WorldWideScience

Sample records for active case finding

  1. Active case finding of tuberculosis in Europe: a Tuberculosis Network European Trials Group (TBNET) survey

    DEFF Research Database (Denmark)

    Bothamley, G H; Ditiu, L; Migliori, G B

    2008-01-01

    Tuberculosis control depends on successful case finding and treatment of individuals infected with Mycobacterium tuberculosis. Passive case finding is widely practised: the present study aims to ascertain the consensus and possible improvements in active case finding across Europe. Recommendations...... from national guidelines were collected from 50 countries of the World Health Organization European region using a standard questionnaire. Contacts are universally screened for active tuberculosis and latent tuberculosis infection (LTBI). Most countries (>70%) screen those with HIV infection, prisoners...... and in-patient contacts. Screening of immigrants is related to their contribution to national rates of tuberculosis. Only 25 (50%) out of 50 advise a request for symptoms in their guidelines. A total of 36 (72%) out of 50 countries recommend sputum examination for those with a persistent cough; 13...

  2. Experience of active tuberculosis case finding in nearly 5 million households in India

    Science.gov (United States)

    Satyanarayana, S.; Chadha, S. S.; Das, A.; Thapa, B.; Mohanty, S.; Pandurangan, S.; Babu, E. R.; Tonsing, J.; Sachdeva, K. S.

    2016-01-01

    In India, to increase tuberculosis (TB) case detection under the National Tuberculosis Programme, active case finding (ACF) was implemented by the Global Fund-supported Project Axshya, among high-risk groups in 300 districts. Between April 2013 and December 2014, 4.9 million households covering ~20 million people were visited. Of 350 047 presumptive pulmonary TB cases (cough of ⩾2 weeks) identified, 187 586 (54%) underwent sputum smear examination and 14 447 (8%) were found to be smear-positive. ACF resulted in the detection of a large number of persons with presumptive pulmonary TB and smear-positive TB. Ensuring sputum examination of all those with presumptive TB was a major challenge. PMID:27051605

  3. New strategies for active finding of leprosy cases in the Amazonian region

    Directory of Open Access Journals (Sweden)

    Dony Cristioney Castilho de Campos

    2015-08-01

    Full Text Available AbstractINTRODUCTION: The use of the Self-Image Form (SIF expands the identification of active leprosy cases to neighbors of index cases.METHODS: The SIF was used to screen two groups: case (neighbors of index cases of leprosy and control (individuals residing next to houses without leprosy group. A specialist investigated suspected leprosy cases for disease confirmation.RESULTS: New cases of leprosy were diagnosed in the case group (n = 7, 8.6%, but not the control group.CONCLUSIONS: The new surveillance strategy is inexpensive, efficient, and feasible within a primary health strategy. Future studies can help improve the use of the SIF.

  4. Active case finding strategy for chronic obstructive pulmonary disease with handheld spirometry.

    Science.gov (United States)

    Kim, Joo Kyung; Lee, Chang Min; Park, Ji Young; Kim, Joo Hee; Park, Sung-Hoon; Jang, Seung Hun; Jung, Ki-Suck; Yoo, Kwang Ha; Park, Yong Bum; Rhee, Chin Kook; Kim, Deog Kyeom; Hwang, Yong Il

    2016-12-01

    The early detection and diagnosis of chronic obstructive pulmonary disease (COPD) is critical to providing appropriate and timely treatment. We explored a new active case-finding strategy for COPD using handheld spirometry.We recruited subjects over 40 years of age with a smoking history of more than 10 pack-years who visited a primary clinic complaining of respiratory symptoms. A total of 190 of subjects were enrolled. Medical information was obtained from historical records and physical examination by general practitioners. All subjects had their pulmonary function evaluated using handheld spirometry with a COPD-6 device. Because forced expiratory volume in 6 seconds (FEV6) has been suggested as an alternative to FVC, we measured forced expiratory volume in 1 second (FEV1)/FEV6 for diagnosis of airflow limitation. All subjects were then referred to tertiary referral hospitals to complete a "Could it be COPD?" questionnaire, handheld spiromtery, and conventional spirometry. The results of each instrument were compared to evaluate the efficacy of both handheld spirometry and the questionnaire.COPD was newly diagnosed in 45 (23.7%) patients. According to our receiver-operating characteristic (ROC) curve analysis, sensitivity and specificity were maximal when the FEV1/FEV6 ratio was less than 77%. The area under the ROC curve was 0.759. The sensitivity, specificity, positive predictive value, and negative predictive value were 72.7%, 77.1%, 50%, and 90%, respectively. The area under the ROC curve of respiratory symptoms listed on the questionnaire ranged from 0.5 to 0.65, which indicates that there is almost no difference compared with the results of handheld spirometry.The present study demonstrated the efficacy of handheld spirometry as an active case-finding tool for COPD in a primary clinical setting. This study suggested that physicians should recommend handheld spirometry for people over the age of 40, who have a smoking history of more than 10 pack

  5. Population-level impact of active tuberculosis case finding in an Asian megacity.

    Directory of Open Access Journals (Sweden)

    David W Dowdy

    Full Text Available BACKGROUND: The potential population-level impact of private-sector initiatives for tuberculosis (TB case finding in Southeast Asia remains uncertain. In 2011, the Indus Hospital TB Control Program in Karachi, Pakistan, undertook an aggressive case-finding campaign that doubled notification rates, providing an opportunity to investigate potential population-level effects. METHODS: We constructed an age-structured compartmental model of TB in the intervention area. We fit the model using field and literature data, assuming that TB incidence equaled the estimated nationwide incidence in Pakistan (primary analysis, or 1.5 times greater (high-incidence scenario. We modeled the intervention as an increase in the rate of formal-sector TB diagnosis and evaluated the potential impact of sustaining this rate for five years. RESULTS: In the primary analysis, the five-year intervention averted 24% (95% uncertainty range, UR: 18-30% of five-year cumulative TB cases and 52% (95% UR: 45-57% of cumulative TB deaths. Corresponding reductions in the high-incidence scenario were 12% (95% UR: 8-17% and 27% (95% UR: 21-34%, although the absolute number of lives saved was higher. At the end of five years, TB notification rates in the primary analysis were below their 2010 baseline, incidence had dropped by 45%, and annual mortality had fallen by 72%. About half of the cumulative impact on incidence and mortality could be achieved with a one-year intervention. CONCLUSIONS: Sustained, multifaceted, and innovative approaches to TB case-finding in Asian megacities can have substantial community-wide epidemiological impact.

  6. Active Tuberculosis Case Finding in Port-au-Prince, Haiti: Experiences, Results, and Implications for Tuberculosis Control Programs

    Science.gov (United States)

    Delva, Guesly J.; Fort, Dumesle St.

    2016-01-01

    Background. Haiti has the highest tuberculosis (TB) prevalence in the Americas with 254 cases per 100,000 persons. Case detection relies on passive detection and TB services in many regions suffer from poor diagnostic and clinical resources. Methods. Mache Chache (“Go and Seek”) was a TB REACH Wave 3 funded TB case finding project in Port-au-Prince between July 2013 and September 2014, targeting four intervention areas with insufficient TB diagnostic performance. Results. Based on a verbal symptom screen emphasizing the presence of cough, the project identified 11,150 (11.75%) of all screened persons as TB subjects and 2.67% as smear-positive (SS+) TB cases. Enhanced case finding and strengthening of laboratory services led to a 59% increase in bacteriologically confirmed cases in the evaluation population. In addition, smear grades dropped significantly, suggesting earlier case detection. Xpert® MTB/RIF was successfully introduced and improved TB diagnosis in HIV-infected, smear-negative clinic patients, but not in HIV-negative, smear-negative TB suspects in the community. However, the number needed to screen for one additional SS+ case varied widely between clinic and community screening activities. Conclusion. Enhanced and active TB case finding in Haiti can improve TB diagnosis and care. However, screening algorithms have to be tailored to individual settings, necessitating long-term commitment. PMID:27668093

  7. Risk factors for inadequate TB case finding in Rural Western Kenya: a comparison of actively and passively identified TB patients.

    Directory of Open Access Journals (Sweden)

    Anna H Van't Hoog

    Full Text Available BACKGROUND: The findings of a prevalence survey conducted in western Kenya, in a population with 14.9% HIV prevalence suggested inadequate case finding. We found a high burden of infectious and largely undiagnosed pulmonary tuberculosis (PTB, that a quarter of the prevalent cases had not yet sought care, and a low case detection rate. OBJECTIVE AND METHODS: We aimed to identify factors associated with inadequate case finding among adults with PTB in this population by comparing characteristics of 194 PTB patients diagnosed in a health facility after self-report, i.e., through passive case detection, with 88 patients identified through active case detection during the prevalence survey. We examined associations between method of case detection and patient characteristics, including HIV-status, socio-demographic variables and disease severity in univariable and multivariable logistic regression analyses. FINDINGS: HIV-infection was associated with faster passive case detection in univariable analysis (crude OR 3.5, 95% confidence interval (CI 2.0-5.9, but in multivariable logistic regression this was largely explained by the presence of cough, illness and clinically diagnosed smear-negative TB (adjusted OR (aOR HIV 1.8, 95% CI 0.85-3.7. Among the HIV-uninfected passive case detection was less successful in older patients aOR 0.76, 95%CI 0.60-0.97 per 10 years increase, and women (aOR 0.27, 95%CI 0.10-0.73. Reported current or past alcohol use reduced passive case detection in both groups (0.42, 95% CI 0.23-0.79. Among smear-positive patients median durations of cough were 4.0 and 6.9 months in HIV-infected and uninfected patients, respectively. CONCLUSION: HIV-uninfected patients with infectious TB who were older, female, relatively less ill, or had a cough of a shorter duration were less likely found through passive case detection. In addition to intensified case finding in HIV-infected persons, increasing the suspicion of TB among HIV

  8. Community-based active tuberculosis case finding in poor urban settlements of Phnom Penh, Cambodia: a feasible and effective strategy.

    Directory of Open Access Journals (Sweden)

    Natalie Lorent

    Full Text Available In light of the limitations of the current case finding strategies and the global urgency to improve tuberculosis (TB case-detection, a renewed interest in active case finding (ACF has risen. The WHO calls for more evidence on innovative ways of TB screening, especially from low-income countries, to inform global guideline development. We aimed to assess the feasibility of community-based ACF for TB among the urban poor in Cambodia and determine its impact on case detection, treatment uptake and outcome.Between 9/2/2012-31/3/2013 the Sihanouk Hospital Center of HOPE conducted a door-to-door survey for TB in deprived communities of Phnom Penh. TB workers and community health volunteers performed symptom screening, collected sputum and facilitated specimen transport to the laboratories. Fluorescence microscopy was introduced at three referral hospitals. The GeneXpert MTB/RIF assay (Xpert was performed at tertiary level for individuals at increased risk of HIV-associated, drug-resistant or smear-negative TB. Mobile phone/short message system (SMS was used for same-day issuing of positive results. TB workers contacted diagnosed patients and referred them for care at their local health centre.In 14 months, we screened 315.874 individuals; we identified 12.201 aged ≥ 15 years with symptoms suggestive of TB; 84% provided sputum. We diagnosed 783, including 737 bacteriologically confirmed, TB cases. Xpert testing yielded 41% and 48% additional diagnoses among presumptive HIV-associated and multidrug-resistant TB cases, respectively. The median time from sputum collection to notification (by SMS of the first positive (microscopy or Xpert result was 3 days (IQR 2-6. Over 94% commenced TB treatment and 81% successfully completed it.Our findings suggest that among the urban poor ACF for TB, using a sensitive symptom screen followed by smear-microscopy and targeted Xpert, contributed to improved case detection of drug-susceptible and drug-resistant TB

  9. Feasibility, yield, and cost of active tuberculosis case finding linked to a mobile HIV service in Cape Town, South Africa: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Katharina Kranzer

    Full Text Available BACKGROUND: The World Health Organization is currently developing guidelines on screening for tuberculosis disease to inform national screening strategies. This process is complicated by significant gaps in knowledge regarding mass screening. This study aimed to assess feasibility, uptake, yield, treatment outcomes, and costs of adding an active tuberculosis case-finding program to an existing mobile HIV testing service. METHODS AND FINDINGS: The study was conducted at a mobile HIV testing service operating in deprived communities in Cape Town, South Africa. All HIV-negative individuals with symptoms suggestive of tuberculosis, and all HIV-positive individuals regardless of symptoms were eligible for participation and referred for sputum induction. Samples were examined by microscopy and culture. Active tuberculosis case finding was conducted on 181 days at 58 different sites. Of the 6,309 adults who accessed the mobile clinic, 1,385 were eligible and 1,130 (81.6% were enrolled. The prevalence of smear-positive tuberculosis was 2.2% (95% CI 1.1-4.0, 3.3% (95% CI 1.4-6.4, and 0.4% (95% CI 1.4 015-6.4 in HIV-negative individuals, individuals newly diagnosed with HIV, and known HIV, respectively. The corresponding prevalence of culture-positive tuberculosis was 5.3% (95% CI 3.5-7.7, 7.4% (95% CI 4.5-11.5, 4.3% (95% CI 2.3-7.4, respectively. Of the 56 new tuberculosis cases detected, 42 started tuberculosis treatment and 34 (81.0% completed treatment. The cost of the intervention was US$1,117 per tuberculosis case detected and US$2,458 per tuberculosis case cured. The generalisability of the study is limited to similar settings with comparable levels of deprivation and TB and HIV prevalence. CONCLUSIONS: Mobile active tuberculosis case finding in deprived populations with a high burden of HIV and tuberculosis is feasible, has a high uptake, yield, and treatment success. Further work is now required to examine cost-effectiveness and affordability and

  10. Yield of intensified tuberculosis case-finding activities using Xpert(®) MTB/RIF among risk groups in Nepal.

    Science.gov (United States)

    Khanal, S; Baral, S; Shrestha, P; Puri, M; Kandel, S; Lamichanne, B; Elsey, H; Brouwer, M; Goel, S; Chinnakali, P

    2016-06-21

    Contexte : Vingt-deux districts du Népal où des activités intensifiées de recherche des cas (ICF) de la tuberculose (TB) ont été mises en œuvre au sein de groupes à risque sous l'égide du projet TB REACH en collaboration avec le programme national TB entre juillet 2013 et novembre 2015.Objectifs : Evaluer le rendement du dépistage de la TB grâce à un algorithme basé sur la microscopie de frottis suivie d'un test Xpert(®) MTB/RIF.Schéma : Etude descriptive basée sur des données recueillies en routine.Résultats : Sur un total de 145 679 individus dépistés, 28 574 (19,6%) ont été présumés atteints de TB ; 1239 (4,3%) d'entre eux ont eu une confirmation du diagnostic de TB ; parmi ces derniers, 1195 (96%) ont mis en route un traitement anti-tuberculose. Le rendement a été le plus élevé parmi les personnes vivant avec le virus l'immunodéficience humaine (PVVIH) (6,1%) suivies par les contacts domiciliaires (3,5%) et les habitants des bidonvilles (0,5%). Dans d'autres groupes à risque comme les prisonniers, les travailleurs d'usine, les réfugiés et les diabétiques, le rendement a été inférieur à 0,5%. Le nombre de personnes à dépister (NNS) pour diagnostiquer un cas de TB active a été de 17 pour les PVVIH, de 29 pour les contacts domiciliaires et de 197 pour les habitants des bidonvilles urbains. Sur 11 525 patients émanant soit du programme ICF soit du dépistage de routine, 112 (1%) ont eu un diagnostic de TB multirésistante.Conclusion : Le rendement en termes de cas de TB dépistés parmi les groupes à risque comme les PVVIH et les contacts domiciliaires a été substantiel. Même si ce rendement a été modeste parmi les habitants des bidonvilles, ceux-ci justifient néanmoins une intervention en raison de leur nombre élevé et de leur médiocre accès aux soins.

  11. Demography and findings of reported rape cases.

    Science.gov (United States)

    Quader, M M; Rahman, M H; Kamal, M; Ahmed, A U; Saha, S K

    2010-01-01

    Six hundred and ninety nine cases of alleged rape were studied by the authors during the period from 2007-2008 at the Mymensingh Medical College, Mymensingh. Of these cases, 122 had positive findings of recent sexual intercourse; 250 cases had the positive findings of habituated sexual intercourse, and 327 cases had no findings of sexual intercourse but they complained of forcible sexual intercourse and found no sign of sexual intercourse. Most of the alleged victims of rape were nulliparous 87.12% and parous was only 12.87%. 430 (61.51%) cases of reported victims who were students of schools and colleges were not considered as rape cases considering their victim's history of love affairs, leaving home secretly with their lovers, living with them for many days. Gang rape was not so common (4.29% of raped cases) in our study. Age groups, their occupations, living areas, time of arrival for medico-legal examination have been studied. Most of the cases were students (61.51%). A few numbers of victims were subjected to gang rape. Examination and reporting the cases have been discussed.

  12. Active Case Finding of Pulmonary Tuberculosis through Screening of Respiratory Symptomatics Using Sputum Microscopy: Is It Time to Change the Paradigm?

    Directory of Open Access Journals (Sweden)

    Eva Carolina del Portillo-Mustieles

    2013-01-01

    Full Text Available Background. One of the main strategies for the early detection of pulmonary tuberculosis (PTB is through the screening of individuals with symptoms compatible with PTB. Although this is programmatic strategy for active case finding, its yield is not well known. Objective. To determine the yield of pulmonary tuberculosis active case finding through the screening of respiratory symptomatic (RS patients at a general hospital. Methods. RS patients were defined as subjects complaining of cough and/or sputum for a period of 2 or more weeks. Outpatients and their companions were approached while they waited in the outpatient care areas of the hospital to detect RS. Two samples from different days or 2 samples taken 2 hours apart on the same day were collected. Results. 122 RS patients were identified. Fifty-seven patients (46.7% had at least one sputum sample analyzed. Three patients presented a positive smear and 2 were culture positive; neither had upper airway symptoms. None of the patients with productive cough and upper airway symptoms had a positive smear (. Only 19 (33.3% returned to the laboratory to retrieve their results. Conclusion. Current strategy to screen RS patients based only on clinical data has a low compliance. Specific strategies to increase compliance (removal of barriers, incentives, etc. should be implemented.

  13. Challenges from Tuberculosis Diagnosis to Care in Community-Based Active Case Finding among the Urban Poor in Cambodia: A Mixed-Methods Study.

    Directory of Open Access Journals (Sweden)

    Natalie Lorent

    Full Text Available While community-based active case finding (ACF for tuberculosis (TB holds promise for increasing early case detection among hard-to-reach populations, limited data exist on the acceptability of active screening. We aimed to identify barriers and explore facilitators on the pathway from diagnosis to care among TB patients and health providers.Mixed-methods study. We administered a survey questionnaire to, and performed in-depth interviews with, TB patients identified through ACF from poor urban settlements in Phnom Penh, Cambodia. Additionally, we conducted focus group discussions and in-depth interviews with community and public health providers involved in ACF, respectively.Acceptance of home TB screening was strong among key stakeholders due to perceived reductions in access barriers and in direct and indirect patient costs. Privacy and stigma were not an issue. To build trust and facilitate communication, the participation of community representatives alongside health workers was preferred. Most health providers saw ACF as complementary to existing TB services; however, additional workload as a result of ACF was perceived as straining operating capacity at public sector sites. Proximity to a health facility and disease severity were the strongest determinants of prompt care-seeking. The main reasons reported for delays in treatment-seeking were non-acceptance of diagnosis, high indirect costs related to lost income/productivity and transportation expenses, and anticipated side-effects from TB drugs.TB patients and health providers considered home-based ACF complementary to facility-based TB screening. Strong engagement with community representatives was believed critical in gaining access to high risk communities. The main barriers to prompt treatment uptake in ACF were refusal of diagnosis, high indirect costs, and anticipated treatment side-effects. A patient-centred approach and community involvement were essential in mitigating barriers

  14. Bringing state-of-the-art diagnostics to vulnerable populations: The use of a mobile screening unit in active case finding for tuberculosis in Palawan, the Philippines

    Science.gov (United States)

    Morishita, Fukushi; Garfin, Anna Marie Celina Gonzales; Lew, Woojin; Oh, Kyung Hyun; Yadav, Rajendra-Prasad; Reston, Janeth Cuencaho; Infante, Lenie Lucio; Acala, Maria Rebethia Crueldad; Palanca, Dean Lim; Kim, Hee Jin; Nishikiori, Nobuyuki

    2017-01-01

    Background Globally, case detection of tuberculosis (TB) has stabilized in recent years. Active case finding (ACF) has regained an increased attention as a complementary strategy to fill the case detection gap. In the Philippines, the DetecTB project implemented an innovative ACF strategy that offered a one-stop diagnostic service with a mobile unit equipped with enhanced diagnostic tools including chest X-ray (CXR) and Xpert®MTB/RIF (Xpert). The project targeted the rural poor, the urban poor, prison inmates, indigenous population and high school students. Methods This is a retrospective review of TB screening data from 25,103 individuals. A descriptive analysis was carried out to compare screening and treatment outcomes across target populations. Univariate and multivariate analyses were performed to identify predictors of TB for each population. The composition of bacteriologically-confirmed cases by smear and symptom status was further investigated. Results The highest yield with lowest number needed to screen (NNS) was found in prison (6.2%, NNS: 16), followed by indigenous population (2.9%, NNS: 34), the rural poor (2.2%, NNS: 45), the urban poor (2.1%, NNS: 48), and high school (0.2%, NNS: 495). The treatment success rate for all populations was high with 89.5% in rifampicin-susceptible patients and 83.3% in rifampicin-resistant patients. A relatively higher loss to follow-up rate was observed in indigenous population (7.5%) and the rural poor (6.4%). Only cough more than two weeks showed a significant association with TB diagnosis in all target populations (Adjusted Odds Ratio ranging from 1.71 to 6.73) while other symptoms and demographic factors varied in their strength of association. The urban poor had the highest proportion of smear-positive patients with cough more than two weeks (72.0%). The proportion of smear-negative (Xpert-positive) patients without cough more than two weeks was the highest in indigenous population (39.3%), followed by prison

  15. Single Finds. The case of Roman Egypt

    DEFF Research Database (Denmark)

    Christiansen, Erik

    2006-01-01

    Survery of single or stray finds from Roman Egypt and discussion of them as evidence for the circulation and use of coins......Survery of single or stray finds from Roman Egypt and discussion of them as evidence for the circulation and use of coins...

  16. Cutaneous findings in five cases of malaria

    Directory of Open Access Journals (Sweden)

    Jignesh B Vaishnani

    2011-01-01

    Full Text Available Malaria is an infectious disease caused by protozoa of the genus Plasmodium. Cutaneous lesions in malaria are rarely reported and include urticaria, angioedema, petechiae, purpura, and disseminated intravascular coagulation (DIC. Here, five malaria cases associated with cutaneous lesions have been described. Out of the five cases of malaria, two were associated with urticaria and angioedema, one case was associated with urticaria, and other two were associated with reticulated blotchy erythema with petechiae. Most of the cutaneous lesions in malaria were nonspecific and reflected the different immunopathological mechanism in malarial infection.

  17. MRI finding of ethylmalonic encephalopathy: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Yong; Lee, Shi Kyung; Han, Chun Hwan; Rho, Eun Jin [Kangnam General Hospital Public Corporation, Seoul (Korea, Republic of)

    2002-12-01

    Ethylmalonic encephalopathy is a rare syndrom characterized by developmental delay, acrocyanosis, petechiae, chronic diarrhea, and ethylmalonic, lactic, and methylsuccinic aciduria. We report the MRI finding of ethylmalonic encephalopathy including previously unreported intracranial hematoma.

  18. Muscular cysticercosis: Case report and imaging findings

    Directory of Open Access Journals (Sweden)

    Neide Regina Simões Olmo

    Full Text Available Summary Cysticercosis is a parasitic disease caused by a worm of the Cestoda class. The most prevalent form affects the nervous system. This case report is from a 78-year-old female patient evaluated at Clínica Mult Imagem, in the city of Santos, Brazil, who presented a form of the disease that differed from the classic neurocysticercosis, in this case muscular cysticercosis. This and other forms of manifestation justify further studies to ensure adequate recognition, diagnosis and treatment of this parasitic disease.

  19. Discovery and Use of Online Learning Resources: Case Study Findings

    Directory of Open Access Journals (Sweden)

    Laurie Miller Nelson

    2004-04-01

    Full Text Available Much recent research and funding have focused on building Internet-based repositories that contain collections of high-quality learning resources, often called ‘learning objects.’ Yet little is known about how non-specialist users, in particular teachers, find, access, and use digital learning resources. To address this gap, this article describes a case study of mathematics and science teachers’ practices and desires surrounding the discovery, selection, and use of digital library resources for instructional purposes. Findings suggest that the teacher participants used a broad range of search strategies in order to find resources that they deemed were age-appropriate, current, and accurate. They intended to include these resources with little modifications into planned instructional activities. The article concludes with a discussion of the implications of the findings for improving the design of educational digital library systems, including tools supporting resource reuse.

  20. Cytogenetics Findings in a Histiocytic Sarcoma Case

    Science.gov (United States)

    Alonso-Dominguez, J. M.; Calbacho, M.; Talavera, M.; Villalon, C.; Abalo, L.; Garcia-Gutierrez, J. V.; Lozano, S.; Tenorio, M.; Villarrubia, J.; Lopez-Jimenez, J.; Ferro, M. T.

    2012-01-01

    Histiocytic sarcoma (HS) is a neoplasm derived from histiocytes. Its diagnosis was not clear until its immunohistochemistry profile was correctly established. Not much is known about its genetic properties. We report a case of a 48-year-old male patient whose bone marrow was almost completely occupied by monomorphic medium size neoplastic cellularity. Its immunohistochemical profile was CD68+, CD4+, CD45+ with negativity of other dendritic cells, and other lineage markers. Cytogenetic study showed 4 related clones: one with trisomy 8 and extra material on the short arms of chromosome 4; a second line with tetrasomy of chromosome 8, add(4)(p16); the third clone had the same alterations as the previous and deletion of chromosome 3 at q11; the fourth line had tetrasomy 8 and translocation t(3;5)(q25;q35). To our knowledge this is the first HS case showing chromosome 8 trisomy and tetrasomy and the other described alterations. PMID:22937328

  1. Cytogenetics Findings in a Histiocytic Sarcoma Case

    Directory of Open Access Journals (Sweden)

    J. M. Alonso-Dominguez

    2012-01-01

    Full Text Available Histiocytic sarcoma (HS is a neoplasm derived from histiocytes. Its diagnosis was not clear until its immunohistochemistry profile was correctly established. Not much is known about its genetic properties. We report a case of a 48-year-old male patient whose bone marrow was almost completely occupied by monomorphic medium size neoplastic cellularity. Its immunohistochemical profile was CD68+, CD4+, CD45+ with negativity of other dendritic cells, and other lineage markers. Cytogenetic study showed 4 related clones: one with trisomy 8 and extra material on the short arms of chromosome 4; a second line with tetrasomy of chromosome 8, add(4(p16; the third clone had the same alterations as the previous and deletion of chromosome 3 at q11; the fourth line had tetrasomy 8 and translocation t(3;5(q25;q35. To our knowledge this is the first HS case showing chromosome 8 trisomy and tetrasomy and the other described alterations.

  2. Two Cases of Melasma with Unusual Histopathologic Findings

    Science.gov (United States)

    Kang, Won-Hyoung

    2006-01-01

    We reported two cases of clinically typical melasma presenting with unusual histopathologic findings. In one case, the epidermal melanocytes were markedly increased in number and protruded into the dermis, and in the other case, increased epidermal pigmentation as well as dermal melanocytosis were found. We suggested that the various treatment modalities of melasma should be applied depend on its histopathologic finding. PMID:16614533

  3. Finding Community Structures In Social Activity Data

    KAUST Repository

    Peng, Chengbin

    2015-05-19

    Social activity data sets are increasing in number and volume. Finding community structure in such data is valuable in many applications. For example, understand- ing the community structure of social networks may reduce the spread of epidemics or boost advertising revenue; discovering partitions in tra c networks can help to optimize routing and to reduce congestion; finding a group of users with common interests can allow a system to recommend useful items. Among many aspects, qual- ity of inference and e ciency in finding community structures in such data sets are of paramount concern. In this thesis, we propose several approaches to improve com- munity detection in these aspects. The first approach utilizes the concept of K-cores to reduce the size of the problem. The K-core of a graph is the largest subgraph within which each node has at least K connections. We propose a framework that accelerates community detection. It first applies a traditional algorithm that is relatively slow to the K-core, and then uses a fast heuristic to infer community labels for the remaining nodes. The second approach is to scale the algorithm to multi-processor systems. We de- vise a scalable community detection algorithm for large networks based on stochastic block models. It is an alternating iterative algorithm using a maximum likelihood ap- proach. Compared with traditional inference algorithms for stochastic block models, our algorithm can scale to large networks and run on multi-processor systems. The time complexity is linear in the number of edges of the input network. The third approach is to improve the quality. We propose a framework for non- negative matrix factorization that allows the imposition of linear or approximately linear constraints on each factor. An example of the applications is to find community structures in bipartite networks, which is useful in recommender systems. Our algorithms are compared with the results in recent papers and their quality and e

  4. Neuropathology of AIDS: An Autopsy Review of 284 Cases from Brazil Comparing the Findings Pre- and Post-HAART (Highly Active Antiretroviral Therapy and Pre- and Postmortem Correlation

    Directory of Open Access Journals (Sweden)

    Ana Cristina Araújo Lemos Silva

    2012-01-01

    Full Text Available A retrospective study of central nervous system (CNS in 284 autopsy AIDS cases in Brazil (1989–2008 divided into 3 groups: A (without antiretroviral treatment: 163 cases; B (other antiretroviral therapies: 76 cases; C (HAART for 3 months or more: 45 cases. In 165 (58.1% cases, relevant lesions were found, predominantly infections (54.2%; the most frequent was toxoplasmosis (29.9% followed by cryptococcosis (15.8%, purulent bacterial infections (3.9%, and HIV encephalitis (2.8%; non-Hodgkin lymphomas occurred in 1.4% and vascular lesions in 1.1%. There was no difference when compared the frequency of lesion among the groups; however, toxoplasmosis was less common while HIV encephalitis was more frequent in group C related to A. CNS lesions remain a frequent cause of death in AIDS; however, the mean survival time was four times greater in group C than in A. In 91 (55.1% of 165 cases with relevant brain lesions (or 32% of the total 284 cases, there was discordance between pre- and postmortem diagnosis; disagreement type 1 (important disease that if diagnosed in life could change the patient prognosis occurred in 49 (53.8% of 91 discordant cases (17.6% of the total 284 indicating the autopsy importance, even with HAART and advanced diagnostics technologies.

  5. Finding similar price preferences on tourism activities

    OpenAIRE

    Lorenzo Masiero; Juan L. Nicolau

    2011-01-01

    This article builds on the double role of the effect of prices on the choice of tourism activities: not only is it the only component of a destination marketing strategy that represents income but also a determinant factor in tourist choice. On this account, identifying patterns of tourists with different degrees of sensitivities to prices would help them design an appropriate bundle of activities and have a clear definition of the segment the destination should try to attract. Accordin...

  6. Inflammatory pseudotumor of the liver: 13 cases of MRI findings

    Institute of Scientific and Technical Information of China (English)

    Fu Hua Yah; Kang Rong Zhou; Ya Ping Jiang; Wei Bin Shi

    2001-01-01

    @@INTRODUCTION Inflammatory pseudotumor of the liver ,a rare benign lesion ,is often confused with the malignant tumors .Until 1998,less than 80 cases had been reported in the world [1,2].The accuracy of the pre-surgical diagnosis was low p[3,4] ,and very few materials on the diagnosis using dynamic MRI were reported [5-7] .We collected thirteen cases of inflammatory pseudotumor of the liver were collected and roved by pathology with MRI studies .Our purpose is to describe and analyze the MRI findings of this lesion and find out the valuable signs suggesting the diagnosis so as to avoid unnecessary operations.

  7. CT findings of tracheal mucormycosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Jong Kwan; Jung, Hyun Seouk; Kim, Ki Jun; Lee, Sung Yong; Kim, Kyung Mi [The Catholic Univ. of Korea, Inchon (Korea, Republic of)

    1999-09-01

    Pulmonary mucormycosis is a opportunistic mycosis, typically occurring in immunocompromised or diabetic patients. It is characterized as an infection of the pulmonary parenchyma and larger bronchi, and involves extensive vascular thrombosis and tissue necrosis. A variety of CT findings have been reported, but tracheal involvement is extremely rare. We report the case of a patient with tracheal mucormycosis placing particular emphasis on the CT findings.

  8. Autoimmune Pancreatitis: A Case of Atypical Radiographic Findings

    Directory of Open Access Journals (Sweden)

    Shawhin Karimi

    2016-10-01

    Full Text Available Autoimmune pancreatitis (AIP is a rare pancreatic disorder that can present as a manifestation of a broader systemic inflammatory disease known as immunoglobulin G4-related systemic disease (IGG4-RSD. AIP is divided into two subtypes based on clinical, radiological, and histological findings. The disease can be mistaken for pancreatic cancer because of overlapping clinical and radiological findings, but early recognition can help avoid unnecessary surgery. We present a case of a 65-year-old female with suspected acute gallstone pancreatitis found to have AIP based on serology, radiological findings, and response to steroids.

  9. MR imaging finding of xanthogranulomatous cholecystitis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Gyee; Kang, Heoung Keun; Jeong, Yong Yeon; Cho, Yong Ho; Jang, Nam Kyu [Chonnam Univ. Medical School, Kwangju (Korea, Republic of)

    1999-07-01

    We describe a case of xanthogranulomatous cholecystitis in which there was close correlation between MR and histopathological finding and review the previous literature. On both T1- and T2-weighted MR images, multiple gallstones and diffuse wall thickening of the gallbladder were seen, with multiple hyperintense intramural nodules. The nodules were pathologically confirmed as xanthogranuloma.

  10. Biliary ascariasis: MR cholangiography findings in two cases

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Cheol Mok; Kim, Tae Kyoung; Ha, Hyun Kwon; Kim, Pyo Nyun; Lee, Moon Gyu [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2001-09-01

    We describe the imaging features of two cases of biliary ascariasis. Ultrasonography and CT showed no specific abnormal findings, but MR cholangiography clearly demonstrated an intraductal linear filling defect that led to the correct diagnosis. MR cholangiography is thus a useful technique for the diagnosis of biliary ascariasis.

  11. The neuroradiological findings in a case of Revesz syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Scheinfeld, Meir H. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiology, Bronx, NY (United States); Montefiore Medical Center, Department of Radiology, Bronx, NY (United States); Lui, Yvonne W.; Gomes, William A.; Bello, Jacqueline A. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiology, Bronx, NY (United States); Kolb, Edward A. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Pediatrics, The Children' s Hospital at Montefiore, Bronx, NY (United States); Engel, Harry M. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Ophthalmology, Bronx, NY (United States); Weidenheim, Karen M. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Pathology, Bronx, NY (United States)

    2007-11-15

    Revesz syndrome is a variant of dyskeratosis congenita characterized by aplastic anemia, retinopathy, and central nervous system abnormalities. We describe a 3-year-old boy in whom the spectrum of neuroimaging findings, including intracranial calcifications, cerebellar hypoplasia and unusual brain lesions were found by biopsy to be gliosis despite their enhancement and progression. In patients with dyskeratosis-related syndromes, non-neoplastic parenchymal brain lesions occur and gliosis should be considered in the differential diagnosis for progressive enhancing brain lesions. Should this finding be confirmed consistently in additional cases, brain biopsy could potentially be avoided. (orig.)

  12. Adult cerebellar medulloblastoma: CT and MRI findings in eight cases

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho Neto, Arnolfo de; Bertoldi, Guilherme A. [Parana Univ., Curitiba, PR (Brazil). Radiologia Diagnostica]. E-mail: arnolfo.carvalho@avalon.sul.com.br; Gasparetto, Emerson L. [Parana Univ., Curitiba, PR (Brazil). Hospital das Clinicas. Secao de Radiologia Diagnostica; Ono, Sergio E. [Parana Univ., Curitiba, PR (Brazil). Faculdade de Medicina; Gomes, Andre F. [Diagnostico Avancado Por Imagem (DAPI), Curitiba, PR (Brazil)

    2003-06-01

    Medulloblastoma is a brain tumor of neuro epithelial origin, which represents 15 to 30% of all pediatric brain tumors, and less than 1% of CNS adult neoplasms. We report the imaging findings of 8 adult patients with medulloblastoma. The mean age was 35 years, ranging from 20 to 65 years, and the male:female rate was 3:5. The tumors were predominantly lateral (63%), hyperdense on CT scans (83%), and on the MRI, hypointense on T1 (100%) and hyperintense on T2 (80%) weighted images. It was seen intratumoral necrosis and cysts in six cases and calcifications in three. Hydrocephalus was observed in 5 cases and brain stem invasion in four. The imaging findings of medulloblastomas in adults are different of those in child, and also nonspecific. Although these tumors are uncommon in adults, they must be considered in the differential diagnosis of cerebellar masses in the posterior fossa of this age group. (author)

  13. Laryngeal schwannoma: a case report with emphasis on sonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Luis Ronan Marquez Ferreira de, E-mail: luisronan@gmail.com [Universidade Federal do Triangulo Mineiro (UFTM), Uberaba, MG (Brazil); De Nicola, Harley; Yamasaki, Rosiane; Pedroso, Jose Eduardo; Brasil, Osiris de Oliveira Campones do; Yamashita, Helio [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina

    2014-05-15

    Schwannomas are benign nerve sheath tumors composed of Schwann cells, which normally produce the insulating myelin sheath covering peripheral, cranial and autonomic nerves. Twenty-five to forty-five percent of all schwannomas occur in the head and neck region, but location of such tumors in the larynx is rarely observed. The present report is aimed at describing a clinical case of laryngeal schwannoma, with emphasis on sonographic findings. (author)

  14. A new case of Grange syndrome without cardiac findings.

    Science.gov (United States)

    Wallerstein, Robert; Augustyn, Ann Marie; Wallerstein, Donna; Elton, Leslie; Tejeiro, Beatriz; Johnson, Valerie; Lieberman, Kenneth

    2006-06-15

    Grange syndrome comprises arterial stenoses with hypertension, brachysyndactyly, bone fragility, learning disability, and cardiac defects. To date, we know of two reported families with five affected individuals. We report on one of the youngest cases, in a third family, a 3-year-old girl with brachysyndactyly, renal artery stenosis with hypertension, and bone fragility. She does not have apparent cardiac disease, suggesting cardiac anomalies may not be an obligatory finding in this syndrome.

  15. Pertussis -- a case finding study amongst returnees from Op Herrick.

    Science.gov (United States)

    Cooper, N K; Bricknell, M C M; Holden, G R; McWilliam, C

    2007-06-01

    We present a case finding study of serologically confirmed Pertussis amongst BFG-based returnees from Op HERRICK. The role of Pertussis in the aetiology of the commonplace "Kabul Cough" is discussed. It is recommended that enhanced health surveillance for Pertussis takes place both during and after future deployments to Afghanistan, to prevent the potential onward transmission of a potentially fatal illness to unimmunised children.

  16. CT Findings of Small Bowel Anisakiasis: Analysis of Four Cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Wee Kyoung; Song, Soon Young; Cho, On Koo; Koh, Byung Hee [Hanyang University College of Medicine, Seoul (Korea, Republic of); Kim, Yong Soo; Jung, Woo Kyoung; Kim, Min Yeong [Hanyang University Guri Hospital, College of Medicine, Guri (Korea, Republic of)

    2011-02-15

    We wanted to describe the CT findings of small bowel anisakiasis with the pathologic correlation. Four patients with surgically and pathologically proven small bowel anisakiasis were included in this retrospective study. They were three men and one woman and their ages ranged from 28 to 43 years (mean age: 38 years). We evaluated their clinical, CT and histological findings. All the patients had a history of ingesting raw fish within 24 hours from the time of symptom onset. They complained of abdominal pain (n=4), nausea (n=4), vomiting (n=2) and diarrhea (n=1). Physical examination revealed tenderness (n=4), rebound tenderness (n=4) and increased bowel sounds (n=3). Leukocytosis was noted in all the patients on the laboratory examination. None of the patients showed eosinophilia. The CT findings were segmental small bowel wall thickening with preserved layering (n=4), focal segmental luminal narrowing with proximal dilatation (n=4), peritoneal thickening (n=3), mesenteric or omental infiltration (n=4) and varying degrees of ascites (n=4). On the histopathologic examination, they revealed an infiltration of eosinophils (n=4) in all layers of the bowel wall with severe edema. The larvae were found on surgico-pathologic examination in all the cases. The CT findings may be helpful to make the specific diagnosis of small bowel anisakiasis in a patient with the clinical findings of an acute abdomen and a history of eating raw fish

  17. From Use Cases to Activity Cases

    DEFF Research Database (Denmark)

    Bækgaard, Lars

    2005-01-01

    Use cases can be used to capture requirements and to subdivide IT-systems into functionally coherent units. Information systems are activity systems that carry out important business activities. Many systems development methods recognize activity modeling as an important development activity. Use...

  18. Pathological Findings in Accidental Electrocution in a Horse (Case Report

    Directory of Open Access Journals (Sweden)

    Adrian Florin Gal

    2016-11-01

    Full Text Available Recently, the veterinarians are dealing with a number of cases that require forensic expertise. Such a circumstance could be the accidental electrocution in animals, one of the causes of unnatural death. There is a scarcity with reference to the pathological findings in veterinary forensic medicine. In this paper, we present the main lesions that occurred in a horse with accidental electrocution that was presented for complete necropsy survey. A horse corpse was sent to the Pathology Department (Faculty of Veterinary Medicine, Cluj-Napoca, Romania for a full medical survey. Preliminary results and external examination: the body was in rigor mortis; from the nasal cavities drained out reddish foam and in the mouth was observed the presence of ingested feed (straw that was not chewed, suggesting a quick death. The findings detected after internal examination of the carcass were poor blood coagulability, haemorrhagic diathesis throughout the body, with haemorrhages of various sizes in different body regions (e.g., muscles of the withers, in the gluteal muscle, the mucosa of epiglottis, larynx, trachea, in the interstitium of the lung, and ecchymosis in the left kidney. Some other lesions detected were infarcts and haemorrhages in the fundic region of the stomach’s mucosa. In electrocution, haemorrhages are most often located in the respiratory tract, aspect observed in our case too. However, the diagnosis of electrocution has to corroborate the necropsy findings (which are not specific, with some other data such as the fulminant death and inspection of power source.

