Sample records for accidents graves dans

  1. Pendant la visite de M. Krasucki Grave accident du travail dans le tunnel du LEP

    Ration, Jean


    In the LEP tunnel, where M. Krasucki came some hours before, an accident occured and a worker was seriously injuried, but its days do not seem in danger (together with another article about the visit of M. Krasucki)

  2. R and D relative to the serious accidents in the PWR type reactors: assessment and perspectives; R and D relative aux accidents graves dans les reacteurs a eau pressurisee: bilan et perspectives

    Bentaib, A.; Bonneville, H.; Caroli, H.; Chaumont, B.; Clement, B.; Cranga, M.; Koundy, V.; Laurent, B.; Micaelli, J.C.; Meignen, R.; Pichereau, F.; Plassart, D.; Van-Dorsselaere, P. [Institut de Radioprotection et de Surete Nucleaire (IRSN), 92 - Clamart (France); Ducros, G.; Journeau, Ch.; Magallon, D. [CEA Cadarache, 13 - Saint Paul lez Durance (France); Durin, M.; Studer, E. [CEA Saclay 91 - Gif sur Yvette (France); Seiler, J.M. [CEA Grenoble, 38 (France); Ranval, W. [Electricite de France (EDF), 75 - Paris (France)


    This document presents the current state of the research relative to the grave accidents realized in France and abroad. It aims at giving the most exhaustive possible and objective vision of this original field of research. He allows to contribute to the identification and to the hierarchical organization of the needs of R and D, this hierarchical organization in front of, naturally, to be completed by a strong lighting on needs in terms of safety analyses associated with the different risks and the physical phenomena, in particular with the support of probability evaluations of safety level 2, whose the level of sharpness must be sufficient not to hide, by construction, physical phenomena of which the limited knowledge leads to important uncertainties. Let us note that neither the safety analyses, nor the E.P.S. 2 are presented in this document. This report presents the physical phenomena which can arise during a grave accident, in the reactor vessel and in the reactor containment, their chain and the means allowing to ease the effects. The corresponding scenarios are presented to the chapter 2. The chapter 3 is dedicated to the progress of the accident in the reactor vessel; the degradation of the core in reactor vessel (3.1), the behavior of the corium in bottom of reactor vessel (3.2) the break of the reactor vessel (3.3) and the fusion in pressure (3.4) are thus handled there. The chapter 4 concerns the phenomena which can lead to a premature failure of the containment, namely the direct heating of gases of the containment (4.1), the hydrogen risk (4.2) and the vapor explosion (4.3). The phenomenon which can lead to a delayed failure from the containment, namely the interaction corium-concrete, is approached on the chapter 5. The chapter 6 is dedicated to the problems connected to the keeping back and to the corium cooling in reactor vessel and out of reactor vessel, namely the keeping back in reactor vessel by re-flooding of the primary circuit or by re

  3. Neutronics aspects associated to the prevention and mitigation of severe accidents in sodium cooled reactor cores; Aspects de neutronique associes a la prevention et a la reduction des accidents graves dans les coeurs de reacteurs a caloporteur sodium

    Poumerouly, S.


    Among all the types of accidents to be considered for the safety licensing of a plant, some have a very low probability of occurrence but might have very important consequences: the severe accidents or Hypothetical Core Disruptive Accidents (HCDA). The studies on the scenario of these accidents are performed in parallel to the prevention studies. In this PhD report, two representative safety cases are studied: the Unprotected Loss Of Flow (ULOF) and the Total Instantaneous Blockage (TIB). The objectives are to understand what causes the reactivity increase during these accidents and to find means to reduce the energetic release of the scenario (ULOF) or to find ways to trigger the core prior to the propagation of the accident (TIB). At first, the accidents are studied in static calculations with the ERANOS code system. The accidents are divided into several steps and the reactivity insertions at each step are explained. This study shows the importance of the removal of the structures as well as of the radial leakage changes during the core slumping-down. The study also gives the amounts of fuel to be ejected or of absorber to be injected in both accidents. These values give tracks to the following more accurate studies, the transient studies. The transient studies were performed with the SIMMER code system, coupling thermo-hydraulics and neutronics. SIMMER data and algorithms have been improved so as to better predict ERANOS results (former discrepancies were up to 1.5$). The SIMMER reactivity calculation is improved by 0.8$ with variations of reactivity due to the motion of materials correctly predicted. A new algorithm for the {beta}-effective was implemented in SIMMER so as to be more accurate and easier to manage. SIMMER is then used to calculate the secondary phase of the ULOF, while the primary phase is calculated with ERANOS thanks to some assumptions. The assumptions are very much based on the fact that the movement of materials stops whenever the energy

  4. Safety apparatus for serious radioactive accidents (1962); Materiel d'intervention en cas d'accident radioactif grave (1962)

    Estournel, R.; Rodier, J. [Commissariat a l' Energie Atomique, Centre de Production de Plutonium, Marcoule (France). Centre d' Etudes Nucleaires


    In the case of a serious radioactive accident, radioactive dust and gases may be released into the atmosphere. It is therefore necessary to be able to evaluate rapidly the importance of the risk to the surrounding population, and to be able to ensure, even in the event of an evacuation of the Centre, the continuation of the radioactivity analyses and the decontamination of the personnel. For this, the Anti-radiation Protection Service at Marcoule has organised mobile detection teams and designed a mobile laboratory and a mobile shower-unit. After describing the duty of the mobile teams, the report gives a description of the apparatus which would be used at the Marcoule Centre in the case of a serious radioactive accident. The method of using this apparatus is given. (authors) [French] Lors d'un accident radioactif grave, des poussieres et des gaz radioactifs peuvent etre relaches dans l'atmosphere. II est alors indispensable d'evaluer rapidement l'importance du risque couru par les populations environnantes, et de pouvoir assurer, meme dans le cas de l'evacuation du Centre, la poursuite des analyses radioactives et la decontamination du personnel. Pour cela, le Service de Protection contre les Radiations du Centre de Marcoule a mis sur pied des equipes mobiles de detection et realise une semi-remorque laboratoire ainsi qu'une semi-remorque douches. Apres avoir defini la mission des equipes mobiles, le rapport donne la description du materiel d'intervention qui serait mis en oeuvre par le Centre de Marcoule dans le cas d'un accident radioactif grave. Il precis le mode d'utilisation de ce materiel. (auteurs)

  5. Décision d'amputation dans la prise en charge initiale d'une luxation ouverte grave de la cheville à propos d'un cas observé à l'Hôpital Laquintinie de Douala suite à un accident par moto-taxi

    Tsatedem, Faustin Atemkeng; Tsiagadigui, Jean Gustave; Ndando, Richard Polle; Arabo, Mohamadou Saidou; Bayiha, Alphonse; Kenfack, Bruno


    La décision d'amputation pour traumatisme grave de membre n'est pas toujours facile à prendre. Les auteurs rapportent le cas d'un traumatisme ouvert de la cheville gauche avec luxation tibiotalienne complète, référé pour amputation. Il s'agit d'une passagère d'une moto-taxi percutée par une voiture. A l'admission, le pouls tibial postérieur était présent et le score dit MESS (Mangled Extremity Severity Score) côté à 5, ce qui a permis et d'éviter l'amputation. Après débridement et réduction, une broche transplantaire a permis d'immobiliser la cheville et de faire les pansements. L'amputation a été évitée. La cicatrisation dirigée de la peau a été suivie par la kinésithérapie. La mobilité de la cheville autorise une marche avec cannes au quatrième mois post-opératoire. Les auteurs recommandent l'utilisation du MESS dans la décision d'amputation après traumatisme grave de membre. PMID:23396997

  6. Study of the ruthenium fission-product behavior in the containment, in the case of a nuclear reactor severe accident; Etude du comportement du produit de fission ruthenium dans l'enceinte de confinement d'un reacteur nucleaire, en cas d'accident grave

    Mun, Ch


    Ruthenium tetroxide is an extremely volatile and highly radio-toxic species. During a severe accident with air ingress in the reactor vessel, ruthenium oxides may reach the reactor containment building in significant quantities. Therefore, a better understanding of the RuO{sub 4}(g) behaviour in the containment atmosphere is of primary importance for the assessment of radiological consequences, in the case of potential releases of this species into the environment. A RuO{sub 4}(g) decomposition kinetic law was determined. Steam seems to play a catalytic role, as well as the presence of ruthenium dioxide deposits. The temperature is also a key parameter. The nature of the substrate, stainless steel or paint, did not exhibit any chemical affinities with RuO{sub 4}(g). This absence of reactivity was confirmed by XPS analyses, which indicate the presence of the same species in the Ru deposits surface layer whatever the substrates considered. It has been concluded that RuO{sub 4}(g) decomposition corresponds to a bulk gas phase decomposition. The ruthenium re-volatilization phenomenon under irradiation from Ru deposits was also highlighted. An oxidation kinetic law was determined. The increase of the temperature and the steam concentration promote significantly the oxidation reaction. The establishment of Ru behavioural laws allowed making a modelling of the Ru source term. The results of the reactor calculations indicate that the values obtained for {sup 106}Ru source term are closed to the reference value considered currently by the IRSN, for 900 MWe PWR safety analysis. (author)

  7. Épidémiologie des accidents domestiques graves de l'enfant admis en réanimation pédiatrique polyvalente à l'hôpital d'enfants de Rabat-Maroc

    Rafai, Mostafa; Mekaoui, Nour; Chouaib, Naoufal; Bakkali, Hicham; Belyamani, Lahcen; El Koraichi, Alae; El Kettani, Salma Ech-Cherif


    Introduction Les accidents domestiques de l'enfant représentent un vrai problème de santé publique dans les pays industrialisés. Au Maroc, la priorité en santé publique est toujours donnée aux pathologies infectieuses, et bien qu'elle soit très peu décrite, la pathologie accidentelle de l'enfant devient de plus en plus fréquente dans notre pays avec une mortalité importante. L'objectif est de mettre le point sur la prévalence, la gravité, les aspects étiologiques, les facteurs de risque et les circonstances de survenue de ces accidents, ainsi que les moyens de prévention active et passive. Méthodes Enquête rétrospective descriptive sur une période de douze mois portant sur tous les enfants pris en charge pour accident domestique grave au service de réanimation pédiatrique polyvalente de l'hôpital universitaire d'enfants de Rabat. Résultats Parmi 698 admissions, 108 cas d'accidents domestiques graves ont étaient colligés (soit 15,5%), L’âge moyen des enfants était de 04ans tout accident confondu, avec un sex-ratio de 1,08 en faveur des garçons. L’évolution générale était marquée par le décès de 16 enfants (soit 14,8%) parmi 164 décès toute pathologie confondue au cours de la même période d’étude (soit 9,75% des décès) avec une durée moyenne d'hospitalisation de 04jours. les brûlures constituaient le premier accident dans notre série par 37cas, et elles étaient la première cause de mortalité par huit cas; par ailleurs, la population la plus à risque de brûlure était les nourrissons (67,6%). L'inhalation intrabronchique d’épingle à foulard (accident particulier dans notre contexte islamique) à été retrouvée chez six cas. Conclusion Les accidents domestiques de l'enfant constituent rarement une préoccupation de premier plan dans la population alors qu'ils sont parfois très graves et source d'une mortalité importante. Le meilleur traitement reste la prévention active et passive. PMID:26015848

  8. Décision d'amputation dans la prise en charge initiale d'une luxation ouverte grave de la cheville à propos d'un cas observé à l'Hôpital Laquintinie de Douala suite à un accident par moto-taxi

    Tsatedem, Faustin Atemkeng; Tsiagadigui, Jean Gustave; Ndando, Richard Polle; Arabo, Mohamadou Saidou; Bayiha, Alphonse; Kenfack, Bruno


    La décision d'amputation pour traumatisme grave de membre n'est pas toujours facile à prendre. Les auteurs rapportent le cas d'un traumatisme ouvert de la cheville gauche avec luxation tibiotalienne complète, référé pour amputation. Il s'agit d'une passagère d'une moto-taxi percutée par une voiture. A l'admission, le pouls tibial postérieur était présent et le score dit MESS (Mangled Extremity Severity Score) côté à 5, ce qui a permis et d'éviter l'amputation. Après débridement et réduction, ...

  9. Un chercheur du CERN tué dans un accident


    The accident occured on Sunday between Collonges and Pougnu (Pays de Gex): 4 russians scientists were aboard the vehicle; the driver lost the control of the vehicle and the car made a barrel. (1/4 page)

  10. Le rôle de l’omalizumab dans le traitement de l’asthme allergique grave

    Chapman, Kenneth R; Cartier, André; Hébert, Jacques; McIvor, R Andrew; Schellenberg, R Robert


    CONTEXTE : Un nouveau traitement anti-immunoglobuline E (anti-IgE) contre l’asthme, l’omalizumab, a été approuvé au Canada. OBJECTIF : Passer en revue les données fondamentales et cliniques sur l’omalizumab et examiner le rôle possible de ce médicament dans la prise en charge de l’asthme au Canada. MÉTHODOLOGIE : Une recherche documentaire a été effectuée dans MEDLINE afin de repérer les études menées de 1960 à 2006 sur l’omalizumab. La recherche a également porté sur les résumés de réunions scientifiques récentes dans le domaine des maladies respiratoires et des allergies; par ailleurs, toute donnée non publiée a été demandée au fabricant. Après avoir revu et résumé les données, un comité mixte constitué de spécialistes des maladies respiratoires et des allergies a rédigé un ensemble de recommandations relatives à l’utilisation de l’omalizumab. RÉSULTATS : L’omalizumab est un anticorps monoclonal humanisé qui se lie au domaine C epsilon 3 de la molécule d’IgE pour former des complexes immuns solubles qui sont éliminés par le système réticulo-endothélial. L’administration d’injections sous-cutanées espacées de deux ou de quatre semaines à la dose recommandée entraîne une diminution rapide des taux d’IgE circulantes libres. Lors de deux essais cliniques de phase III menés auprès de 1 405 adultes et adolescents atteints d’asthme modéré à grave qui recevaient des doses moyennes stables de corticostéroïdes en inhalation (CSI), l’omalizumab a diminué les taux d’exacerbation par rapport au placebo et a été associé à une amélioration des symptômes ainsi qu’à une épargne plus importante des corticostéroïdes. Dans un essai mené auprès de 419 patients atteints d’asthme grave non maîtrisé malgré l’utilisation de doses élevées de CSI et de la prise concomitante d’agonistes bêta-2 à action prolongée, les exacerbations graves étaient de 50 % moins fréquentes chez


    Hartono Hartono


    Full Text Available In paper Development of port infrastructure in Indonesia is now no longer the responsibility of centralgovernment, along with limited funds and the government's insistence seaport infrastructure needs. Toaccelerate economic growth, the government issued Government Regulation as a legal umbrella. The purpose ofthis study was to examine public-private partnership opportunities in the construction of graving dock andshipyard management. Targets do is review, the criteria are prioritized cooperation and cooperationpriorities.This study used qualitative and quantitative approach, a descriptive qualitative approach throughinterviews used to assess the normative aspect. The quantitative approach used to assess the priority criteriaforms of cooperation and public-private partnership in development graving dock and shipyard management byusing the Analytical Hierarchy Process (AHP. Based on the AHP analysis can be concluded that the expertsdisagree about the priority criteria of cooperation, where the majority of them choose the duration as the maincriterion. As for the analysis of priorities of the cooperation of all experts choose Built-Operate-Transfer (BOT,which is deemed suitable for long-term investment of up to 30 years. BOT puts private partners to more freely tofinance, construct, operate, anticipated rate of return on capital (rate of return and the risks of commercial andregulatory aspects

  12. Radiometric evaluation of graves of victims of the accident with Cesium 137 in Goiania, GO, Brazil: 25 years after; Avaliacao radiometrica das sepulturas das vitimas do acidente com o Cesio 137 em Goiania: 25 anos apos

    Lage, Leonardo B.; Correa, Rosangela da S.; Santos, Eliane E. dos, E-mail:, E-mail:, E-mail: [Centro Regional de Ciencias Nucleares do Centro-Oeste (CRCN-CO/CNEN-GO), Abadia de Goias, GO (Brazil); Freitas-Junior, Ruffo, E-mail: [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Faculdade de Medicina. Programa de Mastologia


    Twenty-five years after the radiation accident in Goiania, this study aims to evaluate the radiological situation in the area demarcated by the graves of the victims of the accident with cesium-137. Radiometric survey was carried out on the surface that encompasses the four graves and vicinity, from a pre-established mesh. Dose rate measurements were carried out, using the IdentFINDER equipment, positioned at 1 m height from the ground. The values of dose rates at the points measured ranged from 0.03 to 0.07 μSv/h. This variation of dose rate is less than those obtained in the local graveyard and are in the range of background radiation observed in Goiania. Considering the results obtained 25 years after the accident, it was concluded that engineering barriers adopted at that time are effective, stating the place absolutely safe from a radiological point of view, both for the individual from the public as to the environment.

  13. [Graves' ophthalmopathy].

    Badelon, Isabelle; Morax, Serge


    Graves' ophthalmopathy (GO) is a chronic autoimmune process that affects the retrobulbar tissue and has strong etiological links with graves' disease. Pathogenesis is incompletely understood. Symptoms include proptosis, extraocular muscle dysfunction, eyelid swelling and retraction. In its severe expression, it is a disfiguring and potentially sight threatening disease that profoundly influences and impairs the quality of life of affected individuals. Only a minority of patients develop severe expressions of the disease, requiring aggressive treatments. Glucocorticoids, orbital radiotherapy and decompressive orbital surgery represent a mainstay and a well established treatment for severe and active GO.

  14. Management of a severe accident on a pressurised water reactor in France; La gestion d'un accident grave sur un reacteur a eau sous pression en France



    This brief document defines what a severe accident is on a nuclear reactor, indicates the different failure modes which have been defined (vapour explosion in the reactor vessel, hydrogen explosion, and so on). It describes the management of a core fusion accident for pressurized water reactors, for which a guide has been designed, the GIAG (intervention guide for a severe accident situation). The principles of such an intervention are described, and then the approach for an EPR reactor

  15. [Graves' ophthalmopathy].

    Eckstein, A; Dekowski, D; Führer-Sakel, D; Berchner-Pfannschmidt, U; Esser, J


    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease and the full clinical picture can impair the quality of life of the patients considerably. Active inflammation can often be effectively treated by intravenous steroids/immunosuppression, however does not lead to full remission, since inflammation rather quickly results in irreversible fibrosis and increase of orbital fat. Very important is the control of risk factors (smoking cessation, good control of thyroid function, selenium supplementation) to prevent progression to severe stages. Treatment should rely on a thorough assessment of activity and severity of GO. Rehabilitative surgery (orbital decompression, squint surgery, eyelid surgery) is needed in many patients to restore function and appearance. Anti-thyroid-stimulating hormone (TSH) receptor antibodies do specifically occur in these patients and correlate to the course of thyroid and eye disease. The levels of these antibodies can be used for treatment decisions at certain time points of the disease.

  16. Envenimation scorpionique compliqué d'un accident vasculaire cérébral ischemique


    Les piqûres de scorpion sont dans un certain nombre de pays, un accident fréquemment rencontré, et un risque grave. Au Maroc, les données épidémiologiques établies par le centre anti-poison (CAPM) montrent que les piqûres scorpioniques se placent en tête de toutes les intoxications relevées par le centre (60%). Les envenimations scorpioniques posent un grand problème de santé publique. L'apparition de signes neurologiques lors d'une envenimation scorpionique témoigne d'une envenimation grave ...

  17. Major accidents involving dangerous chemicals and Standard Basic Self-Protection; Accidentes graves en los que intervangan sustancias quimica peligrosas y Norma Basica de Autoproteccion

    Alonso Fernandez, L.


    Nuclear and radioactive facilities and other centers, institutions and agencies engaged in activities that may lead to emergency situations, are subject to specific regulations directed to take measures to prevent and control risks at source and to act initially in emergency situations and limit the consequences, in order to protect people, property and the environment. With these premise, place the following article, which summarizes the basic guidelines in the field of major accident and self-protection, summarizing the implications of current legislation in this field. (Author)

  18. Contribution of prototypic material tests on the Plinius platform to the study of nuclear reactor severe accident; Contribution des essais en materiaux prototypiques sur la plate-forme Plinius a l'etude des accidents graves de reacteurs nucleaires

    Journeau, Ch


    The PLINIUS experimental platform at CEA Cadarache is dedicated to the experimental study of nuclear reactor severe accidents thanks to experiments between 2000 and 3500 K with prototypic corium. Corium is the mixture that would be formed by an hypothetical core melting and its mixing with structural materials. Prototypical corium has the same chemical composition as the corium corresponding to a given accident scenario but has a different isotopic composition (use of depleted uranium,...). Research programs and test series have been performed to study corium thermophysical properties, fission product behaviour, corium spreading, solidification and interaction with concrete as well as its coolability. It was the frame of research training of many students and was realized within national, European and international collaborations. (author)

  19. Ampleur et impact des évènements indésirables graves liés aux soins: étude d'incidence dans un hôpital du Centre-Est tunisien

    Bouafia, Nabiha; Bougmiza, Iheb; Bahri, Fathi; Letaief, Mondher; Astagneau, Pascal; Njah, Mansour


    Introduction La prévention des événements indésirables représente une priorité de santé du fait de leur fréquence et de leur gravité potentielle. Ce travail a été mené afin d'avoir un diagnostic de la situation épidémiologique relative aux événements indésirables survenant dans notre hôpital. Méthodes Une étude prospective a été menée auprès de tous les patients qui ont été hospitalisés au CHU Farhat Hached - Sousse (Tunisie) sur une période d'un mois dans quatorze services de l'hôpital. La détection d'évènement indésirable grave (EIG) était basée sur les critères adoptés dans différentes études. Les tests T et Chi 2 ont été utilisés pour identifier les facteurs contribuant à l'apparition d'évènements indésirables. Résultats Au total, 162 EIG ont été identifiés pendant la période. 45% de ces évènements étaient des infections nosocomiales. Ces EIG ont eu comme conséquences un décès chez 9,2% des patients, la mise en jeu du pronostic vital de 26% des patients et la prolongation de la durée de séjour chez 61,7% d'entre eux. L'admission dans des circonstances particulières et l'exposition à des soins invasifs étaient identifiés comme des facteurs de risque potentiels EIG. Conclusion Le renforcement de la stratégie de gestion des risques sanitaires en ciblant préférentiellement le risque infectieux constitue une étape fondamentale dans l'amélioration de la sécurité des patients au sein de notre établissement de santé. PMID:24711868

  20. Graves' Disease Associated with Cerebrovascular Disease and Antiphospholipid Antibody Syndrome

    Ines Khochtali


    have increased risk for developing thromboembolic accidents, which are favoured by a simultaneous presence of antiphospholipid antibodies syndrome. in this paper, we describe the case of a patient with Graves' disease, who developed strokes with antiphospholipid antibodies syndrome.

  1. Material effects on multiphase phenomena in late phases of severe accidents of nuclear reactors; Effets des materiaux sur les phenomenes multiphasiques se produisant lors des phases avancees d'accident grave de reacteur nucleaire

    Seiler, J.M.; Froment, K


    This paper reviews and presents work carried out in the French Atomic Energy Commission (CEA) on the subject of nuclear severe accidents, i.e. those which are accompanied by melting of the nuclear core material. The emphasis is on the (crucial) thermodynamic and material behaviour of corium melts in the solidus-liquidus temperature interval, which is linked to the thermal hydraulic description. A global model approach is proposed. The work is presented in the context of the overall international effort in the area. (authors)

  2. Fukushima accident: the consequences in Japan, France and in Japan; Accident de Fukushima: les repercusions au Japon, en France et dans le Japon

    Foucher, N.; Sorin, F.


    This document begins with a description of the Fukushima accident, the second article reviews the main consequences in Japan of the accident: setting of a forbidden zone around the plant, restriction of the exports of food products, or the shutdown of the Hamaoka plant. The third article is the reporting of an interview of L. Oursel, deputy general director of the Areva group, this interview deals mainly with the safety standard of the EPR and with the issue of passive safety systems. The last part of the document is dedicated to the consequences in France (null sanitary impact, cooperation between Areva, EdF, CEA and the Japanese plant operator Tepco...) and in the rest of the world: the organization of resistance tests in the nuclear power plants operating in the European Union, the decision about the agreement of EPR and AP1000 reactor has been delayed in United-Kingdom, acceleration of the German program for abandoning nuclear energy, Italy suspends its nuclear program, China orders a general overhaul of the safety standard of its nuclear power plants, Poland and Romania reaffirm their trust in nuclear energy, France wishes a 'mechanism' allowing a quick international intervention in case of major nuclear accident, Russia proposes measures to improve nuclear safety. (A.C.)

  3. Les accidents du travail dans le transport urbain en commun de la ville province de Kinshasa, République Démocratique du Congo: une étude transversale descriptive

    Wangata, Jemima; Elenge, Myriam; De Brouwer, Christophe


    Introduction Le transport en commun urbain constitue un secteur où les travailleurs sont très exposés aux accidents du travail. Cette étude visait une description épidémiologique des accidents du travail dans le secteur informel du transport en commun à Kinshasa en vue d'apporter les pistes d'amélioration de la sécurité des travailleurs dans cette activité. Méthodes Un questionnaire sur les accidents du travail, administré en Décembre 2012 a permis d'explorer les tendances significatives entre les accidents et leurs circonstances, leurs facteurs associés, leurs conséquences au sein d'une population des travailleurs (n = 472) du transport en commun à Kinshasa. Résultats Durant les 12 derniers précédant l’étude 76.5% des travailleurs ont connu au moins un accident du travail, 54,8% ont connu un arrêt d'au moins 1jour. Les accidents liés à la circulation routière étaient plus important suivis des chutes. Les facteurs ayant montré des différences significatives étaient le travail sous l'influence de l'alcool et le port des équipements de protection individuelle. Les plaies (46,3%) et les contusions (39,4%) étaient les lésions les plus courantes. Les membres supérieurs (51,3%) et inférieurs (30,7%) étaient les plus atteints. 76,6% des travailleurs ont assumé seuls leur prise en charge médicale. Conclusion L'incidence des accidents du travail dans ce secteur est très élevée. La mise en place d'une politique de prévention et gestion de différents facteurs associés ainsi qu'un système de déclaration d'accidents est nécessaire dans ce secteur. Les patrons ainsi que les politiques devraient veiller à une prise en charge médicale correcte pour des travailleurs accidentés. PMID:25667703

  4. Chernobyl in the French mass media 14 years after the accident; Tchernobyl dans la presse francaise 14 ans apres



    The author presents how the mass media have dealt with the fourteenth anniversary of the Chernobyl accident. Nowadays Chernobyl epitomizes the hazards of nuclear energy. Public opinion has become extremely sensitive to topics concerning human health. This sensitivity is due to previous important affairs such as the scandal of the tainted blood, the mad cow disease or the syndrome of the Balkan war. Most media have broadened the debate to the sanitary impact of nuclear activities. The hyper-mediatization of the legal case of a man prosecuting the French state for no having taken adequate measures when the radioactive cloud spread over France, has given the feeling that French authorities have always wrongly minimized the consequences of the accident. (A.C.)

  5. Graves disease (image)

    Graves disease is an autoimmune disorder that involves overactivity of the thyroid gland (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea, and anxiety.

  6. Accidents - Chernobyl accident; Accidents - accident de Tchernobyl



    This file is devoted to the Chernobyl accident. It is divided in four parts. The first part concerns the accident itself and its technical management. The second part is relative to the radiation doses and the different contaminations. The third part reports the sanitary effects, the determinists ones and the stochastic ones. The fourth and last part relates the consequences for the other European countries with the case of France. Through the different parts a point is tackled with the measures taken after the accident by the other countries to manage an accident, the cooperation between the different countries and the groups of research and studies about the reactors safety, and also with the international medical cooperation, specially for the children, everything in relation with the Chernobyl accident. (N.C.)

  7. Graves' ophthalmopathy: interdisciplinary approach

    O I Vinogradskaya


    Full Text Available Graves' ophthalmopathy constitutes a major therapeutic challenge, so specialists of various disci-plines have to combine their forces. According to the last consensus of EUGOGO (European Group On Graves' Orbitopathy the treatment of choice for Graves' ophthalmopathy is pulses of glucocorticoid (GC. Evidence for the superiority of any of the different intravenous (iv glucocorticoid schedules is lacking. Objective: to evaluate the efficacy of two different methylprednisolone pulse therapy schedules in Graves' ophthalmopathy. Materials and Methods: 30 Graves' patients with Graves' ophthalmopathy were subcategorized into two groups: Group A subjects (n = 14 were given iv glucocorticoid daily for 5 days (total 5 g and Group B patients (n = 16 were given iv glucocorticoid weekly for 5 weeks (total 5 g. All patients were examined by the ophthalmologist before and in 1 and 12 weeks after the treatment. Results: We found that in group A visual acuity was significantly higher than in group B at 12 weeks. By 12 week proptosis, diplopia had improved as well as CAS had fallen in two groups but there were no significant differences between the two groups. Conclusion: Both schedules are effective on proptosis, soft tissue swelling. Daily pulse therapy appeared to be more effective on visual acuity. Thereby in case of active Graves' ophthalmopathy associated with impairment of visual acuity, daily pulse therapy is a treatment of choice. But, in spite of improvement, strabismus, diplopia, proptosis have a marked negative effect on quality of life, disturb a lifestyle. In these cases surgery should be considered. After end of our research two patients (3 orbits had bone decompression with a good result. We consider that eye muscle surgery is next needed to restore their binocular vision.

  8. Graves' Disease Associated with Cerebrovascular Disease and Antiphospholipid Antibody Syndrome


    Thyroid disorders are commonly associated with coagulopathy. Patients with hyperthyroidism have increased risk for developing thromboembolic accidents, which are favoured by a simultaneous presence of antiphospholipid antibodies syndrome. in this paper, we describe the case of a patient with Graves' disease, who developed strokes with antiphospholipid antibodies syndrome.

  9. Modeling Graves' Orbitopathy in Experimental Graves' Disease.

    Banga, J P; Moshkelgosha, S; Berchner-Pfannschmidt, U; Eckstein, A


    Graves' orbitopathy (GO), also known as thyroid eye disease is an inflammatory disease of the orbital tissue of the eye that arises as a consequence of autoimmune thyroid disease. The central feature of the disease is the production of antibodies to the thyrotropin hormone receptor (TSHR) that modulate the function of the receptor leading to autoimmune hyperthyroidism and GO. Over the years, all viable preclinical models of Graves' disease have been incomplete and singularly failed to progress in the treatment of orbital complications. A new mouse model of GO based upon immunogenic presentation of human TSHR A-subunit plasmid by close field electroporation is shown to lead to induction of prolonged functional antibodies to TSHR resulting in chronic disease with subsequent progression to GO. The stable preclinical GO model exhibited pathologies reminiscent of human disease characterized by orbital remodeling by inflammation and adipogenesis. Inflammatory lesions characterized by CD3+ T cells and macrophages were localized in the orbital muscle tissue. This was accompanied by extensive adipogenesis of orbital fat in some immune animals. Surprisingly, other signs of orbital involvement were reminiscent of eyelid inflammation involving chemosis, with dilated and congested orbital blood vessels. More recently, the model is replicated in the author's independent laboratories. The pre-clinical model will provide the basis to study the pathogenic and regulatory roles of immune T and B cells and their subpopulations to understand the initiation, pathophysiology, and progression of GO.

  10. L'hemorragie grave du peripartum en milieu de reanimation dans un centre universitaire tunisien de niveau 3: épidémiologie et facteurs de risque de mortalité maternelle

    Nasr, Laidi Ben; Marzouk, Sofiene Ben; Kehila, Mehdi; Jabri, Hamed; Thamleoui, Saber; Maghrebi, Hayen


    L'hémorragie grave du péripartum demeure une des causes principales de mortalité maternelle. L'objectif de notre étude était de décrire le profil épidémiologique des patientes qui ont été prises en charge en milieu de réanimation suite à une hémorragie grave du péripartum et de rechercher d’éventuels facteurs de risque de mortalité. Notre étude est rétrospective descriptive et analytique. Nous avons inclus tous les cas d'hémorragie du péripartum ayant séjourné en unité de réanimation obstétri...

  11. Graves orbitopathy: a perspective.

    Perros, Petros; Krassas, Gerasimos E


    Advances in the past few years have helped clinicians understand some of the pathogenetic mechanisms of Graves orbitopathy (GO), particularly the role of receptors for TSH and insulin-like growth factor I in the orbit. Optimal treatment strategies have been formulated and published by the European Group on Graves' Orbitopathy, which are hoped to improve the management of patients with this condition. The administration of intravenous pulses of steroids has been established as a superior treatment approach compared with other steroid regimens. In addition, orbital radiotherapy was effective in a subgroup of patients with GO who had eye dysmotility. The use of immunotherapies for the treatment of GO is currently being explored; of these, rituximab has emerged as a promising new agent.

  12. Digging One's Own Grave

    Arvo Krikmann


    Full Text Available The paper aims to demonstrate that some points in the explicationof the figurative expression digging one’s own grave via the concept of blending given by Gilles Fauconnier and Mark Turner are problematic: (1 Not understanding the consequences of one’s deeds is an almost universal presuppositionof and impulse or motivation for actualizing any utterance with a forewarning or gloating content (e.g., proverbs, not the singularity characterizing just the expression of grave-digging as such. (2 The inversion of causal and temporal structure is not the case because of metonymic association between the concepts of the grave and death, as a result of which specific causal and temporal order loses any significance. Many synonymous examples can be given in which the image refers to events before the death, between the death and funeral, as well as those after burial. (3 The source domain needs not to be restricted to natural death and modern civilized funerals but should include also the cases of violent deaths, e.g., the scenario of execution and the scenario of hunting and trapping. Preliminarily, a very brief synopsis of the main phases of development of cognitive linguistic theory of metaphor and some favourite examples of blends, used also in previous works, is provided.

  13. SARNET european excellence network on nuclear reactor major accidents. Display and realizations after a year of operating; Sarnet reseau d'excellence europeen sur les accidents graves de reacteur nucleaire. Son deploiement et ses realisations apres une annee de fonctionnement



    The Sarnet (Severe Accident Research NETwork of excellence) is devoted to the research on major accidents of water cooled reactors. The developed knowledge will be integrated in a simulation tool ASTEC co-developed with the IRSN and the GRS. This evaluation report presents the context, the objectives and the program of the Sarnet network. It discusses the network operating and the ASTEC simulation code. Some examples of experimental programs are provided. (A.L.B.)

  14. Study of diluting and absorber materials to control reactivity during a postulated core melt down accident in Generation IV reactors; Etude des materiaux sacrificiels absorbants et diluants pour le controle de la reactivite dans le cas d'un accidnet hypothetique de fusion du coeur de reacteurs de quatrieme generation

    Plevacova, K.


    In order to limit the consequences of a hypothetical core meltdown accident in Generation IV Sodium Fast Reactors, absorber materials in or near the core, such as boron carbide B{sub 4}C, and diluting materials in the core catcher will be used to prevent recriticality within the mixture of molten oxide fuel and molten structures called corium. The aim of the PhD thesis was to select materials of both types and to understand their behaviour during their interaction with corium, from chemical and thermodynamic point of view. Concerning B{sub 4}C, thermodynamic calculations and experiments agree with the formation of two immiscible phases at high temperature in the B{sub 4}C - UO{sub 2} system: one oxide and one boride. This separation of phases can reduce the efficiency of the neutrons absorption inside the molten fuel contained in the oxide phase. Moreover, a volatilization of a part of the boron element can occur. According to these results, the necessary quantity of B{sub 4}C to be introduced should be reconsidered for postulated severe accident sequence. Other solution could be the use of Eu{sub 2}O{sub 3} or HfO{sub 2} as absorber material. These oxides form a solid solution with the oxide fuel. Concerning the diluting materials, mixed oxides Al{sub 2}O{sub 3} - HfO{sub 2} and Al{sub 2}O{sub 3} - Eu{sub 2}O{sub 3} were preselected. These systems being completely unknown to date at high temperature in association with UO{sub 2}, first points on the corresponding ternary phase diagrams were researched. Contrary to Al{sub 2}O{sub 3} - Eu{sub 2}O{sub 3} - UO{sub 2} system, the Al{sub 2}O{sub 3} - HfO{sub 2} - UO{sub 2} mixture presents only one eutectic and thus only one solidification path which makes easier forecasting the behaviour of corium in the core catcher. (author) [French] Resume: Afin de limiter les consequences d'un accident grave avec la fusion du coeur dans un reacteur a neutrons rapides de generation IV refroidi au sodium, la recriticite doit

  15. Avancée dans la prévention des « chutes de plain-pied » au travail Progress in the prevention of occupational “falls on the same level”. Proposed operational definition of a new category: “Motion perturbation accidents (MPAs” Avances en la prevención de « caídas al mismo nivel » en el trabajo. Propuesta de la definición operacional de una nueva categoría : « los Accidentes con Perturbación del Movimiento (APM »

    Sylvie Leclercq


    Full Text Available La chute de plain-pied reste un accident du travail fréquent et grave. La terminologie qualifiant ces accidents est variée, relativement imprécise et n’intègre pas la diversité des accidents rencontrés sous les différentes appellations. L’intérêt de considérer une catégorie d’accidents du travail avec perturbation du mouvement (APM est tout d’abord mis en évidence à partir de divers extraits de récits d’accidents. Un modèle est ensuite proposé pour les APM montrant que, dans ces cas particuliers d’accident la blessure est souvent la conséquence de l’association fortuite entre l’énergie du mouvement perturbé de la victime et un élément matériel rendu blessant de par ses propriétés et appelé a posteriori un « danger circonstanciel ». Enfin, le raisonnement qui sous-tend la classification de ces accidents est explicité. Il apparaît notamment que la prévention ciblant les causes immédiates de la blessure est difficile voire impossible dans les cas d’APM en raison principalement des exigences inhérentes au travail et de contraintes que ferait peser sur l’entreprise l’application de cette prévention. La prévention à la source du risque tend alors à devenir la seule possible. Ainsi, de banal, l’APM devient un révélateur de dysfonctionnements au sein du système de production.Falls on the same level remain frequent and serious occupational accidents. The terminology used to describe these accidents is varied and somewhat imprecise. Moreover it does not integrate the variety of accidents with different names. The advantage of considering an occupational accident category with motion perturbation (MPA is demonstrated, based on extracts from various occupational accident accounts. A model is then proposed for MPAs that shows that in these specific cases of accidents, the injury often results from a fortuitous association between the victim’ perturbed motion energy and a physical element that

  16. Study of top reflooding in case of severe accident and in particular oxidation of Uranium, Zirconium, Oxygen melts; Etude du renoyage par le haut en cas d'accident grave et en particulier oxydation des melanges (U,Zr,O)

    Brunet-Thibault, E


    In 1979, the Three Mile Island (TMI) accident occurred in United States and accelerated research activities in the field of severe accidents. Severe accident management procedures imply massive water injections to flood the core. The work of this thesis bent principally over this reflooding. The first part of the study concerns the core oxidation enhancement during the reflooding phase which leads to a rough increase of the concentration of burnable hydrogen in the containment. This is why the study carried on the analysis of the contribution of the oxidation of U-Zr-O mixtures, towards the total production of hydrogen during reflooding. In the second part, the study concerns top flooding modelling i.e.: with injection of water in the hot legs. Here, we attempted to define bases and realize a model allowing to describe this type of reflooding. These models were validated on the simulation of the parameter with MAAP4 code. (author)

  17. [Radiotherapy for Graves' ophthalmopathy].

    Kuhnt, T; Müller, A C; Janich, M; Gerlach, R; Hädecke, J; Duncker, G I W; Dunst, J


    Graves' ophthalmopathy (GO) is the most frequent extrathyroidal manifestation of Graves' disease, an autoimmune disorder of the thyroid, whereas the precise pathogenesis still remains unclear. In Hashimoto's thyroiditis the occurrence of proptosis is an extremely rare event. The therapy for middle and severe courses of GO shows in partly disappointing results, although several therapy modalities are possible (glucocorticoid therapy, radiotherapy, antithyroid drug treatment, surgery). All these therapies lead in only 40 - 70 % to an improvement of the pathogenic symptoms. An intensive interdisciplinary cooperation is necessary to satisfy the requirements for the treatment of Graves' ophthalmopathy. As a consequence of the very different results of the few of clinical studies that were accomplished with reference to this topic, treatment by radiotherapy in the management of the disease is presently controversially discussed. In the German-speaking countries the radiotherapy is, however, firmly established as a therapy option in the treatment of the moderate disease classes (class 2-5 according to NO SPECS), especially if diplopia is present. This article describes the sequences, dosages and fractionation schemes as well as the risks and side effects of the radiotherapy. Altogether, radiotherapy is assessed as an effective and sure method. The administration of glucocorticoids can take place before the beginning of or during the radiotherapy. For the success of treatment the correct selection of patients who may possibly profit from a radiotherapy is absolutely essential. By realising that GO proceeds normally over a period of 2-5 years, which is followed by a period of fibrotic alteration, the application of the radiotherapy in the early, active phase is indispensable. A precise explanation for the effects of radiotherapy in treatment of the GO does not exist at present. The determination of the most effective irradiation doses was made from retrospectively evaluated

  18. Fisiopatologia da asma grave

    Todo-Bom, Ana; Mota-Pinto, Anabela


    Não tem resumo. Transcreve-se o primeiro parágrafo: A história natural da asma e os condicionalismos de uma evolução para formas moderadas ou graves não está completamente estabelecida. Contudo, quer os factores genéticos quer os factores ambientais, serão determinantes na fisiopatologia e no prognóstico da doença. A asma é, por definição, uma doença inflamatória crónica das vias aéreas caracterizada por uma obstrução brônquica generalizada mas variável que é, pelo menos parcialmente, reve...

  19. Epidemiology of Graves' orbitopathy.

    Putta-Manohar, Sudeep; Perros, Petros


    Thyroid orbitopathy is a relatively rare disease. Prevalence data are lacking and can only be estimated. The incidence of thyroid orbitopathy has been documented in one American study (16 cases per 100,000 population per year for females and 2.9 cases per 100,000 population for males). Thyroid orbitopathy can affect every race and age group. The majority of patients present in middle age with concurrent thyrotoxicosis due to Graves' disease. The onset of orbitopathy usually coincides with the hyperthyroidism, though the two may be asynchronous by months or sometimes years. A small proportion of patients with thyroid orbitopathy have primary hypothyroidism or are euthyroid. Female patients outnumber males by 2-5 to 1. Smoking increases the risk of thyroid orbitopathy up to 8-fold.

  20. Modeling in fast dynamics of accidents in the primary circuit of PWR type reactors; Modelisation en dynamique rapide d'accidents dans le circuit primaire des reacteurs a eau pressurisee

    Robbe, M.F


    Two kinds of accidents, liable to occur in the primary circuit of a Pressurized Water Reactor and involving fast dynamic phenomena, are analyzed. The Loss Of Coolant Accident (LOCA) is the accident used to define the current PWR. It consists in a large-size break located in a pipe of the primary circuit. A blowdown wave propagates through the circuit. The pressure differences between the different zones of the reactor induce high stresses in the structures of the lower head and may degrade the reactor core. The primary circuit starts emptying from the break opening. Pressure decreases very quickly, involving a large steaming. Two thermal-hydraulic simulations of the blowdown phase of a LOCA are computed with the Europlexus code. The primary circuit is represented by a pipe-model including the hydraulic peculiarities of the circuit. The main differences between both computations concern the kind of reactor, the break location and model, and the initialization of the accidental operation. Steam explosion is a hypothetical severe accident liable to happen after a core melting. The molten part of the core (called corium) falls in the lower part of the reactor. The interaction between the hot corium and the cold water remaining at the bottom of the vessel induces a massive and violent vaporization of water, similar to an explosive phenomenon. A shock wave propagates in the vessel. what can damage seriously the neighbouring structures or drill the vessel. This work presents a synthesis of in-vessel parametrical studies carried out with the Europlexus code, the linkage of the thermal-hydraulic code Mc3d dedicated to the pre-mixing phase with the Europlexus code dealing with the explosion, and finally a benchmark between the Cigalon and Europlexus codes relative to the Vulcano mock-up. (author)

  1. Hashimoto's thyroiditis following Graves' disease.

    Umar, Husaini; Muallima, Nur; Adam, John M F; Sanusi, Harsinen


    Both Graves' disease and chronic thyroiditis (Hashimoto's thyroiditis) are autoimmune diseases of thyroid gland. Graves' disease is caused by stimulation of TSH receptor located on the thyroid gland by an antibody, which is known as TSH receptor antibody (TRAb). Furthermore, this may lead to hyperplasia and hyperfunction of the thyroid gland. On the contrary, the cause of Hashimoto's thyroiditis is thought due to a TSH stimulation-blocking antibody (TSBAb) which blocks the action of TSH hormone and subsequently brings damage and atrophy to thyroid gland. Approximately 15-20% of patients with Graves' disease had been reported to have spontaneous hypothyroidism resulting from the chronic thyroiditis (Hashimoto's disease). Pathogenesis for chronic thyroiditis following anti-thyroid drug treatment in patients with Graves' disease remains unclear. It has been estimated that chronic thyroiditis or Hashimoto's disease, which occurs following the Graves' disease episode is due to extended immune response in Graves' disease. It includes the immune response to endogenous thyroid antigens, i.e. thyroid peroxidase and thyroglobulin, which may enhance lymphocyte infiltration and finally causes Hashimoto's thyroiditis. We report four cases of chronic thyroiditis (Hashimoto's disease) in patients who have been previously diagnosed with Graves' hyperthyroidism. In three cases, Hashimoto's thyroiditis occurs in 7 to 25 years after the treatment of Grave's disease; while the other case has it only after few months of Grave's disease treatment. The diagnosis of Hashimoto's disease (chronic thyroiditis) was based on clinical manifestation, high TSHs level, positive thyroid peroxidase antibody and thyroglobulin antibody, and supported by positive results of fine needle aspiration biopsy. Moreover, the result of histopathological test has also confirmed the diagnosis in two cases. All cases have been successfully treated by levothyroxine treatment.

  2. Graves opthalmopathy and psychoendocrinopathies

    Ghanem Asaad


    Full Text Available Purpose: To assess the psychiatric and endocrinological changes in patients with Graves ophthalmopathy (GO. Design: A prospective, controlled, University Hospital based study Subjects and Methods: The current study comprised 60 patients diagnosed with GO at Mansoura Ophthalmic Center. Thirty five patients of them with moderate to severe GO formed the study group and twenty five patients with negligible to very mild GO formed the control group in the euthyroid state. The study group was further subdivided based on their predominant clinical signs into a proptosis subgroup and a muscle restriction subgroup . Psychiatric changes were assessed with the Middlesex Hospital Questionnaire (MHQ. Biochemical analyses included serum-free thyroxine and thyroid-stimulating hormone (TSH concentrations, TSH receptor antibody (TRAb activity and anti-thyroglobulin particle agglutination (TGPA and antithyroid microsomal particle agglutination (MCPA. Results: The proptosis group reported significantly higher scores on anxiety, depression, and phobia than the muscle restriction group (P< 0.0001. The proptosis and muscle restriction subgroups reported significantly higher scores on all subscales compared to the control group (P < 0.05. The scale scores of depression and phobia showed a positive correlation with scores of anxiety (P< 0.0001. The serum TRAb activity showed a significant correlation with anxiety, phobia and hysteria (P < 0.0001. Conclusion: The psychiatric aspect of GO should be evaluated during routine follow-up and should be considered when making management decisions. Thyroid specific antibodies may be useful in confirming the diagnosis of GO.

  3. Fluxes of radionuclides in the agricultural production after a nuclear accident: countermeasures and decontamination techniques; Flux des radionucleides dans les productions agricoles suite a un accident nucleaire: contre-mesures et techniques de rehabilitation

    Jouve, A. [CEA Centre d`Etudes Nucleaires de Cadarache, 13 -Saint-Paul-lez-Durance (France)]|[Universite de Provence, 13 - Marseille (France)


    This thesis deals with the radiological consequences of a nuclear accident through the radioactive contamination of the food chain and the subsequent countermeasures for decreasing the fluxes of radionuclides and decontaminating agricultural lands. After a brief summary of the radioprotection ground and context in case of a nuclear accident, this work surveys existing data on the fluxes of radionuclides in soils and from soil to plants. The research work focuses on both the prediction of the fluxes of radionuclides and possible countermeasures: the measurement of the bioavailability of radionuclides in the soil solution, its use in a mathematical expression to quantify the soil-to-plant transfer of caesium and strontium, and the perspectives of an innovative technique of soil decontamination. The obtained results show that based on 4 coefficients, it is possible to predict crop contamination within a 3 % confidence interval: the fluid solid distribution coefficient of radionuclides kd, the amount of chemical analogues of caesium and strontium, i.e. potassium and calcium, respectively, soil pH and a constant characterising the plant species that is concerned. However, it generally appears from soil to plant transfer studies that the reduction of the fluxes of radionuclides is not a promising way of radiological exposure mitigation after a nuclear accident. The work performed shows that it is more efficient to tackle the source of the contamination, i.e. decontaminate the soil. The proposed technique of soil scraping using a turf harvester appears to be the most advantageous among the tested options, for the decontamination of peat-bog meadows. (author).

  4. Development of a shell finite element. Application to the thermo-viscoplastic behaviour of a PWR vessel during a severe accident; Developpement d`un element fini coque. Application au comportement thermo-viscoplastique d`une cuve de reacteur nucleaire (REP) en situation d`accident grave

    Diaz, V


    The aim of this study is to develop a model for the thermo-viscoplastic behaviour of he power water reactor lower head during a severe accident, so as to implement it in codes representing the whole accident progress (scenario codes). So it has to give a precise solution in a short cpu-time. The main loadings are the internal pressure and the strong longitudinal and transverse thermal gradients. To deal with this problem, the idea is to develop a new shell element with variable mechanical parameters with the temperature. This is possible in taking advantage of the properties of the bending center line, called neutral fiber. Besides, this new shell element has the particularity to be able to melt without modifying the initial dimensions of the structure. Then, we have developed a complete program to study the mechanical resistance of the vessel. The visco-plastic behaviour is considered as a loading (so it is placed in the second member of the system to be solved) and represented by a Norton law whose parameters depend on the temperature, the law is integrated explicitly which necessitates the introduction of criteria limiting the time step. The rupture criterion by creep is defined by a damage law whereas the rupture criterion by plasticity is based on the exceeding of the mean limit stress in the thickness. Then the model was validated by comparing the results with those of a Castem 2000 volume mesh (finite element code). Finally the model was coupled with the scenario codes ICARE2 and MAAP4 and tested on two typical severe accidents. The results are very satisfactory both on accuracy and cpu-time execution. (author) 113 refs.

  5. [Orbital decompression for Graves' ophthalmopathy].

    Boulétreau, P; Breton, P; Freidel, M


    Graves' ophthalmopathy is a complex orbital condition with a controversial pathogenesis. It is the clinical expression of a discordance between the inextensible orbit and hypertrophic muscular and fatty elements within the orbit responding to immunological stimulation. The relationship between the orbital and its content can be improved by surgical expansion which increases the useful volume of the orbit. This procedure can be combined with lipectomy to decrease the volume of the orbital contents. We briefly recall the history of surgical decompression techniques and present our experience with Graves' ophthalmopathy patients.

  6. Typologie des Accidents Cyclistes

    Amoros, Emmanuelle; BILLOT-GRASSET, Alice; Hours, Martine


    L'usage du vélo est en hausse en ville ; cette pratique est encouragée dans le cadre du développement durable et de la lutte contre la sédentarité. Pour accompagner cela, il faut réduire les risques d'accident, et pour ce faire, mieux les connaître. Nous utilisons le Registre des victimes de la circulation routière du Rhône, basé sur les services hospitaliers (dont les urgences) ; il est quasi-exhaustif : env. 1100 blessés à vélo/an versus 120 dans les données officielles. L'ensemble des cycl...

  7. Bicycle accidents.

    Lind, M G; Wollin, S


    Information concerning 520 bicycle accidents and their victims was obtained from medical records and the victims' replies to questionnaires. The analyzed aspects included risk of injury, completeness of accident registrations by police and in hospitals, types of injuries and influence of the cyclists' age and sex, alcohol, fatigue, hunger, haste, physical disability, purpose of cycling, wearing of protective helmet and other clothing, type and quality of road surface, site of accident (road junctions, separate cycle paths, etc.) and turning manoeuvres.

  8. Clinical evaluation of Graves ophthalmopathy

    Janićijević-Petrović Mirjana A.


    Full Text Available Introduction. Graves ophthalmopathy is an autoimmune disease, which is the consequence of thyroid dysfunction. Ocular manifestations occur in 50% of patients with Graves disease. The changes occur due to the inflammatory cell infiltration of retrobulbar fat tissue and extraocular muscles. Ultrasonography of eye orbit provides important information about the condition of retrobulbar adipose tissue and the thickness of extraocular muscles. Objective. The aim of our study was to show the clinical significance of orbital ultrasonography in the diagnostics and follow-up of patients with Graves disease. Methods. The authors examined 154 patients with Graves ophthalmopathy at the Clinic of Ophthalmology of the Clinical Centre in Kragujevac during the period 2008–2010. Ophthalmological examination included visual acuity testing (Snellen chart, biomicroscopy and applanation tonometry, direct and indirect ophthalmoscopy, dry eye testing and exophthalmometry (Hertel. Orbital ultrasonography examination and extraorbital muscle measurement was done by ultrasound B-scan. Results. The disease was more frequent in women (79.87% aged from 36–45 years. Most patients had hyperthyreoidism (54.55%. In relation to the duration of the disease, the most frequent clinical signs were bilateral ptosis, conjunctival chemosis and periorbital edema. According to our data the highest number of patients had enlarged medial straight muscle. Conclusion. Graves ophthalmopathy is the most frequent sign of thyroid disease. By orbital ultrasonography we detected extended echogram and measured the thickness of the extraocular muscle. Computerized tomography and magnetic resonance scan were utilized for cases of insufficiently manifested clinical signs of the disease. The advantages of ultrasonography lie in easy handling, patients’ comfort, short time of examination and possibilities of repetition.

  9. Accident Statistics

    Department of Homeland Security — Accident statistics available on the Coast Guard’s website by state, year, and one variable to obtain tables and/or graphs. Data from reports has been loaded for...

  10. Sports Accidents



    Le Docteur Kiebel, chirurgien à Genève, est aussi un grand ami de sport et de temps en temps médecin des classes genevoises de ski et également médecin de l'équipe de hockey sur glace de Genève Servette. Il est bien qualifié pour nous parler d'accidents de sport et surtout d'accidents de ski.

  11. Contribution of radio-iodine 131 in the treatment of Grave's Basedow disease in the department of nuclear medicine of Ibn Sina Hospital in Rabat; Apport de l'iode 131 dans le traitement de la maladie de Basedow dans le service de medecine nucleaire de l'hopital Ibn Sina de Rabat

    Mbodj, M.; Amjad, I. [Faculte de Medecine de Dakar, Lab. de Biophysique et de Medecine Nucleaire, UCAD, Dakar (Senegal); Guerrouj, H.; Ben Rais, N.A. [Hopital Ibn Sina de Rabat, Service de Medecine Nucleaire, Rabat (Morocco)


    One hundred and twenty-nine Grave's Basedow diseases in any gender and variable age patients, coming from several cities of Morocco, were randomized in a study of radio-iodine treatment who took place at the nuclear medicine department of Ibn Sina Hospital (Rabat, Morocco) during the period (from January 2001 to December 2008). The radio-iodine treatment was a first, second or third option and radio-iodine activities delivered varied (from 222 to 555 MBq 6 to 15 mCi) according to the age, the thyroid volume, the degree of hyperthyroidism and socio-economical situation. The high amounts of {sup 131}I were reserved especially to the patients who live far and whose socio-economic level is low with an aim of quickly obtaining an easily controllable state of hypothyroidism by a substitute treatment. The results showed that: (1) 57.36% of patients reverted to euthyroidism (n = 74) with a patient having received two {sup 131}I cures. The second cure was justified by recurrence of hyperthyroidism after the first cure; (2) 34.88% passed in hypothyroidism (n = 45) with three patients having received two cures of {sup 131}I, the second cure was justified by recurrence of hyperthyroidism after the first cure in two patients and by the persistence of the hyperthyroidism after the first cure for the third patient. The average time of passage in hypothyroidism was 4.5 months; (3) 7.76% had remained in hyperthyroidism after the radioactive iodine treatment. Finally, 92.24% of our patients treated by radioactive iodine had passed in euthyroidism or hypothyroidism against 7.76% whose hyperthyroidism had persisted or occurred. (authors)

  12. Raconter Accident nocturne de Patrick Modiano Raconter Accident nocturne de Patrick Modiano

    Jurate Kaminskas


    Full Text Available Modiano affirme que chaque roman marque un pas en avant dans la réalisation de son oeuvre. « J’ai l’impression qu’à chaque livre je me suis débarrassé d’un truc pour essayer d’accéder à d'autres choses », explique-t-il dans un entretien avec Laurence Liban. Qu’en est-il donc pour Accident nocturne ?Modiano affirme que chaque roman marque un pas en avant dans la réalisation de son oeuvre. « J’ai l’impression qu’à chaque livre je me suis débarrassé d’un truc pour essayer d’accéder à autre chose », explique-t-il dans un entretien avec Laurence Liban. Qu’en est-il donc pour Accident nocturne ?

  13. PREGO (presentation of Graves' orbitopathy) study

    Perros, Petros; Žarković, Miloš; Azzolini, Claudio


    BACKGROUND/AIMS: The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. METHODS: Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres...

  14. Biventricular Takotsubo cardiomyopathy in Graves hyperthyroidism.

    Perkins, Matthew J; Schachter, David T


    Graves hyperthyroidism is commonly seen in clinical practice and Takotsubo stress cardiomyopathy is an increasingly recognized cardiac complication of physical or emotional stress. We report the rare case of a patient with Graves hyperthyroidism that was complicated by severe biventricular takotsubo cardiomyopathy, which was demonstrated on heart catheterization. After appropriate pharmacologic treatment of her hyperthyroidism, she had complete resolution of her cardiomyopathy.

