 9 (30%) patients in the bare stent group after a mean period of 133.1 days and in 4 (13.3%) patients in the covered stent group after a mean of 179.5 days. The incidence of stent dysfunction was significantly lower in the covered stent group (P = 0.046). Tumor ingrowth occurred exclusively in the bare stent group (P = 0.007). Median survival was 180.5 days for the Wallstent and 243.5 days for the Viabil group (P = 0.039). Complications and mean cost were ...

International Nuclear Information System (INIS)

Diffusion magnetic resonance imaging (MRI) has become an important tool in the radiologic diagnosis of diseases of the brain as it measures molecular motion of water that characterizes the microstructure of tissues. Its most important clinical use to date is the early detection of cerebral ischemia by revealing the ischemic injury shortly after vessel occlusion and simultaneously providing therapy-relevant information on the tissue at risk. Furthermore, diffusion MRI is diagnostically promising in other diseases of the brain and is thus increasingly becoming part of routine clinical protocols in the diagnosis of tumors, inflammation, trauma, demyelination, dysmyelination and neurodegeneration. Although abnormalities of diffusion are generally not pathognomonic, diffusion MRI affords information about tissue changes for specific disorders that complements information obtained with standard MR techniques and frequently shows pathology earlier. In addition, diffusion MRI can be applied to ...

International Nuclear Information System (INIS)

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 ...

British Library Electronic Table of Contents (United Kingdom)

Percutaneous coronary revascularisation [PCR] improves angina and health related quality of life [HRQOL] compared to standard medical therapy. It is unknown whether PCR has the same benefits for patients with a history of CABG. Over a period of 5?years, we assessed HRQOL of patients undergoing PCR using Part 1 of the Nottingham Health Profile [NHP] at baseline 3, 12 and 24?months. We compared HRQOL after PCR in 255 patients with CABG to 2680 without. There were more males [81.1% v 69.6% p?=?0.002] and older patients [mean age 60.1?years v. 58.0 p?=?0.03] in CABG group. Perceived HRQOL improved at 24?months for pain, energy and emotional reaction but the improvement was less in the CABG group. However, mean NHP scores at 24?months for those with CABG had returned to baseline levels for slee...