  19. Case Report of Arm Kimura Disease with Atypical MR Finding

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hee Young; Kim, Baek Hyun; Lee, Young Hen; Kang, Chang Ho; Lee, Guen Young; Seo, Bo Kyoung; Lee, Ju Han [Korea University Ansan Hospital, Ansan (Korea, Republic of); Kim, Ye Lim; Hong, Suk Ju [Korea University Guro Hospital, Seoul (Korea, Republic of)

    2010-03-15

    Kimura disease is a rare chronic inflammatory condition of unknown origin that occurs mainly in young Asian male patients. Kimura disease is characterized by painless subcutaneous swelling and lymphadenopathy of the head and neck, associated with peripheral blood eosinophilia and increased serum IgE. According to some previous reports about a rare form of Kimura disease of the upper arm, soft tissue masses of the subcutaneous fat layer were demonstrated in the medial trochlear area, which showed strong and homogenous enhancement with marked perilesional edema and fat infiltrations on enhanced magnetic resonance imaging (MRI). In this case report, we introduce a case of Kimura disease of the upper arm in a 13-year male patient, which was seen as a well-marginated soft tissue mass without perilesional edema or fatty infiltrations on MRI. In this case study, we discuss the characteristics of the clinical and pathologic findings associated with unusual MRI findings, and report the Kimura disease with a different pathophysiology by anti-inflammatory drugs.

  20. Case of herpes simplex encephalitis (HSE) with characteristic CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Imamura, Shigehiro (Kumamoto Rosai Hospital (Japan)); Nakayama, Toshio; Yamanaga, Hiroaki; Nakanishi, Ryoji; Ideta, Tooru

    1984-01-01

    CT scans of a 59-year-old woman, with serologically comfirmed herpes simplex encephalitis (HSE) were studied sequentially from 9 days after onset. The initial findings in CT scan were low density areas in insular cortex, claustrum and hippocampus. The low density areas, then, spread to the temporal lobe, rectal and cingulate gyri and occipital lobe, according to clinical progression of the disease. However, these low density areas disappeared and changed into isodensity areas in 25-35 days after oneset, which then returned to low density areas again in 51 days after onset. Thes characteristic phenomenon resembled a ''fogging effect,'' which is frequently seen during the second or third week after onset of ischemic cerebral infarction. HSE is characterized pathologically by acute hemorrhagic necrotizing encephalitis. Though cerebral angiography was not performed in this case, these characteristic CT findings suggested that HSE may have been associated with vascular involvement.

  1. Sweet syndrome: Clinical and Laboratory Findings of 31 Cases

    Directory of Open Access Journals (Sweden)

    Serap Güneş Bilgili

    2013-03-01

    Full Text Available Background and Design: Sweet syndrome is an inflammatory disease characterized by the abrupt onset of pain, red papules and plaques, fever, neutrophilic leukocytosis, and dermal neutrophilic infiltrate. There are not enough data about Sweet syndrome in Turkey. In this article, we studied clinical, laboratory, histopathological, and epidemiological characteristics of patients, who presented to our clinic, and compared the findings with the literature. Materials and Methods: All patients diagnosed with Sweet syndrome in our clinic between 2005 and 2011 were included in the study. The epidemiological, clinical, and laboratory findings were retrospectively evaluated. Results: A total of 31 patients with Sweet’s syndrome - 24 female (77.4%, 7 male (22.6%; aged 23-82 years – included in the study. The average age of the patients was 48 years. Cutaneous lesions were most frequently localized in the upper extremity. Conjunctivitis was the common systemic manifestation, followed by fever, arthralgia, and myalgia. The most common trigger factor was infections of the upper respiratory tract. In histopathological evaluations of skin biopsies, dense neutrophil infiltration compatible with Sweet syndrome was detected in the dermis. Also, findings of vasculitis were determined in 3 patients. Discussion: The clinical and laboratory findings in our study are mostly similar to those reported in the literature. We found evidence of vasculitis in 10% of cases, therefore, we think the presence of vasculitis does not necessarily rule out the diagnosis of Sweet syndrome

  2. Sonographic Findings for Posttraumatic Pacinian Neuroma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Eun; Ha, Doo Hoe; Lee, Sang Min; Kim, Gwang Il [CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2009-12-15

    Pacinian neuroma is a rare tumor characterized by hypertrophy and hyperplasia of preexisting pacinian corpuscles. This tumor most frequently presents as a small superficial mass affecting the hands and feet, which produces localized sharp pain. The etiology is unknown, but local trauma has been postulated as an important factor. Here we report a case of posttraumatic pacinian neuroma in a 24-year-old woman who presented with severe local pain in the palm. The clinical features, and the sonographic and pathologic findings of posttraumatic pacinian neuroma are discussed

  3. MRI Findings of Brucellar Spondylitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Woo; Kim, Myung Soon; Kim, Young Ju [Dept. of Radiology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    2013-03-15

    Brucellosis is a systemic infectious disease, and musculoskeletal involvement is a frequent complication. Particularly, spondylitis is a common involvement. However, early diagnosis of brucellar spondylitis is often difficult due to non-specific clinical symptoms and long latent period. Especially in Korea, where tuberculosis is an endemic disease, differentiation between tuberculous and brucellar spondylitis is clinically and radiologically more challenging. A 59-year-old male cattle farmer, who presented with non-specific back pain, had spondylitis on magnetic resonance imaging (MRI), and serologic test finally confirmed brucellar spondylitis. Therefore, we report a case of a rather rare disease in Korea, brucellar spondylitis with a review of MRI findings.

  4. CT findings of esophageal schwannoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Man Ho; Ryu, Dae Shick; Eom, Dae Woon; Shin, Dong Rock; Choi, Soo Jung; Ahn, Jae Hong; Park, Man Soo; Yoo, Dong Kon [Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung (Korea, Republic of)

    2015-03-15

    Esophageal schwannomas are a relative rare benign neoplasm that usually occurs in the upper esophagus, in the middle aged women. We report a case of a 67-year-old man with a lower esophageal schwannoma. This lesion was composed of homogenous density, iso-attenuating with the chest wall muscle on pre- and post-contrast chest computed tomography (CT). The CT findings of the esophageal schwannoma are similar to those of esophageal leiomyoma. Hense, esophageal schwannoma may be a differential diagnosis with esophageal leiomyoma.

  5. Unusual bone-scan findings in acute osteomyelitis: case report. [/sup 99m/Tc tracer technique

    Energy Technology Data Exchange (ETDEWEB)

    Russin, L.D.; Staab, E.V.

    1976-07-01

    In osteomyelitis, bone-scan findings precede the appearance of bone changes on radiographs. In cases where focal ischemia occurs, the earliest scan finding may be a cold area that later becomes hot as active periostitis develops.

  6. Infantile fibrosarcoma: Magnetic resonance imaging findings in six cases

    Energy Technology Data Exchange (ETDEWEB)

    Canale, Sandra [Department of Radiology, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France)], E-mail: canalesandra@yahoo.com; Vanel, Daniel [Department of Radiology, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France); Istituti Ortopedici Rizzoli, 1/10 via di Barbiano, 40136 Bologna (Italy); Couanet, Dominique [Department of Radiology, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France); Patte, Catherine [Department of Pediatrics, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France); Caramella, Caroline; Dromain, Clarisse [Department of Radiology, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France)

    2009-10-15

    Purpose: To retrospectively review magnetic resonance (MR) imaging features in a series of six infantile fibrosarcomas to find out if MR can suggest this unusual diagnosis and to highlight the value of MR during and following treatment. Materials and methods: The records of six cases of histologically proven infantile fibrosarcoma were retrieved from the files of our cancer center. All imaging data available were consensually reviewed by two radiologists. Results: There were five females and one male (age range at diagnosis, 0-12 months; mean, 6 months). The most common finding was a well-circumscribed single mass in five patients (83%). All tumors had arisen on limbs; at their proximal or distal extremity or at the root of the limb. The masses were 9 cm large in mean diameter. The initial tumor signal was isointense to muscle on T1-weighted and hyperintense on T2-weighted sequences. All masses were well circumscribed and half of them contained internal fibrous septa. The internal signal was homogeneous in three patients and heterogeneous in the three others. An intense enhancement was seen in all three contrast-enhanced exams available; heterogeneous in two cases and homogeneous in one. Osseous erosion was observed in only one patient who was the only one with distant metastasis. After treatment (chemotherapy and very limited surgery), tumors had totally disappeared, leaving muscle fat infiltration in two patients and subcutaneous fat hypertrophy in one patient. Conclusion: Although imaging findings are not specific of infantile fibrosarcoma, this diagnosis could be suggested when MR imaging depicts a large well-circumscribed mass arising in a limb at birth or during the neonatal period. This mass is sometimes heterogeneous and septate and exhibits an isointense T1- and hyperintense T2-weighted signals and strong enhancement. MR is also the technique of choice for follow-up during treatment which consists nowadays almost exclusively in chemotherapy.

  7. Case of cerebral cryptococcosis. Mainly computerized tomographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Yamagami, Tatsuhito; Nomura, Takayoshi; Imagawa, Kenji; Asai, Akira; Kawasaki, Michiro (National Hospital of Nagoya (Japan))

    1984-05-01

    A 66-year-old female was admitted to our hospital with chief complaint of vertigo, gait disturbance and dysarthria. These symptoms started about one year before admission and worsened. Vomiting and urinary incontinence appeared. Neurological examination revealed left cerebellar ataxia and dysarthria. In plain CT (computerized tomography) irregular ill-defined low density area was noted in the cerebellar vermis and bilateral cerebellar hemispheres. And slight ventricular dilatation was found. Irregular shape of ring-like enhancement corresponding to capsule and patchy or mottled enhancement inside the tumor were seen. Suboccipital craniectomy was performed and yellowish necrotic tumor with hard capsule was removed. Histological diagnosis was not neoplasm or tuberculoma. Postoperatively liver function progressively worsened. She died due to disseminated intravascular coagulation. Autopsy revealed typical liver cirrhosis without malignant change. 3.0 x 2.5 cm sized, slightly hard, yellowish lesion was found on upper part of cerebellar hemispheres. This had extremely necrotic tissue and a great number of cryptococcus neoformans were found. And other intracranial lesion was not confirmed. Finding of pulmonary cryptococcosis was not gained. Our case is very rare because of solitary cerebellar abscess and absence of meningitic episode or pulmonary cryptococcosis. There are three types of inflammation in cerebral cryptococcosis. The commonest manifestation is the meningitic type, the second mode is granulomatous lesion and the third and the least presentation is intracranial abscess formation. CT reveals various finidngs according to clinical stage. CT findings are those of meningitis, meningoencephalitis, granuloma and abscess. Cryptococcal granuloma or abscess often simulates brain abscess, glioma and metastatic brain tumor. We discussed CT findings of cerebral cryptococcosis and examined the CT number of our case.

  8. INTRACRANIAL MENINGIOMAS - MR IMAGING FINDINGS IN 30 CASES

    Directory of Open Access Journals (Sweden)

    Bonthu

    2016-03-01

    Full Text Available OBJECTIVE To present the magnetic resonance imaging findings of 30 cases of intracranial meningiomas diagnosed in a single institute. Magnetic resonance imaging (MRI with contrast is the modality of choice for diagnosis of meningiomas. Objective of this study was to describe typical and atypical locations and findings of intracranial meningiomas on magnetic resonance imaging. MATERIALS AND METHODS This study was conducted at Department of Radiology, Government General Hospital, Kakinada from January 2013 to August 2014 over a period of 20 months. 30 patients of intracranial meningiomas of 15-75 years’ age group were studied. RESULTS A higher incidence noted in females. Most of the tumours are solitary. The most common sites of occurrence are the cerebral convexities, parasagittal location/falx, posterior fossa, sphenoid ridge, olfactory groove. Majority were typical (WHO grade 1 in 96.6%, only 3.4% were atypical (WHO grade 2. Most of the tumours showed low signal on T1- (60% and high signal on T2- (68% and FLAIR (69% weighted images. Also, the lesions showed heterogeneous signal on T1 (60%, T2 (68% and FLAIR (64% sequences. After contrast administration, 67% of the tumours presented intense and 33% showed moderate and heterogenous enhancement. The most common sites of occurrence are the cerebral convexities, parasagittal location/falx, posterior fossa, sphenoid ridge, olfactory groove and others accounting for 33.3%, 20%, 20%, 10%, 6.7%, 10% respectively. Areas of vasogenic oedema around the tumours were seen in 33% of the cases. Twenty percent of the cases showed bone infiltration, and the dural tail sign was seen in 56% of the tumours. CONCLUSION The diagnosis of meningioma is usually straightforward except when it presents in unusual locations and with atypical imaging characteristics. MRI is the modality of choice for diagnosis as well as for predicting the success of its complete removal.

  9. Various hysterosalpingography findings of female genital tuberculosis: A case series

    Directory of Open Access Journals (Sweden)

    Nargess Afzali

    2013-01-01

    Full Text Available Background: Genital tuberculosis is a chorionic disease and mostly occurs by haematogenous spread from extra genital source like lungs, peritoneum, lymph nodes and bones. Transmission through a sexual intercourse is also possible. Since the majority of patients are in reproductive ages, involvement of fallopian tubes and endometrium cause infertility in patients. Cases: Reviewing 4 cases of female genital tuberculosis, which referred to an infertility treatment center with various symptoms, we encountered various appearances on hysterosalpingography (HSG. Conclusion: The genitourinary tract is the most common site of extra pulmonary TB. The primary focus of genital tuberculosis is fallopian tubes, which are almost always affected bilaterally but not symmetrically. Because of common involvement of fallopian tubes and endometrial cavity, disease causes infertility. Diagnosis is not easy because genital tuberculosis has a wide range of clinical and radiological manifestations with slow growing symptoms. Detailed hysterosalpingography finding may be helpful in better diagnosis of the disease. This case series aims to depict the various hystrosalpingographic appearances and pathology produced by tuberculosis and related literatures are reviewed in order to establish a better diagnostic evaluation of genital tuberculosis

  10. CT findings of ganglioglioma. Report of 2 cases

    Energy Technology Data Exchange (ETDEWEB)

    Velasquez, G.R.; Yamazaki, Shingo; Yamaguchi, Takekane (Tokyo Medical and Dental Univ. (Japan). School of Medicine)

    1984-06-01

    The authors report 2 cases of gangliogliomas of the sellar region, one of which was associated with chromophobe adenoma. Case 1. A 14-year-old female was admitted for a visual disturbance. Neurological examination showed bitemporal hemianopsia and secondary optic atrophy. CT scan showed an isodense mass in the suprasellar region, with homogneous enhancement by contrast medium and an accompanying low-density area in the left thalamus adjacent to the enhanced tumor mass. The histological diagnosis of the surgical specimen was ganglioglioma. Case 2. A 52-year-old female was admitted under the diagnosis of pituitary adenoma. Neurological examination showed bitemporal hemianopsia and signs of acromegaly. Plain skull X-ray film showed sellar ballooning and decalcification of the posterior clinoid process. The tumor resected in the first operation was histologically diagnosed as chromophobe adenoma mixed with ganglioglioma. In the follow-up, she showed signs and symptoms of a recurrent tumor, which was revealed to be ganglioglioma without any recurrence of chromophobe adenoma in the subsequent operations. The CT scan before the second operation showed an isodense supraand intrasellar mass with marked enhancement. Ganglioglioma is a rare, benign, nerve-cell tumor, mostly occurring in childhood and adolescence. The CT findings, together with the clinical history, the age of the patient, and the tumor location, may suggest the tentative preoperative diagnosis of ganglioglioma.

  11. Diphyllobothrium latum: A case of an incidental finding

    Institute of Scientific and Technical Information of China (English)

    Simon Lal; A Hillary Steinhart

    2007-01-01

    Colorectal cancer screening can be performed by fecal occult blood testing,sigmoidoscopy,double contrast barium enema or colonoscopy. Colonoscopy has the significant advantage that polyps can be removed during the same procedure. Occasionally,colonoscopy can also reveal unexpected findings,including parasitic infections,even in asymptomatic patients. Tapeworms or cestodes are hermaphroditic parasites,which can live for considerable periods of time in the human gastrointestinal tract. Fish tapeworm (Diphyllobothrium species) are endemic in various parts of the world,the commonest species being Diphyllobothrium latum. Humans are the main definitive host for D. Latum and the majority of individuals harbouring the parasite are asymptomatic,while 40% of infected individuals may have low vitamin B12 levels. We describe a case of D. latum infection found on routine colonoscopic screening for colorectal cancer in an asymptomatic patient,which was successfully treated with praziquantel. The infection likely arose following raw fish (sushi) consumption.

  12. Femoral arteriographic finding in acute ergotism: Report of A Case

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, H. S.; Lee, K. N.; Cha, S. B. [St. Mary' s Hospital, Catholic Medical College, Seoul (Korea, Republic of)

    1971-10-15

    A case of acute ergotism with angiographic demonstration of bilateral femoral artery involvement is reported. A 27-year-old married woman was admitted because of sudden onset of severe pain in both flanks and lower legs, followed by numbness and coldness of the skin on both legs. The attack occurred after the administration of ergot tartrate as postpartum care. Femoral arteriography was performed on 10th day of illness with the Seldinger technic. The femoral arteries were generally smaller in caliber than normal. There was no definite evidence of occlusive disease. Findings were more or less symmetrical and extended to lower legs where only fine branches were visualized. The final diagnosis was diffuse vasospasm due to acute ergotism with secondary occlusion of the arteries of lower leg bilaterally.

  13. MR findings of subacute necrotizing myelopathy: case report

    Energy Technology Data Exchange (ETDEWEB)

    Na, Dong Gyu; Chang, Kee Hyun; Han, Moon Hee; Kim, Hyun Jip; Kim, Chong Jai; Chi, Je G. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1994-04-15

    Subacute necrotizing myelopathy(SNM) is a rare non-tumorous disease of spinal cord characterized by subacute clinical course of progressive neurological deterioration. We report MR findings of a patient with pathologically proved SNM. 1 case of pathologically proved subacute necrotizing myelopathy. The patients was a 56-year-old man with progressive motor weakness and sensory loss of the lower extremities, and urinary and fecal incontinence for 11 months. Spine MRI revealed diffuse enlargement of the thoracic spinal cord from T2 to T7 level. Signal intensity of the expanded spinal cord was isointense relative to normal cord on T1-weighted image and hyperintense on proton-density and T2-weighted images. On contrast enhanced T1-weighted image, there was diffuse homogeneous enhancement in the expanded cord lesion. MR demonstration of stable persistence of spinal cord lesion or atrophy over months or years with clinical findings of gradual progressive neurologic deterioration may be helpful in the diagnosis of SNM.

  14. Clinical Needs Finding: Developing the Virtual Experience, A Case Study

    Science.gov (United States)

    Mittal, Vaishali; Thompson, Megan; Altman, Stuart M; Taylor, Peter; Summers, Alexander; Goodwin, Kelsey; Louie, Angelique Y

    2013-01-01

    We describe an innovative program at the University of California, Davis for students to engage in clinical needs finding. Using a team-based approach, students participated in clinical rotations to observe firsthand the needs of clinicians at the university affiliated medical center. The teams were asked to develop documentary-style videos to capture key experiences that would allow future viewers to use the videos as “virtual” clinical rotations. This was conceived as a strategy to allow students in prohibitively large classes, or students in programs at institutions without associated medical or veterinary school programs, to experience clinical rotations and perform needs assessments. The students' perspectives on the experience as well as instructor analysis of best practices for this type of activity are presented and discussed. We found that the internship experience was valuable to the students participating, by not only introducing the practice of needs finding but for increasing the students' confidence in the practice of engineering design and their ability to work independently. The videos produced were of such high quality that instructors from other institutions have requested copies for instructional use. Virtual clinical rotations through video experiences may provide a reasonable substitute for students who do not have the ability to participate in rotations in person. PMID:23483373

  15. Case-finding for pulmonary tuberculosis in Penang.

    Science.gov (United States)

    Hooi, L N

    1994-09-01

    The process of case-finding was studied in 100 consecutive patients with pulmonary tuberculosis treated by the Chest Clinic, Penang Hospital. The median time from the onset of the illness until the initial medical consultation was two weeks (patient's delay). This delay was longer in males, patients with lower than secondary education and drug abusers. Only 47% of patients were put on treatment with a correct diagnosis within one month of the first consultation (doctor's delay). Almost all patients had at least one symptom suggestive of tuberculosis at presentation and the mean number of consultations before diagnosis was three. Patients who first visited government medical facilities had shorter doctor's delay than those who first saw private practitioners, and patients who first consulted a private practitioner were the least likely to be appropriately investigated by sputum examination and chest radiography. The median total delay was three months and at the time of diagnosis, 95% of patients had moderate or far advanced disease radiologically. In order to shorten doctor's delay, all medical practitioners, especially those in the private sector, should be made aware of the importance of early diagnosis and the proper management of tuberculosis. Health education campaigns for the public should also be undertaken to shorten patient's delay.

  16. Finding Worst-Case Flexible Schedules using Coevolution

    DEFF Research Database (Denmark)

    Jensen, Mikkel Thomas

    2001-01-01

    Finding flexible schedules is important to industry, since in many environments changes such as machine breakdowns or the appearance of new jobs can happen at short notice.......Finding flexible schedules is important to industry, since in many environments changes such as machine breakdowns or the appearance of new jobs can happen at short notice....

  17. Imaging Finding of Multiple Endocrine Neoplasia Type 1: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yum, Tae Jun; Cho, Hee Woo [Dept. of Radiology, Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    2012-08-15

    Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant inherited syndrome with characteristic clinical and radiological manifestations. Many reports on MEN1 have been published; however, no cases of radiologically diagnosed MEN1 have been reported. Therefore, we report on a radiologically diagnosed case of MEN1 with clinical symptoms of gastroduodenal ulcer.

  18. Medical imaging findings in Cobb syndrome: two case reports

    Institute of Scientific and Technical Information of China (English)

    WANG Guang-bin; XU Lei; ZHAO Bin; CAI Shi-feng; SHI Hao; LI Hui-hua; QU Lei

    2005-01-01

    @@ Cobb syndrome, also known as cutaneomeningospinal angiomatosis, is a rare clinical entity characterized by the combination of a vascular skin nevus and an angioma in the spinal canal at the same metamere.1 It was first described by Berenbruch in 1890 and did not receive recognition until Cobb's description2 in 1915. Only few documents about this disease had been reported.1 We present two cases here and review the other reported cases.

  19. The rapid evolution of CT findings in pulmonary langerhans cell histiocytosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Tae Wook; Lee, Kyung Soo; Cho, Eun Yoon [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-07-15

    Imaging findings of pulmonary Langerhans cell histiocytosis (PLCH) demonstrate evolving changes over time, and the radiological transitions shown by imaging tools may allow a prediction of histopathological activity in PLCH. However, there are no reports describing how rapidly CT findings change with time. We describe a case of PLCH that showed a rapid evolutional change of the pulmonary lesions in a 48-year-old man, in which the nodular lesions showed cystic changes within two-month follow-up periods on chest CT scans.

  20. CT and pathologic findings of a case of subdural osteoma

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung Eun; Kim, Ji Eun; Yang, Hee Jin [Seoul Municipal Boramae Hospital, Seoul (Korea, Republic of)

    2002-09-01

    A 43-year-old female presented with persistent headache and dizziness which had first occurred two years earlier. The physical and neurological findings at admission were unremarkable, though plain radiography revealed the presence of a dense calcified mass in the left frontal area, and CT showed that a homogeneous high-density nodule was attached to the inner surface of the left frontal skull. The hard bony mass found and excised during surgery was shown at histopathologic examination to be a subdural osteoma. We describe the clinicopathologic findings of this entity and discuss the radiological features which suggest its subdural location.

  1. Head banging persisting during adolescence: A case with polysomnographic findings

    Directory of Open Access Journals (Sweden)

    Ravi Gupta

    2014-01-01

    Full Text Available Head banging is a sleep-related rhythmic movement disorder of unknown etiology. It is common during infancy; however, available literature suggests that prevalence decreases dramatically after childhood. We report the case of a 16-year-old male who presented with head banging. The symptoms were interfering with his functioning and he had been injured because of the same in the past. We are presenting the video-polysomnographic data of the case. Possible differential diagnoses, etiology, and treatment modalities are discussed. The boy was prescribed clonazepam and followed up for 3 months. Parents did not report any episode afterward.

  2. Extracolonic gastrointestinal tract morphologic findings in a case of pseudomembranous collagenous colitis.

    Science.gov (United States)

    Fons, Mark E; Stein, Daniel J; Patel, Anna; Ferrer, Modeson-Samuel; Ammon, Helmut; Mackinnon, Alexander C; Komorowski, Richard A; Yan, Benjamin C

    2013-06-01

    "Pseudomembranous collagenous colitis" is a morphologic variant of collagenous colitis in which active inflammation with pseudomembrane formation is prominent and which has been associated with infectious, toxic, and ischemic etiologies. However, extracolonic morphologic findings in patients with pseudomembranous collagenous colitis have not been previously described. Here, we present a case of a patient with pseudomembranous collagenous colitis with abnormal extracolonic findings. These include gastric antral mucosa with histologic features reminiscent of ischemic injury and reactive gastropathy with intraepithelial lymphocytosis and partial villous atrophy in the duodenal and ileal biopsies. The findings in the small intestinal biopsies resemble those seen in enteric mucosa in patients with conventional collagenous colitis. Our pathologic findings as well as the clinical course of the patient further emphasize the clinical and histologic similarities shared by pseudomembranous collagenous colitis and conventional collagenous colitis.

  3. Radiological findings of congenital lipoid adrenal hyperplasia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Jeong; Shin, Joo Yong; Lee, Hee Jung; Lee, Jin Hee; Sohn, Cheol Ho; Lee, Sung Moon; Kim, Hong; Woo, Seong Ku; Suh, Soo Ji [Keimyung Univ. School of Medicine, Taegu (Korea, Republic of)

    2001-05-01

    Congenital lipoid adrenal hyperplasia (CLAH) is a rare autosomal recessive disorder characterized by the marked accumulation of lipids and cholesterol in the adrenal cortex, and the failure of adrenal steroids to synthesise. We report the ultrasound (US), computed tomographic (CT), and magnetic resonance (MR) imaging findings in a four-day-old female neonate with CLAH.

  4. CT findings in three cases of cystic meningioma

    Energy Technology Data Exchange (ETDEWEB)

    Kusumoto, Kazuhiro; Nishizawa, Teruhiko; Kasamo, Shizuya; Asakura, Tetsuhiko; Mihara, Tadahiro (Kagoshima Univ. (Japan). Faculty of Medicine)

    1983-02-01

    The authors have encountered three cases of cystic meningioma among a total of 46 cases. Case 1. This 16-year-old boy complained of headache, nausea, and vomiting for about 5 months. He also felt double vision. On admission, the subjective complaints were headache, nausea, and vomiting, but there was no objective symptom. In CT scans a well-circumscribed low-density area with a nodule-like iso-density mass at the anterolaterally portion was shown in the left temporal rogion. This iso-density mass was homogenously enhanced in the contrast study. In an operation, approximately 60 ml of xanthochromic fluid was aspirated, and the nodule-like mass was totally removed. The histological diagnosis was meningothelial meningioma with a large cyst. Case 2. This 49-year-old woman had complained of blurred vision for 4 months before her admission. An ophthalmologist discovered a choked disc and referred her to our department. On admission a neurological examination disclosed a bilateral choked disc and disturbed visual acuity in her left eye. In CT scans, the mass, which was located in the right frontotemporal region, was markedly enhanced, and a small low-density lesion was recognized in it. Angiographically, a tumor stain fed by the middle meningeal artery was shown. The pathologic al diagnosis was angioblastic meningioma. Case 3. This 68-year-old woman, who had had several attacks of loss of consciousness within the 3 years before admission, had now complained of nausea and vomiting for one month. On admission, neurological examination disclosed paraparesis and paresthesia of the lt. lower limb. In CT scans an irregular mass contiguous to the falx was enhanced; it was surrounded by a low-density lesion which was considered to continue to the ependymal layer of the lateral ventricle. Multilobular cysts were found, and about 10 ml of xanthochromic fluid was aspirated . The histological diagnosis was angioblastic meningioma.

  5. CASE REPORT: Papillary Adenoma of Kidney- An Incidental Autopsy Finding: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Bhakti D. Deshmukh

    2012-01-01

    Full Text Available Background: Renal papillary adenoma is usually an incidental finding at autopsy with an incidence of 7% to 23%. The frequency of small papillary tumours of kidney increases with age to approximately 40% of the population over the age of 65. These tumours occur morefrequently in scarred kidneys, acquired renal cystic disease and in children with von Hippel-Lindau syndrome. Case history: In this report we describe renal papillary adenoma incidentally detected during autopsies of two elderly males. Gross examination of kidneyshowed two tiny subcapsular yellowish nodules in one case and single nodule with similar morphology in the other. Microscopic examination in both the cases showed a well circumscribed tumour composed of densely packed tubules and papillae lined by small cuboidal to columnar cells with rounded uniform nuclei. However there was no nuclear atypia, mitosis or necrosis.

  6. Clinical findings in two cases of atypical scrapie in sheep: a case report

    Directory of Open Access Journals (Sweden)

    Chaplin Melanie

    2007-02-01

    Full Text Available Abstract Background Atypical scrapie is a recently recognised form of transmissible spongiform encephalopathy of sheep that differs from classical scrapie in its neuropathological and biochemical features. Most cases are detected in apparently healthy sheep and information on the clinical presentation is limited. Case presentation This report describes the clinical findings in two sheep notified as scrapie suspects and confirmed as atypical scrapie cases by immunohistochemistry and Western immunoblotting. Although both sheep displayed signs suggestive of a cerebellar dysfunction there was considerable variation in the individual clinical signs, which were similar to classical scrapie. Conclusion Any sheep presenting with neurological gait deficits should be assessed more closely for other behavioural, neurological and physical signs associated with scrapie and their presence should lead to the suspicion of scrapie.

  7. Cerebellopontine angle lipomas: magnetic resonance imaging findings in two cases

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Rafael S. [Clinica de Diagnostico por Imagem Multi-Imagem, Rio de Janeiro, RJ (Brazil); Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Dept. de Radiologia; Brito, Cecilia Castelo Branco [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Fac. de Medicina; Carvalho, Gustavo A. [Clinica Bambina, Rio de Janeiro, RJ (Brazil). Dept. de Neurocirurgia; Hospital Silvestre, Rio de Janeiro, RJ (Brazil); Domingues, Romeu C. [Clinicas CDPI e Multi-Imagem, Rio de Janeiro RJ (Brazil); Gasparetto, Emerson L. [Clinicas CDPI e Multi-Imagem, Rio de Janeiro RJ (Brazil)

    2009-07-01

    Vestibular schwannomas and meningiomas are the most common lesions of the cerebellopontine angle (CPA), accounting for approximately 85-90% of the tumors seen in this location. Lipomas are rare at this topography, representing about 0.15% of the CPA lesions. These tumors are mal developmental masses that arise from abnormal differentiation of the meninx primitive. Clinically, CPA lipomas can cause slowly progressive neurological symptoms and signs affecting cranial nerves or brain stem. Because these lesions usually are strongly attached to the surrounding structures, any surgical attempts of complete resection can result in neural or vascular damage, reinforcing the importance of the pre-operative imaging diagnosis. Although the CT findings of CPA lipomas can be typical, the magnetic resonance (MR) imaging, especially the fat suppression sequences, had improved the identification of these lesions. We aimed to report two patients with a CPA lipoma, emphasizing the MR imaging findings. (author)

  8. Ultrasonographic findings of epipericardial fat necrosis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Yeong; Hwang, Hye Jeon; Lee, Kwan Seop; Lee, In Jae; Park, Kyoung Ha [Dept. of Internal Medicine, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2016-04-15

    Epipericardial fat necrosis (EFN) is an infrequent cause of acute chest pain. In rare cases like these, conservative treatment is necessary. Clinically, EFN may mimic emergent cardiopulmonary conditions, such as acute myocardial infarction. Computed tomography (CT) and magnetic resonance imaging characteristics of EFN is well described as encapsulated fatty lesion with perilesional soft tissue strands and thickening of adjacent pericardium in the epipericardial area. For confirmation of the diagnosis, involution of this lesion on follow-up is important. We present a case of EFN observed with ultrasonography (USG). This lesion was shown as a well-defined ovoid shaped mass with heterogeneous echogenicity in the left side of cardiophrenic space on USG. There was no color flow on Doppler USG. Follow-up USG and CT revealed decrease in the size of the lesion.

  9. Diphyllobothrium latum: A case of an incidental finding

    OpenAIRE

    Lal , Simon; Steinhart, A Hillary

    2007-01-01

    Colorectal cancer screening can be performed by fecal occult blood testing, sigmoidoscopy, double contrast barium enema or colonoscopy. Colonoscopy has the significant advantage that polyps can be removed during the same procedure. Occasionally, colonoscopy can also reveal unexpected findings, including parasitic infections, even in asymptomatic patients. Tapeworms or cestodes are hermaphroditic parasites, which can live for considerable periods of time in the human gastrointestinal tract. Fi...

  10. Electrocardiographic findings of carbon monoxide intoxication; two cases

    Directory of Open Access Journals (Sweden)

    Ü. Kaldirim

    2013-12-01

    Discussion and Conclusion: Although there is no classic ”carbon monoxide” ECG pattern, sinus tachycardia and ST-T depressions are the most common ECG findings. Even a small amount of exposure to CO can cause myocardial infarction, especially in patients with coronary artery disease. Patients admitting to ED with chest pain and ECG changes may be considered as a possible CO poisoning and patients with CO poisoning must be carefully evaluated for cardiovascular disease.

  11. Prevalence of radiological findings among cases of severe secondary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Paulo Gustavo Sampaio Lacativa

    Full Text Available CONTEXT AND OBJECTIVE: Patients with end stage renal disease (ESRD and secondary hyperparathyroidism (HPT2 are prone to develop heterotopic calcifications and severe bone disease. Determination of the sites most commonly affected would decrease costs and patients' exposure to X-ray radiation. The aim here was to determine which skeletal sites produce most radiographic findings, in order to evaluate hemodialysis patients with HPT2, and to describe the most prevalent radiographic findings. DESIGN AND SETTING: This study was cross-sectional, conducted in one center, the Hospital Universitário Clementino Fraga Filho (HUCFF, in Rio de Janeiro, Brazil. METHODS: Whole-body radiographs were obtained from 73 chronic hemodialysis patients with indications for parathyroidectomy due to severe HPT2. The regions studied were the skull, hands, wrists, clavicles, thoracic and lumbar column, long bones and pelvis. All the radiographs were analyzed by the same two radiologists, with great experience in bone disease interpretation. RESULTS: The most common abnormality was subperiosteal bone resorption, mostly at the phalanges and distal clavicles (94% of patients, each. "Rugger jersey spine" sign was found in 27%. Pathological fractures and deformities were seen in 27% and 33%, respectively. Calcifications were presented in 80%, mostly at the forearm fistula (42%, abdominal aorta and lower limb arteries (35% each. Brown tumors were present in 37% of the patients, mostly on the face and lower limbs (9% each. CONCLUSION: The greatest prevalence of bone findings were found on radiographs of the hands, wrists, lateral view of the thoracic and lumbar columns and femurs. The most prevalent findings were bone resorption and ectopic calcifications.

  12. Cheilitis glandularis: Case report with respect to immunohistochemical findings

    Directory of Open Access Journals (Sweden)

    Friedrich, Reinhard E.

    2016-01-01

    Full Text Available Cheilitis glandularis (CG is a rare benign affection of the lip mucosa. The etiology and pathogenesis of CG are unknown. Surgical measures are the leading therapeutic options to treat CG. This case report on a 55-year-old female illustrates the recurrent affection of the lips over several years and local therapy. Furthermore, the study of the resected glands intends to differentiate the lesions with respect to the recently introduced concept of immunoglobulin G4-related diseases.

  13. STURGE WEBER SYNDROME WITH UNUSUAL INTRACRANIAL FINDINGS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Shailendra Kumar

    2014-04-01

    Full Text Available The Sturge-Weber Syndrome, also known as encephalotrigeminal angiomatosis, is a rare vascular neurocutaneous alteration. The main clinical features of this syndrome are facial vascular cutaneous naevus, usually unilateral, which often follows the outline distribution of trigeminal nerve. We hereby are reporting a clinical case of Sturge-Weber Syndrome in a 16 year old female patient who presented with oral, cutaneous and ocular manifestations related to the syndrome.

  14. Radiologic findings of perforated jejunal diverticulitis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Jeong Hwa; Lee, Dong Ho; Kim, Hyoung Jung; Lim, Joo Won; Ko, Young Tae; Park, Yong Koo [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2006-04-15

    We report a case of perforated jejunal diverticulitis in a 68-year-old man with iatrogenic Cushing's syndrome. The patient presented with right upper abdominal pain. Ultrasonography showed a hypoechoic structure connected to a small bowel loop, and subsequent CT examination showed multiple diverticula in proximal jejunal loops with free air trapped within the mesenteric leaf. Segmental resection of the jejunal loop confirmed jejunal diverticulitis with perforation.

  15. Osseous metaplasia in gliosarcoma : an unusual histologic finding : case report

    OpenAIRE

    2014-01-01

    Gliosarcoma (GS) is a malignant neoplasm of the central nervous system that has coexisting glial and mesenchymal components. GSs are rarely related to osseous metaplasia. The authors report a case of GS in a male patient presenting apathy and catatonia. Computed tomography/magnetic resonance imaging showed an expansive process affecting the left frontal lobe. At microscopy, a malignant glioma constituted by highly atypical glial cells intermingled with spindle-shaped cells was identified. The...

  16. Prenatal findings in congenital leukemia: a case report.

    OpenAIRE

    2011-01-01

    We here describe a case of congenital leukemia that ended in intrauterine fetal demise at 30 weeks of gestation. Acute enlargement of the fetal trunk, elevated pulsatility index of the umbilical artery with concomitant decline of pulsatility index of the middle cerebral artery, pleural effusion, and polyhydramnios preceded the fetal death. Diagnosis of congenital myeloid leukemia was suggested by microscopic examination of the placental tissue, revealing immature myeloid precursors filling th...

  17. Karyotypic findings in chronic myeloid leukemia cases undergoing treatment

    OpenAIRE

    Anupam Kaur; Simran Preet Kaur; Amarjit Singh; Jai Rup Singh

    2012-01-01

    Background: Chronic myeloid leukemia (CML) is a clonal myeloproliferative expansion of primitive hematopoietic progenitor cells. Materials and Methods: In the present study, CML samples were collected from various hospitals in Amritsar, Jalandhar and Ludhiana. Results: Chromosomal alterations seen in peripheral blood lymphocytes of these treated and untreated cases of CML were satellite associations, double minutes, random loss, gain of C group chromosomes and presence of marker chr...

  18. Intraspinal primitive neuroectodermal tumor: Imaging findings in six cases

    Energy Technology Data Exchange (ETDEWEB)

    Duan Xiaohui [Department of Radiology, The Second Affiliated Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China); Department of Radiology, Traditional Chinese Medical Hospital of Guangdong Province, No. 111 Dade Road, Guangzhou 510120, Guangdong (China); Ban Xiaohua [Department of Radiology, The Second Affiliated Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China); Liu Bo [Department of Radiology, Traditional Chinese Medical Hospital of Guangdong Province, No. 111 Dade Road, Guangzhou 510120, Guangdong (China); Zhong Xiaomei; Guo Ruomi; Zhang Fang; Liang Biling [Department of Radiology, The Second Affiliated Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China); Shen Jun, E-mail: junshenjun@hotmail.com [Department of Radiology, The Second Affiliated Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China)

    2011-11-15

    Purpose: To retrospectively review CT and MRI findings in a series of six intraspinal primitive neuroectoderal tumors and to find out their radiological features. Methods: CT and MRI of six patients with surgically and pathologically proved intraspinal primitive neuroectoderal tumor were retrospectively reviewed. The tumor location, morphological features, signal intensity, calcification, contrast enhancement characteristics, involvement of paraspinal soft tissues and adjacent bony structures were assessed. Results: Of six patients, four had extradural lesions and two had intradural, extramedullary lesions. Most lesions were well defined and manifested heterogeneous iso- or hypo-intense signal on T1-weighted imaging and hyper-intense signal on T2-weighted imaging and moderate attenuation on CT, and were heterogeneously enhanced after contrast enhancement. The lesion extending through the intervertebral foramen with a large paraspinal soft tissue mass formed was found in four patients and vertebral bone involvement was seen in four patients. Conclusions: Although imaging findings are not specific of intraspinal primitive neuroectoderal tumor, this diagnosis could be suggested when MR imaging depicts an intradural, extramedullary or extradural large well-circumscribed mass which extends out from intervertebral foramen and invades paraspinal soft tissues or vertebral bones in a young patient.

  19. A case of congenital hypothyroidism presented with dysmyelinization findings

    Institute of Scientific and Technical Information of China (English)

    Sevil Ar Yuca; Cahide Ylmaz; Avni Kaya; Lokmanstyol; Ertan Sal; Yasar Cesur; Hseyin Caksen

    2014-01-01

    The central nervous system is one of the most crucial targeted systems of hyphotiroidism where tissues undergo various broad developmental processes such as neuronal and glial cellular differentiation, migration and myelinization.However brain images are mainly normal.In this article we present findings related to a1-year-old girl who has been referred to our outpatient clinic with complaints of slowing of movement and lack of interest.She was diagnosed with hypothyroidism.Her brain magnetic resonance image obtained during diagnosis displayed dysmyelinization.It showed improvement afterNa-L thyroxin therapy during follow up.