  15. Dermopathy of Graves' disease: Clinico-pathological correlation.

    Reddy, Sagili Vijaya Bhaskar; Gupta, Sushil Kumar; Jain, Manoj


    Dermopathy of Graves' disease is a classical, but uncommon extrathyroidal manifestation of Graves' disease. The images of a typical case of dermopathy of Graves' disease are presented along with clinico-pathological correlation.

  16. Organic chemistry and radiochemistry: study of chemical interactions between iodine and paint of French nuclear reactor in a severe accident situation; Chimie organique et radiochimie. Etude des interactions chimiques iode-peinture dans un reacteur nucleaire (de type R.E.P.) en situation d'accident grave

    Aujollet, Y. [Direction Generale de la Surete Nucleaire et de la Radioprotection, 75 - Paris (France)


    In Phebus (French in pile facility; PWR scale 1/5000) experiments, performed by the Institut de Radioprotection et de Surete Nucleaire, few quantities of organic iodides were registered after interaction between iodine and reactor containment paint. This study concerns all mechanisms of chemical reactions between iodine and the polymer of the paint in order to estimate the organic iodides released from the paint. At first, all the paint components had been identified. Several models of chemical sites of the polymer were synthesized and tested with iodine in different conditions of temperature and radiation. These experiments showed interactions between iodine and secondary or tertiary amines by charge transfer. In few cases, the complex of tertiary amines creates oxidation reactions. (author)

  17. Mass Graves, Landscapes of Terror

    Ferrándiz, Francisco


    Full Text Available The recent exhumation of mass graves from the Spanish Civil War and the Post-War years, mostly involving the largely abandoned graves of the Francoist rearguard, have become a central element in contemporary debates about the conflict and the regime following it. In this paper, the complexity and dynamism of this process is analysed, including from political and legal initiatives of great social and media impact to local actions on the ground, at times failed, ephemeral or almost imperceptible, but no less crucial. From the point of view of many of the people involved in the pro-exhumation associations, opening up the graves is part of a basic exercise in justice and ‘dignification’, showing the scope and systematic nature of repression while reverting the ‘infrahuman’ disposition of the executed corpses, a feeling crystallised in the common expression ‘thrown’ or ‘buried like dogs’, used very often to justify the need of carrying out exhumations. Politics of dignification and ‘rehumanization’ of these ‘incorrectly’ buried bodies are incorporating, in the last few months, elements drawn from international law, such as the concept of ‘crimes against humanity’.

    Las exhumaciones de fosas comunes de la Guerra Civil española y la posguerra de la última década, muy especialmente de fosas abandonadas de la retaguardia franquista, se han colocado en un lugar central de los debates contemporáneos sobre la naturaleza y alcance de la contienda y el régimen que surgió de ella. En este artículo, se analiza la complejidad y dinamismo del proceso, que incluye desde iniciativas políticas y judiciales de enorme proyección pública y mediática, como la Ley de la Memoria o el controvertido auto de Garzón sobre los crímenes del franquismo, hasta acciones locales a veces fallidas, imperceptibles o efímeras, pero no menos cruciales. Desde el punto de vista de muchos de los actores sociales implicados en las exhumaciones

  18. Accident: Reminder


    There is no left turn to Point 1 from the customs, direction CERN. A terrible accident happened last week on the Route de Meyrin just outside Entrance B because traffic regulations were not respected. You are reminded that when travelling from the customs, direction CERN, turning left to Point 1 is forbidden. Access to Point 1 from the customs is only via entering CERN, going down to the roundabout and coming back up to the traffic lights at Entrance B

  19. [Differential diagnosis of Graves' orbitopathy. Case report].

    Erdei, Annamária; Steiber, Zita; Gazdag, Annamária; Bodor, Miklós; Berta, Eszter; Szász, Róbert; Szántó, Antónia; Ujhelyi, Bernadett; Barna, Sándor; Berényi, Ervin; Nagy, V Endre


    Graves' orbitopathy is the extrathyroidal manifestation of Graves' disease, which is the most common cause of exophthalmos. As eye symptoms usually coincide with the development of thyrotoxicosis, the diagnosis of the disease is rarely difficult. The aim of the authors was to summarize the differential diagnosis of Graves' orbitopathy based on literature review and presentation of their own four problematic cases on this topic. They conclude that symptoms similar to endocrine orbitopathy are present in other disorders. Endocrinologists need to be aware of these other conditions to avoid treatment failures.

  20. Pneumonia grave por "Chlamydia psittaci"



    Full Text Available A psitacose, também conhecida como ornitose, é causada pela Chlamydia psittaci; caracteriza-se por doença de início insidioso, sintomas brandos e inespecíficos, lembrando infecção de vias aéreas superiores. Acomete principalmente o pulmão, sendo raramente doença sistêmica e fatal. Descreve-se um caso raro de pneumonia por Chlamydia psittaci que evoluiu para insuficiência respiratória aguda, necessitando de ventilação mecânica. Destaca-se a importância em considerar o diagnóstico, especialmente em casos de pneumonia comunitária que evolui de modo insatisfatório, que não responde à terapia antimicrobiana e cuja epidemiologia é positiva para exposição às aves. O diagnóstico precoce é fundamental devido à excelente resposta terapêutica. O diagnóstico tardio pode levar a curso grave e fatal da doença.

  1. Orbital Volumetry in Graves' Orbitopathy

    Al-Bakri, Moug; Rasmussen, Åse Krogh; Thomsen, Carsten


    .6 cm(3) in controls, 8.7 ± 8.0 cm(3) in GO without DON, and 9.4 ± 3.1 cm(3) in GO with DON. The muscle and fat volumes were higher in patients with GO than in controls (P orbits with and without DON were not significantly different. The volume of the optic nerve were...... similar in the 3 groups. The number of apical, coronal 2 mm thick slices with no fat was 2.9 ± 0.9 in normal orbits, it was 4.1 ± 1.0 in GO orbits without DON and 5.3 ± 0.8 in GO orbits with DON (P = 0.007). Conclusion. Apical muscle enlargement may be more important than orbital fat enlargement......Purpose. We wanted to investigate the relative significance of fat and muscle enlargement in the development of dysthyroid optic neuropathy (DON) in Graves' orbitopathy (GO). Methods. Preoperative coronal CT scans of 13 patients with and without DON who subsequently underwent orbital decompression...

  2. Self-reported accidents

    Møller, Katrine Meltofte; Andersen, Camilla Sloth


    The main idea behind the self-reporting of accidents is to ask people about their traffic accidents and gain knowledge on these accidents without relying on the official records kept by police and/or hospitals.......The main idea behind the self-reporting of accidents is to ask people about their traffic accidents and gain knowledge on these accidents without relying on the official records kept by police and/or hospitals....

  3. Accidents corporels de la circulation routière liés à l'exercice d'une profession. Etude au sein de la cohorte Gazel

    Chiron, M; Lafont, S; Bernard, M; CHASTANG, JF; Zins, M; Lagarde, E


    On observe les accidents corporels de la route survenus aux membres de la cohorte Gazel entre 1989 et 2000, en distinguant les accidents « de mission » (accidents du travail proprement dits), de trajet domicile-travail et lors d'un déplacement privé. On calcule les incidences pour ces trois types d'accidents. Les accidents de mission sont les moins graves, et concernent surtout les hommes. Les accidents de trajet concernent surtout les femmes. On recherche ensuite les facteurs de risque de ch...

  4. [Neonatal hyperthyroidism and maternal Graves disease].

    Ben Ameur, K; Chioukh, F Z; Marmouch, H; Ben Hamida, H; Bizid, M; Monastiri, K


    The onset of Graves disease during pregnancy exposes the neonate to the risk of hyperthyroidism. The newborn must be monitored and treatment modalities known to ensure early treatment of the newborn. We report on the case of an infant born at term of a mother with Graves disease discovered during pregnancy. He was asymptomatic during the first days of life, before declaring the disease. Neonatal hyperthyroidism was confirmed by hormonal assays. Hyperthyroidism was treated with antithyroid drugs and propranolol with a satisfactory clinical and biological course. Neonatal hyperthyroidism should be systematically sought in infants born to a mother with Graves disease. The absence of clinical signs during the first days of life does not exclude the diagnosis. The duration of monitoring should be decided according to the results of the first hormonal balance tests.

  5. Les accidents de la route liés à une activité professionnelle. In: Le véritable enjeu de l'insécurité routière : la victime

    Charbotel, B.


    Deux types d'accidents de la route sont liés au travail : les accidents de trajet entre le domicile et le travail et les accidents survenant en mission pour l'employeur. Les accidents de la route en mission sont, dans de nombreux pays, la première cause d'accident mortel du travail (de 20 a 40 % des accidents du travail mortels). En France, près de 40 % des accidents du travail mortels sont des accidents de la route, et le taux de 60 % des accidents mortels est atteint si l'on comptabilise le...

  6. Bilateral carpal tunnel syndrome in Graves' disease.

    Manganelli, P; Pavesi, G; Salaffi, F


    Carpal tunnel syndrome (CTS) may be associated with endocrinopathies, such as hypothyroidism and acromegaly. A direct relationship between CTS and hyperthyroidism has recently been suggested. We now report a case in which bilateral CTS developed after treatment of Graves' disease, thus, questioning the possibility of a relationship between these two disease processes.


    Diksha Sapkota


    Full Text Available Background: Road traffic accidents, considered as global tragedies, are in increasing trend however, the safety situation is very severe in developing countries incurring substantial amount of human, economic and social costs. Motorcycle crashes, the commonest form, occur mostly on economically active population. However, there is limited coverage of studies on economic burden of motorcycle crashes. This study aims to estimate the total cost and DALYs lost due to motorbike accidents among victims of Kathmandu Valley.Materials and Methods: Retrospective cross-sectional study was conducted among the patients having history of motorbike accidents within past twelve months and at least 3 months from the date of data collection. Interview was conducted using proforma among 100 victims of accidents and their care giver in case of death from November 15, 2014 to May 15, 2015. Cost estimation of motorbike accident was done based on human capital approach. Data collection tool was pretested and collected data were analyzed by SPSS and Microsoft excel. Results: Males (79% belonging to the economically productive age group shared the highest proportion among total accidents victims. Most common reason for accidents was reported to be poor road condition (41%. Indirect cost was found to be significantly higher than direct costs highlighting its negative impact on economy of family and nation due to productivity loss. Total Disability Adjusted Life Years (DALYs lost per person was found to be 490 years and national estimation showed large burden of motorbike accidents due to huge DALY loss.Conclusions: For low resource countries like Nepal, high economic costs of motorbike accidents can pose additional burden to the fragile health system. These accidents can be prevented, and their consequences can be alleviated. There is an urgent need for reinforcement of appropriate interventions and legislation to decrease the magnitude of it and its associated grave

  8. Diagnosis and classification of Graves' disease.

    Menconi, Francesca; Marcocci, Claudio; Marinò, Michele


    Graves' disease (GD) is an autoimmune disorder involving the thyroid gland, typically characterized by the presence of circulating autoantibodies that bind to and stimulate the thyroid hormone receptor (TSHR), resulting in hyperthyroidism and goiter. Organs other than the thyroid can also be affected, leading to the extrathyroidal manifestations of GD, namely Graves' ophthalmopathy, which is observed in ~50% of patients, and Graves' dermopathy and acropachy, which are quite rare. Presumably, the extrathyroidal manifestations of GD are due to autoimmunity against antigens common to the thyroid and other affected organs. Although its exact etiology remains to be completely understood, GD is believed to result from a complex interaction between genetic susceptibility and environmental factors. Clinically, GD is characterized by the manifestations of thyrotoxicosis as well as by its extrathyroidal features when present, the latter making the diagnosis almost unmistakable. In the absence of ophthalmopathy, the diagnosis is generally based on the association of hyperthyroidism and usually diffuse goiter confirmed with serum anti-TSHR autoantibodies (TRAbs). Hyperthyroidism is generally treated with anti-thyroid drugs, but a common long term treatment strategy in patients relapsing after a course of anti-thyroid drugs (60-70%), implies the use of radioactive iodine or surgery.

  9. Analysis of CT scatnning for Graves'ophthalmopathy%Graves'眼病的CT扫描分析

    傅德生; 许雪亮; 向前; 鲍捷; 杨春霖; 易文殊; 丁凤奎



  10. Tratamiento de la osteoporosis grave con teriparatide

    Marcelo A. Sarli


    Full Text Available El objetivo de este trabajo retrospectivo fue evaluar el tratamiento de la osteoporosis grave con teriparatide (PTH y comparar nuestros resultados con los publicados en la literatura médica. Se incluyeron cuarenta y seis pacientes, cuarenta y dos mujeres y cuatro varones, edad: 69.15 ± 9.43 años. Seis eran vírgenes de tratamiento y cuarenta tratados previamente con bisfosfonatos. Treinta y dos pacientes habían tenido 93 fracturas de las cuales 86 vertebrales. Cuarenta y seis recibieron PTH 6 meses, 29 pacientes durante 12 meses y 20 completaron los 18 meses sugeridos. La densidad mineral ósea (DMO de columna lumbar aumentó significativamente desde el primer control a los 6 meses (p < 0.0001. La DMO de cuello de fémur alcanzó un incremento significativo al final del tratamiento (p = 0.002. La osteocalcina aumentó significativamente al mes, seguido por el ß crosslaps (beta-CTx, prueba en suero al tercer mes y la fosfatasa alcalina ósea, regresando los marcadores de recambio óseo a niveles basales a los 18 meses. Las calcemias y las calciurias no se modificaron significativamente, pero 8 pacientes tuvieron hipercalcemias leves y tres hipercalciurias asintomáticas. El tratamiento fue bien tolerado y no se registraron efectos adversos graves que requirieran suspender el tratamiento. En conclusión, la PTH es una alternativa útil y segura para el tratamiento de la osteoporosis grave. Nuestros resultados concuerdan con los previamente publicados en la literatura médica.

  11. Laser accidents: Being Prepared

    Barat, K


    The goal of the Laser Safety Officer and any laser safety program is to prevent a laser accident from occurring, in particular an injury to a person's eyes. Most laser safety courses talk about laser accidents, causes, and types of injury. The purpose of this presentation is to present a plan for safety offices and users to follow in case of accident or injury from laser radiation.

  12. [Accidents with the "paraglider"].

    Lang, T H; Dengg, C; Gabl, M


    With a collective of 46 patients we show the details and kinds of accidents caused by paragliding. The base for the casuistry of the accidents was a questionnaire which was answered by most of the injured persons. These were questions about the theoretical and practical training, the course of the flight during the different phases, and the subjective point of view of the course of the accident. The patterns of the injuries showed a high incidence of injuries of the spinal column and high risks for the ankles. At the end, we give some advice how to prevent these accidents.

  13. 75 FR 65030 - Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Native American Graves Protection and... nominations for two members of the Native American Graves Protection and Repatriation Review Committee....

  14. 75 FR 13140 - Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Native American Graves Protection and... nominations for one member of the Native American Graves Protection and Repatriation Review Committee....

  15. Current insights into animal models of Graves' disease and orbitopathy.

    Wiesweg, B; Johnson, K T M; Eckstein, A K; Berchner-Pfannschmidt, U


    Graves' disease (GD) is a systemic autoimmune disease that is characterized by hyperthyroidism, orbitopathy and in rare cases dermopathy. Graves' orbitopathy (GO) is an inflammatory disease of eye and orbit which occurs in about 30-60% of patients. Hyperthyroidism occurs due to the presence of stimulating TSHR-autoantibodies (TRAbs) leading to increased serum levels of thyroid hormones. Attempts to induce Graves' disease in mice by immunization against the hTSHR or its variants have resulted in production of TRAbs that stimulate thyroid follicular cells to increase thyroid hormone secretion. Graves' like orbital changes, such as inflammation, adipogenesis and muscle fibrosis are more difficult to induce. In this review we summarize different methods used to induce murine Graves'-like disease and their impact on murine orbits.

  16. Communication and industrial accidents

    As, Sicco van


    This paper deals with the influence of organizational communication on safety. Accidents are actually caused by individual mistakes. However the underlying causes of accidents are often organizational. As a link between these two levels - the organizational failures and mistakes - I suggest the conc

  17. Accidents - personal factors

    Zaitsev, S.L.; Tsygankov, A.V.


    This paper evaluates influence of selected personal factors on accident rate in underground coal mines in the USSR. Investigations show that so-called organizational factors cause from 80 to 85% of all accidents. About 70% of the organizational factors is associated with social, personal and economic features of personnel. Selected results of the investigations carried out in Donbass mines are discussed. Causes of miner dissatisfaction are reviewed: 14% is caused by unsatisfactory working conditions, 21% by repeated machine failures, 16% by forced labor during days off, 14% by unsatisfactory material supply, 16% by hard physical labor, 19% by other reasons. About 25% of miners injured during work accidents are characterized as highly professionally qualified with automatic reactions, and about 41% by medium qualifications. About 60% of accidents is caused by miners with less than a 3 year period of service. About 15% of accidents occurs during the first month after a miner has returned from a leave. More than 30% of accidents occurs on the first work day after a day or days off. Distribution of accidents is also presented: 19% of accidents occurs during the first 2 hours of a shift, 36% from the second to the fourth hour, and 45% occurs after the fourth hour and before the shift ends.

  18. Accident investigation and analysis

    Kampen, J. van; Drupsteen, L.


    Many organisations and companies take extensive proactive measures to identify, evaluate and reduce occupational risks. However, despite these efforts things still go wrong and unintended events occur. After a major incident or accident, conducting an accident investigation is generally the next ste


    Pande Made Udiyani


    Full Text Available Kajian keselamatan PLTN menggunakan metodologi kajian probabilistik sangat penting selain kajian deterministik. Metodologi kajian menggunakan Probabilistic Safety Assessment (PSA Level 3 diperlukan terutama untuk estimasi kecelakaan parah atau kecelakaan luar dasar desain PLTN. Metode ini banyak dilakukan setelah kejadian kecelakaan Fukushima. Dalam penelitian ini dilakukan implementasi PSA Level 3 pada kajian keselamatan PWR, postulasi kecelakan luar dasar desain PWR AP-1000 dan disimulasikan di contoh tapak Bangka Barat. Rangkaian perhitungan yang dilakukan adalah: menghitung suku sumber dari kegagalan teras yang terjadi, pemodelan kondisi meteorologi tapak dan lingkungan, pemodelan jalur paparan, analisis dispersi radionuklida dan transportasi fenomena di lingkungan, analisis deposisi radionuklida, analisis dosis radiasi, analisis perlindungan & mitigasi, dan analisis risiko. Kajian menggunakan rangkaian subsistem pada perangkat lunak PC Cosyma. Hasil penelitian membuktikan bahwa implementasi metode kajian keselamatan PSA Level 3 sangat efektif dan komprehensif terhadap estimasi dampak, konsekuensi, risiko, kesiapsiagaan kedaruratan nuklir (nuclear emergency preparedness, dan manajemen kecelakaan reaktor terutama untuk kecelakaan parah atau kecelakaan luar dasar desain PLTN. Hasil kajian dapat digunakan sebagai umpan balik untuk kajian keselamatan PSA Level 1 dan PSA Level 2. Kata kunci: PSA level 3, kecelakaan, PWR   Reactor safety assessment of nuclear power plants using probabilistic assessment methodology is most important in addition to the deterministic assessment. The methodology of Level 3 Probabilistic Safety Assessment (PSA is especially required to estimate severe accident or beyond design basis accidents of nuclear power plants. This method is carried out after the Fukushima accident. In this research, the postulations beyond design basis accidentsof PWR AP - 1000 would be taken, and simulated at West Bangka sample site. The

  20. Radiologia contrastada do timo na miastenia grave

    José Lamartine de Assis


    Full Text Available Foram estudados 20 casos de miastenia grave mediante exame radiológico simples para evidenciar a persistência ou hipertrofia do timo e estudar, comparativamente, os resultados dêste método propedêutico com o uso do enfisema do mediastino seguido de pneumografia e/ou planigrafia. Com tal procedimento foi possível mostrar, em 18 dos casos, a persistência ou hipertrofia do timo. Em alguns casos foram analisados os diversos aspectos radiológicos do timo em suas relações com as medidas terapêuticas, adotadas em particular com o uso do ACTH, radioterapia e/ou timectomia; neste particular, os autores não puderam tirar conclusões definitivas por ser pequeno o número de casos estudados.

  1. Radiotherapy in the management of Graves` ophthalmopathy

    Sakata, Koh-ichi; Hareyama, Masato; Oouchi, Atsushi; Shidou, Mitsuo; Nagakura, Hisayasu; Morita, Kazuo; Osanai, Hajime; Ohtsuka, Kenji; Hinoda, Yuji [Sapporo Medical Univ. (Japan). School of Medicine


    To report the results of radiotherapy for patients with failure, adverse reactions or relative contraindications to the use of steroids or immunosuppressants, by using newly developed quantitative indexes. Fourteen female and six male patients with Graves` ophthalmopathy were treated with radiotherapy between 1989 and 1996. Prior to radiotherapy, eight patients received treatment with prednisone, four received immunosuppressants and four received a combination of both. Four patients with contraindications to steroids were initially managed with radiotherapy. Most of the patients received a dose of 24-28 Gy in 2 Gy fractions. We used the newly developed motility limitation index to assess extraocular motility. Treatment was well tolerated. There have been no late complications. All 12 patients with soft tissue signs such as edema, irritation, tearing and pain were improved. Proptosis did not improve or improved only slightly, 3 mm at best. However, proptosis in all but two has been stabilized and has not deteriorated in the follow-up period. Most of the patients have experienced an improvement of eye-muscle motility. Extraocular muscles that work for elevation were impaired more severely than the other muscles and this tended to remain. Of the 16 patients using steroids before or when radiotherapy was initiated, 15 were tapered off and only one patient required additional steroids, thus sparing the majority from steroid adverse reactions. Radiotherapy was effective in preventing exacerbations of active inflammatory ophthalmopathy in patients with Graves` disease with minimal morbidity and thus eliminated the adverse reactions associated with protracted corticosteroid use. The newly developed motility limitation index was useful in detecting delicate changes in motility of individual extraocular muscles. (author)

  2. Outcome of Very Long-Term Treatment with Antithyroid Drugs in Graves' Hyperthyroidism Associated with Graves' Orbitopathy

    L. Elbers; M. Mourits; W. Wiersinga


    Background: It is still debated which treatment modality for Graves' hyperthyroidism (GH) is most appropriate when Graves' orbitopathy (GO) is present. The preference in our center has been always to continue antithyroid drugs for GH (as the block-and-replace [B-R] regimen) until all medical and/or

  3. "独草"大事故%A Grave Accident by A Single Grass



    @@ 草遍地皆是,随处可见.一草一木不足为奇,何以谈得上大事故呢? 事情发生在二十世纪五十年代,吉林丰满水力发电厂.这里群山环绕,近百米高巍巍的混凝土大坝将松花江拦腰截断,在两山峡谷之间,座落着美丽的松花湖.某个夏季,在大坝的夹缝微土之间长出了一些杂草.年复一年,发电厂运行十多年了,谁也没有注意到这些无足轻重的杂草.

  4. Persistence of airline accidents.

    Barros, Carlos Pestana; Faria, Joao Ricardo; Gil-Alana, Luis Alberiko


    This paper expands on air travel accident research by examining the relationship between air travel accidents and airline traffic or volume in the period from 1927-2006. The theoretical model is based on a representative airline company that aims to maximise its profits, and it utilises a fractional integration approach in order to determine whether there is a persistent pattern over time with respect to air accidents and air traffic. Furthermore, the paper analyses how airline accidents are related to traffic using a fractional cointegration approach. It finds that airline accidents are persistent and that a (non-stationary) fractional cointegration relationship exists between total airline accidents and airline passengers, airline miles and airline revenues, with shocks that affect the long-run equilibrium disappearing in the very long term. Moreover, this relation is negative, which might be due to the fact that air travel is becoming safer and there is greater competition in the airline industry. Policy implications are derived for countering accident events, based on competition and regulation.

  5. Accidents with sulfuric acid

    Rajković Miloš B.


    Full Text Available Sulfuric acid is an important industrial and strategic raw material, the production of which is developing on all continents, in many factories in the world and with an annual production of over 160 million tons. On the other hand, the production, transport and usage are very dangerous and demand measures of precaution because the consequences could be catastrophic, and not only at the local level where the accident would happen. Accidents that have been publicly recorded during the last eighteen years (from 1988 till the beginning of 2006 are analyzed in this paper. It is very alarming data that, according to all the recorded accidents, over 1.6 million tons of sulfuric acid were exuded. Although water transport is the safest (only 16.38% of the total amount of accidents in that way 98.88% of the total amount of sulfuric acid was exuded into the environment. Human factor was the common factor in all the accidents, whether there was enough control of the production process, of reservoirs or transportation tanks or the transport was done by inadequate (old tanks, or the accidents arose from human factor (inadequate speed, lock of caution etc. The fact is that huge energy, sacrifice and courage were involved in the recovery from accidents where rescue teams and fire brigades showed great courage to prevent real environmental catastrophes and very often they lost their lives during the events. So, the phrase that sulfuric acid is a real "environmental bomb" has become clearer.

  6. Graves' Disease that Developed Shortly after Surgery for Thyroid Cancer

    Hea Min Yu


    Full Text Available Graves' disease is an autoimmune disorder that may present with various clinical manifestations of hyperthyroidism. Patients with Graves' disease have a greater number of thyroid nodules and a higher incidence of thyroid cancer compared with patients with normal thyroid activity. However, cases in which patients are diagnosed with recurrence of Graves' disease shortly after partial thyroidectomy for thyroid cancer are very rare. Here we report a case of hyperthyroid Graves' disease that occurred after partial thyroidectomy for papillary thyroid cancer. In this case, the patient developed hyperthyroidism 9 months after right hemithyroidectomy, and antithyroglobulin autoantibody and thyroid stimulating hormone receptor stimulating autoantibody were positive. Therefore, we diagnosed Graves' disease on the basis of the laboratory test results and thyroid ultrasonography findings. The patient was treated with and maintained on antithyroid drugs. The mechanism of the recurrence of Graves' disease in this patient is still unclear. The mechanism may have been the improper response of the immune system after partial thyroidectomy. To precisely determine the mechanisms in Graves' disease after partial thyroidectomy, further studies based on a greater number of cases are needed.

  7. Les cellulites cervico-faciales graves, facteurs et critères de gravité

    Lakouichmi, Mohammed; Tourabi, Khalid; Abir, Bader-eddine; Zouhair, Said; Lahmiti, Saad; Hattab, Nadia Mansouri


    La cellulite cervico-faciale grave est une infection polymicrobienne extensive et redoutable du tissu cellulo-adipeux de la face et du cou. L'objectif de cette étude est d'analyser certains facteurs favorisants et d’évaluer les critères de gravité en fonction des formes anatomo-cliniques. Il s'agit d'une étude rétrospective réalisée, entre janvier 2007 et décembre 2012, au service de chirurgie maxillo faciale de l'hôpital militaire Avicenne de Marrakech. Sur 147 cas de cellulites cervico-faciales pris en charge au niveau du service, 13 dossiers de cellulites graves ont été retenus. Neuf hommes (69%) et quatre femmes (31%) ont fait l'objet de cette étude, avec un âge moyen de 35 ans. Tous les patients ont été adressés pour prise en charge secondaire après avoir pris des anti-inflammatoires (AI). Sept cas (54%) étaient immunocompétents. La cause dentaire était soulevée chez neufs cas (69%). Cinq cas (38%) ont présenté une forme pseudo phlegmoneuse avec des signes compressifs des voies aéro-digestives. L'extension médiastinale a été observée chez quatre patients (31%). La forme nécrosante extensive a été retrouvée dans trois cas (23%). L’étude bactériologique, réalisée chez tous les patients, avait mis en évidence une flore microbienne mixte et polymorphe. Les cellulites cervico-faciales graves posent un réel problème de prise en charge thérapeutique. L'analyse des facteurs favorisants et l’évaluation des critères de gravité dans cette série ont permis de limiter une évolution défavorable. PMID:26113891

  8. Concomitant Graves' disease and Hashimoto's thyroiditis, presenting as primary hypothyroidism.

    Cronin, C C


    Hypothyroidism in patients with Graves\\' disease is usually the result of ablative treatment. We describe a 58 year old man with Graves\\' ophthalmopathy and pre-tibial myxoedema, who presented with spontaneous primary hypothyroidism. Circulating TSH receptor antibody activity was increased, while thyroid microsomal antibody was detectable in titres greater than one in one hundred thousand. It is likely that the TSH receptor antibody of Graves\\' disease was ineffective in stimulating hyperthyroidism because of concomitant thyroid destruction due to Hashimoto\\'s disease. Alternatively, primary hypothyroidism could have resulted from the effects of a circulating TSH receptor blocking antibody.

  9. Boating Accident Statistics

    Department of Homeland Security — Accident statistics available on the Coast Guard’s website by state, year, and one variable to obtain tables and/or graphs. Data from reports has been loaded for...

  10. Accident resistant transport container

    Andersen, John A.; Cole, James K.


    The invention relates to a container for the safe air transport of plutonium having several intermediate wood layers and a load spreader intermediate an inner container and an outer shell for mitigation of shock during a hypothetical accident.

  11. Accidents with sulfuric acid

    Rajković Miloš B.


    Sulfuric acid is an important industrial and strategic raw material, the production of which is developing on all continents, in many factories in the world and with an annual production of over 160 million tons. On the other hand, the production, transport and usage are very dangerous and demand measures of precaution because the consequences could be catastrophic, and not only at the local level where the accident would happen. Accidents that have been publicly recorded during the last eigh...

  12. Orbital dissection defatting technique for Graves disease.

    Hecht, S D; Guibor, P; Wolfley, D; Wiggs, E O


    Five patients with Graves disease and bilateral proptosis were treated with different incisional approaches. They all underwent orbital decompression by removal of the anterior medial orbital walls, the anterior ethmoidal sinuses, the orbital floors, and multiple incisions of the orbital periosteums . The defatting technique, which consists of applying manual anterior orbital pressure with alternate removing of small lobules of fat, was added when it was intraoperatively decided by Hertel exophthalmometer measurement that more decompression was needed. It is estimated that one-third more reduction in proptosis resulted. An average total decrease in proptosis of 9 mm per orbit occurred. Both visual accuities and visual fields returned to normal. The only important complication was the development of hypertropia in down gaze in one patient. A potential value of this technique is its use with orbital floor decompression alone. It may be possible to avoid removing the medial and lateral walls of the orbit, thereby decreasing complications. Defatting may also be a valuable addition in those rare cases where all decompression techniques available are needed to affect an adequate decompression.

  13. Miastenia grave distal: relato de caso

    Scola Rosana Herminia


    Full Text Available Relatamos o caso de uma mulher de 30 anos com quadro de fraqueza muscular nos membros inferiores com predomínio distal com início há 7 anos. Na evolução apresentou fraqueza muscular nos membros superiores. O exame físico mostrava nervos cranianos sem alterações, hipotrofia bilateral de quadriceps e interósseos dos pés, redução da força muscular mais intensa em tibiais anteriores e interósseos dorsais dos pés e reflexos tendinosos globalmente hipoativos. Foi realizado teste de estimulação repetitiva que mostrou decremento maior que 10% no nervo fibular e ulnar. A dosagem de anticorpos anti-receptor de acetilcolina foi positiva. Tomografia computadorizada de tórax foi normal. Dosagem de hormônios tireoidianos mostrou evidências laboratoriais de hipertireoidismo, porém sem manifestações clínicas. Foi iniciado tratamento com piridostigmina havendo melhora importante do quadro clínico. A fraqueza distal é um sintoma inicial raro na miastenia grave (MG. Contudo, a MG deve entrar no diagnóstico diferencial de doenças que cursam com fraqueza muscular distal de membros superiores ou inferiores.


    Carmen María Samaniego Fernández


    Full Text Available El objetivo de este artículo es presentar la información publicada hasta el momento sobre la supervivencia, las secuelas y la calidad de vida de las enfermedades mencionadas por la declaración de la Comisión de Bioética de la Sociedad Española de Ginecología y Obstetricia (SEGO como extremadamente graves e incurables, subsidiarias de interrupción voluntaria del embarazo más allá de las veintidós semanas de edad gestacional, según lo contemplado por la Ley Orgánica 2/2010 de Salud Sexual y Reproductiva y de la Interrupción Voluntaria del Embarazo. Los profesionales sanitarios deben conocer los aspectos médicos, los avances terapéuticos y el pronóstico de dichas enfermedades, siendo un deber ético transmitir dicha información a los progenitores.

  15. Historic Sites and Grave Markers at Litttle Bighorn Battlefield, Montana

    National Park Service, Department of the Interior — This is a vector point file showing the historic sites and grave markers at Little Bighorn Battlefield National Monument (LIBI). The coordinates for this dataset...


    Singh, S. K.; Hatwal, A.; Agarwal, J.K.; Bajpai, H.S.; Sharma, I


    SUMMARY The case of a 37 year old male is described who initially presented as paranoid schizophrenia unresponsive to anti-psychotic drug treatment and subsequently developed features of Grave's disease. Treatment with carbimazole alone improved his psychiatric symptoms.

  17. Paracentral Corneal Dellen:A Rare Sign of Graves Ophthalmopathy

    Jianhua Yan; Zhongyao Wu


    Purpose: To report a rare sign, paracentral corneal dellen that developed in a middleaged female patient with Graves ophthalmopathy.Methods:A paracentral corneal dellen developed in the left eye in a 42-year-old woman who was diagnosed as Graves ophthalmopathy. The patient had remarkable upper eyelid retraction, upper eyelid lag and upward motility restriction. The Graves ophthalmopathy was classified as Grade V according to NOSPECS classification.Results:Local artificial tear film and 0.3% Tobramycin eye drops were administered to both eyes.Twenty-four hours later, the left corneal dellen disappeared.Conclusions:Graves ophthalmopathy can lead to paracentral corneal dellen because of severe upper eyelid retraction and upward motility restriction of the eye in spite of the lack of lagophthalmos. Artificial tear drop and antibiotic eye drop therapy helped even though the patient did not have corneal exposure.

  18. Successful treatment of Graves disease in pregnancy with Lugol's iodine.

    Jamieson, A; Semple, C G


    We report a case of Grave's disease in pregnancy complicated by intolerance of standard antithyroid drug therapy. We describe the success of prolonged use of organic iodine as a primary treatment prior to surgical intervention.

  19. Orbital metastases from neuroendocrine carcinoma, masquerading as graves orbitopathy.

    Sira, Mano; Clauss, Ralf P; Maclean, Chris; Rose, Geoffrey E


    We describe a patient with metastases from neuroendocrine carcinoma masquerading as Graves ophthalmopathy. This rare tumour possibly has a propensity for orbital spread, and we postulate a mechanism evoking the 'seed and soil' hypothesis.

  20. Preclinical models of Graves' disease and associated secondary complications.

    Moshkelgosha, Sajad; So, Po-Wah; Diaz-Cano, Salvador; Banga, J Paul


    Autoimmune thyroid disease is the most common organ-specific autoimmune disorder which consists of two opposing clinical syndromes, Hashimoto's thyroiditis and Graves' (hyperthyroidism) disease. Graves' disease is characterized by goiter, hyperthyroidism, and the orbital complication known as Graves' orbitopathy (GO), or thyroid eye disease. The hyperthyroidism in Graves' disease is caused by stimulation of function of thyrotropin hormone receptor (TSHR), resulting from the production of agonist antibodies to the receptor. A variety of induced mouse models of Graves' disease have been developed over the past two decades, with some reproducible models leading to high disease incidence of autoimmune hyperthyroidism. However, none of the models show any signs of the orbital manifestation of GO. We have recently developed an experimental mouse model of GO induced by immunization of the plasmid encoded ligand binding domain of human TSHR cDNA by close field electroporation that recapitulates the orbital pathology in GO. As in human GO patients, immune mice with hyperthyroid or hypothyroid disease induced by anti-TSHR antibodies exhibited orbital pathology and chemosis, characterized by inflammation of orbital muscles and extensive adipogenesis leading to expansion of the orbital retrobulbar space. Magnetic resonance imaging of the head region in immune mice showed a significant expansion of the orbital space, concurrent with proptosis. This review discusses the different strategies for developing mouse models in Graves' disease, with a particular focus on GO. Furthermore, it outlines how this new model will facilitate molecular investigations into pathophysiology of the orbital disease and evaluation of new therapeutic interventions.

  1. Human lymphocyte antigens (HLA) and Graves' disease in Turkey.

    Orhan, Y; Azezli, A; Carin, M; Aral, F; Sencer, E; Molvalilar, S


    To evaluate the association of HLA types with Turkish patients with Graves' disease, HLA typing, clinical findings, and thyroid antibodies were correlated. The HLA types, clinical findings (ophthalmopathy and age at onset), and thyroid stimulating hormone (TSH) receptor (TRAb) and antithyroid microsomal antibodies (MAb) were analyzed. Seventy Turkish patients with Graves' disease and 306 control subjects were assessed. Serological HLA typing was performed in HLA A, B, C, DR, and DQ loci. There was a significantly increased prevalence of HLA B8, B49, DR3, DR4, and DR10 in Graves' disease. The association of Graves' disease with HLA DR3 was found to be less strong than previously described. The HLA DR4 antigen may contribute to the predisposition of Graves' disease in Turkey. The results suggest that HLA B7, B13, DR7, DQw2, and DQw3 may confer a protective effect for Graves' disease in Turkey. Patients carrying HLA B12, B18, and B44 haplotypes had a tendency to develop the disease at a later age. The difference from the other studies may be the result of the selection of the controls; in part, of the variability in serological typing reagents; and, also, of the rather weak HLA associations with the disease.

  2. Accidents in nuclear ships

    Oelgaard, P.L. [Risoe National Lab., Roskilde (Denmark)]|[Technical Univ. of Denmark, Lyngby (Denmark)


    This report starts with a discussion of the types of nuclear vessels accidents, in particular accidents which involve the nuclear propulsion systems. Next available information on 61 reported nuclear ship events in considered. Of these 6 deals with U.S. ships, 54 with USSR ships and 1 with a French ship. The ships are in almost all cases nuclear submarines. Only events that involve the sinking of vessels, the nuclear propulsion plants, radiation exposures, fires/explosions, sea-water leaks into the submarines and sinking of vessels are considered. For each event a summary of available information is presented, and comments are added. In some cases the available information is not credible, and these events are neglected. This reduces the number of events to 5 U.S. events, 35 USSR/Russian events and 1 French event. A comparison is made between the reported Soviet accidents and information available on dumped and damaged Soviet naval reactors. It seems possible to obtain good correlation between the two types of events. An analysis is made of the accident and estimates are made of the accident probabilities which are found to be of the order of 10{sup -3} per ship reactor years. It if finally pointed out that the consequences of nuclear ship accidents are fairly local and does in no way not approach the magnitude of the Chernobyl accident. It is emphasized that some of the information on which this report is based, may not be correct. Consequently some of the results of the assessments made may not be correct. (au).

  3. Color-flow Doppler sonography in Graves disease: "thyroid inferno".

    Ralls, P W; Mayekawa, D S; Lee, K P; Colletti, P M; Radin, D R; Boswell, W D; Halls, J M


    Graves disease is a common diffuse abnormality of the thyroid gland usually characterized by thyrotoxicosis. We performed color-flow Doppler sonography in 16 patients with Graves disease and compared the results with those in 15 normal volunteers and 14 patients with other thyroid diseases (eight with multinodular goiter, four with focal masses, and two with papillary thyroid carcinoma). All 16 Graves disease patients exhibited a pulsatile pattern we call "thyroid inferno." This pattern consists of multiple small areas of intrathyroidal flow seen diffusely throughout the gland in both systole and diastole. In systole, both high-velocity flow (color coded white) and lower velocity flow (color coded red and blue) were noted. In diastole, fewer areas of flow and lower velocity flow were noted. Patients with Graves disease also exhibited color flow around the periphery of the gland. The inferno pattern did not occur in normal subjects or in patients with other thyroid diseases. On occasion, focal areas of intrathyroidal flow were detected in patients with multinodular goiter and focal thyroid masses. High-resolution gray-scale images did not show the small vascular channels from which the flow signal originated. Color-flow Doppler sonography shows promise as a cost-effective, noninvasive technique for diagnosing Graves disease.

  4. Esclerodermia, tireoidite e miastenia grave: estudo de um caso

    Antonio L. dos Santos Werneck


    Full Text Available Uma paciente de 36 anos com miastenia grave desenvolveu após dois anos intolerância ao frio, o que conduziu ao diagnóstico de tireoidite de Hashimoto. Quatro anos mais tarde apresentou pele espessada nas mãos (esclerodermia limitada. O quadro clínico e os exames complementares encaminharam o diagnóstico para a forma CREST de esclerodermia sistêmica progressiva. Discute-se a dificuldade diagnóstica da esclerodermia, assim como suas síndromes de superposição. Doença de Hashimoto e miastenia grave constituem associação pouco frequente. A presença de esclerodermia e miastenia grave é rara. Não encontramos na literatura a coincidência destas três doenças.

  5. Clinical experience of radiation therapy for Graves` ophthalmopathy

    Takahashi, Takeo; Mitsuhashi, Norio; Nagashima, Hisako; Sakurai, Hideyuki; Murata, Osamu; Ishizeki, Kei; Shimaya, Sanae; Hayakawa, Kazushige; Niibe, Hideo [Gunma Univ., Maebashi (Japan). School of Medicine


    The effect of radiation therapy for Graves` ophthalmopathy was evaluated. Ten patients with Graves` ophthalmopathy were treated with radiation therapy between 1992 and 1993 in Gunma University Hospital. All patients had a past history of hyperthyroidism and received 2,000 cGy to the retrobulbar tissues in 20 fractions. Nine of ten patients were treated with radiation therapy after the failure of corticosteroids. Six patients (60%) showed good or excellent responses. The exophthalmos type was more responsive to radiation therapy than the double vision type in this series. Two of five patients with the exophthalmos type demonstrated excellent responses, and their symptoms disappeared almost completely. The improvement of symptoms appeared within 3-6 months, and obvious clinical effects were demonstrated after 6 months of radiotherapy. Radiation therapy was well tolerated, and we have not observed any side effects of radiation therapy. In conclusion, radiation therapy is effective treatment for Graves` ophthalmopathy. (author)

  6. An update on the medical treatment of Graves' hyperthyroidism.

    Marinò, Michele; Latrofa, Francesco; Menconi, Francesca; Chiovato, Luca; Vitti, Paolo


    Medical treatment of Graves' hyperthyroidism is based on the use of thionamides; namely, methimazole and propylthiouracil. In the past, methimazole was preferred by European endocrinologists, whereas propylthiouracil was the first choice for the majority of their North American colleagues. However, because of the recent definition of a better side-effect profile, methimazole is nowadays the first choice world while. Although thionamides are quite effective for the short-term control of Graves' hyperthyroidism, a relatively high proportion of patients relapses after thionamide withdrawal. Other possible medical treatments, include iodine and compounds containing iodine, perchlorate, lithium (as an adjuvant in patients undergoing radioiodine therapy), β-adrenergic antagonists, glucocorticoids, and some new molecules still under investigation. Management of Graves' hyperthyroidism using thionamides as well as the other available medical treatments is here reviewed in detail, with a special mention of situations such as pregnancy and lactation, as well as neonatal and fetal thyrotoxicosis.

  7. Messiniense: compleja y grave crisis ecologica

    Aguirre, E.


    yacimientos de mamíferos fósiles en España y otras regiones con importantes novedades, entre ellas diversos intercambios intercontinentales, en el mismo intervalo cronológico añaden cuestiones de interés además de obligar a la correlación entre la estratigrafía basada en series marinas y la biostratigrafía continental. A las singularidades de estas series se añade el descubrimiento reciente de homínidos fósiles con indicios de bipedia en edades comprendidas en este intervalo. En el mismo se han datado graves eventos paleogeográficos, geodinámicos, paleoambientales y paleoclimáticos, que empezaron a investigarse hace 40 años como la «Crisis de Salinidad del Mediterráneo*, y sobre cuyo desarrollo e interacciones se han publicado diversos modelos más o menos incompletos: aislamiento del mediterráneo, descenso global del nivel del mar, acreción continental y orogenia, glaciación, deterioro de la cubierta vegetal. Una interpretación de la secuencia de eventos en estos diversos campos de estudio de Historia de la Tierra y de la Vida, y sus interacciones, puede trazarse con una calibración del orden de los cien mil años.

  8. Comparative evaluation of oculometric variables in graves' ophthalmopathy

    Hélio Amante Miot


    Full Text Available OBJECTIVES: To estimate oculometric parameters of Graves' ophthalmopathy in comparison to healthy eyes using digital photography and digital image analysis. INTRODUCTION: Graves' ophthalmopathy is the main cause of eye proptosis. Because these protrusions cause clinically perceived distortions in orbital architecture, digital photographs can be used to detect and quantify these changes. METHODS: We carried out a cross-sectional study comprising 12 healthy volunteers and 15 Graves' ophthalmopathy patients with the purpose of evaluating the use of simple, non-invasive digital photography to estimate oculometric parameters of Graves' ophthalmopathy and compare them with the parameters of unaffected eyes. Facial photographs of cases and controls were taken in a standardized manner. Oculometric parameters were compared between the groups and then correlated to proptometer measures. RESULTS: All estimated oculometric variables showed significant differences between the groups, in particular with regard to mediopupilar aperture, lateral height, distance from the iris edge to the lateral boundary of the palpebral fissure, and distance from the higher point of the iris to the lateral limit of the palpebral fissure. The product of medial aperture and horizontal palpebral fissure also revealed greater discrepancy between the groups. Proptometer measures showed significant linear correlation between the distance from the iris edge to the lateral boundary of the palpebral fissure and between the distance from the higher point of the iris to the lateral limit of palpebral fissure (p<0.05. CONCLUSIONS: Comparative analysis of oculometric parameters in Graves' ophthalmopathy suggests that eye proptosis is related to an asymmetric increase in lateral oculometric measures. Standardized digital photographs can be used in clinical practice to objectively estimate oculometric parameters of Graves' ophthalmopathy patients.

  9. Analisis Kebijakan dan Efektivitas Organisasi

    Amir Syarifudin Kiwang


    Full Text Available Penerapan Peraturan Gubernur Nusa Tenggara Timur Nomor 8 Tahun 2011 tentang Organisasi dan Tata Kerja Unit Pelaksana Teknis Pendidikan dan Pelatihan Koperasi dan Usaha Mikro Kecil dan Menengah pada Dinas Koperasi dan Usaha Mikro Kecil dan Menengah Provinsi Nusa Tenggara Timur adalah dalam rangka untuk meningkatkan efektivitas kerja organisasi pada UPT Diklat Koperasi dan UMKM. Penelitian ini berusaha untuk melihat dampak kebijakan organisasi terhadap efektivitas organisasi dengan menggunakan enam elemen variabel dari kebijakan dan praktik manajemen. Keenam elemen tersebut adalah penetapan tujuan strategis, pencarian dan pemanfaatan sumber daya, lingkungan prestasi, proses komunikasi, kepemimpinan dan pengambilan keputusan, serta adaptasi dan inovasi organisasi. Penelitian kualitatif ini menggunakan pendekatan studi kasus. Teknik analisis data yang digunakan adalah analisis data model Miles dan Huberman, yang terdiri atas reduksi data, display/penyajian data, dan kesimpulan/verifikasi. Hasil penelitian menunjukkan bahwa efektivitas organisasi pada UPT Diklat koperasi dan UMKM belum berjalan secara baik, hal ini dapat dilihat dari beberapa hal antara lain, belum adanya tenaga spesialisasi pengelola diklat dan tenaga khusus (sarjana di bidang perkoperasian dan kondisi lingkungan kerja (lingkungan prestasi pada UPT Diklat koperasi dan UMKM yang belum efektif. Penempatan pegawai juga belum tepat, mutasi ke UPT Diklat Koperasi dan UMKM tidak memperhatikan latar belakang pendidikan dan spesialisasi/keahlian pegawai sehingga membutuhkan waktu dalam proses penyesuaian serta menurunkan jumlah pelaksanaan diklat dikarenakan keterbatasan alokasi dana.

  10. Hipertrigliceridemia familiar grave durante a gestação

    Casulari Luiz Augusto; Wesgueber Myrian; Silva Ricardo Cassiano B.; Soares Henrique F.; Domingues Lucilia


    A presença de hipertrigliceridemia grave durante a gravidez é rara, mas comporta grande possibilidade de desenvolver complicações, como a pancreatite aguda, que coloca em risco a mãe e o feto. Apresentamos o relato da evolução da gestação de uma paciente portadora de hipertrigliceridemia grave que havia apresentado pancreatite aguda dois meses antes da fecundação. Foi tratada durante o pré-natal com dieta e 3,0 g de ácidos graxos de cadeia ômega-3 (ácidos eicosapentaenóico 14% e docosahexaenó...

  11. Thymic Hyperplasia Presenting as a Neck Mass in Graves Disease

    Serkan Yener


    Full Text Available We describe a female patient who presented with Graves disease and a neck mass. Radiological characteristics of the mass suggested thymic hyperplasia. She was treated with methimazole, and because the mass did not regress after six months of therapy, the patient had total thyroidectomy and thymectomy. Pathological examination was consistent with chronic lymphocytic thyroiditis and thymic hyperplasia. Microscopic changes in the thymus can be detected in one third of patients with Graves disease, but massive enlargement is rare. It has been reported that regression occurs in most patients after a euthyroid state has been achieved; however, in some patients, thymectomy may be indicated. Turk Jem 2009; 13: 11-2

  12. Peripartum cardiomyopathy in a patient with Graves' disease.

    Kajiya, Takashi; Lee, Souki; Yamashita, Makoto; Sasaki, Yuichi; Kamizono, Yusuke; Imamura, Masakazu; Toyonaga, Koichi; Toda, Hitoshi; Koriyama, Nobuyuki; Tei, Chuwa


    Peripartum cardiomyopathy (PPCM) is a rare life-threatening cardiomyopathy of unknown etiology that occurs during the peripartum period in previously healthy women. Autoimmune and viral factors have been suggested to be involved in PPCM. Here we describe a patient with Graves' disease, which is one of the organ-specific autoimmune diseases, who developed acute heart failure due to PPCM at 2 weeks after her first delivery. The patient recovered completely with conservative treatment for heart failure. An association between PPCM and Graves' disease has not been reported before. PPCM may be an organ-specific autoimmune disease, so the coexistence of other autoimmune diseases should be considered in PPCM patients.

  13. Treating the thyroid in the presence of Graves' ophthalmopathy

    Hegedüs, Laszlo; Bonnema, Steen J; Smith, Terry J


    The etiology of Graves' orbitopathy (GO) remains enigmatic. Optimal therapeutic choices for the hyperthyroidism associated with Graves' disease (GD) in the presence of GO remain controversial. Whether antithyroid drugs (ATDs), radioiodine (RAI), or thyroidectomy should be favored in such patients...... - independent of extent - do not influence the natural course of GO. RAI can cause de novo development or progression of GO, which is largely preventable with oral steroid prophylaxis. In patients with mild GO, the thyroid treatment is largely independent of GO. Moderate to severe GO should be treated promptly...

  14. Chernobyl accident and its consequences

    Gittus, J.H.


    The paper concerns the Chernobyl reactor accident, with emphasis on the design of the RBMK reactor and nuclear safety. A description is given of the Chernobyl nuclear power plant, including details of the RMBK reactor and safety systems. Comments on the design of the RBMK by UK experts prior to the accident are summarized, along with post-accident design changes to improve RBMK safety. Events of the Chernobyl accident are described, as well as design deficiencies highlighted by the accident. Differences between the USSR and UK approaches to nuclear safety are commented on. Finally source terms, release periods and environmental consequences are briefly discussed.

  15. Localization of a sound source in in a guided medium and reverberating field. Contribution to a study on leak localization in the internal wall of containment of a nuclear reactor in the case of a severe reactor accident; Localisation d`une source acoustique en milieu guide et champ reverberant. Contribution a l`etude sur la localisation de fuite de l`enceinte de confinement d`une centrale nucleaire en situation accidentelle grave

    Thomann, F


    Basic data necessary for the localization of a leak in the internal wall of the containment are presented by studying the sound generated by gas jets coming out of (leaking fissures) as well as propagation in a guided medium. The results acquired have led us to choose the simple intercorrelation method and the matched filed processing method, both of which are likely to adequately handle our problems. Whereas the intercorrelation method appears to be limited in scope when dealing in the guided medium, the matched field processing is suited to leak localization over a surface of approximately 1000 m{sup 2} (for a total surface of 10 000 m{sup 2}). Preliminary studies on the leak signal and on replicated signals have led us to limit the frequency band to 2600 - 3000 Hz. We have succeeded in locating a leak situated in an ordinary position with a minimum amount of replicated signals and basic data. We have improved on the estimation of Bartlett and MVDE (minimum variance distortion less filter) rendering them even more effective. Afterwards, we considered the severe accident situation and showed that the system can be installed in situ. (author) 88 refs.

  16. Keratoacanthoma Dan Perawatannya

    Indah Heriyanti


    Keratoacanthoma adalah suatu tumor jinak yang berasal dari jaringan epitel dan biasanya di jumpai pada permukaan kulit yang umumnya terjadi pada bagian kulit yang sering terkena sinar matahari dimana tumor ini dapat sembuh dengan spontan. Lesi ini biasanya berawal sebagai makula yang kecil yang berwarna merah dan kemudian menjadi papula yang kokoh dan bersisik pada permukaanya. Papul ini dengan cepat membesar selama 2 sampai 8 minggu. Pada awalnya berbentuk bulat atau oval,kokoh menonjol ...

  17. Auto-estima na forma inativa da oftalmopatia de Graves Inactive Graves' ophthalmopathy and self-esteem

    Carlos Henrique de Toledo Magalhães


    Full Text Available OBJETIVOS: Avaliar a auto-estima dos pacientes com oftalmopatia de Graves na fase inativa. MÉTODOS: Foram avaliados 30 pacientes portadores de oftalmopatia de Graves, eutireoideanos, na fase inativa, com idade variando entre 26 e 65 anos, média 43 ± 11,0 anos, denominado grupo estudo e 39 indivíduos que não apresentavam oftalmopatia de Graves, com idade variando entre 18 e 67 anos, média de 41 ± 13,4 anos, selecionados na população geral denominado grupo controle. Para avaliar a auto-estima foi utilizada a escala de auto-estima Rosenberg Unifesp-EPM aplicada por meio de entrevista. Os valores dos escores de auto-estima nos dois grupos estudados foram comparados pelo teste não paramétrico de Mann-Whitney. O mesmo teste foi aplicado com objetivo de comparar os resultados obtidos no grupo oftalmopatia de Graves considerando a gravidade da doença. RESULTADOS: Não foi observada alteração com significância estatística na auto-estima dos pacientes com oftalmopatia de Graves (p=0,057. O grupo estudo apresentou, em média, valores inferiores de auto-estima, comparado ao grupo controle. Não houve diferença da auto-estima entre os pacientes dos subgrupos leve e moderado-grave (P=0,2710. CONCLUSÃO: A oftalmopatia de Graves na fase inativa não afetou a auto-estima dos pacientes, no grupo estudado.PURPOSE: To assess the self-esteem of Graves' ophthalmopathy patients in the inactive phase. METHODS: Thirty euthyroid patients were evaluated in the inactive phase of disease with age ranging from 26 to 65 years, average of 43 ± 11,0 years, called study group and 39 individuals without Graves' ophthalmopathy with age ranging from 18 to 67 years, average of 41 ± 13,4 years, selected from the general population called control group. To evaluate the self-esteem the Rosenberg UNIFESP/EPM self-esteem scale, applied by means of an interview, was utilized. The self-esteem scores in the two studied groups were compared by means of the non

  18. Occupational accidents aboard merchant ships

    Hansen, H.L.; Nielsen, D.; Frydenberg, Morten


    Objectives: To investigate the frequency, circumstances, and causes of occupational accidents aboard merchant ships in international trade, and to identify risk factors for the occurrence of occupational accidents as well as dangerous working situations where possible preventive measures may...... be initiated. Methods: The study is a historical follow up on occupational accidents among crew aboard Danish merchant ships in the period 1993–7. Data were extracted from the Danish Maritime Authority and insurance data. Exact data on time at risk were available. Results: A total of 1993 accidents were...... rate of accidents than Danish citizens. Age was a major risk factor for accidents causing permanent disability. Change of ship and the first period aboard a particular ship were identified as risk factors. Walking from one place to another aboard the ship caused serious accidents. The most serious...

  19. Intérêt du registre du Rhône pour le suivi des victimes. Vers une meilleure définition du blessé grave, des incidences aux prévalences

    Chiron, M


    Comme tous les registres, le registre du Rhône des victimes d'accidents de la circulation permet de mesurer des incidences. Par exemple : sept personnes sur mille sont blessées chaque année dans un accident de la circulation (dont plus d'une sur cent meurt). Une connaissance précise de l'incidence de telle ou telle lésion traumatique par accident de la circulation est possible, ainsi que celle de la mortalité immédiate. Ainsi une personne sur mille est victime chaque année du 'coup du lapin' ...


    Wayan Eko Radityo


    Full Text Available Depresi merupakan gangguan mood berupa kesedihan yang intens, berlangsung dalamwaktu lama, dan mengganggu kehidupan normal yang insidennya semakin meningkatseiring dengan meningkatnya tekanan hidup. Tahun 2020, depresi diperkirakanmenempati urutan kedua penyakit di dunia. Gejala-gejala depresi terdiri dari gangguanemosi, gangguan kognitif, keluhan somatik, gangguan psikomotor, dan gangguanvegetatif. Salah satu gejala depresi yang muncul adalah gangguan tidur yang bisaberupa insomnia, bangun secara tiba-tiba, dan hipersomnia. Hal ini disebabkan olehgangguan neurotransmiter dan regulasi hormon. Selain sebagai gejala depresi, gangguantidur juga bisa merupakan penyebab depresi. Beberapa penelitian memberikanhubungan gangguan tidur dapat meningkatkan risiko depresi di kemudian hari.

  1. [Drowning accidents in childhood].