  20. Karyotypic findings in chronic myeloid leukemia cases undergoing treatment

    Directory of Open Access Journals (Sweden)

    Anupam Kaur

    2012-01-01

    Full Text Available Background: Chronic myeloid leukemia (CML is a clonal myeloproliferative expansion of primitive hematopoietic progenitor cells. Materials and Methods: In the present study, CML samples were collected from various hospitals in Amritsar, Jalandhar and Ludhiana. Results: Chromosomal alterations seen in peripheral blood lymphocytes of these treated and untreated cases of CML were satellite associations, double minutes, random loss, gain of C group chromosomes and presence of marker chromosome. No aberrations were observed in control samples. Karyotypic abnormalities have also been noted in the Ph-negative cells of some patients in disease remission. Conclusion: This is a novel phenomenon whose prognostic implications require thorough and systematic evaluation.

  1. Anterior Segment Findings in Vitamin A Deficiency: A Case Series

    Science.gov (United States)

    Rubino, Pierangela; Mora, Paolo; Ungaro, Nicola; Gandolfi, Stefano A.; Orsoni, Jelka G.

    2015-01-01

    Vitamin A deficiency is a rare but vision threatening disorder in the developed world, which can lead to blindness for severe keratomalacia with cornea scarring and perforation or night blindness due to impaired dark adaptation. Conversely, the disease is quite common in developing countries, as a consequence of chronic malnutrition. The correct diagnosis and therapy with prompt vitamin A supplementation avoid blindness. We report a series of 3 local cases with different age and causes for vitamin A deficiency. The diagnostic workup, therapy, and prognosis are discussed. PMID:26509090

  2. Prenatal findings in congenital leukemia: a case report.

    Science.gov (United States)

    Sato, Yukiyasu; Izumi, Yukiko; Minegishi, Katsura; Komada, Munekazu; Yamada, Shigehito; Kakui, Kazuyo; Tatsumi, Keiji; Mikami, Yoshiki; Fujiwara, Hiroshi; Konishi, Ikuo

    2011-01-01

    We here describe a case of congenital leukemia that ended in intrauterine fetal demise at 30 weeks of gestation. Acute enlargement of the fetal trunk, elevated pulsatility index of the umbilical artery with concomitant decline of pulsatility index of the middle cerebral artery, pleural effusion, and polyhydramnios preceded the fetal death. Diagnosis of congenital myeloid leukemia was suggested by microscopic examination of the placental tissue, revealing immature myeloid precursors filling the lumina of fetal vessels in the umbilical cord and chorionic villi. Extensive vascular involvement of the placenta by leukemic cells was considered to be a primary cause of the fetal death.

  3. Imaging findings of cerebellopontine angle cistern melanocytoma : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Mi; Choi, Jin Ok; Joo, Myung Jin [Presbyterian Medical Center, Chunju (Korea, Republic of)

    2000-03-01

    Because melanocytes are found throughout the leptomeninges, primary melanotic pigmented tumors such as pigmented meningioma, malignant melanoma, melanoblastosis, and melanocytoma can arise from this region. Melanocytomas have been described in the literature as isodense or hyperdense compared with brain parenchyme, as seen on noncontrast-enhanced CT, and as showing relatively homogeneous enhancement MR imaging demonstrates a high signal on T1-weighted images, and an iso to hypointense signal on T2-weighted images. We report the imaging findings of a melanocytoma that showed hyperdense attenuation on precontrast CT with homogeneous enhancement and hyperintense signal intensity on T1-weighted images and dark signal intensity enhancement on T2-weighted images, and also review the literature. (author)

  4. Hashimoto encephalopathy: a case report with proton MR spectroscopic findings

    Institute of Scientific and Technical Information of China (English)

    SU Tian-hao; JIN Er-hu; HE Wen

    2011-01-01

    A 52-year-old female patient with Hashimoto encephalopathy was admitted to hospital for clinical treatment,and the findings on MR spectroscopy (MRS) and MR imaging (MRI) in the brain were reported.MRS revealed the decreases in N-acetylaspartate (NAA/Cr=1.19) and myo-inositol peaks,and the elevations in lipid,lactate,glutamate/glutamine multiplet and choline (Cho/Cr=1.21) peaks which supported a cerebral inflammatory change,in addition to multifocal hyperintensities on T2WI and fluid-attenuated inversion recovery (FLAIR) images,slight hyperintensities on diffusion weighted imaging (DWI),hypointensities on T1WI.The atrophy of the brain was revealed on follow-up MRI two years later.

  5. Osseous metaplasia in gliosarcoma: an unusual histologic finding. Case report

    Directory of Open Access Journals (Sweden)

    Eduardo Cambruzzi

    2014-04-01

    Full Text Available Gliosarcoma (GS is a malignant neoplasm of the central nervous system that has coexisting glial and mesenchymal components. GSs are rarely related to osseous metaplasia. The authors report a case of GS in a male patient presenting apathy and catatonia. Computed tomography/magnetic resonance imaging showed an expansive process affecting the left frontal lobe. At microscopy, a malignant glioma constituted by highly atypical glial cells intermingled with spindle-shaped cells was identified. The lesion showed areas of necrosis with pseudopalisading formation, focus of osseous metaplasia, and positive immunoexpression of S100, CD99 and vimentin in both elements. Only the sarcomatous component exhibited negative immunoexpression of glial fibrillary acidic protein (GFAP. The diagnosis of GS was then established.

  6. CT findings of primary thyroid lymphoma : report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Ji Yong; Lee, Nam Joon; Seol, Hye Young; Kim, Jung Hyuk [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-03-01

    We describe two cases of primary thyroid lymphoma, involving 64-and 74-year-old women who presented with a rapidly growing palpable mass in the anterior neck. In both patients, plain radiographs of this region revealed tracheal displacement and soft tissue mass, and CT scans demonstrated the presence of a large soft tissue mass with homogeneously low attenuation, predominantly located in the unilateral lobe of the thyroid gland. Within the masses there was no calcification, necrosis, or hemorrhage, though in one patient the trachea was involved posteriorly by the mass Both masses appeared as cold nodules on RI scan, and in both patients, the final diagnosis was diffuse large cell type non-Hodgkin's lymphoma with a background of Hashimoto's thyroiditis.

  7. A case of Wilson's disease with characteristic laparoscopic findings.

    Science.gov (United States)

    Muro, Shin-Ichiro; Yasunaka, Tetsuya; Wada, Nozomu; Morimoto, Yuki; Ikeda, Fusao; Shiraha, Hidenori; Takaki, Akinobu; Noso, Kazuhiro; Iwasaki, Hiroaki; Yamamoto, Kazuhide

    2014-04-01

    A 44-year-old male was pointed out liver function abnormality by medical check-up. Blood examination and computed tomography showed liver cirrhosis. Then, he was referred to our hospital for further examination. After blood test, viral markers revealed previous infection of hepatitis B virus (HBV). We estimated the etiology of his liver disease as previous HBV infection. On laparoscopic examination, his liver surface was nodular with mixed yellowish nodules and ash gray to copper-colored nodules in the diameter of 3-10 mm. There were large regenerative nodules in segments 3 and 4. Large regenerative nodules and irregular steatosis were contradictory to HBV-related liver cirrhosis, so then we supposed Wilson's disease. The amount of copper excretion in the urine was 326.6 μg (>100 μg/24 h). After D-penicillamine administration, urinary copper excretion increased to 2151.5 μg/24 h. Though hepatic copper concentration was 174.5 μg/g wet tissue (>200 μg/g wet tissue), his laboratory data fulfilled the Leipzig diagnostic criteria proposed by EASL. Laparoscopic examination with liver biopsy has advantages to survey many disease-specific findings on liver surface and to obtain adequate liver sample. Laparoscopic examination is one of the effective procedures for diagnosing relatively rare liver disease like Wilson's disease.

  8. Obstetric ultrasonographic findings of Chiari type II: Case report

    Directory of Open Access Journals (Sweden)

    Alptekin Tosun

    2009-01-01

    Full Text Available Chiari malformations divided into 3 groups. Chiari type I malformation is caudal protrusion of cerebellar tonsils. Type II malformation is the most common and associate with meningomyelocele. Type III is a high cervical men-ingoencephalocele and uncommon.Spina bifida, has classified into open and closed forms as skin covered spine lesions. Cranial signs are not ac-companiment on closed type. Open type usually diag-nosed on prenatal period. Typical findings are ventricu-lomegaly, lemon sign (bifrontal indentation, banana sign (Chiari II malformation, obliteration of cisterna magna and small BPD and body measurements according to gestation age. Occipital horns are higher than 10 mm in ventriculomegaly. Choroid plexus are small and looking like tear. Limon sign defines biconcave frontal bones as looking like a lemon. Banana sign and obliteration of cis-terna magna resulted cause of hypoplasia of posterior fossa. Compression of cerebellum causing abnormal lo-calization, although cerebellar tonsils and vermis herni-ated to foramen magnum. Hemispheres are wrapping brain stem and looking like ‘‘C’’ (banana sign. Spinal longitudinal sonogram reveals open spine and skin de-fect, although dilatation on spine canal and increased in-terpedincular distance.

  9. Neuropsychological Findings in Subclinical Hypothyroidism: A Case Report

    Directory of Open Access Journals (Sweden)

    Selma Tural Hesapçıoğlu

    2013-12-01

    Full Text Available There are structural and functional associations between hormone systems and central nervous system. Disturbances of thyroid hormone should cause neuropsychiatric symptoms. It is seen that there might be indistinct brain dysfunction symptoms in patients with euthyroid Hashimato disease. His neuropsychiatric profile assessed by examination and a battery included neuropsychiatric tests. Cancellation Test, Stroop Test TBAG form, Auditory Verbal Learning Test, Bender Gestalt Visual Motor Test and WISC-R tests were carried to patient. Failure in executive functioning and complex attention was determined in patient. In Bender Gestalt Visual Motor Test, perceiving of visual stimulus, visual motor coordination and predicating of perceived stimulus with motor functioning were significantly disordered. WISC-R subtests were also supporting these findings. Thyroid hormones and the problems with thyroid gland may cause some disturbances in neuropsychological profile. It should be helpful to see thyroid functioning tests in patients which referred with neuropsychological symptoms. (Jo­ur­nal of Cur­rent Pe­di­at­rics 2013; 11: 146-9

  10. Case of calcified intracranial tuberculoma presenting unique MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Kinjo, Toshihiko; Mukawa, Jiro; Miyagi, Kouichi; Takara, Eiichi; Mekaru, Susumu; Ishikawa, Yasunari

    1988-05-01

    A 41-year-old male patient was admitted in our Ryukyu University Hospital complaining of parosmia. He had a history of miliary tuberculosis 21 years ago. Neurologically he showed left anosmia and hyperreflexia of the right upper extremity. Plain skull X-P and CT scan revealed a calcified mass, 25 mm in diameter, at the left frontal base. In MRI, the mass showed isointensity using the T/sub 1/ weighted inversion recovery sequence and heterogenously low intensity using the T/sub 2/ weighted spin echo sequence. Surgery was performed by bifrontal craniotomy. Then the tumor was removed totally including two coexisting small tumors. Histologically, they consisted of calcified caseous tissue and thick collagen capsule, suggesting old calcified tuberculomas. Postoperative course was uneventful and did not result in meningitis. Antituberculous therapy of streptmycin, isoniazid and rifapicin was given for 2 weeks, started on the operative day. MRI findings were presented in detail and the guideline of antituberculous therapy to the tuberculoma was discussed.

  11. Doppler findings in chronic ectopic pregnancy: case report.

    Science.gov (United States)

    Abramov, Y; Nadjari, M; Shushan, A; Prus, D; Anteby, S O

    1997-05-01

    Chronic ectopic pregnancy is an uncommon form of tubal pregnancy manifested as a pelvic mass with minimal symptoms and a low or absent titer of human chorionic gonadotropin. For this reason, most of the reported cases have been diagnosed only after explorative laparotomy. The value of Doppler ultrasonography for preoperative diagnosis of this entity has not yet been established. We report on a 36-year-old patient who was admitted for intermittent right lower quadrant abdominal pain of 3 months' duration, and a right adnexal mass found on pelvic examination. On Doppler ultrasonography, a right complex adnexal mass was demonstrated, characterized by extensive external vascularization, aberrant vessels and arteriovenous shunting, but with no internal blood flow. Explorative laparotomy revealed a right tubal mass adherent to the omentum, and covered by numerous enlarged and tortuous blood vessels originating in the omentum. Pathological examination of the mass revealed a chronic ectopic pregnancy. The possible contribution of Doppler-specific characteristics for the diagnosis of chronic ectopic pregnancy is described and discussed.

  12. A case of bowel schitosomiasis not adhering to endoscopic findings

    Institute of Scientific and Technical Information of China (English)

    Manfredi Rizzo; Pasquale Mansueto; Daniela Cabibi; Elisetta Barresi; Kaspar Berneis; Mario Affronti; Gabriele Di Lorenzo; Sergio Vigneri; Giovam Battista Rini

    2005-01-01

    Schistosomiasis is a chronic worm infection caused by a species of trematodes, the Schistosomes. We may distinguish a urinary form from Schistosomes haematobium and an intestinal-hepatosplenic form mainly from Schistosomes mansonicharacterized by nausea, meteorism, abdominal pain, bloody diarrhea,rectal tenesmus, and hepatosplenomegaly. These infections represent a major health issue in Africa,Asia, and South America, but recently S mansoni has increased its prevalence in other countries, such as Europe countries and USA, due to international travelers and immigrants, with several diagnostic and prevention problems. We report a case of a 24-yearold patient without HIV infection, originated from Ghana, admitted for an afebrile dysenteric syndrome.All microbiologic studies were negative and colonoscopy revealed macroscopic lesions suggestive of a bowel inflammatory chronic disease. Since symptoms became worse, a therapy with mesalazine (2 g/d) was started,depending on the results of a bowel biopsy, but without any resolution. The therapy was stopped after 2 wk when the following result was available: a diagnosis of"intestinal schistosomiasis" was done (two Schistosoma eggs were detected in the colonic mucosa) and this was confirmed by the detection of Schistosoma eggs in the feces. Therapy was therefore changed to praziquantel(40 mg/kg, single dose), a specific anti-parasitic agent,with complete recovery. Schistosomiasis shows some peculiar difficulties in terms of differential diagnosis from the bowel inflammatory chronic disease, as the two disorders may show similar colonoscopic patterns.Since this infection has recently increased its prevalence worldwide, it was considered in the differential diagnosis of our patient with gastrointestinal symptoms.

  13. A Classic Case of Subcutaneous Cysticercosis: A Rare Case with Sonological Findings and Review of Literature

    Science.gov (United States)

    Naren Satya, Srinivas M.; Mayilvaganan, Kamala Retnam; Amogh, V.N.; Balakrishna, B.V.; Gautam, Munnangi Satya; Prathyusha, Ivvala Sai

    2016-01-01

    Summary Background Cysticercosis is a parasitic infection caused by the larval stages of the pork tapeworm, Taenia solium. The subcutaneous form of the disease is a relatively rare clinical entity. Despite its rarity, it is imperative for a radiologist to be aware of this subcutaneous form of the disease and its various radiological patterns while evaluating any subcutaneous swelling. In this paper, we aimed to describe a typical case of ‘subcutaneous cysticercosis involving the left anterior chest wall’ with high resolution ultrasound findings. We also discussed the role of other imaging modalities in a case of subcutaneous cysticercosis. To the best of our knowledge, our case is only the second documented case report of sonological evaluation of subcutaneous cysticercosis involving the left anterior chest wall and the first case with high resolution ultrasound images of the lesion. Case Report An 11-year-old male presented with a painless, subcutaneous swelling over the left anterior chest wall for the last 2 months. High resolution ultrasound showed a well-defined, thin-walled, cystic lesion with an eccentric, echogenic focus in the subcutaneous plane. On change of the posture of the patient, this focus showed mobility. The hypoechoic area surrounding this cyst showed significant exudative fluid collection with diffuse, floating echoes and thin, incomplete internal septations. The adjacent soft tissues were thickened and irregular, suggestive of edema. This was followed by an excision biopsy. Histopathological examination revealed cysticercus cellulose parasite with an extensive mixed inflammatory cell infiltrate in the surrounding tissue. The patient was also administered oral antihelminthic therapy. Repeat ultrasound examination at the end of this management regimen showed complete healing with no e/o any remnant or recurrent cystic lesion, abscess or edema in the subcutaneous plane. Conclusions Subcutaneous cysticercosis is a relatively rare form of

  14. Imaging findings of perirenal epithelioid angiomyolipoma mimicking a malignant retroperitoneal tumor: A case report with imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Youn; Woo, Ji Young; Shin, Mi Kyoung; Lee, Yul; Hwang, Ji Young; Kim, Hee Yeong [Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Park, Sung Bae [Dept. of Surgery, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-09-15

    Epithelioid angiomyolipoma (EAML) is an uncommon, variant type of angiomyolipoma with a possibility of metastatic transformation and distant spread. Angiomyolipomas, including epithelioid variant type, are mostly renal in origin. EAML originating from extrarenal location is very rare and imaging findings are not well described. Herein, we reported a very rare case of EAML arising from the perirenal space that mimicked a malignant retroperitoneal tumor, in a 39-year-old female.

  15. Chandra Finds Surprising Black Hole Activity In Galaxy Cluster

    Science.gov (United States)

    2002-09-01

    Scientists at the Carnegie Observatories in Pasadena, California, have uncovered six times the expected number of active, supermassive black holes in a single viewing of a cluster of galaxies, a finding that has profound implications for theories as to how old galaxies fuel the growth of their central black holes. The finding suggests that voracious, central black holes might be as common in old, red galaxies as they are in younger, blue galaxies, a surprise to many astronomers. The team made this discovery with NASA'S Chandra X-ray Observatory. They also used Carnegie's 6.5-meter Walter Baade Telescope at the Las Campanas Observatory in Chile for follow-up optical observations. "This changes our view of galaxy clusters as the retirement homes for old and quiet black holes," said Dr. Paul Martini, lead author on a paper describing the results that appears in the September 10 issue of The Astrophysical Journal Letters. "The question now is, how do these black holes produce bright X-ray sources, similar to what we see from much younger galaxies?" Typical of the black hole phenomenon, the cores of these active galaxies are luminous in X-ray radiation. Yet, they are obscured, and thus essentially undetectable in the radio, infrared and optical wavebands. "X rays can penetrate obscuring gas and dust as easily as they penetrate the soft tissue of the human body to look for broken bones," said co-author Dr. Dan Kelson. "So, with Chandra, we can peer through the dust and we have found that even ancient galaxies with 10-billion-year-old stars can have central black holes still actively pulling in copious amounts of interstellar gas. This activity has simply been hidden from us all this time. This means these galaxies aren't over the hill after all and our theories need to be revised." Scientists say that supermassive black holes -- having the mass of millions to billions of suns squeezed into a region about the size of our Solar System -- are the engines in the cores of

  16. Clinico-pathogenetic findings and management of chondrodystrophic myotonia (Schwartz-Jampel syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Francomano Clair A

    2003-07-01

    Full Text Available Abstract Background Chondrodystrophic myotonia or Schwartz-Jampel syndrome is a rare genetic disorder characterized by myotonia and skeletal dysplasia. It may be progressive in nature. Recently, the gene responsible for Schwartz-Jampel syndrome has been found and the defective protein it encodes leads to abnormal cartilage development and anomalous neuromuscular activity. Case Presentation We report the clinical findings and the management of an 8-year-old boy with this disorder. The molecular findings confirm that the patient is a compound heterozygote with a different splicing mutation in each Perlecan allele. This resulted in a significant reduction in the production of the encoded normal protein. Conclusion We discuss the multi-disciplinary management of Schwartz-Jampel syndrome that will facilitate optimal care and timely intervention of patients with this disorder.

  17. Sterile pyuria as the initial finding in a case with Kawasaki disease

    Directory of Open Access Journals (Sweden)

    Bahar Büyükkaragöz

    2015-09-01

    Full Text Available Kawasaki disease is a multisystemic vasculitis of pediatric age group. Early diagnosis and treatment is crucial as coronary artery aneurysms may develop in 20-25% of untreated cases in the 2nd-3rd weeks of the disease. The most common urinary finding in the active period is sterile pyuria; which is believed to be a sign of a more severe systemic inflammation. In this study, a 3.5 year old boy who admitted with high fever was presented. As he had pyuria and elevated acute phase reactants, antibiotic treatment was started with a pre-diagnosis of acute pyelonephritis. Later, with the persistence of fever, detection of a negative urine culture result and emergence of dermal, mucosal and conjunctival changes, incomplete Kawasaki disease (KD was diagnosed. In conclusion, it should be remembered that prolonged fever with sterile pyuria can be the initial findings in KD; before the emergence of typical lesions.

  18. Hemoperitoneum Caused by Hepatic Necrosis and Rupture Following a Snakebite: a Case Report with Rare CT Findings and Successful Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jae Hong; Yoo, Dong Gon; Choi, Soo Jung; Lee, Jong Hyeog; Park, Man Soo; Kwak, Jin Ho; Jung, Seung Mun; Ryu, Dae Shick [GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2007-12-15

    Snakebites are a relatively common occurrence worldwide and are estimated to affect greater than 2.5 million humans annually, of whom more than 100,000 will die. Imaging manifestations associated with this entity have rarely been described in the scientific literature. We recently obtained a successful clinical outcome after gelatin sponge sheet embolization of the hepatic artery in the case of a snakebite which caused hemoperitoneum associated with hepatic necrosis and rupture. Until now, this type of complication after a snakebite has not been reported in the literature. We report the computed tomographic and angiographic findings in a case of a snakebite resulting in hemoperitoneum caused by hepatic rupture and necrosis with active bleeding. In conclusion, snakebites have complex venomous effects. They may lead to various changes in hemostasis. In our case, snakebite-induced coagulopathy by a Korean viper resulted in hepatic necrosis and rupture with active bleeding. To our knowledge, this is the first published case about CT findings of hepatic necrosis and rupture with active bleeding after a snakebite and should be recognized as a possible complication following snakebites. We report the computed tomographic and angiographic findings in the case of a recently obtained successful clinical outcome after embolization of the hepatic artery in the case of a snakebite causing hemoperitoneum associated with hepatic necrosis and rupture with active bleeding.

  19. Commissioners' Monthly Case Activity Report

    Data.gov (United States)

    Occupational Safety and Health Review Commission — Total cases pending at the beginning of the month, total cases added to the docket during the month, total cases disposed of during the month, and total cases...

  20. Finding influential spreaders from human activity beyond network location

    CERN Document Server

    Min, Byungjoon; Makse, Hernán A

    2015-01-01

    Most centralities proposed for identifying influential spreaders on social networks to either spread a message or to stop an epidemic require the full topological information of the network on which spreading occurs. In practice, however, collecting all connections between agents in social networks can be hardly achieved. As a result, such metrics could be difficult to apply to real social networks. Consequently, a new approach for identifying influential people without the explicit network information is demanded in order to provide an efficient immunization or spreading strategy, in a practical sense. In this study, we seek a possible way for finding influential spreaders by using the social mechanisms of how social connections are formed in real networks. We find that a reliable immunization scheme can be achieved by asking people how they interact with each other. From these surveys we find that the probabilistic tendency to connect to a hub has the strongest predictive power for influential spreaders amo...

  1. Study of combined Laparoscopic and Hystero scopic findings in 100 cases of Infertility

    Directory of Open Access Journals (Sweden)

    Samipa Shah

    2014-07-01

    Full Text Available A total of 100 women underwent combined diagnostic laparoscopy and simultaneous diagnostic hysteroscopy during the period of January 2012 to June 2013. Age ranged from 19 years to 38 years and a mean age was 26.6 years. Abnormal Laparoscopic findings were noted in 77% cases where some form of abnormality found through hysteroscopy in 40% cases. Bilateraltubal patency was demonstrated in 78% cases. Bilateral tubal blockage found in 3% and unilateral tubal occlusion was present in 13% cases. In 2% cases bilateral block with beaded appearance found suggestive of tuberculosis (TB. Of total 100 cases, 10% cases were found to have endometriosis, 12% had polycystic ovarian syndrome (PCOS, dermoid cyst found in 5% cases, chocolate cyst found in 4% cases and 10% had functional cyst of ovary. Pelvic adhesions were found in 25% patients. Myomas were found in 8% cases - 2% found on laparoscopy and 6% at hysteroscopy. Endometrial polyps wererevealed in 5% and Asherman’s syndrome in 4% patients on diagnostic hysteroscopy. Combined laparoscopy and hysteroscopy was diagnostic in 27% of cases, 50% were diagnosed through laparoscopy alone, 13% through hysteroscopy alone while in 10% cases findings were normal. In our study, tubo-peritoneal factors were responsible for infertility in 38% cases, ovarian factors in 31% cases and PCOS in 12% cases.

  2. Finding Influential Spreaders from Human Activity beyond Network Location.

    Directory of Open Access Journals (Sweden)

    Byungjoon Min

    Full Text Available Most centralities proposed for identifying influential spreaders on social networks to either spread a message or to stop an epidemic require the full topological information of the network on which spreading occurs. In practice, however, collecting all connections between agents in social networks can be hardly achieved. As a result, such metrics could be difficult to apply to real social networks. Consequently, a new approach for identifying influential people without the explicit network information is demanded in order to provide an efficient immunization or spreading strategy, in a practical sense. In this study, we seek a possible way for finding influential spreaders by using the social mechanisms of how social connections are formed in real networks. We find that a reliable immunization scheme can be achieved by asking people how they interact with each other. From these surveys we find that the probabilistic tendency to connect to a hub has the strongest predictive power for influential spreaders among tested social mechanisms. Our observation also suggests that people who connect different communities is more likely to be an influential spreader when a network has a strong modular structure. Our finding implies that not only the effect of network location but also the behavior of individuals is important to design optimal immunization or spreading schemes.

  3. Chronic pancreatitis in dogs: a retrospective study of clinical, clinicopathological, and histopathological findings in 61 cases.

    Science.gov (United States)

    Bostrom, Brier M; Xenoulis, Panagiotis G; Newman, Shelley J; Pool, Roy R; Fosgate, Geoffrey T; Steiner, Jörg M

    2013-01-01

    The objective of this study was to characterize the clinical, clinicopathological, and histopathological findings of dogs with chronic pancreatitis. The necropsy database at Texas A&M University was searched for reports of dogs with histological evidence of chronic pancreatitis defined as irreversible histologic changes of the pancreas (i.e. fibrosis or atrophy). A reference necropsy population of 100 randomly selected dogs was used for signalment and concurrent disease comparisons. Cases were categorized as clinical or incidental chronic pancreatitis based on the presence of vomiting, decreased appetite, or both vs. neither of these signs. All archived pancreas samples were scored histologically using a published scoring system. Sixty-one dogs with chronic pancreatitis were included. The most frequent clinical signs were lethargy, decreased appetite, vomiting, and diarrhea. Compared to the reference necropsy population, chronic pancreatitis cases were more likely to be older, neutered, of the non-sporting/toy breed group, and to have concurrent endocrine, hepatobiliary, or neurological disease. Clinical cases had significantly higher histological scores for pancreatic necrosis and peripancreatic fat necrosis, and were significantly more likely to have hepatobiliary or endocrine disease as well as increased liver enzyme activities, or elevated cholesterol and bilirubin concentrations. In conclusion, clinical disease resulting from chronic pancreatitis might be related to the presence of pancreatic necrosis and pancreatic fat necrosis. The signalment, presentation, and concurrent diseases of dogs with chronic pancreatitis are similar to those previously reported for dogs with acute pancreatitis.

  4. CBP Active Dumping and Active Countervailing (AD/CVD) Cases

    Data.gov (United States)

    Department of Homeland Security — The datasets provide information from CBP's reference files on active anti-dumping and active countervailing cases. This data includes associated case numbers (if...

  5. Ultrasonographic findings of aspergillus bursitis in a patient with a renal transplantation: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byeong Seong; Yang, Myeon Jun; Kim, Young Min; Youm, Yoon Seok; Choi, Seong Hoon; Park, Sung Bin; Jeong, Ae Kyung [University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan (Korea, Republic of)

    2008-04-15

    Aspergillus bursitis is an uncommon condition demonstrated as a nonspecific soft tissue mass. To our knowledge, the ultrasonographic findings of aspergillus bursitis in immunocompromised patients have not been previously reported. Here, we report a case of aspergillus bursitis in a renal transplant recipient, accompanied by the associated ultrasonographic findings.

  6. Classifications,symptoms and imaging findings of 195 cases confirmed by biopsy or postoperative pathology

    Institute of Scientific and Technical Information of China (English)

    董秦雯

    2014-01-01

    Objective To summarize and analyze the classifications,symptoms,imaging findings of the cerebral space occupying lesions which confirmed by biopsy or postoperative pathology.Methods The classifications,symptoms,imaging findings of 195 cases who visited the Neurology Department of Naval General Hospital were analyzed by retrospective study.Results Classifications:among the 86 neoplastic lesions(NL),there were 49

  7. Imaging findings of intragastric gallstone and bouveret's syndrome : case report

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seong Youb; Seong, Hun; Park, Jong Yeon; Seo, Chang Hye; Jang, Kyung Jae; Cho, Seong Rak [Department of Radiology, Dae Dong Hospital, Pusan (Korea, Republic of)

    2000-01-01

    Gallstone ileus is a well-known complication of cholelithiasis, but is relatively rare. Most ectopic gallstones are located in the small bowel; they are rarely found in the stomach and duodenum. We describe the imaging findings of a case of intragastric gallstone, as well as a case in which duodenal obstruction was caused by a large gallstone (Bouveret's syndrome). (author)

  8. Imaging findings of desmoplastic fibroma rarely involoving the clavicle: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Dong Min; Juhng, Seon Kwan; Sohn, Young Jun; Kim, Hun Soo [Wonkwang University School of Medicine and Hospital, Iksan (Korea, Republic of)

    2014-02-15

    Desmoplastic fibroma of bone is a rare locally aggressive, but non-metastatic tumor. In this case report, we present a desmoplastic fibroma in an unusual location, the clavicle. Desmoplastic fibroma involving the clavicle is extremely rare, with only 2 reported cases before 1985. We report the imaging findings of a desmoplastic fibroma of the clavicle with a review of the relevant literature.

  9. Interpreting a genetic case-control finding: What can be said, what cannot be said and implications in Indian populations

    Directory of Open Access Journals (Sweden)

    Ghosh Saurabh

    2007-01-01

    Full Text Available Identification of genetic variants responsible for complex disorders using association mapping is an active area of research. There are two broad classes of association methodologies: population-based case-control studies and family-based transmission analyses. While case-control analyses are more popular and in general, more powerful than family-based analyses, they suffer from some inherent limitations. Thus, it is of importance, to understand the implications of an association finding obtained from a case-control study design. This article discusses the relative advantages and disadvantages of the two classes of association analyses, particularly in the context of genetic diversity in Indian populations.

  10. Ganglioneuroblastoma of the Hypothalamus: Radiologic and Pathological Findings of a Case

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Young Jun; Jeon, Se Jeong; Choi, See Sung [Wonkwang University Hospital, Iksan (Korea, Republic of)

    2009-03-15

    Ganglion cell tumors of the central nervous system (CNS) are uncommon. There have been few reports in the literature about ganglion cell tumors that arise from the spinal cord, pineal gland, cerebral hemisphere or cerebellum. We recently experienced a case of ganglioneuroblastoma that developed from the hypothalamus in 4-year-old boy. To the best of our knowledge, this is the first reported case of ganglioneuroblastoma in the hypothalamus. We report on this case and we present the neuroimaging and pathologic findings

  11. A Putative Case of Methotrexate-Related Lymphoma: Clinical Course and PET/CT Findings

    OpenAIRE

    Rachel C. Jankowitz; James Ganon; Todd Blodgett; Christine Garcia; Samuel Jacobs

    2009-01-01

    Patients with autoimmune conditions develop lymphoproliferative disorders (LPDs) at a higher frequency than normal both in association with and independent of Methotrexate (MTX). We describe a case of MTX-associated lymphoma in a patient with psoriasis on long-standing MTX. The case is notable for the initial tumor burden, the dramatic disappearance of the PET-CT findings on discontinuation of MTX, and the subsequent early regrowth of disease. Our case report is illustrative of an MTX-related...

  12. MRI findings of type II sacral agenesis: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang A; Kim, Myung Soon; Kwon, Woo Cheol [Dept. of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju (Korea, Republic of)

    2016-07-15

    Sacral agenesis (or caudal regression syndrome) is a rare congenital anomaly involving various levels of coccygeal, sacral, and even lumbar or lower thoracic vertebral dysgenesis, as well as spinal cord abnormalities. A few cases have been previously reported in Korea, especially based upon MRI findings. We describe a case of a 4-year-old girl with partially bilateral agenesis of the sacrum (type II), and club-shaped (chisel-shaped) spinal cord disruption. We also review MRI findings of sacral agenesis, focused on classification and radiological findings.

  13. Respiratory bronchiolitis: radiographic and CT findings in a pathologically proven case

    Energy Technology Data Exchange (ETDEWEB)

    Essadki, O.; Chartrand-Lefebvre, C.; Grenier, P. [Department of Radiology, Pitie-Salpetrire Hospital, Paris (France); Briere, J. [Department of Pathology, Laennec Hospital, Paris (France)

    1998-12-01

    A small number of cases of cigarette-smoking-associated respiratory bronchiolitis (RB) with positive findings on the chest radiograph have been reported in the literature. High-resolution computed tomography (HRCT) findings are available in even fewer cases. We describe the case of an asymptomatic female smoker presenting with a reticulomicronodular infiltrate on a routine chest radiograph. High-resolution CT was characterized by ground-glass opacities and centrilobular micronodules with an upper lobe predominance. Surgical biopsy revealed peribronchiolar lesions, with accumulation of brown pigmented macrophages in the lumen of alveolar and bronchiolar lumen, consistent with the pathologic diagnosis of RB. (orig.) With 3 figs., 12 refs.

  14. An unusual autopsy case of cytokine storm-derived influenza-associated encephalopathy without typical histopathological findings: autopsy case report.

    Science.gov (United States)

    Nara, Akina; Nagai, Hisashi; Yamaguchi, Rutsuko; Yoshida, Ken-ichi; Iwase, Hirotaro; Mizuguchi, Masashi

    2015-03-01

    Cytokine storm-derived influenza-associated encephalopathy is a severe complication, affecting not only the brain but also multiple systemic organs including the heart and lungs. Hundreds of Japanese children are afflicted by influenza-associated encephalopathy every year. Influenza-associated encephalopathy can be diagnosed by pathological changes, such as advanced brain edema and disruption of astrocytic projections, which is known as clasmatodendrosis. In the present case, despite the absence of significant histopathological findings in the brain, the diagnosis of influenza-associated encephalopathy was made on the basis of autopsy findings such as brain swelling, pathological findings including diffuse alveolar damage, and increase in the concentrations of interleukin-6 in both the serum and cerebrospinal fluid. In this case, the interval from high fever to death was approximately 7 hours and may have been too short for histopathological features to develop. This is an unusual autopsy case of cytokine storm-derived influenza-associated encephalopathy without typical histopathological findings.

  15. Implementation and effect of intensified case finding on diagnosis of tuberculosis in a large urban HIV clinic in Uganda : a retrospective cohort study

    NARCIS (Netherlands)

    Hermans, Sabine; Nasuuna, Esther; van Leth, Frank; Byhoff, Elena; Schwarz, Miriam; Hoepelman, Andy; Lange, Joep; Manabe, Yukari C.

    2012-01-01

    Background: Increased detection of tuberculosis (TB) using intensified or active case finding (ICF) is one of the cornerstones of the Stop TB Strategy, and contrasts with passive case finding (PCF) which relies on self-reported symptoms. There is no clear guidance on implementation strategies. We im

  16. FDG-PET Findings of Intraductal Oncocytic Papillary Neoplasms of the Pancreas: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Takashi Kato

    2012-06-01

    Full Text Available Intraductal oncocytic papillary neoplasm (IOPN of the pancreas is a rare pancreatic tumor. To date, there have been three case reports of IOPN which showed strong positivity on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET, raising the possibility of distinguishing IOPNs from other intraductal papillary mucinous neoplasms (IPMNs using FDG-PET. However, all three cases had large tumors, approximately 10 cm in diameter, and there are no case reports of FDG-PET findings of small IOPNs, i.e. tumors the average size of malignant IPMNs (3–5 cm. We report two cases with IOPN of average size with FDG-PET findings. Computed tomography (CT showed a multilocular cystic lesion 4 cm in diameter with a mural nodule 1 cm in diameter (case 1 and a cystic lesion 5 cm in diameter with a papillary mural nodule 4 cm in diameter (case 2. FDG-PET showed abnormal uptake at the same location as the pancreatic tumor revealed by CT in both cases. The maximum standardized uptake values of the lesions were 3.4 and 4.2, respectively. Surgical resection was performed and the tumor was diagnosed as IOPN with carcinoma in situ (case 1 and IOPN with minimal invasion (case 2. FDG-PET may be useful for diagnosing malignancy in IOPN, as it is in IPMN. However, in our two cases, strong accumulation was not observed in the IOPNs, which were within the average size range of malignant IPMNs.

  17. Clinical and arthroscopic findings in recreationally active patients

    Directory of Open Access Journals (Sweden)

    Fowler Elizabeth M

    2010-01-01

    Full Text Available Abstract Objective To examine the diagnostic accuracy of standard clinical tests for the shoulder in recreational athletes with activity related pain. Design Cohort study with index test of clinical examination and reference standard of arthroscopy. Setting Sports Medicine clinic in Sheffield, U.K. Participants 101 recreational athletes (82 male, 19 female; mean age 40.8 ± 14.6 years over a six year period. Interventions Bilateral evaluation of movements of the shoulder followed by standardized shoulder tests, formulation of clinical diagnosis and shoulder arthroscopy conducted by the same surgeon. Main Outcome Measurements Sensitivity, specificity, likelihood ratio for a positive test and over-all accuracy of clinical examination was examined retrospectively and compared with arthroscopy. Results Isolated pathology was rare, most patients (72% having more than one injury recorded. O'Brien's clinical test had a mediocre sensitivity (64% and over-all accuracy (54% for diagnosing SLAP lesions. Hawkins test and Jobe's test had the highest but still not impressive over-all accuracy (67% and sensitivity (67% for rotator cuff pathology respectively. External and internal impingement tests showed similar levels of accuracy. When a positive test was observed in one of a combination of shoulder tests used for diagnosing SLAP lesions or rotator cuff disease, sensitivity increased substantially whilst specificity decreased. Conclusions The diagnostic accuracy of isolated standard shoulder tests in recreational athletes was over-all very poor, potentially due to the majority of athletes (71% having concomitant shoulder injuries. Most likely, this means that many of these injuries are missed in general practice and treatment is therefore delayed. Clinical examination of the shoulder should involve a combination of clinical tests in order to identify likely intra articular pathology which may warrant referral to specialist for surgery.

  18. Brachialis periosteal avulsion injury: case report with magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Lam, Justin Chak Yiu; Lee, Ka Lok Ryan; Griffith, James F. [Prince of Wales Hospital, Department of Imaging and Interventional Radiology, Shatin, N.T (China)

    2016-11-15

    Brachialis periosteal avulsion injury is an uncommon injury occurring in young children. The injury may be misinterpreted or overlooked because of misleading or subtle radiological findings. A case of 7-year-old child with post-traumatic elbow pain and subtle findings on elbow radiography is presented. The injury was initially misinterpreted as an avulsion fracture of the medial epicondyle. Following radiological review, a diagnosis of brachialis periosteal avulsion injury was made. The radiographic and magnetic resonance imaging (MRI) findings of this injury are presented to stress the value of comparing the radiographic findings with previous imaging and to increase awareness of this uncommon injury. (orig.)

  19. Benchmarking Alumni Relations in Community Colleges: Findings from a 2015 CASE Survey. CASE White Paper

    Science.gov (United States)

    Paradise, Andrew

    2016-01-01

    Building on the inaugural survey conducted three years prior, the 2015 CASE Community College Alumni Relations survey collected additional insightful data on staffing, structure, communications, engagement, and fundraising. This white paper features key data on alumni relations programs at community colleges across the United States. The paper…

  20. Benchmarking Alumni Relations in Community Colleges: Findings from a 2012 CASE Survey. CASE White Paper

    Science.gov (United States)

    Paradise, Andrew; Heaton, Paul

    2013-01-01

    In 2011, CASE founded the Center for Community College Advancement to provide training and resources to help community colleges build and sustain effective fundraising, alumni relations and communications and marketing programs. This white paper summarizes the results of a groundbreaking survey on alumni relations programs at community colleges…

  1. A Rare Case of Invasive Apocrine Carcinoma of the Breast with Unusual Radiologic Findings

    Directory of Open Access Journals (Sweden)

    Min Kim

    2016-05-01

    Full Text Available Invasive apocrine carcinoma (IAC of the breast is a rare subtype of breast malignancy. Its incidence is not well known, but it is approximately less than 1% to 4%. For these reasons, there are few reports and little information on the radiologic appearance of IAC. Furthermore, most of the case reports show malignant features which are similar to invasive ductal carcinoma (IDC. We present a rare case of IAC without typical malignant feature on mammography, and ultrasonography (USG. Imaging findings on computed tomography (CT, magnetic resonance imaging (MRI, and 18F-fluorodeoxyglucose (FDG positron emission tomography (PET/CT are also presented. The nodule in our case showed a relatively benign feature on USG and it is the first case of IAC with unusual findings. Therefore, this report may encourage radiologists to consider the malignant potential and perform pathologic correlation even if a newly developed nodule does not present with a typical malignant feature on USG.

  2. Pneumoperitoneum diagnosed as an incidental finding using focus assessed transthoracic echocardiography: a case report

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg

    2010-01-01

    Introduction In this case report we describe how pneumoperitoneum was diagnosed in a patient admitted with acute chest pain, as an incidental finding using focus assessed transthoracic echocardiography (FATE). Case report A 79-year-old male smoker with arterial hypertension was admitted to a coro......Introduction In this case report we describe how pneumoperitoneum was diagnosed in a patient admitted with acute chest pain, as an incidental finding using focus assessed transthoracic echocardiography (FATE). Case report A 79-year-old male smoker with arterial hypertension was admitted...... to a coronary unit with a sudden onset of constant left sided thoracic pain. At position 1 (subcostal) of the FATE protocol, the heart and liver could not be visualised. Instead the peritoneum could be seen as a hyperechoic stripe, corresponding horizontal reverberation artefacts was visible under...... in extracardial diseases can directly ensure the patients a quicker diagnosis and treatment....

  3. Consolidating findings from business process change case studies using system dynamics: The example of employee morale

    Directory of Open Access Journals (Sweden)

    Zuzana Kristekova

    2012-12-01

    Full Text Available In this paper, we explore system dynamics as a useful approach to consolidate findings from case studies on business process change (BPC projects. We compile data from 65 BPC case studies to develop a system dynamics simulation model that helps us to investigate ‘employee morale’ as an important construct in BPC projects. We show that such simulation models consolidate the complex and often non-linear findings from BPC case studies in a way that makes it available to discourse among researchers, lecturers and students as well as BPC professionals. Thus, this paper contributes to knowledge management and learning by suggesting system dynamics as a valuable approach to illustrate and convey the complex relationships between important constructs in BPC. This paper also contributes to the domain of business process management by demonstrating the benefits of system dynamics as a way to review and consolidate the abundance of BPC case studies.

  4. A Case of Bell's Palsy with an Incidental Finding of a Cerebellopontine Angle Lipoma.

    Science.gov (United States)

    Lagman, Carlito; Choy, Winward; Lee, Seung J; Chung, Lawrance K; Bui, Timothy T; Yang, Isaac; Goldman, Howard W

    2016-08-24

    This case report illustrates the potential fallacy of attributing a patient's symptoms to an incidental finding. Serial imaging of small, asymptomatic cerebellopontine angle (CPA) lipomas is favored. It is imperative to accurately diagnose CPA lipoma on imaging and differentiate it from more common CPA lesions. We herein present a patient with symptoms consistent with Bell's palsy and an incidental finding of a CPA lipoma. Additionally, we performed a review of the literature for case reports of patients presenting with facial symptoms and diagnosed with a CPA lipoma.

  5. MR findings of squamous cell carcinoma arising from chronic osteomyelitis of the tibia: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Han, Dong Hwa; Lee, Ji Hae; Cho, Woo Ho; Kim, Jae Hyung; Jeong, Myeong Ja; Kim, Soung Hee; Kim, Ji Young; Kim, Soo Hyun; Kang, Mi Jin; Bae, Kyung Eun [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2016-05-15

    Malignant transformation is a rare and late complication of untreated chronic osteomyelitis. Known radiographic findings of the malignant transformation of chronic osteomyelitis are osteolytic or mixed sclerotic and osteolytic lesions with or without soft tissue mass. But its magnetic resonance (MR) imaging findings are rarely described in the literature. We experienced a case of an 82-year-old man diagnosed with squamous cell carcinoma arising from long standing chronic osteomyelitis of the tibia. Our case indicates that radiologists should consider the possibility of malignant transformation in patients with untreated chronic osteomyelitis, with enhancing soft tissue mass invading and extending through underlying bone cortex and medulla on MR imaging.

  6. Primary melanoma of the breast: A case report with imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Yeom, Yoo Kyung; Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Chae, Eun Young; Choi, Woo Jung; Song, In Hye [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2015-11-15

    Primary breast melanoma is extremely rare, and as such, there are no established radiologic findings in the literature. This report describes a case of primary malignant melanoma with mammography, ultrasonography, and magnetic resonance imaging findings. Our case study demonstrates a well-circumscribed heterogeneous rim-enhancing mass, with an internal cystic or necrotic portion seen using three modalities. Thus, although rare, this condition should be included in the differential diagnosis of a well-demarcated heterogeneous breast mass, and further pathological confirmation is needed.

  7. MR findings of desmoplastic fibroma of the spine. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kong, K.Y.; Kang, H.S.; Jung, H.W.; Kim, J.J.; Lee, C.K. [Seoul National Univ. College of Medicine (Korea, Republic of). Dept. of Radiology

    2000-07-01

    We report on the MR imaging findings in a case of spinal desmoplastic fibroma (DF). DF of the bone is a rare, locally aggressive tumor. It is commonly located in long bones, pelvis or mandible. DF involving the spine is extremely rare and difficult to distinguish from other bony lesions such as giant cell tumor, chordoma and fibrous dysplasia of the spine. This case of DF of the spine showed MR findings similar to those of DF arising in the metaphysis of a long bone.

  8. Magnetic resonance imaging findings in primary lymphoma of the liver: a case report

    Directory of Open Access Journals (Sweden)

    Bilaj Fatmir

    2012-09-01

    Full Text Available Abstract Introduction Primary lymphoma of the liver is an extremely rare finding, with the few such cases reported in the literature to date describing indeterminate imaging findings, being focused more on computed tomography. To the best of our knowledge, there is no prior report describing magnetic resonance imaging scan findings with such a lesion. In the case reported here, magnetic resonance imaging gave us the opportunity to ascertain the correct diagnosis, confirmed by histopathology, thus avoiding unnecessary surgery or other treatments. Although this condition is rare, knowledge of magnetic resonance imaging findings will be invaluable for radiologists and other medical subspecialties that may face such cases in the future in helping to provide adequate management for affected patients. Case presentation A focal lesion was incidentally detected by ultrasound in a 75-year-old asymptomatic Albanian man being treated for benign hypertrophy of prostate. Chest and abdomen computed tomography scans did not reveal any abnormal findings besides a solid focal lesion on the right lobe of the liver and a mild homogenous enlargement of the prostate gland. Subsequently, magnetic resonance imaging of the upper abdomen was performed for better characterization of this lesion. Our patient was free of symptoms and his laboratory test results were normal. Conclusions The magnetic resonance imaging scan results showed some distinctive features that helped us to make the correct diagnosis, and were thus very important in helping us provide the correct treatment for our patient.

  9. A case of dialysis-related amyloidosis of the hip and cervical spine: imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Gyung Kyu; Kang, Ik Won; Min, Seon Jung; Cho, Seong Whi; Kim, Seok Woo; Jang, Woo Young [Hallym University College of Medicine, Chuncheon (Korea, Republic of); Lee, Seon Joo [Inje University College of Medicine, Seoul (Korea, Republic of); Suh, Kyung Jin [Dankook University College of Medicine, Busan Paik Hospital, Busan (Korea, Republic of)

    2006-05-15

    Dialysis-related amyloidosis is a complication of long-term hemodialysis and it is characterized by the accumulation of {beta} 2-microglobulin in the osteoarticular structures. We describe here the imaging findings of a case of dialysis-related amyloidosis involving the hip and cervical spine in a 62-year-old woman who received long-term dialysis. We focus here on the CT and MR imaging findings of the cervical spine and we include a review of the relevant literatures.

  10. US and MRI Findings of Penile Metastasis from Rectal Adenocarcinoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ha Yeun [Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2012-03-15

    Metastatic tumors of the penis originating from the gastrointestinal tract are rare clinical conditions. We experienced a case of penile metastasis in a 59-year-old man who underwent an abdomino-peritoneal resection for a moderately-differentiated adenocarcinoma of the rectum 4 years earlier. We report penile ultrasonography and magnetic resonance imaging findings on this uncommon metastatic penile tumor from a rectal adenocarcinoma and briefly review radiologic findings and relevant literature

  11. Intraventricular tuberculoma. Report of four cases in children. [CT scan findings described

    Energy Technology Data Exchange (ETDEWEB)

    Berthier, M.; Sierra, J.; Leiguarda, R.

    1987-03-01

    Four cases of intraventricular tuberculoma (IVT) in children are here reported. In none of the patients was there clinical evidence pointing to the intraventricular location. CT scan findings comprised three stages of development, namely: immature, mature and old. Ependymal attachment and asymmetric hydrocephalus were present in three cases, meningitis in two and ependymitis in one. Septum pellucidum traction was clearly observed in two patients, strongly supporting an adhesive process characteristic of intraventricular tuberculosis. Following specific treatment, the tuberculomas remitted partially or entirely.

  12. Tuberous sclerosis: Analysis of 24 cases with emphasis on atypical findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ju; Suh, Jung Ho; Joo, Suk Hyun; Chung, Tae Sub [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1990-10-15

    We retrospectively analysed the clinical and CT findings of 24 cases with tuberous sclerosis with special emphasis upon the atypical presentation. The cases with classic clinical triad were accounted for in 21%, while 33% presented with atypical clinical features. The most common and characteristic CT finding is that of the subependymal calcified nodules of the lateral ventricle, which was seen in 85% of our cases. Cortical tuber and white matter lesions were demonstrated in 65% and 55%, respectively. Three cases showed cortical tuber and white matter lesion without subependymal tuber. The cortical tuber usually exhibited low density or calcified lesion, but showed high density in 2 cases. Other findings of tuberous sclerosis included intraventricular tumor, ventriculomegaly, and cortical atrophy. One case clearly demonstrated parenchymal tuber on MR imaging. In conclusion, diagnosis of tuberous sclerosis is usually made on the clinical bases initially. However, CT and MR are also diagnostic even in unusual clinical presentation such as unexplained retardation or epilepsy or when the classic clinical triad is incomplete. If only cortical tuber or white matter lesion is present, it is difficult to diagnose tuberous sclerosis and to differentiate from other cortical mass lesion. Therefore, careful evaluation is required with familiarity with the atypical appearance of the disease.

  13. Epithelioid Myofibroblastoma in an Old-Male Breast: A Case Report with MRI Findings

    Directory of Open Access Journals (Sweden)

    Seyma Yildiz

    2015-01-01

    Full Text Available Myofibroblastoma of the breast (MFB is a very rare benign stromal tumor. In recent years, increase in mammographic screenings has resulted in increased diagnosis of MFB. Most cases are old males and postmenopausal women. MFB may be confused as malignant, clinically, morphologically, or by imaging. Immunohistochemistry is essential for final diagnosis in these cases. We report a case of a pathologically diagnosed MFB in an 80-year-old male patient who had coexisting prostate cancer and describe its imaging characteristics, especially magnetic resonance imaging (MRI. In this paper, histopathological and MRI findings of the MFB were discussed.

  14. A Putative Case of Methotrexate-Related Lymphoma: Clinical Course and PET/CT Findings

    Directory of Open Access Journals (Sweden)

    Rachel C. Jankowitz

    2009-01-01

    Full Text Available Patients with autoimmune conditions develop lymphoproliferative disorders (LPDs at a higher frequency than normal both in association with and independent of Methotrexate (MTX. We describe a case of MTX-associated lymphoma in a patient with psoriasis on long-standing MTX. The case is notable for the initial tumor burden, the dramatic disappearance of the PET-CT findings on discontinuation of MTX, and the subsequent early regrowth of disease. Our case report is illustrative of an MTX-related NHL in an autoimmune patient. Conclusion. Withdrawal of MTX in a patient with lymphoma is reasonable before initiating chemotherapy, but observation for early regrowth of disease is necessary.

  15. A Putative Case of Methotrexate-Related Lymphoma: Clinical Course and PET/CT Findings.

    Science.gov (United States)

    Jankowitz, Rachel C; Ganon, James; Blodgett, Todd; Garcia, Christine; Jacobs, Samuel

    2009-01-01

    Patients with autoimmune conditions develop lymphoproliferative disorders (LPDs) at a higher frequency than normal both in association with and independent of Methotrexate (MTX). We describe a case of MTX-associated lymphoma in a patient with psoriasis on long-standing MTX. The case is notable for the initial tumor burden, the dramatic disappearance of the PET-CT findings on discontinuation of MTX, and the subsequent early regrowth of disease. Our case report is illustrative of an MTX-related NHL in an autoimmune patient. Conclusion. Withdrawal of MTX in a patient with lymphoma is reasonable before initiating chemotherapy, but observation for early regrowth of disease is necessary.

  16. MRI findings of small cell neuroendocrime carcinoma of the uterine cervix: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Won, You Sun; Yi, Boem Ha; Lee, Hae Kyung; Lee, Min Hee; Choi, Seo Youn; Kwak, Jeong Ja [Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2015-10-15

    Small cell neuroendocrine carcinoma of the uterine cervix is a rare primary neoplasm, accounting for less than 5% of all uterine cervical cancers. The tumor is known to have an aggressive behavior and poor prognosis. In this article, we present the MRI findings of 5 cases of pathologically-proven small cell neuroendocrine carcinoma of the uterine cervix, including diffusion-weighted images.

  17. Acute appendicitis in children: ultrasound and CT findings in negative appendectomy cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Ho; Choi, Young Hun; Kim, Woo Sun; Cheon, Jung-Eun; Kim, In-One [Seoul National University Hospital, Department of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    To decrease the negative appendectomy rate in children, knowledge of the misleading imaging findings on US and CT in negative appendicitis cases is important. To evaluate the negative appendectomy rate and describe the imaging findings of US and CT that lead radiologists to misdiagnose acute appendicitis in children. From 2007 to 2013, 374 children operated for suspected appendicitis were proved to either have acute appendicitis (n = 348) or to be negative for appendicitis (n = 26) on pathological reports. Negative appendectomy rates were compared among imaging modalities, age groups and genders. We retrospectively reviewed US and CT findings from negative appendectomy cases. The overall negative appendectomy rate was 7.0% (26/374). There were no statistically significant differences among the subgroups. The most common misleading presentations on US were sonographic tenderness (9/16, 56%) and non-compressibility (9/16, 56%). The most common misleading finding on CT were the presence of an appendicolith or hyperdense feces (5/12, 42%). Periappendiceal fat inflammation was observed in only one case of negative appendicitis on US and on CT. Radiologists can misdiagnose children with equivocal diameters of appendices as having acute appendicitis when sonographic tenderness or non-compressibility is present on US and when an appendicolith or hyperdense feces is noted on CT. The possibility of negative appendicitis should be borne in mind when periappendiceal fat inflammation is absent or minimal in indeterminate cases. (orig.)

  18. Oral findings of hypophosphatemic vitamin D-resistant rickets: report of two cases

    Institute of Scientific and Technical Information of China (English)

    SU Ji-mei; LI Yun; YE Xiao-wei; WU Zhi-fang

    2007-01-01

    @@ Hypophosphatemic vitamin D-resistant rickets or X-linked hypophosphatemia (XLH) is a rare hereditary metabolic disease manifesting marked hypophosphatemia, short stature and rickets. Its prevalence is approximately 1 in 20 000. Except early exfoliation of the teeth, there are a few oral findings of XLH described in China.1,2 Here we present two cases in one family.

  19. An unusual endoscopic finding: Trichuris trichiura. Case report and review of the literature.

    Science.gov (United States)

    Lorenzetti, R; Campo, S M A; Stella, F; Hassan, C; Zullo, A; Morini, S

    2003-11-01

    Detection of Trichuris trichiura during colonoscopic examination is an unusual finding, at least in developed countries. We report a case of a coincidental endoscopic diagnosis of whipworm infestation performed in a patient referred to our open-access endoscopy even before a faecal examination for ova and/or parasites had been performed. Review of literature on colonoscopic diagnosis of T. trichuria is provided.

  20. MR imaging and ultrasonographic findings of tensor fasciae suralis muscle: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keun Ho; Shim, Jae Chan; Lee, Ghi Jai; Lee, Kyoung Eun; Kim, Ho Kyun; Suh, Jung Ho [Dept. of Radiology, Seoul Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2015-10-15

    The tensor fasciae suralis muscle is a very rare anomalous muscle located in the popliteal region. This anatomic variation has been reported often through cadaver studies. However, there are only a few radiologic reports of this entity. We presented a case of tensor fasciae suralis muscle detected as an incidental finding in magnetic resonance imaging and ultrasound.

  1. Cystic Embryonal Sarcoma of the Kidney: Report of a Case with US and CT Findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bong Man; Lee, Jee Young; Lee, Young Seok; Yoo, Dong Soo; Myong, Na He; Lee, Gil Ho; Kim, You Me [Dankook University College of Medicine, Cheonan (Korea, Republic of)

    2010-06-15

    Here we report a case in a 41-year-old woman histologically proven cystic embryonal sarcoma of the kidney, with emphasis on the imaging findings and pathological features. A large lobulated solid mass in the cystically dilated pelvocalyceal region was accompanied with hydroureter as depicted on both ultrasound and contrast-enhanced CT images.

  2. Brain MR finding of {beta}-fluoroethyl acetate rodenticide intoxication: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Young; Jung, Cheol Kyu; Lee, Seung Ro; Park, Dong Woo [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2008-05-15

    {beta}-fluoroethyl acetate rodenticide intoxication can manifest as several different clinical abnormalities such as respiratory, neurologic, cardiologic and fluid-electrolyte problems. We report here on the MR findings of a case that showed symmetric cytotoxic edema in the while matter of the cerebral hemispheres after the ingestion of {beta} - fluoroethyl acetate rodenticide by a woman who was attempting suicide.

  3. Can tuberculosis case finding among health-care seeking adults be improved?

    DEFF Research Database (Denmark)

    Rudolf, F; Haraldsdottir, Thorny Linda; Mendes, M S

    2014-01-01

    SETTING: The Bandim Health Project study area in Bissau, Guinea-Bissau. OBJECTIVE: To assess the potential usefulness of predictors (elsewhere applied) and clinical scores (TBscore and TBscore II) based on signs and symptoms typical of tuberculosis (TB) in case finding. DESIGN: Observational...

  4. Fair and accurate fact-finding in Dutch atrocity crimes cases

    NARCIS (Netherlands)

    Best, G.N.

    2016-01-01

    This dissertation examines the adjustments that Dutch courts have made to the practice of Dutch criminal procedure in order to overcome the evidential limitations of atrocity crimes cases and thereby ensure fairness of proceedings and accurate fact-finding. To this end, this study investigates and a

  5. A Case of Scapulothoracic Dissociation with Brachial Plexus Injury: Magnetic Resonance Imaging Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, G.K.; Suh, K.J.; Choi, J.A.; Oh, O.Y. [Dept. of Radiology, Hallym Univ. College of Medicine, Hangang Sacred Heart Hospital, Seoul (Korea)

    2007-11-15

    Scapulothoracic dissociation is defined as violent lateral or rotational displacement of the shoulder girdle from its thoracic attachments with severe neurovascular injury. We describe the radiographic and associated magnetic resonance (MR) imaging findings of a case of scapulothoracic dissociation with brachial plexus injury in a 17-year-old man, and include a review of the relevant literature.

  6. A case of bleeding gastric lipoma: US, CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Regge, D. [Inst. for Research and Cure of Cancer, Turin (Italy); Lo Bello, G.; Bianchi, G.; Cuomo, G. [Dept. of Radiology, General Hospital of Rivoli, Turin (Italy); Martincich, L. [Dept. of Radiology, Univ. of Turin (Italy); Suriani, R. [Dept. of Gastroenterology, General Hospital of Rivoli, Turin (Italy); Cavuoto, F. [Department of Surgery, General Hospital of Rivoli, I-10060 Turin (Italy)

    1999-03-01

    We report a case of gastric lipoma which manifested with an episode of acute gastrointestinal hemorrhage. Preoperative diagnosis was based on the US, CT, and MRI findings, as the results of gastrointestinal endoscopy were inconclusive. The role of current imaging methods, and particularly of MRI, is discussed. (orig.) With 5 figs., 15 refs.

  7. Fatal tolperisone poisoning: autopsy and toxicology findings in three suicide cases.

    Science.gov (United States)

    Sporkert, Frank; Brunel, Christophe; Augsburger, Marc P; Mangin, Patrice

    2012-02-10

    Tolperisone (Mydocalm) is a centrally acting muscle relaxant with few sedative side effects that is used for the treatment of chronic pain conditions. We describe three cases of suicidal tolperisone poisoning in three healthy young subjects in the years 2006, 2008 and 2009. In all cases, macroscopic and microscopic autopsy findings did not reveal the cause of death. Systematic toxicological analysis (STA) including immunological tests, screening for volatile substances and blood, urine and gastric content screening by GC-MS and HPLC-DAD demonstrated the presence of tolperisone in all cases. In addition to tolperisone, only the analgesics paracetamol (acetaminophen), ibuprofen and naproxen could be detected. The blood ethanol concentrations were all lower than 0.10 g/kg. Tolperisone was extracted by liquid-liquid extraction using n-chlorobutane as the extraction solvent. The quantification was performed by GC-NPD analysis of blood, urine and gastric content. Tolperisone concentrations of 7.0 mg/l, 14 mg/l and 19 mg/l were found in the blood of the deceased. In the absence of other autopsy findings, the deaths in these three cases were finally explained as a result of lethal tolperisone ingestion. To the best of our knowledge, these three cases are the first reported cases of suicidal tolperisone poisonings.

  8. Audio Key Finding: Considerations in System Design and Case Studies on Chopin's 24 Preludes

    Science.gov (United States)

    Chuan, Ching-Hua; Chew, Elaine

    2006-12-01

    We systematically analyze audio key finding to determine factors important to system design, and the selection and evaluation of solutions. First, we present a basic system, fuzzy analysis spiral array center of effect generator algorithm, with three key determination policies: nearest-neighbor (NN), relative distance (RD), and average distance (AD). AD achieved a 79% accuracy rate in an evaluation on 410 classical pieces, more than 8% higher RD and NN. We show why audio key finding sometimes outperforms symbolic key finding. We next propose three extensions to the basic key finding system—the modified spiral array (mSA), fundamental frequency identification (F0), and post-weight balancing (PWB)—to improve performance, with evaluations using Chopin's Preludes (Romantic repertoire was the most challenging). F0 provided the greatest improvement in the first 8 seconds, while mSA gave the best performance after 8 seconds. Case studies examine when all systems were correct, or all incorrect.

  9. Radiological Imaging Findings of a Case with Vertebral Osteoid Osteoma Leading to Brachial Neuralgia

    Directory of Open Access Journals (Sweden)

    Erkan Gokce

    2013-01-01

    Full Text Available Osteoid osteoma is a small, benign osteoblastic tumor consisting of a highly vascularized nidus of connective tissue surrounded by sclerotic bone. Three-quarters of osteoid osteomas are located in the long bones, and only 7-12% in the vertebral column. The classical clinical presentation of spinal osteoid osteoma is that of painful scoliosis. Other clinical features include nerve root irritation and night pain. Osteoid osteoma has characteristic computed tomography (CT findings. Because magnetic resonance imaging (MRI findings of the osteoid osteomas causing intense perinidal edema can be confusing, these patients should be evaluated with clinical findings and other imaging techniques. In this study, we present X-ray, CT, and MRI findings of a case with osteoid osteoma located in thoracic 1 vertebra left lamina and transverse process junction leading to brachial neuralgia symptoms.

  10. Audio Key Finding: Considerations in System Design and Case Studies on Chopin's 24 Preludes

    Directory of Open Access Journals (Sweden)

    Elaine Chew

    2007-01-01

    Full Text Available We systematically analyze audio key finding to determine factors important to system design, and the selection and evaluation of solutions. First, we present a basic system, fuzzy analysis spiral array center of effect generator algorithm, with three key determination policies: nearest-neighbor (NN, relative distance (RD, and average distance (AD. AD achieved a 79% accuracy rate in an evaluation on 410 classical pieces, more than 8% higher RD and NN. We show why audio key finding sometimes outperforms symbolic key finding. We next propose three extensions to the basic key finding system—the modified spiral array (mSA, fundamental frequency identification (F0, and post-weight balancing (PWB—to improve performance, with evaluations using Chopin's Preludes (Romantic repertoire was the most challenging. F0 provided the greatest improvement in the first 8 seconds, while mSA gave the best performance after 8 seconds. Case studies examine when all systems were correct, or all incorrect.

  11. Impact of intensified case-finding strategies on childhood TB case registration in Nepal.

    Science.gov (United States)

    Joshi, B; Chinnakali, P; Shrestha, A; Das, M; Kumar, A M V; Pant, R; Lama, R; Sarraf, R R; Dumre, S P; Harries, A D

    2015-06-21

    Contexte : Sept districts d'intervention avec des stratégies intensifiées de recherche active des cas de tuberculose (TB) mis en œuvre par une organisation non gouvernementale et sept districts témoins gérés par le Programme National Tuberculose au Népal.Objectifs : Evaluer les différences en termes d'enregistrement des cas de TB de l'enfant et de taux d'enregistrement pour 100 000 population entre deux périodes (année 1 = mars 2012 à mars 2013 et année 2 = mars 2013 à mars 2014) dans les districts d'intervention et les districts témoins.Schéma : Revue de dossiers rétrospective grâce aux données recueillies en routine.Résultats : Les cas de TB de l'enfant ont augmenté de 271 à 360 entre l'année 1 et l'année 2 dans les districts d'intervention (le taux d'enregistrement est passé de 18,2 à 24,2/100 000) et de 97 à 113 dans les districts témoins (13,4 à 15,6/100 000) : les augmentations ont été significativement plus importantes dans les districts d'intervention par rapport aux districts témoins. Les augmentations ont également été plus importantes chez les enfants de 0 à 4 ans et chez ceux qui ont eu une TB pulmonaire à frottis négatif et extra-pulmonaire. Parmi diverses stratégies de recherche des cas, le dépistage des contacts familiaux, les services conjoints privés-publics et les camps de santé mobiles pour la TB ont été les plus performants.Conclusion : Un paquet de stratégies intensifiées de recherche des cas a été associé à une augmentation des enregistrements de cas de TB de l'enfant au Népal. Il faut également envisager des approches diagnostiques supplémentaires pour augmenter encore l'enregistrement des cas.

  12. Evaluation of TB Case Finding through Systematic Contact Investigation, Chhattisgarh, India

    Directory of Open Access Journals (Sweden)

    Kshitij Khaparde

    2015-01-01

    Full Text Available Rationale. Contact investigation is an established tool for early case detection of tuberculosis (TB. In India, contact investigation is not often conducted, despite national policy, and the yield of contact investigation is not well described. Objective. To determine the yield of evaluating household contacts of sputum smear-positive TB cases in Rajnandgaon district, Chhattisgarh, India. Methods. Among 14 public health care facilities with sputum smear microscopy services, home visits were conducted to identify household contacts of all registered sputum smear-positive TB cases. We used a standardized protocol to screen for clinical symptoms suggestive of active TB with additional referral for chest radiograph and sputa collection. Results. From December 2010 to May 2011, 1,556 household contacts of 312 sputum smear-positive TB cases were identified, of which 148 (9.5% were symptomatic. Among these, 109 (73.6% were evaluated by sputum examination resulting in 11 cases (10.1% of sputum smear-positive TB and 4 cases (3.6% of smear-negative TB. Household visits contributed additional 63% TB cases compared to passive case detection alone. Conclusion. A standard procedure for conducting household contact investigation identified additional TB cases in the community and offered an opportunity to initiate isoniazid chemoprophylaxis among children.

  13. Building Strong Geoscience Departments: Case Studies and Findings from Six Years of Programming

    Science.gov (United States)

    Iverson, E. A.; Lee, S.; Ormand, C. J.; Feiss, P. G.; Macdonald, H.; Manduca, C. A.; Richardson, R. M.

    2011-12-01

    Begun in 2005, the Building Strong Geoscience Departments project sought to help geoscience departments respond to changes in geosciences research, academic pressures, and the changing face of the geosciences workforce by working as a team, planning strategically, and learning from the experiences of other geoscience departments. Key strategies included becoming more central to their institution's mission and goals; articulating the department's learning goals for students; designing coordinated curricula, co-curricular activities, and assessments to meet these goals; and recruiting students effectively. A series of topical workshops identified effective practices in use in the U.S. and Canada. These practices were documented on the project website and disseminated through a national workshop for teams of faculty, through activities at the AGU Heads and Chairs workshops, and in a visiting workshop program bringing leaders to campuses. The program has now involved over 450 participants from 185 departments. To understand the impact of the program, we engaged in ongoing discussion with five departments of various sizes and institutional types, and facing a variety of immediate challenges. In aggregate they made use of the full spectrum of project offerings. These departments all reported that the project brought an important new perspective to their ability to work as a department: they have a better understanding of how their departments' issues relate to the national scene, have more strategies for making the case for the entire department to college administrators, and are better poised to make use of campus resources including the external review process. These results were consistent with findings from end-of-workshop surveys. Further they developed the ability to work together as a team to address departmental challenges through collective problem solving. As a result of their workshop participation, two of the departments who considered their department to be

  14. First report of MRI findings in a case of an autoamputated wandering calcified ovary

    Directory of Open Access Journals (Sweden)

    Mahajan PS

    2014-03-01

    Full Text Available Parag Suresh Mahajan, Nazeer Ahamad, Sheik Akbar Hussain Department of Radiology, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar Abstract: An autoamputated wandering calcified ovary (AWCO is an extremely rare cause of abdominal calcification in the pediatric population. We present the magnetic resonance imaging (MRI features of AWCO in a child. To our knowledge, the MRI features of AWCO have not been previously described in the published literature. Our case report indicates that the MRI findings are characteristic in the diagnosis of an AWCO and can completely obviate the need for invasive procedures in this mostly benign disease. An AWCO should be considered in all cases of mobile calcific opacities on radiographs in female patients. We advise that MRI be conducted in all suspected cases of AWCO for accurate and noninvasive diagnosis, and regular follow-up should be performed with ultrasound. The findings in our case report have the potential to change the course of investigations and management in suspected cases. Keywords: magnetic resonance imaging, ovary, adnexa, autoamputation, wandering calcification

  15. Unusual computed tomography findings of radionecrosis after chemoradiation of stage IV hypopharyngeal cancer: a case report

    Directory of Open Access Journals (Sweden)

    Baba Yuh

    2011-01-01

    Full Text Available Abstract Introduction Radionecrosis (post-radiotherapy laryngeal submucosal inflammation and necrosis is a complication of (chemo radiotherapy for hypopharyngeal cancer that is difficult to differentiate from tumor recurrence. Case presentation A 67-year-old Japanese man presented with a condition extremely difficult to diagnose differentially as radionecrosis or tumor recurrence after radiotherapy for hypopharyngeal cancer. Although tumor recurrence was suspected from clinical conditions and computed tomography findings, pathologic analysis revealed no evidence of tumor recurrence, and successful therapy with steroids and antibiotics reduced the mucosal edema. Conclusion Our findings emphasize the wide spectrum of radiographic presentation of radionecrosis after chemoradiation of stage IV hypopharyngeal cancer.

  16. Small-bowel Diverticulosis: Imaging Findings and Review of Three Cases

    Directory of Open Access Journals (Sweden)

    B. De Peuter

    2009-01-01

    It may lead to symptoms presenting with an acute onset or to chronic and nonspecific complaints. As the presentation is often similar to other pathologies (acute appendicitis, pancreatitis, or acute cholecystis and in many cases diagnosis is made on basis of surgical findings, careful analysis of the imaging landmarks may be warranted to aid in the early stages of detection. In this report, we present clinical and morphological findings in three patients where small-bowel diverticulitis was surgically proven. The relevant literature is reviewed, and typical imaging properties are discussed.

  17. MR imaging findings of retinal hemorrhage in a case of nonaccidental trauma

    Energy Technology Data Exchange (ETDEWEB)

    Altinok, Deniz; Saleem, Sheena; Smith, Wilbur [Children' s Hospital of Michigan, Department of Pediatric Imaging, Detroit, MI (United States); Zhang, Zaixiang [Wayne State University School of Medicine, Department of Radiology, Detroit, MI (United States); Markman, Lisa [Children' s Hospital of Michigan, Child Protection Team, Detroit, MI (United States)

    2009-03-15

    Retinal hemorrhage is a well-recognized manifestation of child abuse found in many babies with shaken baby syndrome. The presence of retinal hemorrhage is generally associated with more severe neurological damage and a worse clinical outcome. MR imaging findings of retinal hemorrhages are not well described in the pediatric literature. We present a 6-month-old boy with new-onset seizures, subdural hemorrhage and bilateral retinal hemorrhages that were detected by MRI and confirmed by indirect ophthalmoscopy. This case demonstrates the MR imaging findings of retinal hemorrhages and the importance of radiologists being able to recognize these specific imaging features. (orig.)

  18. Radiologic Imaging Findings of Bilateral Infiltrating Pseudoangiomatous Stromal Hyperplasia of the Breasts:A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Go, Hee Sun; Jeh, Su Kyung [Dept. of Radiology, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul (Korea, Republic of)

    2013-04-15

    Pseudoangiomatous stromal hyperplasia (PASH), a rare benign lesion, shows the proliferation of the breast stromal tissue mimicking the low grade angiosarcoma (1-7). The most common mammographic and ultrasound finding of PASH is a circumscribed mass without calcification and it is difficult to distinguish from the phyllodes tumor and fibroadenoma (1-4, 8). Up to our knowledge, PASH presenting as rapid bilateral breast enlargement, as seen in our case, is very rare. In addition, several English medical literature were reported in this kind of manifestation of PASH (3, 4, 8). We described imaging findings of diffuse, infiltrating, and bilateral manifectation of PASH.

  19. CT findings of primary undifferentiated pleomorphic sarcoma in the small bowel: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Youe Ree; Lee, Young Hwan; Yoon, Kwon Ha; Yun, Ki Jung [Wonkwang University School of Medicine and Hospital, Institute of Wonkwang Medical Science, Iksan (Korea, Republic of)

    2015-11-15

    Undifferentiated pleomorphic sarcoma (UPS), previously known as malignant fibrous histiocytoma, is a soft tissue sarcoma arising from mesenchymal tissue of the body. UPS of the gastrointestinal tract is known to be rare and only a few cases have been reported in the literature. Based on our case and review of the other relevant literature, the CT findings of primary UPS of the small bowel included nodular bowel wall thickening with homogeneous enhancement. It presents as a rapidly growing tumor without bowel obstruction, and it may be accompanied by distant metastasis.

  20. An Unusual Case of Ascending Pancreatitis with Mediastinal Involvement: A Case Report with CT and MRI Findings

    Directory of Open Access Journals (Sweden)

    Ernesto Di Cesare

    2014-01-01

    Full Text Available Fluid collections are common findings of pancreatitis and spread, more often, along preferential drainage pathways in the abdomen. In some rare cases, fluid collections may spread towards extra-abdominal sites like the mediastinum leading to the formation of mediastinal collections. We present the case of a 52-years-old man with pain in the right upper quadrant of the abdomen and mid-epigastrium lasting for some hours. Laboratory tests suggested a diagnosis of pancreatitis. CT and subsequent MRI revealed changes consistent with acute exacerbation on chronic pancreatitis spreading to the mediastinum and to the greater omentum. The patient received medical treatment and reported gradual improvement in his laboratory results and CT findings.

  1. MRI findings of the subacute combined degeneration of the spinal cord : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Joo Chang; Cha, Sang Hoon; Lee, Sang Soo; Hun, Bae Il; Han, Gi Seok; Kim, Sung Jin; Park, Kil Sun [College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju (Korea, Republic of)

    2000-05-01

    Subacute combined degeneration (SCD) of the spinal cord is a neurological complication arising from vitamin B{sub 12} deficiency. Typical findings are demyelination and axonal loss of the posterior and lateral columns of the thoracic and cervical spinal cord, leading to sensory ataxia and paresthesia. Clinical and neurological features and MRI findings all contribute to the diagnosis of this entity. In the Korean medical literature, only one case of of SCD involving pre-treatment MRI has been reported. We describe one case of SCD in a post-gastrectomy patient who initially presented with progressive sensory abnormality in both upper and lower extremities and showed T2 hyperintensity in the posterior and lateral columns of the spinal cord; this diminished, with clinical improvement, after vitamin B12 therapy. Our report includes the MR images obtained during follow up. (author)

  2. Imaging findings in a case of Gorlin-Goltz syndrome: a survey using advanced modalities

    Energy Technology Data Exchange (ETDEWEB)

    Bronooh, Pegah [Dental School, Shiraz University of Medical Sciences, Shiraz (Iran, Islamic Republic of); Shakibafar, Ali Reza [TABA Medical Imaging Center, Shiraz (Iran, Islamic Republic of); Houshyar, Maneli; Nafarzade, Shima [Oral Pathology Department, Babol Dental School, Babol (Iran, Islamic Republic of)

    2011-12-15

    Gorlin-Goltz syndrome is an infrequent multi-systemic disease which is characterized by multiple keratocysts in the jaws, calcification of falx cerebri, and basal cell carcinomas. We report a case of Gorlin-Goltz syndrome in a 23-year-old man with emphasis on image findings of keratocyctic odontogenic tumors (KCOTs) on panoramic radiograph, computed tomography, magnetic resonance (MR) imaging, and Ultrasonography (US). In this case, pericoronal lesions were mostly orthokeratinized odontogenic cyst (OOC) concerning the MR and US study, which tended to recur less. The aim of this report was to clarify the characteristic imaging features of the syndrome-related keratocysts that can be used to differentiate KCOT from OOC. Also, our findings suggested that the recurrence rate of KCOTs might be predicted based on their association to teeth.

  3. Imaging findings in a case of Gorlin-Goltz syndrome: a survey using advanced modalities.

    Science.gov (United States)

    Bronoosh, Pegah; Shakibafar, Ali Reza; Houshyar, Maneli; Nafarzade, Shima

    2011-12-01

    Gorlin-Goltz syndrome is an infrequent multi-systemic disease which is characterized by multiple keratocysts in the jaws, calcification of falx cerebri, and basal cell carcinomas. We report a case of Gorlin-Goltz syndrome in a 23-year-old man with emphasis on image findings of keratocyctic odontogenic tumors (KCOTs) on panoramic radiograph, computed tomography, magnetic resonance (MR) imaging, and Ultrasonography (US). In this case, pericoronal lesions were mostly orthokeratinized odontogenic cyst (OOC) concerning the MR and US study, which tended to recur less. The aim of this report was to clarify the characteristic imaging features of the syndrome-related keratocysts that can be used to differentiate KCOT from OOC. Also, our findings suggested that the recurrence rate of KCOTs might be predicted based on their association to teeth.

  4. Parry-Romberg syndrome: findings in advanced magnetic resonance imaging sequences - case report

    Energy Technology Data Exchange (ETDEWEB)

    Paula, Rafael Alfenas de; Ribeiro, Bruno Niemeyer de Freitas, E-mail: alfenas85@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Hospital Universitario Clementino Fraga Filho; Bahia, Paulo Roberto Valle [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Dept. de radiologia; Ribeiro, Renato Niemeyer de Freitas [Hospital de Clinica de Jacarepagua, Rio de Janeiro, RJ (Brazil); Carvalho, Lais Balbi de [Universidade Presidente Antonio Carlos (Unipac), Juiz de Fora, MG (Brazil)

    2014-05-15

    Parry-Romberg syndrome is a rare disease characterized by progressive hemifacial atrophy associated with other systemic changes, including neurological symptoms. Currently, there are few studies exploring the utilization of advanced magnetic resonance sequences in the investigation of this disease. The authors report the case of a 45-year-old patient and describe the findings at structural magnetic resonance imaging and at advanced sequences, correlating them with pathophysiological data. (author)

  5. Ultrasonographic findings of ascaris in the small bowel: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Cheol; Shin, Hyeong Cheol; Kim, Hyung Hwan; Bae, Won Kyung; Kim, Il Young [Cheonan Hospital, Soonchunhyang University college of Medicine, Cheonan (Korea, Republic of); Park, Seong Jin [Bucheon Hospital, Soonchunhyang University college of Medicine, Bucheon (Korea, Republic of); Choi, Jin Soo [Keimyung University college of Medicine, Taegu (Korea, Republic of)

    2003-12-15

    Ascariasis is one of the most common helminthic disease worldwide and evoked variable clinical manifestations by the migration of worm in the alimentary and biliary tract. The ultrasonographic detection of ascaris in the small bowel is relatively difficult, and no report on the ultrasonographic findings have been published in Korea. On abdominal ultrasonography, ascaris is seen as an intraluminal tubular structure with 4 linear echogenic stripes and movement. We report a case of ascaris in the small bowel detected by abdominal ultrasonography.

  6. Factors associated with trace evidence analysis and DNA findings among police reported cases of rape

    OpenAIRE

    Forr, Camilla

    2016-01-01

    Background: The medical examination after rapes has two main goals: to provide high-quality care for the victim and to collect evidence to be used in the crime investigation. Collected samples are sent for forensic analysis upon police request. However, little is known about how the police select cases to be submitted for analysis. Furthermore, few studies report the DNA findings and associated factors. The aim of this study was to examine whether victim-, suspect- and assault characteristics...

  7. Dental findings in Saethre-Chotzen syndrome (acrocephalosyndactyly type III): report of case.

    Science.gov (United States)

    Goho, C

    1998-01-01

    Saethre-Chotzen syndrome is characterized primarily by facial and digital anomalies. This case report describes multiple dental anomalies in a patient with Saethre-Chotzen, not reported in previous descriptions of the syndrome. These features are teeth with broad, bulbous crowns, thin, narrow tapering roots, and diffuse pulp stones in the pulp chambers of all posterior teeth. These dental findings, along with being associated with the syndrome, may influence dental care for these patients.

  8. (18)F-FDG PET/CT findings in a case with HIV (-) Kaposi sarcoma.

    Science.gov (United States)

    Ozdemir, E; Poyraz, N Y; Keskin, M; Kandemir, Z; Turkolmez, S

    2014-01-01

    Although mucocutaneous sites are the most frequently encountered sites of involvement, Kaposi Sarcoma (KS) may also occasionally involve the breast and the skeletal, endocrine, urinary and nervous systems.. Various imaging modalities may be used to delineate the extent of the disease by detecting unexpected sites of involvement. Herein, we report a case of classical type KS, in whom staging with (18)F-FDG PET/CT imaging disclosed widespread disease and unexpected findings of bone and salivary gland involvement.