    Krandick, G; Mantel, K


    This is a report on five boys aged between 1 and 5 years who, after prolonged submersion in cold water, were treated at our department. On being taken out of the water, all the patients were clinically dead. After 1- to 3-hour successful cardiopulmonary resuscitation, with a rectal temperature of about 27 degrees C, they were rewarmed at a rate of 1 degree/hour. Two patients died within a few hours after the accident. One patient survived with an apallic syndrome, 2 children survived with no sequelae. In the event of a water-related accident associated with hypothermia, we consider suitable resuscitation to have preference over rewarming measures. The most important treatment guidelines and prognostic factors are discussed.

  2. Dementia and Traffic Accidents

    Petersen, Jindong Ding; Siersma, Volkert; Nielsen, Connie Thurøe;


    BACKGROUND: As a consequence of a rapid growth of an ageing population, more people with dementia are expected on the roads. Little is known about whether these people are at increased risk of road traffic-related accidents. OBJECTIVE: Our study aims to investigate the risk of road traffic......-related accidents for people aged 65 years or older with a diagnosis of dementia in Denmark. METHODS: We will conduct a nationwide population-based cohort study consisting of Danish people aged 65 or older living in Denmark as of January 1, 2008. The cohort is followed for 7 years (2008-2014). Individual's personal...... data are available in Danish registers and can be linked using a unique personal identification number. A person is identified with dementia if the person meets at least one of the following criteria: (1) a diagnosis of the disease in the Danish National Patient Register or in the Danish Psychiatric...

  3. RENEB accident simulation exercise

    Brzozowska, Beata; Ainsbury, Elizabeth; Baert, Annelot; Beaton-Green, Lindsay; Barrios, Leonardo; Barquinero, Joan Francesc; Bassinet, Celine; Beinke, Christina; Benedek, Anett; Beukes, Philip; Bortolin, Emanuela; Buraczewska, Iwona; Burbidge, Christopher; De Amicis, Andrea; De Angelis, Cinzia


    Purpose: The RENEB accident exercise was carried out in order to train the RENEB participants in coordinating and managing potentially large data sets that would be generated in case of a major radiological event. Materials and methods: Each participant was offered the possibility to activate the network by sending an alerting email about a simulated radiation emergency. The same participant had to collect, compile and report capacity, triage categorization and exposure scenario results ob...

  4. 78 FR 22292 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of.... SUMMARY: The National Park Service is soliciting nominations for one member of the Native American Graves... nominations submitted by Indian tribes, Native Hawaiian organizations, and traditional Native...

  5. 77 FR 65406 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of.... SUMMARY: The National Park Service is soliciting nominations for one member of the Native American Graves... nominations submitted by Indian tribes, Native Hawaiian organizations, and traditional Native...

  6. Treatment of Graves' hyperthyroidism: evidence-based and emerging modalities

    Hegedüs, Laszlo


    Currently there are three well-established treatment options for hyperthyroid Graves' disease (GD): antithyroid drug therapy with thionamides (ATD), radioactive iodine treatment with (131)I, and thyroid surgery. This article reviews the current evidence so the reader can evaluate advantages...

  7. Selenium and the Course of Mild Graves' Orbitopathy

    C. Marcocci; G.J. Kahaly; G.E. Krassas; L. Bartalena; M. Prummel; M. Stahl; M.A. Altea; M. Nardi; S. Pitz; K. Boboridis; P. Sivelli; G. von Arx; M.P. Mourits; L. Baldeschi; W. Bencivelli; W. Wiersinga


    Background Oxygen free radicals and cytokines play a pathogenic role in Graves' orbitopathy. Methods We carried out a randomized, double-blind, placebo-controlled trial to determine the effect of selenium (an antioxidant agent) or pentoxifylline (an antiinflammatory agent) in 159 patients with mild

  8. Radiotherapy for Graves' orbitopathy : randomised placebo-controlled study

    Mourits, MP; van Kempen-Harteveld, ML; Garcia, MBG; Koppeschaar, HPF; Tick, L; Terwee, CB


    Background The best treatment (steroids, irradiation, or both) for moderately severe Graves' orbitopathy, a self-limiting disease is not known. We tested the efficacy of external beam irradiation compared with sham-irradiation. Methods In a double-blind randomised clinical trial, 30 patients with mo

  9. Measuring disease activity to predict therapeutic outcome in Graves' ophthalmopathy

    Terwee, C.B.; Prummel, M.F.; Gerding, M.N.; Kahaly, G.J.; Dekker, F.W.; Wiersinga, W.M.


    OBJECTIVE: The concept of disease activity in Graves' ophthalmopathy (GO) might explain why as many as one-third of patients do not respond to immunosuppressive treatment, because only patients in the active stage of disease are expected to respond. The hypothesis was adopted that a parameter used t

  10. A patient with Graves' disease, thrombocytopenia and chronic hepatitis B.

    Szeto, C C; Chow, C C; Ko, G. T.; K. Y. LI; Yeung, V. T.; Cockram, C S


    A 22-year-old Chinese man, a HBsAg carrier, presented with relapse of thyrotoxic Graves' disease complicated by thrombocytopenia and hepatitis. Platelet count and liver enzymes gradually improved following successful treatment of the thyrotoxicosis with radioactive iodine. Possible pathogenetic links and therapeutic implications are discussed.

  11. Graves' disease: thyroid function and immunologic activity

    Gossage, A.A.R.; Crawley, J.C.W.; Copping, S.; Hinge, D.; Himsworth, R.L.


    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of (/sup 9/ during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity - TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p<0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination.

  12. Graves' disease: thyroid function and immunologic activity

    Gossage, A.A.; Crawley, J.C.; Copping, S.; Hinge, D.; Himsworth, R.L.


    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of (/sup 99m/Tc)pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity--TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p less than 0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination.

  13. 78 FR 21410 - Native American Graves Protection and Repatriation Review Committee: Meetings


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meetings AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves... Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves...

  14. 77 FR 23196 - Native American Graves Protection and Repatriation Act Regulations


    ... Office of the Secretary 43 CFR Part 10 RIN 1024-AD99 Native American Graves Protection and Repatriation... Secretary of the Interior (Secretary) is responsible for implementation of the Native American Graves... implementing the Native American ] Graves Protection and Repatriation Act for purposes of factual accuracy...

  15. 77 FR 65407 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of.... SUMMARY: The National Park Service is soliciting nominations for one member of the Native American Graves... Review Committee was established by the Native American Graves Protection and Repatriation Act of...

  16. [Chernobyl nuclear power plant accident and Tokaimura criticality accident].

    Takada, Jun


    It is clear from inspection of historical incidents that the scale of disasters in a nuclear power plant accident is quite low level overwhelmingly compared with a nuclear explosion in nuclear war. Two cities of Hiroshima and Nagasaki were destroyed by nuclear blast with about 20 kt TNT equivalent and then approximately 100,000 people have died respectively. On the other hand, the number of acute death is 30 in the Chernobyl nuclear reactor accident. In this chapter, we review health hazards and doses in two historical nuclear incidents of Chernobyl and Tokaimura criticality accident and then understand the feature of the radiation accident in peaceful utilization of nuclear power.

  17. The work of the South Manchester Accident Rescue Team (SMART).

    Redmond, A D


    Skills acquired in the hospital do not necessarily translate to the scene of an accident. However, training in certain hospital specialties, particularly accident and emergency medicine, will expose doctors to dealing with very ill patients in a less rigidly structured environment. The operating theatre is a disciplined and controlled environment. Skill in anaesthesia, monitoring and operating, if tested only in these circumstances may be found to be gravely inadequate when exposed to the fluctuant and hostile environment at the site. Doctors who wish to do this sort of work or are designated to do it, must undergo regular and frequent training, especially if they are not trained in accident and emergency departments. This has long been recognised by the British Association for Immediate Care. In combination with the Royal College of Surgeons of Edinburgh they have now established a diploma in Immediate Medical Care. In urban areas the need for a doctor to attend at the scene of an accident is usually limited to entrapment. These occasions are likely to be infrequent and this can result in a lack of preparedness for such events. Interhospital transfer, primarily from peripheral hospitals to the specialist services of a teaching hospital, often involves critically ill and injured patients. The management of these cases by the mobile team provides regular, frequent exposure to working in a 'hostile' environment. Relationships with the rescue services are developed and staff become familiar with equipment and call-out procedures. The care of transported patients is improved. None of our patients have died in transit or within 6 h of arrival at base.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Future Prospects for the Treatment of Graves' Hyperthyroidism and Eye Disease.

    Neumann, S; Place, R F; Krieger, C C; Gershengorn, M C


    Although there are adequate therapies for Graves' hyperthyroidism, mild to moderate Graves' orbitopathy (GO) is usually treated symptomatically whereas definitive therapy is reserved for severe, vision-threatening GO. Importantly, none of the treatment regimens for Graves' disease used today are directed at the pathogenesis of the disease. Herein, we review some aspects of what is known about the pathogenesis of these 2 major components of Graves' disease, specifically the apparent important roles of the TSH and IGF-1 receptors, and thereafter describe future therapeutic approaches directed at these receptors. We propose that targeting these receptors will yield effective and better tolerated treatments for Graves' disease, especially for GO.

  19. 伊朗 Graves 眼病的临床特点%Clinical features of Graves' ophthalmopathy in Iran

    Ali Sadeghi Tari; Mohammad Taher Rajabi; Khalil Hamzedust; Seyed Ziaeddin Tabatabaie; Abolfazl Kasai


    AIM:To determine the clinical characteristics of a prospective study of patients with Graves' ophthalmopathy.METHODS:We reviewed clinical manifestations,and medical records of 103 patients in whom Graves' ophthalmopathy WaS diagnosed between 2003 and 2005.RESULTS:Among 103 patients with Graves' ophthalmopathy,48(46.6%)male and 55(53.3%)female(F:M=1.1),with mean age of 45 (range;18-73) years,95 (92.2%)patients had Graves' hyperthyroidism,3(2.9%) had primary hypothyroidism,and 5 (4.8%) were euthyroid.The mean duration of ocular symptoms was 13.2 (range 2-95) months) while the mean duration of dysthyroid symptoms was 39.4(range 6-180) months.Unilaterality was occurred in 12 patients.Eyelid retraction was present in 90 patients (87%),whereas the approximate frequency of exophthalmos was 77.6%(80 patients);restrictive extraocular myopathy.29% (30 patients);evidence of extraocular enlargement on CT-scan in 52 patients of 70 patients (74%) that was evaluated,and optic nerve dysfunction,5.8%(6 patients).22(21%)patients hadglaucoma associated with Graves' ophthalmopathy that 7 (6.7%)of them were normal-tension glaucoma.CONCLUSION:Eyelid retraction Was the most common clinical sign of Graves' ophthalmopathy in our patients.Larger prospective studies are suggested to evaluate both the prevalenoe and possible racial difference in its dinical presentation in Iranian population.%目的:研究分析伊朗 Graves 眼病患者的临床特点.方法:回顾分析 2003/2005 年确诊为 Graves 眼病的103例患者临床资料.结果:在103例 Graves 眼病患者中,48例(46.6%)为男性,55例(53.3%)为女性(男女比例为1.1).年龄18-73(平均45)岁,95例(92.2%)表现为甲状腺机能亢进,3例(2.9%)表现为原发性甲状腺机能减退,5例(4.8%)甲状腺机能正常.出现眼部症状的时间为2~95 (平均3.2)mo,而表现出甲状腺功能障碍的时间为6~180(平均39.4)mo.12例患者单眼发病,90例(87%)患者有眼睑退缩,80例(77.6%)患者

  20. Habitat Evaluation Procedures Report; Graves Property - Yakama Nation.

    Ashley, Paul; Muse, Anthony


    A habitat evaluation procedures (HEP) analysis was conducted on the Graves property (140 acres) in June 2007 to determine the number of habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the property as partial mitigation for habitat losses associated with construction of McNary Dam. HEP surveys also documented the general ecological condition of the property. The Graves property was significantly damaged from past/present livestock grazing practices. Baseline HEP surveys generated 284.28 habitat units (HUs) or 2.03 HUs per acre. Of these, 275.50 HUs were associated with the shrubsteppe/grassland cover type while 8.78 HUs were tied to the riparian shrub cover type.

  1. Doenças da tireoide e miastenia grave

    J. Lamartine de Assis


    Full Text Available Os autores estudam o comportamento da tireóide em um grupo de 304 pacientes com miastenia grave, constatando 15 casos de tireopatias, sendo 9 de hipertireoidismo, um de hipotireoidismo e 5 de bócio sem alterações da função tireoidiana. Nenhum paciente era proveniente de região de bócio endêmico e não havia bócio familiar. A tireotoxicose, que foi a disfunção mais frequente, foi estudada quanto a sua prevalência em pacientes miastênicos, quanto a sua influência sobre os sintomas da miastenia grave e quanto à época do seu aparecimento.

  2. Graves' hyperthyroidism and moderate alcohol consumption: evidence for disease prevention

    Carle, A.; Bülow Pedersen, I.; Knudsen, N.


    BACKGROUND: We recently demonstrated that moderate alcohol consumption is associated with a considerable reduction in the risk of autoimmune hypothyroidism, similar to findings in other autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. We aimed to study a possible....... CONCLUSIONS: Moderate alcohol consumption is associated with a considerable reduction in the risk of Graves' disease with hyperthyroidism - irrespective of age and sex. Autoimmune thyroid disease seems to be much more dependent on environmental factors than hitherto anticipated....

  3. Assessment at the 66. day of projected external doses for populations living in the North-West fallout zone of the Fukushima nuclear accident. Impact of population evacuation measures; Evaluation au 66. jour des doses externes projetees pour les populations vivant dans la zone de retombee Nord-Ouest de l'accident nucleaire de Fukushima. Impact des mesures d'evacuation des populations



    This document reports a dose assessment study performed by the IRSN (the French Radioprotection and Safety Nuclear Institute) 66 days after the Fukushima nuclear accident. A new dose assessment was carried out by IRSN to estimate projected doses due to external exposure from radioactive deposits, for exposure durations of 3 months, 1 year and 4 years before evacuation. The purpose of this report is to provide insight on all radiological assessments performed to the knowledge of the IRSN (the French Radioprotection and Safety Nuclear Institute) to date and the impact of population evacuation measures to be taken to minimize the medium and long-term risks of developing leukaemia or other radiation-induced cancers. This report only considers the external doses already received as well as the doses that may be received in the future from fallout deposits, regardless of doses received previously from the radioactive plume

  4. Learning from incidents and accidents

    Drupsteen, L.; Kampen, J. van


    There are many different definitions for what constitutes an incident or an accident, however the focus is always on unintended and often unforeseen events that cause unintended consequences. This article is focused on the process of learning from incidents and accidents. The focus is on making sure

  5. [Practical management of CPB accident].

    Depoix, J-P; Fenet, L; Provenchere, S


    Accident of CPB is a reality. It is important to be prepared for discussion with the family, with the hospital administration, eventually with the justice. But we have also to support perfusionnist and anesthetic team in charge of the patient during accident.

  6. Severe accident recriticality analyses (SARA)

    Frid, W.; Højerup, C.F.; Lindholm, I.


    Recriticality in a BWR during reflooding of an overheated partly degraded core, i.e. with relocated control rods, has been studied for a total loss of electric power accident scenario. In order to assess the impact of recriticality on reactor safety, including accident management strategies, the ...

  7. Hipertrigliceridemia familiar grave durante a gestação

    Casulari Luiz Augusto


    Full Text Available A presença de hipertrigliceridemia grave durante a gravidez é rara, mas comporta grande possibilidade de desenvolver complicações, como a pancreatite aguda, que coloca em risco a mãe e o feto. Apresentamos o relato da evolução da gestação de uma paciente portadora de hipertrigliceridemia grave que havia apresentado pancreatite aguda dois meses antes da fecundação. Foi tratada durante o pré-natal com dieta e 3,0 g de ácidos graxos de cadeia ômega-3 (ácidos eicosapentaenóico 14% e docosahexaenóico 11,13%. Os níveis de triglicerídeos foram mantidos abaixo de 800 mg/dl, sendo este limite considerado seguro para evitar o desenvolvimento de pancreatite aguda. A gestação evoluiu, sem intercorrências, para parto vaginal, a termo. O recém-nato não apresentou alterações morfológicas ao nascimento. Concluímos que, nesta paciente grávida e portadora de hipertrigliceridemia grave, uma dieta adequada e o emprego de ácidos graxos de cadeia ômega-3 foram eficazes em prevenir a pancreatite aguda. Esta abordagem terapêutica pode ser uma alternativa para as gestantes portadoras de hipertrigliceridemia familiar.

  8. Industrial accidents triggered by lightning.

    Renni, Elisabetta; Krausmann, Elisabeth; Cozzani, Valerio


    Natural disasters can cause major accidents in chemical facilities where they can lead to the release of hazardous materials which in turn can result in fires, explosions or toxic dispersion. Lightning strikes are the most frequent cause of major accidents triggered by natural events. In order to contribute towards the development of a quantitative approach for assessing lightning risk at industrial facilities, lightning-triggered accident case histories were retrieved from the major industrial accident databases and analysed to extract information on types of vulnerable equipment, failure dynamics and damage states, as well as on the final consequences of the event. The most vulnerable category of equipment is storage tanks. Lightning damage is incurred by immediate ignition, electrical and electronic systems failure or structural damage with subsequent release. Toxic releases and tank fires tend to be the most common scenarios associated with lightning strikes. Oil, diesel and gasoline are the substances most frequently released during lightning-triggered Natech accidents.

  9. Traffic Accidents on Slippery Roads

    Fonnesbech, J. K.; Bolet, Lars


    Police registrations from 65 accidents on slippery roads in normally Danish winters have been studied. The study showed: • 1 accident per 100 km when using brine spread with nozzles • 2 accidents per 100 km when using pre wetted salt • 3 accidents per 100 km when using kombi spreaders The results...... of accidents in normally Danish winter seasons are remarkable alike the amount of salt used in praxis in the winter 2011/2012. • 2.7 ton NaCl/km when using brine spread with nozzles • 5 ton NaCl/km when using pre wetted salt. • 5.7 ton NaCl/km when using kombi spreaders The explanation is that spreading...

  10. World health day - 7th april, 2004 "road safety is no accident"

    S C Saxena


    Full Text Available In 1948, the First World Health Assembly called for the creation of a "World Health Day". Since 1950, World Health Day has been celebrated on the 7th of April of each year. The objective of World Health Day is to raise global awareness of a specific health theme to highlight a priority area of concern for the World Health Organization (WHO. The Day serves as a launch for a long-term advocacy program for which activities will be undertaken and resources provided well beyond 7th April.To Celebrate the theme of this year "Road Safety is No accident", on 7th April 2004 around the globle, hundreds of organizations hosted events to help raise awareness about road traffic injuries, their grave consequences and enormous casts to society. They alsocontributed to spreading the message that such injuries can be prevented.In 1948, the First World Health Assembly called for the creation of a "World Health Day". Since 1950, World Health Day has been celebrated on the 7th of April of each year. The objective of World Health Day is to raise global awareness of a specific health theme to highlight a priority area of concern for the World Health Organization (WHO. The Day serves as a launch for a long-term advocacy program for which activities will be undertaken and resources provided well beyond 7th April.To Celebrate the theme of this year "Road Safety is No accident", on 7th April 2004 around the globle, hundreds of organizations hosted events to help raise awareness about road traffic injuries, their grave consequences and enormous casts to society. They alsocontributed to spreading the message that such injuries can be prevented.t '            ■The accident is defined as unexpected, unplanned event envolving injury, disability or death. The accidents occur in almost all countries. The most alarming fact is that accidents kill more young trained adults between 15-24 years of age group of males, mainly among two wheelers. All sorts of accidents

  11. Dan Performer Mei Lanfang

    Risum, Janne


    The convention of performing female characters (dan characters) in Beijing opera, as practised by its most prominent male performer of female characters Mei Lanfang, and its and his cultural context and aesthetic aim...

  12. Liever kraanwater dan bronwater

    Kole, A.P.W.


    Een test in het Restaurant van de Toekomst van de invloed van CO2-labels op het aankoopgedrag van consumenten, heeft nog geen duidelijk beeld opgeleverd. Wel pakten mensen vaker kraanwater dan bronwater.

  13. New target for immunotherapy of Graves ophthalmopathy%Graves 眼病免疫治疗的新靶点



    @@ Graves 眼病(Graves ophthalmopathy,GO) 或称甲状腺相关性眼病(thyroid associated ophthalmopathy,TAO)是长期以来困扰内分泌医师的常见病症之一,目前尚无理想的治疗方法,常用免疫调节、球后放射照射、眼眶减压术等疗法.GO 的发病机制尚未完全明了,目前认为细胞免疫和体液免疫共同参与了GO 的发生和发展.

  14. Makna Dan Ideologi Punk

    Daniar Wikan Setyanto


    Punk Sebagai sebuah subkultur telah diadaptasi oleh para remaja Indonesia bukan hanya sebagai semangat bermusik, namun merambah sebagai ideologi dan gaya hidup. Punk merupakan warisan budaya dari barat yang awalnya bergerak pada bidang musik, namun lambat lain punk telah menjadi sebuah identitas global yang mewakili para remaja radikal yang memiliki visi anti kemapanan dan anti pemerintah. Selain ideologinya yang kontroversi, punk mempengaruhi dinamika fashion di dunia. Asesoris punk diadapta...

  15. Insuficiencia mitral grave posvalvuloplastia mitral percutánea

    Julio C. Echarte Martínez


    Full Text Available RESUMENIntroducciónLa valvuloplastia mitral percutánea es en la actualidad el tratamiento de elección en pacientesportadores de estenosis mitral de etiología reumática si la anatomía es apropiada.La insuficiencia mitral grave posvalvuloplastia continúa siendo un desafío.ObjetivoDeterminar las causas de insuficiencia mitral grave posvalvuloplastia mitral.Material y métodosSe realizaron 110 valvuloplastias mitrales percutáneas en forma consecutiva en 107 pacientes(3 repetidas por reestenosis en el Instituto de Cardiología y Cirugía Cardiovascular deCuba, entre el 17 de junio de 1998 y el 30 de junio de 2004 (106 por el método de Inoue y 4por Multitrack; el tiempo de evolución promedio fue de 24,6 meses (máximo 72 y mínimo1,93 meses. La insuficiencia mitral se clasificó por ecocardiografía Doppler en leve si elárea regurgitante era menor de 4 cm2, moderada si era de 4-8 cm2. y grave si era > 8 cm2 ypor ventriculografía izquierda según los criterios de Sellers. Para lograr correlación entre laclasificación por ecocardiografía Doppler color de tres grados y la de Sellers (cuatro gradosla insuficiencia mitral 1+ se consideró leve, 2+ y 3+ moderada y 4+, grave.ResultadosSe produjeron cinco insuficiencias mitrales graves posprocedimiento (4,54% del total. Tresde ellas necesitaron reemplazo valvular mitral por rotura de la valva anterior. Las dos restantesse encuentran bajo tratamiento médico.ConclusiónLos mecanismos de producción de la insuficiencia mitral posvalvuloplastia mitral percutáneason multifactoriales. Puede ocurrir en manos expertas.REV ARGENT CARDIOL 2010;78:222-227.

  16. Chernobyl accident and its consequences

    Gittus, J.H.; Bonell, P.G.; Hicks, D.


    The USSR power reactor programme is first described. The reasons for the accident at the Chernobyl-4 RBMK nuclear reactor on 26 April 1986, the sequence of events that took place, and the immediate and long-term consequences are considered. A description of the RBMK-type reactors is given and the design changes resulting from the experience of the accident are explained. The source terms describing the details of the radioactivity release associated with the accident and the environmental consequences are covered in the last two sections of the report. Throughout the text comments referring to the UK Nuclear Installations Inspectorate Safety assessment principles have been inserted. (U.K.).

  17. [Prevention of bicycle accidents].

    Zwipp, H; Barthel, P; Bönninger, J; Bürkle, H; Hagemeister, C; Hannawald, L; Huhn, R; Kühn, M; Liers, H; Maier, R; Otte, D; Prokop, G; Seeck, A; Sturm, J; Unger, T


    For a very precise analysis of all injured bicyclists in Germany it would be important to have definitions for "severely injured", "seriously injured" and "critically injured". By this, e.g., two-thirds of surgically treated bicyclists who are not registered by the police could become available for a general analysis. Elderly bicyclists (> 60 years) are a minority (10 %) but represent a majority (50 %) of all fatalities. They profit most by wearing a helmet and would be less injured by using special bicycle bags, switching on their hearing aids and following all traffic rules. E-bikes are used more and more (145 % more in 2012 vs. 2011) with 600,000 at the end of 2011 and are increasingly involved in accidents but still have a lack of legislation. So even for pedelecs 45 with 500 W and a possible speed of 45 km/h there is still no legislative demand for the use of a protecting helmet. 96 % of all injured cyclists in Germany had more than 0.5 ‰ alcohol in their blood, 86 % more than 1.1 ‰ and 59 % more than 1.7 ‰. Fatalities are seen in 24.2 % of cases without any collision partner. Therefore the ADFC calls for a limit of 1.1 ‰. Some virtual studies conclude that integrated sensors in bicycle helmets which would interact with sensors in cars could prevent collisions or reduce the severity of injury by stopping the cars automatically. Integrated sensors in cars with opening angles of 180° enable about 93 % of all bicyclists to be detected leading to a high rate of injury avoidance and/or mitigation. Hanging lamps reduce with 35 % significantly bicycle accidents for children, traffic education for children and special trainings for elderly bicyclists are also recommended as prevention tools. As long as helmet use for bicyclists in Germany rates only 9 % on average and legislative orders for using a helmet will not be in force in the near future, coming up campaigns seem to be necessary to be promoted by the Deutscher

  18. Treatment of severe Graves eye disease%严重Graves眼病的治疗



    @@ Graves眼病分型 Graves眼病是一种眼眶内的眼外肌和眶后脂肪结缔组织受累的自身免疫性疾病,是导致眼球突出的常见疾病.Hall等将Graves眼病分为Graves病眼型(Graves' ophthalmopathy)和眼型Graves病(ophthalmopathy Graves' disease,orbital Graves' disease).

  19. Three Mile Island Accident Data

    National Oceanic and Atmospheric Administration, Department of Commerce — Three Mile Island Accident Data consists of mostly upper air and wind observations immediately following the nuclear meltdown occurring on March 28, 1979, near...

  20. Violencia en la pareja hacia mujeres con transtorno mental grave

    González Cases, Juan Carlos


    Este estudio tiene como objetivo principal analizar la prevalencia y características de la violencia de pareja hacia mujeres con un trastorno mental grave. La muestra consta de 142 mujeres mayores de 18 años, que en algún momento de su vida adulta habían tenido una relación de pareja y que estaban en atención en recursos públicos de salud mental de la Comunidad de Madrid. A través de entrevista se aplicaron cuestionarios validados para la medición de violencia psicológica, sexual y física. Ad...

  1. Esclerodermia, tireoidite e miastenia grave: estudo de um caso

    Antonio L. dos Santos Werneck; Tamara Checcacci-Balod; Graça Tuma


    Uma paciente de 36 anos com miastenia grave desenvolveu após dois anos intolerância ao frio, o que conduziu ao diagnóstico de tireoidite de Hashimoto. Quatro anos mais tarde apresentou pele espessada nas mãos (esclerodermia limitada). O quadro clínico e os exames complementares encaminharam o diagnóstico para a forma CREST de esclerodermia sistêmica progressiva. Discute-se a dificuldade diagnóstica da esclerodermia, assim como suas síndromes de superposição. Doença de Hashimoto e miastenia gr...

  2. Nuclear fuel cycle facility accident analysis handbook

    Ayer, J E; Clark, A T; Loysen, P; Ballinger, M Y; Mishima, J; Owczarski, P C; Gregory, W S; Nichols, B D


    The Accident Analysis Handbook (AAH) covers four generic facilities: fuel manufacturing, fuel reprocessing, waste storage/solidification, and spent fuel storage; and six accident types: fire, explosion, tornado, criticality, spill, and equipment failure. These are the accident types considered to make major contributions to the radiological risk from accidents in nuclear fuel cycle facility operations. The AAH will enable the user to calculate source term releases from accident scenarios manually or by computer. A major feature of the AAH is development of accident sample problems to provide input to source term analysis methods and transport computer codes. Sample problems and illustrative examples for different accident types are included in the AAH.

  3. Paragliding accidents in remote areas.

    Fasching, G; Schippinger, G; Pretscher, R


    Paragliding is an increasingly popular hobby, as people try to find new and more adventurous activities. However, there is an increased and inherent danger with this sport. For this reason, as well as the inexperience of many operators, injuries occur frequently. This retrospective study centers on the helicopter rescue of 70 individuals in paragliding accidents. All histories were examined, and 43 patients answered a questionnaire. Nineteen (42%) pilots were injured when taking off, 20 (44%) during the flight, and six (13%) when landing. Routine and experience did not affect the prevalence of accident. Analysis of the causes of accident revealed pilot errors in all but three cases. In 34 rescue operations a landing of the helicopter near the site of the accident was possible. Half of the patients had to be rescued by a cable winch or a long rope fixed to the helicopter. Seven (10%) of the pilots suffered multiple trauma, 38 (54%) had injuries of the lower extremities, and 32 (84%) of them sustained fractures. Injuries to the spine were diagnosed in 34 cases with a fracture rate of 85%. One patient had an incomplete paraplegia. Injuries to the head occurred in 17 patients. No paraglider pilot died. The average hospitalization was 22 days, and average time of working inability was 14 weeks. Fourteen (34%) patients suffered from a permanent damage to their nerves or joints. Forty-three percent of the paragliders continued their sport despite the accident; two of them had another accident. An improved training program is necessary to lower the incidence of paragliding accidents. Optimal equipment to reduce injuries in case of accidents is mandatory. The helicopter emergency physician must perform a careful examination, provide stabilization of airways and circulation, give analgesics, splint fractured extremities, and transport the victim on a vacuum mattress to the appropriate hospital.

  4. Severe accident analysis using dynamic accident progression event trees

    Hakobyan, Aram P.

    In present, the development and analysis of Accident Progression Event Trees (APETs) are performed in a manner that is computationally time consuming, difficult to reproduce and also can be phenomenologically inconsistent. One of the principal deficiencies lies in the static nature of conventional APETs. In the conventional event tree techniques, the sequence of events is pre-determined in a fixed order based on the expert judgments. The main objective of this PhD dissertation was to develop a software tool (ADAPT) for automated APET generation using the concept of dynamic event trees. As implied by the name, in dynamic event trees the order and timing of events are determined by the progression of the accident. The tool determines the branching times from a severe accident analysis code based on user specified criteria for branching. It assigns user specified probabilities to every branch, tracks the total branch probability, and truncates branches based on the given pruning/truncation rules to avoid an unmanageable number of scenarios. The function of a dynamic APET developed includes prediction of the conditions, timing, and location of containment failure or bypass leading to the release of radioactive material, and calculation of probabilities of those failures. Thus, scenarios that can potentially lead to early containment failure or bypass, such as through accident induced failure of steam generator tubes, are of particular interest. Also, the work is focused on treatment of uncertainties in severe accident phenomena such as creep rupture of major RCS components, hydrogen burn, containment failure, timing of power recovery, etc. Although the ADAPT methodology (Analysis of Dynamic Accident Progression Trees) could be applied to any severe accident analysis code, in this dissertation the approach is demonstrated by applying it to the MELCOR code [1]. A case study is presented involving station blackout with the loss of auxiliary feedwater system for a

  5. Makna Dan Ideologi Punk

    Daniar Wikan Setyanto


    Full Text Available Punk Sebagai sebuah subkultur telah diadaptasi oleh para remaja Indonesia bukan hanya sebagai semangat bermusik, namun merambah sebagai ideologi dan gaya hidup. Punk merupakan warisan budaya dari barat yang awalnya bergerak pada bidang musik, namun lambat lain punk telah menjadi sebuah identitas global yang mewakili para remaja radikal yang memiliki visi anti kemapanan dan anti pemerintah. Selain ideologinya yang kontroversi, punk mempengaruhi dinamika fashion di dunia. Asesoris punk diadaptasi oleh budaya bopuler sebagai pernak-pernik fashion. Kini punk, telah menjadi bagian dari dunia fashion di seluruh dunia. Apa sebenarnya yang melatar belakangi munculnya Punk? bagaimana Punk bisa berkembang di Indonesia? Kata Kunci: punk, fashion, budaya populer

  6. DanRIS

    Skou, Carl Verner


    Windows 2000/XP/Vista platform computerprogram til DanRIS indberetning baseret på indskrivning af klienter på CPR, klientsforløb, faseforløb, ASI EuropASI composite score beregninger. Udgave: Udgivelsesdato: 01-01-2009......Windows 2000/XP/Vista platform computerprogram til DanRIS indberetning baseret på indskrivning af klienter på CPR, klientsforløb, faseforløb, ASI EuropASI composite score beregninger. Udgave: Udgivelsesdato: 01-01-2009...

  7. Craniotomia descompressiva bifrontal no tratamento do edema cerebral grave

    Walter C. Pereira


    Full Text Available São apresentados os resultados obtidos com craniotomia descompressiva bifrontal ampla em 12 doentes com edema cerebral grave e irreversível com os métodos convencionais de tratamento, provocado em 10 por traumatismo crânio-encefálico. Todos os pacientes apresentavam quadro neurológico muito grave, com sinais de comprometimento do tronco cerebral superior. Angiografia caro-tídea bilateral foi praticada sistematicamente, tanto no pré como no pós-operatório, constituindo-se no fator decisivo para a indicação cirúrgica. Seis (50% dos doentes sobreviveram, apresentando 5 (41,6% recuperação neurológica e psíquica praticamente totais. Levando em conta estes resultados, consideramos esta técnica cirúrgica o melhor recurso de tratamento em tais casos, máxime se indicada precocemente. São necessários, contudo, cuidados pós-operatórios especiais com estes pacientes, que devem, sempre que possível, ser mantidos em unidade de terapia intensiva, em virtude da grande incidência de complicações, mormente respiratórias.

  8. Clinical update: treatment of hyperthyroidism in Graves' ophthalmopathy.

    Azzam, Ibrahim; Tordjman, Karen


    The presence of thyroid eye disease (TED) may influence the treatment of hyperthyroidism in patients with Graves' disease. Moreover, treatment of hyperthyroidism may affect the course of Graves' ophthalmopathy (GO). We review the literature and summarise recent knowledge about the impact of treatment modality for hyperthyroidism in GO. Anti-thyroid drugs (ATDs) remain the simplest and safest way to treat hyperthyroidism in patients with GO, but they are associated with a high relapse rate of hyperthyroidism and they have no effect on the course of GO. Radioactive iodine (RAI) treatment may be associated with exacerbation of GO especially in high risk patients, when glucocorticoid prophylaxis may be indicated. Large prospective trials are still lacking to define the exact effect of RAI on the course of GO, particularly in relation to other known risk factors. Likewise, clear guidelines for prophylactic glucocorticoid therapy are needed. RAI should be cautiously used in patients with more severe ophthalmopathy and concomitant I.V glucocorticoids should be considered. Thyroid surgery, whether total or subtotal thyroidectomy, has no effect on the course of ophthalmopathy. However, total thyroid ablation that combines surgery with radioactive iodine, as a means of achieving thyroid antigen disappearance, is increasingly gaining attention for the treatment of patients with GO, especially those undergoing thyroid surgery, but also for those with severe unresponsive ophthalmopathy. Studies supporting this approach are awaited.

  9. Hyperthyroidism in Graves disease. Current trends in management and diagnosis

    Haibach, H.


    The radioimmunoassay for T/sub 3/ is now widely available and is a useful diagnostic tool for hyperthyroidism, especially in T/sub 3/-thyrotoxicosis. It is an essential tool in the management of hyperthyroidism that persists after treatment with normal T/sub 4/ serum levels or, in euthyroid cases, with low T/sub 4/ serum levels. In these conditions, it reflects the metabolic state more accurately than serum levels of T/sub 4/. A promising new test is the response of radioimmunoassayable TSH to protirelin relin (TRH) administration. An absent response indicates pituitary suppression and thyroid autonomy as seen in frank hyperthyroidism or euthyroid Graves disease, treated or untreated. It is safer and quicker than the conventional T/sub 3/ suppression test of thyroid radioactive iodine uptake and may replace it at least partly in the future. The recently recognized sharp decline in the remission rate of patients subjected to thyroid drug therapy in the last decade has made this treatment much less efficacious. By necessity, it will probably lead to greater reliance on treatment with radioactive iodine in the majority of the patients with the hyperthyroidism of Graves disease.

  10. Accident Tolerant Fuel Analysis

    Curtis Smith; Heather Chichester; Jesse Johns; Melissa Teague; Michael Tonks; Robert Youngblood


    Safety is central to the design, licensing, operation, and economics of Nuclear Power Plants (NPPs). Consequently, the ability to better characterize and quantify safety margin holds the key to improved decision making about light water reactor design, operation, and plant life extension. A systematic approach to characterization of safety margins and the subsequent margins management options represents a vital input to the licensee and regulatory analysis and decision making that will be involved. The purpose of the Risk Informed Safety Margin Characterization (RISMC) Pathway research and development (R&D) is to support plant decisions for risk-informed margins management by improving economics and reliability, and sustaining safety, of current NPPs. Goals of the RISMC Pathway are twofold: (1) Develop and demonstrate a risk-assessment method coupled to safety margin quantification that can be used by NPP decision makers as part of their margin recovery strategies. (2) Create an advanced “RISMC toolkit” that enables more accurate representation of NPP safety margin. In order to carry out the R&D needed for the Pathway, the Idaho National Laboratory is performing a series of case studies that will explore methods- and tools-development issues, in addition to being of current interest in their own right. One such study is a comparative analysis of safety margins of plants using different fuel cladding types: specifically, a comparison between current-technology Zircaloy cladding and a notional “accident-tolerant” (e.g., SiC-based) cladding. The present report begins the process of applying capabilities that are still under development to the problem of assessing new fuel designs. The approach and lessons learned from this case study will be included in future Technical Basis Guides produced by the RISMC Pathway. These guides will be the mechanism for developing the specifications for RISMC tools and for defining how plant decision makers should propose and

  11. [Accidents of fulguration].

    Virenque, C; Laguerre, J


    Fulguration, first electric accident in which the man was a victim, is to day better known. A clap of thunder is decomposed in two elements: lightning, and thunder. Lightning is caused by an electrical discharge, either within a cloud, or between two clouds, or, above all, between a cloud and the surface of the ground. Experimental equipments owned by the French Electricity Company and by the Atomic Energy Commission, have allowed to photograph lightnings and to measure certain physical characteristics (Intensity variable between 25 to 100 kA, voltage variable between 20 to 1 000 kV). The frequency of storms was learned: the isokeraunic level, in France, is about 20, meaning that thunder is heard twenty days during one year. Man may be stricken by thunder by direct hit, by sudden bursting, by earth current, or through various conductors. The electric charge which reached him may go to the earth directly by contact with the ground or may dissipate in the air through a bony promontory (elbow). The total number of victims, "wounded" or deceased, is not now known by statistics. Death comes by insulation breakdown of one of several anatomic cephalic formations: skull, meninx, brain. Many various lesions may happen in survivors: loss of consciousness, more or less long, sensorial or motion deficiencies. All these signs are momentary and generally reversible. Besides one may observe much more intense lesions on the skin: burns and, over all, characteristic aborescence (skin effect by high frequency current). The heart is protected, contrarily to what happens with industrial electrocution. The curative treatment is merely symptomatic : reanimation, surgery for burns or associated traumatic lesions. A prevention is researched to help the lonely man, in the country or in the mountains in the houses (lightning conductor, Faraday cage), in vehicles (aircraft, cars, ships). The mysterious and unforseeable character of lightning still stays, leaving a door opened for numerous

  12. Accident tolerant fuel analysis

    Smith, Curtis [Idaho National Laboratory; Chichester, Heather [Idaho National Laboratory; Johns, Jesse [Texas A& M University; Teague, Melissa [Idaho National Laboratory; Tonks, Michael Idaho National Laboratory; Youngblood, Robert [Idaho National Laboratory


    Safety is central to the design, licensing, operation, and economics of Nuclear Power Plants (NPPs). Consequently, the ability to better characterize and quantify safety margin holds the key to improved decision making about light water reactor design, operation, and plant life extension. A systematic approach to characterization of safety margins and the subsequent margins management options represents a vital input to the licensee and regulatory analysis and decision making that will be involved. The purpose of the Risk Informed Safety Margin Characterization (RISMC) Pathway research and development (R&D) is to support plant decisions for risk-informed margins management by improving economics and reliability, and sustaining safety, of current NPPs. Goals of the RISMC Pathway are twofold: (1) Develop and demonstrate a risk-assessment method coupled to safety margin quantification that can be used by NPP decision makers as part of their margin recovery strategies. (2) Create an advanced ''RISMC toolkit'' that enables more accurate representation of NPP safety margin. In order to carry out the R&D needed for the Pathway, the Idaho National Laboratory is performing a series of case studies that will explore methods- and tools-development issues, in addition to being of current interest in their own right. One such study is a comparative analysis of safety margins of plants using different fuel cladding types: specifically, a comparison between current-technology Zircaloy cladding and a notional ''accident-tolerant'' (e.g., SiC-based) cladding. The present report begins the process of applying capabilities that are still under development to the problem of assessing new fuel designs. The approach and lessons learned from this case study will be included in future Technical Basis Guides produced by the RISMC Pathway. These guides will be the mechanism for developing the specifications for RISMC tools and for defining how plant

  13. Grossesse dans une corne rudimentaire: difficultés diagnostiques et prise en charge thérapeutique

    Mamouni, Nisrine; Ghazal, Nabil; Erraghay, Sanaa; Bouchikhi, Chahrazed; Banani, Abdelaziz


    La survenue d'une grossesse dans une corne utérine rudimentaire est une situation obstétricale extrêmement rare et potentiellement grave, menaçant le pronostic materno-fœtal. Les auteurs rapportent cinq observations de grossesse dans une corne utérine rudimentaire, à travers lesquelles, ils relatent les difficultés sur le plan diagnostique ainsi que la prise en charge thérapeutique de cette entité pathologique, soulignant l'intérêt de l’échographie endovaginale, de l'IRM pelvienne et de la cœlioscopie dans le diagnostic précoce de ce type de malformation uterine. PMID:27583078

  14. The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy.

    Bartalena, Luigi; Baldeschi, Lelio; Boboridis, Kostas; Eckstein, Anja; Kahaly, George J; Marcocci, Claudio; Perros, Petros; Salvi, Mario; Wiersinga, Wilmar M


    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mechanisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient's quality of life. Local measures (artificial tears, ointments and dark glasses) and control of risk factors for progression (smoking and thyroid dysfunction) are recommended for all patients. In mild GO, a watchful strategy is usually sufficient, but a 6-month course of selenium supplementation is effective in improving mild manifestations and preventing progression to more severe forms. High-dose glucocorticoids (GCs), preferably via the intravenous route, are the first line of treatment for moderate-to-severe and active GO. The optimal cumulative dose appears to be 4.5-5 g of methylprednisolone, but higher doses (up to 8 g) can be used for more severe forms. Shared decision-making is recommended for selecting second-line treatments, including a second course of intravenous GCs, oral GCs combined with orbital radiotherapy or cyclosporine, rituximab or watchful waiting. Rehabilitative treatment (orbital decompression surgery, squint surgery or eyelid surgery) is needed in the majority of patients when GO has been conservatively managed and inactivated by immunosuppressive treatment.

  15. Akromegali Dan Gigantisme

    Silvani, Melati; Pase, M. Aron; Syafril, Santi; Lindarto, Dharma; Solin, Steffie S


    Hormon pertumbuhan manusia (Growth Hormone/GH) merupakan peptida rantai tunggal yang terdiri dari 191 asam amino, yang diisolasi dari sel somatotrop pada kelenjar hipofisis anterior pada tahun 1956, dan pertama kali digunakan sebagai terapi untuk penatalaksanaan dwarfisme hipofisis pada tahun 1958. Dwarfisme hipofisis adalah bentuk klasik dari defisiensi hormon pertumbuhan pada anak-anak Melati Silvani

  16. Macapat dan Santiswara

    Darusuprapta, Darusuprapta


    Dalam khazanah kebudayaan Indonesia, khusus Jawa, hidup berkembangan kesenian macapat yang disebut juga  macapatan, dan kesenian santiswara yang disebut pula santiswaran. Macapatan lebih mengutamakan pembacaan teks dengan dendangan tembang kemudian diikuti sarasehan atau diskusi yang membahas segala segi isi teks bacaannya, sedangkan santiswaran lebih mengutamakan alunan swara dengan dendangan tembang disertai iringan bunyi tabuh-tabuhan.

  17. Nuclear accident dosimetry intercomparison studies.

    Sims, C S


    Twenty-two nuclear accident dosimetry intercomparison studies utilizing the fast-pulse Health Physics Research Reactor at the Oak Ridge National Laboratory have been conducted since 1965. These studies have provided a total of 62 different organizations a forum for discussion of criticality accident dosimetry, an opportunity to test their neutron and gamma-ray dosimetry systems under a variety of simulated criticality accident conditions, and the experience of comparing results with reference dose values as well as with the measured results obtained by others making measurements under identical conditions. Sixty-nine nuclear accidents (27 with unmoderated neutron energy spectra and 42 with eight different shielded spectra) have been simulated in the studies. Neutron doses were in the 0.2-8.5 Gy range and gamma doses in the 0.1-2.0 Gy range. A total of 2,289 dose measurements (1,311 neutron, 978 gamma) were made during the intercomparisons. The primary methods of neutron dosimetry were activation foils, thermoluminescent dosimeters, and blood sodium activation. The main methods of gamma dose measurement were thermoluminescent dosimeters, radiophotoluminescent glass, and film. About 68% of the neutron measurements met the accuracy guidelines (+/- 25%) and about 52% of the gamma measurements met the accuracy criterion (+/- 20%) for accident dosimetry.

  18. Accident knowledge and emergency management

    Rasmussen, B.; Groenberg, C.D.


    The report contains an overall frame for transformation of knowledge and experience from risk analysis to emergency education. An accident model has been developed to describe the emergency situation. A key concept of this model is uncontrolled flow of energy (UFOE), essential elements are the state, location and movement of the energy (and mass). A UFOE can be considered as the driving force of an accident, e.g., an explosion, a fire, a release of heavy gases. As long as the energy is confined, i.e. the location and movement of the energy are under control, the situation is safe, but loss of confinement will create a hazardous situation that may develop into an accident. A domain model has been developed for representing accident and emergency scenarios occurring in society. The domain model uses three main categories: status, context and objectives. A domain is a group of activities with allied goals and elements and ten specific domains have been investigated: process plant, storage, nuclear power plant, energy distribution, marine transport of goods, marine transport of people, aviation, transport by road, transport by rail and natural disasters. Totally 25 accident cases were consulted and information was extracted for filling into the schematic representations with two to four cases pr. specific domain. (au) 41 tabs., 8 ills.; 79 refs.

  19. Radioactive materials transport accident analysis

    McSweeney, T.I.; Maheras, S.J.; Ross, S.B. [Battelle Memorial Inst. (United States)


    Over the last 25 years, one of the major issues raised regarding radioactive material transportation has been the risk of severe accidents. While numerous studies have shown that traffic fatalities dominate the risk, modeling the risk of severe accidents has remained one of the most difficult analysis problems. This paper will show how models that were developed for nuclear spent fuel transport accident analysis can be adopted to obtain estimates of release fractions for other types of radioactive material such as vitrified highlevel radioactive waste. The paper will also show how some experimental results from fire experiments involving low level waste packaging can be used in modeling transport accident analysis with this waste form. The results of the analysis enable an analyst to clearly show the differences in the release fractions as a function of accident severity. The paper will also show that by placing the data in a database such as ACCESS trademark, it is possible to obtain risk measures for transporting the waste forms along proposed routes from the generator site to potential final disposal sites.

  20. 75 FR 12377 - Native American Graves Protection and Repatriation Act Regulations-Disposition of Culturally...


    ... Interior 43 CFR Part 10 Native American Graves Protection and Repatriation Act Regulations-- Disposition of... Part 10 RIN 1024-AD68 Native American Graves Protection and Repatriation Act Regulations--Disposition... rule with request for comments. SUMMARY: This final rule implements the Native American...

  1. 78 FR 27078 - Native American Graves Protection and Repatriation Act Regulations


    ... Government Relations with Native American Tribal Governments'' (59 FR 22951, April 29, 1994); Executive Order... Office of the Secretary of the Interior 43 CFR Part 10 RIN 1024-AD99 Native American Graves Protection.... SUMMARY: This final rule revises regulations implementing the Native American Graves Protection...

  2. 76 FR 69282 - Native American Graves Protection and Repatriation Review Committee: Meeting


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American Graves Protection and... effect the agreed-upon disposition of Native American human remains determined to be...

  3. 75 FR 9429 - Native American Graves Protection and Repatriation Review Committee: Meetings


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meetings AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of three meetings of the Native American Graves... agreement, of Native American human remains determined to be culturally unidentifiable; and presentations...

  4. 77 FR 7180 - Native American Graves Protection and Repatriation Review Committee: Meeting


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves Protection... of Native American human remains determined to be culturally unidentifiable; presentations by...

  5. 77 FR 53228 - Native American Graves Protection and Repatriation Review Committee: Meeting


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American Graves..., as required by law, in order to effect the agreed-upon disposition of Native American human...

  6. Premature hair greying may predict reduced bone mineral density in Graves' disease.

    Leary, A C


    BACKGROUND: Premature hair greying has been associated with low bone mineral density (BMD), and it may be more frequent in Graves\\' disease. AIMS: To determine whether premature greying is associated with reduced BMD in women with Graves\\' disease and in control women, and to examine whether premature greying is more common in Graves\\' disease. METHODS: Premature greying (> 50% grey by 40 years) and BMD were determined in 44 women with a history of Graves\\' disease and 133 female controls referred for routine BMD measurement. Exclusion criteria included diseases or drugs known to affect BMD. RESULTS: Mean Z and T scores at the lumbar spine were significantly lower (P < 0.04) in subjects with premature greying than in those not prematurely grey among women with Graves\\' disease, but not among control women. Multiple regression confirmed this difference between Graves\\' and control women (P = 0.041). There were no differences at other measurement sites. Of Graves\\' patients, 36% were prematurely grey compared with 25% of control women (P = 0.14). CONCLUSION: Premature greying may be a weak marker for reduced BMD in women with a history of Graves\\' disease, but it is not a marker in normal women.

  7. Evaluación de un programa de intervención familiar en pacientes psicóticos y con trastornos graves de la personalidad.

    Luz Celia Fernández Martín


    Full Text Available El objetivo de este trabajo es evaluar la efectividad de las intervenciones familiares que tienen lugar en una Unidad de Hospitalización Parcial, en pacientes psicóticos en un primer episodio y pacientes con un trastorno de la personalidad, cuyos síntomas son particularmente graves o dan lugar a un notable deterioro de la actividad social o laboral. Además se describe el marco conceptual en que se desenvuelve el tratamiento, los objetivos que se pretenden, así como los procedimientos de la intervención, evaluándose finalmente los resultados al alta en aspectos concretos del tratamiento como relaciones con la familia y con personas ajenas a la misma, asunción y toma de la medicación, actitud frente a la enfermedad o frente al futuro, y actividades de la vida diaria.

  8. Padrao epidemiologico das oclusopatias muito graves em adolescentes brasileiros

    Karen Glazer Peres


    Full Text Available OBJETIVO: Descrever o padrão de distribuição das oclusopatias em adolescentes brasileiros e identificar fatores associados a esse agravo bucal. MÉTODOS: Foram analisados dados de 7.328 e 5.445 adolescentes de 12 e 15-19 anos, respectivamente, participantes da Pesquisa Nacional de Saúde Bucal (SBBrasil 2010. O desfecho foi oclusopatia muito grave segundo o índice de estética dental. As variáveis de exposição foram sexo, cor da pele, renda familiar mensal, número de bens, aglomeração no domicílio, cárie não tratada, perda dentária, uso, frequência e motivo da consulta odontológica. Foram conduzidas análises de regressão logística considerando a complexidade do desenho amostral, com base em modelo hierarquizado. RESULTADOS: Prevalência de oclusopatia muito grave foi observada em 6,5% e 9,1% nos jovens de 12 e 15-19 anos, respectivamente. Após análise ajustada, a chance do desfecho foi 1,59 (IC95% 1,08;2,34 vez maior nos pardos e pretos em relação aos brancos e 2,66 (IC95% 1,26;5,63 vezes maior dentre aqueles com perda de pelo menos um primeiro molar aos 12 anos. Jovens de 15-19 anos cuja renda familiar mensal foi de até R$ 1.500,00 (OR 2,69 [IC95% 1,62;4,47] e aqueles que consultaram o dentista para tratamento (OR 2,59 [IC95% 2,55;4,34] apresentaram maior chance de oclusopatia muito grave quando comparados aos de maior renda e que procuraram o dentista para prevenção. CONCLUSÕES: A distribuição das oclusopatias em adolescentes brasileiros segue o padrão de iniquidade social de outros agravos à saúde. Essas informações são úteis para a formulação de critérios relacionados tanto com a distribuição e provisão de recursos quanto com as prioridades de tratamento ortodôntico fundamentados no princípio da equidade da atenção à saúde bucal.

  9. The child accident repeater: a review.

    Jones, J G


    The child accident repeater is defined as one who has at least three accidents that come to medical attention within a year. The accident situation has features in common with those of the child who has a single accident through simple "bad luck", but other factors predispose him to repeated injury. In the child who has a susceptible personality, a tendency for accident repetition may be due to a breakdown in adjustment to a stressful environment. Prevention of repeat accidents should involve the usual measures considered appropriate for all children as well as an attempt to provide treatment of significant maladjustment and modification of a stressful environment.

  10. Hindsight Bias in Cause Analysis of Accident

    Atsuo Murata; Yasunari Matsushita


    It is suggested that hindsight becomes an obstacle to the objective investigation of an accident, and that the proper countermeasures for the prevention of such an accident is impossible if we view the accident with hindsight. Therefore, it is important for organizational managers to prevent hindsight from occurring so that hindsight does not hinder objective and proper measures to be taken and this does not lead to a serious accident. In this study, a basic phenomenon potentially related to accidents, that is, hindsight was taken up, and an attempt was made to explore the phenomenon in order to get basically insights into the prevention of accidents caused by such a cognitive bias.

  11. Severe accident simulation at Olkiuoto

    Tirkkonen, H.; Saarenpaeae, T. [Teollisuuden Voima Oy (TVO), Olkiluoto (Finland); Cliff Po, L.C. [Micro-Simulation Technology, Montville, NJ (United States)


    A personal computer-based simulator was developed for the Olkiluoto nuclear plant in Finland for training in severe accident management. The generic software PCTRAN was expanded to model the plant-specific features of the ABB Atom designed BWR including its containment over-pressure protection and filtered vent systems. Scenarios including core heat-up, hydrogen generation, core melt and vessel penetration were developed in this work. Radiation leakage paths and dose rate distribution are presented graphically for operator use in diagnosis and mitigation of accidents. Operating on an graphically for operator use in diagnosis and mitigation of accidents. Operating on an 486 DX2-66, PCTRAN-TVO achieves a speed about 15 times faster than real-time. A convenient and user-friendly graphic interface allows full interactive control. In this paper a review of the component models and verification runs are presented.

  12. Fukushima accident study using MELCOR

    Randall O Gauntt


    The accidents at the Fukushima Daiichi nuclear power station stunned the world as the sequences played out over severals days and videos of hydrogen explosions were televised as they took place.The accidents all resulted in severe damage to the reactor cores and releases of radioactivity to the environment despite heroic measures had taken by the operating personnel.The following paper provides some background into the development of these accidents and their root causes,chief among them,the prolonged station blackout conditions that isolated the reactors from their ultimate heat sink — the ocean.The interpretations given in this paper are summarized from a recently completed report funded by the United States Department of Energy (USDOE).

  13. Road characteristics and bicycle accidents.

    Nyberg, P; Björnstig, U; Bygren, L O


    In Umeå, Sweden, defects in the physical road surface contributed to nearly half of the single bicycle accidents. The total social cost of these injuries to people amount to at least SEK 20 million (SEK 60,000 or about USD 8,500 per accident), which corresponds to the estimated loss of "eight life equivalents a year". Improved winter maintenance seems to have the greatest injury prevention potential and would probably reduce the number of injuries considerably, whereas improved road quality and modification of kerbs would reduce the most severe injuries. A local traffic safety program should try to prevent road accidents instead of handling the consequences of them. In accordance with Parliament decisions on traffic we would like to see increased investment in measures favoring bicycle traffic, where cycling is seen as a solution, not as a problem.

  14. Bathtub immersion accidents involving children.

    Pearn, J; Nixon, J


    A review of 19 consecutive serious bathtub immersion accidents (11 survivals, 8 fatalities) is presented. In all instances, consciousness was lost in the water. Unlike other childhood accidents which usually show a male predominance, the sexes are equally affected. The modal age is 11 months. Six separate causes of bath drownings and near-drownings have been identified, and in 14 of the 19 accidents, two or more causes were operating concurrently. Median estimated immersion time for survivals was four minutes, and five minutes for fatalities. The median depth of water was eight inches. An 'at risk' profile for home bathtub drownings is presented; this includes the youngest or second youngest child of a large family, a family of grade 4 to 7 sociooccupational status (congalton) and a family in which routine is temporarily broken.

  15. Internal Accident Report on EDH

    SC Department


    The A2 Safety Code requires that, the Internal Accident Report form must be filled in by the person concerned or any witness to ensure that all the relevant services are informed. Please note that an electronic version of this form has been elaborated in collaboration with SC-IE, HR-OPS-OP and IT-AIS. Whenever possible, the electronic form shall be used. The relative icon is available on the EDH Desktop, Other tasks page, under the Safety heading, or directly here: If you have any questions, please contact the SC Secretariat, tel. 75097 Please notice that the Internal Accident Report is an integral part of the Safety Code A2 and does not replace the HS50.