  9. Dental findings in patients with West syndrome: a report of two cases.

    Science.gov (United States)

    Khatri, Amit; Kalra, Namita; Tyagi, Rishi; Baweja, Mani; Khandelwal, Deepak

    2014-01-01

    West syndrome a rare, severe form of epilepsy occurs in early infancy. It is characterized by a triad consisting of infantile spasms that occurs in clusters, arrest of psychomotor development and hypsarrhythmia on electroencephalogram. We present here two cases of west syndrome where patients required dental care due to the presence of certain dental findings. Preventive measurements such as controlled diet and proper oral hygiene along with professional dental management are recommended in patients with west syndrome to avoid dental problems.

  10. Dental findings in patients with West syndrome: A report of two cases

    OpenAIRE

    Amit Khatri; Namita Kalra; Rishi Tyagi; Mani Baweja; Deepak Khandelwal

    2014-01-01

    West syndrome a rare, severe form of epilepsy occurs in early infancy. It is characterized by a triad consisting of infantile spasms that occurs in clusters, arrest of psychomotor development and hypsarrhythmia on electroencephalogram. We present here two cases of west syndrome where patients required dental care due to the presence of certain dental findings. Preventive measurements such as controlled diet and proper oral hygiene along with professional dental management are recommended in p...

  11. US and mammographic findings of myofibroblastoma in the female breast: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Seog Wan; Jeon, Soo Bin [Chonbuk University Medical College, Jeonju (Korea, Republic of); Lee, Ji Shin [Chonnam University Medicine College, Gwangju (Korea, Republic of); Kim, Dong Sug [Yeungnam University Medicine College, Daegu (Korea, Republic of)

    2005-07-15

    Myofibroblastoma is a rare benign mesenchymal tumor of the breast. It presents as a well circumscribed, solitary nodular mass, and it has been reported to mainly occur in male patients. To our knowledge, few reports have described the radiologic appearance of myofibroblastoma in the female breast and there has been no report from Korea. We describe the mammographic, sonographic and histologic findings of a case of myofibroblastoma that presented as a well defined mass mimicking fibroadenoma in a 44-year-old woman.

  12. Finding information about mental health in microblogging platforms: a Case study of depression

    OpenAIRE

    Wilson, Max L.; Ali, Susan Abubakir; Valstar, Michel F.

    2014-01-01

    Searching for online health information has been well studied in web search, but social media, such as public microblogging services, are well known for different types of tacit information: personal experience and shared information. Finding useful information in public microblogging platforms is an on-going hard problem and so to begin to develop a better model of what health information can be found, Twitter posts using the word “depression” were examined as a case study of a search for a ...

  13. MR imaging findings in subacute combined degeneration of the spinal cord: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki Jun; Lee, Jae Hee; Lee, Sung Yong; Chung, Sung Woo [Our Lady of Mercy Hospital, The Catholic University of Korea, Incheon (Korea, Republic of)

    2000-09-01

    Vitamin B12 deficiency can cause neurologic complications in the spinal cord, brain, and optic and peripheral nerves. Subacute combined degeneration is a rare disease of demyelinating lesions of the spinal cord, affecting mainly the posterior and lateral columns of the thoracic cord. We report the MR imaging findings of a case of subacute combined degeneration of the spinal cord in a patient with vitamin B12 deficiency and mega loblastic anemia. (author)

  14. Radiologic Findings of Influenza A (H1N1) Pneumonia: Report of Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jin Kyoung; Ahn, Myeong Im; Jung, Jung Im; Han, Dae Hee; Park, Seog Hee; Park, Chan Kwon; Kim, Young Kyoon [Seoul St. Mary' s Hospital, Seoul (Korea, Republic of)

    2010-08-15

    Novel influenza A (H1N1) infection is a highly infectious disease, which has been rapidly spreading worldwide since it was first documented in March of 2009 in Mexico. We experienced and report two cases of Influenza A (H1N1) pneumonia, accompanied by chest radiographic and CT findings. The chest radiographs revealed diffuse haziness and extensive airspace consolidation, whereas the CT scans demonstrated multifocal areas of ground glass opacity and airspace consolidation with a CT halo sign.

  15. Tuberculosis case--finding and treatment in the central prison of Qazvin province, Islamic Republic of Iran.

    Science.gov (United States)

    Assefzadeh, M; Barghi, R Gh; Shahidi, Sh S

    2009-01-01

    As a part of a comprehensive programme of tuberculosis (TB) control in the central prison in Qazvin, Islamic Republic of Iran, a programme of active case-finding was carried out from February 2004 to July 2005. From the 768 prisoners examined, 41 (5.3%) were suspected of TB and gave sputum samples. A total of 7 smear-positive TB cases were found, giving a TB prevalence in the prison of 910 per 100,000, 113 times the total TB prevalence in Qazvin province in the same year. From 7 diagnosed and treated patients, 4 were cured with the category 1 standard regimen, 1 completed treatment and 2 failed to complete treatment. Improvements are needed in TB case recognition of prisoners, especially newcomers.

  16. Four cases of solid pseudopapillary tumors of pancreas: Imaging findings and pathological correlations

    Energy Technology Data Exchange (ETDEWEB)

    Vargas-Serrano, Blanca [Servicio de Radiologia, Hospitales Universitarios Virgen del Rocio, Avda Manuel Siurot s/n, Sevilla 41013 (Spain); Dominguez-Ferreras, Esther [Servicio de Radiologia, Hospitales Universitarios Virgen del Rocio, Avda Manuel Siurot s/n, Sevilla 41013 (Spain)]. E-mail: blancavargas@terra.es; Chinchon-Espino, David [Servicio de Anatomia Patologica, Hospitales Universitarios Virgen del Rocio, Avda Manuel Siurot s/n, Sevilla 41013 (Spain)

    2006-04-15

    Objective: Solid pseudopapillary tumor of the pancreas (SPTP tumor) is a rare pancreatic neoplasm with low malignant potential, which usually affects female patients in the second or third decades of life. It is a non-functional, slow-growing neoplasm that very often reaches considerable size before the first symptoms appear. Symptomatology is frequently related to tumor size. Surgical excision is usually curative in most cases. Infrequently the tumor can appear in male patients or in aged women, which can make the diagnosis more difficult. Some patients develop liver metastases in the follow-up that can be resected. Our purpose is to review the radiological and pathological findings of SPTP with emphasis on these infrequent cases. Subjects and methods: The medical records and radiological findings of patients who underwent surgery for SPTP between 2000 and 2005 were retrospectively reviewed. Study eligibility required that patients had undergone surgical resection and that a SPTP had been pathologically proved. Results: Four cases of solid pseudopapillary tumor of the pancreas were diagnosed and treated in our institution in the study period. Two of the patients, developed on follow-up liver metastases, and peritoneal, hepatic, and nodal metastases, respectively. Conclusion: Solid pseudopapillary tumors are well-encapsulated neoplasms that usually have a good prognosis after surgical excision. A malignant behavior is uncommon and in this case lymph node involvement, hepatic metastases and occasionally peritoneal invasion may also occur. Resection of liver metastases can prolong the long-term survival of the patients.

  17. Analyses of the angiographic findings in cases of childhood moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Satoh, S.; Shibuya, H.; Suzuki, S.; Matsushima, Y.

    1988-04-01

    Cerebral angiograms of 34 patients with childhood moyamoya disease have been analysed, this analysis having revealed the following findings. The blood flow to abnormal net-like vessels (ANV) in the base of the brain is mainly supplied from the internal carotid artery (ICA) in the early stage of this disease. In a later stage, however the blood supply is mainly from the posterior cerebral artery (PCA). Though, no remarkable change was found in the volumes of ANV from the early to later stages of the disease, the leptomeningeal collaterals, the most prominent anastomoses in moyamoya disease, had a tendency to decrease during the later stage with the development of PCA stenosis. Eighteen occlusive PCA lesions were found in the proximal portion of the PCA in eight cases (44%), and in the distal in nine cases (50%). The incidence of aneurysm (1.5%) and intracranial bleeding was low as compared to cases of adult moyamoya disease.

  18. A case of overlapping of Sturge Weber syndrome-Klippel Trenaunay syndrome and ophthalmological findings

    Directory of Open Access Journals (Sweden)

    Ersin Aydın

    2016-12-01

    Full Text Available Sturge-Weber syndrome (SWS is a neurocutaneous syndrome characterized by facial port wine stains, vascular lesions in the ipsilateral brain and meninges, and glaucoma. Klippel-Trenaunay syndrome (KTS is a rare congenital malformation associated with cutaneous vascular malformation, bony or soft tissue hypertrophy and venous varicosities in the affected limb. Although some cases have been reported in the literature, an overlap between these two phakomatoses is extremely rare and they have systemic and ocular affects. Here, we present a case showing the properties of both SWS and KTS and having interesting ophthalmological findings. This case is presented to emphasize that eye related complications might also be seen in these syndromes.

  19. CT findings of skull and intracranial metastatic neuroblastoma. Report of 3 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kuroki, M.; Kameyama, S.; Toyama, M.; Watanabe, M; Kurokawa, I. (Nagaoka Red Cross Hospital, Niigata (Japan))

    1982-05-01

    Three cases of neuroblastoma with intracranial metastases were reported. The first case was a 13-year-old girl with sacral neutroblastoma who had metastases to the left parietal bone and dura, and had bilateral intraorbital metastases. The second case was a 13-year-old girl with mediastinal neutroblastoma who had metastases to the dura at the left middle fossa, and had bilateral intraorbital metastases. The third case was a 49-year-old woman with esthesioneuroblastoma which had invaded to the dura at the right middle fossa and the right orbit. CT findings of the brain of these three cases were investigated, and summarized as follows: 1) The intracranial invasions of the metastatic tumors were seen to be slightly high density (EMI-number 25 - 27) in plain scans, and homogeneously enhanced as a well-defined high density mass (EMI-number 35 - 37). 2) The tumors invading the skull were observed as a mass lesion of the bone on osteolytic lesion. 3) The intraorbital metastatic tumors were seated on the orbital wall invading the rectal muscles, but they remained extraconal. It was emphasized that CT could give valuable information for the diagnosis of skull and intracranial metastasis of neutroblastoma.

  20. MR findings in cases of suspected impacted fracture of the femoral neck

    Energy Technology Data Exchange (ETDEWEB)

    Stiris, M.G.; Lilleaas, F.G. [Aker Hospital, Oslo (Norway). Dept. of Diagnostic Radiology

    1997-09-01

    Purpose: To evaluate MR imaging of the hip in patients with a clinically suspected impacted fracture of the femoral neck in cases where conventional plain films show negative or equivocal findings. Material and Methods: Twenty-seven such patients were prospectively examined by MR imaging with a 1.0 T unit, within 24 hours of admittance to hospital. A coronal T1-weighted turbo spin-echo sequence (n=27), and a coronal STIR sequence (n=25) or a coronal T2-weighted turbo spin-echo fast saturation sequence (n=2) were used. The evaluations were made by 2 radiologists with experience in musculoskeletal radiology. Results: There were 6 patients with a petrochanteric fracture, 2 without and 4 with slight displacement. Five patients had an impacted fracture of the femoral neck, and 3 had a fracture of the superior pubic bone. Of 2 patients with advanced arthrosis, i had an impacted femoral neck fracture and the other a nondisplaced intertrochanteric fracture. There was 1 patient who had sustained a nondisplaced acetabular fracture with increased joint fluid and muscle contusions. Three patients had muscle contusions only. Two patients had bone marrow contusions only, while 2 others with advanced coxarthrosis had increased joint fluid only. Three patients showed normal findings. Our findings led to emergency surgery in 13 cases, and conservative measures directed to the specific MR findings in 14 patients. Conclusion: MR imaging should be the first modality of choice in examining patients with a clinically suspected impacted fracture of the femoral neck where conventional films show negative or equivocal findings. (orig.).

  1. Neuroradiological findings and clinical features of fourth-ventricular meningioma: A study of 10 cases

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, B.-Y.; Yin, B.; Li, Y.-X. [Department of Radiology, Huashan Hospital, Fudan University, Shanghai (China); Wu, J.-S. [Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai (China); Chen, H. [Department of Neuropathology, Huashan Hospital, Fudan University, Shanghai (China); Wang, X.-Q., E-mail: wangxq10@126.com [Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai (China); Geng Daoyng, E-mail: fdhsgdy@126.com [Department of Radiology, Huashan Hospital, Fudan University, Shanghai (China)

    2012-05-15

    Aim: To present the neuroradiological and clinical findings of fourth-ventricular meningiomas to increase awareness of this entity. Materials and methods: The computed tomography (CT; n = 5), magnetic resonance imaging (MRI; n = 9) features and clinical presentations of 10 patients with pathologically documented fourth-ventricular meningiomas were retrospectively analysed. Results: All tumours appeared as well-demarcated masses in the fourth ventricle at CT and MRI. The tumour shape was round in eight cases (80%) and irregular in two cases (20%). The CT images of five cases showed predominantly isoattenuation in three cases and high attenuation in two cases, with a mean attenuation value of 52 HU. In addition, calcifications were seen in three cases. At MRI, nine masses were isointense (n = 6) or hypointense (n = 3) to grey matter on T1-weighted images and mildly hyperintense (n = 4), isointense (n = 3), hypointense (n = 1), and of mixed signal intensity (n = 1) on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. Signal voids were visible in two cases. Enhancement after injection of contrast material was marked homogeneous (n = 5) or heterogeneous (n = 5) on CT or T1-weighted images. Three tumours had mild peritumoural oedema. Three tumours were associated with obstructive hydrocephalus. The pathological subtype of the 10 meningiomas was fibromatous (n = 5), atypical (n = 2), and one each of transitional, psammomatous, and clear-cell type. Conclusion: Although fourth-ventricular meningioma is quite rare, it should be considered in differential diagnosis of neoplasms within the fourth ventricle. The relatively typical radiological appearance, combined the age and sex of patients, can suggest the diagnosis of fourth-ventricular meningioma.

  2. Neuroendocrine tumors of the lung: major radiologic findings in a series of 22 histopathologically confirmed cases

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Marcel Koenigkam, E-mail: marcelk46@yahoo.com.br [Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (HCFMRP-USP), SP (Brazil); Department of Diagnostic and Interventional Radiology, Heidelberg University (Germany); Barreto, Andre Rodrigues Facanha [Clinica Radius, Clinica Sao Carlos Imagem and Santa Casa de Misericordia de Fortaleza, Fortaleza, CE (Brazil); Chagas Neto, Francisco Abaete [Program of Health Sciences Applied to the Locomotor System - Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), Ribeirao Preto, SP (Brazil); Muglia, Valdair Francisco; Elias Junior, Jorge [Division of Radiology, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRPUSP), Ribeirao Preto, SP (Brazil)

    2012-07-15

    Objective: To describe key imaging findings in a series of cases of primary neuroendocrine tumors of the lung (NTLs), with emphasis on computed tomography changes. Materials And Methods: Imaging studies of 22 patients (12 men, mean age 60 years) with histopathologically confirmed diagnosis, evaluated in the author's institution during the last five years were retrospectively reviewed by two radiologists, with findings being consensually described focusing on changes observed at computed tomography. Results: The authors have described five typical carcinoids, three atypical carcinoids, three large-cell neuroendocrine carcinomas (LCNCs), and 11 small-cell lung cancers (SCLCs). Only one typical carcinoid presented the characteristic appearance of central endobronchial nodule with distal pulmonary atelectasis, while the others were pulmonary nodules or masses. The atypical carcinoids corresponded to peripheral heterogeneous masses. One out of the three LCNCs was a peripheral homogeneous mass, while the others were ill-defined and heterogeneous. The 11 SCLCs corresponded to central, infiltrating and heterogeneous masses with secondary pleuropulmonary changes. Calcifications were absent both in LGNCs and SCLCs. Metastases were found initially and also at follow-up of all the cases of LCNCs and SCLCs. Conclusion: Although some imaging features may be similar, radiologic findings considered together with clinical information may play a relevant role in the differentiation of histological types of NTLs. (author)

  3. Chest radiography and thoracic computed tomography findings in children who have family members with active pulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Uzum, Kazim; Karahan, Okkes I.; Dogan, Sukru; Coskun, Abdulhakim E-mail: coskuna@erciyes.edu.tr; Topcu, Faik

    2003-12-01

    Objective: The chest radiography and TCT findings in children who had contacted with adult family members with active pulmonary tuberculosis were compared. The contributions of thoracic computed tomography to the diagnosis of tuberculosis were investigated. Methods and material: The children who were 0-16 years old (n=173) and children of families with an adult member which was diagnosed as pulmonary tuberculosis were evaluated. The children were considered in two groups based on the absence (n=125) or presence (n=48) of complaints and/or ambiguous symptoms such as lack of appetite, mild cough, sweating, history of lung infection, low body weight and those with suspicious chest radiography findings (12 cases) were included in this study. Asymptomatic patients (n=125) did not undergo TCT. Patients who had positive PPD skin tests only received isoniazid. If the TCT demonstrated enlarged lymph nodes or parenchymal lesions, minimally active pulmonary tuberculosis was diagnosed and antituberculous treatment was given. Results and discussions: TCT revealed lymph node enlargement or parenchymal lesions in 39 children (81.2%). Of the 12 children whose CXRs revealed suspicious lymph node enlargement and/or infiltration, five had normal findings in TCT whereas the initial findings were confirmed in the remaining seven. These data suggest that there is a correlation between the presence of ambiguous symptoms in exposed children and TCT findings; chest radiography and TCT findings do not yield parallel findings. All the patients who received anti-TB treatment were resolved in the control examinations. Conclusion: In this study there is a correlation between presence of ambiguous symptoms and TCT findings, but the chest radiography and TCT findings do not yield harmony in exposed children with ambiguous symptoms (suspicious tuberculosis cases). These observations should be considered in children with symptoms similar to those of exposed children, but with no definite history of

  4. Multiple idiopathic external and internal resorption: Case report with cone-beam computed tomography findings

    Energy Technology Data Exchange (ETDEWEB)

    Celikten, Berkan; Uzuntas, Ceren Feriha; Kurt, Hakan [Faculty of Dentistry, Ankara University, Ankara (Turkmenistan)

    2014-12-15

    Root resorption is loss of dental hard tissue as a result of clastic activities. The dental hard tissue of permanent teeth does not normally undergo resorption, except in cases of inflammation or trauma. However, there are rare cases of tooth resorption of an unknown cause, known as 'idiopathic root resorption.' This report would discuss a rare case of multiple idiopathic resorption in the permanent maxillary and mandibular teeth of an otherwise healthy 36-year-old male patient. In addition to a clinical examination, the patient was imaged using conventional radiography and cone-beam computed tomography (CBCT). The examinations revealed multiple external and internal resorption of the teeth in all four quadrants of the jaws with an unknown cause. Multiple root resorption is a rare clinical phenomenon that should be examined using different radiographic modalities. Cross-sectional CBCT is useful in the diagnosis and examination of such lesions.

  5. Multiple idiopathic external and internal resorption: Case report with cone-beam computed tomography findings.

    Science.gov (United States)

    Celikten, Berkan; Uzuntas, Ceren Feriha; Kurt, Hakan

    2014-12-01

    Root resorption is loss of dental hard tissue as a result of clastic activities. The dental hard tissue of permanent teeth does not normally undergo resorption, except in cases of inflammation or trauma. However, there are rare cases of tooth resorption of an unknown cause, known as "idiopathic root resorption." This report would discuss a rare case of multiple idiopathic resorption in the permanent maxillary and mandibular teeth of an otherwise healthy 36-year-old male patient. In addition to a clinical examination, the patient was imaged using conventional radiography and cone-beam computed tomography (CBCT). The examinations revealed multiple external and internal resorption of the teeth in all four quadrants of the jaws with an unknown cause. Multiple root resorption is a rare clinical phenomenon that should be examined using different radiographic modalities. Cross-sectional CBCT is useful in the diagnosis and examination of such lesions.

  6. Severe malaria - a case of fatal Plasmodium knowlesi infection with post-mortem findings: a case report

    Directory of Open Access Journals (Sweden)

    Adem Patricia

    2010-01-01

    Full Text Available Abstract Background Zoonotic malaria caused by Plasmodium knowlesi is an important, but newly recognized, human pathogen. For the first time, post-mortem findings from a fatal case of knowlesi malaria are reported here. Case presentation A formerly healthy 40 year-old male became symptomatic 10 days after spending time in the jungle of North Borneo. Four days later, he presented to hospital in a state of collapse and died within two hours. He was hyponatraemic and had elevated blood urea, potassium, lactate dehydrogenase and amino transferase values; he was also thrombocytopenic and eosinophilic. Dengue haemorrhagic shock was suspected and a post-mortem examination performed. Investigations for dengue virus were negative. Blood for malaria parasites indicated hyperparasitaemia and single species P. knowlesi infection was confirmed by nested-PCR. Macroscopic pathology of the brain and endocardium showed multiple petechial haemorrhages, the liver and spleen were enlarged and lungs had features consistent with ARDS. Microscopic pathology showed sequestration of pigmented parasitized red blood cells in the vessels of the cerebrum, cerebellum, heart and kidney without evidence of chronic inflammatory reaction in the brain or any other organ examined. Brain sections were negative for intracellular adhesion molecule-1. The spleen and liver had abundant pigment containing macrophages and parasitized red blood cells. The kidney had evidence of acute tubular necrosis and endothelial cells in heart sections were prominent. Conclusions The overall picture in this case was one of systemic malaria infection that fit the WHO classification for severe malaria. Post-mortem findings in this case were unexpectedly similar to those that define fatal falciparum malaria, including cerebral pathology. There were important differences including the absence of coma despite petechial haemorrhages and parasite sequestration in the brain. These results suggest that further

  7. MR imaging and ultrasonography findings of early myositis ossificans: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Ryeol [Jeju National University Hospital, Department of Radiology, Jeju-si, Jeju Special Self-Governing Province (Korea, Republic of); Park, So Young; Jin, Wook [Kyung Hee University Hospital at Gangdong, Department of Radiology, Seoul (Korea, Republic of); Won, Kyu Yeoun [Kyung Hee University Hospital at Gangdong, Department of Pathology, Seoul (Korea, Republic of)

    2016-10-15

    Myositis ossificans (MO) is a benign soft tissue lesion with non-neoplastic heterotopic bone formation. MO in the intermediate and mature stages can be easily diagnosed if characteristic imaging findings such as a peripheral zonal pattern of ossification with variable thickness is observed. However, it is difficult to correctly diagnose early MO because it can mimic malignancy clinically, radiologically, and histopathologically. We report a case of early pseudosarcomatous phase of non-traumatic MO with atypical imaging findings. A 59-year-old woman presented with pain followed by a mass in the left thigh within a week. MR imaging and ultrasonography showed an intramuscular lesion with preserved muscle fascicles in the vastus lateralis muscle. Intralesional ossification or calcification was not seen on ultrasonography. A diagnosis of myositis ossificans was made by ultrasonographically guided biopsy. (orig.)

  8. Reactive lymphoid hyperplasia of the liver mimicking hepatocellular carcinoma: incidental finding of two cases.

    Science.gov (United States)

    Lv, Ang; Liu, Wendy; Qian, Hong-Gang; Leng, Jia-Hua; Hao, Chun-Yi

    2015-01-01

    Reactive lymphoid hyperplasia is a rare disease that forms a mass-like lesion and is characterized by the proliferation of non-neoplastic, polyclonal lymphocytes forming follicles. We recently encountered 2 cases of reactive lymphoid hyperplasia of liver, both of which were asymptomatic and mimicked hepatocellular carcinoma by various imaging modalities. Based on the clinical impression of hepatocellular carcinoma, surgical resections were performed. Microscopic findings revealed that both lesions consisted of an aggregation of lymphocytes consisting of predominantly B-cells, with multiple lymphoid follicles positive for CD10 and negative for bcl-2, consistent with the diagnosis of reactive lymphoid hyperplasia. Polyclonality of both lesions was further confirmed by B cell receptor gene rearrangement study. The incidence of reactive lymphoid hyperplasia in the liver is exceedingly rare, and it is difficult to differentiate such lesions from hepatic malignancies based upon clinical grounds. The clinicopathological findings and literature review of this report may be helpful to improve the clinical decision-making.

  9. Fat deposition in the urinary bladder wall: Incidental finding on abdominal computed tomography: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Min Ho; Moon, Sung Kyoung; Ahn, Sung Eun; Park, Seong Jin; Lim, Joo Won; Lee, Dong Ho [Dept. of Radiology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

    2015-02-15

    In a computed tomography (CT) scan, fat deposition in the urinary bladder wall is seen as a linear hypoattenuating band surrounded by soft tissue density. It is uncommon, but is often seen in normal cases. However, there is no report of fat deposition in the urinary bladder wall in Korea. The authors encountered a 62-year-old male patient who showed an incidental hypoattenuating band in the urinary bladder wall on abdominal CT. The patient showed no clinical signs related to fat deposition in the urinary bladder wall. When the patient's previous abdominal CT was retrospectively reviewed, the same CT finding was seen. This linear hypoattenuating band within the urinary bladder wall should be considered as a normal CT finding, although it is uncommon.

  10. Churg-Strauss Syndrome with Cardiac Involvement: A Case Report with CT and MRI Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seong Joo; Cho, Young Jun; Kim, Keum; Hwang, Cheol Mok; Kim, Dae Ho [Dept. of Radiology, Konyang University College of Medicine, Daegu (Korea, Republic of); Choi, Eu Gene [Dept. of Internal Medicine, Konyang University College of Medicine, Daegu (Korea, Republic of)

    2012-02-15

    This is a case report of Churg-Strauss Syndrome (CSS) associated with cardiac involvement which is demonstrated in chest CT and cardiac MRI (CMR) without specific cardiac symptoms. A 32-year-old woman had a 3-year history of bronchial asthma, chronic sinusitis, and otitis media. The patient had various typical findings of CSS. The patient had no specific cardiac symptoms or signs such as chest pain, palpitations, syncope, or murmur, but she had diffuse low attenuation lesions in the inner wall of the left ventricle (LV) in contrast-enhanced CT. This corresponded to the area of subendocardial hyperenhancement in delayed contrast-enhanced CMR images. She was treated with steroids for 2 months. Follow-up delayed contrast-enhanced CMR of the LV showed a decrease in the size of the subendocardial enhancement area, and she had no symptoms. Therefore, the radiologist and clinician both should pay careful attention to observe possible cardiac involvement in case of CSS.

  11. Barriers to the effective use of medico-legal findings in sexual assault cases worldwide.

    Science.gov (United States)

    Mont, Janice Du; White, Deborah

    2013-09-01

    Despite the increasing implementation of standardized rape kits across jurisdictions, the medico-legal findings generated by these tools are often not related to positive criminal justice outcomes. Given that there has been no global investigation of the factors that might impede their successful use in cases of sexual assault, we conducted a review of relevant scholarly and "grey" literature from industrialized and less-developed regions. One key theme to emerge from the analysis concerned certain problematic practices and behaviors of professional groups involved in the various stages of the post-sexual assault process. We found that a lack of competence in handling sexual assault cases, contempt for women who have been victimized, and corruption among some forensic examiners, police, scientists, and legal personnel often have shaped the collection, processing, analysis, and use of medico-legal evidence. We discuss recent initiatives and future directions for research that might serve to address these issues.

  12. Correlation of fine needle aspiration cytology findings with thyroid function test in cases of lymphocytic thyroiditis.

    Science.gov (United States)

    Sood, Neelam; Nigam, Jitendra Singh

    2014-01-01

    Background. Chronic lymphocytic thyroiditis is the second most common thyroid lesion diagnosed on FNAC after goiter. FNAC is reliable tool in the diagnosis of thyroid lesion. Objective. To correlate FNAC cytologic findings with TFT in the lymphocytic thyroiditis. Methods. 175 patients with thyroid swellings were referred for FNAC as well as TFT during 2011-2013. Fine needle aspiration cytology was performed using non-aspiration or aspiration techniques and TFT performed on Beckman culter access 2. Results. Lymphoid infiltrate was seen in 55 cases. The commonest age group of lymphocytic thyroiditis was 21-30 years with male : female ratio being 1 : 10. Anti-TPO and TSH were elevated in 96.16% (25/26) of cases with grade 3 lymphoid infiltrate, 94.12% (16/17) of cases with grade 2, and 91.67% (11/12) of cases with 1 grade. Increased anti-TPO with raised TSH without any lymphoid infiltrate was seen in 5 cases and 5 cases showed only raised TSH without raised anti-TPO and without any lymphoid infiltrate. We observed that grade 3 lymphocytic infiltration has correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. We also observed that anti-TPO and TSH together are significant even if no lymphocytic infiltration is present. Conclusion. Grade 3 lymphocytic infiltration has statistical correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. Anti TPO was adjunct to TSH in grade 3. The presence of Hurthle cell change, giant cells, and granulomas has no statistical correlation with lymphocytic thyroiditis.

  13. Correlation of Fine Needle Aspiration Cytology Findings with Thyroid Function Test in Cases of Lymphocytic Thyroiditis

    Directory of Open Access Journals (Sweden)

    Neelam Sood

    2014-01-01

    Full Text Available Background. Chronic lymphocytic thyroiditis is the second most common thyroid lesion diagnosed on FNAC after goiter. FNAC is reliable tool in the diagnosis of thyroid lesion. Objective. To correlate FNAC cytologic findings with TFT in the lymphocytic thyroiditis. Methods. 175 patients with thyroid swellings were referred for FNAC as well as TFT during 2011–2013. Fine needle aspiration cytology was performed using non-aspiration or aspiration techniques and TFT performed on Beckman culter access 2. Results. Lymphoid infiltrate was seen in 55 cases. The commonest age group of lymphocytic thyroiditis was 21–30 years with male : female ratio being 1 : 10. Anti-TPO and TSH were elevated in 96.16% (25/26 of cases with grade 3 lymphoid infiltrate, 94.12% (16/17 of cases with grade 2, and 91.67% (11/12 of cases with 1 grade. Increased anti-TPO with raised TSH without any lymphoid infiltrate was seen in 5 cases and 5 cases showed only raised TSH without raised anti-TPO and without any lymphoid infiltrate. We observed that grade 3 lymphocytic infiltration has correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. We also observed that anti-TPO and TSH together are significant even if no lymphocytic infiltration is present. Conclusion. Grade 3 lymphocytic infiltration has statistical correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. Anti TPO was adjunct to TSH in grade 3. The presence of Hurthle cell change, giant cells, and granulomas has no statistical correlation with lymphocytic thyroiditis.

  14. Case of dentato-rubro-pallido-luysian atrophy. MRI findings and disturbance of ocular movement

    Energy Technology Data Exchange (ETDEWEB)

    Usui, Sadanari; Komiya, Tadatoshi

    1988-06-01

    A clinical case of dentato-rubro-pallido-luysian atrophy (DRPLA) was reported. We established several aspects on the basis of MRI findings and a neuro-otological study. A 47-year-old woman had gait disturbance, involuntary movements, speech disturbance, and memory disturbance at the age of 42. She was admitted to the hospital because of worsening of the gait disturbance. Neurological examinations showed choreo-athetosis of the face, neck and upper extremities, mental disturbance, and scanning speech. However, she had neither ocular disturbance nor epilepsy or myoclonus. On the MRI-CT, an atrophy of midbrain and pontine tegmentum was observed. The neuro-otological study showed gaze nystagmus at the horizontal gaze, rebound nystagmus, hypometria of the saccade, saccadic pursuit, reduction of the optokinetic nystagmus, and increase in caloric nystagmus by means of visual input. A severe atrophy of the brainstem tegmentum and a mild atrophy of the cerebellar hemisphere and cerebral cortex are regarded as neuro-radiological features of DRPLA. Moreover, tegmental atrophy is related to ocular disturbance as a clinical feature. Various neuro-otological findings reveal many systems of ocular movements, i.e., a smooth pursuit system, a saccade system, and a vestibulo-ocular reflex system, involving flocculus. DRPLA can be clinically diagnosed by means of clinical features, MRI findings, and neuro-otological findings. A variety of neuro-otological abnormalities may indicate a progression of the ocular disturbance and a variety of lesions.

  15. Abdominal ultrasonographic findings associated with feline infectious peritonitis: a retrospective review of 16 cases.

    Science.gov (United States)

    Lewis, Kristin M; O'Brien, Robert T

    2010-01-01

    The feline infectious peritonitis virus (FIPV) is a mutated form of the feline enteric coronavirus (FeCV) that can present with a variety of clinical signs. The purpose of this retrospective study was to analyze abdominal ultrasonographic findings associated with cats with confirmed FIPV infection. Sixteen cases were included in the study from a review of medical records at two academic institutions; inclusion was based either on necropsy lesions (n=13) or a combination of histopathological, cytological, and clinicopathological findings highly suggestive of FIPV infection (n=3). The liver was judged to be normal in echogenicity in 11 (69%) cats, diffusely hypoechoic in three cats, focally hyperechoic in one cat, and focally hypoechoic in one cat. Five cats had a hypoechoic subcapsular rim in one (n=3) or both (n=2) kidneys. Free fluid was present in the peritoneal cavity in seven cats and in the retroperitoneal space in one cat. Abdominal lymphadenopathy was noted in nine cats. The spleen was normal in echogenicity in 14 cats and was hypoechoic in two. One cat had bilateral orchitis with loss of normal testicular architecture. Although none of these ultrasonographic findings are specific for FIPV infection, a combination of these findings should increase the index of suspicion for FIPV infection when considered along with appropriate clinical signs.

  16. An Unusual Case of Hemosiderotic Fibrohistiocytic Lipomatous Lesion: Correlation of MRI and Pathologic Findings

    Directory of Open Access Journals (Sweden)

    Ronald S. A. de Vreeze

    2008-01-01

    Full Text Available The spectrum of lipomatous lesions ranges from benign to highly malignant disease. Differentiation between these lesions is important to indicate prognosis and choose the most appropriate treatment. Hemosiderotic fibrohistiocytic lipomatous lesion (HFLL is a rare subtype of lipomatous tumor. The diagnosis is usually based on clinical, histological, and immunohistochemical information. Where magnetic resonance (MR imaging is a suitable modality to assess fatty tumors, no data is reported on MR imaging of HFLL. Here, the MR characteristics are described in correlation with pathologic findings in a case of HFLL in the left thigh, an unusual location.

  17. Incidental optochiasmatic cavernoma: Case report of an unusual finding on 3 Tesla MRI.

    Science.gov (United States)

    Trentadue, Mirko; Pozzi Mucelli, Roberto; Piovan, Enrico; Pizzini, Francesca Benedetta

    2016-08-01

    Cavernoma is a vascular hamartoma, which represents 10-20% of all central nervous system vascular malformations. The majority (80%) of them are supratentorial, while involvement of the cranial nerves and the optic pathways is extremely rare. The main clinical presentation of optochiasmatic cavernomas consists of chiasmatic apoplexy, which is a neurosurgical emergency. Here, we report a case in which the finding was incidentally detected in a 49-year-old man. We describe the imaging characteristics of the lesion in such a rare location, highlighting the role of magnetic resonance imaging (MRI) (specifically 3 Tesla) in the management of asymptomatic patients.

  18. An Adult Case of Unicommissural Unicuspid Aortic Valve Diagnosed Based on the Intraoperative Findings.

    Science.gov (United States)

    Yamanaka, Tetsuo; Fukatsu, Toru; Ichinohe, Yoshimaro; Komatsu, Hirotaka; Seki, Masahiro; Sasaki, Kenichi; Takai, Hideaki; Kunihara, Takashi; Hirata, Yasunobu

    2016-01-01

    We herein report an adult case of unicommissural unicuspid aortic valve (UAV). A 59-year-old man, who was noted to have a cardiac murmur at 31 years of age, was admitted to our hospital due to acute heart failure. Severe calcification in the aortic valve with severe low-flow/low-gradient aortic stenosis and moderate aortic regurgitation was observed and thought to be the cause of heart failure, however, the etiology of aortic valve dysfunction was not clear. Aortic valve replacement was subsequently performed, and unicommissural UAV was diagnosed according to the intraoperative findings. UAV is very rare congenital aortic valve disease which is rarely diagnosed preoperatively.

  19. Early MRI findings in stab wound of the cervical spine: two case reports

    Energy Technology Data Exchange (ETDEWEB)

    Alkan, A.; Baysal, T.; Sarac, K.; Sigirci, A.; Kutlu, R. [Inonu Universitesi Turgut Ozal Tip Merkezi, Radyoloji Anabilim Dali, Malatya (Turkey)

    2002-01-01

    MR imaging was found to be the most sensitive modality for the detection of spinal cord abnormalities in the acutely injured spine. Although it is reported that traumatic pneumomyelogram indicates a base-of-skull or middle cranial fossa fracture and is almost certainly associated with intracranial subarachnoid air, early MR imaging may demonstrate subarachnoid air in penetrating trauma of the spinal cord without head injury. We report two cervical-spine stab-wound cases, one of which had subarachnoid air on early MR findings. (orig.)

  20. Dental findings in patients with West syndrome: A report of two cases

    Directory of Open Access Journals (Sweden)

    Amit Khatri

    2014-01-01

    Full Text Available West syndrome a rare, severe form of epilepsy occurs in early infancy. It is characterized by a triad consisting of infantile spasms that occurs in clusters, arrest of psychomotor development and hypsarrhythmia on electroencephalogram. We present here two cases of west syndrome where patients required dental care due to the presence of certain dental findings. Preventive measurements such as controlled diet and proper oral hygiene along with professional dental management are recommended in patients with west syndrome to avoid dental problems.

  1. Arnold-Chiari Type II Malformation: A Case Report and Review of Prenatal Sonographic Findings

    Directory of Open Access Journals (Sweden)

    Maryam Nik Nejadi

    2008-01-01

    Full Text Available The Arnold-Chiari malformation is a congenital abnormality of CNS, characterized by downwarddisplacement the parts of the cerebellum, fourth ventricle, pons and medulla oblongata into thespinal canal. This malformation is one of causative factor of death in neonates and infants. Athorough understanding of the direct and indirect sonographic findings is necessary for diagnosis ofChiari II malformation in the developing fetus.In this case report, we present a Chiari malformation II detected at 23 weeks of gestation by routinelysonographic screening. The Role of prenatal sonography in recognition of the malformation andprognostic value of these features are discussed.

  2. CT findings in ischaemic hepatic failure due to intra-arterial embolisation: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Catalano, O. [Dept. of Radiological Sciences, Univ. `Federico II`, Naples (Italy)

    1997-01-01

    Liver infarction is relatively uncommon. It may be secondary to several conditions such as sepsis, shock, sickle-cell anaemia, eclampsia, vasculitis, metastatic disease, bacterial endocarditis, rheumatic heart disease, trauma, portal venous occlusion or compression, oral contraception, anaesthesia, hepatic artery thrombosis, therapeutical or inadvertent hepatic artery ligation, intra-arterial chemotherapy or embolisation. A case of hepatic infraction, unusual for iatrogenic pathogenesis, submassive extension with acute hepatic failure, and CT findings of an internally branching pattern due to intravascular gas was observed. (orig./AJ)

  3. CT findings of primary localized amyloidosis of the urinary bladder: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwan; Kim, See Hyung; Kim, Mi Jeong; Kim, Sang Pyo [Keimyung Univ. College of Medicine/Dongsan Hospital, Daegu (Korea, Republic of)

    2012-08-15

    Primary localized amyloidosis is a rare disease that impairs the organs and tissue function, caused by extracellular deposition of amyloid protein. Although amyloid proteins can be deposited in localized or systemic organs, the bladder is a rare site. CT showed diffuse infiltrative mass in the left urinary bladder wall, and the left ureterovesical junction with enhancement and perivesical invasion, which mimics urothelial carcinoma. However, pathological diagnosis was localized primary amyloidosis. We report here on the CT findings of a rare case of primary localized amyloidosis of the urinary bladder with brief review of the literature.

  4. A Case of Fibrovascular Polyp of the Stomach: Sonographic and Computed Tomographic Findings

    Directory of Open Access Journals (Sweden)

    Shin

    2016-01-01

    Full Text Available Fibrovascular polyps are rare, pedunculated, tumor-like lesions that are usually found in the esophagus; occurrence in the stomach is very rare. To our knowledge, sonographic and CT findings of a fibrovascular polyp in the stomach have never been reported. Here, we report a case of a fibrovascular polyp that was identified in the gastric antrum and prolapsed into the duodenal bulb. Sonography revealed a hyperechoic polypoid mass in the gastric antrum, which prolapsed into the duodenal bulb upon a change in the patient’s position. CT also revealed a pedunculated polypoid mass with an inner fatty component.

  5. CT scan findings in three cases of multiple sclerosis with homonymous hemianopsia

    Energy Technology Data Exchange (ETDEWEB)

    Arikado, Takuji; Ariga, Hiroko; Kase, Manabu; Nagata, Renpei; Tashiro, Kunio (Hokkaido Univ., Sapporo (Japan). School of Medicine)

    1983-11-01

    Three cases of clinically definite multiple sclerosis manifested homonymous hemianopsia. A 35-year-old female, in whom right optic neuritis developed as the initial symptom, manifested right homonymous hemianopsia 4 months later followed by cerebral symptoms another 4 months later. A 25-year-old male developed sudden brain stem and cerebellar symptoms associated with right abducens palsy and right homonymous hemianopsia. In a 26-year-old female developed right homonymous hemianopsia 13 years after the first attack of recurrent optic neuritis. CT-scan in these three cases revealed the presence of a ''plaque'' located in the white matter of the left occipital lobe in cases 1 and 2 and in the left peririgone white matter in case 3 as the causative lesion for the right homonymous hemianopsia. These findings indicate that the optic radiation may be involved in multiple sclerosis resulting in homonymous hemianopsia. CT scan is of value in determining the location of the affected intracranial lesion in multiple sclerosis.

  6. Music evoked autobiographical memory after severe acquired brain injury: preliminary findings from a case series.

    Science.gov (United States)

    Baird, A; Samson, S

    2014-01-01

    Music evoked autobiographical memories (MEAMs) have been characterised in the healthy population, but not, to date, in patients with acquired brain injury (ABI). Our aim was to investigate music compared with verbal evoked autobiographical memories. Five patients with severe ABI and matched controls completed the experimental music (MEAM) task (a written questionnaire) while listening to 50 "Number 1 Songs of the Year" (from 1960 to 2010). Patients also completed the Autobiographical Memory Interview (AMI) and a standard neuropsychological assessment. With the exception of Case 5, who reported no MEAMs and no autobiographical incidents on the AMI and who also had impaired pitch perception, the range of frequency and type of MEAMs in patients was broadly in keeping with their matched controls. The relative preservation of MEAMs in four cases was particularly noteworthy given their impaired verbal and/or visual anterograde memory, and in three cases, autobiographical memory impairment. The majority of MEAMs in both cases and matched controls were of a person/people or a period of life. In three patients music was more efficient at evoking autobiographical memories than the AMI verbal prompts. This is the first study of MEAMs after ABI. The findings suggest that music is an effective stimulus for eliciting autobiographical memories, and may be beneficial in the rehabilitation of autobiographical amnesia, but only in patients without a fundamental deficit in autobiographical recall memory and intact pitch perception.

  7. MRI findings of cryptococcal infection on CNS: The long term follow-up: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Min Yun; Sol, Chang Ho; Kim, Byung Soo [Pusan National University College of Medicine, Pusan (Korea, Republic of); Jung, Chun Phil [Maryknoll Hospital, pusan (Korea, Republic of); Park, Beung Ho [Dong-a University College of Medicine, Pusan (Korea, Republic of)

    1993-07-15

    Authors presented the serial changes of brain MRI findings in two cases of cryptococcal meningitis. The MRI findings of the first patient (53 year old female) consisted of dilated Virchow-Robin spaces, leptomeningeal enhancement, cryptococcals and hydrocephalus. Dilated Virchow-Robin spaces were noted on the first MR obtained 33 days after symptom onset. The size and number of dilated Virchow-Robin space gradually decreased since 119 days after symptom onset (62 days after treatment). Faint leptomeningeal enhancement was found at cerebellar region on the first MRI, which became more distant and intense on the day 119, probably due to improper treatment. The leptomeningeal enhancement decreased on the days 156. Mild hydrocephalus was noted on MRI obtained 70 days after symptom onset, which markedly aggravated on the days 119. It decreased after steroid therapy alone. Enhancing cryptococcomas of variable size were noted at the right temporal lobe and cerebellum on MRI of the day 119, which decreased in size and number on the day 156. On the day 295 MRI showed nearly disappearance of the dilated Virchow-Robin space, but final leptomeningeal enhancement, cerebellar cryptococcomas and hydrocephalus still remained. The MRI findings of the second patient(36 year old female) showed the findings similar to those of the first patient. Initial MRI obtained 18 days after symptom onset showed no abnormal findings. Dilated Virchow-Robin spaces were noted on the day 36 (13 days after treatment onset), which nearly disappeared on the day 109. Enhancing cryptococcomas in both basal ganglia and cerebral cortex and leptomeningeal enhancement were noted on MRI of the day 136. Both cryptococcomas and leptomeningeal enhancement decreased in size and enhancing degree on the day 157. Hydrocephalus was noted on the day 109.

  8. CYTOMORPHOLOGICAL FEATURES OF HASHIMOTO THYROIDITIS-WITH SONOLOGICAL AND SEROLOGICAL FINDINGS-ANALYSIS OF 80 CASES

    Directory of Open Access Journals (Sweden)

    Sreechithra

    2014-09-01

    Full Text Available BACKGROUND: Hashimoto thyroiditis is the most common form of thyroiditis. The incidence is found more in the coastal areas for which iodine excess is described as a probable etiology .Ours is a coastal area, where significant number of females is coming to the hospital with diffuse enlargement of thyroid. This prompted us to do the current study. FNAC is a simple, cost effective, diagnostic modality which when used in combination with sonological and serological investigations, helps the clinicians in the correct diagnosis, even in the early stage of the disease. MATERIALS AND METHODS: Retrospective study was done for a period of 18 months from January1rst 2013 to JUNE 31rst 2014. The clinical, sonological and serological aspects of 80 cases of Hashimoto's thyroiditis were studied and compared with the cytomorphological features. RESULTS: The peak incidence of Hashimoto’s thyroiditis was seen in women of 2nd decade. Coexisting colloid goiter was noted in significant number of cases. Subclinical thyroid and euthyroid cases (serologically showed cytomorphological features diagnostic of thyroiditis. Correlation with sonological features were seen in 66 % of cases. Lymphocytic infiltrate in follicular cell clusters, background lymphocytes and plasma cells and hurthle cells were diagnostic of hashimoto's thyroiditis. CONCLUSION: The increased frequency of Hashimoto’s thyroiditis in younger age group, in euthyroid cases and its coexistence with colloid goiter should prompt us to take more detailed and large scale study in Kerala, especially in the coastal areas. FNA should be done as a first line mode of investigation, since it helps in identifying Hashimoto thyroiditis in the initial stages when the serological findings may be normal.

  9. Clinical and gross pathological findings of Johne's disease in a calf: A case report

    Directory of Open Access Journals (Sweden)

    Faez Firdaus Abdullah Jesse

    2016-09-01

    Full Text Available Objective: This case report describes a clinical case of Johne's disease (JD in a Friesian calf aging one and half years. Materials and methods: Physical examination of the calf was carried out, history of the farm as well as samples for laboratory examinations were obtained. The laboratory examinations included hematological examinations by direct wet mount, hematocrit centrifugation technique and Giemsa stain, biochemical evaluation of serum, bacterial culture and isolation from feces and aspirate from the swollen jaw. Results: Clinical history showed that the farm had a history of JD, and routine health screening revealed that one of the calves had clinical signs suggestive of Johne's disease. Physical examination of the calf revealed a lumpy jaw, enlarged bilateral pre-scapular and pre-femoral lymph nodes, while hematological and biochemical findings showed a normocytic normochromic anemia, severe leukocytosis with neutropilic left shift and lymphocytosis with hyperproteinemia characterized by hyperglobulinemia. Fecal bacterial tests showed the presence of acid fast bacilli. Based on the history and laboratory findings, the cow was diagnosed with JD. In order to ensure effective control measures, the calf was culled from the heard. Postmortem examination revealed inflamed pre-scapular and pre-femoral lymph nodes with the presence of paramphistomes in the rumen mucosa. Conclusion: Since JD is a chronic disease that lingers in livestock farms, there is need for early identification and culling of infected animal in order to limit its devastation on the farm. [J Adv Vet Anim Res 2016; 3(3.000: 292-296

  10. The Ultrasound and MRI Findings of Uterine Adenofibroma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Jung; Rha, Sung Eun; Byun, Jae Young; Lee, Ah Won [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2011-09-15

    Adenofibroma is an extremely rare benign m'ullerian mixed tumor composed of epithelium and mesenchymal cells. Most uterine adenofibromas occur in the endometrium, but they rarely protrude into the vagina. To date, only a few such cases with the imaging findings have been reported. Therefore, we report here on the sonographic and magnetic resonance (MR) imaging findings of a case of endometrial adenofibroma protruding into the vaginal cavity in a 28-year-old woman. The uterine adenofibroma appeared as a large intracavitary echogenic mass containing multiple small internal cysts, and it was distending the vaginal cavity on transrectal sonography. T2- weighted MR images showed a large intracavitary mass with heterogeneous high signal intensity protruding into the vaginal cavity. On gadolinium-enhanced T1-weighted MR images, heterogeneous septa-like enhancement was noted in the mass. Although uterine adenofibroma is extremely rare, adenofibroma can be suggested as a possible diagnosis when an intracavitary uterine mass, with multiple internal small cystic components and enhancing septa-like structures, is protruding into the vaginal cavity on imaging

  11. Visceral leishmaniasis elimination programme in India, Bangladesh, and Nepal: reshaping the case finding/case management strategy.

    Directory of Open Access Journals (Sweden)

    Dinesh Mondal

    Full Text Available OBJECTIVE: We sought to estimate visceral leishmaniasis (VL burden in Bangladesh, India, and Nepal and document care-seeking behaviour for VL to provide baseline information for monitoring the VL elimination program and identify options for improved case finding and management. DESIGN: A cross-sectional study using cluster sampling (clusters being villages of 4 VL endemic districts was used in order to document all current and existing VL cases over the preceding 12 mo. Extended (in-depth interviews were conducted in a subsample of households to explore (a VL-related knowledge, attitudes, and practices of the population; (b use of VL care by patients; and (c delay between onset of symptoms, diagnosis, and start of treatment, as well as treatment interruption. Findings were discussed with national program managers and policy makers to develop improved strategies. RESULTS: Screening for VL was done in 18,933 households (106,425 inhabitants. The estimated annual incidence of VL in the endemic districts was on average 22 times higher than the elimination target of less than one case per 10,000 inhabitants in 2015. This incidence varied widely between study sites, from 9.0 to 29.8 per 10,000 inhabitants. The percentage of newly detected cases through the household screening was high in the districts least covered by health-care services (particularly Rajshahi, Bangladesh, 49%; and to a lesser extent Vaishali in Bihar, India, 32.5%, and much lower in districts with greater availability of VL care (Muzaffarpur, India, 3.8%. On average 267 houses had to be visited, i.e., at least three to four working days per health worker, to identify a new VL (ranging from 1,432 houses in Muzaffarpur, India to only 166 houses in Rajshahi, Bangladesh. Knowledge of the disease and its vectors was good in India and Nepal but poor in Bangladesh (Rajshahi where very little attention has been given to VL over the last decades. Although all socio-demographic indicators

  12. Computed tomography findings in 10 cases of iliac vein compression (May-Thurner) syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Oguzkurt, Levent [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey)]. E-mail: loguzkurt@yahoo.com; Tercan, Fahri [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Pourbagher, M. Ali [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Kizilkilic, Osman [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Turkoz, Riza [Baskent University, Adana Teaching and Medical Research Center, Department of Thoracic and Cardiovascular Surgery, Adana (Turkey); Boyvat, Fatih [Baskent University, Faculty of Medicine, Department of Radiology, Ankara (Turkey)

    2005-09-01

    Objective: To present the computed tomography (CT) findings for the iliac veins of 10 patients who had left-sided lower extremity deep vein thrombosis due to iliac vein compression syndrome. Materials and methods: The CT findings for 10 cases of left-sided acute or chronic deep vein thrombosis caused by iliac vein compression syndrome were retrospectively evaluated. The patients were five women and five men (mean age {+-} S.D., 49.9 {+-} 15.6 years). In each patient with iliac vein compression syndrome, the diagnosis of the compression was established by venography performed during endovascular treatment. Diameter of the left common iliac vein was also measured in 14 control subjects without any lower extremity venous disease for comparison. Results: In all 10 cases, CT images in the transverse plane demonstrated the left common iliac vein being compressed by the overlying right common iliac artery. The mean diameter at the origin of the left common iliac vein (3.5 mm) in patients group was much smaller than the mean diameter of the same vein (11.5 mm) in the control group (p < 0.01). The mean percent stenosis of the left common iliac vein due to compression by the artery was 68%. Conclusion: Pelvic CT images in the transverse plane are useful for detecting iliac vein compression by the overlying right common iliac artery in patients with left-sided deep vein thrombosis. Radiologists should be aware of this imaging finding of iliac vein compression by the artery where the inferior vena cava bifurcates into the common iliac veins.

  13. [Evaluation of clinical and laboratory findings of adult visceral leishmaniasis cases].

    Science.gov (United States)

    Ural, Serap; Kaptan, Figen; Sezak, Nurbanu; El, Sibel; Örmen, Bahar; Türker, Nesrin; Demirdal, Tuna; Vardar, İlknur; Özkan Çayıröz, Pınar; Çakalağaoğlu, Fulya

    2015-10-01

    Visceral leishmaniasis (VL, kala-azar) is a zoonotic infection caused by Leishmania species which are transmitted to humans by the bites of infected female phlebotomine sandflies. Leishmania infantum is the responsible species of VL in Aegean, Mediterranean, and Central Anatolia regions of Turkey mainly observed sporadically in pediatric age groups. The aim of this study was to evaluate the clinical and laboratory findings of adult patients with VL who were admitted to our hospital. A total of 10 patients (3 female, 7 male; age range: 18-67 years, mean age: 39.3 ± 16.51) followed in the infectious diseases clinic of the hospital between 2000 and 2013 were evaluated retrospectively. The diagnosis of VL was based on the presence of appropriate clinical and physical examination, as well as biochemical findings, positive serological test results (indirect fluorescent antibody test, and rK39 rapid antigen test) and/or detection of amastigote forms of parasite in the bone marrow aspiration samples. Of the cases three were diagnosed with both bone marrow and serology positivity, five with bone marrow positivity and one of each only with liver biopsy and positive serology result. Time interval from onset of the symptoms until the establishment of the specific clinical diagnosis was ranged from 2 to 12 weeks. The most frequent initial symptoms were fever, fatigue and abdominal distension. None of the patients had immunosupressive conditions such as HIV infection, corticosteroid use, immunosupressive treatment, or transplantation. All the patients were from Aegean region and six were living in rural areas. In all cases, hepatosplenomegaly, increased erythrocyte sedimentation rate, albumin/globulin ratio inversion, anemia, leukopenia and among nine cases trombocytopenia were detected. In one case acute renal failure has been developed before treatment and the patient was admitted to dialysis program. Bacterial superinfection occurred in two cases. Patients were treated with

  14. Massive right-sided Bochdalek hernia with two unusual findings: a case report

    Directory of Open Access Journals (Sweden)

    Deb Subrato J

    2011-10-01

    Full Text Available Abstract Introduction In this report, the case of an adult patient with a massive right-sided Bochdalek hernia with multiple displaced abdominal organs, including the liver and gallbladder, is described. This patient presented with acute cholecystitis of the malpositioned gallbladder. During surgery, nodular regenerative hyperplasia of the liver was also found. To the best of this author's knowledge, these two entities have never been reported in association with this rare condition. Case presentation A 54-year-old Caucasian man presented with nausea and epigastric pain. He had a known history of right-sided Bochdalek hernia which was being managed expectantly. A computerized tomogram revealed the massive hernia with displaced stomach, liver, intestine and omentum into his right thorax. It was believed that our patient had bowel incarceration and he was therefore taken to surgery, where acute cholecystitis and a macronodular liver was identified. A thoracoabdominal approach was used to remove his gallbladder, reduce the herniated viscera and reconstruct his diaphragm. A liver biopsy identified nodular regenerative hyperplasia of the ectopic liver. There were no postoperative complications and at 12 month follow-up, our patient continues to do well. Conclusion This case report describes two unusual findings associated with a congenital Bochdalek diaphragmatic hernia that have never been reported. In addition, unique caveats to the surgical management of this complex rare condition are discussed.

  15. Emphasis on the MR imaging findings of brown tumor: a report of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Won Sun; Sung, Mi Sook; Chun, Kyung-Ah; Kim, Jee-Young; Lim, Hyun Wook; Lim, Yeon Soo; Yoo, Won Jong; Chung, Myung Hee [The Catholic University of Korea, College of Medicine, Bucheon St. Mary' s Hospital, Department of Radiology, Sosa-dong, Bucheon, Kyunggi-do (Korea, Republic of); Park, Sun-Won [Seoul National University, College of Medicine, Boramae Medical Center, Department of Radiology, Dongjak-gu, Seoul (Korea, Republic of); Lee, Kee-Haeng [The Catholic University of Korea, Department of Orthopaedic Surgery, Bucheon St. Mary' s Hospital, Sosa-dong, Bucheon, Kyunggi-do (Korea, Republic of)

    2011-02-15

    Brown tumors are focal reactive osteolytic lesions that are encountered in patients with primary or secondary hyperparathyroidism, and these tumors have nonspecific magnetic resonance (MR) imaging findings. However, there are only a few reports on MR imaging of brown tumors. The purpose of this study is to describe the spectrum of MR imaging findings of brown tumors. The MR imaging features of five patients with clinical and pathological evidence of brown tumor were retrospectively reviewed by two radiologists. The patients had primary hyperparathyroidism, which was confirmed as parathyroid adenoma (n = 2) and parathyroid carcinoma (n = 3). The MR images were evaluated for the presence of solid or cystic portions, the signal intensity of the lesions, the contrast enhancement pattern and the presence of cortex destruction and fluid-fluid levels. Twelve bone lesions were detected on the MR images of five patients; three lesions in two patients, four lesions in one patient, and one lesion in two patients. The tumor was solid in three lesions, mixed solid and cystic in four, and cystic in five. All the solid lesions were accompanied by mixed lesions. Discontinuity of the cortex and adjacent soft-tissue enhancement were seen in all the solid lesions. Fluid-fluid levels were seen in two cases within the cystic component of the mixed lesions and cystic lesions. The five patients with brown tumor demonstrated a wide spectrum of MR imaging findings. There are few lesions that are osteolytic on the radiographs and that show a short T2 on MR imaging, such as brown tumor. Multiple cystic or mixed lesions are the expected findings of brown tumors. (orig.)

  16. Ultrasonographic and computed tomographic findings of hemorrhagic cholecystitis; report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bum Soo; Byun, Jae Young; Shinn, Kyung Sub [Catholic Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Jong Woo [Kangnung Dongin Hospital, Kangnung (Korea, Republic of)

    1996-01-01

    Hemorrhagic cholecystitis(HC) is a rare complication of gallbladder(GB) disease characterized by mucosal and intraluminal hemorrhage of the GB. We report ultrasonographic(US) and computed tomographic(CT) findings of two cases of HC. Hemorrhagic fluid filled in the inflamed GB lumen was initially seen as homogeneous hyperdense and hyperattenuated lesion on both US and CT, respectively. As resolution of the hematoma and gangrenous change of the GB wall progress, US showed inhomogeneous mixed echogenic lesion in the GB having partially indistinct border, mimicking an invasive mass. At this stage, CT still showed homogeneous hyperdense hematoma and a small amount of fluid in the GB, without evidence of contrast enhancement.

  17. Radiologic Findings of Immunoglobulin G4 Related Sclerosing Esophagitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Sun; Kim, Su Young; Lee, Byung Hoon; Hwang, Yoon Joon; Han, Yoon Hee [Dept. of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Koyang (Korea, Republic of)

    2012-02-15

    We describe a case of immunoglobulin G4 (IgG4)-related sclerosing esophagitis occurring in a 63-year-old man with progressive dysphagia and 10-kg weight loss over 9 months. An esophagoscopy revealed significant stricture with diffuse mucosal friability and ulceration at mid esophagus level. Barium esophagogram showed diffuse stenosis at the mid and lower esophagus levels with ulcerations and irregularity of the mucosa. Multidetector computed tomography revealed diffuse edematous and circumferential thickening of the submucosa and muscle layer of this esophageal segment. Fluorine 18 fluorodeoxyglucose positron emission tomography (FDG PET) revealed diffuse mild FDG uptake in mid to lower esophagus. Although benign inflammatory lesion was suspected based on the imaging findings, the patient underwent surgery for worsening esophageal stricture and the esophageal lesion was pathologically confirmed as IgG4-related sclerosing esophagitis. Radiologic benignancy and high clinical suspicion for IgG4-related sclerosing disease may help making a proper decision and avoiding unnecessary operation.

  18. Ultrasonography findings of thyroid metastasis in a patient with hepatocellular carcinoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Ho; Park, Noh Hyuck; Lim, Jae Hoon; Park, Chan Sub; Seong, Su Ok; Kwon, Tae Jung [Myongji Hospital, Goyang (Korea, Republic of)

    2015-03-15

    Although the thyroid gland is one of the most vascular organs of the body, metastatic disease in the thyroid is encountered infrequently. However, at autopsy, the incidence rate of thyroid metastasis ranges from 1.25% to 24%. The primary sites are the kidney, lung, breast, and gastrointestinal tract. We report a rare case of a hepatocellular carcinoma metastatic to the thyroid gland. The patient had multiple palpable masses in the anterior and left lateral neck along the internal jugular chain on physical examination 9 months after the initial diagnosis of liver tumor. These masses were confirmed as metastasis from hepatocellular carcinoma by ultrasonography-guided 16-G core needle biopsy. We discuss the sonographic findings of thyroid metastasis and their use as an additional aid for differentiating between unknown primary tumor and thyroid metastasis.

  19. [MRI findings in iliotibial band friction syndrome: a report of two cases].

    Science.gov (United States)

    Isusi, M; Oleaga, L; Campo, M; Grande, D

    2007-01-01

    We present the magnetic resonance imaging (MRI) findings in two males clinically diagnosed with iliotibial band friction syndrome (IBFS), a frequent cause of pain in the lateral compartment of the knee. Coronal T2-weighted images with fat saturation show an ill-defined area of high signal intensity in the soft tissues situated immediately below the iliotibial band lateral to the external condyle of the femur. No thickening of the iliotibial band or changes in its signal intensity were observed. Osseous edema and subchondral osseous erosion in the external condyle of the femur were observed in both cases. Pain in the lateral compartment of the knee might be due to multiple causes that should be included in the differential diagnosis and MRI can play a significant role in reaching the definitive diagnosis.

  20. Auditory dysfunction in selected syndromes and patterns of malformations: review and case findings.

    Science.gov (United States)

    Hall, J W; Prentice, C H; Smiley, G; Werkhaven, J

    1995-01-01

    Hundreds of syndromes may be associated with hearing impairment. Within recent years, there has been heightened research and clinical interest in hearing and syndromes, probably due to both advances in molecular genetics and improved techniques for auditory assessment of infants and young children. An example of the current appreciation for the possible relation between auditory dysfunction and syndromes or patterns of malformations is the inclusion of syndromes as a risk factor for hearing impairment by the 1990 Joint Committee on Infant Hearing. In this paper, we review syndromes and patterns of malformation that are frequently or occasionally associated with hearing impairment. In addition, we illustrate, in case studies, auditory findings that may be associated with three of these syndromes and patterns of malformation: Carpenter syndrome, ichthyosiform dermatosis, and Townes syndrome. We conclude with a discussion of strategies for audiologic assessment and management of infants and children with syndromes and patterns of malformations.

  1. MRI findings of a large pedunculated eccrine poroma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Hyun; Ryu, Jeong Ah; Lee, Jung Il; Pyo, Ju Yeon; Oh, Young Ha [Dept. of ,Hanyang University Guri Hospital, Guri (Korea, Republic of); Lee, Chul Min [Dept. of Radiology, Hanyang University Hospital, Seoul (Korea, Republic of)

    2016-02-15

    Eccrine poroma is a rare benign neoplasm of the eccrine sweat gland that usually presents as a small skin lesion such as a papule or nodule. This benign tumor has an overall good prognosis; however, eccrine porocarcinomas can arise from long-standing pre-existing benign eccrine poromas. We reported the case of a 37-year-old man with mental retardation who presented with an 8-cm pedunculated and densely pigmented eccrine poroma on the left hip. The tumor showed low signal intensity on T1-weighted MRI, with inhomogenously high signal intensity on T2-weighted images and strong contrast enhancement after intravenous gadolinium administration. It directly extended from the dermal layer, and the subcutaneous tissue was preserved. Radiologists should be aware that eccrine poromas could be large and pedunculated. Furthermore, related MRI findings and diagnostic clues should be carefully considered.

  2. MRI findings of the brain in high-voltage electrical burn patient: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Cheung Sook; Hong, Sung Hwan; Lee, Myung Joon; Cho, Seong Whi; Lee, Eil Seong; Kang, Ik Won [Hallym University College of Medicine, Seoul (Korea, Republic of)

    2003-05-01

    We report the delayed sequelae arising in a case of electrical injury, reviewing the literature on the subject and focusing on the MRI findings of the brain. A 23-year-old male suffered burns to the left parietal scalp, both feet, and the anterior chest wall. Neurological symptoms and MRI abnormalities appeared 14 days after the insult and continued for about three months. T1-weight MR images demonstrated homogeneous hypointensity, while T2-weighted images depicted hyperintense finger-like projections. Contrast-enhanced T1-weighted images demonstrated strong band-like enhancement, indicating meningeal hyperemia. Follow-up MR imaging showed that the lesion had disappeared, indicating that the cerebral edema and meaningeal hyperemia were reversible.

  3. Van der Woude syndrome: Report of two cases with supplementary findings

    Directory of Open Access Journals (Sweden)

    Chandramani B More

    2013-01-01

    Full Text Available Van der Woude syndrome (VWS is a rare developmental disorder with an autosomal dominant inheritance and variable expressivity, occurring in about 1 of every 1,00,000-2,00,000 people. This syndrome is remarkably variable. It is characterized by orofacial manifestations like lower lip pits, cleft lip and/or cleft palate, hypodontia, cleft or bifid uvula, syngnathia, narrow high arched palate, ankyloglossia and hyper nasal voice. We report two interesting cases of VWS with characteristic orofacial features and an unusual additional finding of bilateral commissural pits. The purpose of this article is to facilitate understanding of etio-pathogenesis, clinical manifestations, role of genetic counseling and with special emphasis on commissural pits as an additional feature in VWS.

  4. Methylmalonic Acidemia: Diagnosis and Neuroimaging Findings of This Neurometabolic Disorder (An Iranian Pediatric Case Series

    Directory of Open Access Journals (Sweden)

    Parvaneh KARIMZADEH

    2013-08-01

    Full Text Available How To Cite This Article: Karimzadeh P, Jafari N, Jabbehdari S, Taghdiri MM, Nemati H, Saket S, Alaee MR, Ghofrani M, Tonakebni SH. Methylmalonic Acidemia: Diagnosis and Neuroimaging Findings of This Neurometabolic Disorder (An Iranian Pediatric Case Series. Iran J Child Neurol. 2013 Summer; 7(3: 63-66. ObjectiveMethylmalonic acidemia is one of the inborn errors of metabolism resulting in the accumulation of acylcarnitine in blood and increased urinary methylmalonic acid excretion. This disorder can have symptoms, such as neurological and gastrointestinal manifestations, lethargy, and anorexia.Materials & MethodsThe patients who were diagnosed as methylmalonic acidemia in the Neurology Department of Mofid Children’s Hospital in Tehran, Iran, between 2002 and 2012 were included in our study. The disorder was confirmed by clinical findings, neuroimaging findings, and neurometabolic and geneticassessment in reference laboratory in Germany. We assessed the age, gender, past medical history, developmental status, clinical manifestations, and neuroimaging findings of 20 patients with methylmalonic acidemia.ResultsEighty percent of the patients were offspring of consanguineous marriages. Half of the patients had Failure to thrive (FTT due to anorexia; 85% had history of developmental delay or regression, and 20% had refractory seizure, which all of them were controlled. The patients with methylmalonic acidemia were followed for approximately 5 years and the follow-up showedthat the patients with early diagnosis had a more favorable clinical response in growth index, refractory seizure, anorexia, and neurodevelopmental delay. Neuroimaging findings included brain atrophy, basal ganglia involvement (often in putamen, and periventricular leukomalacia.ConclusionAccording to the results of this study, we suggest that early assessment and diagnosis have an important role in the prevention of disease progression and clinical signs.References:1. Trinh BC

  5. A case of pigmentary orthochromatic leukodystrophy with findings of proton MR spectroscopy and serial brain MRIs.

    Science.gov (United States)

    Sohn, Sung-Yeon; Ko, Young-Jin; Hong, Ji Man; Kim, Se-Hyuk; Kim, Ho-Sung; Kim, Jang-Hee; Chi, Je-Geun; Moon, So Young

    2010-08-15

    Despite a few case reports over the last 60 years, little progress has been made in defining the phenotype, genotype and pathophysiological mechanisms involved in pigmentary orthochromatic leukodystrophy (POLD). Furthermore, there is currently no data available regarding MRI in patients in the relatively early stages of POLD. Here, we present a 37 year old male patient with brain biopsy-proven POLD who had brain MRIs three times during the first year of his clinical course and proton MR spectroscopy (MRS) throughout his diagnostic evaluation. This patient with POLD was clinically characterized by seizures, rapidly progressive frontally predominant dementia and gait disturbance. The brain MRIs taken serially over the first year revealed progressive development of frontal-predominant white matter changes in the periventricular areas during the earlier periods, which later spread into the deep white matter. His MRS was helpful in the diagnostic approach because the results enabled demyelinating changes to be distinguished from other disease processes such as ischemia, gliosis or tumors. The MRS findings also reflected the disease dynamics because metabolic derangement was observed, even in the white matter that appeared normal. The findings presented here provide insight into the dynamics of POLD.

  6. Ophthalmic findings in acute mercury poisoning in adults: A case series study.

    Science.gov (United States)

    Aslan, Lokman; Aslankurt, Murat; Bozkurt, Selim; Aksoy, Adnan; Ozdemir, Murat; Gizir, Harun; Yasar, Ibrahim

    2015-08-01

    The aim of this study is to report ophthalmic findings of acute mercury poisoning in 48 adults referred to emergency department. Full ophthalmologic examination including the best corrected visual acuity, external eye examination, reaction to light, a slit-lamp examination, funduscopy, intraocular pressure measurements, and visual field (VF) and color vision (CV) tests were performed at the presentation and repeated after 6 months. The parametric values of VF test, the mean deviation (MD), and pattern standard deviation (PSD) were recorded in order to compare patients and the 30 healthy controls. The mean parameter of color confusion index in patients was found to be statistically different than controls (p < 0.01). The MD and PSD in patients were different from controls statistically significant (p < 0.01 and p < 0.01, respectively). There was no correlation between the ocular findings and the urine and blood mercury levels. Methyl mercury, held in the school laboratory for experimental purpose, may be a source of poisoning. In this case series, we showed that acute exposure to mercury had hazardous effect on the visual system, especially CV and VF. We propose that emphasizing the public education on the potential hazards of mercury is crucial for preventive community health.

  7. A case of primary malignant fibrous histiocytoma of the pancreas: CT and MRI findings

    Institute of Scientific and Technical Information of China (English)

    Ri-Sheng Yu; Jia-Wei Wang; Ying Chen; Wen-Hong Ding; Xiu-Fang Xu; Li-Rong Chen

    2008-01-01

    Primary malignant fibrous histiocytoma (MFH) of the pancreas is rare and a distinct clinical entity. We report a case of recurrence of pancreatic MFH with computed tomography (CT) and magnetic resonance imaging (MRI)findings. A 67-year-old man presented with a history of decreased body weight over the past 6 mo. Abdominal CT revealed a large, multilocular cystic mass in the head of the pancreas with obvious atrophy in the body and tail of the pancreas. After 6 mo postoperatively, MRI demonstrated a recurrent large mass in the primary area of the head of the pancreas. The lesion was heterogeneous, hypointense to the liver on Tl-weighted imaging, and heterogeneously hyperintense to the liver with a hypointense area in the central part of the tumor on fat-saturated T2-weighted imaging. Contrastenhanced Tl-weighted imaging demonstrated a large multilocular cystic mass with a cystic wall, fibrous septa and enhancement of solid components. To the best of our knowledge, this is the first report on recurrence of primary MFH of the pancreas, and the first with MRI findings.

  8. Lichen amyloidosus: A study of clinical, histopathologic and immunofluorescence findings in 30 cases

    Directory of Open Access Journals (Sweden)

    Salim T

    2005-01-01

    Full Text Available BACKGROUND: Lichen amyloidosus (LA is a primary localized cutaneous amyloidosis characterized clinically by discrete hyperkeratotic hyperpigmented papules and histologically by deposition of amyloid material in previously normal skin without any evidence of visceral involvement. AIMS AND OBJECTIVES: The aim of this work was to study the etiology, clinical features, histopathology and direct immunofluorescence findings in LA. METHODS: A prospective study of 30 patients with clinical, histological and immunofluorescence findings suggestive of LA was undertaken. After a detailed history and clinical examination, two punch biopsies for histopathology and immunofluorescence were taken. RESULTS: Of the 30 patients, 19 (63.3% were males and 11 (36.7% were females with duration of LA ranging from 6-20 months. Pruritus was the presenting symptom in 27 (90% patients. Shin was involved in 26 (86.7% followed by arms in three (10% and back in one (3.3%. Seventeen patients (56% had used scrubs for more than 2 years. Histopathology, direct immunofluorescence and Congo red staining detected amyloid in all cases. CONCLUSIONS: LA commonly presents over the shins as pruritic discrete hyperpigmented papules. Familial predisposition and friction may have a pathogenic role. Histopathological examination is very useful in the detection of amyloid which may be supplemented with direct immunofluorescence and Congo red staining.

  9. Cutaneous mucormycosis and motor vehicle accidents: Findings from an Australian case series.

    Science.gov (United States)

    Ingram, Paul R; Suthananthan, Arul E; Rajan, Ruben; Pryce, Todd M; Sieunarine, Kishore; Gardam, Dianne J; Heath, Christopher H

    2014-11-01

    Cutaneous disease is the third most frequent manifestation of mucormycosis. The clinical manifestations of and subsequent mortality due to cutaneous mucormycosis are dependent on the mode of acquisition and the host immune status. Here, we describe the epidemiology, clinical presentation, microbiology, and outcomes of 16 cutaneous mucormycosis infections managed in an Australian tertiary hospital over a 15-year period. The proportion with localized (56%), deep (38%), and disseminated (6%) cutaneous disease as well as the overall mortality (25%) were consistent with findings reported in the published literature. Two novel forms of hospital-acquired infection were reported following a sacral pressure sore and insertion of a foreign body during a bone graft procedure. The majority of patients were immunocompetent (75%) and/or suffered trauma (56%) with associated environmental contamination. A novel finding was that motor vehicle accidents (MVAs) accounted for 78% of all trauma-related cases, suggesting MVAs should receive greater recognition as a potential precipitant of cutaneous mucormycosis. Aggressive decontamination and debridement of devitalized tissue following trauma is therefore likely to play an important role in the prevention of this rare but potentially devastating infection.

  10. Uncommon manifestations of scrub typhus encephalitis in two cases: Clinical and magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Young Jin; Jeong, Hae Woong [Dept. of Radiology, Inje University Busan Paik Hospital, Busan (Korea, Republic of)

    2015-11-15

    Scrub typhus is a well-known acute febrile illness caused by Orientia tsutsugamushi. This disease has multiorgan involvement, which includes the lungs, heart, liver, spleen, and the central or peripheral nervous system. Scrub typhus involving the central nervous system (CNS) is not rare. However, meningitis and meningoencephalitis can cause changes in mentation and death and are therefore associated with a poor prognosis. We report two consecutive cases of scrub typhus with CNS involvement. One patient presented with extensive white matter involvement, similar to that observed in acute disseminated encephalomyelitis, whereas the other patient presented with subependymal enhancement along the lateral ventricles. To the best of our knowledge, scrub typhus encephalitis, with extensive white matter involvement and subependymal enhancement, are very rarely described findings in the previous literature. Our patients did not show complete recovery, but the symptoms resolved with treatment. Recognizing these uncommon radiologic findings of scrub typhus may be helpful in the early diagnosis of scrub typhus with CNS involvement, which may alter the prognoses of patients.

  11. Sustainability Management with the Sustainability Balanced Scorecard in SMEs: Findings from an Austrian Case Study

    Directory of Open Access Journals (Sweden)

    Susanna Falle

    2016-06-01

    Full Text Available Given the economic importance of small and medium sized enterprises (SMEs and their need for strategic sustainability management, this paper examines the concept of Sustainability Balanced Scorecard (SBSC with respect to SMEs. This case study describes the development of an SBSC in a middle-sized Austrian brewery. The existing methods used in SBSC creation were adapted to suit the company’s specific needs. The findings show that when developing an SBSC it is important to take specific SME characteristics into account and apply methods that allow for adaptation to the prevailing conditions, such as strategic management, organizational structure and resources. In the case study special attention was paid to strategy analysis and thereby the creation of a solid basis for the SBSC. Furthermore, the results show SBSC development is not a process of distinct consecutive steps, as it is often suggested in the literature, but rather that it is a complex process marked by iterative steps. Moreover, the paper highlights the supporting factors and challenges experienced. Whereas top management support, the presence of a project team and high employee involvement were identified as key supporting factors, a lack of specific resources and blurry strategy formulation exert negative influence on the development process. The results presented here should help other SMEs in their development of an SBSC. The paper stimulates scientific discourse on sustainability and strategic management by highlighting the relevant supporting factors and challenges.

  12. SCREENING ASSAYS TO FIND OUT LATE LATENT SYPHILIS CASES - WHICH IS THE BEST ONE?

    Directory of Open Access Journals (Sweden)

    Dr. Dzintars Ozoliņš

    2009-07-01

    Full Text Available The serological methods for diagnosis of syphilis are classified into non-specific (non-treponemal such as Rapid Plasma Reagin (RPR, and specific (treponemal such as Treponema pallidum hemagglutination test (TPHA and Enzyme-linked immunosorbent assay IgG, IgM (ELISA IgG, IgM tests. The aim of this retrospective study was to estimate and compare the sensitivity and specificity of RPR, TPHA and Syphilis ELISA IgG, IgM. The study was conducted on 18 799 clinically healthy persons who had visited the Outpatient clinic of Ministry of the Interior Clinical Centre, Latvia during 2 years period from August 2006 to November 2007. Patients were screened to find out possible late latent syphilis cases by using RPR, TPHA and ELISA IgG, IgM assays. The results showed the highest sensitivity indices of ELISA IgG, IgM and TPHA methods, and the lowest for the RPR test. Highest specificity indices were observed by using ELISA IgG, IgM method followed by TPHA method with lower values and RPR method showing the lowest specificity. To conclude, ELISA IgG, IgM and TPHA methods should be used for screening late latent syphilis cases and ELISA IgG, IgM for diagnosis confirmation. RPR is not recommended for screening purposes.

  13. MRI findings in 6 cases of children by inadvertent ingestion of diphenoxylate-atropine

    Energy Technology Data Exchange (ETDEWEB)

    Xiao Lianxiang [Shandong University School of Medicine, Shandong Medical Imaging Research Institute , No. 44 West Wenhua Road, Jinan 250012 (China); Lin Xiangtao, E-mail: yishui1982@126.com [Shandong University School of Medicine, Shandong Medical Imaging Research Institute, No. 44 West Wenhua Road, Jinan 250012 (China); Cao Jinfeng [Shandong University School of Medicine, Shandong Medical Imaging Research Institute , No. 44 West Wenhua Road, Jinan 250012 (China); Wang Xueyu [Division of Pediatrics, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, Jinan 250021 (China); Wu Lebin [Shandong Medical Imaging Research Institute, No. 324 Jingwu Road, Jinan 250021 (China)

    2011-09-15

    Purpose: Compound diphenoxylate (diphenoxylate-atropine) poisoning can cause toxic encephalopathy in children, and magnetic resonance imaging (MRI) of the brain in this condition has not been reported. This study is to analyze brain MRI findings and to investigate the relations between MRI features and possible pathophysiological changes in children. Methods: Six children accidentally swallowed compound diphenoxylate, 4 males, 2 females, aged 20-46 months, average 33 months. Quantity of ingested diphenoxylate-atropine was from 6 to 30 tablets, each tablet contains diphenoxylate 2.5 mg and atropine 0.025 mg. These patients were referred to our hospital within 24 h after diphenoxylate-atropine ingestion, and underwent brain MRI scan within 24-72 h after emergency treatment. The characteristics of conventional MRI were analyzed. Results: These pediatric patients had various symptoms of opioid intoxication and atropine toxicity. Brain MRI showed abnormal low signal intensity on T1-weighted images (T1WI) and abnormal high signal intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) imaging in bilateral in all cases; abnormal high signal intensity on T1WI, T2WI and FLAIR in 4 cases. Encephalomalacia was observed in 3 cases during follow-up. Conclusion: In the early stage of compound diphenoxylate poisoning in children, multiple extensive edema-necrosis and hemorrhagic-necrosis focus were observed in basic nucleus, pallium and cerebellum, these resulted in the corresponding brain dysfunction with encephalomalacia. MRI scan in the early stage in this condition may provide evidences of brain impairment, and is beneficial for the early diagnosis, treatment and prognosis assessment.

  14. Report of a New Case With Pentasomy X and Novel Clinical Findings

    Directory of Open Access Journals (Sweden)

    Demirhan Osman

    2015-06-01

    Full Text Available Pentasomy X is an extremely rare sex chromosome abnormality, a condition that only affects females, in which three more X chromosomes are added to the normally present two chromosomes in females. We investigated the novel clinical findings in a 1-year-old female baby with pentasomy X, and determined the parental origins of the X chromosomes. Our case had thenar atrophy, postnatal growth deficiency, developmental delay, mongoloid slant, microcephaly, ear anomalies, micrognathia and congenital heart disease. A conventional cytogenetic technique was applied for the diagnosis of the polysomy X, and quantitative fluorescent polymerase chain reaction (QF-PCR using 11 inherited short tandem repeat (STR alleles specific to the chromosome X for the determination of parental origin of X chromosomes. A cytogenetic evaluation revealed that the karyotype of the infant was 49,XXXXX. Comparison of the infant’s features with previously reported cases indicated a clinically recognizable specific pattern of malformations referred to as the pentasomy X syndrome. However, to the best of our know-ledge, this is the first report of thenar atrophy in a patient with 49,XXXXX. The molecular analysis suggested that four X chromosomes of the infant originated from the mother as a result of the non disjunction events in meiosis I and meiosis II. We here state that the clinical manifestations seen in our case were consistent with those described previously in patients with pentasomy X. The degree of early hypotonia constitutes an important early prognostic feature in this syndrome. The pathogenesis of pentasomy X is not clear at present, but it is thought to be caused by successive maternal non disjunctions.