  16. Doenças da tireoide e miastenia grave


    Os autores estudam o comportamento da tireóide em um grupo de 304 pacientes com miastenia grave, constatando 15 casos de tireopatias, sendo 9 de hipertireoidismo, um de hipotireoidismo e 5 de bócio sem alterações da função tireoidiana. Nenhum paciente era proveniente de região de bócio endêmico e não havia bócio familiar. A tireotoxicose, que foi a disfunção mais frequente, foi estudada quanto a sua prevalência em pacientes miastênicos, quanto a sua influência sobre os sintomas da miastenia g...

  17. Changes of Regulatory T Cells in Graves' Disease

    WANG Hongxiang; ZHAO Shi; TANG Xiaoqiong; LI Jingyuan


    The immune mechanism of Graves' diseases (GD) and the roles of regulator T cells were investigated. In 32 patients with GD (GD group) and 20 healthy volunteers (control group), flow cytometry was used to detect the proportion of CD4+CD25+ cells, MACS to isolate CD4+ CD25+ cells,RT-PCR to assay the expression of FOXP3, and ELISA to test the level of IL-10, respectively. It was found that there was no significant change in the proportion of CD4+CD25+ T cells between GD group and control group (P>0.05), while secretion of IL-10 and expression of FOXP3 in GD group were lower than control group (P<0.01 and P<0.05, respectively). In conclusion, though the proportion of regulatory T cells of peripheral blood lymphocytes in the patients with GD, the functions of them were significantly weakened, which might be a pathogenic factor in GD.

  18. The story of the only (? megalith grave on Gotland Island

    Helene Martinsson-Wallin


    Full Text Available In this paper, we discuss the easternmost material expression of the Funnel Beaker Culture – a megalith grave on the west coast of Gotland Island in the Baltic Sea. The people who built and used the megalith brought the Neolithic lifestyle to Gotland. The biography of this monument includes two excavations, of which we participated in the latest in 1984. Our osteological analysis confirms that some thirty individuals of both sexes and various ages were buried there. The structure of the monument is that of a rectangular dolmen. This paper discusses the discovery of this specific site, and explores the existence of this type of monument in a Gotland context. Furthermore, is this really the only megalith on Gotland, or are more of these structures yet to be recognised? Finally, one may ask if the Neolithic way of life really was successful on Gotland.

  19. Doença Pariodontal: fator associado à asma grave?

    Marques, Kaliane Rocha Soledade


    A periodontite constitui-se uma doença crônica de grande prevalência na população, com repercussões imunológicas em todo o organismo. Estima-se que a periodontite pode influenciar na hiper-resposta inflamatória em indivíduos com asma, por meio de alterações imuno-inflamatórias, além de servirem como fontes de microrganismos para o desenvolvimento de infecções pulmonares. Objetivo: Avaliar a possível associação entre a presença periodontite e a asma grave. Método: Estudo caso-co...

  20. Management plan and delivery of care in Graves' ophthalmopathy patients.

    Yang, Morgan; Perros, Petros


    Most patients with Graves' orbitopathy have mild disease that requires no or minimal intervention. For the minority of patients with moderate or severe disease, multiple medical and surgical treatments may be required at different stages. It is crucial that such patients are monitored closely and treatments applied with care in the right sequence. Medical treatments should be used as early as possible and only during the active phase of the disease. Rehabilitative surgery is indicated in the inactive phase of the disease and should follow the sequence: surgical decompression followed by eye muscle surgery, followed by lid surgery. Delivery of care in a coordinated fashion that makes use of best available expertise is important and best implemented through a Combined Thyroid Eye clinic.

  1. [The necklace from the 660 grave in Megara Iblea].

    Verger, Stéphane


    The article analyzes the 660 grave in Megara Iblea, a Greek colony in Sicily, in which a woman has been buried. On her breast a magnificent neckless was found, made of amulets recalling the travel of the sun during the summer solstice. Some objects allude to solar cults (a cock; round pendants), others seem to came from Gallia and Macedonia (summer far West and East), others recall archeological contexts such as tombs in Marvinci, in the Vardar Valley, and allude to relations with female practices of medicine and magic and to female roles characterized by extraordinary powers, due to being descendants of the Sun god. These solar symbols, joint with the discovery of many little objects, typical of children burials, allow to hypotize a relation with the cult of Mater Matuta and seem to point out a difficult or anomalous pregnancy or birth.

  2. Association between polymorphisms in the TSHR gene and Graves' orbitopathy.

    Beata Jurecka-Lubieniecka

    Full Text Available BACKGROUND: Graves' orbitopathy (GO as well as Graves' disease (GD hyperthyroidism originate from an autoimmune reaction against the common auto-antigen, thyroid-stimulating hormone receptor (TSHR. GO phenotype is associated with environmental risk factors, mainly nicotinism, as well as genetic risk factors which initiate an immunologic reaction. In some patients GO is observed before diagnosis of GD hyperthyroidism, while it can also be observed far after diagnosis. The intensity of GO symptoms varies greatly in these patients. Thus, the pathogenesis of GD and GO may correlate with different genetic backgrounds, which has been confirmed by studies of correlations between GO and polymorphisms in cytokines involved in orbit inflammation. The aim of our analysis was to assess genetic predisposition to GO in young patients (age of diagnosis ≤30 years of age, for whom environmental effects had less time to influence outcomes than in adults. METHODS: 768 GD patients were included in the study. 359 of them had clinically evident orbitopathy (NOSPECS ≥2. Patients were stratified by age at diagnosis. Association analyses were performed for genes with a known influence on development of GD - TSHR, HLA-DRB1, cytotoxic T-lymphocyte antigen 4 (CTLA4 and lymphoid protein tyrosine phosphatase (PTPN22. RESULTS: The rs179247 TSHR polymorphism was associated with GO in young patients only. In young GO-free patients, allele A was statistically more frequent and homozygous carriers had a considerable lower risk of disease incidence than patients with AG or GG genotypes. Those differences were not found in either elderly patients or the group analyzed as a whole. CONCLUSIONS: Allele A of the rs179247 polymorphism in the TSHR gene is associated with lower risk of GO in young GD patients.

  3. Atypical Clinical Manifestations of Graves' Disease: An Analysis in Depth

    Mohamed Osama Hegazi


    Full Text Available Over the past few decades, there has been an increase in the number of reports about newly recognized (atypical or unusual manifestations of Graves' disease (GD, that are related to various body systems. One of these manifestations is sometimes the main presenting feature of GD. Some of the atypical manifestations are specifically related to GD, while others are also similarly seen in patients with other forms of hyperthyroidism. Lack of knowledge of the association between these findings and GD may lead to delay in diagnosis, misdiagnosis, or unnecessary investigations. The atypical clinical presentations of GD include anemia, vomiting, jaundice, and right heart failure. There is one type of anemia that is not explained by any of the known etiological factors and responds well to hyperthyroidism treatment. This type of anemia resembles anemia of chronic disease and may be termed GD anemia. Other forms of anemia that are associated with GD include pernicious anemia, iron deficiency anemia of celiac disease, and autoimmune hemolytic anemia. Vomiting has been reported as a presenting feature of Graves' disease. Some cases had the typical findings of hyperthyroidism initially masked, and the vomiting did not improve until hyperthyroidism has been detected and treated. Hyperthyroidism may present with jaundice, and on the other hand, deep jaundice may develop with the onset of overt hyperthyroidism in previously compensated chronic liver disease patients. Pulmonary hypertension is reported to be associated with GD and to respond to its treatment. GD-related pulmonary hypertension may be so severe to produce isolated right-sided heart failure that is occasionally found as the presenting manifestation of GD.

  4. Les kystes hydatiques du foie rompus dans les voies biliaires: a propos de 120 cas

    Mountassir Moujahid


    Full Text Available s et une anastomose bilio digestive choledoco duodenale dans 10 cas. La duree moyenne d�hospitalisation etait de 20jours. Nous deplorons deux deces par choc septique et un troisieme par encephalopathie secondaire a une cirrhose biliaire. La morbidite etait representee par huit abces sous phrenique, douze fistules biliaires prolongees et deux occlusions intestinales. Les kystes hydatiques rompus dans les voies biliaires representent la complication la plus grave de cette pathologie benigne. Le traitement repose sur des methodes radicales qui sont d�une efficacite reconnue, mais de realisation dangereuse et les methodes conservatrices, en particulier la deconnexion kysto biliaire qui est une methode simple et qui donne de bons resultas a court et a long terme.

  5. How to reduce the number of accidents


    Among the safety objectives that the Director-General has established for CERN in 2012 is a reduction in the number of workplace accidents.   The best way to prevent workplace accidents is to learn from experience. This is why any accident, fire, instance of pollution, or even a near-miss, should be reported using the EDH form that can be found here. All accident reports are followed up. The departments investigate all accidents that result in sick leave, as well as all the more common categories of accidents at CERN, essentially falls (slipping, falling on stairs, etc.), regardless of whether or not they lead to sick leave. By studying the accident causes that come to light in this way, it is possible to take preventive action to avoid such accidents in the future. If you have any questions, the HSE Unit will be happy to answer them. Contact us at HSE Unit


    Badunggawa P


    Full Text Available Radiasi yang kita terima setiap saat, termasuk radiasi untuk tujuan kedokteran, mempunyai dampak positif dan negatif terhadap keselamatan manusia dan lingkungan. Dampak positif dari radiasi terhadap keselamatan manusia diantaranya adalah digunakan sebagai pengobatan dan dampak negatifnya adalah tergantung dari besar dosis yang diterima diantaranya adalah mulai dari mual, muntah, pusing-pusing, rambut rontok, menyebabkan kanker, diturunkan secara genetik, dan yang lebih berbahaya lagi adalah menyebabkan kematian. Oleh karena itu kita harus berhati-hati terhadap bahaya yang ditimbulkannya, baik terhadap pekerja radiasi maupun masyarakat umum termasuk pasien. Perlindungan terhadap bahaya yang ditimbulkan radiasi ini dikenal dengan istilah proteksi radiasi. Sehingga dosis yang diterima pertahun oleh pekerja atau masyarakat umum tidak melebihi batas dosis yang ditetapkan oleh Bapeten. Berbagai upaya telah dilakukan untuk meminimalkan bahaya tersebut sehingga pekerja dan pasien merasa aman melakukan dan dikenai tindakan medik.[medicina 2009;40:47-51].  

  7. Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

    Takamatsu, J.; Hosoya, T.; Naito, N.; Yoshimura, H.; Kohno, Y.; Tarutani, O.; Kuma, K.; Sakane, S.; Takeda, K.; Mozai, T.


    Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients.

  8. 76 FR 39007 - Native American Graves Protection and Repatriation Act Regulations- Definition of “Indian Tribe”


    ... Office of the Secretary of the Interior 43 CFR Part 10 RIN 1024-AD98 Native American Graves Protection... regulations implementing the Native American Graves Protection and Repatriation Act (NAGPRA) removes the... implementation of the Native American Graves Protection and Repatriation Act, including the issuance...

  9. Nilai Dan Fungsi Ndungndungen Karo

    Rosita Ginting


    Tesis ini berjudul “Nilai dan Fungsi Ndungndungen Karo”. Tesis ini menjabarkan tentang macam-macam Ndungndungen Karo, nilai-nilai yang terkandung dalam Ndungndungen Karo, fungsi Ndungndungen Karo, dan bagaimana penggunaan Ndungndungen Karo pada saat sekarang ini. Metode yang dipakai dalam penelitian ini adalah metode deskriptif kualitatif, dengan teknik rekaman dan interviu. Metode kepustakaan juga digunakan dalam penelitian ini karena data sekunder dari penelitian ini adalah data-data ya...

  10. Trismus: An unusual presentation following road accident

    Thakur Jagdeep


    Full Text Available Trismus due to trauma usually follows road accidents leading to massive faciomaxillary injury. In the literature there is no report of a foreign body causing trismus following a road accident, this rare case is an exception. We present a case of isolated presentation of trismus following a road accident. This case report stresses on the thorough evaluation of patients presenting with trismus following a road accident.

  11. Detection and analysis of accident black spots with even small accident figures.

    Oppe, S.


    Accident black spots are usually defined as road locations with high accident potentials. In order to detect such hazardous locations we have to know the probability of an accident for a traffic situation of some kind, or the mean number of accidents for some unit of time. In almost all procedures

  12. Sifat Anatomi dan Fisis Kelapa Hibrida

    Hutabarat, Marihot Hamonangan


    Penelitian ini bertujuan untuk mengevaluasi sifat anatomis dan fisis batang kelapa hibrida. Ciri anatomi diamati langsung pada sampel dan menggunakan mikroskop untuk pengamatan dimensi seratnya, dan pengujian sifat fisis menggunakan British Standard. Sifat anatomis dan fisis batang kelapa hibrida bervariasi menurut ketinggian dan kedalaman. Struktur anatomis batang kelapa hibrida didominasi oleh vascular bundle dan parenkim. Serat kayu dapat ditemukan didalam vascular bundle dengan rata-r...

  13. Corporate Cost of Occupational Accidents

    Rikhardsson, Pall M.; Impgaard, M.


    The systematic accident cost analysis (SACA) project was carried out during 2001 by The Aarhus School of Business and PricewaterhouseCoopers Denmark with financial support from The Danish National Working Environment Authority. Its focused on developing and testing a method for evaluating...

  14. New technology for accident prevention

    Byne, P. [Shiftwork Solutions, Vancouver, BC (Canada)


    This power point presentation examined the effects of fatigue in the workplace and presented 3 technologies designed to prevent or monitor fatigue. The relationship between mental fatigue, circadian rhythms and cognitive performance was explored. Details of vigilance related degradations in the workplace were presented, as well as data on fatigue-related accidents and a time-line of meter-reading errors. It was noted that the direct cause of the Exxon Valdez disaster was sleep deprivation. Fatigue related accidents during the Gulf War were reviewed. The effects of fatigue on workplace performance include impaired logical reasoning and decision-making; impaired vigilance and attention; slowed mental operations; loss of situational awareness; slowed reaction time; and short cuts and lapses in optional or self-paced behaviours. New technologies to prevent fatigue-related accidents include (1) the driver fatigue monitor, an infra-red camera and computer that tracks a driver's slow eye-lid closures to prevent fatigue related accidents; (2) a fatigue avoidance scheduling tool (FAST) which collects actigraphs of sleep activity; and (3) SAFTE, a sleep, activity, fatigue and effectiveness model. refs., tabs., figs.

  15. Work Accidents and Professional Diseases

    Doru Hauptmann


    Full Text Available The major accident is defined as “any event occurred, like an emission of dangerous materials or agents, which emerges from uncontrolled evolutions along the exploitation of any objective that leads to the immediate or delayed occurrence of serious dangers with impact over human health or over the environment, inside or outside the objective in which are involved one or more than one dangerous materials”.The dangerous phenomenon is a potential source of harms. In the ambit of industrial risks of accidental origins, this expression more frequently refers to physical phenomena like conflagrations, explosions, toxic gases dispersion, etc.Any accident scenario relates itself to the potential effects at the level of environmental “targets”. In the case of major accidents, we can distinguish the following categories of “targets”: human (employees of the objective, working or resident people in the nearby of the emplacement; the installation or equipments that may stay at the origin of the accidents (dangerous equipments; certain all-important equipments to ensure the safety level of the installation (critical security equipments: control rooms, civil fire brigade headquarters, etc; goods and structures situated in the installation’ environment (ground water, rivers, soil, flora, fauna.


    Lina Kamelia


    Full Text Available Nyeri kepala dan tidur merupakan dua fenomena yang saling mempengaruhi dengan patomekanisme yang kompleks. Nyeri kepala primer, terutama migren, nyeri kepala klaster dan hypnic headache dapat timbul karena pengurangan waktu tidur, parasomnia, maupun gangguan pada regulasi arsitektur tidur terutama fase rapid eye movement. Sebaliknya, adanya nyeri kepala memicu timbulnya berbagai macam gangguan tidur. Studi pencitraan otak dan biokimia menunjukkan peranan penting melatonin dan nukleus suprachiasmatik   yang mengalami disfungsi pada penderita nyeri kepala yang berhubungan dengan gangguan tidur. [MEDICINA 2013;44:101-104].

  17. Perancangan dan Implementasi Modul Praktikum

    Gita Indah Hapsari


    Full Text Available Kemajuan teknologi berbasis komputer berkembang dengan sangat pesat. Seiring dengan perkembangan jaman, kemajuan  tersebut memberikan pengaruh  terhadap  perubahan cara penyampaian pengajaran yang mengarah pada penggunaan jenis media penyampaian. Praktikum merupakan salah satu bentuk pengajaran yang memberikan pengalaman belajar secara nyata terhadap kondisi sebenarnya di lapangan mengenai penggunaan dan implementasi alat praktek yang berhubungan dengan berbagai materi yang dipelajari oleh mahasiswa dan memiliki tujuan untuk memberikan keterampilan dan pengenalan terhadap mahasiswa/peserta didik. Penelitian ini melakukan implementasi teknologi augmented reality terhadap salah satu modul praktikum yaitu pengenalan tata letak hardware dan Port I/O pada motherboard dan bertujuan sebagai alat bantu penyampaian pengajaran praktikum. Pengimplementasian teknologi augmented reality melibatkan aksi oleh user terhadap media penangkapan gambar motherboard menggunakan web camera dan tampilan pemetaan tata letak hardware dan port i/o pada motherboard. Penelitian telah diimplementasikan dan diujicoba terhadap 3 kelas dengan 97 responder. Adapun hasil dari penelitiannya adalah 83% responder menyukai aplikasi, 77% memahami materi, 84,5% menginginkan aplikasi ini menjadi alat bantu ajar, 65,98% meminta materi untuk dilengkapi dan diperbanyak, 77,3% dapat belajar mandiri menggunakan aplikasi ini, tanpa bantuan dari dosen ataupun asisten.


    Tety Anggita Safitri


    Full Text Available Tujuan penelitian ini adalah untuk menguji pengaruh asimetri informasi terhadap underpricing. Penelitian ini menggunakan sampel 63 perusahaan yang melakukan penawaran umum perdana di Bursa Efek Indonesia dalam kurun waktu 2005-2010. Analisis data menggunakan regresi linier berganda, yaitu menguji proksi asimetri informasi yang terdiri atas ukuran perusahaan, umur perusahaan, proporsi saham yang ditawarkan kepada masyarakat, reputasi underwriter dan reputasi auditor terhadap underpricing. Hasil penelitian ini mengindikasikan bahwa reputasi underwriter dan reputasi auditor berpengaruh terhadap underpricing. Ukuran perusahaan, umur perusahaan dan proporsi saham yang ditawarkan tidak berpengaruh terhadap underpricing.The aim of this research is to examine the effect of assymetric information on underpricing. This research used a sample of 63 companies that make initial public offering on the Indonesia Stock Exchange in the period of 2005-2010. The data analysis is using multiple linear regression, which is testing the proxy of asymmetric information which consists of the firm size, the firm age, the proportion of shares offered to the public, underwriter reputation and auditor reputation on underpricing. This research indicates that underwriter reputation and auditor reputation have a significant effect on underpricing. The firm size, the firm age and the proportion of shares offered to the public have no significant effect on underpricing.

  19. 48 CFR 836.513 - Accident prevention.


    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Accident prevention. 836... prevention. The contracting officer must insert the clause at 852.236-87, Accident Prevention, in solicitations and contracts for construction that contain the clause at FAR 52.236-13, Accident Prevention....

  20. 48 CFR 1836.513 - Accident prevention.


    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Accident prevention. 1836... 1836.513 Accident prevention. The contracting officer must insert the clause at 1852.223-70, Safety and Health, in lieu of FAR clause 52.236-13, Accident Prevention, and its Alternate I....

  1. 48 CFR 636.513 - Accident prevention.


    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Accident prevention. 636... CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 636.513 Accident prevention. (a) In... contracting activities shall insert DOSAR 652.236-70, Accident Prevention, in lieu of FAR clause...

  2. Barriers to learning from incidents and accidents

    Dechy, N.; Dien, Y.; Drupsteen, L.; Felicio, A.; Cunha, C.; Roed-Larsen, S.; Marsden, E.; Tulonen, T.; Stoop, J.; Strucic, M.; Vetere Arellano, A.L.; Vorm, J.K.J. van der; Benner, L.


    This document provides an overview of knowledge concerning barriers to learning from incidents and accidents. It focuses on learning from accident investigations, public inquiries and operational experience feedback, in industrial sectors that are exposed to major accident hazards. The document disc

  3. Impacto de la "Ley de promoción de la autonomía personal y atención a las personas en situación de dependencia" en las personas con trastorno mental grave.

    Teodosia Sobrino Calzado


    Full Text Available La Ley 39/2006, conocida como Ley de Dependencia, ha generado, desde su aprobación, desconfianza por estar orientada a la atención de la dependencia, siendo la promoción de la autonomía personal un elemento apenas desarrollado y secundario.
    En el caso de las personas con trastorno mental grave, lo que mayor preocupación ha causado a las organizaciones de profesionales de la salud mental y a las asociaciones de familiares ha sido la compatibilidad de dicha Ley con las prestaciones del Sistema Nacional de Salud y si el baremo establecido se ajustaba a las necesidades de este colectivo.
    Este artículo recoge el trabajo realizado desde diferentes comunidades autónomas por diferentes profesionales en un intento de, tras un análisis de la Ley, plantear a la administración responsable de la misma el necesario ajuste para adaptarla a las características de las personas con trastorno mental grave.
    Se analizan, en primer lugar, sus fortalezas y debilidades. Posteriormente se exponen tres formas diferentes de contrarrestar sus riesgos, en tres comunidades autónomas diferentes. Finalmente se dan las claves de los aspectos de la Ley sobre los que hay que seguir trabajando para que sea una oportunidad para las personas con trastorno mental grave, y no una barrera

  4. Analysing truck position data to study roundabout accident risk

    Kamla, Jwan Jameel Shekh Mohammed


    In order to reduce accident risk, highway authorities prioritise maintenance budgets partly based upon previous accident history. However, as accident rates have continued to fall in most contexts, this approach has become problematic as accident ‘black spots’ have been treated and the number of accidents at any individual site has fallen. Another way of identifying sites of higher accident risk might be to identify near-miss accidents (where an accident nearly happened, but was avoided), whi...

  5. The Role of Oxidative Stress on the Pathogenesis of Graves' Disease

    Miloš Žarković


    Full Text Available Graves' disease is a most common cause of hyperthyroidism. It is an autoimmune disease, and autoimmune process induces an inflammatory reaction, and reactive oxygen species (ROSs are among its products. When balance between oxidants and antioxidants is disturbed, in favour of the oxidants it is termed “oxidative stress” (OS. Increased OS characterizes Graves' disease. It seems that the level of OS is increased in subjects with Graves' ophthalmopathy compared to the other subjects with Graves' disease. Among the other factors, OS is involved in proliferation of orbital fibroblasts. Polymorphism of the 8-oxoG DNA N-glycosylase 1 (hOGG1 involved in repair of the oxidative damaged DNA increases in the risk for developing Grave's disease. Treatment with glucocorticoids reduces levels of OS markers. A recent large clinical trial evaluated effect of selenium on mild Graves' ophthalmopathy. Selenium treatment was associated with an improved quality of life and less eye involvement and slowed the progression of Graves' orbitopathy, compared to placebo.



    Penelitian ini bertujuan membandingkan diversitas dan kerapatan mangrove dengan kepadatan gastropoda dan bivalvia di mangrove alami dan rehabilitasi. Pengukuran ekosistem mangrove menggunakan transek kuadrat 10 m x 10 m. Kelimpahan dan kepadatan gastropoda dan bialvia menggunakan transek kuadrat berukuran 1 m x 1 m. Analisis nMDS, cluster untuk melihat hubungan karekteristik mangrove alami dan rehabilitasi dianalisis secara deskriptif dan analisis regresi untuk mendetermi...

  7. Radioiodine treatment of recurrent hyperthyroidism in patients previously treated for Graves' disease by subtotal thyroidectomy

    Vestergaard, H; Laurberg, P


    Radioiodine therapy is often employed for treatment of patients with relapse of hyperthyroidism due to Graves' disease, after previous thyroid surgery. Little is known about the outcome of this treatment compared to patients with no previous surgery. A total of 20 patients who had received surgical...... treatment for Graves' hyperthyroidism 1-46 years previously and with relapse of the hyperthyroidism, and 25 patients with hyperthyroidism due to Graves' disease and no previous thyroid surgery were treated with radioiodine, following the same protocol. Early after treatment the previously operated patients...

  8. A numerical study on a lumped-parameter model and a CFD code coupling for the analysis of the loss of coolant accident in a reactor containment; Etude numerique 0D-multiD pour l'analyse de perte de refrigerant dans une enceinte de confinement d'un reacteur nucleaire

    Choi, Y.J.


    In the case of PWR severe accident (Loss of Coolant Accident, LOCA), the inner containment ambient properties such as temperature, pressure and gas species concentrations due to the released steam condensation are the main factors that determine the risk. For this reason, their distributions should be known accurately, but the complexity of the geometry and the computational costs are strong limitations to conduct full three-dimensional numerical simulations. An alternative approach is presented in this thesis, namely, the coupling between a lumped-parameter model and a CFD. The coupling is based on the introduction of a 'heat transfer function' between both models and it is expected that large decreases in the CPU-costs may be achieved. First of all, wall condensation models, such as the Uchida or the Chilton-Colburn models which are implemented in the code CAST3M/TONUS, are investigated. They are examined through steady-state calculations by using the code TONUS-0D, based on lumped parameter models. The temperature and the pressure within the inner containment are compared with those reported in the archival literature. In order to build the 'heat transfer function', natural convection heat transfer is then studied by using the code CAST3M for a partitioned cavity which represents a simplified geometry of the reactor containment. At a first step, two-dimensional natural convection heat transfer without condensation is investigated only. Either the incompressible-Boussinesq fluid flow model or the asymptotic low Mach model are considered for solving the time dependent conservation equations. The SUPG finite element method and the implicit scheme are applied for the numerical discretization. The computed results are qualified by the second-order Richardson extrapolation method which allows obtaining the so-called 'Exact values', i.e. grid size independent values. The computations are also validated through non-partitioned cavity case

  9. IJTIHAD KONTEMPORER (Problem dan Solusinya

    Mustaqim Mustaqim


    Full Text Available Ijtiha>d adalah merupakan bahasan yang tak henti-hentinya menjadi kajian ketat para ulama sejak dulu sampai kini, seperti imam al-Ghaza>li> membahas dalam bukunya al mustasfa, demikian juga imam assyaukani membahas dalam bukunya irsyadul puhul dan masih banyak lagi ulama yung membahas dalam masalah ijtiha>d ini, Begitu juga dari kalangan ulama kontemporer seperti, Shaykh Ah}mad Ibra>hi>m, Shaykh ‘Abd al-Wahha>b Khala>f, Dr. Yu>suf al-Qarad}awi>, Dr. T{a>ha> Jabi>r dan masih banyak lagi selain mereka. Bersama itu, pintu ijtiha>d tak pernah tertutup, karena kehidupan masih terus berlanjut, dan kejadian-kejadian masih terus berkembang, timbulnya krisis ekonomi dan sosial, rangkaian masalah dan berbagai macam solusinya, desakan kejadian yang tak pernah dipersiapkan oleh manusia yang menimbulkan aneka ragam kesulitan, dan terus mengakar sampai menyelami kehidupan tekhnologi, perdagangan, atau kehidupan individu dan umum. Berawal dari sini maka merupakan cambuk bagi seorang muslim dengan kebebasan berpikirnya untuk mengerahkan segala kemampuannya terhadap seluruh masalah, sebab islam adalah agama kehidupan yang mencakup segala aspek, Islam bukan hanya berurusan dengan masalah akhirat saja, tapi Islam lahir dalam bentuk yang luas, mampu mengobati penyakit sosial, ekonomi, internasional, dll, dan fiqih sendiri bukan hanya merupakan peraturan belaka, melainkan fiqih mencakup segala masalah tergantung kejadian dan kebutuhan, fiqih masih siap menerima perubahan selama masih tetap dalam rel qur’an dan sunnah, dari sinilah perlu adanya ijtiha>d, Ijtiha>d merupakan hal yang terbuka bagi seorang muslim agar merasakan kebebasan berfikir yang sempurna karena ijtiha>d adalah merupakan sebuah bukti akan luas dan mudahnya syariat islam.

  10. Strategies of radioiodine therapy for Graves' disease

    Lind, P. [Department of Nuclear Medicine and Endocrinology, PET Center Klagenfurt, LKH Klagenfurt (Austria)


    Several therapeutic options are available for the treatment of Graves' disease (GD), including long-term antithyroid drug medication (ATD), near-total resection (NTR) and radioiodine therapy (RIT). These treatments are used with different frequencies depending on geographical location, size of the goitre, age of the patient and experience of the physician. It should be noted that RIT is still being applied more frequently in the United States than in Europe. Despite the fact that RIT was introduced as long ago as 1941, several questions are still the subject of debate: Should a fixed dose or a calculated dose be used. If the dose is calculated, how many Grays (Gy) should be delivered to the thyroid? What is the goal of RIT in GD? Which factors, including ATD, influence the outcome of RIT? Is RIT appropriate in GD with Graves' ophthalmopathy (GO)? Although not all these questions have been answered yet, conclusions can be derived regarding a general strategy for use of RIT in GD. As with surgery, the goal of RIT in GD is euthyroidism with or without L-thyroxine medication. There is a clear advantage of dose calculation over use of a fixed dose because the only factor influencing the outcome is the dose delivered to a certain thyroid volume. To minimise recurrent hyperthyroidism, an ablative approach using a delivered dose of 250 Gy is widely accepted. Beside pretherapeutic T{sub 3} levels, thyroid volume and 24-h thyroid uptake, ATD may influence the outcome of RIT. Today it is accepted by most thyroidologists that, if ATD medication is necessary in overt hyperthyroidism, it should be withdrawn at least 2 days before RIT. In patients with GD and GO, RIT may worsen GO. If RIT is performed in GO it should be done under a 3-month steroid medication regimen. In conclusion, RIT can be considered an appropriate and cost-effective therapy in GD, although the decision regarding treatment should be taken on an individual basis, paying due respect to the course and

  11. [Hanggliding accidents. Distribution of injuries and accident analysis].

    Ballmer, F T; Jakob, R P


    Paragliding--a relatively new sport to Switzerland--brought 23 patients with 48 injuries (38% lower limb and 29% spinal) within a period of 8 months to the Inselspital University hospital in Berne. The aim of the study in characterizing these injuries is to formulate some guidelines towards prevention. With over 90% of accidents occurring at either take off or landing, emphasis on better training for the beginner is proposed with strict guidelines for the more experienced pilot flying in unfavourable conditions.

  12. Exploratory analysis of Spanish energetic mining accidents.

    Sanmiquel, Lluís; Freijo, Modesto; Rossell, Josep M


    Using data on work accidents and annual mining statistics, the paper studies work-related accidents in the Spanish energetic mining sector in 1999-2008. The following 3 parameters are considered: age, experience and size of the mine (in number of workers) where the accident took place. The main objective of this paper is to show the relationship between different accident indicators: risk index (as an expression of the incidence), average duration index for the age and size of the mine variables (as a measure of the seriousness of an accident), and the gravity index for the various sizes of mines (which measures the seriousness of an accident, too). The conclusions of this study could be useful to develop suitable prevention policies that would contribute towards a decrease in work-related accidents in the Spanish energetic mining industry.

  13. Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

    Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa (Toranomon Hospital, Tokyo (Japan))


    HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after [sup 131]I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after [sup 131]I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after [sup 131]I therapy.(author).

  14. Cradle-to-Grave Logistic Technologies for Exploration Missions

    Broyan, James L.; Ewert, Michael K.; Shull, Sarah


    Human exploration missions under study are very limited by the launch mass capacity of exiting and planned vehicles. The logistical mass of crew items is typically considered separate from the vehicle structure, habitat outfitting, and life support systems. Consequently, crew item logistical mass is typically competing with vehicle systems for mass allocation. NASA is Advanced Exploration Systems (AES) Logistics Reduction and Repurposing (LRR) Project is developing four logistics technologies guided by a systems engineering cradle-to-grave approach to enable used crew items to augment vehicle systems. Specifically, AES LRR is investigating the direct reduction of clothing mass, the repurposing of logistical packaging, the processing of spent crew items to benefit radiation shielding and water recovery, and the conversion of trash to propulsion supply gases. The systematic implementation of these types of technologies will increase launch mass efficiency by enabling items to be used for secondary purposes and improve the habitability of the vehicle as the mission duration increases. This paper provides a description, benefits, and challenges of the four technologies under development and a status of progress at the mid ]point of the three year AES project.

  15. Sheehan's syndrome co-existing with Graves' disease.

    Arpaci, D; Cuhaci, N; Saglam, F; Ersoy, R; Cakir, B


    Sheehan's syndrome (SS), which is an important cause of hypopituitarism, is common in developing countries. The most common presentation is the absence of lactation and amenorrhea. Hypothyroidism rather than hyperthyroidism is the usual expected phenomenon in SS. Postpartum hyperthyroidism is also common and Graves' disease (GD) is an important cause of postpartum hyperthyroidism. Here we report a case of a 22-year-old female patient in our clinic presented symptoms of amenorrhea, lack of lactation, palpitations and sweating. Her physical examination revealed goiter, moist skin and proptosis. Her laboratory evaluation showed suppressed thyroid stimulating hormone, elevated levels of free thyroxine and free triiodothyronine. Thyroid antibodies were positive. Tec 99m thyroid scintigraphy results were gland hyperplasia and increased uptake consistent with GD. She gave birth 7 months ago; after delivery she had a history of prolonged bleeding, amenorrhea and inability to lactate. She had hypogonadotropic hypogonadism, hyperprolactinemia and growth hormone deficiency. Serum cortisol and adrenocorticotropic hormone levels were normal. Her magnetic resonance imaging was empty sella. Our diagnosis was GD co-existing with SS. GD with concomitant hypopituitarism is rare but has been described previously, but there are no reports of GD occurring with SS. In this case study, we report a patient with GD associated with SS.

  16. Special features of Graves' disease in early childhood.

    Segni, M; Leonardi, E; Mazzoncini, B; Pucarelli, I; Pasquino, A M


    Graves' disease (GD) is extremely rare in children younger than 4 years of age, but if not recognized and treated it can seriously interfere with growth and development. We report three unrelated children, all females, in whom GD occurred before the age of 3. These children presented with goiter, exophthalmos, tachycardia, and hyperactivity. Moreover, one showed a severe psychomotor delay, and had previously undergone surgery due to craniosynostosis; the other two manifested a language delay. All had high thyroid hormones and thyrotropin receptor antibody (TRAb) serum levels that clearly indicated autoimmune hyperthyroidism. In all of them, the disease presumably had developed during the first or second year of life. No maternal history of GD was present in two. The third child was born to a mother affected with GD during pregnancy, but it is likely that her GD began to develop after 6 months of life. These children are being treated with methimazole, and treatment is still necessary after 32 months. TRAb levels were persistently high at follow-up. Psychological evaluation including language development at follow-up was appropriate for age in two children; the third child improved, but severe mental retardation is still evident. GD assessment in early childhood also needs to focus on psychological evaluation. Pediatricians should be aware of the possibility of permanent brain damage and craniosynostosis due to hyperthyroidism in infancy.

  17. [Graves' disease: ultrasonographic, color Doppler and histological aspects].

    Messina, G; Viceconti, N; Trinti, B


    The aim of the present work was to study the relationship between thyroid low echogenicity, the thyroid blood flow by color-Doppler (CD) and histological features in patients with Graves' disease (GD). Thyroid ultrasonography and CD was performed on 28 patients with GD. In 5 patients has been compared CD with histology. The thyroid volume was higher in 100% of patients with GD at the onset rather than in euthyroidism. Diffuse hypoechogenicity of the thyroid was discovered in 100% of patients with GD at the onset and it persisted in 57.1% of patients that became euthyroid after therapy. Qualitative CD resulted in different patterns that were classified as follow: pattern A ("thyroid inferno") in 17 patients (60.7%); pattern B (mildly increased of parenchymal blood flow) in 11 patients (39.3%). In the 5 histological proven cases, in the pattern A (3 cases) there was a diffuse microfollicular hyperplasia with functional activation notes. There was lymphocytic infiltration. While in the pattern B (two cases) there were a non-follicular hypercellular nodule with pseudocapsule and rare colloid. We conclude that there are two different histological types with different CD patterns in GD.

  18. Fatal motorcycle accidents and alcohol

    Larsen, C F; Hardt-Madsen, M


    A series of fatal motorcycle accidents from a 7-year period (1977-1983) has been analyzed. Of the fatalities 30 were operators of the motorcycle, 11 pillion passengers and 8 counterparts. Of 41 operators 37% were sober at the time of accident, 66% had measurable blood alcohol concentration (BAC......); 59% above 0.08%. In all cases where a pillion passenger was killed, the operator of the motorcycle had a BAC greater than 0.08%. Of the killed counterparts 2 were non-intoxicated, 2 had a BAC greater than 0.08%, and 4 were not tested. The results advocate that the law should restrict alcohol...... consumption by pillion passengers as well as by the motorcycle operator. Suggestions made to extend the data base needed for developing appropriate alcohol countermeasures by collecting sociodemographic data on drivers killed or seriously injured should be supported....

  19. Evaluation de la fonction hépatique au cours du paludisme grave chez les enfants de moins de cinq ans à Kinshasa en République Démocratique du Congo

    Kabamba, Arsène Tshikongo; Mukuku, Olivier; Shamashanga, Laurent Kwete; Kamunga, Daniel Badibanga; Bokanya, Alex Impele; Lukumwena, Zet Kalala; Longanga, Albert Otshudi


    Introduction Le paludisme est toujours compté parmi les problèmes de santé publique prioritaires en République Démocratique du Congo suite au nombre de malades et de décès qu'il provoque. Cette étude évalue l'atteinte de la fonction hépatique au cours du paludisme grave chez les enfants de moins de 5 ans. Méthodes Il s'agit d'une étude cas-témoins menée de janvier à juin 2013 à Kinshasa (République Démocratique du Congo) où le dosage des bilirubines totale, directe et indirecte et la mesure de l'activité enzymatique de la Glutamate Pyruvate Transaminase (GPT), de la Glutamate Oxaloacétate Transaminase (GOT) et du taux d'hémoglobine ont été faits chez 46 enfants âgés de moins de 5 ans atteints de paludisme grave (groupe I) et chez 46 autres considérés sains avec une goutte négative (groupe II). Les résultats obtenus ont été comparés dans les deux groupes et le seuil de signification a été fixé à p bilirubine directe, la bilirubine indirecte et la bilirubine totale chez les enfants atteints du paludisme grave. Ces analyses montrent une différence significative en défaveur de ces derniers (p < 0,001). Conclusion En effet, cette augmentation des taux plasmatiques des paramètres biologiques analysés observée chez les enfants gravement impaludés traduit ainsi une altération de la fonction hépatique au cours d'un paludisme grave chez l'enfant de moins de cinq ans. PMID:25870721

  20. Practical approaches in accident analysis

    Stock, M.

    An accident analysis technique based on successive application of structural response, explosion dynamics, gas cloud formation, and plant operation failure mode models is proposed. The method takes into account the nonideal explosion characteristic of a deflagration in the unconfined cloud. The resulting pressure wave differs significantly from a shock wave and the response of structures like lamp posts and walls can differ correspondingly. This gives a more realistic insight into explosion courses than a simple TNT-equivalent approach.

  1. Analisis dan Optimasi Desain Sistem Reaktor Gas Temperatur Tinggi RGTT200K dan RGTT200KT

    Mohammad Dhandhang Purwadi


    dengan penyelesaian persamaan aljabar linier dari model RGTT200K dan RGTT200KT. Dari analisis dan optimasi ini dihasilkan desain konseptual sistem RGTT200K dan RGTT200KT dengan spesifikasi thermal-flow teras sama, dan peningkatan EUF dari 63% menjadi 80,14% (untuk RGTT200K dan dari 63,6% menjadi 78,02% (untuk RGTT200KT.

  2. Exfoliative Cheilitis dan Penatalaksanaannya

    Dewi Agustina


    Full Text Available Latar Belakang: Exfoliative cheilitis adalah suatu keadaan inflamatori kronis superfisisal yang ditandai dengan adanya pengelupasan permukaankeratin bibir sedangkan area yang lain terjadi pembentukan lapisan keratin. Tujuan: untuk melaporkan suatu  kasus Exfoliative cheilitis yang diikuti +  selama 2 bulan beserta penatalaksanaanya. Laporan kasus: seorang wanita berusia 52 tahun mengeluh bibir bawahnya pecah-pecah, terasa kering dan panas berdasarkan pemeriksaan subyektif dan klinis, Exfoliative cheilitis ditetapkan sebagai diagnosis kerja. Penatalaksanaanya: Komunikasi-Informasi-Edukasi (KIE diberikan kepada pasien pada awal kunjungan disertai pemberian metil prednisolon, Vitamin B1,6,12 dan anjuran untuk menghentikan kebiasaan menjilat-jilat bibir bawah, menghindari stress dan meningkatkan asupan makanan yang mengandung vitamin A. Pada kunjungna berikutnya pemberian metil prednisolon dihentikan karena terdeteksi adanya peningkatan tekanan darah. Untuk selanjutnya kondisi bibir bawah dievaluasi +  selama 2 bulan. Kesimpulan: Progresitas Exfoliative cheilitis dapat dihentikan dengan bantuan KIE serta menghindari faktor pemicu stress, yang pada akhirnya akan dapat meminimalisir aktivitas factitious berupa menjilat-jilat bibir bawah.    Background: Exfoliative cheilitis is a chronic superficial inflammatory condition that is characterized by regular peeling of a superficial excessive layer of karatin, on the other hand, keratinization is developed in the other area. Aim: to report an Exfoliative cheilitis case monitored for two months and its management. Case Report: a 52 year female has been suffering from fissured lower lip with dry and burning sensations. According to subjective and clinical examinations, Exfoliative cheilitis was determined as the working diagnosis. Management: Communication-Information-Education (CIE were given to the patient at the first visit, besides metyl prednisolon and vitamin B1,6,12 administrations. Patient was

  3. [Multicenter paragliding accident study 1990].

    Lautenschlager, S; Karli, U; Matter, P


    During the period from 1.1.90 until 31.12.90, 86 injuries associated with paragliding were analyzed in a prospective study in 12 different Swiss hospitals with reference to causes, patterns, and frequencies. The injuries showed a mean score of over 2 and were classified as severe. Most frequent spine injuries (36%) and lesions of the lower extremity (35%) with a high risk of the ankles were diagnosed. One accident was fatal. 60% of the accidents happened during landing, 26% during launching and 14% during flight. Half of the pilots were affected during their primary training course. Most accidents were caused by inflight error of judgement--especially incorrect estimation of wind conditions--and further the choice of unfavourable landing sites. In contrast to previous injury-reports, only one equipment failure could be noted, but often the equipment was not corresponding with the experience and the weight of the pilot. To reduce the frequency of paragliding-injuries an accurate choice of equipment and an increased attention to environmental factors is mandatory. Furthermore an education-program regarding the attitude and intelligence of the pilot should be included in training courses.

  4. Medical consequences of Chernobyl accident

    Galstyan I.A.


    Full Text Available Aim: to study the long-term effects of acute radiation syndrome (ARS, developed at the victims of the Chernobyl accident. Material and Methods. 237 people were exposed during the accident, 134 of them were diagnosed with ARS. Dynamic observation implies a thorough annual examination in a hospital. Results. In the first 1.5-2 years after the ARS mean group indices of peripheral blood have returned to normal. However, many patients had transient expressed moderate cytopenias. Granulocytopenia, thrombocytopenia, lymphopenia and erythropenia were the most frequently observed things during the first 5 years after the accident. After 5 years their occurences lowered. In 11 patients the radiation cataract was detected. A threshold dose for its development is a dose of 3.2 Gy Long-term effects of local radiation lesions (LRL range from mild skin figure smoothing to a distinct fibrous scarring, contractures, persistently recurrent late radiation ulcers. During all years of observation we found 8 solid tumors, including 2 thyroid cancers. 5 hematologic diseases were found. During 29 years 26 ARS survivors died of various causes. Conclusion. The health of ones with long-term ARS effects is determined by the evolution of the LRL effects on skin, radiation cataracts, hema-tological diseases and the accession of of various somatic diseases, not caused by radiation.

  5. Radioiodine therapy for Graves' disease: case selection and restrictions recommended to patients in North America.

    Wartofsky, L


    Each of the three major therapies for Graves' disease has its own advantages, disadvantages, indications, and contraindications. Today, radioactive iodine (RAI) therapy is the most commonly employed means of therapy for Graves' disease in the United States, with approximately 70% of patients so treated after initial presentation and an additional fraction of arguably 10-15% treated with RAI after failure of antithyroid drugs or surgery. RAI therapy is acknowledged to have the clear-cut advantage of being safe, with low morbidity and cost. The indications for RAI therapy are clear and noncontroversial for most patients with Graves' disease. Moreover, RAI treatment is employed by some thyroidologists for subclinical thyrotoxicosis (normal T4 or T3 but immeasurable TSH), particularly in patients > age 45 due to risks of atrial fibrillation. RAI therapy is not considered indicated or is contraindicated during breast feeding and in pregnancy, subacute thyroiditis, postpartum thyroiditis, struma ovarii, pituitary (TSH-driven) hyperthyroidism, euthyroid, hyperthyroxinemia, and thyroid hormone resistance. Opinions vary on the use of RAI therapy in children with Graves' disease; generally, a lower age cutoff of 17 years is acceptable in most clinics. Even more controversial is whether RAI therapy in the presence of Graves' ophthalmology constitutes a risk for worsening ophthalmopathy. Resolution of this latter issue awaits more definitive studies, but RAI therapy is likely to remain the first choice for most patients with Graves' disease.

  6. Prognostic factors of the outcomes of subtotal thyroid resection in graves disease

    A J Tsurkan


    Full Text Available The long-term results of subtotal resection of thyroid gland on 82 patients with Graves' disease were studied. There was analysed the influence of three factors on outcome at Graves' disease: volume of a thyroid gland before operation, morphological structure of thyroid tissue and volume of thyroid remnant. Outcomes of subtotal resection of thyroid gland were studied on the basis of thyrotropic hormone level of blood in 3, 6, 12 months, 2 and 3 years after operation. Based on research it has been established that the volume of thyroid gland before operation does not influence to outcome of subtotal resection of thyroid gland with Graves' disease. Morphological changes of removed thyroid tissue in the form of colloidal nodules at patients with Graves' disease statistically significantly raise risk of development of postoperative complications after subtotal resection of thyroid gland. The surgeon defining the volume of thyroid rem-nant durng the operation could be mistaken as towards it's increase so towards it's reduction, with an average deviation about 35%. Various outcomes of subtotal resection of thyroid gland at the same volume of thyroid remnant let us conclude that this out-come depends more on intensity of autoimmune process rather than on the volume of thyroid remnant. According modern views to aetiology and patogenesis of Graves' disease, the optimum volume of operation at Graves' disease is thyroidectomy.

  7. Refractory Graves' Disease Successfully Cured by Adjunctive Cholestyramine and Subsequent Total Thyroidectomy

    Yeoree Yang


    Full Text Available The three major forms of treatment for Graves thyrotoxicosis are antithyroid drugs, radioactive iodine therapy and thyroidectomy. Surgery is the definitive treatment for Graves thyrotoxicosis that is generally recommended when other treatments have failed or are contraindicated. Generally, thyrotoxic patients should be euthyroid before surgery to minimize potential complications which usually requires preoperative management with thionamides or inorganic iodine. But several cases of refractory Graves' disease have shown resistance to conventional treatment. Here we report a 40-year-old female patient with Graves' disease who complained of thyrotoxic symptoms for 7 months. Her thyroid function test and thyroid autoantibody profiles were consistent with Graves' disease. One kind of thionamides and β-blocker were started to control her disease. However, she was resistant to nearly all conventional medical therapies, including β-blockers, inorganic iodine, and two thionamides. She experienced hepatotoxicity from the thionamides. What was worse is her past history of serious allergic reaction to corticosteroids, which are often used to help control symptoms. A 2-week regimen of high-dose cholestyramine improved her uncontrolled thyrotoxicosis and subsequent thyroidectomy was successfully performed. In conclusion, cholestyramine could be administered as an effective and safe adjunctive agent for preoperative preparation in patients with severe hyperthyroid Graves's disease that is resistant to conventional therapies.

  8. [Accidents in travellers - the hidden epidemic].

    Walz, Alexander; Hatz, Christoph


    The risk of malaria and other communicable diseases is well addressed in pre-travel advice. Accidents are usually less discussed. Thus, we aimed at assessing accident figures for the Swiss population, based on data of the register from 2004 to 2008 of the largest Swiss accident insurance organization (SUVA). More than 139'000 accidents over 5 years showed that 65 % of the accidents overseas are injuries, and 24 % are caused by poisoning or harm by cold, heat or air pressure. Most accidents happened during leisure activities or sports. More than one third of the non-lethal and more than 50 % of the fatal accidents happened in Asia. More than three-quarters of non-lethal accidents take place in people between 25 and 54 years. One out of 74 insured persons has an accident abroad per year. Despite of many analysis short-comings of the data set with regard to overseas travel, the figures document the underestimated burden of disease caused by accidents abroad and should affect the given pre-health advice.

  9. Severe Accident Recriticality Analyses (SARA)

    Frid, W. [Swedish Nuclear Power Inspectorate, Stockholm (Sweden); Hoejerup, F. [Risoe National Lab. (Denmark); Lindholm, I.; Miettinen, J.; Puska, E.K. [VTT Energy, Helsinki (Finland); Nilsson, Lars [Studsvik Eco and Safety AB, Nykoeping (Sweden); Sjoevall, H. [Teoliisuuden Voima Oy (Finland)


    Recriticality in a BWR has been studied for a total loss of electric power accident scenario. In a BWR, the B{sub 4}C control rods would melt and relocate from the core before the fuel during core uncovery and heat-up. If electric power returns during this time-window unborated water from ECCS systems will start to reflood the partly control rod free core. Recriticality might take place for which the only mitigating mechanisms are the Doppler effect and void formation. In order to assess the impact of recriticality on reactor safety, including accident management measures, the following issues have been investigated in the SARA project: 1. the energy deposition in the fuel during super-prompt power burst, 2. the quasi steady-state reactor power following the initial power burst and 3. containment response to elevated quasi steady-state reactor power. The approach was to use three computer codes and to further develop and adapt them for the task. The codes were SIMULATE-3K, APROS and RECRIT. Recriticality analyses were carried out for a number of selected reflooding transients for the Oskarshamn 3 plant in Sweden with SIMULATE-3K and for the Olkiluoto 1 plant in Finland with all three codes. The core state initial and boundary conditions prior to recriticality have been studied with the severe accident codes SCDAP/RELAP5, MELCOR and MAAP4. The results of the analyses show that all three codes predict recriticality - both superprompt power bursts and quasi steady-state power generation - for the studied range of parameters, i. e. with core uncovery and heat-up to maximum core temperatures around 1800 K and water flow rates of 45 kg/s to 2000 kg/s injected into the downcomer. Since the recriticality takes place in a small fraction of the core the power densities are high which results in large energy deposition in the fuel during power burst in some accident scenarios. The highest value, 418 cal/g, was obtained with SIMULATE-3K for an Oskarshamn 3 case with reflooding



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  11. Singkatan Dan Akronim Dalam Chatting Di Internet

    Hervina M. S.


    Penelitian ini menganalis pola singkatan dan akronim dalam chatting di internet. Tujuan penelitian ini adalah mendeskripsikan pola singkatan dan akronim dalam chatting di internet dan mendeskripsikan pola singkatan dan akronim yang paling dominan digunakan dalam chatting di internet. Teori yang digunakan adalah singkatan, akronim, bahasa dalam chatting, sosiolinguistik. Pengumpulan data digunakan dengan metode simak, yaitu penyimakan terhadap penggunaan bahasa (Sudaryanto,1993:133), dan tekni...


    David Samiyono


    Interaksi antar etnis, agama dan budaya bukanlah barang langka di Bali. Sejak semula hal tersebut sudah ada, ketika pulau ini menjadi locus perdagangan hasil bumi. Sebab sesungguhnya kebudayaan Bali menjujung tinggi nilai-nilai keseimbangan dan harmonisasi antar manusia dengan Tuhan (perhyangan, dengan sesama (pawongan dan dengan lingkungan (palemahan. Konsep ini disebut Tri hita karana. Bali kini berubah. Budayanya berorientasi pada jasa, yang berkait dengan industri pariwisata. Sikap orang Bali kini tidak lagi ramah dan harmoni. Akibat ledakan bom dalam bulan Oktober 2002 dan 2005, masyarakat lebih berhati-hati terhadap para pendatang. Ajeg Bali merupakan kearifan lokal –agama dan budaya– masyarakat Bali dalam rangka menanggulangi pengaruh luar yang mengakibatkan perubahan di berbagai bidang sehingga identitas kebalian mengalami degradasi. Ajeg Bali merupakan bentuk resistensi masyar­akat Bali dalam rangka membatasi pendatang dari luar Bali. Kajian ini berusaha untuk menjawab pertanyaan “apakah Ajeg Bali, sebuah kearifan lokal masyarakat Bali dapat membendung pengaruh budaya, agama dan ekonomi masyarakat Bali?”

  13. Current trends in the management of Graves' disease

    Solomon, B.; Glinoer, D.; Lagasse, R.; Wartofsky, L. (Walter Reed Army Medical Center, Washington, DC (USA))


    Members of the American Thyroid Association were invited to participate in a survey of the management of Graves' disease. One primary case and several variations were provided, which differed in respect to age, sex, goiter size, severity, etc. The questionnaire was based on the format used in a similar survey of members of the European Thyroid Association. The aim of the survey was to determine (1) how expert thyroidologist employ diagnostic procedures for this disorder, and (2) the choice of therapy of the three treatment options and its manner of implementation. Questionnaires were sent only to clinically active members. The overall response rate was 62%. Data analysis was possible on 52% of members surveyed and was performed using SPSS and a specific Fortran program. In the laboratory evaluation of the primary case a radioiodine uptake, scan, serum total T4, and basal TSH were requested by 92%, 47%, 83%, and 66%, respectively, with 84% of respondents using an ultrasensitive TSH assay. For management of the primary case, radioiodine treatment was the first choice of 69% of the respondents. Antithyroid drugs were used briefly (3-7 days) before 131I by 28%, whereas 41% said they would employ thioureas after 131I. Of those using 131I, 66% tailored the dose to achieve euthyroidism as the goal of therapy, while 34% aimed for hypothyroidism requiring T4 replacement. Only 30% of respondents chose thioureas as a first line of treatment (72% propylthiouracil; 28% tapazole). The duration of drug therapy was a predetermined fixed interval for 80% of the respondents, with 90% treating for 1-2 yr. Other specific trends in diagnostic approach and therapeutic preferences were identified for the eight variations on the primary case problem.

  14. Lithium as an Alternative Option in Graves Thyrotoxicosis

    Ishita Prakash


    Full Text Available A 67-year-old woman was admitted with signs and symptoms of Graves thyrotoxicosis. Biochemistry results were as follows: TSH was undetectable; FT4 was >6.99 ng/dL (0.7–1.8; FT3 was 18 pg/mL (3–5; TSI was 658% (0–139. Thyroid uptake and scan showed diffusely increased tracer uptake in the thyroid gland. The patient was started on methimazole 40 mg BID, but her LFTs elevated precipitously with features of fulminant hepatitis. Methimazole was determined to be the cause and was stopped. After weighing pros and cons, lithium was initiated to treat her persistent thyrotoxicosis. Lithium 300 mg was given daily with a goal to maintain between 0.4 and 0.6. High dose Hydrocortisone and propranolol were also administered concomitantly. Free thyroid hormone levels decreased and the patient reached a biochemical and clinical euthyroid state in about 8 days. Though definitive RAI was planned, the patient has been maintained on lithium for more than a month to control her hyperthyroidism. Trial removal of lithium results in reemergence of thyrotoxicosis within 24 hours. Patient was maintained on low dose lithium treatment with lithium level just below therapeutic range which was sufficient to maintain euthyroid state for more than a month. There were no signs of lithium toxicity within this time period. Conclusion. Lithium has a unique physiologic profile and can be used to treat thyrotoxicosis when thionamides cannot be used while awaiting elective radioablation. Lithium levels need to be monitored; however, levels even at subtherapeutic range may be sufficient to treat thyrotoxicosis.

  15. Quantifying the risk of extreme aviation accidents

    Das, Kumer Pial; Dey, Asim Kumer


    Air travel is considered a safe means of transportation. But when aviation accidents do occur they often result in fatalities. Fortunately, the most extreme accidents occur rarely. However, 2014 was the deadliest year in the past decade causing 111 plane crashes, and among them worst four crashes cause 298, 239, 162 and 116 deaths. In this study, we want to assess the risk of the catastrophic aviation accidents by studying historical aviation accidents. Applying a generalized Pareto model we predict the maximum fatalities from an aviation accident in future. The fitted model is compared with some of its competitive models. The uncertainty in the inferences are quantified using simulated aviation accident series, generated by bootstrap resampling and Monte Carlo simulations.

  16. Kitab kuning dan perempuan, perempuan dan kitab kuning

    Bruinessen, M.M. van


    Kitab Kuning dan Emansipasi Perempuan: Konflik Budaya? Pengamatan-pengamatan Masdar mengenai kedudukan perempuan dalam diskursus (wacana, bahasan) dominan kitab kuning terasa tidak enak didengar tetapi memang sulit dibantah. Baik dalam penggunaan bahasa (yang sangat memihak kepada jenis mudzakkar) m

  17. Injuries to pedestrians in road traffic accidents.

    Atkins, R. M.; Turner, W H; Duthie, R. B.; Wilde, B. R.


    Although there have been many reports on injuries to occupants of cars in road traffic accidents, there have been few prospective studies of injuries to pedestrians in such accidents. For this reason a two year prospective study of pedestrians in road traffic accidents in the Oxford region was carried out. The incidence of death in pedestrians was significantly higher than in car occupants or motorcyclists. The principal determinant of death was the weight of the vehicle concerned. The most c...

  18. Perancangan dan Analisis Redistribution Routing Protocol OSPF dan EIGRP



    Full Text Available Abstrak OSPF (Open Shortest Path First dan EIGRP (Enhanced Interior Gateway Routing Protocol adalah dua routing protokol yang banyak digunakan dalam jaringan komputer. Perbedaan karakteristik antar routing protokol menimbulkan masalah dalam pengiriman paket data. Teknik redistribution adalah solusi untuk melakukan komunikasi antar routing protokol. Dengan menggunakan software Cisco Packet Tracer 5.3 pada penelitian ini dibuat simulasi OSPF dan EIGRP yang dihubungkan oleh teknik redistribution, kemudian dibandingkan kualitasnya dengan single routing protokol EIGRP dan OSPF. Parameter pengujian dalam penelitian ini adalah nilai time delay dan trace route. Nilai trace route berdasarkan perhitungan langsung cost dan metric dibandingkan dengan hasil simulasi. Hasilnya dapat dilakukan proses redistribution OSPF dan EIGRP. Nilai delay redistribution lebih baik 1% dibanding OSPF dan 2-3% di bawah EIGRP tergantung kepadatan traffic. Dalam perhitungan trace route redistribution dilakukan 2 perhitungan, yaitu cost untuk area OSPF dan metric pada area EIGRP. Pengambilan jalur utama dan alternatif pengiriman paket berdasarkan nilai cost dan metric yang terkecil, hal ini terbukti berdasarkan perhitungan dan simulasi. Kata kunci: OSPF, EIGRP, Redistribution, Delay, Cost, Metric. Abstract OSPF (Open Shortest Path First and EIGRP (Enhanced Interior Gateway Routing Protocol are two routing protocols are widely used in computer networks. Differences between the characteristics of routing protocols pose a problem in the delivery of data packets. Redistribution technique is the solution for communication between routing protocols. By using the software Cisco Packet Tracer 5.3 in this study were made simulating OSPF and EIGRP redistribution linked by technique, then compared its quality with a single EIGRP and OSPF routing protocols. Testing parameters in this study is the value of the time delay and trace route. Value trace route based on direct calculation of cost

  19. Perawatan Pergeseran Mandibula dan Kliking Menggunakan Teknik Edgewise dan Trainer

    Rully Utami


    Full Text Available Kasus ini terjadi pada perempuan usia 22 tahun yang bersedia dipublikasikan untuk kepentingan  ilmu pengetahuan. Keluhan utama mandibula dan dagunya bergeser ke kanan, gigitan terbuka posterior dan bunyi click di persendian temporomandibular. Diagnosis pasien adalah maloklusi Angle kelas III tipe dento skeletal, pergeseran garis tengah mandibula dan dagu ke kanan, gigitan terbuka posterior dan clicking pada sendi temporomandibular. Perawatan dilakukan dengan teknik Edgewise dan trainer. Leveling dan unraveling dilakukan menggunakan kawat stainless steel bulat diameter 0,014 mm dengan multiloop. Trainer digunakan untuk koreksi pergeseran mandibula. Perawatan dilakukan selama 11 bulan, dan menunjukkan hasil hubungan molar pertama kanan menjadi kelas I. Overjet meningkat dari 0,1 mm menjadi 2 mm, overbite meningkat dari 0,2 mm menjadi 2,57 mm, garis tengah mandibula yang semula bergeser ke kanan 4,38 mm menjadi 2,53 mm, gigitan terbuka posterior dan clicking telah terkoreksi. Compromised Treatment of Class III Malocclusion with Mandibular Shifting, Posterior Openbite and Clicking Using Edgewise Technique and Trainer In Adult. This case report described the treatment of an adult female 22 years old who complained that her mandibula and chin shift to the right, posterior openbite and clicking. The patient diagnosed class III molar relationship, skeletal class III malocclusion, mandibular midline and chin shift to the right, posterior openbite and clicking on temporomandibular joint. Treatment was conducted using combination between  Edgewise Technique and trainer.  Leveling and unraveling are achieved by round stainless steel archwire 0,014 mm with multiloop. Trainer used to corrected the mandibular shifting. Result after 1 years treatment showed that the right molar relationship became class I, overjet increased  from 0,1 mm to 2 mm, overbite increased  from 0,2 mm to 2,57 mm, mandibular midline shifting decresed from 4,38 mm to 2,53 mm


    S.O. Bader


    The purpose of this design analysis is to specify and document the total and respirable fractions for radioactive materials that are released from an accident event at the Monitored Geologic Repository (MGR) involving commercial spent nuclear fuel (CSNF) in a dry environment. The total and respirable release fractions will be used to support the preclosure licensing basis for the MGR. The total release fraction is defined as the fraction of total CSNF assembly inventory, typically expressed as an activity inventory (e.g., curies), of a given radionuclide that is released to the environment from a waste form. The radionuclides are released from the inside of breached fuel rods (or pins) and from the detachment of radioactive material (crud) from the outside surfaces of fuel rods and other components of fuel assemblies. The total release fraction accounts for several mechanisms that tend to retain, retard, or diminish the amount of radionuclides that are available for transport to dose receptors or otherwise can be shown to reduce exposure of receptors to radiological releases. The total release fraction includes a fraction of airborne material that is respirable and could result in inhalation doses. This subset of the total release fraction is referred to as the respirable release fraction. Potential accidents may involve waste forms that are characterized as either bare (unconfined) fuel assemblies or confined fuel assemblies. The confined CSNF assemblies at the MGR are contained in shipping casks, canisters, or disposal containers (waste packages). In contrast to the bare fuel assemblies, the container that confines the fuel assemblies has the potential of providing an additional barrier for diminishing the total release fraction should the fuel rod cladding breach during an accident. However, this analysis will not take credit for this additional bamer and will establish only the total release fractions for bare unconfined CSNF assemblies, which may however be

  1. Methodological guidelines for developing accident modification functions

    Elvik, Rune


    This paper proposes methodological guidelines for developing accident modification functions. An accident modification function is a mathematical function describing systematic variation in the effects of road safety measures. The paper describes ten guidelines. An example is given of how to use...... limitations in developing accident modification functions are the small number of good evaluation studies and the often huge variation in estimates of effect. It is therefore still not possible to develop accident modification functions for very many road safety measures. © 2015 Elsevier Ltd. All rights...

  2. Systematics of Reconstructed Process Facility Criticality Accidents

    Pruvost, N.L.; McLaughlin, T.P.; Monahan, S.P.


    The systematics of the characteristics of twenty-one criticality accidents occurring in nuclear processing facilities of the Russian Federation, the United States, and the United Kingdom are examined. By systematics the authors mean the degree of consistency or agreement between the factual parameters reported for the accidents and the experimentally known conditions for criticality. The twenty-one reported process criticality accidents are not sufficiently well described to justify attempting detailed neutronic modeling. However, results of classic hand calculations confirm the credibility of the reported accident conditions.

  3. Aerospace Accident - Injury Autopsy Data System -

    Department of Transportation — The Aerospace Accident Injury Autopsy Database System will provide the Civil Aerospace Medical Institute (CAMI) Aerospace Medical Research Team (AMRT) the ability to...

  4. Occupational Accidents with Agricultural Machinery in Austria.

    Kogler, Robert; Quendler, Elisabeth; Boxberger, Josef


    The number of recognized accidents with fatalities during agricultural and forestry work, despite better technology and coordinated prevention and trainings, is still very high in Austria. The accident scenarios in which people are injured are very different on farms. The common causes of accidents in agriculture and forestry are the loss of control of machine, means of transport or handling equipment, hand-held tool, and object or animal, followed by slipping, stumbling and falling, breakage, bursting, splitting, slipping, fall, and collapse of material agent. In the literature, a number of studies of general (machine- and animal-related accidents) and specific (machine-related accidents) agricultural and forestry accident situations can be found that refer to different databases. From the database Data of the Austrian Workers Compensation Board (AUVA) about occupational accidents with different agricultural machinery over the period 2008-2010 in Austria, main characteristics of the accident, the victim, and the employer as well as variables on causes and circumstances by frequency and contexts of parameters were statistically analyzed by employing the chi-square test and odds ratio. The aim of the study was to determine the information content and quality of the European Statistics on Accidents at Work (ESAW) variables to evaluate safety gaps and risks as well as the accidental man-machine interaction.

  5. HTGR severe accident sequence analysis

    Harrington, R.M.; Ball, S.J.; Kornegay, F.C.


    Thermal-hydraulic, fission product transport, and atmospheric dispersion calculations are presented for hypothetical severe accident release paths at the Fort St. Vrain (FSV) high temperature gas cooled reactor (HTGR). Off-site radiation exposures are calculated for assumed release of 100% of the 24 hour post-shutdown core xenon and krypton inventory and 5.5% of the iodine inventory. The results show conditions under which dose avoidance measures would be desirable and demonstrate the importance of specific release characteristics such as effective release height. 7 tables.

  6. Accident Management in VVER-1000

    F. D'Auria


    Full Text Available The present paper deals with the investigation study on accident management in VVER-1000 reactor type conducted in the framework of a European Commission funded project. The mentioned study involved both experimental and computational fields. The purpose of this paper is to summarize the main findings from the execution of a wide-range analysis focused on AM in VVER-1000 with main regard to the qualification of computational tools and the proposal for an optimal AM strategy for this kind of NPP.


    Juju Masunah


    Full Text Available Abstract: Concepts and Practices of Multi Cultural Education in the United States and in Indonesia. The purpose of this article is to discuss multicultural education consepts and practices in the U.S.A and its application to Indonesia. Data is based on a case study research of two dance educators who implemented multicultural education concept in Columbus, Ohio in year 2007. The result of this research is that two dance educators teach students equally by developing a curriculum and pedagogy that face democracy for all students. This concept and practice is possible to be applied to dance education in Indonesia. Abstrak: Konsep dan Praktik Pendidikan Multikultural di Amerika Serikat dan Indonesia. Tujuan artikel ini adalah untuk mendiskusikan konsep dan praktik pendidikan multikultural di Amerika Serikat dan Indonesia. Data-data diperoleh dari hasil penelitian studi kasus dua orang pendidik tari di Columbus, Ohio yang menerapkan konsep pendidikan multikultural dalam pembelajaran tari pada tahun 2007. Peneli­tian ini menyimpulkan bahwa dua guru tari tersebut memberi perlakuan yang sama dan adil terhadap se­mua siswa dengan cara yang demokratis dengan memperhatikan keberagaman dan keperbedaan siswa. Cara-cara ini sangat memungkinkan untuk diaplikasikan dalam pendidikan tari di Indonesia.

  8. Severe gangrene by cold agglutinemia Gangrena grave causada por crioaglutinina

    Perla Vicari


    crioaglutininemia deve ser confirmada e tratada prontamente em função da risco de possíveis complicações graves.

  9. Long-term sequential monitoring of controlled graves representing common burial scenarios with ground penetrating radar: Years 2 and 3

    Schultz, John J.; Walter, Brittany S.; Healy, Carrie


    Geophysical techniques such as ground-penetrating radar (GPR) have been successfully used for forensic searches to locate clandestine graves and physical evidence. However, additional controlled research is needed to fully understand the applicability of this technology when searching for clandestine graves in various environments, soil types, and for longer periods of time post-burial. The purpose of this study was to determine the applicability of GPR for detecting controlled graves in a Spodosol representing multiple burial scenarios for Years 2 and 3 of a three-year monitoring period. Objectives included determining how different burial scenarios are factors in producing a distinctive anomalous response; determining how different GPR imagery options (2D reflection profiles and horizontal time slices) can provide increased visibility of the burials; and comparing GPR imagery between 500 MHz and 250 MHz dominant frequency antennae. The research site contained a grid with eight graves representing common forensic burial scenarios in a Spodosol, a common soil type of Florida, with six graves containing a pig carcass (Sus scrofa). Burial scenarios with grave items (a deep grave with a layer of rocks over the carcass and a carcass wrapped in a tarpaulin) produced a more distinctive response with clearer target reflections over the duration of the monitoring period compared to naked carcasses. Months with increased precipitation were also found to produce clearer target reflections than drier months, particularly during Year 3 when many grave scenarios that were not previously visible became visible after increased seasonal rainfall. Overall, the 250 MHz dominant frequency antenna imagery was more favorable than the 500 MHz. While detection of a simulated grave may be difficult to detect over time, long term detection of a grave in a Spodosol may be possible if the disturbed spodic horizon is detected. Furthermore, while grave visibility increased with the 2D

  10. [Multiple injuries in mass accidents].

    Wondrák, E


    The treatment starts with reanimation, managing the shock, followed by life-saving surgery on the central nervous system, chest, abdomen, large blood vessels and the uropoietic system. From the very beginning the therapy should be conducted on an intradisciplinary basis, first with the anaesthesiologist, later with other specialists as required. Once the patient's life has been saved, treatment of eyes, hands and systematic attention to extremities should follow. Shock has to be managed within 24 hours. Luxations of large joints should be reposed on the date of injury, open fractures closed, all fractures immobilized in favourable position. No extension should be applied in patients suffering from brain injuries; fractures of the femur should be fixed surgically by a second team in the course of the neurosurgical operation. A stomatologist's assistance makes general anaesthesia possible even with fractures of the jaw. In mass accidents the therapeutic plan for the polytraumatized should be fixed on the following day. A mass accident involving 35 injured treated within two and a half hours demonstrates this procedure in 7 polytraumatized persons.

  11. Morbidade Materna Grave e Near Misses em Hospital de Referência Regional

    Márcia Lait Morse

    Full Text Available OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.

  12. Correspondence model of occupational accidents

    Juan C. Conte


    Full Text Available We present a new generalized model for the diagnosis and prediction of accidents among the Spanish workforce. Based on observational data of the accident rate in all Spanish companies over eleven years (7,519,732 accidents, we classified them in a new risk-injury contingency table (19×19. Through correspondence analysis, we obtained a structure composed of three axes whose combination identifies three separate risk and injury groups, which we used as a general Spanish pattern. The most likely or frequent relationships between the risk and injuries identified in the pattern facilitated the decision-making process in companies at an early stage of risk assessment. Each risk-injury group has its own characteristics, which are understandable within the phenomenological framework of the accident. The main advantages of this model are its potential application to any other country and the feasibility of contrasting different country results. One limiting factor, however, is the need to set a common classification framework for risks and injuries to enhance comparison, a framework that does not exist today. The model aims to manage work-related accidents automatically at any level.Apresentamos aqui um modelo generalizado para o diagnóstico e predição de acidentes na classe de trabalhadores da Espanha. Baseados em dados sobre a frequência de acidentes em todas as companhias da Espanha em 11 anos (7.519.732 acidentes, nós os classificamos em uma nova tabela de contingência risco-injúria (19×19. Através de uma análise por correspondência obtivemos uma estrutura composta por 3 eixos cuja combinação identifica 3 grupos separados de risco e injúria, que nós usamos como um perfil geral na Espanha. As mais prováveis ou frequentes relações entre risco e injúrias identificadas nesse perfil facilitaram o processo de decisão nas companhias em um estágio inicial de apreciação do risco. Cada grupo de risco-injúria tem suas próprias caracter

  13. Induction of animal model of Graves' disease in BALB/c mice

    Zhu-fang Tian; Bing-yin Shi; Xiao-yan Wu; Li Xu


    Objective To construct an animal model of Graves' disease (GD) by immunizing BALB/c mice with hM12 cells co-expressing major histocompatibility complex (MHC) class Ⅱ molecules and human thyrotropin receptor (TSHR) molecules. Methods BALB/c mice in experimental group (H-2d) were immunized with hM12 cells Intraper-itoncally every 2 weeks for six times, while mice in control group were immunized with M12 cells. Five weeks later, the thyroids were histologically examined, and serum samples were tested for thyroid-stimulating antibodies (TSAb) and thyroid hormone levels. Results One BALB/c mouse in experimental group developed Graves'-like disease. Total T4 and T3 levels in this mouse were above the upper limit of normal, TSAb activity was displayed in its serum. The thyroid histologically showed the features of thyroid hyperactivity including thyrocyte hypercellularity and colloid absorption.None of control mice developed Graves'-like disease. Conclusion An animal model with some characteristics of human Graves' disease was successfully induced and the model will facilitate studies aimed directly at understanding the patho-genesis of autoimmunity in Graves' disease.


    Eliza Halim


    Full Text Available ABSTRACTIndonesia has a potency to produce its own propolis, however the propolis market in Indonesia is dominated by imported product, such as from Brazil. Currently, still there is no reasearch which evaluate bioactive compound and nutrient content of Indonesian Propolis (IP compare with Brazilian Propolis (BP. The objectivesof this study were to analyze bioactive compounds and nutrient contents of IP compared to BP. Bioactive compounds and nutrients content were analyzed by gas chromatography–mass spectrophotometry. The resultsshowed both IP and BP contain fenol, α-amyrin, cylolanost, and pyrimidines. Bioactive compounds which specifically found in IP were eudesmane compound, ethyl acridine, lupeol, friedooleanan; while β amyrin and cinnamic acid compound only found in BP. The nutrient contents of IP were higher than BP except for vitamin A. In conclusion, IP might have potential health benefit, similar to BP.Key words: propolis, bioactive, nutrientABSTRAKIndonesia mempunyai potensi untuk menghasilkan propolis tetapi pemasaran propolis di Indonesia didominasi oleh propolis impor seperti propolis yang berasal Brasil. Sampai saat ini belum ada penelitian yang mengungkapkandungan bioaktif dan zat gizi propolis Indonesia (PI dibandingkan dengan propolis Brasil (PB. Oleh karena itu tujuan penelitian ini adalah untuk melakukan kajian kandungan bioaktif dan zat gizi (vitamin dan mineral PI dibandingkan dengan PB. Komponen bioaktif dan kandungn gizi dianalisis dengan metode gas chromatography–mass spectrometry. Hasil analisis menyatakan bahwa baik PI maupun PB mengandung senyawa fenol, α-amyrin, cylolanost, dan pirimidin. Komponen bioaktif unik yang ditemukan di dalam PI adalah senyawaeudesmane, ethyl acridine, lupeol dan friedooleanan; sedangkan β-amyrin dan senyawa asam sinamat hanya ditemukan di dalam PB. Kandungan zat gizi PI lebih tinggi dari PB kecuali kandungan vitamin A. Hal ini menunjukkan bahwa PI kemungkinan mempunyai khasiat untuk

  15. Key Characteristics of Combined Accident including TLOFW accident for PSA Modeling

    Kim, Bo Gyung; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of); Yoon, Ho Joon [Khalifa University of Science, Technology and Research, Abu Dhabi (United Arab Emirates)


    The conventional PSA techniques cannot adequately evaluate all events. The conventional PSA models usually focus on single internal events such as DBAs, the external hazards such as fire, seismic. However, the Fukushima accident of Japan in 2011 reveals that very rare event is necessary to be considered in the PSA model to prevent the radioactive release to environment caused by poor treatment based on lack of the information, and to improve the emergency operation procedure. Especially, the results from PSA can be used to decision making for regulators. Moreover, designers can consider the weakness of plant safety based on the quantified results and understand accident sequence based on human actions and system availability. This study is for PSA modeling of combined accidents including total loss of feedwater (TLOFW) accident. The TLOFW accident is a representative accident involving the failure of cooling through secondary side. If the amount of heat transfer is not enough due to the failure of secondary side, the heat will be accumulated to the primary side by continuous core decay heat. Transients with loss of feedwater include total loss of feedwater accident, loss of condenser vacuum accident, and closure of all MSIVs. When residual heat removal by the secondary side is terminated, the safety injection into the RCS with direct primary depressurization would provide alternative heat removal. This operation is called feed and bleed (F and B) operation. Combined accidents including TLOFW accident are very rare event and partially considered in conventional PSA model. Since the necessity of F and B operation is related to plant conditions, the PSA modeling for combined accidents including TLOFW accident is necessary to identify the design and operational vulnerabilities.The PSA is significant to assess the risk of NPPs, and to identify the design and operational vulnerabilities. Even though the combined accident is very rare event, the consequence of combined

  16. Radiological accidents balance in medicine; Bilan des accidents radiologiques en medecine

    Nenot, J.C.


    This work deals with the radiological accidents in medicine. In medicine, the radiation accidents on medical personnel and patients can be the result of over dosage and bad focusing of radiotherapy sealed sources. Sometimes, the accidents, if they are unknown during a time enough for the source to be spread and to expose a lot of persons (in the case of source dismantling for instance) can take considerable dimensions. Others accidents can come from bad handling of linear accelerators and from radionuclide kinetics in some therapies. Some examples of accidents are given. (O.L.). 11 refs.

  17. Squeal Those Tires! Automobile-Accident Reconstruction.

    Caples, Linda Griffin


    Methods use to reconstruct traffic accidents provide settings for real life applications for students in precalculus, mathematical analysis, or trigonometry. Described is the investigation of an accident in conjunction with the local Highway Patrol Academy integrating physics, vector, and trigonometry. Class findings were compared with those of…

  18. 48 CFR 36.513 - Accident prevention.


    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Accident prevention. 36.513 Section 36.513 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SPECIAL... prevention. (a) The contracting officer shall insert the clause at 52.236-13, Accident Prevention,...

  19. Global estimates of fatal occupational accidents.

    Takala, J


    Data on occupational accidents are not available from all countries in the world. Furthermore, underreporting, limited coverage by reporting and compensation schemes, and non-harmonized accident recording and notification systems undermine efforts to obtain worldwide information on occupational accidents. This paper presents a method and new estimated global figures of fatal accidents at work by region. The fatal occupational accident rates reported to the International Labour Office are extended to the total employed workforce in countries and regions. For areas not covered by the reported information, rates from other countries that have similar or comparable conditions are applied. In 1994, an average estimated fatal occupational accident rate in the whole world was 14.0 per 100,000 workers, and the total estimated number of fatal occupational accidents was 335,000. The rates are different for individual countries and regions and for separate branches of economic activity. In conclusion, fatal occupational accident figures are higher than previously estimated. The new estimates can be gradually improved by obtaining and adding data from countries where information is not yet available. Sectoral estimates for at least key economic branches in individual countries would further increase the accuracy.

  20. Occupational blood exposure accidents in the Netherlands.

    Wijk, P.T.L. van; Schneeberger, P.M.; Heimeriks, K.; Boland, G.J.; Karagiannis, I.; Geraedts, J.; Ruijs, W.L.M.


    BACKGROUND: To make proper evaluation of prevention policies possible, data on the incidence and associated medical costs of occupational blood exposure accidents in the Netherlands are needed. METHODS: Descriptive analysis of blood exposure accidents and risk estimates for occupational groups. Cost

  1. Accidents of bus drivers : an epidemiological approach

    M.L.I. Pokorny (Mirko); D.H.J. Blom (Dick)


    textabstractIn the history of accident research much emphasis has been laid on general statistics, different types of case studies concentrating on various personal factor-s, circumstantial influences etc. Often, in certain waves, the unequal initial liability theory (the accident proneness concept;

  2. An introduction to serious nuclear accident chemistry

    Mark Russell St. John Foreman


    A review of the chemistry occurring inside a nuclear power plant during a serious reactor accident is presented. This includes some aspects of the behavior of nuclear fuel, its cladding, cesium and iodine. This review concentrates on the chemistry of an accident in a water-cooled reactor loaded with uranium dioxide or mixed metal oxide fuel.

  3. Fatal traffic accidents and forensic medicine

    Kazuhiko Kibayashi


    Full Text Available In the event of a traffic accident fatality, the death is reported as an “unusual death,” an inquest is conducted, and, if necessary, a forensic autopsy is performed to prove any causal relationship between the accident and the death, identify the vehicle at fault, and determine the cause of the accident. A forensic autopsy of a traffic accident fatality needs to both determine the cause of death and identify the mechanism of injury, an analytical task that requires observation of three major traffic accident factors: the body, the vehicles involved, and the scene of the accident. Also crucial to determining the cause of death is the process of looking into whether the people involved in the accident had any diseases that might affect their driving performance or were under the influence of alcohol or drugs. In order to reduce the number of people killed in traffic accidents, it will be important to promote joint research uniting forensic medicine, clinical medicine, automotive engineering, and road engineering, take measures to limit the impact of inebriated pedestrians and pedestrians suffering from dementia, and ensure proper screening of alcohol and illegal drug consumption in drivers.

  4. Review of Severe Accident Phenomena in LWR and Related Severe Accident Analysis Codes

    Muhammad Hashim


    Full Text Available Firstly, importance of severe accident provision is highlighted in view of Fukushima Daiichi accident. Then, extensive review of the past researches on severe accident phenomena in LWR is presented within this study. Various complexes, physicochemical and radiological phenomena take place during various stages of the severe accidents of Light Water Reactor (LWR plants. The review deals with progression of the severe accidents phenomena by dividing into core degradation phenomena in reactor vessel and post core melt phenomena in the containment. The development of various computer codes to analyze these severe accidents phenomena is also summarized in the review. Lastly, the need of international activity is stressed to assemble various severe accidents related knowledge systematically from research organs and compile them on the open knowledge base via the internet to be available worldwide.

  5. [Clinical examinations for the traffic accident patients].

    Hitosugi, Masahito


    Traffic accident is a leading cause of unintentional death and about six-thousands annually died in Japan. As about one-million of persons suffer from traffic injuries, most of them seek medical attention. Therefore, medical staffs have to find the injuries accurately and treat immediately. Furthermore, the cause of accident should also be considered; why the accident was occurred, human error of the driver? To solve these problems, clinical examinations were needed. Medical staffs have to understand the characteristics of the traffic injuries: severe and multiple blunt injuries, popular injuries can be estimated with considering the pattern of the accident. Because some of the accidents are occurred when the driver is under the influence of alcohol and other drugs, screening of these subjects should be performed. Because the public is largely unaware of the preventable nature of traffic injuries, in addition to diagnose and treat accurately, we medical staffs have to attend on the primary prevention of the traffic injuries.


    Israyanti, -


    Penelitian ini bertujuan untuk mengetahui perbandingan jumlah kafein, karakteristik proksimat (protein dan lemak) dan rasa dan aroma antara kopi luwak dan kopi biasa dari jenis arabika (Cafeea arabica. L) dan robusta (Cafeea canephora. L). Perlakuan penelitian yakni A1 (luwak robusta), A2 (luwak arabika), B1 (robusta biasa) dan B2 (arabika biasa). Parameter penelitian yaitu pengujian organoleptik pada rasa (metode hedonik) dan aroma (metode ranking), analisa kafein dan uji proksimat berupa ...

  7. Commercial SNF Accident Release Fractions

    J. Schulz


    The purpose of this analysis is to specify and document the total and respirable fractions for radioactive materials that could be potentially released from an accident at the repository involving commercial spent nuclear fuel (SNF) in a dry environment. The total and respirable release fractions are used to support the preclosure licensing basis for the repository. The total release fraction is defined as the fraction of total commercial SNF assembly inventory, typically expressed as an activity inventory (e.g., curies), of a given radionuclide that is released to the environment from a waste form. Radionuclides are released from the inside of breached fuel rods (or pins) and from the detachment of radioactive material (crud) from the outside surfaces of fuel rods and other components of fuel assemblies. The total release fraction accounts for several mechanisms that tend to retain, retard, or diminish the amount of radionuclides that are available for transport to dose receptors or otherwise can be shown to reduce exposure of receptors to radiological releases. The total release fraction includes a fraction of airborne material that is respirable and could result in inhalation doses; this subset of the total release fraction is referred to as the respirable release fraction. Accidents may involve waste forms characterized as: (1) bare unconfined intact fuel assemblies, (2) confined intact fuel assemblies, or (3) canistered failed commercial SNF. Confined intact commercial SNF assemblies at the repository are contained in shipping casks, canisters, or waste packages. Four categories of failed commercial SNF are identified: (1) mechanically and cladding-penetration damaged commercial SNF, (2) consolidated/reconstituted assemblies, (3) fuel rods, pieces, and debris, and (4) nonfuel components. It is assumed that failed commercial SNF is placed into waste packages with a mesh screen at each end (CRWMS M&O 1999). In contrast to bare unconfined fuel assemblies, the


    Dwi Sulistiani


    Full Text Available Dalam era globalisasi dan pedagangan  bebas dewasa ini strategi merger dan akuisisi  merupakan fenomena yang semakin marak dilakukan oleh para pelaku bisnis dan  semakin menarik untuk dicermati bersama. Untuk menjalankan perusahaan para manajemen perusahaan selalu dituntut menjaga pertumbuhan usahanya secara optimal. Penerapan strategi merger dan akuisisi merupakan jalan pintas untuk mewujudkan pertumbuhan usaha tanpa perusahaan perlu memulai dari awal suatu jenis usaha yang baru. Dalam suatu kondisi perusahaan yang kuat cenderung membeli perusahaan lain untuk meningkatkan daya saing dan penghematan biaya. Perusahaan yang terlibat dalam merger dan akuisisi akan dapat diperoleh pangsa pasar yang lebih besar dan efisiensi terhadap biaya. Perusahaan yang merasa tidak dapat bertahan hidup secara individual biasanya merelakan diri untuk menjadi target akuisisi. Merger dan akuisisi merupakan suatu realitas dan tantangan yang harus siap dihadapi oleh para pelaku usaha dalam era perdagangan bebas saat ini. Namun tingkat kesuksesan dalam melakukan kegiatan merger dan akuisisi juga sangat dipengaruhi oleh kondisi internal perusahaan meliputi sumber daya, kapabilitas dan kompetensi inti yang dimiliki oleh perusahaan. Tulisan ini akan mencoba memberikan pemahaman bahwa sumber daya, kapabilitas dan  kompetensi inti merupakan faktor penting dalam melakukan kegiatan penggabungan usaha yang pada akhirnya dapat menentukan tingkat keberhasilan proses merger dan akuisisi yang sedang dijalankan oleh perusahaan

  9. Pollen studies of textile from an Iron Age grave at Hammerum, Denmark

    Enevold, Renée


    was rewarded with a set of results which permitted detailed interpretation. Large amounts of pollen of crops and associated anthropogenic plants in the textile sample suggest that agricultural work was the primary source of the pollen embedded in the clothing. In contrast, the pollen assemblages from......This article presents the methods employed and the results obtained in pollen studies of a prehistoric grave, identifying a fascinating and productive context for pollen analyses: prehistoric textiles. The methods involved direct sampling from the grave during excavation and various measures aimed...... at minimizing the risk of contamination, thereby maximising the information gained about various aspects of contemporary prehistoric life. The example used was an Iron Age grave from Hammerum, Denmark which was found to contain very well preserved clothing. The clothing and surrounding sediment were block...

  10. Image and Role of the Queen Mother of the West in Han Grave Art



    Full Text Available The present article is a detailed study of the image of an ancient Chinese goddess, The Queen Mother of the West, called Xiwangmu 西王母 in Chinese. In the mythological tradition, Xiwangmu is a goddess who possesses the elixir of immortality and dwells in the western paradise, on the magic mountain Kunlun 崑崙. While her image can be found in mural paintings, and on lacquered objects and bronze mirrors, it appears primarily in the form of relief images on the stones and bricks of grave chambers and temples in the Han (206 BCE–220 CE grave complexes. The literary tradition reveals a multifunctional role of the mother, with her many attributes developing in accordance with the changing values of social and mythological concepts. The article concludes with a detailed discussion of her image and role within the wider cosmological context of Han grave art.

  11. Heterotopic relation between media and materiality in children's online memorials and on children's graves

    Sandvik, Kjetil; Christensen, Dorthe Refslund

    place across media. We show how the death of an infant can lead to mediation, remediation and mediatization strategies which involves both the uses and arrangement of objects on memorial pages and on children’s graves as well as uses of new social technologies, that produce, negotiate and develop social......In this paper we analyze how bereaved parents make use of various media-strategies on online memorial sites and on children’s graves when performing processes of grief and commemoration for their stillborns and infants, and how these processes are not just linked to one particular media but take...... relations with the dead child and the (re)negotiating of parenthood. We understand media as a function of an object reflected in human practices and embedded and structured by the different materialities they are intertwined with. We argue that the use of media and materiality online and on the graves are...

  12. Analysis of Fukushima Daiichi Accident Using HFACS

    Mohamed, Saeed Almheiri [Korea Advanced Institue of Science and Technology, Daejeon (Korea, Republic of)


    The shadow of Fukushima Daiichi nuclear power plant (NPP) accident is still too big and will last long. On the other hand, it could still teach us lots of lessons to better design and operate nuclear power plants. In this paper, we will be focusing on the Fukushima Daiichi accident, especially on human organizational factors. We will analyze the accident using Human Factors Analysis and Classification System (HFACS) in order to better understand the organizational climate of TEPCO{sup 1} and NISA{sup 2} that led to Fukushima Daiichi Accident. HFACS was developed for the U. S. aviation industry and has been used at many industries like the rail and mining industries. We found that the HFACS to be greatly beneficial in investigating the latent and organizational causes for the accident. The application results show that the causes of Fukushima Daiichi accident were spread out from sharp end (i.e. Unsafe Act) to blunt end (i. e. Organizational Influences). This means that the corresponding countermeasures should cover from front line staff to management. Thus, we managed to develop a better understanding on how to prevent similar errors or violations. The incident and near-miss have a lot of helpful information because it may show the actual and latent deficiencies of complex systems. We applied the HFACS into Fukushima Daiichi accident to better locate the causes related to both sharp and blunt ends of operation of NPP. In order to derive useful lessons from the accident analysis, the analyst should try to find the similarities not differences from the incident. It is imperative that whatever accident/incident analysis systems we use, we should fully utilize the disastrous Fukushima accident.

  13. Evaluation of Railway Level Crossing Attributes on Accident Causation in Lagos, Nigeria.

    Adeolu O Dina


    Full Text Available Abstract The study examines the contribution of Railway Level Crossing (RLCphysical attributes to accident occurrence using the12 major level crossings within the Lagos metropolis. The 48km single track mainline section under consideration which barely make up 1.1% of the entire narrow gauge track network of the country within a 5 year period contributed about 45% of the total National crossing accidents recorded in Nigeria. The method of investigation involved recording the individual attributes of each RLC such asgates, pedestrian traffic, car traffic light, proximity of signage to crossing, vehicular traffic as dummy variables.The regression analysis  was used to measure their effect on accidents.The result indicates gates, pedestrians and the location of signage had significant impact on accidents occurrence at level crossings within Lagos metropolis. Based on the findings, enhancement of active warning systems among other recommendations was suggested as potent counter measures for RLC accident reduction. Abstrak Penelitian menguji tingkat kontribusi atribut fisik dari perlintasan jalan kereta api terhadap kejadian kecelakaan menggunakan 12 perlintasan utama dalam kota metropolis Lagos. 48 km jalan utama tunggal menjadi pertimbangan yang hampir meningkat 1.1% dari seluruh trek sempit jaringan negara dalam jangka waktu 5 tahun menyumbang sekitar 45% dari total kecelakaan perlintasan secara Nasional di Nigeria. Metode penelitian melibatkan catatan dari masing-masing atribut RLC seperti pintu gerbang, pejalan kaki, lampu lalu lintas mobil, kedekatan tanda penyebarangan, lalu lintas kendaraan sebagai variabel dumi. Analisis regresi digunakan untuk mengukur pengaruh dari atribut terhadap kecelakaan. Hasilnya menunjukkan pintu gerbang, pejalan kaki, dan lokasi tanda perlintasan mempunyai dampak signifikan pada kecelakaan dalam kota metropolis Lagos.Berdasarkan penemuan tersebut, perbaikan dari sistem peringatan aktif disarankan sebagai upaya


    Fahrudin Fahrudin


    Full Text Available Permodelan sandbox dibuat dengan system tektonik konvergen dan divergen dengan menggunakan pergerakan satu sumbu. Permodelan ini bertujuan untuk membuat alat mesin sandbox yang bisa digunakan untuk penelitian dan pengajaran. Mesin berhasil dibuat dan sudah diujicobakan. Ujicoba dengan menggunakan satu lapisan pasir yang diambil dari Formasi Ngrayong. Percobaan selanjutnya dengan beberapa lapisan. Percobaan dilakukan dengan pengamatan yang meliputi pengamatan permukaan dan penampang verikal. Pengamatan yang aspek morfologi, kelurusan struktur, dan perkembangan sesar yang terbentuk. Hasil percobaan menunjukkan bahwa pembentukan morfologi sangat berkaitan dengan pembentukan sesar. Struktur sesar dengan pola forward propagating thrust faults. Sesar tersebut disebabkan imbrikasi. Lipatan yang terbentuk akibat mekanisme propagasi sesar.[Design of Compression and Extensional of the Sandbox Model and Its Benefit] Divergent and convergent tectonic sytem can be studied from the sandbox modelling. This model has a axis of movement. Sandbox models itends to study the progress of structural geology such as fault and fold. We successfully made machine of sandbox. This machine has basal detachment from duraluminum. Material for model is taken by loose sand from Ngrayong Formation. This experiment focused to observation about morphology in surface and thrust or backthrust in subsurface. This experiment has compression system. Result of model was that morphological sequences associated with fault sequences. Fault is formed to have the pattern of forward propagating thrust faults. It’s caused by imbricate thrust system. Folding is formed by the mechanism of fault propagation folding. 

  15. The Roma: People without a Home or Grave

    Vera Klopčič


    Full Text Available Although the Roma have been living in Europe for centuries, they still face rejection by majority populations, being treated as undesirable strangers in almost all European countries. Written evidence of their arrival can be traced back to the fourteenth and fifteenth centuries. There are many legends and myths about their origins and reasons for emigrating from their country of origin. Until recently, the Roma transmitted their own history only as oral tradition. One of the best-known contemporary Roma intellectuals, journalist and writer Rajko Djurić, picturesquely explains the importance of the Romany language for further exploration of Roma culture and their origin: “Romany is the only book they brought from India; it constitutes their collective memory and reflects the views of this people, to themselves, to the world, and to other peoples. Their language is an inventory of the material and spiritual culture to which they once belonged, and contains elements of culture of other peoples that they came into contact with during their long and yet insufficiently studied journey.” When the Roma arrived in Europe, their lifestyle differed significantly from that of other European peoples. As a result, majorities and other groups in Europe intervened in their lives for centuries. They were forced to abandon their nomadic way of life. In the past, authorities often expelled them from their territory and they did not enjoy legal protection when violence or crimes were committed against them. Living in isolated settlements, excluded from social life, segregated, and discriminated against by others, they lived on the margins as a people without a home or a grave. At the same time, they established their parallel world as a system of social norms valid within their community, and within it all non-Roma were perceived as gadje ‘outsiders’. Roma legends explain the reasons for their nomadic way of life: they contain stories of persecution and

  16. Mediastinal neoplasms in patients with Graves disease: a possible link between sustained hyperthyroidism and thymic neoplasia?

    Boyd Jonathan D


    Full Text Available Abstract Background Anterior mediastinal masses are a rare but well documented finding in Graves disease. The vast majority of these lesions represents benign thymic hypertrophy and regress after treatment of the hyperthyroidism. A small percentage of these cases however represent neoplastic/malignant diseases which require further treatment. Cases 12 year old boy with one year history of refractory Graves disease was found to have an anterior mediastinal mass and underwent curative thyroidectomy for sustained hyperthyroidism. Cervical lymphadenopathy was detected during the procedure and biopsy was obtained. A 23 year old woman who presented with a one month history of hyperthyroid symptoms, was diagnosed with Graves disease and also was found to have an anterior mediastinal mass on imaging. Biopsy of the anterior mediastinal mass was obtained and subsequently the patient underwent robotic thymectomy. Histologic examination and immunophenotyping of the cervical lymph node in a 12 year old boy revealed neoplastic proliferation of T lymphoblasts diagnostic of T lymphoblastic leukemia/lymphoma. Examination of the anterior mediastinal mass biopsy in the 23 year old woman revealed type B1 thymoma which was confirmed after examination of the subsequent robotic thymectomy specimen. Conclusion This is the first reported case of T cell lymphoblastic lymphoma and the third reported case of thymoma associated with sustained hyperthyroidism due to Graves disease. These cases indicate that an anterior mediastinal mass in a patient with active Graves disease may be due to a neoplastic cause, which may require definitive treatment. Caution should be exercised when dismissing a mediastinal mass as benign thymic hyperplasia in patients with active Graves disease.


    Wahyu Widodo


    Full Text Available Abstract Makalah ini membahas konsep budaya politik berpusat pada imajinasi (pikiran dan perasaan manusia yang merupakan dasar semua tindakan. Dalam rangka menuju arah pembangunan dan modernisasi suatu masyarakat akan menempuh jalan yang berbeda antara satu masyarakat dengan yang lain, dan itu terjadi karena peranan kebudayaan sebagai salah satu faktor. Budaya politik dapat membentuk aspirasi, harapan, preferensi, dan prioritas tertentu dalam menghadapi tantangan yang ditimbulkan oleh perubahan sosial politik. Pada gilirannya, disimpulkan bahwa peran budaya politik santun, bersih dan beretika dalam rangka memperkokoh kehidupan berbangsa dan bernegara menuju Indonesia baru adalah: pertama, etika politik dan pemerintahan mengandung misi kepada setiap pejabat dan elite politik untuk bersikap jujur, amanah, sportif, siap melayani, berjiwa besar, memiliki keteladanan, rendah hati, dan siap untuk mundur dari jabatan publik apabila terbukti melakukan kesalahan dan secara moral kebijakannya bertentangan dengan hukum dan rasa keadilan masyarakat. Kedua, perlu dilakukan upaya penanaman suatu kesadaran bahwa politik yang hendak kita perjuangkan bukan semata politik kekuasaan, melainkan suatu politik yang mengedepankan panggilan pengabdian demi kesejahteraan masyarakat luas, dialektika antara partai dan politikus serta masyarakat yang kritis. Ketiga, budaya politik santun, bersih dan beretika ini diperlukan karena dapat membuat para elite politik menjauhi sikap dan perbuatan yang dapat merugikan bangsa Indonesia. Akhirnya, disarankan agar dilaksanakan kembali pendidikan budi pekerti yang merupakan pondasi bagi pelaksanaan Civic Education agar tercipta generasi yang tidak hanya mau menjadi politisi, namun paham budaya dan etika politik.   Kata kunci: budaya politik, kehidupan berbangsa dan bernegara, menuju Indonesia baru

  18. Doença de Graves associada à artrite idiopática juvenil Graves' disease associated with juvenile idiopathic arthritis

    Vanessa de Matos Santos Mendonça Marques


    Full Text Available Os autores relatam o caso de uma menina de 10 anos de idade com diagnóstico de doença de Graves (DG, em tratamento com propiltiouracil, que desenvolveu uveíte e artrite poliarticular e cuja mãe também tem DG e lúpus discoide. São discutidos os diagnósticos diferenciais de artrite inflamatória que surge em uma criança com doença tireoidiana autoimune medicada com drogas antitireóideas.The authors report the case of a 10-year-old girl with Graves' disease (GD, treated with propylthiouracil, who developed uveitis and polyarticular arthritis, and whose mother also had GD and discoid lupus. The differential diagnosis of inflammatory arthritis that appears in a child with autoimmune thyroid disease managed with antithyroid drugs is discussed.

  19. Postpartum thyrotoxicosis in a patient with Graves' disease. Association with low radioactive iodine uptake

    Eckel, R.H.; Green, W.L.


    A patient with previously diagnosed Graves' hyperthyroidism had a transient episode of thyrotoxicosis three months postpartum. This was associated with a diffusely enlarged thyroid gland, a rise in antithyroid microsomal antibody titer, a 24-hour radioactive iodine uptake (RAIU) of 1%, and an aspiration biopsy specimen suggestive of chronic lymphocytic thyroiditis. An alternative cause for the depressed RAIU was not discovered. This case would suggest that patients with previously diagnosed Graves' disease can have thyrotoxicosis without an enhanced RAIU and that the postpartum thyrotoxin syndrome may involve an immunologic injury causing a release of performed thyroid hormone.

  20. Epidemiología del traumatismo torácico grave

    Cordero Lorenzana, María Lourdes


    [Resumen] Objetivo: Características del traumatismo torácico grave en UCI. Mortalidad. Material y método: Análisis descriptivo retrospectivo, univariado y regresión de 100 variables en 1174 pacientes con traumatismo torácico grave (1993-2010). Resultados: Más varones (4:1) de 43,5±18,9 años. 96,5% de traumatismos torácicos cerrados y 89% asociado. Lesiones óseas frecuentes: fracturas costales (71,2%) y claviculares (17,9%). Otras: contusión pulmonar (44%), hemotórax (41,7...

  1. [Treatment of hyperthyroidism due to Graves' disease: what is the recommended antithyroid drug during pregnancy?].

    Caron, P


    Clinical hyperthyroidism during the first trimester of pregnancy due to Graves' disease can be associated with maternal, obstetrical and fetal complications, indicating an active treatment to restore normal thyroid function. Antithyroid drugs are the first line treatment in pregnant women with hyperthyroidism. Due to the increased congenital malformations reported in neonates after first-trimester carbimazole/methimazole treatment and propylthiouracil associated hepatotoxicity, the recommended treatment for pregnant women with hyperthyroid Graves' disease is propylthiouracil during the first trimester of pregnancy and following the first trimester, consideration should be given switching to carbimazole/methimazole during the second part of gestation.

  2. ¿Hay diferencias entre la violencia grave y la violencia menos grave contra la pareja?: un análisis comparativo

    Enrique Echeburúa


    Full Text Available En este estudio ex post facto se lleva a cabo una descripción de las características presentadas por 1.081 casos denunciados por violencia contra la mujer en las comisarías de la Ertzaintza del País Vasco. En primer lugar, se presentan las variables psicológicas y sociodemográficas del agresor y de la víctima, así como de la relación de pareja. Y en segundo lugar, se determinan las diferencias más significativas entre la violencia grave y la violencia menos grave en relación con esas mismas variables. Los resultados ponen de manifiesto que tanto los agresores como las víctimas tienden a ser jóvenes, con una sobrerrepresentación de agresores y víctimas extranjeros inmigrantes. En el caso de los maltratadores graves, tienden a ser celosos o posesivos, a sentirse humillados por la ruptura de la pareja, lo que redunda directamente en un descenso de su autoestima y a consumir abusivamente alcohol o drogas. Por lo que se refiere a las víctimas de la violencia grave, se suelen sentir con frecuencia en peligro de muerte y están más fácilmente en circunstancias de vulnerabilidad, como una edad muy joven, una personalidad muy dependiente, una situación de enfermedad crónica o de dependencia económica, un consumo de drogas o un entorno de soledad. Se comentan las implicaciones de este estudio para la investigación y para la práctica clínica.


    Akmal Zainal Abidin


    Full Text Available CORELATION BETWEEN ISLAM AND ECONOMY. This paper aims to identifies about the correlation between economic and Islam. Islam is the perfect religion that governs all things in life, including the economy. This is evident with the concept of  well-being which is described in the al-Quran and Sunnah. Basically the goal of every human life is to prosper, although humans make sense of  well- being with a different perspective. Most understand economics assume that welfare is the welfare of  earthly material. But to make sense of well-being with the term al-Falah, is meaning holistic wellbeing and balance between material and spiritual dimensions. al-Quran and Sunnah have taught that the human being will be achieved if  living in balance between material and spiritual. This is because human life does not just stop in the life of this world, but there is still a second life that will be faced by humanity in the hereafter, and well-being will be achieved with the truth is that people can balance the needs of the world and the hereafter, and that is what is taught in Islamic economics. Keywords: Islam, Economy, Prosperity. Tulisan ini bertujuan untuk menjelasakn tentang korelasi antara ekonomi  dan  Islam.  Islam  adalah  agama  yang  sempurna  yang mengatur segala hal dalam kehidupan ini, termasuk juga ekonomi. Hal ini terbukti dengan konsep kesejahteraan yang dipaparkan dalam al-Quran dan Sunnah. Pada dasarnya tujuan hidup setiap manusia adalah untuk mencapai kesejahteraan, meskipun manusia memaknai kesejahteraan dengan perspektif  yang berbeda-beda. Sebagian besar paham ekonomi menganggap bahwa kesejahteraan adalah kesejahteraan material duniawi. Namun Islam memaknai kesejahteraan dengan istilah  Falah  yang  berarti  kesejahteraan  holistik  dan  seimbang antara dimensi material dan spiritual. Al-Quran dan Sunnah telah mengajarkan bahwa kesejahteraan akan tercapai jika manusia menjalani hidup secara seimbang antara material dan

  4. Accidents in Canada: mortality and hospitalization.

    Riley, R; Paddon, P


    For Canadians under 45, accidents are the leading cause of both death and hospitalization. For the Canadian population as a whole, accidents rank fourth as a cause of death, after cardiovascular disease (CVD), cancer and respiratory disease. This article analyzes accident mortality and hospitalization in Canada using age-specific rates, age-standardized mortality rates (ASMR), and potential years of life lost (PYLL). The six major causes of accidental death for men are motor vehicle traffic accidents (MVTA), falls, drowning, fires, suffocation and poisoning. For women, the order is slightly different: MVTA, falls, fires, suffocation, poisoning and drowning. From 1971 to 1986, age-standardized mortality rates (ASMR) for accidents decreased by 44% for men and 39% for women. The largest decrease occurred in the under 15 age group. Accidents accounted for 11.5% of total hospital days in 1985, and 8% of hospital discharges. Because young people have the highest rates of accidental death, potential years of life lost (PYLL) are almost as high for accidents as for cardiovascular disease, although CVD deaths outnumbered accidental deaths by almost five to one in 1985.

  5. An analysis of aircraft accidents involving fires

    Lucha, G. V.; Robertson, M. A.; Schooley, F. A.


    All U. S. Air Carrier accidents between 1963 and 1974 were studied to assess the extent of total personnel and aircraft damage which occurred in accidents and in accidents involving fire. Published accident reports and NTSB investigators' factual backup files were the primary sources of data. Although it was frequently not possible to assess the relative extent of fire-caused damage versus impact damage using the available data, the study established upper and lower bounds for deaths and damage due specifically to fire. In 12 years there were 122 accidents which involved airframe fires. Eighty-seven percent of the fires occurred after impact, and fuel leakage from ruptured tanks or severed lines was the most frequently cited cause. A cost analysis was performed for 300 serious accidents, including 92 serious accidents which involved fire. Personal injury costs were outside the scope of the cost analysis, but data on personnel injury judgements as well as settlements received from the CAB are included for reference.

  6. Road accidents and business cycles in Spain.

    Rodríguez-López, Jesús; Marrero, Gustavo A; González, Rosa Marina; Leal-Linares, Teresa


    This paper explores the causes behind the downturn in road accidents in Spain across the last decade. Possible causes are grouped into three categories: Institutional factors (a Penalty Point System, PPS, dating from 2006), technological factors (active safety and passive safety of vehicles), and macroeconomic factors (the Great recession starting in 2008, and an increase in fuel prices during the spring of 2008). The PPS has been blessed by incumbent authorities as responsible for the decline of road fatalities in Spain. Using cointegration techniques, the GDP growth rate, the fuel price, the PPS, and technological items embedded in motor vehicles appear to be statistically significantly related with accidents. Importantly, PPS is found to be significant in reducing fatal accidents. However, PPS is not significant for non-fatal accidents. In view of these results, we conclude that road accidents in Spain are very sensitive to the business cycle, and that the PPS influenced the severity (fatality) rather than the quantity of accidents in Spain. Importantly, technological items help explain a sizable fraction in accidents downturn, their effects dating back from the end of the nineties.


    Abu Bakar M.Luddin


    Abstrak: Kinerja Kepala Sekolah dalam Kegiatan Bimbingan dan Konseling. Penelitian ini bertujuan mendeskripsikan kinerja kepala sekolah dalam pelaksanaan kegiatan bimbingan dan konseling. Penelitian dilaksanakan di SMU Negeri 2 Kota Binjai, dengan memergunakan rancangan deskriptif kualitatif. Subjek penelitian adalah kepala sekolah, koordinator bimbingan dan konseling, dan guru pembimbing. Data di­kumpulkan dengan observasi, wawancara mendalam, dan kajian dokumen, dan selanjutnya dianalisis sete­lah melalui proses triangulasi antarsubjek dan informasi. Temuan penelitian menunjukkan bahwa kinerja kepala sekolah terkait dengan pelaksanaan kegiatan bimbingan dan konseling masih belum sepenuhnya sebagaimana yang diharapkan. Kepala sekolah perlu meningkatkan kinerjanya dalam menjalankan fungsi koordinasi dan kepengawasan untuk mencapai kegiatan bimbingan dan konseling yang efektif.

  8. Risiko Ergonomi Ketidaksesuaian Desain dan Ukuran Tempat Duduk Sepeda Motor terhadap Antropometri pada Mahasiswa

    Zulkifli Djunaidi


    Full Text Available Transportasi merupakan hal yang sangat dibutuhkan dalam menunjang pembangunan nasional. Belum baiknya sistem transportasi massal di Indonesia, membuat masyarakat lebih memilih menggunakan kendaraan pribadi, seperti sepeda motor yang praktis dan ekonomis untuk digunakan. Namun, dalam menggunakan sepeda motor, aspek ergonomi dan kenyamanan bagi pengendara perlu untuk diperhatikan. Desain dan ukuran tempat duduk sepeda motor yang tidak sesuai dengan antropometri duduk statis pengendara dapat menimbulkan kelelahan pada pengendara dan mengakibatkan terjadinya kecelakaan. Tujuan dari penelitian ini adalah untuk mengetahui risiko ergonomi dari ketidaksesuaian antara desain dan ukuran tempat duduk sepeda motor dengan antropometri duduk statis. Untuk menganalisis risiko ergonomi, dilakukan penelitian dengan desain deskriptif analitik pada mahasiswa di sekitar lingkungan kampus Fakultas Kesehatan Masyarakat Universitas Indonesia pada bulan Oktober sampai dengan Desember 2009. Jumlah sampel sebanyak 100 orang responden, dibagi menjadi 50 orang laki-laki dan 50 orang perempuan. Sampel responden dipilih dengan metode cluster random sampling, sedangkan tipe sepeda motor dipilih berdasarkan yang paling banyak digunakan dengan metode simple stratified random sampling. Hasil penelitian menunjukkan bahwa terdapat ketidaksesuaian antara ukuran tempat duduk sepeda motor dengan antropometri duduk statis pada mahasiswa. Adanya ketidaksesuaian tersebut dapat mengakibatkan risiko ergonomi pada pengendara dan terjadinya kecelakaan lalu lintas. Ergonomic Risks of Incompatibility of Design and Size of Motorcycle Seat againts Anthropometry among College Students Transportation is something needed most to support national development. Bad mass transportation system in Indonesia, makes people prefer to use private vehicles, such as motorcycle which is practical and economical to use. However, riders need to consider ergonomic and comfortability aspects in using motorcycle

  9. Symmetric increased skeletal muscular uptake of F-18 fluoro-deoxyglucose: A clue for the diagnosis of Graves' disease.

    Santhosh, Sampath; Mittal, Bhagwant Rai; Kashyap, Raghava; Bhattacharya, Anish; Singh, Baljinder


    F-18 fluoro-deoxyglucose (FDG) uptake in the thyroid and thymus is well reported in patients with Graves' disease. Incidental skeletal muscle uptake has also been reported in other non-musculoskeletal (benign and malignant) pathologies. We report a patient of Graves' disease showing symmetrical skeletal muscle uptake but no thyroidal or thymus uptake of FDG.

  10. 78 FR 31570 - Prospective Grant of a Start-Up Exclusive Patent License Agreement: Treatment of Graves' Disease...


    ... a Start-Up Exclusive Patent License Agreement: Treatment of Graves' Disease, Hyperthyroidism and...' Disease, hyperthyroidism and thyroid cancer. DATES: Only written comments or applications for a license... useful in treating hyperthyroidism and Graves' disease, an autoimmune disease that is commonly...


    Gandes Nurseto


    Pendidikan seni tari perlu diberikan pada Sekolah Dasar karena keunikan, kebermaknaan terletak pada pemberian pengalaman estetik dalam bentuk berapresiasi dan menggunakan model pembelajaran yang PAIKEM Pembelajaran, Aktif, Inovatif, Kreatif, Efektif dan Menyenagkan dalam proses pembelajaran didalam kelas dari Standar Kompetensi dan Komptensi Dasar mengapresiasi karya seni tari tunggal nusantara yang bertujuan untuk mengenalkan karya seni tari daerah lain. Masalah dalam penelitian ini bagaiman...

  12. Kandidiasis di Mulut akibat Khemoterapi dan Penatalaksanaannya


    Latar belakang: kandidiasis (kandidosis) adalah infeksi jamur yang disebabkan oleh spesies Candida biasanya Candida albicans. Faktor predisposisi yang memicu kandidiasis adalah terganggunya ekologi mulut karena antara lain pemakaian antibiotika, kortikosteroid, penyakit kronis dan keganasan, beberapa gangguan darah; terapi radiasi di leher dan kepala; khemoterapi; leukimia, obat sitotoksik, juga kebersihan mulut yang buruk. Tujuan: melaporkan kasus kandidiasis di mulut karena khemoterapi dan ...

  13. Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre

    Bové, Kira Bang; Watt, Torquil; Vogel, Asmus


    ' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease.METHODS: 157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre......' disease versus 4% in nodular goitre (p = 0.038), anxiety was 18 versus 13% (p = 0.131). Symptoms of anxiety (p = 0.04) and depression (p = 0.01) increased with comorbidity. Anxiety symptoms increased with duration of Graves' disease (p = 0.04). Neither thyroid function nor autoantibody levels were...... associated with anxiety and depression symptoms.CONCLUSIONS: Anxiety and depression symptoms were more severe in Graves' disease than in nodular goitre. Symptoms were positively correlated to comorbidity and duration of Graves' disease but neither to thyroid function nor thyroid autoimmunity....