  15. Hepatic Rupture Caused by Hemolysis, Elevated Liver Enzyme, and Low Platelet Count Syndrome: A Case Report with Computed Tomographic and Conventional Angiographic Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Cheong Bok; Ahn, Jae Hong; Choi, Soo Jung; Lee, Jong Hyeog; Park, Man Soo; Jung, Seung Mun; Ryu, Dae Sik [Dept. of Radiology, Asan Foundation, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2013-03-15

    The authors recently obtained successful clinical outcome after embolization of the hepatic artery and right inferior phrenic artery in a pregnant patient with hemolysis, elevated liver enzyme, and low platelet count (HELLP) syndrome causing hepatic rupture. We report the computed tomographic and conventional angiographic findings in a case of HELLP syndrome, resulting in hepatic infarction and rupture with active bleeding.

  16. Kosovo – UNMIK accountability: Human Rights Advisory Panel Finds Discrimination in Privatization Cases

    Directory of Open Access Journals (Sweden)

    Wolfgang Benedek

    2015-10-01

    Full Text Available ENGLISH: The Human Rights Advisory Panel (HRAP established in 2006 to strengthen the accountability of UNMIK in Kosovo so far has dealt mainly with cases regarding property and missing persons. In two recent cases of members of the Egyptian and the Serbian minority (Fillim Guga and Nevenka Ristić it also dealt with privatization of socially - owned enterprises and found discrimination on ethnic grounds by the Special Chamber of the Supreme Court, established by UNMIK for such cases, which raises the accountability of UNMIK. In doing so the panel applied Article 14 of the ECHR on prohibition of discrimination in conjunction with Article 6 ECHR on fair trial in the light of relevant jurisprudence of the European Court of Human Rights. It also pointed out that in these cases the Special Chamber did not recognize a prima facie case of indirect discrimination and did not apply the principle of reversal of proof as required by the Anti - Discrimination Law of Kosovo. On behalf of UNMIK, the Special Representative of the Secretary - General defended the findings of the Special Chamber. The conclusions and recommendations in the Opinion of the Panel hold UNMIK accountable for the violations found and require it to take immediate and effective measures including an apology and adequate compensation for non-pecuniary damage as well as urging EULEX and other competent authorities in Kosovo to reopen the case by the Special Chamber. The work of the HRAP raises wider issues of accountability of international missions like UNMIK, to which it makes an important contribution. DEUTSCH: Das menschenrechtliche Beratungspanel, welches 2006 ins Leben gerufen wurde, um die Verantwortlichkeit von UNMIK im Kosovo zu stärken, hat sich bisher hauptsächlich mit Fällen zum Eigentumsrecht und hinsichtlich verschwundener Personen beschäftigt. In zwei aktuellen Fällen, die Mitglieder der ägyptischen bzw. serbischen Minderheit betrafen (Fillim Guga und Nevenka Risti

  17. Contrast-associated transient cortical blindness: three cases with MRI and electrophysiology findings.

    Science.gov (United States)

    Baguma, Marius; Younan, Nadia; London, Frédéric; Ossemann, Michel; Vandermeeren, Yves

    2016-09-26

    Transient cortical blindness (TCB) is a rare but striking complication following contrast agent injection. TCB might be secondary to a direct toxicity of the contrast agent, leading to an osmotic disruption of the blood-brain barrier (BBB), with a preferential involvement of the posterior circulation and occipital cortex. We report a series of three patients with contrast medium-associated TCB (intra-arterial injection of non-ionic contrast agent during diagnostic cerebral angiography for two of them and coronary angioplasty for the other one). In two patients, the magnetic resonance imaging (MRI) was unremarkable; in the other patient, typical MRI findings were observed, with FLAIR hyperintensities in the right occipital cortex and decreased apparent diffusions coefficient (ADC). Interestingly, this patient also presented posterior rhythmic epileptiform activities on electroencephalogram during the first 36 h. Visual evoked potentials (VEPs) showed normal retinal potential, but a massive destructuration of the later potentials of the cortical origin. To our knowledge, this is the first time that VEPs acquired during TCB are reported. We discuss these findings with respect to the pathophysiology of TCB.

  18. Organisational readiness and Lean Thinking implementation: findings from three emergency department case studies in New Zealand.

    Science.gov (United States)

    Rees, Gareth H

    2014-01-01

    This paper describes and contrasts the implementation of Lean Thinking – a quality methodology that emphasises waste reduction and performing at higher levels of productivity with the same or less resources – into New Zealand's healthcare system. As the field is relatively new, three literature-based exemplar cases were developed to provide an analysis framework to analyse the three New Zealand research sites, which had activities, teamwork, leadership and sustainability as its core themes. Each research site's case was developed from primary data gathered through interviews, augmented by secondary data from project reports, District Health Board websites and media stories. The results highlight the benefits of a supportive quality-focussed organisational culture, executive management involvement and cross-functional teams as enablers. Further, work intensification and workplace resistance were also evident in varying levels within the sites. The study, while reiterating the problems of introducing quality methods from other domains into healthcare, presents the New Zealand context and reinforces that organisational preparedness as a significant factor which contributes to implementation success. This study goes beyond investigations of the use of Lean tools, changing improvement metrics and descriptive statistics to identify the contexts and variables which surround quality and process improvement implementations.

  19. Methamphetamine in hair and interpretation of forensic findings in a fatal case.

    Science.gov (United States)

    Beránková, Katerina; Habrdová, Vilma; Balíková, Marie; Strejc, Premysl

    2005-10-04

    Hair analysis for drugs has been developing and is considered a significant tool for distinguishing between recent and long-term drug abuse in forensic and clinical toxicology. Chronic consumption of drugs can gradually induce certain harmful effects on the human organism and can exacerbate some pre-existing diseases. Analysis for drugs in blood or urine in isolation does not provide sufficient information about the history of drug-use by a person and their results cannot be correlated directly with the toxic effects displayed. The chronic abuse of methamphetamine is known to be associated with cardiovascular diseases. During or after autopsy certain types of morphologic alterations are found in the hearts of stimulant addicts. The rapid increase in blood pressure after an intravenous methamphetamine dose can be risky for addicts with arteriosclerosis. However, the anamnestic data about a deceased person may not always be available to explain the pathological findings and to classify the cause of death correctly. The aim of this study was to demonstrate the value of hair analysis for drugs in the context of explaining pathological cardiovascular alterations observed during the autopsy in a case where methamphetamine consumption was involved. In this case, only methamphetamine and metabolites were detected with traces of ephedrine. Ephedrine is the precursor chemical in the illicit synthesis of methamphetamine (known in the Czech Republic as "Pervitin"). The femoral blood level of methamphetamine was 1500 ng/ml. It was documented by a witness that the 31-year-old man died within 1h after an intravenous injection of the drug. The cause of death was established as cerebral edema due to cerebellar bleeding shortly after an intravenous dose of methamphetamine. Findings of methamphetamine in the first three 2-cm hair segments (numbered from the roots) were nearly equal (132+/-9 ng/mg). In the fourth 2-cm segment, it was approximately one-half of previous values. In the

  20. Atypical Radiological Findings in Patients with Hydatid Cysts of the Lung, Study of 1024 Cases

    Directory of Open Access Journals (Sweden)

    Saeed Mirsadraee

    2013-10-01

    Full Text Available Introduction : The objective of this study was to give a description of the most prominent atypical radiological presentations of lung hydatidosis. Materials and methods: All patients diagnosed with pulmonary hydatidosis by surgical exploration were included in this study. Standard chest roentgenogram and computed tomography CT were evaluated before surgery for lung cysts or unknown lesions. Radiological findings were divided into two categories: 1- Typical hydatid cysts that were previously presented by imaging as a hydatid cyst in the form of an intact cyst, water lily sign and crescent sign. 2- Atypical hydatid cysts that were not similar to typical previously mentioned hydatid cysts. Results: During a 26-year period, 1024 subjects with pulmonary hydatidosis were diagnosed and operated on. Chest X-rays (interpreted in 832 cases showed perforated cysts in 190 (23% and atypical findings such as mass, alveolar type infiltration, abscess and collapse in 113 (13% patients. Seventy-nine patients had a thoracic CT scan in which atypical cysts were detected in 32 subjects (40.5% such as: thick wall cavity in 9 patients (28%, solid masses in 7 (21%, abscesses in 6 (18%, consolidation in 3 (9%, fungus balls in 3 (9%, collapse (atelectasis in 2 (6% and round pneumonia in 2 (6%. Cavity was significantly more frequent in the right lung (90% and mass-like opacity was significantly more frequent in the lower lung field (100%. Conclusion: Hydatid cysts should be considered for most of localized radiological pictures of the lung without respect to localization, size and count of lesions.

  1. Adult meningitis in a setting of high HIV and TB prevalence: findings from 4961 suspected cases

    Directory of Open Access Journals (Sweden)

    Meintjes Graeme

    2010-03-01

    Full Text Available Abstract Background The presentation and causes of adult meningitis in South Africa have changed substantially as a result of HIV. Knowledge of aetiology and laboratory findings in patients presenting with meningitis are important in guiding management. We performed a retrospective study to determine these findings in a setting of high HIV and TB prevalence in Cape Town. Methods Patients undergoing lumbar punctures between 1st January 2006 and 31st December 2008 at a public sector referral hospital were studied. Cases were classified by microbiological diagnosis, or in the absence of definitive microbiology as 1 normal CSF (neutrophils ≤ 1 × 106/L, lymphocytes ≤ 5 × 106/L, protein ≤ 0.5 g/dL, glucose ≥1.5 mmol/L, 2 minor abnormalities (neutrophils 2-5, lymphocytes 6-20, protein 0.51-1.0, glucose 1.0-1.49 or 3 markedly abnormal (neutrophils>5, lymphocytes>20, protein>1.0, glucose Results 5578 LPs were performed on 4549 patients, representing 4961 clinical episodes. Of these, 2293 had normal CSF and 931 had minor abnormalities and no aetiology identified. Of the remaining 1737, microbiological diagnoses were obtained in 820 (47%. Cryptococcus accounted for 63% (514 of microbiological diagnoses, TB for 28% (227, bacterial meningitis for 8% (68. Of the remaining 917 who had marked abnormalities, the majority (59% had a sterile lymphocytic CSF. Of note 16% (81 patients with confirmed Cryptococcus, 5% (12 with TB and 4% (3 with bacterial meningitis had normal CSF cell-counts and biochemistry. Conclusions Cryptococcal and tuberculous meningitis are now the commonest causes of adult meningitis in this setting. TB meningitis is probably underdiagnosed by laboratory investigation, as evidence by the large numbers presenting with sterile lymphocytic markedly abnormal CSFs.

  2. CT findings and surgical treatment of atlanto-axial rotatory fixation. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Shoji, Akira; Harano, Hideyuki; Okumura, Terufumi (Fukuroi Municipal Hospital, Shizuoka (Japan)); Nakagawa, Hiroshi; Sugiyama, Tadamitsu

    1984-07-01

    A case of atlanto-axial rotatory fixation (AARF) was presented in a 19-year-old female who developed sudden onset of neck pain and limitation of neck movement after direct carotid angiography for seizure disorder. Neurological examination was negative except for cock-robin posture and mild hypesthesia and hypalgesia in left C/sub 2/ distribution. Plain films of the cervical spine disclosed abnormal alignment of C/sub 1/-C/sub 2/ and possible rotational dislocation. Bilateral selective vertebral angiography showed marked anterior and posterior displacement of left and right vertebral artery, respectively, at the level of C/sub 1/. On CT metrizamide myelography, there was clockwise rotation of C/sub 1/ on C/sub 2/ with locked facet on the left but no evidence of cord compression was found. With diagnosis of AARF, manual reduction under general anesthesia and with fluoroscopic control was first attempted without success. Therefore, the patient underwent open reduction by using high speed air-drill and posterior fusion of C/sub 1/ to C/sub 3/ with acryl and wire. Postoperative course was uneventful and the patient went back to work as a computer operator in three months. The etiology of AARF was described by many authors, but in our case, congenital hypogenesis of transverse and alar ligaments plus minor trauma was most suggested. For neurological manifestations of AARF, occipital neuralgia, headache, neck pain, limitation of neck movement and cock-robin posture were reported, but the cock-robin posture was most characteristic and was an important symptom for the early diagnosis. In neuroradiological findings of AARF, plain CT and CT metrizamide myelography are very useful. Because they clearly demonstrate the degree of rotation and interlocking of atlanto-axial joints, and the presence of cord compression.

  3. Drivers of routine immunization coverage improvement in Africa: findings from district-level case studies.

    Science.gov (United States)

    LaFond, Anne; Kanagat, Natasha; Steinglass, Robert; Fields, Rebecca; Sequeira, Jenny; Mookherji, Sangeeta

    2015-04-01

    There is limited understanding of why routine immunization (RI) coverage improves in some settings in Africa and not in others. Using a grounded theory approach, we conducted in-depth case studies to understand pathways to coverage improvement by comparing immunization programme experience in 12 districts in three countries (Ethiopia, Cameroon and Ghana). Drawing on positive deviance or assets model techniques we compared the experience of districts where diphtheria-tetanus-pertussis (DTP3)/pentavalent3 (Penta3) coverage improved with districts where DTP3/Penta3 coverage remained unchanged (or steady) over the same period, focusing on basic readiness to deliver immunization services and drivers of coverage improvement. The results informed a model for immunization coverage improvement that emphasizes the dynamics of immunization systems at district level. In all districts, whether improving or steady, we found that a set of basic RI system resources were in place from 2006 to 2010 and did not observe major differences in infrastructure. We found that the differences in coverage trends were due to factors other than basic RI system capacity or service readiness. We identified six common drivers of RI coverage performance improvement-four direct drivers and two enabling drivers-that were present in well-performing districts and weaker or absent in steady coverage districts, and map the pathways from driver to improved supply, demand and coverage. Findings emphasize the critical role of implementation strategies and the need for locally skilled managers that are capable of tailoring strategies to specific settings and community needs. The case studies are unique in their focus on the positive drivers of change and the identification of pathways to coverage improvement, an approach that should be considered in future studies and routine assessments of district-level immunization system performance.

  4. Radiological findings at a South African forensic pathology laboratory in cases of sudden unexpected death in infants

    Directory of Open Access Journals (Sweden)

    Naomi Fenton-Muir

    2012-02-01

    Full Text Available Objectives The work serves as a preliminary evaluation of the utility of the full-body radiography in examining cases of SUDI. Setting This paper reviews findings from full-body digital radiography in cases of sudden unexpected death in infants (SUDI in 2008 at the Salt River Forensic Pathology Laboratory in Cape Town. Subjects Cases of SUDI referred to the mortuary and undergoing full-body digital radiography were reviewed (192 cases. Design Imaging reports were cross-referenced with death registry data. Manner of death, cause of death, whether an autopsy had taken place, and radiological findings, were recorded and analysed. Results The absence of bony fractures was recorded as an imaging finding in 40% of cases. The most common type of imaging pathology was lung disease. In cases where autopsies were performed and pathology was found on imaging, the findings of the two methods of examination were consistent. Conclusions Imaging may have served to assist CoD determination based on case history, and therefore full-body radiography may improve the workflow in busy forensic pathology laboratories. More detailed and consistent recording of imaging findings is required before stronger conclusions may be drawn regarding the utility of full body digital imaging of paediatric cases in forensic pathology laboratories.

  5. Doppler-ultrasonographic finding of air in the portal vein: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ki Soon; Lee, Kwan Sup; Lee, Yul; Chung, Soo Young; Bae, Sang Hoon [College of Medicine, Hallym University, Seoul (Korea, Republic of)

    1994-03-15

    Classically air in the portal vein has been detected on plain radiography, but computed tomography and ultrasonography have been shown to be more sensitive. We report a case of air in the PV in a 10-day-old infant with pneumatosis intestinalis with its ultrasonographic and Doppler findings. The patient was a 10-day-old infant born by cesarean section at 41 weeks. Simple abdomen film revealed branching pattern of radiolucent air shadows within in contour of liver, gas distention of bowel loops and thickenod bowel walls with lincar intraluminal air shadows in abdomen, suggesting necrotizing enterocolitis. So we performed Doppler ultrasonography. Ultrasonography showed branching pattern of hyperechogenic dots and along the lumen of left portal vein. The color Doppler study revealed an aliasing duo to increased velocity and whirling pattern of blood flow, and the Duplex Doppler spectral display showed sharp, vertical bidirectional spikes by air in portal vein. Air in the portal vein can be easily diagnosed by the following signs: hyperechogenic dots in the portal vein on ultrasonography and vertical, sharp bidirectional spikes superimposed on the usual Doppler tracing of the portal vein on Duplex ultrasonography.

  6. Hypohidrotic ectodermal dysplasia: dental, clinical, genetic and dermatoglyphic findings of three cases.

    Science.gov (United States)

    Kargül, B; Alcan, T; Kabalay, U; Atasu, M

    2001-01-01

    Patients with hypohidrotic ectodermal dysplasia (HED) are characterized by the clinical manifestations of hypodontia, hypohidrosis, hypotrichosis and a highly characteristic facial physiognomy. This disorder is inherited as an X-linked trait. This report presents three cases with HED in which the clinical evaluation (intraoral and radiological), genetic findings and SEM examination of hair. Boys 6 to 14 year old and a 11 year old girl were referred to the Marmara University, Faculty of Dentistry, complaining of oligodontia in the maxillary and mandibular arches and delay in eruption of other teeth. Peg-shaped teeth have been observed. The dermatoglyphs of the patients were striking. SEM examination of hair demonstrated a distinctly abnormal longitudinal grooving along the entire length of each hair and a desquamation of the surface cuticles. The treatment was planned in a multidisciplinary odontological group involving pediatric dentistry, orthodontics, prosthodontics and oral surgery and maxillofacial radiology of future dental habilitation. A specially designed overdenture, a removable prosthesis and osseointegrated implants were constructed. Periodic recall visits were advised, to monitor the dentures and implants during periods of growth and development, and eruption of the permanent teeth.

  7. Epidermoid cyst in Meckel's cave with unusual computed tomography and magnetic resonance imaging findings. Case report.

    Science.gov (United States)

    Arai, Atsushi; Sasayama, Takashi; Koyama, Junji; Fujita, Atsushi; Hosoda, Kohkichi; Kohmura, Eiji

    2010-01-01

    A 27-year-old woman presented with headache and occasional numbness over her right face. Computed tomography revealed a hypodense mass in the middle cranial fossa and another adjacent hyperdense mass in the posterior fossa with erosion of the right petrous apex. Magnetic resonance imaging revealed the lesion in the middle cranial fossa as iso- to hypointense on T(1)-weighted and hyperintense on T(2)-weighted imaging, with peripheral enhancement after gadolinium administration, and the adjacent lesion in the posterior fossa as hyperintense on T(1)-weighted and hypointense on T(2)-weighted imaging. During surgery, these lesions mimicking two adjacent distinct tumors were revealed to connect through Meckel's cave. The hypodense lesion in the middle cranial fossa consisted of pearly-like solid contents, and the hyperdense lesion in the posterior cranial fossa consisted of viscid dark-green materials. The tumors were gross totally resected with endoscopic assistance. Histological examination confirmed that the tumor was an epidermoid cyst. The present case cyst indicates that although the diffusion-weighted imaging sequence is useful for detection of intracranial epidermoid cysts, epidermoid cysts including viscous materials with unusual radiological findings could complicate the preoperative diagnosis.

  8. Ultrasonographic and Scintigraphic Findings of Thyroid Hemiagenesis in a Child: Report of a Rare Male Case

    Directory of Open Access Journals (Sweden)

    Ümit Yaşar Ayaz

    2015-01-01

    Full Text Available Thyroid hemiagenesis is a rare congenital anomaly in which one lobe of thyroid gland fails to develop. It is much rarer in males. There is a higher incidence of associated thyroid disorders in patients with thyroid hemiagenesis; therefore early and prompt diagnosis is important for children. We present the ultrasonographic and scintigraphic findings of thyroid hemiagenesis in an eight-year-old-boy. On ultrasonography (US, left lobe of the thyroid gland could not be demonstrated and the right lobe showed minimal hyperplasia. Its echogenicity was normal and no nodule was seen. On thyroid scintigraphy, left lobe of thyroid gland or any ectopic thyroid tissue could not be demonstrated, while the right lobe showed minimal hyperplasia. Without performing any invasive procedure, we enrolled the child in a follow-up program with the guidance of US and scintigraphy, which were effective both in making the final diagnosis of thyroid hemiagenesis and in evaluating the current status of the present thyroid tissue. In conclusion, if only one thyroid lobe is detected in a pediatric case initially with US or scintigraphy, the diagnosis of thyroid hemiagenesis should be suggested and, before any unnecessary or invasive attempt, the other complementary method (scintigraphy/US should be performed.

  9. Synthetic cathinone pharmacokinetics, analytical methods, and toxicological findings from human performance and postmortem cases.

    Science.gov (United States)

    Ellefsen, Kayla N; Concheiro, Marta; Huestis, Marilyn A

    2016-05-01

    Synthetic cathinones are commonly abused novel psychoactive substances (NPS). We present a comprehensive systematic review addressing in vitro and in vivo synthetic cathinone pharmacokinetics, analytical methods for detection and quantification in biological matrices, and toxicological findings from human performance and postmortem toxicology cases. Few preclinical administration studies examined synthetic cathinone pharmacokinetic profiles (absorption, distribution, metabolism, and excretion), and only one investigated metabolite pharmacokinetics. Synthetic cathinone metabolic profiling studies, primarily with human liver microsomes, elucidated metabolite structures and identified suitable biomarkers to extend detection windows beyond those provided by parent compounds. Generally, cathinone derivatives underwent ketone reduction, carbonylation of the pyrrolidine ring, and oxidative reactions, with phase II metabolites also detected. Reliable analytical methods are necessary for cathinone identification in biological matrices to document intake and link adverse events to specific compounds and concentrations. NPS analytical methods are constrained in their ability to detect new emerging synthetic cathinones due to limited commercially available reference standards and continuous development of new analogs. Immunoassay screening methods are especially affected, but also gas-chromatography and liquid-chromatography mass spectrometry confirmation methods. Non-targeted high-resolution-mass spectrometry screening methods are advantageous, as they allow for retrospective data analysis and easier addition of new synthetic cathinones to existing methods. Lack of controlled administration studies in humans complicate interpretation of synthetic cathinones in biological matrices, as dosing information is typically unknown. Furthermore, antemortem and postmortem concentrations often overlap and the presence of other psychoactive substances are typically found in combination

  10. A fatal case of a paint thinner ingestion: comparison between toxicological and histological findings.

    Science.gov (United States)

    Argo, Antonina; Bongiorno, David; Bonifacio, Antonino; Pernice, Valentina; Liotta, Rosa; Indelicato, Serena; Zerbo, Stefania; Fleres, Pierangela; Ceraulo, Leopoldo; Procaccianti, Paolo

    2010-06-01

    Toluene and xylene are aromatic hydrocarbons commonly used as an industrial solvent for the manufacturing of pharmaceuticals, paints, and chemicals. The Occupational Safety and Health Administration has determined that toluene levels of 2000 parts per million (ppm) are considered dangerous to life and health. Several studies have examined the absorption of toluene and xylene following inhalation and oral ingestion in humans. Volatile organic compounds that are absorbed into the blood are distributed throughout the body; in particular, distribution of absorbed toluene and xylene in humans and rodents is characterized by preferential uptake in well-perfused and lipophil tissues such as the brain, liver, lungs, and body fat and also in central nervous system. The available studies indicate that xylenes are rapidly absorbed independently from the kind of exposition. We illustrate a fatal case of self-poisoning by ingestion of varnishes diluting solvents, reporting the identification and quantification of volatile organic compounds (toluene, o-m-p xylene) from human biologic liquids and viscera samples using the Solid-Phase Microextraction-Headspace-Gas Chromatography/Mass Spectrometry to toxicological analysis, and the histopathological findings evaluated in liver, kidney, and lungs.

  11. Rhino-orbital Mucormycosis: Clinical Findings and Treatment Outcomes of Four Cases

    Directory of Open Access Journals (Sweden)

    Şeyda Karadeniz Uğurlu

    2015-08-01

    Full Text Available In this case report, we present the clinical findings and therapeutic outcomes of four rhino-orbital mucormycosis patients. The four patients (1 female, 3 male; age range, 55-77 years all had diabetes mellitus and two also had chronic renal failure. All patients exhibited proptosis, sinusitis, and dark-colored lesions on the nasopharynx and/or hard palate; three patients had ipsilateral peripheral facial paralysis. Visual acuity was no light perception in the two patients with severe orbital involvement and 0.8 in two patients with limited orbital involvement. Histopathological examination of the hard palate, nasopharynx or sinus biopsy revealed typical Mucor hyphae. Systemic liposomal amphotericin B was initiated in all patients. The patients with limited ocular involvement received amphotericin B both intravenously and by local irrigation; both patients had complete recovery. The other two patients underwent orbital exenteration; one patient died after declining systemic treatment postoperatively. Rapid diagnosis and treatment are important for the survival of rhino-orbital mucormycosis patients. With orbital involvement, surgical debridement and systemic and local treatment with antifungal agents may help avoid mutilating surgery like exenteration. (Turk J Ophthalmol 2015; 45: 169-174

  12. Encapsulated subdural empyema. A case report with special reference to CT findings and operative indications

    Energy Technology Data Exchange (ETDEWEB)

    Tokunaga, Yoshiharu; Inoue, Masaru; Ishizaka, Hiroaki; Koga, Hiroaki; Kawano, Teruaki; Mori, Kazuo

    1985-04-01

    A case of encapsulated subdural empyema was reported. This 1.5-year-old boy was admitted with the increasing confusion and convulsion. Eight months prior to admission, he had craniotomy for traumatic acute epidural hematoma on the left side. Following a coagulation of the middle meningeal artery which was the bleeding source, the dura was opened but no cortical damage was noted at that time. The computed tomographic (CT) scan on admission revealed a large subdural collection with a thin enhancing rim on the left side. Emergency craniotomy revealed a collection of subdural pus, which was irrigated and a catheter was put for continuous drainage. Postoperatively, the patient did well, however, following removal of the catheter, three weeks after the first operation, the subdural empyema was reexpanded with a very thick enhancing rim on CT scan. Ultrasonography also clearly demonstrated the formation of the thick membranes. The large craniotomy was performed and empyema with the outer and inner memberanes of 8mm thick was totally excised. Post-operative CT scan did not show any enhancing rim, indicating that enchancement was caused by newly formed vessels within the membranes per se. This findings are totally different from those observed in the brain abscess in which ring enhancement on CT continues months to years following so-called extracapsular excision of abscess. In the brain abscess, surrounding glial tissue with plenty neovascularization is left intact, even after the operation. (author).

  13. Feline cholecystitis and acute neutrophilic cholangitis: clinical findings, bacterial isolates and response to treatment in six cases.

    Science.gov (United States)

    Brain, Philip H; Barrs, Vanessa R; Martin, Patricia; Baral, Randolph; White, Joanna D; Beatty, Julia A

    2006-04-01

    Clinicopathological findings from six cats with confirmed cholecystitis or acute neutrophilic cholangitis are presented. Historical findings included lethargy and anorexia or inappetence of up to five days duration. On physical examination all cats were pyrexic and four out of six were jaundiced and had cranial abdominal pain. Bile samples were obtained by cholecystocentesis at exploratory coeliotomy (two cases) or by percutaneous, ultrasound-guided cholecystocentesis (four cases). Gall bladder rupture and bile peritonitis occurred subsequent to ultrasound-guided cholecystocentesis in one case. The most common bacterial isolate was Escherichia coli (four cases); E coli was isolated alone in two cases, in combination with a Streptococcus species (one case) and in combination with a Clostridium species (one case). Streptococcus species alone was isolated from one case, as was Salmonella enterica serovar Typhimurium. The latter is the first reported case of Salmonella-associated cholecystitis in a cat. Concurrent pancreatic or intestinal disease was detected histologically in three cases. All cases were treated with antimicrobials based on in vitro susceptibility results. Treatment was successful in five cases. One cat with concurrent diffuse epitheliotropic intestinal lymphoma was euthanased. Percutaneous ultrasound-guided cholecystocentesis is an effective, minimally-invasive technique enabling identification of bacterial isolates in cats with inflammatory hepatobiliary disease.

  14. Analysis and planning of dose-finding studies with active control; Auswertung und Planung von Dosis-Findungsstudien mit aktiver Kontrolle

    Energy Technology Data Exchange (ETDEWEB)

    Helms, Hans-Joachim

    2014-06-04

    In the clinical development of radiopharmaceuticals the dose finding plays an important role. The contribution is focused on the evaluation and planning of dose finding studies with active control. It is of primary interest to find the lowest dose that yields the same efficacy as the active control. Besides the target dose confidence intervals are of importance to describe the quality of the target dose estimation. The calculation of case numbers and the determination of the dose steps to be studied are challenging under practical conditions. The contribution covers the demonstration of the statistical model the parameter estimation and the asymptotic properties based on maximum likelihood theory, the spline-based evaluation of nonlinear dose finding studies with active control and the planning of design and number of cases.

  15. Narrative-Based Intervention for Word-Finding Difficulties: A Case Study

    Science.gov (United States)

    Marks, Ian; Stokes, Stephanie F.

    2010-01-01

    Background: Children with word-finding difficulties manifest a high frequency of word-finding characteristics in narrative, yet word-finding interventions have concentrated on single-word treatments and outcome measures. Aims: This study measured the effectiveness of a narrative-based intervention in improving single-word picture-naming and…

  16. The innovation impact of EU emission trading. Findings of company case studies in the German power sector

    Energy Technology Data Exchange (ETDEWEB)

    Rogge, Karoline S. [Fraunhofer-Institut fuer Systemtechnik und Innovationsforschung (ISI), Karlsruhe (Germany); Swiss Federal Inst. of Technology Zurich (ETH Zurich) (Switzerland). Dept. of Management, Technology, and Economics; Schneider, Malte; Hoffmann, Volker H. [Swiss Federal Inst. of Technology Zurich (ETH Zurich) (Switzerland). Dept. of Management, Technology, and Economics

    2010-05-01

    This paper provides a comprehensive analysis of how the European Emission Trading System (EU ETS) as the core climate policy instrument of the European Union has impacted innovation. Towards this end, we investigate the impact of the EU ETS on research, development, and demonstration (RD and D), adoption, and organizational change. In doing so, we pay particular attention to the rela-tive influences of context factors (policy mix, market factors, public acceptance) as well as firm characteristics (value chain position, technology portfolio, size, vision). Empirically, our analysis is based on multiple case studies with 19 power generators, technology providers, and project developers in the German power sector which we conducted from June 2008 until June 2009. We find that the innovation impact of the EU ETS has remained limited so far because of the scheme's initial lack in stringency and predictability and the relatively greater importance of context factors. Additionally, the impact varies tremendously across technologies, firms, and innovation dimensions, and is most pronounced for RD and D on carbon capture technologies and corporate procedural change. Our analysis suggests that the EU ETS by itself may not provide sufficient incentives for fundamental changes in corporate climate innovation activities at a level adequate for reaching political long-term targets. Based on the study's findings, we derive a set of policy and research recommendations. (orig.)

  17. Survey of laboratory findings in suspected cases of bovine spongiform encephalopathy in Denmark from 1990 to 2000

    DEFF Research Database (Denmark)

    Agerholm, J.S.; Tegtmeier, C.L.; Nielsen, T.K.

    2002-01-01

    A survey of the laboratory findings in suspected cases of bovine spongiform encephalopathy (BSE) in Denmark from I June 1990 to '31 December 2000 is presented. During this period BSE was a notifiable disease, and the heads of suspected cases were submitted according to the legislation on BSE....... A total of 176 submissions were made, mostly from bovines with neurological disorders and mainly during the last 3 years of this period. Lesions or other laboratory findings consistent with severe neurological disorders were found in 115 cases. The most frequent diagnosis was encephalic 41 p listeriosis...

  18. Finding the Chinese-American Self in Scholarly Activities and Achievements

    Directory of Open Access Journals (Sweden)

    Shuyong Jiang

    2012-12-01

    Full Text Available As intellectual immigrants, many of the overseas Chinese librarians have a second advanced degree in a subject area and are active in research and scholarly publication. They are in a unique position to promote Chinese culture in a foreign cultural environment and to find their identities through their scholarly activities. The paper is an attempt to showcase some important research outcomes by overseas Chinese librarians. It illustrates how overseas Chinese librarians bring more perspectives in understanding different cultures of East and West. Their achievements in publishing and research have become part of their self-expression as Chinese-Americans.

  19. Tuberculosis Case Finding in Benin, 2000–2014 and Beyond: A Retrospective Cohort and Time Series Study

    Science.gov (United States)

    Ade, Serge; Békou, Wilfried; Adjobimey, Mênonli; Adjibode, Omer; Ade, Gabriel; Harries, Anthony D.; Anagonou, Séverin

    2016-01-01

    Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The “R” software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22%) were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT) represented 78%  ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15–34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country. PMID:27293887

  20. Jugular bulb diverticulum combined with high jugular bulb: a case report with CT and MRA findings

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Seog Wan [College of Medicine, Chonbuk National Univ., Jeonju (Korea, Republic of)

    2004-12-01

    Jugular bulb diverticulum is a rare condition that is characterized by the outpouching of the jugular bulb, and this can lead to hearing loss, tinnitus and vertigo. A few reports have revealed the radiologic findings about jugular bulb diverticulum, but none of them have described the MRA findings concerning this lesion. We present here the CT and MR venography findings in regards to a large high jugular blub and diverticulum we observed in a 47-year-old woman.

  1. Neuroradiological, neurophysiological and molecular findings in infantile Krabbe disease: two case reports

    Directory of Open Access Journals (Sweden)

    Vargiami E

    2016-06-01

    Full Text Available Krabbe disease is an autosomal recessive neurodegenerative disorder due to a defect of the lysosomal enzyme β-galactocerebrosidase (β-GALC. Depending on the age of onset, the disease is classified into infantile and later-onset forms. We report neuroradiological, neurophysiological and molecular findings in two Greek patients with the infantile form of Krabbe disease. The index patients presented at the age of 3.5 and 6 months, respectively, due to developmental delay. Magnetic resonance imaging (MRI of the first patient’s brain demonstrated signs of leukodystrophy, while nerve conduction velocities (NCVs were significantly decreased. The second patient’s MRI at the age of 4 months was initially normal, but at 18 months demonstrated leukodystrophic alterations as well, whereas NCVs were also significantly delayed. In both patients, a severe decrease in β-GALC, activity supported the diagnosis of Krabbe disease, while the final diagnosis was confirmed by molecular genetic testing. Two homozygous mutations of the GALC gene, the c.411_413delTAA [p.K139del] mutation in the first patient, and the c.749T>C [p.I250T] mutation in the second patient, were identified. At their last follow-up visit at the age of 4 and 6 years, respectively, both patients were bedridden and quadri-plegic, suffering from frequent respiratory tract infections and fed through a gastrostomy. Both mutations found in homozygosity in these two unrelated patients of Greek ancestry, could pinpoint a common origin. Genotyping of patients with Krabbe disease is important, in order to contribute to the creation of a European mutation database and to further study possible genotype-phenotype correlations of the disease.

  2. Aicardi syndrome: a case report and radiologic findings; Sindrome de Aicardi: relato de caso e achados radiologicos

    Energy Technology Data Exchange (ETDEWEB)

    Granzotto, Enrico; Prado, Cecilia Hissae Miyake Almeida; Barros, Andre Della Barba; Botter, Carlos Eduardo [Clinica Radiologica Documenta Ltda., Ribeirao Preto, SP (Brazil)]. E-mail: gram79@gmail.com; Mendes, Rozana de Miranda [Santa Casa de Ribeirao Preto, SP (Brazil); Granzotto, Ticiana [Curso de Especializacao em Oftalmologia Professor Ivo Correa Meyer de Porto Alegre, RS (Brazil)

    2008-07-01

    The authors report the findings of Aicardi syndrome, a disease of unknown etiology composed of multiple spasms, chorioretinal lacunae and agenesis of the corpus callosum. They present a case of Aicardi syndrome with characteristic clinical presentation and magnetic resonance imaging findings. The disease, despite being considered rare, has characteristic imaging findings. Over the past years magnetic resonance imaging has improved its ability in demonstrating other findings besides agenesis of the corpus callosum, making the radiologist's role very important in the diagnostic suspicion of this disease. (author)

  3. Histopathologic findings in two cases with history of intrastromal corneal ring segments insertion

    Directory of Open Access Journals (Sweden)

    Mohammad Al-Amry

    2011-01-01

    Full Text Available Intrastromal corneal ring segments (INTACS implantation for mild myopia or keratoconus is simple and effective in most cases. Rarely, major complications can occur due to implantation. In this case report, we present two examples of possible intraoperative and postoperative complications of INTACS. The first case had histopathologic documentation of Descemet′s membrane perforation as an intraoperative complication and the second case had accumulation of foamy histiocytes along the lamellar channels which has not been previously reported. These complications suggest further study is required on the long term effect of INTACS implantation on corneal tissue.

  4. Finding the right research journal - a case example of rejection and acceptance of an article

    DEFF Research Database (Denmark)

    Bonde, Lars Ole

    A case example related to a symposium about the peer review process in Nordic Journla of Music Therapy and other scientific journals......A case example related to a symposium about the peer review process in Nordic Journla of Music Therapy and other scientific journals...

  5. High-resolution computed tomography findings of early mucinous adenocarcinomas and their pathologic characteristics in 22 surgically resected cases

    Energy Technology Data Exchange (ETDEWEB)

    Miyata, Naoko, E-mail: n.miyata@scchr.jp [Division of Thoracic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka 411-8777 (Japan); Endo, Masahiro [Division of Diagnostic Radiology, Shizuoka Cancer Center Hospital (Japan); Nakajima, Takashi [Division of Pathology, Shizuoka Cancer Center Hospital (Japan); Kojima, Hideaki; Maniwa, Tomohiro; Takahashi, Shoji; Isaka, Mitsuhiro [Division of Thoracic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka 411-8777 (Japan); Kameya, Toru [Division of Pathology, Shizuoka Cancer Center Hospital (Japan); Ohde, Yasuhisa [Division of Thoracic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka 411-8777 (Japan)

    2015-05-15

    Highlights: • We clinicopathologically reviewed 22 cases of early mucinous adenocarcinoma. • Radiologically, all cases showed solid or part-solid nodules. • Lobular-bounded margins were observed in 7 cases. • The radiological features could be histologically attributed to mucin production. • One-third of the cases were preoperatively misdiagnosed as inflammatory nodules. - Abstract: Background: The pathological criteria of early-stage mucinous adenocarcinoma of the lung have recently been defined; however, its characteristic radiologic imaging findings are still poorly understood. Thus, this study aimed to clarify the radiologic and pathological findings of early-stage mucinous adenocarcinoma. Materials and methods: In this study, we clinicopathologically reviewed 22 cases of surgically resected mucinous adenocarcinoma in situ (AIS) and minimal invasive adenocarcinoma (MIA), and attempted to elucidate the characteristic radiologic features of early mucinous adenocarcinomas using high-resolution computed tomography (HRCT). Results: Radiologically, the mean value of the maximum diameter of 22 tumours was 2.1 cm (range, 1.0–2.9 cm). Based on the HRCT findings, the tumours were divided into part-solid ground glass nodules (n = 11) and solid nodules (n = 11). The mean CT attenuation value was 25.7 HU (range, 17–35 HU). All tumours, except 3 tumours pathologically diagnosed as AIS, showed air-containing features. According to the preoperative CT findings, 7 (35%) cases were diagnosed as inflammatory nodules. Of these, 4 cases had lobular-bounded margins, and 3 showed vaguely outlined ground glass shadows. Conclusion: The characteristic HRCT findings of mucinous AIS and MIA were solid or part-solid nodules with air-containing spaces. However, some AIS and MIA nodules showed lobular-bounded margins or marginally vaguely outlined ground glass shadows, and were difficult to differentiate from inflammatory nodules.

  6. Finding Quasi-Optimal Network Topologies for Information Transmission in Active Networks

    Science.gov (United States)

    Baptista, Murilo S.; de Carvalho, Josué X.; Hussein, Mahir S.

    2008-01-01

    This work clarifies the relation between network circuit (topology) and behaviour (information transmission and synchronization) in active networks, e.g. neural networks. As an application, we show how one can find network topologies that are able to transmit a large amount of information, possess a large number of communication channels, and are robust under large variations of the network coupling configuration. This theoretical approach is general and does not depend on the particular dynamic of the elements forming the network, since the network topology can be determined by finding a Laplacian matrix (the matrix that describes the connections and the coupling strengths among the elements) whose eigenvalues satisfy some special conditions. To illustrate our ideas and theoretical approaches, we use neural networks of electrically connected chaotic Hindmarsh-Rose neurons. PMID:18941516

  7. Finding quasi-optimal network topologies for information transmission in active networks.

    Directory of Open Access Journals (Sweden)

    Murilo S Baptista

    Full Text Available This work clarifies the relation between network circuit (topology and behaviour (information transmission and synchronization in active networks, e.g. neural networks. As an application, we show how one can find network topologies that are able to transmit a large amount of information, possess a large number of communication channels, and are robust under large variations of the network coupling configuration. This theoretical approach is general and does not depend on the particular dynamic of the elements forming the network, since the network topology can be determined by finding a Laplacian matrix (the matrix that describes the connections and the coupling strengths among the elements whose eigenvalues satisfy some special conditions. To illustrate our ideas and theoretical approaches, we use neural networks of electrically connected chaotic Hindmarsh-Rose neurons.

  8. Inferior mesenteric artery branch avulsion from blunt trauma--CT findings. Case report.

    Science.gov (United States)

    Olson, M; Posniak, H; Gomes, G

    1992-01-01

    Mesenteric arterial injuries are uncommon following blunt abdominal trauma. We describe the computed tomography (CT) findings of a patient with avulsion of a branch of the inferior mesenteric artery following a low-speed motor vehicle accident.

  9. [Radiographic diagnosis of abdominal diseases in foals and ponys. II. Pathologic findings in 60 cases].