    Atip Latipulhayat


    Full Text Available The main objective of an aircraft accident investigation is to find out the most probable causes of such accident. This represents a technical investigation in nature. At the practical level, however, this report is often used as legal evidence before the court. This paper argues that the main purpose of an aircraft acccident investigation is technical in nature and judicial investigation is carried out when the technical investigation found elements of crime that has been alleged as the most probable cause of the accident.   Menurut Konvensi Chicago 1944, tujuan utama suatu investigasi kecelakaan pesawat udara adalah untuk menemukan penyebab terjadinya kecelakaan tersebut. Jadi, investigasi ini bersifat teknis. Namun, laporan investigasi ini seringkali dijadikan alat bukti di pengadilan khususnya apabila faktor kesalahan manusia dianggap sebagai penyebab utama terjadinya kecelakaan tersebut. Investigasi teknis berubah menjadi investigasi yuridis. Tulisan ini berpendapat bahwa hakikat investigasi kecelakaan pesawat udara adalah bersifat teknis dan investigasi yuridis hanya akan dilakukan apabila laporan investigasi teknis menunjukkan adanya elemen kriminal.

  15. Too early to dismiss Yersinia enterocolitica infection in the aetiology of Graves' disease

    Brix, Thomas H; Hansen, Pia S; Hegedüs, Laszlo


    BACKGROUND: Yersinia enterocolitica (YE) infection has long been implicated in the pathogenesis of Graves' disease (GD). The association between YE and GD could, however, also be due to common genetic or environmental factors affecting the development of both YE infection and GD. This potential...

  16. Treatment of Graves' disease with rituximab specifically reduces the production of thyroid stimulating autoantibodies

    El Fassi, Daniel; Banga, J Paul; Gilbert, Jacqueline A;


    Treatment of Graves' disease (GD) with the B-lymphocyte depleting agent rituximab in addition to standard methimazole-therapy prolongs remission. Paradoxically, it does not mediate a reduction in thyrotropin receptor antibody (TRAb) levels over that of methimazole monotherapy. Using a bioassay in...

  17. Affective symptoms and cognitive functions in the acute phase of Graves' thyrotoxicosis

    Vogel, Asmus; Elberling, Tina V; Hørding, Merete;


    patients with Graves' thyrotoxicosis. A control group of 34 individuals matched for age, education and premorbid intelligence was also included. At baseline all patients and control subjects were examined with psychiatric rating scales and a comprehensive neuropsychological battery. The effect of treatment...

  18. B lymphocyte depletion with the monoclonal antibody rituximab in Graves' disease: a controlled pilot study

    El Fassi, Daniel; Nielsen, Claus H; Bonnema, Steen J


    Graves' disease (GD) is a common TSH receptor autoantibody (TRAb)-mediated disorder. Because B lymphocytes are important self-antigen presenting cells and precursors for antibody-secreting plasma cells, temporary B-lymphocyte depletion with the monoclonal antibody rituximab (RTX) might...

  19. Miastenia grave induzida por D-penicilamina em paciente com esclerose sistêmica progressiva

    Paulo E. Marchiori


    Full Text Available Relato de caso de miastenia grave induzida por D-penicilamina. São descutidos os possíveis mecanismos etiopatogênicos envolvidos no desencadeamento da doença e é salientada a presença de anticorpo anti-receptor de acetilcolina e hiperplasia tímica na DPA-MG.

  20. Graves' disease in two pregnancies complicated by fetal goitrous hypothyroidism: successful in utero treatment with levothyroxine

    Bliddal, Sofie; Rasmussen, Åse Krogh; Sundberg, Karin Milner;


    Treatment of Graves' disease during pregnancy with antithyroid drugs (ATDs) poses a risk of inducing hypothyroidism and, thus, development of a goiter to the fetus. PATIENT FINDINGS: We report two patients referred to our department after discovery of a fetal goiter by ultrasound examination...

  1. B lymphocyte depletion with the monoclonal antibody rituximab in Graves' disease: a controlled pilot study

    El Fassi, Daniel; Nielsen, Claus H; Bonnema, Steen Joop


    CONTEXT: Graves' disease (GD) is a common TSH receptor autoantibody (TRAb)-mediated disorder. Because B lymphocytes are important self-antigen presenting cells and precursors for antibody-secreting plasma cells, temporary B-lymphocyte depletion with the monoclonal antibody rituximab (RTX) might...

  2. /sup 131/I-therapy of Graves' disease and non-immunogenic thyrotoxicosis

    Hoeschel, M.; Heinze, H.G.


    From 1977 to 1982, 315 patients suffering from thyrotoxicosis with diffuse and/or nodular goitre or Graves' disease were treated with /sup 131/I. In 246 patients, the results of treatment after 7 months to 5 1/2 years could be evaluated. After a single treatment with /sup 131/I, 72% of the patients with hyperthyroid nodular goitre and 61% of those with diffuse goitre, but only 36% of the patients with Graves' disease showed normal thyroid function. By repeated /sup 131/I treatments - as many as 5 for those with Graves' disease - normal thyroid function could be achieved in nearly all patients examined. Patients with immune thyrotoxicosis, type Graves' disease, showed a high resistance to therapy. A dependence was found between the results of these treatments and previous antithyroidal drug therapy or surgery. The rate of hypothyroidism varied between 4 and 15%. The highest rate of hypothyroidism was observed in operated patients with persistent or recurring thyrotoxicosis.

  3. Graves, Ancestors and Cement in Land disputes in Acholi and Ikland, Uganda

    Meinert, Lotte; Willerslev, Rane; Seebach, Sophie Hooge


    The paper explores the roles of graves, ancestors and concrete pillars in disputes over land across different land-systems, -conflicts, and territory making in northern Uganda by comparing extended cases between Acholi in Gulu district and Ik in Kaabong district . In the post-conflict Acholi region...

  4. Incidence of vitiligo in children with Graves' disease and Hashimoto's thyroiditis

    Prindaville Brea


    Full Text Available Abstract Background Limited data are available on the association between vitiligo and autoimmune thyroid disease in pediatric patients. In addition, reported studies of pediatric patients have been based on a population known to have vitiligo and subsequently evaluated for the presence of thyroid function abnormalities. Methods A retrospective chart review was performed on 333 children who had been followed for thyroid disorders by endocrinologists at the Yale Pediatric Thyroid Center over the last 5 years for autoimmune thyroid disease. Demographical and clinical features of patients found to have thyroid disease and vitiligo were recorded. These studies were approved by the Yale Human Investigation Committee. Results Of the total 333 children and adolescents, 9 (2.7% were noted to have vitiligo. Four patients (44% had Graves' disease and 5 patients (66% had Hashimoto's thyroiditis. For patients with Graves' disease and vitiligo, the average age of onset of thyroid disease was young at 4 ± 0.7 years, and the diagnosis of vitiligo usually preceded that of thyroid disease. For children with Hashimoto's thyroiditis and vitiligo, thyroid disease was diagnosed at an average age of 13.25 ± 2.8 years. Conclusion In our population, 4.6% of children with Graves' disease and 2.0% of children with Hashimoto's thyroiditis had vitiligo. Interestingly, when vitiligo presents with Graves' disease, it occurs in younger rather than older children.

  5. A Danish Early Germanic Iron Age Grave with Tablet Woven Cuffs

    Mannering, Ulla; Knudsen, Lise Ræder


    This article presents exciting new textile information from a Danish Early Germanic Iron Age grave at Broedbaek, North West Jutland, where tiny little fragments of textiles were found on metal clasps and brooches. Some of the textiles appeared to be made in a so far unknown tablet weaving technique....

  6. 78 FR 16295 - Native American Graves Protection and Repatriation Review Committee: Meeting


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... the Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American... the Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native...

  7. 77 FR 74874 - Native American Graves Protection and Repatriation Review Committee: Meeting


    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a telephonic meeting of the Native American... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a telephonic meeting of the Native American...

  8. Educational Interventions Targeted at Minors in Situations of Grave Social Vulnerability and Their Families

    de la Caba Collado, Mariangeles; Rojas, Isabel Bartau


    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The…

  9. Subclinical Hypothyroidism after 131I-Treatment of Graves' Disease: A Risk Factor for Depression?

    Jing Yu

    Full Text Available Although it is well accepted that there is a close relationship between hypothyroidism and depression, previous studies provided inconsistent or even opposite results in whether subclinical hypothyroidism (SCH increased the risk of depression. One possible reason is that the etiology of SCH in these studies was not clearly distinguished. We therefore investigated the relationship between SCH resulting from 131I treatment of Graves' disease and depression.The incidence of depression among 95 patients with SCH and 121 euthyroid patients following 131I treatment of Graves' disease was studied. The risk factors of depression were determined with multivariate logistic regression analysis. Thyroid hormone replacement therapy was performed in patients with thyroid-stimulating hormone (TSH levels exceeding 10 mIU/L.Patients with SCH had significantly higher Hamilton Depression Scale scores, serum TSH and thyroid peroxidase antibody (TPOAb levels compared with euthyroid patients. Multivariate logistic regression analysis revealed SCH, Graves' eye syndrome and high serum TPO antibody level as risk factors for depression. L-thyroxine treatment is beneficial for SCH patients with serum TSH levels exceeding 10 mIU/L.The results of the present study demonstrated that SCH is prevalent among 131I treated Graves' patients. SCH might increase the risk of developing depression. L-thyroxine replacement therapy helps to resolve depressive disorders in SCH patients with TSH > 10mIU/L. These data provide insight into the relationship between SCH and depression.

  10. A randomized controlled trial of orbital radiotherapy versus sham irradiation in patients with mild Graves' ophthalmopathy

    Prummel, MF; Terwee, CB; Gerding, MN; Baldeschi, L; Mourits, MP; Blank, L; Dekker, FW; Wiersinga, WM


    Radiotherapy is often used in Graves' ophthalmopathy, but its efficacy has been doubted. We compared its efficacy with sham irradiation in mild ophthalmopathy. In a double-blind randomized trial, 44 patients received orbital irradiation, and 44 were sham-irradiated. The primary outcome was assessed

  11. The Chernobyl accident consequences; Consequences de l'accident de Tchernobyl



    Five teen years later, Tchernobyl remains the symbol of the greater industrial nuclear accident. To take stock on this accident, this paper proposes a chronology of the events and presents the opinion of many international and national organizations. It provides also web sites references concerning the environmental and sanitary consequences of the Tchernobyl accident, the economic actions and propositions for the nuclear safety improvement in the East Europe. (A.L.B.)


    Garófoli, Adrián; Montoya, Paola; Elías, Carlos; Benzo, Roberto


    El Mal Agudo de Montaña (MAM) es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral) pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2 700m y 4 300m en 63 sujetos que ascendían al cerro Aconcagua (6 962m). Se consideró desaturación de oxígeno con ejercicio a una disminución >=5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. 6 sujetos presentaron MAM grave (9.5%) y requirieron evacuación. La saturación de oxígeno en reposo a 2 700m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2 700m más la saturación inapropiada en reposo a 4 300m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave. PMID:20228017

  13. 48 CFR 852.236-87 - Accident prevention.


    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Accident prevention. 852... Accident prevention. As prescribed in 836.513, insert the following clause: Accident Prevention (SEP 1993....236-13, Accident Prevention. However, only the Contracting Officer may issue an order to stop all...

  14. 46 CFR 4.03-1 - Marine casualty or accident.


    ... States vessel wherever such casualty or accident occurs; or (3) With respect to a foreign tank vessel... 46 Shipping 1 2010-10-01 2010-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1... AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  15. 46 CFR 196.30-5 - Accidents to machinery.


    ... 46 Shipping 7 2010-10-01 2010-10-01 false Accidents to machinery. 196.30-5 Section 196.30-5... Reports of Accidents, Repairs, and Unsafe Equipment § 196.30-5 Accidents to machinery. (a) In the event of an accident to a boiler, unfired pressure vessel, or machinery tending to render the further use...

  16. 46 CFR 97.30-5 - Accidents to machinery.


    ... 46 Shipping 4 2010-10-01 2010-10-01 false Accidents to machinery. 97.30-5 Section 97.30-5 Shipping... Reports of Accidents, Repairs, and Unsafe Equipment § 97.30-5 Accidents to machinery. (a) In the event of an accident to a boiler, unfired pressure vessel, or machinery tending to render the further use...

  17. 46 CFR 78.33-5 - Accidents to machinery.


    ... 46 Shipping 3 2010-10-01 2010-10-01 false Accidents to machinery. 78.33-5 Section 78.33-5 Shipping... Accidents, Repairs, and Unsafe Equipment § 78.33-5 Accidents to machinery. (a) In the event of an accident to a boiler, unfired pressure vessel, or machinery tending to render the further use of the...

  18. Ruthenium release from fuel in accident conditions

    Brillant, G.; Marchetto, C.; Plumecocq, W. [Inst. de Radioprotection et de Surete Nucleaire, DPAM, SEMIC, LETR and LIMSI, Saint-Paul-Lez-Durance (France)


    During a hypothetical nuclear power plant accident, fission products may be released from the fuel matrix and then reach the containment building and the environment. Ruthenium is a very hazardous fission product that can be highly and rapidly released in some accident scenarios. The impact of the atmosphere redox properties, temperature, and fuel burn-up on the ruthenium release is discussed. In order to improve the evaluation of the radiological impact by accident codes, a model of the ruthenium release from fuel is proposed using thermodynamic equilibrium calculations. In addition, a model of fuel oxidation under air is described. Finally, these models have been integrated in the ASTEC accident code and validation calculations have been performed on several experimental tests. (orig.)

  19. MELCOR analysis of the TMI-2 accident

    Boucheron, E.A.


    This paper describes the analysis of the Three Mile Island-2 (TMI-2) standard problem that was performed with MELCOR. The MELCOR computer code is being developed by Sandia National Laboratories for the Nuclear Regulatory Commission for the purpose of analyzing severe accident in nuclear power plants. The primary role of MELCOR is to provide realistic predictions of severe accident phenomena and the radiological source team. The analysis of the TMI-2 standard problem allowed for comparison of the model predictions in MELCOR to plant data and to the results of more mechanistic analyses. This exercise was, therefore valuable for verifying and assessing the models in the code. The major trends in the TMI-2 accident are reasonably well predicted with MELCOR, even with its simplified modeling. Comparison of the calculated and measured results is presented and, based on this comparison, conclusions can be drawn concerning the applicability of MELCOR to severe accident analysis. 5 refs., 10 figs., 3 tabs.

  20. [Severe parachuting accident. Analysis of 122 cases].

    Krauss, U; Mischkowsky, T


    Based on a population of 122 severely injured patients the causes of paragliding accidents and the patterns of injury are analyzed. A questionnaire is used to establish a sport-specific profile for the paragliding pilot. The lower limbs (55.7%) and the lower parts of the spine (45.9%) are the most frequently injured parts of the body. There is a high risk of multiple injuries after a single accident because of the tremendous axial power. The standard of equipment is good in over 90% of the cases. Insufficient training and failure to take account of geographical and meteorological conditions are the main determinants of accidents sustained by paragliders, most of whom are young. Nevertheless, 80% of our patients want to continue paragliding. Finally some advice is given on how to prevent paragliding accidents and injuries.

  1. The Chornobyl accident: A comprehensive risk assessment

    Vargo, G.J. [ed.; Poyarkov, V.; Bar`yakhtar, V.; Kukhar, V.; Los, I.; Kholosha, V.; Shestopalov, V.


    The authors, all of whom are Ukrainian and Russian scientists involved with Chornobyl nuclear power plant since the April 1986 accident, present a comprehensive review of the accident. In addition, they present a risk assessment of the remains of the destroyed reactor and its surrounding shelter, Chornobyl radioactive waste storage and disposal sites, and environmental contamination in the region. The authors explore such questions as the risks posed by a collapse of the shelter, radionuclide migration from storage and disposal facilities in the exclusion zone, and transfer from soil to vegetation and its potential regional impact. The answers to these questions provide a scientific basis for the development of countermeasures against the Chornobyl accident in particular and the mitigation of environmental radioactive contamination in general. They also provide an important basis for understanding the human health and ecological risks posed by the accident.

  2. Safety analysis of surface haulage accidents

    Randolph, R.F.; Boldt, C.M.K.


    Research on improving haulage truck safety, started by the U.S. Bureau of Mines, is being continued by its successors. This paper reports the orientation of the renewed research efforts, beginning with an update on accident data analysis, the role of multiple causes in these accidents, and the search for practical methods for addressing the most important causes. Fatal haulage accidents most often involve loss of control or collisions caused by a variety of factors. Lost-time injuries most often involve sprains or strains to the back or multiple body areas, which can often be attributed to rough roads and the shocks of loading and unloading. Research to reduce these accidents includes improved warning systems, shock isolation for drivers, encouraging seatbelt usage, and general improvements to system and task design.

  3. Review of methodology for accident consequence assessment

    Strenge, D.L.; Soldat, J.K.; Watson, E.C.


    This report reviews current methodologies for reactor accident consequence analysis and describes areas where modifications are warranted. Methodologies reviewed are: (1) Models in Regulatory Guides 1.109, 1.111 and 1.113 used for evaluation of compliance with 10 CFR 50 Appendix I; (2) Models in Regulatory Guides used for evaluation of consequences from accidents of Classes 3-8; (3) Models for evaluation of Class 9 accidents presented in the Reactor Safety Study; and (4) Models in the Liquid Pathway Generic Study. The review is designed to aid in the ultimate goal of selection of a comprehensive set of models to extend the Class 9 methodology of the Reactor Safety Study to the analysis of Classes 3-8 accidents.

  4. The epidemiology of bicyclist's collision accidents

    Larsen, L. B.


    of bicyclists and risk situations. The findings should make a basis for preventive programmes in order to decrease the number and severity of bicyclists collision accidents. Data from the emergency room in a 2 year period was combined with data from questionnaires. The study group consisted of 1021 bicyclists...... group of accidents were the collisions with the 'soft' road users (bicyclists, mopeds, and pedestrians) and another group were the collisions with the 'hard' road users (motor vehicles, motorcycles). Preventive measures have to be directed at both these groups of accidents. To decrease the number...... of collision accidents with motor vehicles it is necessary to separate the bicyclists from the 'hard road traffic' especially at crossings. Preventive measures must also be directed at the bicyclists. Information must be given to warn the bicyclists against the risks, not only for collisions with motor...

  5. Pergaulan Bebas dan Hamil Pranikah

    Farida Farida


    Full Text Available Married by accident cases or pragnancy outside marriage boundages and freeintercourse are blur pictures of our youth generation. In addition to break religious,social, and ethical norms, those acts also ruine their own futures. These cases happenusually because of lack of youth abilities to screen, to select and to choose positiverelationship. In addition, this is because of their unstable emotion, lack of partens’monitoring and less in religious knowledges. To prevent married by accident casesand effects of free intercourse, it is advisable for every families to strengthen faithof their family mambers, to build harmonious communication with the teenagers, toimprove diciplines in family circles, to control educatively and to direct the teenagersin performing positive activities, and to give sex education wisely and proportionally.Furthermore, schools and societies are expected to contribute in monitoring theteenagers so they are not cought up in free intercourse.Key Words: Married By Accident, Intercouse, Teenager, Religion

  6. Severe accident testing of electrical penetration assemblies

    Clauss, D.B. (Sandia National Labs., Albuquerque, NM (USA))


    This report describes the results of tests conducted on three different designs of full-size electrical penetration assemblies (EPAs) that are used in the containment buildings of nuclear power plants. The objective of the tests was to evaluate the behavior of the EPAs under simulated severe accident conditions using steam at elevated temperature and pressure. Leakage, temperature, and cable insulation resistance were monitored throughout the tests. Nuclear-qualified EPAs were produced from D. G. O'Brien, Westinghouse, and Conax. Severe-accident-sequence analysis was used to generate the severe accident conditions (SAC) for a large dry pressurized-water reactor (PWR), a boiling-water reactor (BWR) Mark I drywell, and a BWR Mark III wetwell. Based on a survey conducted by Sandia, each EPA was matched with the severe accident conditions for a specific reactor type. This included the type of containment that a particular EPA design was used in most frequently. Thus, the D. G. O'Brien EPA was chosen for the PWR SAC test, the Westinghouse was chosen for the Mark III test, and the Conax was chosen for the Mark I test. The EPAs were radiation and thermal aged to simulate the effects of a 40-year service life and loss-of-coolant accident (LOCA) before the SAC tests were conducted. The design, test preparations, conduct of the severe accident test, experimental results, posttest observations, and conclusions about the integrity and electrical performance of each EPA tested in this program are described in this report. In general, the leak integrity of the EPAs tested in this program was not compromised by severe accident loads. However, there was significant degradation in the insulation resistance of the cables, which could affect the electrical performance of equipment and devices inside containment at some point during the progression of a severe accident. 10 refs., 165 figs., 16 tabs.

  7. Personality characteristics of the child accident repeater

    Manheimer, Dean I.; Mellinger, Glen D


    From 8874 boys and girls aged 4 to 18 in Berkeley-Oakland, California, 684 were selected to represent high-, intermediateor low-accident-liability children, based on records of medically attended injuries. Using data from intensive interviews with mothers supplemented with school records, we found a statistically significant relation between accident liability and indexes of extraversion, daring, roughhousing, and other traits tending to expose children to hazards. Similar relations held for ...

  8. APRI-6. Accident Phenomena of Risk Importance

    Garis, Ninos; Ljung, J (eds.) (Swedish Radiation Safety Authority, Stockholm (Sweden)); Agrenius, Lennart (ed.) (Agrenius Ingenjoersbyraa AB, Stockholm (Sweden))


    Since the early 1980s, nuclear power utilities in Sweden and the Swedish Radiation Safety Authority (SSM) collaborate on the research in severe reactor accidents. In the beginning focus was mostly on strengthening protection against environmental impacts after a severe reactor accident, for example by develop systems for the filtered relief of the reactor containment. Since the early 90s, this focus has shifted to the phenomenological issues of risk-dominant significance. During the years 2006-2008, the partnership continued in the research project APRI-6. The aim was to show whether the solutions adopted in the Swedish strategy for incident management provides adequate protection for the environment. This is done by studying important phenomena in the core melt estimating the amount of radioactivity that can be released to the atmosphere in a severe accident. To achieve these objectives the research has included monitoring of international research on severe accidents and evaluation of results and continued support for research of severe accidents at the Royal Inst. of Technology (KTH) and Chalmers University. The follow-up of international research has promoted the exchange of knowledge and experience and has given access to a wealth of information on various phenomena relevant to events in severe accidents. The continued support to KTH has provided increased knowledge about the possibility of cooling the molten core in the reactor tank and the processes associated with coolability in the confinement and about steam explosions. Support for Chalmers has increased knowledge of the accident chemistry, mainly the behavior of iodine and ruthenium in the containment after an accident.


    I G. Mahardika


    Full Text Available Penelitian telah dilakukan untuk mengetahui pengaruh pemberian hijauan dan konsentrat yang mengandung urea-kapur dan ubi kayu terhadap produktivitas kambing. Penelitian menggunakan Rancangan Acak Lengkap dengan 4 perlakuan dan 4 ulangan. Ke empat perlakuan yang dicobakan adalah Perlakuan A: ransum dengan 75% konsentrat (mengandung 4% urea, 2% kapur dan 50% ubikayu dan 25% hijauan (40% gamal dan 60% rumput raja, perlakuan B: rasnsum yang terdiri 60% konsentrat 40% hijauan, perlakuan C: ransum dengan 45% konsentrat dan 55% hijauan dan perlakuan D: ransum dengan 30% konsentrat dan 70% hijauan. Hasil penelitian mendapatkan bahwa produktivitas kambing yang mendapat ransum dengan level konsentrat 45% sampai 75% tidak berbeda sedangkan yang mendapat ransum dengan level konsentrat 30% lebih rendah. Ransum yang memebrikan nilai ekonomi tertinggi adalah ransum yang mengandung konsentrat antara 45% sampai 60%.


    Putu Ade Hinduari Putra


    Full Text Available Lebah tanpa sengat (Trigona spp. dapat menghasilkan madu yang bermanfaat bagi kesehatan. Penelitian bertujuan untuk mengetahui : (1 morfologi Trigona spp., (2 struktur internal sarang Trigona spp. pada sarang berbentuk tabung dan bola, (3 volume sarang serta perkiraan produksi madu, beebread dan selanakan Trigona spp. pada sarang berbentuk tabung dan bola. Penelitian dilaksanakan pada bulan November 2014. Sampel yang digunakan adalah koloni dan sarang Trigona spp. berbentuk tabung dan bola yang diambil di Desa Padang Tunggal,Kecamatan Selat, Kabupaten Karangasem, Bali. Hasil penelitian menunjukan bahwa nama spesies dari sampel koloni Trigona spp. pada sarang berbentuk tabung dan bola adalah Trigona laeviceps. Struktur internal sarang Trigona spp. pada sarang berbentuk tabung dan bola mempunyai pola susunan yaitu pot madu, pot beebread dan pot sel anakan. Volume sarang besar memberikan perkiraan total jumlah produksi madu, beebread dan selanakan lebih banyak dibandingkan volume sarang kecil.


    Widya Setyaningrum Bagyoastuti


    Full Text Available Penelitian ini bertujuan untuk mendeskripsikan: (1 peran kepala sekolah dalam memberdayakan perpustakaan sekolah dasar, dan (2 peran pustakawan dalam memberdayakan perpustakaan sekolah dasar. Pendekatan kualitatif digunakan dalam penelitian ini dengan menjadikan perpustakaan SD Muhammadiyah Sapen dan SD Negeri Giwangan sebagai subjek penelitian. Data penelitian dikumpulkan melalui teknik observasi, wawancara, dan dokumentasi kemudian dianalisis dengan mengacu pada model interaktif menurut Miles dan Huberman. Hasil penelitian menunjukkan bahwa pemberdayaan perpustakaan sekolah dasar dimulai manakala terdapat dukungan kepala sekolah dan hadirnya pustakawan penuh waktu yang profesional. Kepala sekolah berperan sebagai (1 manajer sekolah, (2 pemimpin instruksional, dan (3 agen perubahan. Pustakawan berperan sebagai (1 manajer perpustakaan, (2 ahli informasi dan penggiat literasi informasi, (3 pelaku instruksional, dan (4 kolaborator. Pemberdayaan perpustakaan dapat dilakukan dengan (1 meningkatkan partisipasi warga sekolah dalam pengembangan koleksi pustaka, (2 meningkatkan kolaborasi antara pustakawan dengan guru dalam pembelajaran, dan (3 pengembangan literasi informasi yang terintegrasi ke dalam pembelajaran.


    Evayusvita Rustam


    Full Text Available Tujuan dari penelitian ini adalah mengidentifikasi dan mengendalikan hama dan penyakit benih pulai yang terbawa dari lapangan. Identifikasi cendawan dilakukan dengan menginkubasi benih selama 7 hari, sedangkan untuk pengendalian terhadap hama dan penyakit benih diberi insektisida nabati dan kimia. Dari hasil identifikasi jenis cendawan pada benih pulai yaitu Aspergillus sp, Curvularia sp., Fusarium sp., Penicillium sp. dan Rhizopus sp. Persentase infeksi cendawan tertinggi pada benih pulai asal Nagrak (Aspergillus sp. sebesar 92%, Curvularia sp. 29% dan Fusarium sp. 21%, sedangkan persentase infeksi cendawan terendah pada benih pulai asal Jambi (Aspergillus sp. 2% dan Fusarium sp. 1%. Perlakuan terbaik yang dapat mengendalikan hama pada benih pulai adalah perlakuan yang diberi ekstrak daun suren dalam wadah plastik tertutup dan disimpan di ruang suhu kamar 270C selama 2 bulan. Pengendalian penyakit, terbaik pada benih adalah memberi bubuk kunyit ke dalam wadah plastik tertutup dan disimpan di lemari es 160C. Perlakuan tersebut menghasilkan daya kecambah masing-masing 70%.

  13. Tratamento cirúrgico da laringomalácia grave: estudo retrospectivo de 11 casos

    José Antonio Pinto


    Full Text Available A laringomalácia é a anomalia congênita da laringe mais frequente, sendo responsável por cerca de 60% a 75% dos casos de estridor congênito. Apesar de seu curso benigno e autolimitado, 10% dos casos necessitam de intervenção. Atualmente, as supraglotoplastias são consideradas o tratamento padrão da laringomalácia grave. OBJETIVO: Descrever a experiência adquirida pelos autores no tratamento cirúrgico dos pacientes com laringomalácia grave. Metodologia: Estudo retrospectivo. MÉTODO: Os prontuários de 11 casos consecutivos de laringomalácia grave, submetidos ao tratamento cirúrgico entre 2003 e 2012, foram analisados quanto à idade, gênero, sintomas, doenças associadas, técnica cirúrgica adotada, tempo de extubação, complicações cirúrgicas, tempo de internação e evolução clínica. RESULTADOS: Dos 11 casos de laringomalácia grave, seis pacientes (54,5% foram operados com o uso do laser de CO2 e em cinco pacientes (45,5% foram realizadas a técnica a frio. Apenas um paciente (9,1% necessitou reabordagem cirúrgica. Não foram observados casos de complicações cirúrgicas. Todos os pacientes apresentaram melhora clínica importante. CONCLUSÃO: A supraglotoplastia mostrou-se um procedimento eficaz e seguro no tratamento da laringomalácia grave.

  14. The thickness of the retrobulbar portion of the optic nerve in Graves ophthalmopathy measured by ultrasound

    Stefanović Ivan


    Full Text Available Introduction. The clinical diagnostic of Graves ophthalmopathy is based on the association of ocular signs and the disease of the thyroid gland. The evolution of the disease involves the development of eye globe protrusion, extraocular muscle thickening pressuring the optic nerve, which can result in its thickness. Objective. The aim of the paper is to find whether the retrobulbar optic nerve thickened and if there was a correlation between its possible thickening and the thickness of the muscles in Graves ophthalmopathy. We also wished to test the theory of compressive aetiology of such thickening using a 30-degree test. Methods. We examined 28 patients with Graves ophthalmopathy. The thickness of the retrobulbar optic nerve was measured by ultrasound on a B-scan using the Schraeder's method and by the largest thickness of the internal muscle. Results. The thickness of the retrobulbar portion of the optic nerve in the 52 analyzed eyes with signs of the disease ranged between 3.24 mm to 6.30 mm, with median of 5.13 mm, indicating that the majority of the patients had optic nerve thickening rating at this value. Forty-eight eyes had a marked retrobulbar optic nerve thickening, with the thickening over 4 mm, while in 4 eyes with signs of Graves ophthalmopathy the thickness of the optic nerve was within normal limits. We detected that 92.3% of the patients with muscular thickening also had a directly proportional thickening of the retrobulbar optic nerve. By using the 30-degree test we confirmed the diagnosis of compressive neuropathy. Conclusion. Patients with Graves ophthalmopathy and thickened muscles, also have a thickening of the retrobulbar optic nerve; the rate of the thickness directly depends on the degree of the muscular thickness. The word is of compressive neuropathy, i.e. the thickness of the optic nerve is the result of subarachnoid fluid stasis caused by the compression on the optic nerve.

  15. GRIYA DAN OMAH Penelusuran Makna dan Signifikasi di Arsitektur Jawa

    Josef Prijotomo


    Full Text Available Terms and names in architecture may sometimes be powerful in exploring history of ideas. Philology and hermeneutics are discipline of knowledge that utilize this notion in a very throgh and critical way. Inspired by those discipline of knowledge, this musing on `Griya' and `Omah' tries to demonstrate that their meaning is not `house' as many still understand them. Rather, both terms understood by the Jawanese as `any building' constructed. Critical assessment upon old documents named `Kawruh Griya' not only supportive for this understanding among the Javanese, but also provide us with a hint on one of ideals of `what a home is' among the Jawanese. The Javanese once had a notion that to dwell in a house is like sheltering under a shady tree. Since `griya' and `omah' may open our musing up to regions and cultures outside Jawa, this paper will limit its musing within the Jawanese. Abstract in Bahasa Indonesia : Kata, sebutan dan istilah yang digunakan dalam arsitektur terkadang memiliki kemampuan untuk membantu dan menjadi bahan kajian sejarah bagi dunia arsitektur. Kajian filologi dan hermeneutika dengan baik telah memanfaatkan kemampuan tersebut. Tanpa harus memaksakan diri untuk mengikuti dengan ketat bidang pengetahuan tersebut, penelusuran atas arti `griya' dan `omah' ini mencoba untuk mengungkap sebagian kecil dari sejarah arsitektur Jawa. Melalui interpretasi-menerangkan (Poespoprodjo 1987: 194-195 atas arti kedua kata tersebut di dalam berbagai naskah Kawruh Griya, keduanya samasekali tidak memiliki arti: `rumah'. Dengan penelusuran ini ditemukan pula petunjuk yang mengarah pada salah satu gagasan orang Jawa tentang rumah yakni `bagaikan berteduh di bawah pohon'. Meskipun kedua kata tersebut dapat membawa penelusuran ini ke wilayah di luar arsitektur dan masyarakat Jawa, harus diakui bahwa penelusuran ini masih dibatasi pada telusuran internal bahasa Jawa, yakni hanya mengkaji kedua kata tersebut di dalam perjalanan kebahasaan bahasa Jawa


    Indah Ayu Septriyaningrum


    Abstrak  Sistem parkir manual pada pelayanan parkir mall memerlukan pengelolaan dan pengembangan sistem yang lebih rumit dan jauh dari kata efisien. Informasi yang didapatkan pengelola parkir terkait kondisi parkir di lapangan setiap harinya masih kurang. Tujuan dari penelitian ini adalah merancang dan mengembangkan prototype sistem parkir. Metode pengembangan dan perancangan sistem pada penelitian ini adalah metode Waterfall. Hasil yang didapatkan adalah sistem ini dapat mendeteksi keberadaan mobil pada slot parkir yang tersedia dengan bantuan Intel Galileo Board Gen 2 sebagai kontroler, sensor LDR (Light Dependent Resistor dan sensor ultrasonik (PING sebagai alat bantu pendeteksi keberadaan mobil. Sistem dapat menampilkan aktifitas parkir pada aplikasi web seperti kondisi lahan parkir kosong, lahan terisi, waktu masuk, waktu keluar, lama parkir dan kapasitas parkir yang tersedia serta grafik pemakaian lahan parkir. Dapat disimpulkan bahwa perancangan dan pengembangan sistem berhasil diimplementasikan. Kata Kunci : Sistem parkir, waterfall, Intel Galileo Board Gen 2,sensor LDR (Light Dependent Resistor, sensor ultrasonik

  17. Sistem Informasi Penjualan dan Pemesanan Layanan Berbasis Web dan SMS Gateway di Petshop "PetZone"

    Siska Fadhilah Wati


    Full Text Available Dewasa ini teknologi informasi sangat membantu dalam dunia bisnis. Kemudahan yang ditawarkan akan menjaring lebih banyak konsumen. Namun, perusahan tingkat menengah seperti PetZone saat ini masih jarang yang menawarkan kemudahan berbelanja atau pemesanan layanan secara online. Oleh karena itu diperlukan sebuah sistem berbasis web di perusahaan PetZone yang dapat memudahkan pemilik dan karyawan dalam apenjualan, pelayanan, dan pemasaran, serta memudahkan pelanggan dalam jual-beli barang dan jasa. Atas dasar masalah tersebut dibangun Sistem Informasi Penjualan dan Pemesanan Layanan Berbasis Web dan SMS Gateway untuk menunjang proses bisnis yang ada. Sistem informasi dibangun menggunakan bahasa pemrograman PHP framework Codeigniter, javascript untuk tampilan yang dinamis, dan database MySQL. Proses pembuatan dan pengembangan Sistem Informasi Penjualan ini menggunakan metode air terjun. Metode air terjun meliputi kebutuhan pengguna, analisis, rancangan, implementasi dan pengujian. Pemodelan Sistem Informasi yang dibangun menggunakan metode berorientasi objek UML (Unified Modeling Language yang terdiri dari Use case  diagram, Class diagram dan Sequence diagram. Hasil pengujian Sistem Informasi Penjualan dan Pemesanan Layanan Berbasis Web dan SMS Gateway menunjukkan bahwa semua fitur yang terdapat baik dalam sistem informasi maupun SMS gateway dapat bekerja dengan baikdengan ratusan sample data, dan server SMS gateway dapat memproses lebih dari satu SMS secara bersamaan. Dalam perkembangan ke depannya nanti, Sistem Informasi Penjualan dan Pemesanan Layanan Berbasis Web dan SMS Gateway masih dapat dikembangkan lagi dengan menambah fitur-fitur pada SMS gateway sehingga lebih memudahkan konsumen.

  18. Severe accident risks from external events

    Randall O Gauntt


    This paper reviews the early development of design requirements for seismic events in USA early developing nuclear electric generating fleet.Notable safety studies,including WASH-1400,Sandia Siting Study and the NUREG-1150 probabilistic risk study,are briefly reviewed in terms of their relevance to extreme accidents arising from seismic and other severe accident initiators.Specific characteristic about the nature of severe accidents in nuclear power plant (NPP) are reviewed along with present day state-of-art analysis methodologies (methods for estimation of leakages and consequences of releases (MELCOR) and MELCOR accident consequence code system (MACCS)) that are used to evaluate severe accidents and to optimize mitigative and protective actions against such accidents.It is the aim of this paper to make nuclear operating nations aware of the risks that accompany a much needed energy resource and to identify some of the tools,techniques and landmark safety studies that serve to make the technology safer and to maintain vigilance and adequate safety culture for the responsible management of this valuable but unforgiving technology.


    O. Gamankova


    Full Text Available The paper deals with the peculiarities of financial provision of public and private accident insurance. Analyzes the methodology of forming insurance premium rates in private accident insurance. The study examines the practice of reforming the financial security of the state social insurance against accidents. The results show need to implement scientifically proven approach to determining premium rates in the state social insurance based on mathematical statistics and actuarial calculations to ensure that such conditions on the one hand, can insure the risk, and the other - to provide the insurer the ability to perform insurance obligations' commitments. One of the promising areas of improvement Accident Insurance determines to define increasing the role of the private sector to create and attraction of investments, financing, reduce costs, and provision of insurance services on insurance against accidents at a qualitatively higher level. The results show the need to consider the usefulness of a mixed provision of services to accident insurance under state or non-state system, and the viability and effectiveness of the combination of these systems.




    Full Text Available

    Introduction. Car accident mortality is the third order causes of death in the USA, following cardiovascular diseases and cancers. Given present survival and outcome Iranian data, more than 14,000 patients die annually in road accidents. Having a valid and reliable data could be useful in reduce mortality and morbidity reduction.
    Methods. Twenty five percent of total traumatic patients in Isfahan were selected (N=2809 at the time of study (1997-1998. Forty five percent of them with car accident were asked about causes of accidents and risk factors for the severity and type of injuries were recorded based on International Classification of Disease 10.
    Results. Most of the victims were young (10-20 years old, students and industrial workers. Statistically unreasonable numbers of cars without extension of roads and high ways, using old and unsafe cars will affects on accidents.
    Discussion. In comparison with European and some Asian countries, Iran has unacceptable road accidents and it seems necessary to pay more attention to stop the current increasing data.



    Antoni Antoni


    Full Text Available Abstract: Where there is sugar there must be an ant, or likefish and water, as it were appropriate parable likens the Lawand Society, because where there is society there must be lawswill be needed. Law and society are two sides of which aredifficult to separate, because they will need each other andinfluence each other.ملخص:حیث یوجد السكر یجب أن یكون ھناك نملة، أو مثل السمك والماء، كما انھاكانت مناسبة المثل یشبھ القانون والمجتمع، وذلك لأن عندما یكون ھناك مجتمع یجبأن یكون ھناك وستكون ھناك حاجة القوانین .القانون والمجتمع وجھان لوالتي یصعبفصل، لأنھا سوف نحتاج إلى بعضنا البعض وتؤثر على بعضھا البعض.Kata Kunci: hukum dan perubahan masyarakat

  2. Lõuka tuuliku restaureerimine / Dan Lukas

    Lukas, Dan


    Hiiumaal Pühalepa vallas Vahtrepa külas Lõuka talu maadel asuva pukktuuliku ajaloost, restaureerimise käigust. Teostus: Dan Lukas. Muinsuskaitseline järelevalve: Tõnu Sepp, tema kommentaar. Ill.:pukktuuliku lõiked ja korruste plaanid, 7 värv. fotot

  3. Corner Office: Google's Dan Clancy

    Albanese, Andrew Richard; Oder, Norman


    This article presents an interview with Dan Clancy, engineering director for Google Book Search. In this interview, Clancy talks about the pending Google Book Search settlement, involving millions of volumes digitized from libraries, which drew a lawsuit from the Association of American Publishers and the Authors Guild. He also discusses pricing,…

  4. Gangguan Fungsi Penghidu dan Pemeriksaannya

    Effy Huriyati


    Full Text Available AbstrakLatar belakang: Fungsi penghidu pada manusia memegang peranan penting. Gangguan penghidu dapat mempengaruhi keselamatan dan kualitas hidup seseorang. Tujuan: Untuk mengetahui jenis gangguan penghidu, penyebab gangguan penghidu, dan pemeriksaannya. Tinjauan Pustaka: Gangguan penghidu dapat berupa anosmia yaitu hilangnya kemampuan penghidu, atau hiposmia yaitu berkurangnya kemampuan penghidu. Gangguan penghidu disebabkan gangguan konduksi, gangguan sensoria dan gangguan neural. Penyakit tersering penyebab gangguan penghidu yaitu rinosinusitis kronis, rinitis alergi, infeksi saluran nafas atas dan trauma kepala. Ada beberapa modalitas pemeriksaan kemosensoris fungsi penghidu diantaranya Tes “Sniffin sticks”. Dengan tes „Sniffin sticks” dapat diketahui ambang penghidu, diskriminasi penghidu dan identifikasi penghidu seseorang. Kesimpulan: Gangguan penghidu memerlukan perhatian khusus. Diantara beberapa modalitas pemeriksaan kemosensoris penghidu, tes “Sniffin sticks” mempunyai beberapa kelebihan.Kata kunci: Gangguan penghidu, anosmia, hiposmia, tes “Sniffin sticks”.AbstractBackground: Olfactory function in humans plays an important role. Olfactory disorders can affect the safety and quality of life. Objective: To determine the type of olfactory disorder, the causes of olfactory disorders, and the examination. Literature Review: Olfactory disorder can be not smell anything or anosmia, and reduced of smell or hyposmia. Olfactory disorders caused by conduction disturbances, neural disturbances and sensoris disturbances. Disease that often causes disturbances of olfactory function is, chronic rhinosinusitis, allergic rhinitis, upper respiratory tract infections and head trauma. There are several modalities to examine chemosensoris smelling function, one of them is “Sniffin sticks” test. This test can examine threshold, discrimination, and identification of smelling. Conclusions: Impaired smelling require special attention


    Sentot Harman Glendoh


    Full Text Available Small business as an economic activity of society on a small scale, has a central role in the economy of Indonesia. Although the economic crisis has created a great disturbance in the live of large and middle-size business, apparently small business continues to function well in the lower levels of the economy. The main role of small business is: 1 use excess labor; 2 as a producer of goods and services at reachable prices for the lower economic levels of society; 3 as a potential producer of foreign exchange because of the success of this type of industry in producing non-oil commodities for export. Remembering that the role of small business is large and has great influence on the lower economic levels of society, it is quite necessary to pay attention to the development of this sector. Abstract in Bahasa Indonesia : Usaha kecil sebagai kegiatan ekonomi rakyat berskala kecil memiliki peran sentral dalam perekonomian Indonesia. Walaupun krisis ekonomi telah memporakporandakan kehidupan bidang usaha besar dan menengah, ternyata usaha kecil tetap tegar dan berjalan marak dikawasan kehidupan ekonomi tingkat bawah. Peran pokok usaha kecil ini adalah: (1 sebagai penyerap tenaga kerja, (2 sebagai penghasil barang dan jasa pada tingkat harga yang terjangkau bagi kebutuhan rakyat banyak yang berpenghasilan rendah, (3 sebagai penghasil devisa negara yang potensial kerena keberhasilannya dalam meproduksi komoditi ekspor non migas. Mengingat peran usaha kecil tersebut sangat besar andilnya bagi negara dan masyarakat kecil dilapisan bawah, maka pembinaan dan pengembangannya sangat perlu diperhatikan. Kata kunci: pembinaan, pengembangan, usaha kecil.

  6. [Drivers of advanced age in traffic accidents].

    Bilban, Marjan


    The elderly are vulnerable and potentially unpredictable active participants in traffic who deserve special attention. Longer life expectancy entails a greater number of senior drivers, that is, persons with various health problems and difficulties accompanying old age. At the turn of the millennium, the share of population aged 65 or more in Slovenia was around 13%, and in 25 years it will be near as much as 19%. The share of drivers from this age group was 28% a year ago, and it is expected to reach about 54%. Numerous studies have shown that there are many differences in driving attitude between the young and the elderly. The young are by large active victims, and their main offense and cause of accident is speeding, while the elderly are more passive and their main offense is ignoring and enforcing the right of way. This paper focuses on the differences in the occurrence and type of injuries between the young and the elderly drivers, based on an analysis of all road accidents in Slovenia in the period between 1998-2000. Older people (over 65) caused only 4.7% of all road accidents (16.7% of all accidents involving pedestrians, 11.5% of all involving cyclists, 2.7% involving motorcyclists and 5% of all accidents involving car drivers). Of all accidents, 89.3% were without injuries, and the fatal outcome was registered in 0.4% accidents. Among the elderly (65-74 years of age), however, this share was 1%, and rising to 2.7% with the age 75 and above. By calculating the weight index, which discriminates between minor and severe injuries, and the fatal outcome, it was established that age groups 65-74 and > or = 75 cause three and five times greater damage, respectively than age groups from 18 to 54 years. With years, psychophysical changes lead to a drop in driving ability, which in turn increases the risk of road accidents. It is true that elderly people cause less traffic accidents (and also drive less) than the young, but when they are involved in an accident


    Sugeng Haryanto


    Full Text Available Penelitian ini menganalisis kinerja dan tingkat efisiensi bank-bank BUMN dan BUSN yang go Publik di Bursa Efek Indonesia.  Sample penelitian ini mengambil  tiga bank BUMN Bank BNI 46, Bank Mandiri dan Bank BRI  dan tiga bank BUSN (Bank BCA, Bank Niaga dan Bank Panin dengan periode analisis tahun 2005-2011. Varibael yang digunakan meliputi ROA, ROE, LAR. LDR, NPL dan BOPO. Tujuan dari penelitian ini adalah melihat dan menganalisis perbedaan kinerja antara Bank BUMN dan BUSN yang go public di Bursa Efek Indonesia tahun 2005-2011.  Pendekatan pengukuran kinerja yang digunakan adalah Return on Asset (ROA, Return on Equity (ROE dan Loan to Deposit Ratio (LDR, Loan to Asset Ratio (LAR,  dan efisiensi bank. Hasil dari penelitian menunjukkan bahwa 1 Bank-bank nasional, baik itu bank BUMN maupun BUSN menunjukkan kinerja yang semakin baik, 2 tidak terdapat perbedaan yang signifikan antara kinerja bank BUMN dan BUSN untuk variabel ROA, ROE, LAR, LDR, dan BOPO sedangkan variabel NPL yang merupakan indikator risiko kredit menunjukkan adanya perbedaan yang signifikan antara Bank BUMN dan BUSN

  8. Exploring Environmental Effects of Accidents During Marine Transport of Dangerous Goods by Use of Accident Descriptions

    Rømer, Hans Gottberg; Haastrup, P.; Petersen, H J Styhr


    On the basis of 1776 descriptions of water transport accidents involving dangerous goods, environmental problems in connection with releases of this kind are described and discussed. It was found that most detailed descriptions of environmental consequences concerned oil accidents, although most...


    Arif Unwanullah


    Full Text Available Abstrak: Industrialisasi dan Tantangannya pada Sektor Pendidikan. Sumbangan pendidikan dalam perubahan dan pembangunan masa lalu telah bergeser dengan kemajuan teknoekonomi dan komunikasi. Perubahan yang terjadi telah menggeser tatanan kehidupan dan pandangan masyarakat. Materialisme, kapitalisme, efisiensi, dan efektivitas telah menjadi tujuan dan semangat hidup. Pergeseran pandangan masyarakat telah mengubah pula pandangan keberhasilan dan mutu pendidikan, di mana pendidikan diukur dari keberhasilan dalam keterserapan lulusan dalam dunia kerja, oleh karenanya pendidikan dianalisis dari karakteristik sebagai investasi (capital-investment. Pergeseran makna dan tanggung jawab pendidikan mendorong dunia pendidikan melakukan pembaruan dengan alternatif: membangun pembaruan penalaran warganya menuju pemerdekaan dan pendewasaan, pendidikan dilaksanakan secara komprehensif dan bekerjasama dengan semua pihak secara kemitraan, dan membangun visi pendidikan secara komprehensif dan simultan dengan semua pihak. Kata kunci: perubahan sosial, materialistik, modernisasi dan kapitalis Abstract: Industrialization and its education Sector challenges. Contribution of education has shifted with the progress of technology, economy, and communication. The changes have shifted the society's views. Materialism, capitalism, efficiency, and effectiveness have become of interest and enthusiasm for life. The shift has changed society's view, i.e. the view of success and quality of education, in which education is measured from a rate of the absorption of graduates into labor market, therefore education is analyzed from the characteristics of an investment (capital-investment. A shift in meaning and responsibility of education encourages the education sector to create reformation through these following alternatives: creating new thoughts towards liberation and maturation, implementing education comprehensively and cooperating with all parties in partnership, and creating

  10. 基于动态风险平衡的海洋平台事故连锁风险研究%On the risk chain of the offshore oil-drilling platform accidents based on the dynamic risk balance

    郭恒; 陈国明; 朱渊


    The present paper is aimed at introducing a dynamic model for the offshore oil-drilling platform accidents proposed by the authors based on the two concepts, that is, the accident impetus and accident obstruction. As is well known, due to its own restricted conditions, offshore platforms, on the event of fire or explosion, are likely to suffer tragic casualties and material losses, letting alone the environmental contamination. Based on investigating and analyzing plenty of offshore platform accidents both at home and abroad, we have brought forward a new approach to dealing with such tragic accidents, that is, to finding the accident dynamic model characterized as dynamic nature and transient stability. As a matter of fact, a regular oil-drilling platform tends to present a dynamic equilibrium state between the accident impetus and the accident obstruction, while the accident dynamic state indicates a kind of energy that tends to lead to the happening of an accident whereas there exists some kind of transmitting impetus that passes on the energy that may obstruct or prevent the accident from occurring. In view of the dynamic risk balance, we have come up with the accident dynamic model consisting of four steps: first of all, the offshore platform likely to lead to grave accidents are chosen as an object of study, and next, the corresponding factors likely to cause the accidents are analyzed from the points of view of accident-incidence process, and, last of all, the countermeasures were taken in engineering, technology and management. What's more, the risk statistical data and information concerning the accident chains are to be built up when the elementary accident impetus has been determined. And, by this moment, it would be necessary to work out the probability distribution of all transmitting impetus and obstruction factors in the circumstance that the elementary accident-incidence dynamic has been calculated. Furthermore, the analysis results should be made

  11. Reactor Safety Gap Evaluation of Accident Tolerant Components and Severe Accident Analysis

    Farmer, Mitchell T. [Argonne National Lab. (ANL), Argonne, IL (United States); Bunt, R. [Southern Nuclear, Atlanta, GA (United States); Corradini, M. [Univ. of Wisconsin, Madison, WI (United States); Ellison, Paul B. [GE Power and Water, Duluth, GA (United States); Francis, M. [Argonne National Lab. (ANL), Argonne, IL (United States); Gabor, John D. [Erin Engineering, Walnut Creek, CA (United States); Gauntt, R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Henry, C. [Fauske and Associates, Burr Ridge, IL (United States); Linthicum, R. [Exelon Corp., Chicago, IL (United States); Luangdilok, W. [Fauske and Associates, Burr Ridge, IL (United States); Lutz, R. [PWR Owners Group (PWROG); Paik, C. [Fauske and Associates, Burr Ridge, IL (United States); Plys, M. [Fauske and Associates, Burr Ridge, IL (United States); Rabiti, Cristian [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rempe, J. [Rempe and Associates LLC, Idaho Falls, ID (United States); Robb, K. [Argonne National Lab. (ANL), Argonne, IL (United States); Wachowiak, R. [Electric Power Research Inst. (EPRI), Knovville, TN (United States)


    The overall objective of this study was to conduct a technology gap evaluation on accident tolerant components and severe accident analysis methodologies with the goal of identifying any data and/or knowledge gaps that may exist, given the current state of light water reactor (LWR) severe accident research, and additionally augmented by insights obtained from the Fukushima accident. The ultimate benefit of this activity is that the results can be used to refine the Department of Energy’s (DOE) Reactor Safety Technology (RST) research and development (R&D) program plan to address key knowledge gaps in severe accident phenomena and analyses that affect reactor safety and that are not currently being addressed by the industry or the Nuclear Regulatory Commission (NRC).


    Arifuddin - Sahabu


    Full Text Available ABSTRAKS   Penelitian ini menggunakan metode kualitatif dengan bentuk studi kasus. Pengumpulan data dilakukan dengan menggunakan teknik wawancara, dokumentasi, dan observasi. Analisis data mengunakan metode analisis Miles dan Huberman, dengan melalui tiga prosedur yaitu reduksi data, penyajian data dan menarik kesimpulan/verifikasi. Sedangkan keabsahan menggunakan teknik berdasarkan atas kriteria derajat kepercayaan, keteralihan, ketergantungan, dan kepastian suatu data. Tuntutan menghadapi  implementasi Otonomi Daerah mengandung arti pentingnya Pemerintah Daerah memperhatikan kemampuan “self suporting” dalam bidang keuangan. Sumber pendapatan daerah tidak hanya di peroleh dari Pendapatan Asli Daerah, tetapi juga berupa pemberian bagi hasil dari penerimaan Pemerintah Pusat. Diantara sumber penerimaan tersebut adalah Pajak Bumi dan Bangunan. Dalam Undang-undang Nomor 25 Tahun 1999 Tentang perimbangan keuangan antara Pemerintah Pusat  dan Daerah, diantaranya dijelaskan bahwa sumber penerimaan daerah dalam penyelenggaraan desentralisasi berasal dari dana perimbangan penerimaan Pajak Bumi dan Bangunan disamping pemberian Dana Alokasi Umum dan Alokasi Khusus. Langkah Implementasi dari pelaksanan pemungutan Pajak Bumi dan Bangunan tersebut dilakukan Departemen Keuangan melalui Kantor Pelayanan Pajak Bumi dan Bangunan, sedang Pemerintah daerah menerima pelimpahan penagihan pada Sektor Perkotaan dan Sektor Pedesaan. Meskipun telah ada pelimpahan kewenangan kepada daerah, akan tetapi pelimpahan kewenangan tersebut terbatas pada mekanisme penagihan saja, sedang implementor yang menyangkut masalah administrasi masih berada pada Kantor Pelayan Pajak Bumi dan Bangunan. Kondisi demikian ini ditambah dengan kurangnya koordinasi antara unit organisasi pelaksana menyebabkan setiap tahun terjadi tunggakan. Sebagai sandaran teoritik utama  untuk mendiskripsikan serta menganalisis hambatan-hambatan implementasi kebijakan publik (dalam hal ini pemungutan


    Triwibowo Ambar Garjito


    Full Text Available Dengue virus merupakan salah satu virus anggota dari famili Flaviviridae yang sejak tahun 1956 telah dikenal dapat menimbulkan demam dengue maupun demam berdarah dengue (DBD. Penyakit yang ditularkan oleh nyamuk Aedes aegypti ini diperkirakan telah menjangkiti pada selatar 50-100 juta manusia dengan 500.000 kasus di antaranya dalam manifestasi yang ganas yang dikenal sebagai dengue haemorrhagic fever dan dengue shock syndrome dan 25.000 di antaranya berakibat fatal (meninggal. Saat ini pengembangan vaksin merupakan salah satu solusi yang diharapkan dapat menekan penyebaran penyakit tersebut. E (envelope merupakan salah satu bagian dari protein struktural virus yang sangat penting dalam pengembangan vaksin, yaitu sebagai badan yang memproduksi antibodi netralisasi untuk protein. Non-struktural protein l juga telah diketahui sebagai salah satu komponen penting dalam pengembangan vaksin oleh karena kemampuannya untuk dapat diekspresi pada permukaan sel yang diinfeksi yang dapat menjadi target untuk immune cytolisis. Ada dua pendekatan yang digunakan dalam memproduksi suatu vaksin dengue, yaitu: a. Vaksin hidup yang telah dilemahkan (live attenuated vaccine: b. Vaksin hasil rekayasa (engineered vaccine. Penelitian terhadap vaksin DENV baik rekombinan maupun non-rekombinan yang didasarkan pada uji virus telah dilakukan secara terus-menerus baik pada monyet dan manusia. Sampai saat ini telah dikembangkan sejumlah kandidat vaksin DENV yang berdasar pada tetravalent virus dengue, yaitu a. vaksin konvensional, b. vaksin dengue rekombinan berdasar pada flavivirus, c. vaksin intertypic chimeric, d. vaksin chimerivac, e. vaksin dengue rekombinan menggunakan vector non-ftavivirus dan f. vector adenovirus. Namun demikian, sampai sekarang belum ada vaksin yang siap digunakan untuk menangkal infeksi ke empat serotype virus dengue, sehingga masih diharapkan untuk pengembangan virus lebih lanjut.   Kata kunci: Aedes aegypti, dengue virus, vaksin dengue.

  14. Muhammad sebagai pemimpin agama dan negara periode Makkah dan Madinah

    Ummu Zakiyah Maulidah


    Full Text Available Muhammad was born in Mecca between AD 570 and 580 in the Banu Hashims,a reputable family of Quraysh. In Mecca, Muhammad is portrayed as a privatecitizen, as he had to limit himself and adapt his behavior to face the situationduring jahiliyyah era. While, in Medina he governed the community and guidedthem in religious life. His arrival in Medina has significant contribution towardhis role as political leader. His power in this city had protected himself and hisfollowers from violent opposition of the Quraysh. The doctrines he employedin politics were inseparable from the religious values rooted from the Quran.Through his innovation and skillful diplomacy, he had converted the peopleof Mecca and Medina into brighter Arab civilization. Such a positive changereflected his monumental accomplishment for the people.Muhammad lahir di kota Makkah antara tahun 570 sampai 580 Masehi dikeluarga Bani Hasyim, suku Quraisy terkemuka di Arab. Di kota Makkah,Muhammad dianggap sebagai masyarakat biasa, sebab ia harus membatasidirinya dan menyesuaikan prilakunya dalam menghadapi keadaan yangterjadi pada zaman jahiliyyah. Sedangkan di Madinah, ia dianggap sebagaipemimpin masyarakat dan menjadi pembimbing umat dalam hidup beragama.Kedatangannya di Madinah juga memberikan konstribusi besar pada perannyasebagai pemimpin politik. Kekuasaan di kota ini sangat membantu dirinya danpara pengikutnya dari kerasnya kelompok oposisi Quraisy. Doktin-doktrin yangdigunakan Muhammad dalam dunia politik juga tidak lepas dari nilai-nilaiagama yang bersumber dari al Quran. Dengan kreatifitas dan inovasinya dalammemimpin, Muhammad mampu mengarahkan masyarakat Makkah dan Madinah menuju kebangkitan peradaban bangsa Arab yang lebih cemerlang.Kondisi yang semakin membaik tersebut, tidak lain merupakan sebuah karyadan jasa monumental yang telah diukir oleh Muhammad untuk umatnya.

  15. Iodine behaviour in severe accidents

    Dutton, L.M.C.; Grindon, E.; Handy, B.J.; Sutherland, L. [NNC Ltd., Knutsford (United Kingdom); Bruns, W.G.; Sims, H.E. [AEA Technology, Harwell (United Kingdom); Dickinson, S. [AEA Technology, Winfrith (United Kingdom); Hueber, C.; Jacquemain, D. [IPSN/CEA, Cadarache, Saint Paul-Lez-Durance (France)


    A description is given of analyses which identify which aspects of the modelling and data are most important in evaluating the release of radioactive iodine to the environment following a potential severe accident at a PWR and which identify the major uncertainties which affect that release. Three iodine codes are used namely INSPECT, IODE and IMPAIR, and their predictions are compared with those of the PSA code MAAP. INSPECT is a mechanistic code which models iodine behaviour in the aqueous aerosol, spray water and sump water, and the partitioning of volatile species between the aqueous phases and containment gas space. Organic iodine is not modelled. IODE and IMPAIR are semi-empirical codes which do not model iodine behaviour in the aqueous aerosol, but model organic iodine. The fault sequences addressed are based on analyses for the Sizewell `B` design. Two types of sequence have been analysed.: (a) those in which a major release of fission products from the primary circuit to the containment occur, e.g. a large LOCAS, (b) those where the release by-passes the containment, e.g. a leak into the auxiliary building. In the analysis of the LOCA sequences where the pH of the sump is controlled to be a value of 8 or greater, all three codes predict that the oxidation of iodine to produce gas phase species does not make a significant contribution to the source term due to leakage from the reactor building and that the latter is dominated by iodide in the aerosol. In the case where the pH of the sump is not controlled, it is found that the proportion of gas phase iodine increases significantly, although the cumulative leakage predicted by all three codes is not significantly different from that predicted by MAAP. The radiolytic production of nitric acid could be a major factor in determining the pH, and if the pH were reduced, the codes predict an increase in gas phase iodine species leaked from the containment. (author) 4 figs., 7 tabs., 13 refs.

  16. B-cell depletion with rituximab in the treatment of autoimmune diseases. Graves' ophthalmopathy the latest addition to an expanding family

    Nielsen, Claus H; El Fassi, Daniel; Hasselbalch, Hans C;


    of 10 Graves' disease patients remained in remission 400 days after rituximab treatment versus none in the control group, and remarkable improvements in the eye symptoms of patients with Graves' ophthalmopathy were observed. This supports a role for B cells in the pathogenesis of Graves' ophthalmopathy......In this review, the authors summarise the clinical results obtained after therapy with rituximab in autoimmune diseases, including Graves' disease and Graves' ophthalmopathy. On the basis of qualitative and quantitative analyses of B- and T-cell subsets, and autoantibody levels obtained in other...... diseases before and after rituximab therapy, the authors interpret the results of the only two clinical investigations of the efficacy of rituximab in the treatment of Graves' disease and Graves' opthalmopathy reported so far. No significant effect on autoantibody levels was observed. Nonetheless, 4 out...

  17. 白细胞介素-4基因多态性与Graves'病的关系%Association of Interleukin-4 gene polymorphisms with Graves' disease

    龚莹; 蒋玲; 江维岩; 张晓黎; 武传龙


    目的:探讨白细胞介素-4(Interleukin-4,IL-4)基因多态性与Graves'病(Graves'Disease GD)发病易感性的关系.方法:选择汉族GD患者和正常人各100例,采用序列特异性引物聚合酶链反应(PCR-SSP)检测等位基因和基因型.结果:GD组IL-4启动子区-590位置t等位基因频率明显低于对照组(8%对15.5%;P<0.05).GD组IL-4(-590)c/t杂合子基因型频率显著低于对照组(12%对25%;P<0.05).结论:在中国汉族人群中,GD患者和正常人之间存在IL-4(-590)等位基因和基因型频率分布的差异.GD患者IL-4启动子区-590位置t等位基因频率下降,可能使IL-4总的转录活性减低,通过免疫炎症反应导致GD发病.

  18. Review of Novum Inventorium Sepulchrale: Kentish Anglo-Saxon Graves and Grave Goods in the Sonia Chadwick Hawkes Archive (Online Digital Corpus

    Tara-Jane Sutcliffe


    Full Text Available In 2007, the year in which the Society of Antiquaries of London celebrated its tercentenary, what more fitting tribute to those industrious individuals than that their work be made accessible to a new generation of students. One means was by a celebratory exhibition hosted by the Royal Academy, Making History: Antiquaries in Britain, 1707-2007, which showcased a treasure-trove of art, antiquities and manuscripts (for review, see Mount 2007. Structured display is one thing: scholarly use or re-use of antiquarian data is, however, quite another matter. Indeed, therein arguably lays one of the more pressing challenges facing the practice of 'modern' archaeology (see Jones et al. 2001. A timely response was the online publication in October 2007 of the Novum Inventorium Sepulchrale (NIS, a digital corpus of Kentish Anglo-Saxon graves and grave goods. Through this project a wealth of primary data has been made accessible as never before. This resource will be of interest to all those researching Anglo-Saxon Archaeology, particularly material culture and mortuary practices. Whilst the editors express the hope that the NIS will 'enable future generations of researchers to gain a better understanding of the origins of the Anglo-Saxon kingdoms', users will find themselves both delighted and frustrated by the quantity and format of the data presented in it.

  19. Acidentes de trabalho com instrumentos perfurocortantes entre os trabalhadores de enfermagem Accidentes de trabajo con instrumentos perforo cortantes entre enfermeros trabajadores Accidents with sharp instruments among nursing workers

    Leila Maria Mansano Sarquis


    Full Text Available O presente estudo analisou os acidentes de trabalho ocorridos com trabalhadores de enfermagem, de um hospital público, provocados por instrumentos perfurocortantes. A instituição campo de estudo foi um hospital público do interior de São Paulo. A população foi composta por 787 trabalhadores de enfermagem. Na coleta de dados foram usados dois instrumentos: o primeiro foi o questionário que se destinou ao levantamento dos dados referentes aos acidentes de trabalho ocorridos no ano de 1996; o segundo foi a entrevista realizada com estes trabalhadores que sofreram acidentes com instrumentos perfurocortantes. Os resultados encontrados mostram a significativa freqüência desse tipo de acidente entre os auxiliares de enfermagem. A interação do trabalhadores de enfermagem com instrumentos perfurocortantes, indica a grande exposição aos riscos biológicos e às graves doenças.El presente estudio analizó los accidentes de trabajo ocurridos con enfermeros trabajadores, de un hospital público, ocasionados por instrumentos perforo cortantes. La institución campo de estudio fue un hospital público del interior de San Pablo. La población fue compuesta por 787 enfermeros trabajadores. En la coleta de datos fueran usados dos instrumentos: el primer fue un cuestionario que se destinó al examen de datos referentes a los accidentes de trabajo ocurridos en el ano de 1996; el segundo fue una cita con estos trabajadores que sufrieron accidentes con instrumentos perforo cortantes. Los resultados mostran la significativa frecuencia de ese tipo de accidente entre los auxiliares de enfermero. La interacción de los enfermeros trabajadores con instrumentos perforo cortantes indica la grande exposición a los riesgos biológicos y a las graves enfermedades.The present study analyzed the accidents happened at work with the nursing staff of a public hospital, provoked by sharp instruments. All the nursing staff composed the study population. In the

  20. Analisis Kesesuaian dan Daya Dukung untuk Wisata Pantai dan Snorkeling di Pulau Hoga, Kabupaten Wakatobi.

    Ahmad, Bahar


    Kawasan wisata bahari agar dapat dimanfaatkan secara berkelanjutan maka pemanfaatan yang dilakukan harus berkesesuaian dengan kondisi dan daya dukung kawasan. Penelitian ini bertujuan untuk menganalisis kesesuaian dan daya dukung untuk wisata pantai dan snorkeling di Pulau Hoga Kabupaten Wakatobi. Data yang digunakan dalam penelitian ini menggunakan data primer dan sekunder. Pengumpulan data primer menggunakan metode survei lapangan, sedangkan data sekunder diperoleh dari Badan Pusat Statis...


    Abd. Latif


    Kajian ini akan mendiskusikan tentang konsep wanua dan palili dalam struktur kerajaan-kerajaan yang tergabung dalam Konfederasi Ajatappareng di Sulawesi Selatan. Wanua dan palili adalah dua istilah yang digunakan oleh kerajaan pusat terhadap daerah bawahannya. Pertanyaannya, mengapa ada daerah bawahan yang disebut wanua dan yang lainnya disebut palili. Apakah kriteria yang mesti dipunyai satu daerah untuk disebut sebagai wanua dan apakah pula kriteria yang mesti dipunyai satu daerah untuk dis...


    Aprilianti Aprilianti


    Full Text Available Perjanjian sewa guna usaha (leasing yang diadakan oleh Lessor dan Lesseen dilakukan secara tertulis dalam bentuk perjanjian standar. Isi perjanjian tersebut ditentukan oleh jenis dari leasing itu sendiri dan hubungan hukum (hak dan kewajiban timbal balik antara Lessor dan Lessee. Bagi Lessor, hak dan kewajibannya adalah memperoleh pembayaran sebagai imbalan jasa dan menyerahkan barang modal kepada Lessee. Sedangkan hak dan kewajiban Lessee adalah meperoleh kegunaan dari barang modal dan membayar sewa secara berkala. Tidak dipenuhinya hak dan kewajiban masing-masing pihak maka dapat disebut wanprestasi. Perjanjian akan berakhir jika hak dan kewajiban Lessor dan Lessee telah dilaksanakan sesuai dengan perjanjian. Kata Kunci: Leasing, Lessor, Lessee, hak dan kewajiban.


    Helly Prajitno Soetjipto


    konteks sosial dan konstruksi sosial kematian. Euthanasia didiskusikan di dalam suatu kerangka pikir yang mencoba memberi perhatian kepada hal-hal yang kontekstual dan interpretatif fenomena sosial suatu proses kematian dan kejadian kematian


    Abdillah Halim


      Abstrak Perdebatan tidak berkesudahan terus mewarnai perbincangan dan praktek kebebasan beragama, terutama mengenai kata “kebebasan” yang dilekatkan pada agama dan kepercayaan. Jika “kebebasan” dimaknai sebagai kemerdekaan, apa lantas berarti tidak adanya batasan terhadap kemerdekaan tersebut, dalam arti bahwa kebebasan tersebut bersifat mutlak. Atau barangkali “kebebasan” di sini dimaknai sebagai kebebasan relatif yang membuka kemungkinan perumusan definisi dan ruang lingkup yang jelas. Penulis berpandangan bahwa kebebasan beragama bukan kebebasan mutlak yang tidak menuntut pendefinisian, perumusan ruang-lingkup serta norma norma, dan pengaturan. Kebebasan mutlak pada taraf yang demikian bukan kebebasan yang bermakna sebenarnya, namun dapat berarti sebuah keadaan anarki dan anomi. Kebebasan beragama adalah kebebasan relatif yang menuntut adanya penjelasan tentang definisi, ruang lingkup, norma-norma, dan batasan-batasannya.

  5. Persebaran Layanan dan Infrastruktur Telekomunikasi Provinsi Papua

    Prajna Deshanta Ibnugraha


    Full Text Available Layanan dan infrastruktur telekomunikasi merupakan bagian penting dari kehidupan modern karena hampir di segala bidang membutuhkan hal tersebut seperti pendidikan, pemerintahan, ekonomi dan sebagainya. Oleh karena pentingnya sektor telekomunikasi di Indonesia sebagai negara kepulauan maka perlu evaluasi tentang penyebaran layanan dan infrastrukturnya selain dilihat dari sisi fungsional dan perkembangan teknologinya. Provinsi Papua adalah provinsi terbesar di Indonesia namun justru memiliki layanan telekomunikasi yang paling sedikit dan terbatas. Demikian pula untuk penyebaran layanan ke kabupaten maupun ke distrik (kecamatan masih belum merata. Hal tersebut terbukti dari laporan hasil distribusi pita frekuensi yang hanya 1,5% untuk kawasan Maluku dan Papua serta kerapatan layanan tiap kabupaten yang ditunjukkan pada hasil penelitian ini.

  6. Concurrent reactive arthritis, Graves' disease, and warm autoimmune hemolytic anemia: a case report.

    Chiang, Elizabeth; Packer, Clifford D


    Warm antibody autoimmune hemolytic anemia is due to the presence of warm agglutinins that react with protein antigens on the surface of red blood cells causing premature destruction of circulating red blood cells. We report the first case of concurrent reactive arthritis, Graves' disease, and autoimmune hemolytic anemia. A 40-year-old man with reactive arthritis, Graves' disease, type 2 diabetes mellitus, mitral valve prolapse, and Gilbert's disease presented with a one month history of jaundice, fatigue, and black stools. After diagnosis of warm autoimmune hemolytic anemia, the patient was started on prednisone 1 mg/kg with rapid improvement in his anemia and jaundice. Our subject's mother and possibly his maternal grandmother also had autoimmune hemolytic anemia, which raises the possibility of hereditary autoimmune hemolytic anemia, a rarely reported condition.

  7. Reduced parietooccipital white matter glutamine measured by proton magnetic resonance spectroscopy in treated graves' disease patients

    Danielsen, Else Rubæk; Elberling, T.V.; Rasmussen, Åse Krogh


    CONTEXT: Graves' disease is an autoimmune disease of the thyroid gland. Patients often have affective and cognitive complaints, whether these disappear after treatment remains disputed. OBJECTIVE: Our objective was to evaluate cerebral biochemistry in acute and treated Graves' disease. DESIGN: We...... conducted a prospective study, investigating volunteers once and patients before and 1 yr after treatment. SETTING: The study was performed at a radiology department, a memory disorder clinic, and two endocrinology clinics. PATIENTS AND OTHER PARTICIPANTS: Of 53 consecutively referred, newly diagnosed.......01). Acute phase parieto-occipital white matter total choline correlated significantly (r = -0.57; P thyroid function. Pretreatment total T(3) predicted posttreatment occipital gray matter glutamine (r = -0.52; P

  8. Breaking the glass ceiling: an interview with Dr. Shirley Graves, a pioneering woman in medicine.

    Ahmed, Zulfiqar; Mai, Christine L; Elder, Badrea; Rodriguez, Samuel; Yaster, Myron


    Shirley Graves M.D., D.Sc. (honorary) (1936), Professor Emeritus of Anesthesiology and Pediatrics at the University of Florida, was one of the most influential women in medicine in the 1960 and 1970s, a time when the medical profession was overwhelmingly male-dominated. In today's society, it is hard to believe that only 50 years ago, women were scarce in the field of medicine. Yet Dr. Graves was a pioneer in the fields of pediatric anesthesia and pediatric critical care medicine. She identifies her development of the pediatric intensive care unit and her leadership in the Division of Pediatric Anesthesia at the University of Florida as her defining contributions. Through her journal articles, book chapters, national and international lectures, and leadership in the American Society of Anesthesiology and the Florida Society of Anesthesiology, she inspired a generation of men and women physicians to conquer the unthinkable and break through the glass ceiling.

  9. Scientific studies on pottery and pro-porcelain from group of graves in Henglingshan, Guangdong Province


    The findings of the Henglingshan group of graves, Guangdong Province, were appraised as one of the ten major archaeological excavations in 2000. The pottery and proto-porcelain samples excavated from the group of graves in Henglingshan are very important for studying the development history of Guang-dong ceramics. In this paper, the chemical compositions, micro-structure and physical properties of the samples were systematically analyzed. The results were subjected to multivariate statistical analysis. Different compositional patterns were found for specimens from different periods. The reasons for these variations were discussed. In addition, compared with the pottery and proto-porcelain samples from different production sites in other provinces of China, the obvious regional characters and unique law of the development for ancient ceramics of Guangdong were also discussed.

  10. GO-QOL--disease-specific quality of life questionnaire in Graves' orbitopathy.

    Sawicka-Gutaj, Nadia; Bednarczuk, Tomasz; Daroszewski, Jacek; Waligórska-Stachura, Joanna; Miśkiewicz, Piotr; Sowiński, Jerzy; Bolanowski, Marek; Ruchała, Marek


    The main goal of therapy for Graves' orbitopathy (GO) is to restore visual function and to improve quality of life (QOL); therefore, the idea of self-assessment of eye changes by the patient has been developed. We developed a validated Polish version of the GO-QOL questionnaire (GO-QOLpl). As an original version we used the English version of GO-QOL, which consists of 15 questions summarised in two subscales. GO-QOLpl was translated and validated in accordance with standard principles for translation of patient-reported outcomes (PRO). GO-QOLpl is a linguistically validated version of the original GO-QOL questionnaire, which is recommended by the European Group of Graves' Orbitopathy (EUGOGO). We strongly support the use of GO-QOLpl for the assessment of QOL among Polish patients with GO in clinical practice.

  11. Chernobyl post-accident management: the ETHOS project.

    Dubreuil, G H; Lochard, J; Girard, P; Guyonnet, J F; Le Cardinal, G; Lepicard, S; Livolsi, P; Monroy, M; Ollagnon, H; Pena-Vega, A; Pupin, V; Rigby, J; Rolevitch, I; Schneider, T


    ETHOS is a pilot research project supported by the radiation protection research program of the European Commission (DG XII). The project provides an alternative approach to the rehabilitation of living conditions in the contaminated territories of the CIS in the post-accident context of Chernobyl. Initiated at the beginning of 1996, this 3-y project is currently being implemented in the Republic of Belarus. The ETHOS project involves an interdisciplinary team of European researchers from the following institutions: the Centre d'etude sur l'Evaluation de la Protection dans le domaine Nucleaire CEPN (radiological protection, economics), the Institute National d'Agronomie de Paris-Grignon INAPG (agronomy, nature & life management), the Compiegne University of Technology (technological and industrial safety, social trust), and the Mutadis Research Group (sociology, social risk management), which is in charge of the scientific co-ordination of the project. The Belarussian partners in the ETHOS project include the Ministry of Emergencies of Belarus as well as the various local authorities involved with the implementation site. The ETHOS project relies on a strong involvement of the local population in the rehabilitation process. Its main goal is to create conditions for the inhabitants of the contaminated territories to reconstruct their overall quality of life. This reconstruction deals with all the day-to-day aspects that have been affected or threatened by the contamination. The project aims at creating a dynamic process whereby acceptable living conditions can be rebuilt. Radiological security is developed in the ETHOS project as part of a general improvement in the quality of life. The approach does not dissociate the social and the technical dimensions of post-accident management. This is so as to avoid radiological risk assessment and management being reduced purely to a problem for scientific experts, from which local people are excluded, and to take into

  12. The philosopher Socrates had exophthalmos (a term coined by Plato) and probably Graves' disease.

    Papapetrou, Peter D


    According to a previously published theory, Socrates was afflicted with temporal lobe epilepsy since his childhood. Plato, Xenophon, and Aristoxenus described Socrates as having exophthalmos, probably diplopia, and some symptoms compatible with hyperthyroidism. Using these data, we theorize that Socrates had Graves' disease. In order to determine a cause of his temporal lobe epilepsy, we speculate that the philosopher also had autoimmune thyroiditis and Hashimoto encephalopathy during his childhood and his epilepsy may have been a sequel to this hypothesized encephalopathy.

  13. Management of patients with Graves' orbitopathy: initial assessment, management outside specialised centres and referral pathways.

    Perros, Petros; Dayan, Colin M; Dickinson, A Jane; Ezra, Daniel; Estcourt, Stephanie; Foley, Peter; Hickey, Janis; Lazarus, John H; MacEwen, Caroline J; McLaren, Julie; Rose, Geoffrey E; Uddin, Jimmy; Vaidya, Bijay


    Graves' orbitopathy (GO) is uncommon, but responsible for considerable morbidity. A coordinated approach between healthcare professionals is required in order to meet the needs of patients. Early diagnosis can be achieved by a simple clinical assessment. Low-cost effective interventions can be initiated by generalists, which may improve outcomes. Moderate-to-severe GO should be referred to specialised centres. Recommendations for clinical diagnosis, initial management and referral pathways are highlighted.

  14. Incidental Visualization of Thyroid Gland on Bone Scan Caused by Graves' Hyperthyroidism

    Sohn, Myung Hee; Jeong, Hwan Jeong; Kim, Dong Wook; Lim, Seok Tae [Chonbuk National University Medical School, Jeonju (Korea, Republic of)


    A 45-year-old man presented with fatigue and weight loss underwent a Tc-99m MDP bone scan because of increased serum alkaline phosphatase. Delayed images at 4 hours demonstrated diffuse increased activity throughout both lobes of the thyroid in the absence of activity of the stomach and salivary glands. Thyroid laboratory indices and a Tc-99m pertechnetate thyroid scan suggested Graves' hyperthyroidism

  15. Socioeconomic Disparities in the Presentation and Treatment of Graves' Disease and Thyroid Eye Disease.

    Vargason, Caroline W; Chelnis, James G; Barahimi, Behin I; Mawn, Louise A


    Thyroid eye disease (TED) is an inflammatory, autoimmune orbitopathy with multifactorial etiology. Clinical presentation of TED spans a range from mild surface irritation to vision threatening compressive optic neuropathy. Potential vision loss underscores the importance of understanding genetic and environmental factors influencing the severity of TED presentation. This review will describe the classic risk factors for TED, outline treatments for Graves' disease (GD) and TED, and describe newer evidence of socioeconomic disparities in TED presentation.

  16. Cradle-to-Grave Nuclear Fuel Supply Assurance Workshop: Industry’s Potential Role

    Bengelsdorf, Harold (Hal); Hund, Gretchen; Kessler, Carol E.; Mahy, Heidi A.; McGoldrick, Fred; Seward, Amy M.


    The Pacific Northwest Center for Global Security hosted a workshop on June 6, 2007 in Washington D.C. to discuss the feasibility, merits and implications of the United States offering cradle-to-grave nuclear fuel cycle services to other countries. The workshop consisted of a small group of senior individuals from the private sector, government and the national laboratories. The workshop is summarized and recommendations given.

  17. Combination of Cerebral Demyelination and Graves Disease in a Case with Miller Fisher Syndrome

    Sibel Güler; Levent Sinan Bir


    A 44-year-old male patient with a diagnosis of Miller Fisher syndrome, Graves disease and central nervous system demyelination is presented. Clinical and laboratory findings supported the diagnosis of Miller Fisher syndrome. On T2-weighted sections of cranial magnetic resonance imaging, many ovoid-shaped, hyperintense lesions in bilateral deep white matter were detected. Magnetic resonance imaging spectroscopy demonstrated low N-acetylaspartate to creatine (NAA/Cr) ratio consistent with demye...

  18. Imunopatogenesis Treponema pallidum dan Pemeriksaan Serologi

    Efrida ,; Elvinawaty .


    AbstrakSifilis adalah penyakit menular seksual yang sangat infeksius, disebabkan oleh bakteri berbentuk spiral, Treponema pallidum subspesies pallidum. Penyebaran sifilis di dunia telah menjadi masalah kesehatan yang besar dengan jumlah kasus 12 juta pertahun. Infeksi sifilis dibagi menjadi sifilis stadium dini dan lanjut. Sifilis stadium dini terbagi menjadi sifilis primer, sekunder, dan laten dini. Sifilis stadium lanjut termasuk sifilis tersier (gumatous, sifilis kardiovaskular dan neurosi...

  19. Manifestasi Kehamilan Di Rongga Mulut Dan Perawatannya



    Kehamilan merupakan sebuah proses fisiologis yang melibatkan banyak sistem dalam tubuh dan mengakibatkan terjadinya perubahan pada sistem baik secara anatomis maupun fisiologis seperti pada sistem reproduksi, endokrin, sirkulasi pencernaan dan juga rongga mulut. Manifestasi kehamilan di rongga mulut merupakan suatu kondisi yang sering tetjadi, baik pada gigi maupun pada jaringan di sekitamya. Hal ini dapat terlihat dan tingginya tingkat karies, erosi enamel, terjadinya gingivitis kehamila...

  20. Enhanced Accident Tolerant LWR Fuels: Metrics Development

    Shannon Bragg-Sitton; Lori Braase; Rose Montgomery; Chris Stanek; Robert Montgomery; Lance Snead; Larry Ott; Mike Billone


    The Department of Energy (DOE) Fuel Cycle Research and Development (FCRD) Advanced Fuels Campaign (AFC) is conducting research and development on enhanced Accident Tolerant Fuels (ATF) for light water reactors (LWRs). This mission emphasizes the development of novel fuel and cladding concepts to replace the current zirconium alloy-uranium dioxide (UO2) fuel system. The overall mission of the ATF research is to develop advanced fuels/cladding with improved performance, reliability and safety characteristics during normal operations and accident conditions, while minimizing waste generation. The initial effort will focus on implementation in operating reactors or reactors with design certifications. To initiate the development of quantitative metrics for ATR, a LWR Enhanced Accident Tolerant Fuels Metrics Development Workshop was held in October 2012 in Germantown, MD. This paper summarizes the outcome of that workshop and the current status of metrics development for LWR ATF.

  1. Predicting road accidents: Structural time series approach

    Junus, Noor Wahida Md; Ismail, Mohd Tahir


    In this paper, the model for occurrence of road accidents in Malaysia between the years of 1970 to 2010 was developed and throughout this model the number of road accidents have been predicted by using the structural time series approach. The models are developed by using stepwise method and the residual of each step has been analyzed. The accuracy of the model is analyzed by using the mean absolute percentage error (MAPE) and the best model is chosen based on the smallest Akaike information criterion (AIC) value. A structural time series approach found that local linear trend model is the best model to represent the road accidents. This model allows level and slope component to be varied over time. In addition, this approach also provides useful information on improving the conventional time series method.

  2. A Review of Criticality Accidents 2000 Revision

    Thomas P. McLaughlin; Shean P. Monahan; Norman L. Pruvost; Vladimir V. Frolov; Boris G. Ryazanov; Victor I. Sviridov


    Criticality accidents and the characteristics of prompt power excursions are discussed. Sixty accidental power excursions are reviewed. Sufficient detail is provided to enable the reader to understand the physical situation, the chemistry and material flow, and when available the administrative setting leading up to the time of the accident. Information on the power history, energy release, consequences, and causes are also included when available. For those accidents that occurred in process plants, two new sections have been included in this revision. The first is an analysis and summary of the physical and neutronic features of the chain reacting systems. The second is a compilation of observations and lessons learned. Excursions associated with large power reactors are not included in this report.

  3. Assessment of CRBR core disruptive accident energetics

    Theofanous, T.G.; Bell, C.R.


    The results of an independent assessment of core disruptive accident energetics for the Clinch River Breeder Reactor are presented in this document. This assessment was performed for the Nuclear Regulatory Commission under the direction of the CRBR Program Office within the Office of Nuclear Reactor Regulation. It considered in detail the accident behavior for three accident initiators that are representative of three different classes of events; unprotected loss of flow, unprotected reactivity insertion, and protected loss of heat sink. The primary system's energetics accommodation capability was realistically, yet conservatively, determined in terms of core events. This accommodation capability was found to be equivalent to an isentropic work potential for expansion to one atmosphere of 2550 MJ or a ramp rate of about 200 $/s applied to a classical two-phase disassembly.

  4. Bundled automobile insurance coverage and accidents.

    Li, Chu-Shiu; Liu, Chwen-Chi; Peng, Sheng-Chang


    This paper investigates the characteristics of automobile accidents by taking into account two types of automobile insurance coverage: comprehensive vehicle physical damage insurance and voluntary third-party liability insurance. By using a unique data set in the Taiwanese automobile insurance market, we explore the bundled automobile insurance coverage and the occurrence of claims. It is shown that vehicle physical damage insurance is the major automobile coverage and affects the decision to purchase voluntary liability insurance coverage as a complement. Moreover, policyholders with high vehicle physical damage insurance coverage have a significantly higher probability of filing vehicle damage claims, and if they additionally purchase low voluntary liability insurance coverage, their accident claims probability is higher than those who purchase high voluntary liability insurance coverage. Our empirical results reveal that additional automobile insurance coverage information can capture more driver characteristics and driving behaviors to provide useful information for insurers' underwriting policies and to help analyze the occurrence of automobile accidents.

  5. Internal Accident Report: fill it out!


    It is important to report all accidents, near-misses and dangerous situations so that they can be avoided in the future.   Reporting these events allows the relevant services to take appropriate action and implement corrective and preventive measures. It should be noted that the routing of the internal accident report was recently changed to make sure that the people who need to know are informed. Without information, corrective action is not possible. Without corrective action, there is a risk that the events will recur. As soon as you experience or see something amiss, fill out an internal accident report! If you have any questions the HSE Unit will be happy to answer them. Contact us at The HSE Unit

  6. Agricultural implications of the Fukushima nuclear accident

    Nakanishi, Tomoko M.


    More than 4 years has passed since the accident at the Fukushima Nuclear Power Plant. Immediately after the accident, 40 to 50 academic staff of the Graduate School of Agricultural and Life Sciences at the University of Tokyo created an independent team to monitor the behavior of the radioactive materials in the field and their effects on agricultural farm lands, forests, rivers, animals, etc. When the radioactive nuclides from the nuclear power plant fell, they were instantly adsorbed at the site where they first touched; consequently, the fallout was found as scattered spots on the surface of anything that was exposed to the air at the time of the accident. The adsorption has become stronger over time, so the radioactive nuclides are now difficult to remove. The findings of our study regarding the wide range of effects on agricultural fields are summarized in this report. PMID:27538845

  7. Reconfigurable mobile manipulation for accident response



    The need for a telerobotic vehicle with hazard sensing and integral manipulation capabilities has been identified for use in transportation accidents where nuclear weapons are involved. The Accident Response Mobile Manipulation System (ARMMS) platform has been developed to provide remote dexterous manipulation and hazard sensing for the Accident Response Group (ARG) at Sandia National Laboratories. The ARMMS' mobility platform is a military HMMWV [High Mobility Multipurpose Wheeled Vehicle] that is teleoperated over RF or Fiber Optic communication channels. ARMMS is equipped with two high strength Schilling Titan II manipulators and a suite of hazardous gas and radiation sensors. Recently, a modular telerobotic control architecture call SMART (Sandia Modular Architecture for Robotic and Teleoperation) has been applied to ARMMS. SMART enables input devices and many system behaviors to be rapidly configured in the field for specific mission needs. This paper summarizes current SMART developments applied to ARMMS.

  8. Application of new therapies in Graves' disease and thyroid-associated ophthalmopathy: animal models and translation to human clinical trials

    Banga, J Paul; Nielsen, Claus H; Gilbert, Jacqueline A;


    immunosuppression. The recent development of an induced model of experimental Graves' disease, although incomplete as it lacks the extrathyroidal manifestations, provided opportunities to investigate immune intervention strategies, including influence upon the autoreactive B and T cell players in the autoimmune...

  9. Application of new therapies in Graves' disease and thyroid-associated ophthalmopathy: animal models and translation to human clinical trials

    Banga, J Paul; Nielsen, Claus H; Gilbert, Jacqueline A;


    Most current approaches for treating Graves' disease are based essentially upon regimes developed nearly 50 years ago. Moreover, therapeutic approaches for complications such as thyroid-associated ophthalmopathy (TAO) and dermopathy are singularly dependent on conventional approaches of nonspecif...

  10. The influence of position deviation on RAIU and,the corresponding therapeutic dose calculations in patients with Graves hyperthyroidism



    Objective To evaluate the influence of inappropriate position deviation on radioactive iodine uptake(RAIU),effective half-life(Teff)and the corresponding dose variances in patients suffering from Graves hyperthyroidism.Methods RAIU was examined in 20 patients with

  11. Analisis Kinerja EIGRP dan OSPF pada Topologi Ring dan Mesh



    Full Text Available ABSTRAK EIGRP (Enhanced Interior Gateway Routing Protocol dan OSPF (Open Shortest Path Fisrt adalah routing protokol yang banyak digunakan pada suatu jaringan komputer. EIGRP hanya dapat digunakan pada perangkat Merk CISCO, sedangkan OSPF dapat digunakan pada semua merk jaringan. Pada penelitian ini dibandingkan delay dan rute dari kedua routing protokol yang diimplementasikan pada topologi Ring dan Mesh. Cisco Packet Tracer 5.3 digunakan untuk mensimulasikan kedua routing protokol ini. Skenario pertama adalah perancangan jaringan kemudian dilakukan pengujian waktu delay 100 kali dalam 5 kasus. Skenario kedua dilakukan pengujian trace route untuk mengetahui jalur yang dilewati paket data lalu memutus link utama. Pada skenario kedua juga dilakukan perbandingan nilai metric dan cost hasil simulasi dengan perhitungan rumus. Skenario ketiga dilakukan pengujian waktu konvergensi untuk setiap routing protokol pada setiap topologi. Hasilnya EIGRP lebih cepat 386 µs daripada OSPF untuk topologi Ring sedangkan OSPF lebih cepat 453 µs daripada EIGRP untuk topologi Mesh. Hasil trace route menunjukan rute yang dipilih oleh routing protokol yaitu nilai metric dan cost yang terkecil. Waktu konvergensi rata-rata topologi Ring pada EIGRP sebesar 12,75 detik dan 34,5 detik pada OSPF sedangkan topologi Mesh di EIGRP sebesar 13 detik dan 35,25 detik di OSPF. Kata Kunci : EIGRP, OSPF, Packet Tracer 5.3, Ring, Mesh, Konvergensi ABSTRACT EIGRP (Enhanced Interior Gateway Routing Protocol and OSPF (Open Shortest Path Fisrt is the routing protocol that is widely used in a computer network. EIGRP can only be used on devices Brand CISCO, while OSPF can be used on all brands of network. In this study comparison of both the delay and the routing protocol implemented on Ring and Mesh topology. Cisco Packet Tracer 5.3 is used to simulate both the routing protocol. The first scenario is the design of the network and then do the test of time delay 100 times in 5 cases. The

  12. Avaliação e tratamento da hiperglicemia em pacientes graves

    Marina Verçoza Viana


    Full Text Available A hiperglicemia é um problema frequentemente encontrado em pacientes graves em ambiente de terapia intensiva. Sua presença se associa ao aumento da morbidade e da mortalidade, independentemente da causa da admissão (infarto agudo do miocárdio, condição após cirurgia cardiovascular, acidente vascular cerebral e sepse. Entretanto, permanecem muitas dúvidas com relação à fisiopatologia e, particularmente, em relação ao tratamento da hiperglicemia no paciente graves. Na prática clínica, devem ser levados em consideração diversos aspectos para o controle desses pacientes, inclusive os alvos de glicemia, o histórico de diabetes mellitus, a via de nutrição (enteral ou parenteral e o equipamento de monitoramento disponível, o que aumenta substancialmente a carga de trabalho dos profissionais envolvidos nesse tratamento. Esta revisão descreveu a epidemiologia, a fisiopatologia, o tratamento e o monitoramento da hiperglicemia no paciente adulto grave.

  13. Efficacy of (99m)Tc-EDDA/HYNIC-TOC SPECT/CT scintigraphy in Graves' ophthalmopathy.

    Zhao, Rong; Wang, Jiang; Deng, Jinglan; Yang, Weidong; Wang, Jing


    The aim of this study was to investigate the predictive role of the orbital somatostatin receptor scintigraphy with (99m)Tc-EDDA/HYNIC-TOC ((99m)Tc-TOC) to detect clinical stage of Graves' ophthalmopathy and the response to corticosteroid therapy. The subjects of the experiment were 46 patients with Graves' ophthalmopathy (GO) and four volunteers without eye disease or GO as the normal group (NG). Single photon emission computed tomography (SPECT), computed tomography (CT) and the left and right lateral position planar imaging of the heads of the all subjects were obtained 4 h after the intravenous injection of 555 MBq of (99m)Tc-TOC. The (99m)Tc-TOC SPECT/CT was repeated 3 months later. 35 (35/46) patients were received corticosteroid therapy (prednisolone, 10 mg po tid ) for 3 months, however, the other 11 patients as control groups did not receive any treatment. The treatment effect was evaluated both by the orbital (99m)Tc-TOC uptake and NOSPECS. A significant decrease in the O/OC ratio was observed in 22 GO patients between pre- and post-treatment (1.64 ± 0.13 vs. 1.21 ± 0.09, P TOC scintigraphy is a feasible technique to estimate the Graves' ophthalmopathy activity and predict the response to subsequent corticosteroid therapy in GO patients. The technique could be a useful tool for physicians not familiar with CAS determination.

  14. Acute effects of radioiodine therapy on the voice and larynx of basedow-Graves patients

    Isolan-Cury, Roberta Werlang; Cury, Adriano Namo [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP); Monte, Osmar [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Physiology Department; Silva, Marta Assumpcao de Andrada e [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Speech Therapy School; Duprat, Andre [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Otorhinolaryngology Department; Marone, Marilia [Nuclimagem - Irmanity of the Sao Paulo Santa Casa de Misericordia, SP (Brazil). Nuclear Medicine Unit; Almeida, Renata de; Iglesias, Alexandre [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Otorhinolaryngology Department. Endocrinology and Metabology Unit


    Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131). There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim of this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. Material and method: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/) and the s/z ratio, fundamental frequency analysis (Praat software), laryngoscopy and (perceptive-auditory) analysis in three different conditions: pre-treatment, 4 days, and 20 days post-radioiodine therapy. Conditions are based on the inflammatory pattern of thyroid tissue (Jones et al. 1999). Results: No statistically significant differences were found in voice characteristics in these three conditions. Conclusion: Radioiodine therapy does not affect voice quality. (author)

  15. Randomized double-blind trial of prednisone versus radiotherapy in Graves' ophthalmopathy

    Prummel, M.F.; Mourits, M.; Blank, L.; Berghout, A.; Koornneef, L.; Wiersinga, W.M. (Univ. of Amsterdam (Netherlands))


    Corticosteriods are usually given for management of Graves' ophthalmopathy, but they have many and serious side-effects. By comparison, retrobulbar irradiation is well tolerated, although its efficacy has been evaluated only in uncontrolled studies. Therefore, the authors did a double-blind randomized trial, in which 28 patients with moderately severe Graves' ophthalmopathy were treated with a 3-month course of oral prednisone and sham irradiation, and 28 received retrobulbar irradiation (20 Gy) and placebo capsules. Therapeutic outcome, assessed twenty-four weeks after the start of treatment, was determined by the change in the highest NOSPECS class. A successful outcome was observed in 14 prednisone-treated and in 13 irradiated patients. Responders to treatment (but not nonresponders) in both groups showed improvements in total and subjective eye score and a decrease in eye-muscle volume. Response to either treatment was due largely to changes in soft-tissue involvement and eye-muscle motility. Radiotherapy and oral prednisone appear to be equally effective as initial treatment in patients with moderately severe Graves' ophthalmopathy. In view of its better tolerability, radiotherapy should be considered the treatment of first choice.

  16. Enfoque terapéutico de los traumatismos graves de los miembros

    Roberto Joaquín del Gordo D´Amato


    Full Text Available Los traumatismos graves de miembros representan un porcentaje importante dentro de las patologías que consultan los servicios de urgencias de diversos centros hospitalarios. En la actualidad las estadísticas mundiales, nacionales y locales guardan unas proporciones similares en cuanto a frecuencia de presentación, sin embargo en países desarrollados la infraestructura en atención prehospitalaria con personal altamente calificado, permite obtener mejores resultados con respecto a atención y pronóstico de paciente politraumatizados, logrando en los últimos años una disminución significativa en cuanto a frecuencia de mortalidad. En todo traumatismo grave de miembros se requiere un manejo cuidadoso y ordenado a fin de disminuir complicaciones que en muchas ocasiones resultan verdaderamente catastróficas. Al considerar el tratamiento de traumatismos graves de miembros la amputación representa en algunas ocasiones una alternativa, sobre todo en aquellos pacientes con patologías asociadas que contribuyen a una evolución tórpida cuando se realiza reconstrucción.

  17. Chronology of the Third – Fifth Centuries Male Graves from the Tarasovo Burial Ground

    Goldina Rimma D.


    Full Text Available The article focuses on the chronological attribution of male graves from the late Mazunino stage of the Tarasovo burial ground and is a sequel to an earlier article about dating of the early Nyrgynda stage (1st – 2nd centuries of the same site. The three main methods employed in this research include those of formal typology, cultural stratigraphy and the nearest neighbor method. Eighty-six male graves of the third-fifth centuries were analyzed, with 12 identified as a result: first half of the 3rd c. AD (group 1, second half of the 3rd c. AD (2; 3rd c. (3; first half of the 4th c. (group 4; second half of the 3rd – 4th c. (5; third quarter of the 4th c. (6; fourth quarter of the 4th c. (group 7; second half of the 4th c. (8; second half of the 4th – 5th c. (9; 4th – 5th cc. (10; second half of the 3rd – 5th cc. (11 and 3rd – 5th cc. (12. This article minutes investigates the first six groups, while the rest will be covered in the next publication. Artifacts form the third – fifth century female graves of the Tarasovo burial ground will be studied separately.

  18. James George Frazer’s Anthropologic Heritage in the Work of Robert Graves

    Tomislav M. Pavlović


    Full Text Available The works of Sir James George Frazer had an outstanding influence on the literature of modernism. Among those who benefited from Frazer’s ritualism were W. B. Yeats, T. S. Eliot. James Joyce, Ernest Hemingway, D. H. Lawrence, Ezra Pound, Mary Renault, Joseph Campbell, Robert Graves and many others. Robert Graves was known for his famous adaptation of Frazer’s concept of the sacred king who is sacrificed for the benefit of his subjects thus forming the narrative frame for the one of his most controversial novels. The dying king is also identified with the poet striving to attain the favour of the Triple Muse Goddess - who represents the embodiment of true poetic inspiration. The aforementioned concept is not the only thing that Graves inherited from his famous ancestor. In our analysis we laid stress on the customs, rituals, magic symbols and deities both authors dealt with. We also observed a striking resemblance of the style Greves and Frazer developed and their euchemeristic approach to myths as well.

  19. Preserved brains from the Spanish Civil War mass grave (1936) at La Pedraja1, Burgos, Spain.

    Serrulla, Fernando; Herrasti, Lourdes; Navarro, Carmen; Cascallana, Jose Luis; Bermejo, Ana Maria; Marquez-Grant, Nicholas; Etxeberria, Francisco


    During the excavation of the Spanish Civil War mass grave at La Pedraja (Burgos, Spain), 104 individuals were found interred within it, 45 of which displayed brains that were preserved but dehydrated and reduced in size. This exceptional finding has resulted in the formation of a multidisciplinary team, with the aim of obtaining as much information as possible and to primarily understand the taphonomic phenomena that has led to the preservation of these brains. The following types of analyses were undertaken on three of these brains: macroscopy, histology, radiology, chemical-toxicology, genetics, chemical analysis of the soil and 3D modelling for stereolithography. The historical context was considered, plus all archaeological and other forensic data provided by the investigation of the mass grave. The results of the analyses on these morphologically identifiable human brains confirmed the presence of nerve structures, fatty acids, and in one case ante-mortem evidence for an intracranial haemorrhage. The fatty acid profile corresponds to the process of saponification. Therefore, the interpretation is that the preservation of these brains at the mass grave of La Pedraja was due to the saponification process, which was influenced by the manner and cause of death, the chemical composition of the brain, the physicochemical properties of the soil and the meteorological conditions at the time.


    Prof. Supratiknya


    jaran di perguruan tinggi seperti kita kenal sekarang (selanjutnya disebut psikologi, lahir di Jerman pada penghujung abad ke‐19. Selanjutnya psikologi berkembang pesat di Amerika Utara khususnya Amerika Serikat dan negara‐negara lain di Eropa yang lebih dulu mengalami industrialisasi khususnya di Eropa Barat. 1 Alhasil, paling tidak sampai dasawarsa 1980‐an perkembangan dan persebaran psikologi di tingkat global ditandai oleh ketimpangan di antara apa yang oleh Moghaddam (1987 disebut tiga dunia tempat psikologi dikembangkan dan dipraktekkan, disimak antara lain berdasarkan besarnya produksi pengetahuan psikologis yang disebarluaskan melalui penyelenggaraan pendidikan tinggi psikologi maupun lewat publikasi ilmiah berupa baik berkala maupun buku rujukan dan buku teks.


    Haris Herdiansyah


    Full Text Available Dunia pelacuran adalah penuh dengan tekanan, ancaman dan hal negatif cacat yang menyebabkan ketertarikan kepada pelacur oleh karena itu mendorong pelacur untuk menciptakan strategi menghadapi cukup untuk menghadapi apa yang rasa mereka . Tujuan dari studi ini akan meliputi ke luar ketertarikan dan strategi pelacur yang menghadapi transgender di tiga lingkungan sosial berbeda termasuk dalam keluarga, masyarakat dan “ cebongan” ( tempat di mana pelacur bekerja. Ini adalah suatu riset kualitatif. Karena alat pengumpulan data adalah wawancara, dan pengamatan. Studi ini menggunakan purposive sampling. Ada 3 subjek dan 4 orang informan. Untuk menganalisis data menggunakan model interaktif dari Miles & Huberman yang terdiri dari 3 langkah, yaitu reduksi data, menampilkan data dan kesimpulan serta verifikasi. Hasil dari penelitian ini, banyak kecemasan yang dialami oleh waria pelacur yang datang dari lingkungan yang berbeda-beda. Dari keluarga misalnya, merupakan sumber kecemasan tertinggi, ketika keluarga waria mengetahui profesi mereka. Sumber lain berasal dari pengucilan oleh masyarakat dan mucikari, penangkapan oleh polisi dan preman, persaingan antar pelacur dan kekerasan dari pengguna mereka di “cebongan”


    I G A Mirah K


    Full Text Available Ekstravasasi agen kemoterapi ke jaringan sekitarnya merupakan kecelakaan yangdapat menyebabkan kerusakan jaringan progresif ireversibel dalam hitungan jamsampai hari. Manifestasi klinis ekstravasasi berupa nyeri, edema, eritema, danindurasi yang kemudian berkembang menjadi ulkus dan eschar hitam dankerusakan jaringan yang mendasarinya. Pencegahan terjadinya ekstravasasi dapatdilakukan dengan menggunakan pembuluh darah yang paten dan dengan aliranyang cepat dan tetap memperhatikan keluhan yang disampaikan pasien. Setiaptenaga kesehatan yang akan menangani pasien kanker dengan kemoterapi, dituntutmemiliki pengetahuan mengenai ekstravasasi agen kemoterapi yang bergunadalam meningkatkan pelayanan pada pasien dan mengurangi morbiditas.

  3. MDCT findings in sports and recreational accidents

    Bensch, Frank V; Koivikko, Mika P; Koskinen, Seppo K (Dept. of Radiology, Toeoeloe Hospital, Helsinki (Finland)), email:


    Background. Sports and recreational accidents involving critical areas of the body occur commonly in the general population. Reports on their demographics and recommendations for screening procedures are, however, few. Purpose. To assess injuries of the craniofacial area, spine, and torso resulting from sports and recreational accidents with multidetector computed tomography (MDCT) as primary imaging method in a Level I trauma center. Material and Methods. All emergency room CT requests over a time span of 105 months were reviewed retrospectively for trauma mechanism and injury. Patients were identified using an electronic picture archiving and communications system (PACS), and MDCT studies interpreted by two radiologists independently. Results. Of a total of 5898 patients, 492 patients (301 boys/men, 191 girls/women, age range 2-76 years, mean 33.5 years, median 29.5 years) with sports or recreational accidents emerged. A total of 102 traumatic findings were diagnosed, thereof 72 (71%) serious. The three most commonly encountered serious injuries were intracranial injury, fractures of facial bones, and vertebral injuries. The three most common injury mechanisms were bicycling, horseback riding, and team ball sports. Patients from recreational activities were on average significantly younger (29.2 years) than those from sports accidents (36.9 years; P < 0.001). Only age groups <21 years and 41-50 years differed in injury severity from the other age groups (P = 0.004 and P = 0.063, respectively). Of all trauma mechanisms, only bicycling had a significantly increased risk of injury (P < 0.001). Conclusion. Injuries in sports and recreational accidents presented with an overall incidence of 21%, of which 71% are serious. The most common mechanisms of injury were bicycling, horseback riding, and team ball sports. The largest incidence of serious injury involved bicycling. Because of the high probability of a serious injury and the high energies that are often involved

  4. Accident progression event tree analysis for postulated severe accidents at N Reactor

    Wyss, G.D.; Camp, A.L.; Miller, L.A.; Dingman, S.E.; Kunsman, D.M. (Sandia National Labs., Albuquerque, NM (USA)); Medford, G.T. (Science Applications International Corp., Albuquerque, NM (USA))


    A Level II/III probabilistic risk assessment (PRA) has been performed for N Reactor, a Department of Energy (DOE) production reactor located on the Hanford reservation in Washington. The accident progression analysis documented in this report determines how core damage accidents identified in the Level I PRA progress from fuel damage to confinement response and potential releases the environment. The objectives of the study are to generate accident progression data for the Level II/III PRA source term model and to identify changes that could improve plant response under accident conditions. The scope of the analysis is comprehensive, excluding only sabotage and operator errors of commission. State-of-the-art methodology is employed based largely on the methods developed by Sandia for the US Nuclear Regulatory Commission in support of the NUREG-1150 study. The accident progression model allows complex interactions and dependencies between systems to be explicitly considered. Latin Hypecube sampling was used to assess the phenomenological and systemic uncertainties associated with the primary and confinement system responses to the core damage accident. The results of the analysis show that the N Reactor confinement concept provides significant radiological protection for most of the accident progression pathways studied.

  5. A study of the effect of seasonal climatic factors on the electrical resistivity response of three experimental graves

    Jervis, John R.; Pringle, Jamie K.


    Electrical resistivity surveys have proven useful for locating clandestine graves in a number of forensic searches. However, some aspects of grave detection with resistivity surveys remain imperfectly understood. One such aspect is the effect of seasonal changes in climate on the resistivity response of graves. In this study, resistivity survey data collected over three years over three simulated graves were analysed in order to assess how the graves' resistivity anomalies varied seasonally and when they could most easily be detected. Thresholds were used to identify anomalies, and the ‘residual volume' of grave-related anomalies was calculated as the area bounded by the relevant thresholds multiplied by the anomaly's average value above the threshold. The residual volume of a resistivity anomaly associated with a buried pig cadaver showed evidence of repeating annual patterns and was moderately correlated with the soil moisture budget. This anomaly was easiest to detect between January and April each year, after prolonged periods of high net gain in soil moisture. The resistivity response of a wrapped cadaver was more complex, although it also showed evidence of seasonal variation during the third year after burial. We suggest that the observed variation in the graves' resistivity anomalies was caused by seasonal change in survey data noise levels, which was in turn influenced by the soil moisture budget. It is possible that similar variations occur elsewhere for sites with seasonal climate variations and this could affect successful detection of other subsurface features. Further research to investigate how different climates and soil types affect seasonal variation in grave-related resistivity anomalies would be useful.

  6. Dose estimates from the Chernobyl accident

    Lange, R.; Dickerson, M.H.; Gudiksen, P.H.


    The Lawrence Livermore National Laboratory Atmospheric Release Advisory Capability (ARAC) responded to the Chernobyl nuclear reactor accident in the Soviet Union by utilizing long-range atmospheric dispersion modeling to estimate the amount of radioactivity released (source term) and the radiation dose distribution due to exposure to the radioactive cloud over Europe and the Northern Hemisphere. In later assessments, after the release of data on the accident by the Soviet Union, the ARAC team used their mesoscale to regional scale model to focus in on the radiation dose distribution within the Soviet Union and the vicinity of the Chernobyl plant. 22 refs., 5 figs., 5 tabs.

  7. Accident Safety Design for High Speed Elevator

    Tawiwat Veeraklaew


    Full Text Available There have been many elevators exist in buildings for such a long time; however, an accident might happen as a free fall due to lacks of maintenance or some other accident such as firing. Although this situation is rarely occurred, many people are still concerned about it. The question here is how to make passengers to feel safe and confident when they are using an elevator, especially, high speed elevator. This problem is studied here in this paper as a free fall spring-mass-damper system with the stiffness and damping coefficient can be computed as minimum jerk of the system with given constraints on trajectories.

  8. Lessons learned from early criticality accidents

    Malenfant, R.E.


    Four accidents involving the approach to criticality occurred during the period July, 1945, through May, 1996. These have been described in the format of the OPERATING EXPERIENCE WEEKLY SUMMARY which is distributed by the Office of Nuclear and Facility Safety. Although the lessons learned have been incorporated in standards, codes, and formal procedures during the last fifty years, this is their first presentation in this format. It is particularly appropriate that they be presented in the forum of the Nuclear Criticality Technology Safety Project Workshop closest to the fiftieth anniversary of the last of the four accidents, and that which was most instrumental in demonstrating the need to incorporate lessons learned.


    Woods, Michael; /SLAC


    A graduate student received a laser eye injury from a femtosecond Ti:sapphire laser beam while adjusting a polarizing beam splitter optic. The direct causes for the accident included failure to follow safe alignment practices and failure to wear the required laser eyewear protection. Underlying root causes included inadequate on-the-job training and supervision, inadequate adherence to requirements, and inadequate appreciation for dimly visible beams outside the range of 400-700nm. This paper describes how the accident occurred, discusses causes and lessons learned, and describes corrective actions being taken.

  10. Analisis Perbandingan Database Jurnal Elektronik Emerald, ProQuest ABI/INFORM dan SpringerLink Bidang Manajemen dan Ekonomi

    Karyatin, Arianiansyah


    Penelitian ini dilakukan pada situs database jurnal elektronik Emerald, ProQuest ABI/INFORM dan SpringerLink. Tujuan penelitian ini adalah untuk mengetahui bagaimana konten (muatan) subjek kajian manajemen dan ekonomi pada database Emerald, ProQuest ABI/INFORM dan SpringerLink dan untuk mengetahui di dalam database manakah diantara database Emerald, ProQuest ABI/INFORM, dan Springerlink yang memuat bidang kajian manajemen dan ekonomi yang paling lengkap. Metode yang digunakan dalam pene...

  11. [A case of membranous nephropathy with ANCA-associated necrotizing glomerulonephritis during oral administration of PTU for Graves' disease].

    Fujii, Takayuki; Kawamata, Toyotaka; Ueda, Shiro; Akikusa, Bunshiro; Hasegawa, Shigeru; Tsukahara, Tsunemichi; Iesato, Kenji; Ogawa, Makoto; Saisho, Hiromitsu


    We experienced a coincidental case of two types of glomerulopathy associated with Graves' disease. A 64-year-old man, who had been treated with propylthiouracil(PTU) for Graves' disease for 15 years, was admitted to our hospital for macroscopic hematuria and rapidly progressive deterioration of renal function. Although his thyroid function had been within the normal range during treatment, the level of thyrotropin receptor antibody(TRAb) gradually increased from a year before admission. Serological tests revealed that he was positive for myeloperoxidase-antineutrophil cytoplasmic antibody(MPO-ANCA). The renal biopsy specimen showed necrotizing and crescentic glomerulonephritis(GN) superimposed on membranous nephropathy(MN). This is a rare case of MN complicated with ANCA associated crescentic GN in a Graves' disease patient. Association of these two renal alterations was not clearly defined. MN involved with Graves' disease also has been rarely reported. Some reports demonstrated deposition of thyroglobulin and other thyroid related antigens in the glomeruli. In the present case, long-term impairment of Graves' disease and elevation of TRAb might have been responsible for the formation and deposition of thyroid-associated immune complex in the glomeruli. As for crescentic GN, PTU might have induced ANCA-associated GN independently of MN. This case is instructive for considering the relation between Graves' disease and renal injury.

  12. First international workshop on severe accidents and their consequences. [Chernobyl Accident


    An international workshop on past severe nuclear accidents and their consequences was held in Dagomys region of Sochi, USSR on October 30--November 3, 1989. The plan of this meeting was approved by the USSR Academy of Sciences and by the USSR State Committee of the Utilization of Atomic Energy. The meeting was held under the umbrella of the ANS-SNS agreement of cooperation. Topics covered include analysis of the Chernobyl accident, safety measures for RBMK type reactors and consequences of the Chernobyl accident including analysis of the ecological, genetic and psycho-social factors. Separate reports are processed separately for the data bases. (CBS)

  13. Morbidade materna extremamente grave: uso do Sistema de Informação Hospitalar

    Maria da Consolação Magalhães


    Full Text Available OBJETIVO: Estimar a prevalência da morbidade materna extremamente grave e identificar procedimentos hospitalares associados. MÉTODOS: Foram utilizados dados do Sistema de Informação Hospitalar fornecidos pela Secretaria de Saúde de Juiz de Fora, MG, de 2006 a 2007. Foram selecionadas as internações para procedimentos obstétricos (n = 8.620 mulheres cujo diagnóstico principal compreendia todo o capítulo XV, gravidez, parto e puerpério, da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde, Décima Revisão. Foram identificados os códigos dos procedimentos realizados, procedimentos especiais e atos profissionais que pudessem contemplar o critério de morbidade materna extremamente grave da Organização Mundial da Saúde e outros procedimentos não habitualmente utilizados no período gravídico-puerperal. A análise de regressão logística foi utilizada para identificar associações entre desfecho e variáveis selecionadas. RESULTADOS: A prevalência de morbidade materna foi 37,8/1000 mulheres e a proporção de mortalidade foi 12/100.000 mulheres. O tempo de internação > 4 dias foi 13 vezes mais alto entre as mulheres que apresentaram alguma morbidade. Após análise ajustada, os fatores preditores de morbidade materna extremamente grave foram: tempo de internação, número de internações e filhos natimortos, e os procedimentos/condições mais frequentes foram a transfusão de hemoderivados (15,7/1.000, "permanência a maior" (9,5/1.000 e pré-eclâmpsia grave/eclâmpsia (8,2/1.000. CONCLUSÕES: Foi alta a prevalência de morbidade materna extremamente grave, associada principalmente às internações e variáveis relacionadas ao recém-nascido. O critério para identificação dos casos e o uso do Sistema de Informações Hospitalares mostraram-se úteis para a vigilância da morbimortalidade materna e para ampliar o conhecimento sobre os aspectos que a envolvem, contribuindo para a

  14. Intoxicaciones agudas graves en un servicio de medicina intensiva durante doce años

    Palazón Sánchez C


    Full Text Available Fundamento: Conocer la epidemiología de las intoxicaciones agudas graves en un servicio de medicina intensiva y evaluar el pronóstico de la PCR y mortalidad asociada a los distintos tóxicos Métodos: Estudio retrospectivo realizado en el servicio de medicina intensiva polivalente de 10 camas, ubicado en un Hospital General de adultos. Período de estudio 12 años. Revisión de las historias clínicas de las personas ingresadas en el servicio de medicina intensiva por intoxicaciones agudas graves. Se recogieron datos demográficos, existencia de PCR al ingreso, necesidad de VM, complicaciones de las intoxicaciones agudas graves y mortalidad de la serie. Se realizó un análisis global y por año de estudio. El tratamiento estadístico de los datos se realizó con el paquete SPSS mediante la "t" de Student o la "chi" cuadrado, considerando valores significativos si p<0,05 Resultados: Se han incluido 233 sujetos, de los que 130 fueron varones. La estancia media fue de 4 días. El 63% de los pacientes fueron menores de 40 años (p<0,05. La intoxicación más frecuente fue la medicamentosa debida a un solo producto (72%. La supervivencia tras la PCR fue del 40% (4/10. La mortalidad global se situó en el 5,6% (n=13, habiendo precisado el 92% de los sujetos que posteriormente murieron, VM en algún momento de su ingreso en la unidad de cuidados intensivos. Conclusiones: En nuestro medio, la intoxicación más frecuente es la medicamentosa. La mortalidad se muestra dependiente del carácter de voluntariedad, pero independiente del tipo de tóxico (medicamentoso o no. La PCR asociada a las intoxicaciones agudas graves tiene, en nuestra serie, un mejor pronostico que la asociada a otras patologías. La VM asociada a las intoxicaciones agudas graves tiene una mortalidad baja (15,7%

  15. Violent deaths among composers (accidents, drownings and murders)

    Breitenfeld, Darko; Vodanović, Marijo; Akrap, Ankica; Juran, Dominik; Kranjčec, Darko; Vuksanović, Marina


    In this study, we described different accidents, drowning and murders as the main cause of death among 145 composers. We included accidents (48 composers), drowning (26 composers) and murders (71 composers) which were mainly fatal, and premature. Accidents are the third leading cause of deaths today. Murders were often during the wars and revolutions (World War I, II, French, Russian revolution). We mentioned all of the etiologies of these accidents, drowning and murders according to the c...


    - - Nurjanah


    Full Text Available Tujuan penelitian adalah menentukan komposisi gizi, asam amino, taurin, mineral makro dan mikro,dan vitamin B12 pada ubur-ubur (Aurelia aurita segar dan kering. Asam amino esensial pada ubur-uburyaitu arginina, leusina, valina, treonina, lisina, isoleusina, fenilalanina, metionina, dan histidina, sedangkanasam amino non esensial yaitu asam glutamat, glisina, asam aspartat, serina, alanina, dan tirosina. Asamamino esensial tertinggi segar dan kering adalah arginina sebesar 1,72% (bk dan 1,44% (bk dan terendahhistidina yaitu sebesar 0,19% (bk dan 0,13% (bk. Asam amino non esensial segar dan kering tertinggiadalah asam glutamat dan glisina yaitu sebesar 3,26% (bk dan 2,62% (bk dan terkecil tirosina sebesar0,38% (bk dan 0,41% (bk. Taurin segar sebesar 2,68% (bk dan kering sebesar 0,67% (bk. Mineral makrotertinggi segar dan kering adalah natrium yaitu 180.092,1 ppm (bk dan 111.209,4 ppm (bk, terkecil adalahkalsium yaitu 5.750,2 ppm (bk dan 11,1 ppm (bk. Mineral mikro tertinggi segar dan kering adalah iodium yaitu8.291,5 ppm (bk dan 1.800 ppm (bk dan yang terkecil adalah tembaga yaitu 1,1 ppm (bk dan 0,6 ppm (bk.Vitamin B12 segar adalah 396,6 μm/100 g (bk dan kering 63,5 μm/100 g (bk.Kata kunci: asam amino, mineral, taurin, ubur-ubur (Aurelia aurita, vitamin B12

  17. Accidents due to falls from roof slabs

    Bruno Alves Rudelli

    Full Text Available CONTEXT AND OBJECTIVE Falls from the roof slabs of houses are accidents of high potential severity that occur in large Brazilian cities and often affect children and adolescents. The aims of this study were to characterize the factors that predispose towards this type of fall involving children and adolescents, quantify the severity of associated lesions and suggest preventive measures. DESIGN AND SETTING Descriptive observational prospective longitudinal study in two hospitals in the metropolitan region of São Paulo. METHODS Data were collected from 29 cases of falls from roof slabs involving children and adolescents between October 2008 and October 2009. RESULTS Cases involving males were more prevalent, accounting for 84%. The predominant age group was schoolchildren (7 to 12 years old; 44%. Leisure activities were most frequently being practiced on the roof slab at the time of the fall (86%, and flying a kite was the most prevalent game (37.9%. In 72% of the cases, the children were unaccompanied by an adult responsible for them. Severe conditions such as multiple trauma and traumatic brain injuries resulted from 79% of the accidents. CONCLUSION Falls from roof slabs are accidents of high potential severity, and preventive measures aimed towards informing parents and guardians about the dangers and risk factors associated with this type of accident are needed, along with physical protective measures, such as low walls around the slab and gates with locks to restrict free access to these places.

  18. Severe Accident Test Station Activity Report

    Pint, Bruce A [ORNL; Terrani, Kurt A [ORNL


    Enhancing safety margins in light water reactor (LWR) severe accidents is currently the focus of a number of international R&D programs. The current UO2/Zr-based alloy fuel system is particularly susceptible since the Zr-based cladding experiences rapid oxidation kinetics in steam at elevated temperatures. Therefore, alternative cladding materials that offer slower oxidation kinetics and a smaller enthalpy of oxidation can significantly reduce the rate of heat and hydrogen generation in the core during a coolant-limited severe accident. In the U.S. program, the high temperature steam oxidation performance of accident tolerant fuel (ATF) cladding solutions has been evaluated in the Severe Accident Test Station (SATS) at Oak Ridge National Laboratory (ORNL) since 2012. This report summarizes the capabilities of the SATS and provides an overview of the oxidation kinetics of several candidate cladding materials. A suggested baseline for evaluating ATF candidates is a two order of magnitude reduction in the steam oxidation resistance above 1000ºC compared to Zr-based alloys. The ATF candidates are categorized based on the protective external oxide or scale that forms during exposure to steam at high temperature: chromia, alumina, and silica. Comparisons are made to literature and SATS data for Zr-based alloys and other less-protective materials.

  19. ANS severe accident program overview & planning document

    Taleyarkhan, R.P.


    The Advanced Neutron Source (ANS) severe accident document was developed to provide a concise and coherent mechanism for presenting the ANS SAP goals, a strategy satisfying these goals, a succinct summary of the work done to date, and what needs to be done in the future to ensure timely licensability. Guidance was received from various bodies [viz., panel members of the ANS severe accident workshop and safety review committee, Department of Energy (DOE) orders, Nuclear Regulatory Commission (NRC) requirements for ALWRs and advanced reactors, ACRS comments, world-wide trends] were utilized to set up the ANS-relevant SAS goals and strategy. An in-containment worker protection goal was also set up to account for the routine experimenters and other workers within containment. The strategy for achieving the goals is centered upon closing the severe accident issues that have the potential for becoming certification issues when assessed against realistic bounding events. Realistic bounding events are defined as events with an occurrency frequency greater than 10{sup {minus}6}/y. Currently, based upon the level-1 probabilistic risk assessment studies, the realistic bounding events for application for issue closure are flow blockage of fuel element coolant channels, and rapid depressurization-related accidents.

  20. Diving Accidents. Analyses of Underlying Variables.


    Nitrogen narcosis 3 0.3 bad gas 3 0.3 Total 1,036 100.1 1,033 100.2 Another factor of potential relevance in mishap occurrence was the time of day...exposure air, and nitrogen -oxygen equivalent air were all at relatively high risk of terminating in a mishap. Accident rates for the other variables

  1. Accidents with biological material in workers

    Cleonice Andréa Alves Cavalcante


    Full Text Available The objective was to describe the accidents with biological material occurred among workers of Rio Grande do Norte, Brazil, between 2007 and 2009. Secondary data were collected in the National Notifiable Diseases Surveillance System by exporting data to Excel using Tabwin. Among the types of occupational accidents reported in the state, the biological accidents (no. = 1,170 accounted for 58.3% with a predominance of cases among nurses (48.6%. The percutaneous exposure was the most frequent occurrence and the circumstances of the accidents were related to the handling of sharps and the most common organic material was blood (63.5%. More than 50% of the workers were vaccinated against hepatitis B, but without information regarding the evaluation of vaccine response. The study revealed the need of improvement in the quality of the information, once the sub-entries and inconsistencies make the National Notifiable Diseases Surveillance System less trustworthy in the characterization of the affected workers.

  2. [Current situation of accidents in the world].

    Aguilar-Zinser, José Valente


    According to the World Health Organization (WHO), the number of traffic accidents is of concern. About 1.2 million people die every year on the roadways and about 20 to 50 million suffer from non-lethal trauma. Countries with low or medium incomes have higher rates of lethality by traffic accidents (21.5 and 19.5 per 100,000 habitants, respectively) than countries with higher incomes (10.3 per 100,000). It is estimated that the cost of traffic accidents in countries that are members of the Organization for Economic Cooperation and Development (OECD), escalate to rates that are between 2-5% of the gross domestic product (GDP). According to data from the health sector in Mexico, these rates are equivalent to 1.3 of GDR The WHO foresees that traffic accident traumas will rise to be the third cause of mortality in 2030. Because of the high complexity of the transport sector, it is necessary that the Transport and Communication Ministry works in a multidisciplinary and intersectorial fashion to ensure that the land transportation systems operate effectively in accordance with national economic development and the quality of life of the Mexican people.

  3. Chernobyl accident. [Radiation monitoring in UK

    Gittus, J.H.


    A brief report is given of the implications for the UK from the radioactivity released during the Chernobyl accident. Results of radio-activity monitoring around the UK are given and the additional radiation doses to the UK population are evaluated.

  4. Speed Variance and Its Influence on Accidents.

    Garber, Nicholas J.; Gadirau, Ravi

    A study was conducted to investigate the traffic engineering factors that influence speed variance and to determine to what extent speed variance affects accident rates. Detailed analyses were carried out to relate speed variance with posted speed limit, design speeds, and other traffic variables. The major factor identified was the difference…

  5. Fatal accidents among Danes with multiple sclerosis

    Brønnum-Hansen, Henrik; Hansen, Thomas; Koch-Henriksen, Nils


    We compared the rate of fatal accidents among Danes with multiple sclerosis (MS) with that of the general population. The study was based on linkage of the Danish Multiple Sclerosis Registry to the Cause of Death Registry and covered all 10174 persons in whom MS was diagnosed during the period 1953...

  6. Analysis of Credible Accidents for Argonaut Reactors

    Hawley, S. C.; Kathern, R. L.; Robkin, M. A.


    Five areas of potential accidents have been evaluated for the Argonaut-UTR reactors. They are: • insertion of excess reactivity • catastrophic rearrangement of the core • explosive chemical reaction • graphite fire • fuel-handling accident. A nuclear excursion resulting from the rapid insertion of the maximum available excess reactivity would produce only 12 MWs which is insufficient to cause fuel melting even with conservative assumptions. Although precise structural rearrangement of the core would create a potential hazard, it is simply not credible to assume that such an arrangement would result from the forces of an earthquake or other catastrophic event. Even damage to the fuel from falling debris or other objects is unlikely given the normal reactor structure. An explosion from a metal-water reaction could not occur because there is no credible source of sufficient energy to initiate the reaction. A graphite fire could conceivably create some damage to the reactor but not enough to melt any fuel or initiate a metal-water reaction. The only credible accident involving offsite doses was determined to be a fuel-handling accident which, given highly conservative assumptions, would produce a whole-body dose equivalent of 2 rem from noble gas immersion and a lifetime dose equivalent commitment to the thyroid of 43 rem from radioiodines.

  7. Inventory of socioeconomic costs of work accidents

    Mossink, J.; Greef, M. de


    The European Commission has prioritised the need to develop knowledge of the economic and social costs arising from occupational accidents and illnesses in their communication about a new Community strategy on safety and health at work for 2002-06. This report from the Agency aims to contribute to t

  8. Development of the Severe Accident Analysis DB for the Severe Accident Management Expert System (I)

    Park, Soo Yong; Ahn, Kwang Il [KAERI, Daejeon (Korea, Republic of)


    This report contains analysis methodologies and calculation results of 5 initiating events of the severe accident analysis database system. The Ulchin 3,4 NPP has been selected as reference plants. Based on the probabilistic safety analysis of the corresponding plant, 54 accident scenarios, which was predicted to have more than 10-10 /ry occurrence frequency, have been analyzed as base cases for the Large loss of Coolant sequence database. The functions of the severe accident analysis database system will be to make a diagnosis of the accident by some input information from the plant symptoms, to search a corresponding scenario, and finally to provide the user phenomenological information based on the pre-analyzed results. The MAAP 4.06 calculation results in this report will be utilized as input data to develop the database system

  9. Utilization of accident databases and fuzzy sets to estimate frequency of HazMat transport accidents.

    Qiao, Yuanhua; Keren, Nir; Mannan, M Sam


    Risk assessment and management of transportation of hazardous materials (HazMat) require the estimation of accident frequency. This paper presents a methodology to estimate hazardous materials transportation accident frequency by utilizing publicly available databases and expert knowledge. The estimation process addresses route-dependent and route-independent variables. Negative binomial regression is applied to an analysis of the Department of Public Safety (DPS) accident database to derive basic accident frequency as a function of route-dependent variables, while the effects of route-independent variables are modeled by fuzzy logic. The integrated methodology provides the basis for an overall transportation risk analysis, which can be used later to develop a decision support system.

  10. Radiative heat transfer modelling in a PWR severe accident sequence

    Magali Zabiego; Florian Fichot [Institut de Radioprotection et de Surete Nucleaire - BP 3 - 13115 Saint-paul-Lez-Durance (France); Pablo Rubiolo [Westinghouse Science and Technology - 1344 Beulah Road - Pittsburgh - PA 15235 (United States)


    a debris bed. In particular, an expression of the conductivity was established in cells in which remaining cylinders and debris particles coexist. In the present document, after a recall of the main lines of the modelling, an application to a reactor sequence is proposed. A severe accident transient with core degradation is simulated. The radiative transfer model is shown to behave properly and to smoothly calculate the transitions between the successive core configurations. A comparison with the more classical Hottel method shows that the present model gives a better prediction of the degradation progression owing to a more accurate estimate of the radial heat transfers. References: [1] M. Zabiego et al., ICARE/CATHARE V1: application to a PWR 900 MWe severe accident sequence, SARJ, Tokyo, 1999; [2] M. Zabiego, F. Fichot, P. Rubiolo Transfert radiatif lors d'une sequence accidentelle dans un coeur de Reacteur a Eau sous Pression, Congres Francais de Thermique, SFT 2004, Presqu'ile de Giens, 25-28 mai 2004. (authors)


    Sunarto Sunarto


    Full Text Available Kepuasan merupakan perasaan seseorang mengenai kesenangan atau kekecewaan sebagai hasil membandingkan antara kinerja dan harapan. Jumlah kunjungan Puskesmas tahun 2007 sebesar 3.094.027 pasien yang terdiri dari 3.076442 rawat jalan dan 17.585 rawat inap. Penelitian untuk mengentahui gambaran tingkat kepuasan dan untuk mengetahui perbedaan tingkat kepuasan dan harapan pasien yang mendapatkan pelayanan Puskemas dan rumah sakit menurut wilayah Kabupatet / Kota di Propinsi DIY Penelitian ini merupakan penelitian deskriptif analitik dengan menggunakan rancangan cros sectional. Instrumen penelitian yang digunakan adalah kuisioner dengan 35 item pernyataan yang diambil dari atribut-atribut SERVQUAL dalam 5 dimensi. Total sampel untuk lima Kabupaten Kota sebanyak 1000, masing-masing Kabupaten Kota 200. Penelitian ini dilakukan terhadap pasien yang menerima pelayanan kesehatan di Puskesmas dan Rumah Sakit Daerah di Kabupaten-Kota Daerah Istimewa Yogyakarta. Penilaian tingkat kepuasan pasien ketika mereka berobat ke Puskesmas dan Rumah Sakit di Propinsi DIY, dengan menggunakan skala O sampai 4. Hasilnya adalah dimensi tangibles, rata-rata kepuasan pasien (2,96 cukup dan harapan pasien (3,38 pada dimensi reliability, rata-rata kepuasan pasien (3,01 bagus dan harapan pasien (3,40. Pada dimensi responsiveness, rata-rata kepuasan pa-sien (3,07 bagus dan harapan pasien (3,42. Dimensi assurance, rata-rata kepuasan pasien (3, 1 0 bagus dan harapan pasien (3 ,42. pada dimensi emphaty, rata-rata kepuasan pasien (3,02 bagus dan harapan pasien (3,35. Hasil uji statistik didapatkan nilai p > 0.05, berarti pada alpha 5%, dapat disimpulkan bahwa tidak terdapat perbedaan tingkat kepuasan diantara kelima wilayah kabupaten/kota di DIY. Penilaian tingkat kepuasan pasien, ketika mereka berkunjung ke Puskesmas dan Rumah Sakit di DIY secara rata-rata bagus dan tidak ada perbedaan tingkat kepuasan menurut wilayah Kabupaten-Kota di Propinsi DIY. Kata Kunci : Kepuasan, harapan

  12. Facial trauma among victims of terrestrial transport accidents

    Sérgio d'Avila; Kevan Guilherme Nóbrega Barbosa; Ítalo de Macedo Bernardino; Lorena Marques da Nóbrega; Patrícia Meira Bento; Efigênia Ferreira e Ferreira


    ABSTRACT INTRODUCTION: In developing countries, terrestrial transport accidents - TTA, especially those involving automobiles and motorcycles - are a major cause of facial trauma, surpassing urban violence. OBJECTIVE: This cross-sectional census study attempted to determine facial trauma occurrence with terrestrial transport accidents etiology, involving cars, motorcycles, or accidents with pedestrians in the northeastern region of Brazil, and examine victims' socio-demographic characteri...

  13. 48 CFR 652.236-70 - Accident Prevention.


    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Accident Prevention. 652... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts of Provisions and Clauses 652.236-70 Accident Prevention. As prescribed in 636.513, insert the following clause: Accident Prevention (APR 2004) (a) General....

  14. 48 CFR 52.236-13 - Accident Prevention.


    ... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Accident Prevention. 52.236-13 Section 52.236-13 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION....236-13 Accident Prevention. As prescribed in 36.513, insert the following clause: Accident...

  15. Concussion in Motor Vehicle Accidents: The Concussion Identification Index


    Motor Vehicle Accidents; TBI (Traumatic Brain Injury); Brain Contusion; Brain Injuries; Cortical Contusion; Concussion Mild; Cerebral Concussion; Brain Concussion; Accidents, Traffic; Traffic Accidents; Traumatic Brain Injury With Brief Loss of Consciousness; Traumatic Brain Injury With no Loss of Consciousness; Traumatic Brain Injury With Loss of Consciousness

  16. [Fatal electric arc accidents due to high voltage].

    Strauch, Hansjürg; Wirth, Ingo


    The frequency of electric arc accidents has been successfully reduced owing to preventive measures taken by the professional association. However, the risk of accidents has continued to exist in private setting. Three fatal electric arc accidents caused by high voltage are reported with reference to the autopsy findings.

  17. 49 CFR 178.345-8 - Accident damage protection.


    ... or more than 2 inches from the point of attachment to the tank must have accident damage protection... accident damage protection device; or (iii) Attached to the cargo tank in accordance with the requirements... damaged in an accident could result in a loss of lading from the cargo tank must be protected by...

  18. The case for research into the zero accident vision

    Zwetsloot, G.I.J.M.; Aaltonen, M.; Wybo,J.L.; Saari, J.; Kines, P.; Beeck, R. op de


    This discussion paper is written out of a concern. We noticed that many companies with a good safety reputation have adopted a zero accident vision, yet there is very little scientific research in this field. The zero accident vision addresses the accidents causing deaths and severe injuries among c

  19. Developing techniques for cause-responsibility analysis of occupational accidents.

    Jabbari, Mousa; Ghorbani, Roghayeh


    The aim of this study was to specify the causes of occupational accidents, determine social responsibility and the role of groups involved in work-related accidents. This study develops occupational accidents causes tree, occupational accidents responsibility tree, and occupational accidents component-responsibility analysis worksheet; based on these methods, it develops cause-responsibility analysis (CRA) techniques, and for testing them, analyzes 100 fatal/disabling occupational accidents in the construction setting that were randomly selected from all the work-related accidents in Tehran, Iran, over a 5-year period (2010-2014). The main result of this study involves two techniques for CRA: occupational accidents tree analysis (OATA) and occupational accidents components analysis (OACA), used in parallel for determination of responsible groups and responsibilities rate. From the results, we find that the management group of construction projects has 74.65% responsibility of work-related accidents. The developed techniques are purposeful for occupational accidents investigation/analysis, especially for the determination of detailed list of tasks, responsibilities, and their rates. Therefore, it is useful for preventing work-related accidents by focusing on the responsible group's duties.

  20. Vast voer in zoogperiode belangrijker dan gedacht

    Peet-Schwering, van der C.M.C.; Binnendijk, G.P.; Troquet, L.M.P.


    Biggen die voor spenen vast voer opnemen (eters) groeien na spenen circa 50 gram per dag sneller dan biggen die tijdens de zoogperiode geen vast voer opnemen (niet-eters). Daarnaast groeien zwaardere biggen bij spenen circa 50 gram per dag sneller dan lichtere biggen bij spenen. Dit blijkt uit onder

  1. Radiations cosmiques : danger dans l'Espace

    Bonnet-Bidaud, J. M.; Dzitko, H.


    Au sol, l'atmosphere nous protege plus ou moins bien. Mais dans l'espace ou a bord des avions de ligne, l'homme est directement expose aux rayonnements cosmiques qui peuvent etre mortels. Un veritable frein a la presence humaine prolongee dans l'espace. Une menace que les agences spatiales prennent tres au serieux.

  2. Dhenggung Asmarandana dan Dhegung Banten: Sebuah Komparasi

    Teguh -


    Full Text Available The Comparation of Dhenggung Asmarandana and Dhegung Banten. Penelitian ini membahas perbandinganantara gending Dhenggung Asmaradana gaya Surakarta dengan gending Dhegung Banten gaya Yogyakarta.Berdasarkan penelitian dapat disimpulkan bahwa kedua gending memiliki persamaan dan perbedaan. Persamaankeduanya terletak pada laras, pathet, bentuk gendhing, struktur gendhing, serta balungan gending. Sedangkanperbedaannya hanya pada nama dan garap tabuhan bonang.




    Identitas brand menjadi masalah penting dalam lingkungan bisnis yang semakin kompleks dan penuh dengan persaingan. Salah satu cara yang dapat dilakukan seorang entrepreneur untuk menunjukkan identitas brand adalah melalui personal branding. Strategi personal branding sangat dipengaruhi oleh konsep diri dan strategi komunikasi yang dimiliki oleh seorang entrepreneur. Tulisan ini menggambarkan bagaimana strategi personal branding mempengaruhi keberhasilan seorang entrepreneur

  4. Severe Accident Test Station Design Document

    Snead, Mary A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Yan, Yong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Howell, Michael [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Keiser, James R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Terrani, Kurt A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)


    The purpose of the ORNL severe accident test station (SATS) is to provide a platform for evaluation of advanced fuels under projected beyond design basis accident (BDBA) conditions. The SATS delivers the capability to map the behavior of advanced fuels concepts under accident scenarios across various temperature and pressure profiles, steam and steam-hydrogen gas mixtures, and thermal shock. The overall facility will include parallel capabilities for examination of fuels and irradiated materials (in-cell) and non-irradiated materials (out-of-cell) at BDBA conditions as well as design basis accident (DBA) or loss of coolant accident (LOCA) conditions. Also, a supporting analytical infrastructure to provide the data-needs for the fuel-modeling components of the Fuel Cycle Research and Development (FCRD) program will be put in place in a parallel manner. This design report contains the information for the first, second and third phases of design and construction of the SATS. The first phase consisted of the design and construction of an out-of-cell BDBA module intended for examination of non-irradiated materials. The second phase of this work was to construct the BDBA in-cell module to test irradiated fuels and materials as well as the module for DBA (i.e. LOCA) testing out-of-cell, The third phase was to build the in-cell DBA module. The details of the design constraints and requirements for the in-cell facility have been closely captured during the deployment of the out-of-cell SATS modules to ensure effective future implementation of the in-cell modules.

  5. Penerapan Sistem Remunerasi dan Kinerja Pelayanan

    Tri Wisesa Soetisna


    Full Text Available Remunerasi dapat memengaruhi motivasi pegawai sekaligus meningkatkan kinerjanya. Demikian halnya di rumah sakit sebagai institusi pelayanan kesehatan yang padat modal, sumber daya manusia serta padat ilmu dan teknologi. Penelitian ini bertujuan untuk menganalisis persepsi pegawai terhadap implementasi sistem remunerasi dan kinerja unit pelayanan bedah jantung dewasa (UPBJD di rumah sakit. Penelitian ini menggunakan pendekatan mixed methods (kuantitatif dan kualitatif. Desain penelitian kuantitatif adalah potong lintang menggunakan instrumen kuesioner self-assessment. Sedangkan desain penelitian kualitatif adalah deskriptif, dilakukan melalui focus group discussion dan telaah dokumen pada data berupa buku jadwal, buku registrasi, catatan keperawatan, dan rekam medis. Pengambilan data dilakukan pada tahun 2013 di salah satu rumah sakit di Jakarta. Responden/informan adalah staf medis fungsional, perawat, dan petugas administrasi berjumlah 29 orang. Data dianalisis secara univariat (metode kuantitatif, dan content analysis (metode kualitatif. Hasil penelitian menunjukkan bahwa sebagian besar staf medis fungsional dan perawat tidak puas (71,2% dengan beberapa hal dalam penerapan sistem remunerasi, seperti pada sistem penggajian dan penentuan grading. Terlihat kinerja unit pelayanan bedah jantung dewasa mengalami kenaikan setiap tahun sebelum dan setelah penerapan sistem remunerasi. Diharapkan agar rumah sakit ini dapat memperbaiki sistem remunerasi yang sesuai ketentuan kebijakan dan menyusun formulasi insentif dan bonus yang lebih sesuai dengan kondisi saat ini serta perlu dilakukan sosialisasi yang tepat dan evaluasi secara berkala. Implementation of Remuneration System and Service Performance Remuneration can influence worker`s motivation, and improve their performance. Likewise in hospital as capital-intensive, human resources-intensive as well as knowledge and technology-intensive health care institution. This study aimed to analyze employee

  6. Occurrence of Type 1 Diabetes in Graves' Disease Patients Who Are Positive for Antiglutamic Acid Decarboxylase Antibodies: An 8-Year Followup Study

    Matsuo Taniyama


    Full Text Available Glutamic acid decarboxylase antibodies (GADAs are one of the markers of islet cell autoimmunity and are sometimes present before the onset of type 1 diabetes (T1D. GADA can be present in Graves' patients without diabetes; however, the outcome of GADA-positive Graves' patients is not fully understood, and the predictive value of GADA for the development of T1D in Graves' patients remains to be clarified. We investigated the prevalence of GADA in 158 patients with Graves' disease and detected GADA in 10 patients. They were followed up to discover whether or not T1D developed. In the course of eight years, 2 patients with high titers of GADA developed T1D, both had long-standing antithyroid drug-resistant Graves' disease. Thus, Graves' disease with high GADA titer seems to be at high risk for T1D.

  7. Bus accident severity and passenger injury: evidence from Denmark

    Prato, Carlo Giacomo; Kaplan, Sigal


    examining occurrence of injury to bus passengers. Results Bus accident severity is positively related to (i) the involvement of vulnerable road users, (ii) high speed limits, (iii) night hours, (iv) elderly drivers of the third party involved, and (v) bus drivers and other drivers crossing in yellow or red...... principle of sustainable transit and advance the vision “every accident is one too many”. Methods Bus accident data were retrieved from the national accident database for the period 2002–2011. A generalized ordered logit model allows analyzing bus accident severity and a logistic regression enables...

  8. Analysis of surface powered haulage accidents, January 1990--July 1996

    Fesak, G.M.; Breland, R.M.; Spadaro, J. [Dept. of Labor, Arlington, VA (United States)


    This report addresses surface haulage accidents that occurred between January 1990 and July 1996 involving haulage trucks (including over-the-road trucks), front-end-loaders, scrapers, utility trucks, water trucks, and other mobile haulage equipment. The study includes quarries, open pits and surface coal mines utilizing self-propelled mobile equipment to transport personnel, supplies, rock, overburden material, ore, mine waste, or coal for processing. A total of 4,397 accidents were considered. This report summarizes the major factors that led to the accidents and recommends accident prevention methods to reduce the frequency of these accidents.

  9. Comparative Assessment of Severe Accidents in the Chinese Energy Sector

    Hirschberg, S.; Burgherr, P.; Spiekerman, G.; Cazzoli, E.; Vitazek, J.; Cheng, L


    This report deals with the comparative assessment of accidents risks characteristic for the various electricity supply options. A reasonably complete picture of the wide spectrum of health, environmental and economic effects associated with various energy systems can only be obtained by considering damages due to normal operation as well as due to accidents. The focus of the present work is on severe accidents, as these are considered controversial. By severe accidents we understand potential or actual accidents that represent a significant risk to people, property and the environment and may lead to large consequences. (author)


    Johari Johari


    Full Text Available Tugas dan wewenang Pusat Pelaporan dan Analisis Transaksi Keuangan (PPATK terdapat di dalam Pasal 26 dan Pasal 27 Undang-Undang No. 25 Tahun 2003 tentang Tindak Pencucian Uang. Berdasarkan ketentuan tersebut, tugas dan wewenang PPATK tersebut bertujuan untuk mendeteksi terjadinya tindak pidana pencucian uang, dan membantu penegakan hukum yang berkaitan dengan pencucian uang, termasuk tindak pidana asal yang melahirkannya (predicate offences. Namun, Peranan PPATK akan berjalan secara efektif apabila aparat penegak hukum seperti Kepolisian, Kejaksaan, Pengadilan, Bea dan Cukai, para regulator seperti Bank Indonesia, Departemen Keuangan, Badan Pengawas Pasar Modal serta Penyedia Jasa Keuangan, industri perbankan, asuransi, perusahaan pembiayaan, dana pensiun, perusahaan efek, pengelola reksadana, media massa, masyarakat bekerjasama secara terorganisir dan terpadu dalam pemberantasan tindak pencucian uang di Indonesia. Dengan kewenangan yang dimilikinya, PPATK dapat mengejar hasil dari kejahatan, apabila hasil kejahatan tersebut dapat dikejar dan disita maka negara dengan sendirinya akan mengurangi tindak kejahatan itu sendiri. Kata kunci : Pencucian uang, tindak pidana pencucian uang (money laundering, kejahatan terorganisir, dan Pusat Pelaporan dan Analisis Transaksi Keuangan (PPATK.

  11. Graves' Disease

    ... medication that replaces their natural thyroid hormone. Medications Beta blockers. Health care providers may prescribe a medication called a beta blocker to reduce many of the symptoms of hyperthyroidism, ...

  12. Graves' Disease

    ... This condition results from a buildup of certain carbohydrates in the skin — the cause of which also ... lead to heart rhythm disorders, changes in the structure and function of the heart muscles, and the ...

  13. Discordant hypothyroxinemia and hypertriiodothyroninemia in treated patients with hyperthyroid Graves' disease

    Chen, J.J.; Ladenson, P.W.


    Hypothyroxinemia and hypertriiodothyroninemia may occur in the course of antithyroid drug or /sup 131/I treatment for hyperthyroid Graves' disease. To determine the frequency of combined high serum T3 and low serum T4 concentrations during such treatment and to assess the clinical significance of its recognition, we reviewed 60 patients treated for hyperthyroid Graves' disease with antithyroid drugs (n = 43) or radioactive iodine (n = 17). Six of these patients (10%) were found to have high serum T3 and low serum T4 concentrations during therapy. Four were receiving antithyroid drugs, and 2 had received radioactive iodine. At the time this abnormality occurred, 4 patients were euthyroid, 1 was hypothyroid, and 1 was hyperthyroid. The serum TSH concentration was increased in 2, at the upper limit of normal in 1, and undetectable in 3 patients. After discontinuation or reduction in the dose of antithyroid drug, clinical and chemical euthyroidism was restored in 2 additional patients with previously elevated TSH levels. In 2 patients, both of whom previously had undetectable serum TSH levels, clinical hyperthyroidism persisted or recurred, and additional therapy was required. No patient developed permanent hypothyroidism during the period of follow-up (1-22 months). An additional 19 of the 60 patients (32%) had an elevated serum T3 level with a normal serum T4 concentration during the course of follow-up. Among the 19 patients, the magnitude of serum T3 elevation was not different between clinically euthyroid (n = 13) and hyperthyroid (n = 6) patients. We conclude that discordance of serum T4 and T3 concentrations is frequently encountered in patients with hyperthyroid Graves' disease during or after therapy. The low serum T4 level does not predict hypothyroidism, nor does a high serum T3 level predict hyperthyroidism.


    Mohammad Pajhouhi


    Full Text Available Pretibial myxedema is an uncommon manifestation of Graves' disease and because of its rarity, information regarding its natural course and its relationship with other manifestations of Graves' disease is not sufficient."nWe reviewed 150 consecutive cases diagnosed as having pretibial myxedema in a twenty-year period in a tertiary care center. Only one patient in this group did not have ophthalmopathy, and the majority of cases had significant proptosis and ophthalmopathy, 30% required orbital decompression surgery. Dermopathy is a late manifestation of the Graves' disease and its onset is usually after the diagnosis of hyperthyroidism and ophthalmopathy. In a few patients, dermopathy preceded diagnosis of hyperthyroidism or the onset of ophthalmopathy. Fourteen patients have never had hyperthyroid, eleven patients in this group had developed spontaneous hypothyroidism."nAll cases showed the involvement of the lower extremities, and only one patient showed to have combined upper and lower extremities involvement. The most common form of thyroid dermopathy was non-pitting edema. Nodular and plaque forms were also relatively common and occurred with equal frequency. Polypoid form occurred in one patient and elephantiatic form in another. There was no consistent correlation among different types of dermopathy and severity of eye disease."nDuring a three-month to nineteen-year follow up in 120 patients, complete remission was observed only in twelve patients. Partial remission was more common and occurred more frequently in patients who had local steroid therapy. it is possible that patients with remission might have been excluded of the follow up program.Thus, the remission data should be interpreted cautiously.

  15. Current perspectives on the role of orbital fibroblasts in the pathogenesis of Graves' ophthalmopathy.

    Dik, Willem A; Virakul, Sita; van Steensel, Leendert


    Graves' ophthalmopathy (GO) is an extra-thyroidal complication of Graves' disease (GD; Graves' hyperthyroidism) characterized by orbital tissue inflammation, expansion, remodeling and fibrosis. Although the initiating trigger of GO is still indistinct, excessive orbital fibroblast activity is at the heart of its pathogenesis. Orbital fibroblasts are activated by cellular interactions with immune cells and the soluble factors they secrete. Orbital fibroblasts, especially from GO patients, express the thyrotropin receptor (TSH-receptor; TSHR), and activation of the orbital fibroblast population by stimulatory autoantibodies directed against the TSHR may provide an important link between GD and GO. Furthermore, stimulatory autoantibodies directed against the insulin-like growth factor-1 receptor have been proposed to contribute to orbital fibroblast activation in GO. Activated orbital fibroblasts produce inflammatory mediators thereby contributing to the orbital inflammatory process in GO. Moreover, orbital fibroblasts exhibit robust proliferative activity and extracellular matrix (especially hyaluronan) synthesizing capacity and can differentiate into adipocytes and myofibroblasts with disease progression, thereby contributing to tissue expansion/remodeling and fibrosis in GO. Orbital fibroblasts, especially those from GO patients, exhibit a hyper-responsive phenotype when compared to fibroblasts from other anatomical regions, which may further contribute to GO pathogenesis. Fibrocytes have been identified as additional source of orbital fibroblasts in GO, where they may contribute to orbital tissue inflammation, adipogenesis and remodeling/fibrosis. This review addresses our current view on the role that orbital fibroblasts fulfill in GO pathogenesis and both established as well as less established not fully crystallized concepts that need future studies will be discussed.

  16. Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

    Bartalena, L.; Marcocci, C.; Bogazzi, F.; Panicucci, M.; Lepri, A.; Pinchera, A. (Univ. of Pisa (Italy))


    We studied the effects of radioiodine treatment of hyperthyroidism due to Graves' disease on Graves' ophthalmopathy and the possible protective role of corticosteroids. Between June 1985 and June 1988, 26 patients were randomly assigned to treatment with radioiodine alone (group 1) and 26 to treatment with this agent and concomitant administration of systemic prednisone for four months (group 2). The initial dose of prednisone was 0.4 to 0.5 mg per kilogram of body weight for one month; the drug was gradually withdrawn over the next three months. All patients were evaluated at 3-month intervals for 18 months after they underwent radioiodine therapy. Ocular changes were assessed with the ophthalmopathy index; patients with moderate-to-severe changes (scores greater than or equal to 4) were excluded from the study. Before treatment, 10 patients in group 1 and 5 in group 2 had no evidence of ophthalmopathy: in none of them did ocular symptoms appear after radioiodine therapy. Among the patients in group 1 with an initial ophthalmopathy index greater than or equal to 1, ocular disease worsened in 56 percent (mostly involving soft-tissue changes and extraocular-muscle function) and did not change in 44 percent. In contrast, ophthalmopathy improved in 52 percent and did not change in 48 percent of group 2. The mean ophthalmopathy index increased from 1.5 to 3.0 in group 1 (P less than 0.005) and decreased from 2.2 to 1.3 in group 2 (P less than 0.05). We conclude that systemic corticosteroid treatment prevents the exacerbations of Graves' ophthalmopathy that occur after radioiodine therapy in a substantial proportion of patients with hyperthyroidism who have some degree of ocular involvement before treatment.




    Full Text Available CONTEXT Acute surgical pathology may be overlooked in pregnancy. Despite advances in medical technology, preoperative diagnosis of potentially grave pathologies of the gastrointestinal tract (GIT is often delayed due to overlap with symptoms of pregnancy non-specific elevation of some laboratory parameters due to pregnancy and a dilemma for obstetricians and surgeons in ordering radiological imaging modalities given the risk associated with fetal exposure to ionizing radiation and contrast. AIMS The aim of this study is to analyse the cases of gastrointestinal tract problems encountered in pregnancy so that increasing awareness can be created among obstetricians. This is important because early diagnosis and timely intervention can significantly improve maternal and fetal outcome in these cases. SETTINGS AND DESIGN There is a retrospective case study of potentially grave GIT problems encountered at Vanivilas hospital, Bangalore, a tertiary referral institute wherein the clinical presentation was confounded by pregnancy. MATERIALS AND METHODS All the included cases were analysed for age of the patient, pre-existing gastrointestinal tract disorders, gestational age at diagnosis, maternal and fetal outcome. RESULTS A total of 8 cases of GIT problems in pregnancy were studied. Though acute appendicitis is the most common cause of GIT emergency in pregnancy as quoted in literature 5, we did not encounter any case of acute appendicitis in pregnancy in the study period. Other conditions which were encountered were small bowel obstruction, stomach and bowel perforation and bleeding oesophageal varices. Whilst few of the conditions could be managed conservatively without harm to the pregnancy, others required a laparotomy and reparative procedures. Delay in diagnosis and intervention proved to be fatal in some of these women. CONCLUSIONS Knowledge about potentially grave gastrointestinal tract problems during pregnancy, high index of clinical suspicion

  18. Kandidiasis di Mulut akibat Khemoterapi dan Penatalaksanaannya

    Sri Budiarti Wonso Hardjono


    Full Text Available Latar belakang: kandidiasis (kandidosis adalah infeksi jamur yang disebabkan oleh spesies Candida biasanya Candida albicans. Faktor predisposisi yang memicu kandidiasis adalah terganggunya ekologi mulut karena antara lain pemakaian antibiotika, kortikosteroid, penyakit kronis dan keganasan, beberapa gangguan darah; terapi radiasi di leher dan kepala; khemoterapi; leukimia, obat sitotoksik, juga kebersihan mulut yang buruk. Tujuan: melaporkan kasus kandidiasis di mulut karena khemoterapi dan penatalaksanaannya. Kasus dan penatalaksanaannya: seorang anak laki-laki umur 3 tahun 11 bulan penderita Leukimia Limfoblastik Akut (LLA sedang dalam perawatan khemoterapi menderita kandidiasis di mulut sehingga mengalami disfoni dan disfagia. Makanan dimasukkan lewat hidung. Klinis pasien terlihat lemah infus lewat tangan. Dalam mulut terlihat patch putih tebal menutupi permukaan dorsal dan ventral lidah, palatum durum dan ventral lidah, palatum durum dan molle, mukosa pipi kanan kiri dan gingiva rahang atas dan bawah. Pasien disedasi untuk dilakukan pengerokan lapisan kandida di mulut; pemberian Nystatin solution dan ketokonazol dilanjutkan. Pengerokan psedomembran kandidiasis telah memberikan hasil yang memuaskan, satu minggu kemudian rongga mulut pasien sudah terlihat bersih, pasien sudah dapat makan minum melalui mulut, juga sudah dapat berbicara lagi/tidak serah. Kesimpulan: Pembersihan jamur dengan pengerokan telah dilakukan, kandidiasis pseudomembran dapat diangkat dan mulut pasien sudah bersih, pasien dapat makan dan berbicara lagi.   Background: Candidiasis (candidosis is an fungal infection caused by Candida species usually Candida albicans. Predisposing factors which trigger candidiasis are the ecological disruption caused by use of oral antibiotics, corticosteroids, malignancy and chronic disease; some blood disorders; head and neck radiation; chemotherapy; leukimia, cytotoxic drugs, as well as poor oral hygiene. Aim: To report a case of


    Roswita Lumban Tobing


    Full Text Available Artikel ini bertujuan untuk memaparkan konstruksi determinan pada frasa nomina bahasa Perancis dan bahasa Indonesia. Analisis yang digunakan adalah analisis kontrastif. Hasil analisis menunjukkan bahwa nomina bahasa Perancis memiliki jenis kelamin (maskulin/feminin dan jumlah (tunggal/jamak. Gender dan jumlah dalam bahasa Prancis memiliki aturan konkordansi yang dapat memengaruhi bentuk dan makna nomina. Dalam bahasa Indonesia, meskipun nomina memiliki konsep gender tunggal dan jamak, jenis dan jumlah dalam bahasa Indonesia tidak muncul secara eksplisit. Bentuk ini hanya ditandai dengan karakteristik semantik tertentu yang dapat menunjukkan jenis kelamin, bentuk tunggal, dan bentuk jamak.

  20. Pathogenesis of Graves disease%Graves病的发病机制

    王曙; 郭华


    @@ Graves病(Graves disease,GD)是一种器官特异性自身免疫病,与桥本甲状腺炎(Hashimoto thyroiditis,HT)同属自身免疫性甲状腺疾病(autoimmune thyroid disease,AITD).其患病率约为1%-2%[1].患者主要临床表现为高代谢综合征,部分患者可以出现甲状腺相关眼病(thyroid associated ophthalmopathy,TAO)、胫前黏液性水肿和(或)肝脏损害.

  1. Traumatismo materno grave y cirugía múltiple con resultado perinatal exitoso

    Hasbun H,Jorge; Benitez S,Susana; Cornejo R,Rodrigo; Asencio C,Ramón; Navarro A,José Luis; DANILLA E,STEFAN


    El traumatismo mayor de la embarazada es frecuente, tiene riesgo de muerte y agrega a sus complicaciones propias, las generadas por el embarazo como prematurez, desprendimiento placentario y daño perinatal. Presentamos el caso de una embarazada de 27 semanas, con traumatismo grave por atropello, fracturas óseas y desforramiento extenso de extremidad inferior derecha, que fue sometida a tratamiento quirúrgico con reducción y corrección de luxofracturas, aseo e injertos cutáneos. Se complica co...

  2. Avaliação e tratamento da hiperglicemia em pacientes graves

    Marina Verçoza Viana; Rafael Barberena Moraes; Amanda Rodrigues Fabbrin; Manoella Freitas Santos; Fernando Gerchman


    A hiperglicemia é um problema frequentemente encontrado em pacientes graves em ambiente de terapia intensiva. Sua presença se associa ao aumento da morbidade e da mortalidade, independentemente da causa da admissão (infarto agudo do miocárdio, condição após cirurgia cardiovascular, acidente vascular cerebral e sepse). Entretanto, permanecem muitas dúvidas com relação à fisiopatologia e, particularmente, em relação ao tratamento ...

  3. Association of the thyroid stimulating hormone receptor gene (TSHR) with Graves' disease

    Brand, Oliver J; Barrett, Jeffrey C; Simmonds, Matthew J;


    Graves' disease (GD) is a common autoimmune disease (AID) that shares many of its susceptibility loci with other AIDs. The thyroid stimulating hormone receptor (TSHR) represents the primary autoantigen in GD, in which autoantibodies bind to the receptor and mimic its ligand, thyroid stimulating...... hormone, causing the characteristic clinical phenotype. Although early studies investigating the TSHR and GD proved inconclusive, more recently we provided convincing evidence for association of the TSHR region with disease. In the current study, we investigated a combined panel of 98 SNPs, including 70...

  4. Induction of animal model of Graves disease in BALB/c mice


    Objective To construct an animal model of Graves' disease(GD)by immunizing BALB/c mice with hM12 cells co-expressing major histocompatibility complex(MHC)class II molecules and human thyrotropin receptor(TSHR)molecules.Methods BALB/c mice in experimental group(H-2d)were immunized with hM12 cells intraperitoneally every 2 weeks for six times,while mice in control group were immunized with M12 cells.Five weeks later,the thyroids were histologically examined,and serum samples were tested for thyroid-stimulatin...

  5. Peritonitis secondary to ruptured splenic abscess: a grave complication of typhoid fever.

    George, Peter; Ahmed, Ashfaq; Maroli, Roshan; Tauro, Leo Francis


    Splenic abscesses are increasingly being identified, possibly due to widespread use of imaging modalities in clinical practice. The commonest clinical features are high grade fever and exclusively localised left upper quadrant abdominal pain. These symptoms are similar to most infectious diseases prevalent in the tropics, making imaging by ultrasonography or computer tomography a necessity in the diagnosis. There are reports from different geographic areas on splenic abscesses associated with typhoid fever. We reported ruptured splenic abscess presenting with peritonitis as a rare and grave complication of typhoid fever.

  6. Samantha Matthews. Poetical Remains – Poets’ Graves, Bodies, and Books in the Nineteenth Century

    Marc PORÉE


    Full Text Available What is left of poets after they have passed away? Graves and books, answers Samantha Matthews in Poetical Remains, a study which capitalizes on body-oriented essays, while threatening to drive the trend into the ground, since it offers the ultimate take on poets—viewing them as terminal cases, but assessing their books as open-ended. The work purports to examine what it views as the particular affinity between poets' physical and literary “remains” in the Romantic to late Victorian period. B...

  7. Craniectomía descomprensiva precoz en el trauma craneoencefálico grave

    Lacerda Gallardo, Angel Jesús


    Se realizó un estudio cuasiexperimental en pacientes con trauma craneoencefálico grave con 12 horas de evolución, cuyo objetivo fue evaluar el efecto de la craniectomía descompresiva precoz para controlar la hipertensión intracraneal asociada. Los pacientes fueron divididos en dos grupos de acuerdo al tratamiento recibido, en el Grupo I se incluyeron a los que se les realizó craniectomía descompresiva y en el Grupo II, los que recibieron el tratamiento convencional. Se estudiaron 68 casos, 45...

  8. Systemic adverse events following rituximab therapy in patients with Graves' disease

    El Fassi, D; Nielsen, Claus Henrik; Junker, Michael Peter;


    Background and aim: Rituximab (RTX) therapy has shown promising results in Graves´ disease (GD), with or without ophthalmopathy. We examined the occurrence of adverse events in GD patients treated with RTX. Subjects and methods: Ten patients received RTX and methimazole, while ten patients received...... had the third highest increase in immunoglobulin deposition on monocytes by day 14. The arthralgias persisted in two of the patients, despite glucocorticoid rescue therapy. Conclusions: We report articular adverse events in three and gastrointestinal symptoms in two out of ten GD patients who received...

  9. Nutrición y anemias en pacientes graves Nutrition and anaemias in critical illness


    Introducción: Realizamos un estudio clínico original sobre nutrición en pacientes graves, que incluye a un grupo heterogéneo típico de pacientes críticos, con/sin anemias, que nos han ingresado en la Unidad de Cuidados Intensivos, UCI. Es difícil individualizar y generalizar la relativa importancia de todos los factores que pueden contribuir a estas anemias en la admisión en la Unidad, incluyendo las deficiencias nutricionales, las alteraciones inflamatorias, la respuesta a las agresiones, la...

  10. Unidad hospitalaria de patología dual grave: un año de experiencia

    Esfors Hernández, Jorge; Villar García, Mariano; Rubio Perlado, Begoña; Juan i Porcar, María; Romero Marmaneu, Francisca


    Se trata de un estudio observacional, descriptivo, transversal en el que se incluyeron los pacientes ingresados en la Unidad de Hospitalización del Programa de Patología Dual Grave (UHPPDG) durante un año. Los datos sociodemográficos, clínicos y farmacológicos se obtuvieron mediante hojas de recogida de datos diseñadas al efecto. El total de pacientes ingresados fue de 82 en cuyo perfil prevalecen los varones con una edad media de 36,7 años, derivados del subprograma ambulatori...

  11. Victims’ language: (noisy silences and (grave parodies to talk (unknowingly about individuals’ forced disappearance

    Gabriel Gatti


    Full Text Available Based on the results of research carried out between 2005 and 2008 about social universes constructed in Argentina and Uruguay around the figure of the disappeared detainee, this piece aims to systematize several answer to one the more complex problems this repression figure bears: that of representation of facts and their consequences. This work focuses no on all possible answers, but on several of the more innovative and creative: those betting on talking about the impossibility to talk (the noisy silences, and those betting on forcing language up to its limit (grave parodies.

  12. Complicaciones hemorrágicas graves en las gestantes quirúrgicas

    Yamila Zayas Nápoles; Dunior Peláez Rodríguez; Miladis Justo Hernández; Leticia Fernández Álvarez; Marjuris Arias Pérez


    Las hemorragias obstétricas ocurren aproximadamente en un tres a un cinco porciento de los embarazos y son responsables del 75 % de las complicaciones durante la gestación y del 25 % de la mortalidad materna. Se realizó un estudio descriptivo de corte transversal en 58 pacientes ingresadas en la Unidad de Cuidados Intensivos del Hospital General Docente “Dr. Ernesto Guevara de la Serna”, con el diagnóstico de hemorragia obstétrica grave; en el período de enero de 2010 a abril de 2013, con el ...

  13. Factores pronósticos en el traumatismo craneoencefálico grave

    José Purón-Barrera; Elizabeth Reyes-Ramírez; Andrés Andrés-Matos; Alberto Piriz-Assa


    Se señalaron los factores relacionados con la mortalidad del trauma craneoencefálico grave y que pueden influir sobre su pronóstico. La presencia de puntuación en la Escala de Glasgow ¿ 8, hiperglicemia, shock, necesidad de ventilación mecánica, alteraciones pupilares y múltiples lesiones en la tomografía axial computarizada (TAC) entre las cuales siempre estuvo asociado el hematoma subdural concuerda con lo referido por otros estudios. El hallazgo de hipernatremia tuvo alta significación est...

  14. Coincidence of remission of postpartum Graves' disease and use of omega-3 fatty acid supplements

    Breese McCoy Sarah J


    Full Text Available Abstract I developed Graves' Disease four months postpartum. After one year on propylthiouracil, I learned that omega-3 fatty acids may reduce inflammation associated with certain autoimmune disorders, although no investigations for thyroiditis have been reported. Within eight weeks of beginning flaxseed oil supplements, TSH levels normalized, but fell somewhat when flaxseed was decreased and PTU discontinued. During another pregnancy, plasma TSH normalized, but was again suppressed by four weeks postpartum, then undetectable by four months. This time, flaxseed supplementation alone coincided with TSH normalization. Omega-3 fatty acids should be investigated as a potential treatment for autoimmune thyroid disease.

  15. Progressive bilateral ophthalmoparesis--a case of simultaneous autoimmunity: balancing Graves' ophthalmoparesis and ocular myasthenia.

    Canepa, Carlo; Venu, Maya


    A 44-year-old woman with no medical history presented with a 1-year history of horizontal diplopia, bilateral exophthalmos and progressive asymmetrical ophthalmoparesis, with no pupillary dysfunction or ptosis. Within 3 months of her initial presentation, she noticed paresis of right eye abduction, followed after 1 month with paresis of left eye abduction. Initial investigations revealed positive antiperoxidase antibodies for Graves' disease and positive AChR for myasthenia gravis. MRI of the brain showed increased intensity in bilateral inferior rectus muscles and CT of the chest showed thymic hyperplasia. Treatment with carbimazole and pyridostigmine was started, with complete resolution after 1 month.

  16. Estudo dos linfócitos circulantes por anticorpos monoclonais na miastenia grave

    Paulo E. Marchiori


    Full Text Available Os autores avaliam os linfócitos T (CD3, CD4, CD8, CD4/8 por anticorpos monoclonais e rosácea em 20 pacientes e linfócitos B por Fab' por imunofluorescência em 9 pacientes com miastenia grave. Observam elevação significante na população de linfócito B e redução nos linfócitos T totais CD3+ por rosáceas. Não foram observadas modificações nas subpopulações celulares com timectomia e corticosteróides.

  17. Walter Miles, Pop Warner, B. C. Graves, and the psychology of football.

    Baugh, Frank G; Benjamin, Ludy T


    In 1926-1927, a graduate student, B. C. Graves, working with Stanford University psychologist Walter Miles and legendary football coach Pop Warner, conducted an investigation of variations in signal calling as they affected the charging times of football players. The study was one of two that involved Miles and the ingenious multiple chronograph that he had invented to time the reactions of seven players simultaneously. These studies represented a brief digression in the career of Miles, who certainly was no sport psychologist. They tell of an interesting collaboration between scientist and coaches that produced one of the richest studies in sport psychology in the first half of the twentieth century.

  18. Peritonitis secondary to ruptured splenic abscess:A grave complication of typhoid fever

    Peter George; Ashfaq Ahmed; Roshan Maroli; Leo Francis Tauro


    Splenic abscesses are increasingly being identified, possibly due to widespread use of imaging modalities in clinical practice. The commonest clinical features are high grade fever and exclusively localised left upper quadrant abdominal pain. These symptoms are similar to most infectious diseases prevalent in the tropics, making imaging by ultrasonography or computer tomography a necessity in the diagnosis. There are reports from different geographic areas on splenic abscesses associated with typhoid fever. We reported ruptured splenic abscess presenting with peritonitis as a rare and grave complication of typhoid fever.

  19. Tratamento cirúrgico da laringomalácia grave: estudo retrospectivo de 11 casos


    A laringomalácia é a anomalia congênita da laringe mais frequente, sendo responsável por cerca de 60% a 75% dos casos de estridor congênito. Apesar de seu curso benigno e autolimitado, 10% dos casos necessitam de intervenção. Atualmente, as supraglotoplastias são consideradas o tratamento padrão da laringomalácia grave. OBJETIVO: Descrever a experiência adquirida pelos autores no tratamento cirúrgico dos pacientes com laringomalá...

  20. Enfermedad de Graves y cáncer de tiroides. Reporte de caso.

    Manrique-Hurtado, Helard; Servicio de Endocrinología, Hospital Nacional Arzobispo Loayza. Lima.; Pinto-Valdivia, Miguel; Servicio de Endocrinología, Hospital Nacional Cayetano Heredia. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima.; Acosta-Chacaltana, Max; Servicio de Endocrinología, Hospital Nacional Arzobispo Loayza. Lima.


    Se reporta el caso de una mujer de 62 años con antecedente de cáncer de recto curado, con Enfermedad de Graves de reciente diagnóstico. El examen físico mostró un bocio difuso y presencia de un nódulo en el polo inferior del lóbulo derecho. El perfil tiroideo mostró un TSH suprimido y hormonas tiroideas aumentadas. Los anticuerpos antitiroideos fueron negativos. La ecografía de tiroides confirmó la presencia de un nó...