    Science.gov (United States)

    Gerhards, H; Klein, H J; Offeney, F

    1990-08-01

    A diagnostic approach based on clinical and radiographic examinations for evaluation of young foals and small ponies with acute abdominal discomfort is presented. Standing right to left lateral abdominal radiographs were taken of 54 foals and 6 ponies using a previously described technique. Interpretation of the radiographs was in conjunction with all clinical and laboratory findings and patient management. Using this approach, the site and cause of acute abdominal discomfort could be diagnosed accurately in 55 of 60 (91%) patients as confirmed by clinical, surgical or necropsy findings. Typical radiographs and photographs taken at surgery or at necropsy are presented. Typical radiographic findings, their interpretation and possible underlying gastrointestinal diseases are listed. The incorporation of standing lateral abdominal radiography in the clinical evaluation of foals and ponies with acute abdominal diseases gives findings of high diagnostic significance and should contribute to clinical decision-making. Abdominal radiography can replace data from rectal palpation in foals and ponies.

  10. MR findings in acute Lyme disease affecting the knee. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Cavallaro, A.; Harrer, T.; Richter, H.; Bautz, W.; Fellner, F.A. [Friedrich-Alexander-Univ., Erlangen-Nuernberg (Germany)

    2002-07-01

    In this paper we report a case with primarily unspecific arthralgia after surgical therapy of hallux valgus deformity and consecutive reflex sympathetic dystrophy in which MR led to the diagnosis of Lyme disease. (orig.)

  11. Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series

    Directory of Open Access Journals (Sweden)

    Marcello H. Nogueira-Barbosa

    2015-12-01

    Full Text Available Abstract Objective: The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Materials and Methods: Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Results: Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5% patients (mean age, 50.9 years; age range, 42-58 years; 42% female. Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Conclusion: Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion.

  12. Imaging Findings of Sonography and Computed Tomography for a Penile Leiomyosarcoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jin; Chung, Jae Joon; Yu, Jeong Sik; Kim, Joo Hee [Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2009-12-15

    We report the ultrasonographic and computed tomography (CT) findings of a deep type of penile leiomyosarcoma that helped characterize a penile mass along with a review of the published literature. Leiomyosarcoma of the penis is a very rare disease characterized by a lobulated, expansile, soft tissue mass in CT images, with peripheral rim enhancement and internal homogeneous low density. The ultrasonographic findings revealed a lobulated and heterogeneously hypoechoic solid mass at the distal tip of the penis.

  13. Endoscopic findings and clinicopathologic characteristics of colonic schistosomiasis:A report of 46 cases

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To make a retrospective analysis of endoscopy findings and clinicopathologic characteristics of colonic schistosomiasis in order to further improve our understanding of the disease and decrease its misdiagnosis. METHODS:Endoscopy findings and clinicopathologic characteristics of 46 intestinal schistosomiasis patients were retrospectively analyzed.All the patients underwent colonoscopy and all biopsy specimens stained with hematoxylin and eosin were observed under a light microscope. RESULTS:Of the 46 co...

  14. CT and orbital ultrasound findings in a case of Castleman disease.

    Science.gov (United States)

    Brubaker, Jacob W; Harrie, Roger P; Patel, Bhupendra C; Davis, Don K; Mamalis, Nick

    2011-01-01

    A 53-year-old man with a 2-month history of left periorbital swelling was found to have a large solid intraconal mass on CT scan. Orbital ultrasound showed that the lesion had a cavernous pattern of internal reflectivity. Histopathology revealed hyaline-vascular type Castleman disease (CD). This article represents the first reported orbital ultrasound findings in CD. The findings of CT scan and ultrasound may be useful in the preoperative evaluation of orbital hyaline-vascular type CD.

  15. Synchronous Morgagni and Bochdalek Hernias: A Case Report of a Unique Approach to a Rare Finding

    Directory of Open Access Journals (Sweden)

    Schlager

    2016-06-01

    Full Text Available Introduction Multiple unilateral congenital diaphragmatic hernias (CDH are extremely rare, described only five times in the medical literature. Concurrent ipsilateral Bochdalek and Morgagni hernias are rarer still with only two cases previously described. In all reported cases of multiple concurrent defects, the hernias were repaired in an open fashion, either via a thoracotomy or laparotomy with both of the two combined Bochdalek and Morgagni hernias repaired via laparotomy. Case Presentation In this case report we have a 2-day-old who developed respiratory distress and on CT scan was found to have a congenital diaphragmatic hernia (CDH or eventration. This patient is ideal for this case report because he meets a lot of the previously established criteria for minimally invasive repair of congenital diaphragmatic hernias - minimal respiratory compromise, no congenital heart defects - and he has synchronous defects which have very rarely been seen before. Here we present the first reported case of concurrent ipsilateral Bochdalek and Morgagni hernias repaired in a one-stage minimally invasive fashion, approaching the Bochdalek hernia thoracoscopically and the Morgagni laparoscopically. The patient had a quick recovery post-operatively and he continues to do well. Conclusions From this experience, we argue that in the right circumstances a completely minimally invasive approach can be taken for synchronous congenital diaphragmatic hernias.

  16. Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases

    Energy Technology Data Exchange (ETDEWEB)

    Boukobza, Monique [APHP - Paris-Diderot University, Department of Neuroradiology and Therapeutic Angiography, Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, Paris (France); Crassard, Isabelle; Bousser, Marie-Germaine [Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Department of Neurology, Paris (France); Chabriat, Hugues [Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Department of Neurology, Paris (France); INSERM UMR 1161 and DHU NeuroVasc, Paris (France)

    2016-01-15

    The main objectives of the present study are to assess the incidence of cerebral venous thrombosis (CVT) presenting as isolated subarachnoid hemorrhage (SAH) and to determine the occurrence of cortical venous thrombosis (CoVT). Among 332 patients with CVT, investigated with the same CT and MR standardized protocol, 33 (10 %) presented with SAH, associated in 11 cases with hemorrhagic infarct or intracerebral hemorrhage. This study is based on 22 cases of CVT presenting as SAH in the absence of hemorrhagic brain lesion. Diagnosis of sinus thrombosis was established on T2* and magnetic resonance venography and that of CoVT on T2* sequence. Diagnostic of SAH was based on fluid-attenuated inversion recovery (FLAIR) sequence. CVT involved lateral sinus in 18 patients, superior sagittal sinus in 16, and straight sinus in 1. Cortical veins were involved in all patients, in continuity with dural sinus thrombosis when present. SAH was circumscribed to few sulci in all cases and mainly localized at the convexity (21 cases). CoVT implied different areas on the same side in four patients and was bilateral in seven. There was no perimesencephalic or basal cisterns hemorrhage. Cortical swelling was present in 12 cases, associated with localized edema. All patients except one had a favorable outcome. This report shows that the incidence of CVT presenting as isolated SAH is evaluated to 6.4 % and that SAH is, in all cases, in the vicinity of CoVT and when dural thrombosis is present in continuity with it. (orig.)

  17. Pathological findings in 2 cases of fatal 25I-NBOMe toxicity.

    Science.gov (United States)

    Walterscheid, Jeffrey P; Phillips, Garrett T; Lopez, Ana E; Gonsoulin, Morna L; Chen, Hsin-Hung; Sanchez, Luis A

    2014-03-01

    The research compound 25I-NBOMe, also known as CIMBI-5 or INBMeO, was created in academic laboratories as a potent serotonin 2A receptor agonist. Because of its high affinity and ambiguous legal status, recreational drug enthusiasts have used this compound as a powerful alternative to other hallucinogenic drugs such as lysergic acid diethylamide. We report 2 deaths after 25I-NBOMe ingestion by decedents who attended separate "rave" parties. The first case involved a 21-year-old male who admitted taking "acid" to his friend. A sudden violent rage caused him to flail about, and he subsequently became unresponsive. The postmortem examination revealed numerous external injuries that were consistent with physical aggression. The second case involved a 15-year-old female who was socializing outside a rave party, became ill, and rapidly deteriorated as her friend transported her to the hospital. The postmortem assessment was similar to the first case in that external contusions featured prominently. Comprehensive toxicology screens in both cases revealed only evidence of marijuana use. A deeper analysis using time-of-flight mass spectrometry revealed the presence of 25I-NBOMe, which was further confirmed by tandem-mass spectrometry. The behavior and injuries in these cases reveal a consistent pattern preceding fatal 25I-NBOMe toxicity.

  18. Leptomeningeal enhancement as a sole magnetic resonance imaging finding of secondary central nervous system vasculitis: A case report

    Directory of Open Access Journals (Sweden)

    Arsida Bajrami

    2016-12-01

    Full Text Available The main radiological findings of central nervous system (CNS consist of multiple subcortical infarcts, parenchymal and leptomeningeal enhancement, petechial hemorrhages on MRI and multifocal caliber changes of the vessels on MRA and DSA. Solely or prominent leptomeningeal enhancement is rarely seen as an isolated manifestation of CNS. We report a case of intracerebral vasculitis secondary to inflammatory bowel disease (IBD showing leptomeningeal enhancement as a unique finding in routine contrast-enhanced cranial MRI and aimed to emphasize the importance of these finding in diagnosing CNS.

  19. Idiopathic muscular hypertrophy of the esophagus. Postmortem incidental finding in six cases and review of the literature.

    Science.gov (United States)

    Demian, S D; Vargas-Cortes, F

    1978-01-01

    Six cases of idiopathic muscular hypertrophy of the esophagus were found at autopsy in a relatively short period of time. As has been the experience in previously reported cases, our finding was incidental at the autopsy in all of the cases. In only one of our patients were there relevant symptoms and radiographic changes that could be attributed to the disease. How often patients with muscular hypertrophy of the esophagus have the clinical syndrome of diffuse esophageal spasm remains unclear. It is therefore evident that only by awareness of this entity can studies of esophageal funtion, x-ray films, and appropriate treatment prevent serious morbidity and occasional mortality from the disease.

  20. Imaging Findings in Chiari I Malformation with Syringomyelia in a Case of Charcot Shoulder

    Directory of Open Access Journals (Sweden)

    Shantanu Kumar

    2011-01-01

    Full Text Available Neuropathic arthropathy of the shoulder is reported in only 5% of cases. Here, we report a rare case of neuropathic arthropathy of the shoulder, secondary to Chiari malformation Type I with associated syringomyelia, that remained undetected for four years. A 38-year-old female presented to our Department with a swelling over the right shoulder that had persisted for four years. X-ray of the joint showed destruction of the head of the right humerus, with typical blunt amputated appearance of the bone and increased joint space. Magnetic resonance imaging showed destruction and lateral dislocation of the head of the humerus. Large amount of fluid collection was seen in and around the right shoulder joint. Neuropathic osteoarthropathy can be defined as bone and joint changes that occurs secondary to loss of sensation. In our case, neuropathic shoulder joint was secondary to syringomyelia associated with Chiari I malformation.

  1. Parental influences on adolescents' physical activity and sedentary behavior: longitudinal findings from Project EAT-II

    Directory of Open Access Journals (Sweden)

    Bauer Katherine W

    2008-02-01

    females 5 years later. Younger adolescents appear to be especially influenced by their same-sex parent. These findings suggest that encouragement may be more influential than parental concern for fitness on adolescents' physical activity habits. Further research is needed to determine how parents can help adolescents decrease sedentary behavior time.

  2. A non-alcoholic Wernicke’s encephalopathy case with atypical MRI findings: Clinic versus radiology

    Science.gov (United States)

    Alpaydin, Sezin; Sirin, Hadiye; Calli, Cem; Celebisoy, Neşe

    2015-01-01

    Wernicke's Encephalopathy is an acute neuropsychiatric syndrome that can be seen in both alcohol abusers and non-alcoholic population as a result of thiamine deficiency. We herein report a non-alcoholic patient with typical clinical presentations but atypical MRI findings. Early clinical suspicion of WE is especially important in non-alcoholic patients with atypical MRI findings. The diagnosis of this group is more difficult to make and the prognosis of the syndrome mostly depends on early initiation of thiamine supplementation. PMID:26306933

  3. Reduction en masse of inguinal hernia: MDCT findings of two cases.

    Science.gov (United States)

    Hoshiai, S; Mori, K; Shiigai, M; Uchikawa, Y; Watanebe, A; Shiotani, S; Atake, S; Minami, M

    2015-12-01

    Reduction en masse of inguinal hernia is an extremely rare complication arising from manual reduction of a hernia. The hernial content remaining in the hernia sac returns above the inguinal canal but remains in the abdominal wall. Accurate preoperative diagnosis of reduction en masse of inguinal hernia is challenging because the hernia appears to be reduced upon physical examination. We experienced two cases of reduction en masse. In both cases, multidetector row computed tomography revealed a closed loop obstruction near the inguinal fossa. In addition, we observed a continuous tract of the hernia sac to the inguinal canal and prominent peritoneal thickening suggestive of the hernia sac.

  4. Congenital left ventricular diverticulum, a rare chest fluoroscopy finding: a case report

    Institute of Scientific and Technical Information of China (English)

    WANG Zhi-wei; WU Hong-bing; MAO Zhi-fu; HU Xiao-ping

    2011-01-01

    Congenital left ventricular diverticulum is a very rare cardiac abnormality and it is not completely understood about its etiology, clinical manifestation, diagnosis, treatment and prognosis. This article presents a case of large congenital diverticulum of the left ventricle. The clinical manifestation included paroxysmal supraventricular tachycardia. The diagnosis was made by chest fluoroscopy observation and confirmed by 64-slice CT-angiography. The arrhythmia alleviated instead of antiarrhythmic drugs but by radiofrequency catheter ablation. Due to the rapid growth of the diverticulum, the patient underwent surgical resection finally. Owing to the fatal risks, clinicians should improve the understanding of this disease by deeply studying more cases, in order to standardize the treatment.

  5. Toxicologic Laboratory Findings in Cases Reported with Hanging Death: a Two-Year Retrospective Study in Northeast Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Ranjbar

    2013-09-01

    How to cite this article: Ranjbar R, Liaghat AR, Ranjbar A, Mohabbati H. Toxicologic Laboratory Findings in Cases Reported with Hanging Death: a Two-Year Retrospective Study in Northeast Iran. Asia Pac J Med Toxicol 2013;2:92-5.

  6. Renal cell carcinomas with t(6;11) (p21;q12): presentation of two cases with computed tomography findings.

    Science.gov (United States)

    Zhao, YiJun; Yao, Jin; Chen, Ni; Zeng, Hao; Zhang, Wei

    2015-06-01

    Renal cell carcinomas with t(6;11) (p21;q12) translocation are extremely rare and primarily affect children and young adults. To our knowledge, there has been no case report focusing on the imaging manifestations in the existing literature. Hence, we describe the computed tomography findings of two young adults.

  7. Questionnaire-based case finding of celiac disease in a population of 8- to 9-year-old children

    DEFF Research Database (Denmark)

    Toftedal, Peter; Hansen, Dorte Gilså; Nielsen, Christian

    2010-01-01

    OBJECTIVE: Antibody screenings and diagnosis of celiac disease (CD) among children with type 1 diabetes have suggested that a considerable proportion of children with CD may, in fact, have preclinical (undiagnosed) symptoms. We aimed to test if a questionnaire would lead to significant case finding...

  8. Abusive head trauma: Differentiation between impact and non-impact cases based on neuroimaging findings and skeletal surveys

    Energy Technology Data Exchange (ETDEWEB)

    Sieswerda-Hoogendoorn, T., E-mail: t.sieswerda@amc.nl [Department of Forensic Medicine, Netherlands Forensic Institute, The Hague (Netherlands); Department of Radiology, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Robben, S.G.F., E-mail: s.robben@maastrichtuniversity.nl [Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht (Netherlands); Karst, W.A., E-mail: w.karst@nfi.minvenj.nl [Department of Forensic Medicine, Netherlands Forensic Institute, P.O. Box 24044, 2490 AA The Hague (Netherlands); Moesker, F.M., E-mail: f.moesker@erasmusmc.nl [Faculty of Medicine, Academic Medical Center, Amsterdam (Netherlands); Aalderen, W.M. van, E-mail: w.m.vanaalderen@amc.nl [Department of Paediatrics, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Laméris, J.S., E-mail: j.s.lameris@amc.nl [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Rijn, R.R. van, E-mail: r.r.vanrijn@amc.nl [Department of Forensic Medicine, Netherlands Forensic Institute, The Hague (Netherlands); Department of Radiology, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2014-03-15

    Objectives: To determine whether imaging findings can be used to differentiate between impact and non-impact head trauma in a group of fatal and non-fatal abusive head trauma (AHT) victims. Methods: We included all AHT cases in the Netherlands in the period 2005–2012 for which a forensic report was written for a court of law, and for which imaging was available for reassessment. Neuroradiological and musculoskeletal findings were scored by an experienced paediatric radiologist. Results: We identified 124 AHT cases; data for 104 cases (84%) were available for radiological reassessment. The AHT victims with a skull fracture had fewer hypoxic ischaemic injuries than AHT victims without a skull fracture (p = 0.03), but the relative difference was small (33% vs. 57%). There were no significant differences in neuroradiological and musculoskeletal findings between impact and non-impact head trauma cases if the distinction between impact and non-impact head trauma was based on visible head injuries, as determined by clinical examination, as well as on the presence of skull fractures. Conclusions: Neuroradiological and skeletal findings cannot discriminate between impact and non-impact head trauma in abusive head trauma victims.

  9. Uterus Didelphys with Obstructed Hemivagina and Ipsilateral Renal Agenesis: The Radiologic Findings of Five Cases

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Sun Jung; Yi, Boem Ha; Park, Seong Jin; Lee, Hae Kyung; Lee, Kwon Hae; Lee, Hae Hyeog; Kim, Tae Hee [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2010-08-15

    To evaluate the imaging findings of uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis. From March 2003 to December 2008, five patients with uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis were evaluated as part of this study. We retrospectively reviewed the CT, ultrasound, and MRI findings as well as the medical records of each patient. The patients initially underwent an imaging study for abdominal pain (n=3), recurrent vaginal bleeding (n=1), and prenatal evaluation (n=1). Of the five patients that underwent US, four had hematocolpos and two of them had hematometra. Moreover, three patients underwent a CT examination. The MR examination of four patients revealed hematocolpos (n=3), hematometra (n=1), and a tubular structure resembling an ectopic ureter (n=2). The gynecologic examination of a patient without hematocolpos revealed a pinpoint hole in the vaginal septum. Two of four patients with hematocolpos underwent a vaginal septectomy, which resulted in an improvement of the symptoms. The most common finding of patients with uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis is vaginal fluid collection. Hematometra is not a consistent finding and can be transient according to the menstrual cycle. MR is the most useful imaging modality for the diagnosis of an ectopic ureter.

  10. Neurolymphomatosis on F 18 FDG PET/CT and MRI Findings: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Chae Moon; Lee, Sang Woo; Lee, Hong Je; Song, Bong Il; Kim, Hae Won; Kang, Sungmin; Jeong, Shin Young; Ahn, Byeong Cheol; Lee, Jaetae; Chae, Yee Soo [Kyungpook National Univ. Hospital, Daegu (Korea, Republic of)

    2011-03-15

    Neurolymphomatosis is a rare manifestation of malignant lymphoma. A 74 year old man, in complete remission from diffuse large B cell lymphoma, presented with a loss of pain and temperature sensation in the left hemiface and left upper extremity, and motor weakness in the left upper and both lower extremities. Cerebrospinal fluid analysis and brain magnetic resonance imaging (MRI) findings were negative. Combined fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) revealed multiple linear hypermetabolic lesions along the mandibular branch of the left trigeminal nerve, left brachial plexus, right adrenal gland, right femoral nerve, and both sciatic nerves, which corresponded to the patient's complex neurologic symptoms. C spine and pelvic MRI revealed diffuse thickening with enhancement in the left sciatic nerve, but negative findings for other sites identified by FDG PET/CT. These findings for other sites identified by FDG PET/CT. These findings suggest that FDG PET/CT can detect peripheral nerve infiltration by malignant lymphoma earlier than MRI. Thus, if a patient with a history of lymphoma presents with neurologic symptoms, FDG PET/CT should be performed to evaluate neurolymphomatosis.

  11. Brain MR imaging findings in amyotropic lateral sclersis: report of one case

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Sang Il; Lee, Nam Joon [Korea Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Eui Jong; Choi, Woo Suk [Kyunghee Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-04-01

    Amyotropic lateral sclerosis(ALS) is a progressive degenerative illness of unknown cause; we present its characteristic brain magnetic resonance(MR) findings in one patient. A 58-year-old woman who for two years had been suffering from progressive motor weakness and dysarthria was admitted to our hospital. Physical examination and laboratory findings showed a pattern of both upper and lower motor neuron disease such as decreased motor power(Grade 3), tongue atropy, increased deep tendon reflex, a pattern of lower motor neuron disease, as seen on electromyogram, and a pattern of sparing sensory nervous system, extraocular muscle movement, bladder, and bowel function. On axial brain MR proton-density and T2-weighted images, small round areas of high signal intensity were seen bilaterally in the posterior limb of the internal capsule; these corresponded to the corticospinal tract. Additionally, bilateral, subtle lineal low signal intensity in the precentral gyrus was noted on T2-weighted imaging. On the basis of the findings of clinical and laboratory examination, and of typical MR imaging findings, ALS was diagnosed.

  12. CT finding of ruptured splenic artery aneurysm after cesarean section : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Chang Woo; Kim, Hee Jin [CHA Medical College, Pundang CHA Gerneral Hospital Sungnam, (Korea, Republic of)

    2000-03-01

    Spontaneous rupture of a splenic artery aneurysm during puerperium is rare and is due to the non-specific clinical appearance, diagnosis is difficult. We describe a case of spontaneous rupture of splenic artery aneurysm after a Cesarean section. CT showed high-density ascites localized in the lesser sac and left retroperitoneum.

  13. Magnetic resonance imaging findings in Lhermitte-Duclos disease: reports of three cases

    Institute of Scientific and Technical Information of China (English)

    XU Lei; GAO Pei-yi; LIN Yan; TIAN Tong-de; LEI Jing; MA Li

    2005-01-01

    @@ Lhermitte-Duclos disease (LDD), or dysplastic gangliocytoma of the cerebellum, is a rare hamartomatous lesion characterized by a slowly enlarging mass within the cerebellar cortex. The disease reveals unique appearance on magnetic resonance imaging (MRI). Recognition of the imaging features makes the correct diagnosis possible even without a pathological examination. Three cases are presented and analyzed in this report.

  14. CT findings of diffus pneumocephalus due to bacterial meningitis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Seok, Ji Yeon; Kim, Hyun Sook; Bae, Hee Joon; Chung, Hwa Ryung; Kim, Dae Hong; Yoon, Yong Kyu [Eulji Univ. School of Medicine, Seoul (Korea, Republic of)

    2001-01-01

    We report a case of diffuse pneumocephalus due to infection. Brian CT revealed diffuse brian swelling and diffuse pneumocephalus in the ventricular system, subarachnoid space, subdural/epidural space and superior sagittal sinus. CSF disclosed the presence of a yellowwish-green pus-like liquid. Polymerase chain reaction was positive for Haemophilus influenza Ag.

  15. Problems Teachers Face When Doing Action Research and Finding Possible Solutions: Three Cases

    Science.gov (United States)

    Zhou, Jun

    2012-01-01

    Through case studies, this paper explores problems teachers face when doing action research: for instance, teachers may misunderstand the research, mistrust university researchers, lack the time or adequate library resources to conduct research, lack theoretical guidance or knowledge of research methodology, and feel pressure or frustration during…

  16. Dystonia an unusual presentation in pediatric moyamoya disease: Imaging findings of a case

    Directory of Open Access Journals (Sweden)

    Suresh Kumar

    2016-01-01

    Full Text Available Moyamoya disease (MMD is a rare cerebrovascular disease characterized by idiopathic occlusion of bilateral internal carotid arteries and the development of characteristic leptomeningeal collateral vessels along anterior or posterior circulation. We present an unusual case of MMD presenting with generalized dystonia as the predominant manifestation.

  17. Radiologic findings of secondary systemic amyloidosis associated with tuberculosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Seong Tae; Lee, Jae Mun; Kim, Choon Yul; Shinn, Kyung Sub [Catholic University Medical College, Seoul (Korea, Republic of)

    1995-07-15

    Amyloidosis is a rare systemic disease caused by extracellular deposition of insoluble protein. Systemic amyloidosis is subclassified into idiopathic primary and secondary form. The cause of secondary amyloidosis includes tuberculosis, familial Mediterranean fever, rheumatoid arthritis and multiple myeloma. We report a case of tuberculosis-related, secondary systemic amyloidosis which involved liver, spleen, kidneys, stomach, urinary bladder and lymph nodes.

  18. CT findings of primary squamous cell carcinoma of the stomach: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyoung Min; Lee, Chang Hee; Kim, Kyeong Ah; Park, Cheol Min [Guro Hospital of Korea University, Seoul (Korea, Republic of)

    2008-07-15

    Primary squamous cell carcinoma is a rare tumor of the stomach with an incidence ranging from 0.04% to 0.4% of all diagnosed gastric cancers. We report a case of squamous cell carcinoma in the stomach associated with hypertrophic gastropathy and observed as a huge mass and wall thickening on the greater curvature site by a multidetector CT.

  19. Imaging Findings of Follicular Dendritic Cell Sarcoma: Report of Four Cases

    Energy Technology Data Exchange (ETDEWEB)

    Long-Hua, Qiu; Xiao-Yuan, Feng [Affi liated HuaShan Hospital, Fudan University, Shanghai (China); Qin, Xiao; Ya-Jia, Gu; Jian, Wang [Affiliated Cancer Hospital, Fudan University, Shanghai (China)

    2011-02-15

    Follicular dendritic cell sarcoma is a rare malignant neoplasm and little is known about its radiological features. We present here four cases of follicular dendritic cell sarcomas and we provide the image characteristics of these tumors to help radiologists recognize this entity when making a diagnosis

  20. Management of cases suffering from atypical myopathy: interpretations of descriptive, epidemiological and pathophysiological findings

    DEFF Research Database (Denmark)

    van Galen Verwilghen, Gaby; Votion, D.-M.

    2013-01-01

    Atypical myopathy is highly fatal, but about a quarter of affected horses survive. This highlights the need for provision of supportive treatment for these cases. This review is a practical guideline for equine practitioners and includes suggestions for close monitoring of involved organ systems...

  1. Single case methodology in neurobehavioural rehabilitation: preliminary findings on biofeedback in the treatment of challenging behaviour.

    Science.gov (United States)

    O'Neill, Brian; Findlay, Gemma

    2014-01-01

    The use of single-case methodology (SCM) in brain injury rehabilitation is described and contrasted with other methodologies. SCM is optimal when attempting to meet highly individual presentations or to trial innovative solutions. Portable biofeedback is a potentially effective means of helping persons with brain injury to recognise and regulate emotional states. Emotional dysregulation, associated with disinhibition on tests of executive function, is hypothesised to underpin aggressive challenging behaviour and may be amenable to feedback on heart rate variability, a marker for stress. Two case studies of a novel biofeedback intervention, emWave2, to address aggression directed towards the self and towards others are presented. Data from two A-B designs were analysed using the non-overlap all pairs (NAP) statistical method. Clinical significance of outcome is reported in both cases but only Case 2 reached statistical significance. The discussion highlights limitations of the methodology. Results are discussed in relation to the device helping participants differentiate the physiological state associated with stress. The future application of wearable physiological sensing and feedback systems is explored.

  2. Anatomic findings in revision endoscopic sinus surgery: Case series and review of contributory factors

    Science.gov (United States)

    Bewick, Jessica; Egro, Francesco M.; Masterson, Liam; Javer, Amin R.

    2016-01-01

    Background: It is recognized that patients who undergo endoscopic sinus surgery (ESS) do not always achieve control of their disease. The causes are multifactorial; variations in surgical practice have been identified as possible factors in refractory disease. Objective: To reflect on the frequent anatomic findings of patients with chronic rhinosinusitis (CRS) who require revision ESS. Methods: A retrospective review of patients who required revision ESS at a tertiary institution over a 3-year period. Patients for whom maximal medical therapy failed for CRS underwent computed tomography of the paranasal sinuses and image-guided surgery. Surgical records of anatomic findings were reviewed and analyzed. Results: Over 3 years, a total of 75 patients underwent revision procedures, 28% of all ESS performed in the unit. The most frequent finding was a residual uncinate process in 64% of the patients (n = 48); other findings included a maxillary antrostomy not based on the natural ostium of the maxillary sinus in 47% (n = 35), an oversized antrostomy in 29% (n = 22), resected middle turbinates in 35% (n = 26), middle meatal stenosis in 15% (n = 11), synechiae in 29% (n = 22), and osteitic bone that required drilling in 13% (n = 10). Conclusion: Surgical technique can give rise to anatomic variations that may prevent adequate mucociliary clearance and medication delivery, which leads to failure in ESS in patients with CRS. This study demonstrated the surgical findings encountered in revision ESS that should be highlighted in the training of Ear, Nose and Throat surgeons to help prevent primary failure and reduce health care costs. PMID:28107148

  3. Radiologic Findings of Primary Mucinous Cystadenocarcinoma of the Breast: A Report of Two Cases and a Literature Review

    Science.gov (United States)

    Seong, Minjung; Han, Boo-Kyung; Cho, Soo Youn; Cho, Eun Yoon; Lee, Se Kyung; Lee, Jeong Eon

    2016-01-01

    Primary mucinous cystadenocarcinoma (MCA) of the breast is a rare but pathologically distinct breast tumor. There have been some case reports on primary MCA of the breast; however, they have all focused on pathologic findings. Here, we report the radiologic findings of two cases of MCA along with a review of the literature. Breast MCA shows a circumscribed mass with some calcifications on mammography, an intracystic solid mass without increased vascularity or a vascular stalk on ultrasound, and a heterogeneously enhancing mass within a rim-enhancing cyst with intermediate signal intensity on T2-weighted magnetic resonance imaging. These radiologic findings and the presence of mucin in the percutaneous biopsy specimen should suggest the possibility of MCA in the differential diagnosis of a breast tumor. PMID:27721884

  4. MRI findings of acute cerebral swelling and brain edema in the acute stage. A report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Oki, Hideo; Ueda, Shin; Matsumoto, Keizo; Kashihara, Michiharu; Furuichi, Masashi.

    1988-08-01

    We report two cases, one of acute cerebral swelling and the other with a major stroke, whose MRI has shown very interesting findings. Case 1, a 32-year-old male, was admitted to our service because of a lowering of his consciousness immediately after a head injury. On admission, the patient was semicomatous (E/sub 1/M/sub 2/V/sub 1/, with anisocoria (R > L). His plain skull X-ray was normal. A CT scan, however, demonstrated right isodensity hemispheric swelling associated with a subarachnoid hemorrhage in the right Sylvian fissure. A right carotid angiogram showed no vascular disorders. MR imaging of the spin density demonstrated a hyperintensitive thickening of the gray matter in the whole right hemisphere. Case 2, a 58-year-old female, was admitted because of a sudden onset of loss of consciousness, with right hemiparesis and dysarthria. On admission, her consciousness was semicomatous (E/sub 1/M/sub 3/V/sub 1/), and it deteriorated to a deep coma 1 hour later. A CT scan demonstrated a diffuse left hemispheric low density, with a finding of hemorrhagic infarction in the basal ganglia. MR imaging of the spin density showed a hyperintensitive thickening of the gray matter resembling that of Case 1. The findings of the spin-echo images of our two cases showed a hyperintensitive thickening of the gray matter in both. The hyperintensity and thickening of the gray matter apparently indicated a sort of hyperemia and brain edema. These findings led us to suspect that the hyperemia associated with acute cerebral swelling and ischemic brain edema of our two cases originated in the gray matter, although it has been considered that the pathogenesis of acute cerebral swelling is not known and that brain edema, especially vasogenic edema, will mostly develop in the white matter rather than in the gray matter.

  5. LYMPH NODE ASPIRATION CYTOLOGY FINDING IN HIV INFECTED CASES OF A RURAL POPULATION IN SOUTH INDIA

    Directory of Open Access Journals (Sweden)

    Amrutha

    2015-10-01

    Full Text Available OBJECTIVE: To evaluate the findings of aspiration cytology of lymph nodes in HIV infected subjects in a rural population. STUDY DESIGN: The study was conducted in rural population of field practice area of Kamineni institute of medical sciences ( KIMS, Narketpally, Nalgonda. Fine needle aspiration ( FNA was done from different lymph - node site from 50 HIV infected subjects, both air dried and wet smears were prepared. Routine cytology stains and when required special stain were done. Detailed cytomorphological study was conducted. RESULTS: Tuberculus lymphadenitis 28(56% was most common finding followed by reactive lymphadenitis 14(28%, G ranulomatous lymphadenitis 6(12% and suppurative lymphadenitis 2(4%. No other opportunistic infection or malignancy was seen in our study. CONCLUSION: Tuberculus lymphadenitis is the most common cause of lymphadenopathy in HIV infected individuals follow ed by reactive lympadenitis. Fine needle aspiration cytology ( FNAC is a very useful tool in early diagnosis of opportunistic infection and in providing appropriate treatment .

  6. INTRACRANIAL AND INTRASPINAL TUMOURS: REVIEW OF MRI FINDINGS IN A RARE NF - 2 CASE

    Directory of Open Access Journals (Sweden)

    Sahoo

    2015-02-01

    Full Text Available Neurofibromatosis type 2 is a rare autosomal dominant syndrome, characterized by multiple intracranial and intraspinal tumours associated with ocular abnormalities. The most common tumor associated with the disease is the vestibule cochlear schwannoma, and as many as 10% of patients with this tumor have neurofibromatosis type 2. Based on clinical and imaging findings the diagnostic of neurofibromatosis type 2 can be made. In this report we aim to report a 24 - year - old male who was evaluated for progressive h earing loss, vertigo, ataxic gait and right lower limb weakness. During the workup, cranial CT, Brain and whole s pine MRI was done which showed all the findings in one patient including bilateral vestibulocochlear schwannoma, multiple meningiomas, and intr amedullary and extramedullary tumours in spinal cord.

  7. Radiologic Findings of Distal Ureter with Partially Double Lumen: First Case in the Literature

    Directory of Open Access Journals (Sweden)

    Elif Karadeli

    2013-08-01

    Full Text Available Ureter duplication is the most common congenital anomaly of the urinary system. Ureteral duplication varies from a bifid pelvis to completely separate ureters. The reported incidence varies from 0.8% in an autopsy series, to 40% in a pyelography review, and displays a wide spectrum of imaging findings . The unilateral form occurs about 6 times more commonly than the bilateral form, with the left and right sides being almost equally involved. A 37 year old male with no previous history for stone disease presented to the urology department with right sided colicky pain for three hours. Ultrasonography and Computurized Tomography (CT were performed. We demonstrated radiologic findings of distal ureter with partially double lumen. According to our knowledge, it has not been reported in the literature previously.

  8. Prenatal Diagnosis and Postnatal Findings of Cephalothoracopagus Janiceps Disymmetros: A Case Report

    Directory of Open Access Journals (Sweden)

    Lívia Teresa Moreira Rios

    2012-01-01

    Full Text Available Conjoined twins are rare variants of monozygotic twins, which result from an incomplete division of the embryonic disk. Cephalothoracopagus is a rare twin pregnancy described as imperfect fusion of the head and chest, but separated columns, limbs, and pelvis. They occur with incidence rates that range from 1 per 50,000 to 1 per 100,000 births; however, the incidence of the cephalothoracopagus variety is 1 per 58 conjoined twins. In the case of identical and symmetric faces caused by the orientations of the 2 notochordal axes that are perfectly ventroventral, they are called janiceps disymmetros. We present a prenatal diagnosis of a typical case of cephalothoracopagus janiceps disymmetros and the diagnostic confirmation by image and pathology exams.

  9. Difficulties and findings of an empirical legal research: case studies built on judicial documents

    Directory of Open Access Journals (Sweden)

    Vanessa Dorneles Schinke

    2015-01-01

    Full Text Available This paper describes the journey of an empirical researcher during her doctoral studies. Narrated in first person, it describes the practical difficulties and theoretical discoveries built throughout the development of the research that culminated in the methodological choice of using the strategy of case study. Similarly, it inserts theoretical considerations about the methodological choices that presented themselves during the process, especially Robert Yin and Carlo Ginzburg. It explains how these works enabled the combination of several research strategies, along with case study. It describes in detail and reports the exploratory phase, the contact with other areas of research and with professionals in other fields. The text presents the results of research reported because it is not yet completed. It aims to contribute to the solidification of the debate about production of legal knowledge.

  10. Cone Beam Computed Tomography Findings in Calcifying Cystic Odontogenic Tumor Associated with Odontome: A Case Report

    Directory of Open Access Journals (Sweden)

    Tushar Phulambrikar

    2015-12-01

    Full Text Available The calcifying cystic odontogenic tumor (CCOT is a rare cystic odontogenic neoplasm frequently found in association with odontome. This report documents a case of CCOT associated with an odontome arising in the anterior maxilla in a 28-year-old man. Conventional radiographs showed internal calcification within the lesion but were unable to visualize its relation with the adjacent structures and its accurate extent. In this case cone beam computed tomography (CBCT could accurately reveal the extent and the internal structure of the lesion which aided the presumptive diagnosis of the lesion as CCOT. This advanced imaging technique proved to be extremely useful in the radiographic assessment and management of this neoplasm of the maxilla.

  11. Magnetic Resonance Finding of Acute Marchiafava-Bignami Disease with Diffuse Involvement: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Young Jin; Jeong, Hae Woong; In, Hyun Sin [Dept. of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2011-11-15

    Marchiafava-Bignami disease (MBD) is a rare toxic disorder strongly associated with chronic alcoholism. It is characterized by progressive demyelination and necrosis of the corpus callosum. The process may extend to neighboring white matter and subcortical regions. We report a case of MBD in which fluid-attenuated inversion recovery and diffusion-weighted imaging revealed symmetrical hyperintense lesions with diffuse involvement of the corpus callosum, white matter, corticospinal tract, internal capsule, and middle cerebellar peduncle.

  12. Ophthalmic findings in two cases of methanol optic neuropathy with relapsed vision disturbance

    Institute of Scientific and Technical Information of China (English)

    Xiu-Juan; Zhao; Lin; Lu; Mei; Li; Hui; Yang

    2015-01-01

    <正>Dear Sir,We hereby report two cases of methanol optic neuropathy with relapsed vision disturbance.Methanol intoxication appears after accidental or suicidal oral ingestion of industrial solvents or cleaning and antifreeze liquids or occasionally is due to fraudulent adulteration of wine or other alcoholic beverages.Its ingestion can cause severe visual disturbances and the outcomes of visual disturbances vary diffusively.Some completely or partially recovered,and some suffered

  13. Bone Scintigraphy Findings of A Case with Maffucci's Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Mi; Lee, Jong Jin; Kim, Yu Kyeong; Lee, Jeong Won; Chung, Jin Haeng; Kim, Sang Eun [Seoul National University Bundang Hospital, Seoul (Korea, Republic of)

    2010-06-15

    Maffucci's syndrome is a sporadic rare congenital disease that is characterized by enchondromatosis and soft tissue hemangiomas. A systemic evaluation should be considered because this syndrome is related to generalized meso dermal dysplasia, which has a high likelihood of a malignant transformation. Whole-body bone scintigraphy might be helpful for detecting skeletal involvement. We present a case of Maffucci's syndrome suing bone scintigraphy to evaluate the extent of the disease.

  14. Clear cell odontogenic carcinoma: case report with immunohistochemical findings adding support to the challenging diagnosis

    OpenAIRE

    XAVIER, FLÁVIA CALÓ AQUINO; Rodini, Camila Oliveira; Ramalho,Luciana Maria Pedreira; Sarmento,Viviane Almeida; Nunes, Fabio Daumas

    2008-01-01

    Acesso restrito: Texto completo. p. 403-410 Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor associated with aggressive clinical behavior, metastasis, and low survival. We report a case of CCOC affecting the mandible of a 39-year-old man. The tumor presented a biphasic pattern composed of clear cell nests intermingled with eosinophilic cells and separated by collagenous stroma. Immunoreactivity to cytokeratin (CK), specifically AE1/AE3 and CK 8, 14, 18, and 19 was fou...

  15. Two cases of myotonic dystrophy manifesting various ophthalmic findings with genetic evaluation

    OpenAIRE

    Min Ji Kang; Hye Bin Yim; Hyung Bin Hwang

    2016-01-01

    We report two cases of myotonic dystrophy in one family; both diagnosed from genetic analysis following ophthalmic indications, but before the manifestation of systemic symptoms. A 39-year-old female visited our clinic for routine examination. Mild ptosis, sluggish pupillary response, and bilateral snowflake cataracts were found. Fundus examination revealed an increased cup-to-disc ratio (CDR) in both eyes and a defect in the retinal nerve fiber layer in the right eye. Intraocular pressure wa...

  16. RadioIogic findings of mesenteric hemangioma with gastrointestinal bleeding: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki Nam [College of Medicine, Donga Univ., Pusan (Korea, Republic of)

    2004-09-01

    Mesenteric hemangioma is a rare disease entity. To our knowledge, only scattered reports about this condition have appeared in the literature. Herein, the author presents a rare case of mesenteric hemangioma with duodenal ulceration and invasion of the adjacent pancreatic head and transverse mesocolon. The tumor appeared in the form of a mild contrast enhancement of a low attenuation mass on contrast-enhanced CT.

  17. Focal retrograde amnesia: voxel-based morphometry findings in a case without MRI lesions.

    Directory of Open Access Journals (Sweden)

    Bernhard Sehm

    Full Text Available Focal retrograde amnesia (FRA is a rare neurocognitive disorder presenting with an isolated loss of retrograde memory. In the absence of detectable brain lesions, a differentiation of FRA from psychogenic causes is difficult. Here we report a case study of persisting FRA after an epileptic seizure. A thorough neuropsychological assessment confirmed severe retrograde memory deficits while anterograde memory abilities were completely normal. Neurological and psychiatric examination were unremarkable and high-resolution MRI showed no neuroradiologically apparent lesion. However, voxel-based morphometry (VBM-comparing the MRI to an education-, age-and sex-matched control group (n = 20 disclosed distinct gray matter decreases in left temporopolar cortex and a region between right posterior parahippocampal and lingual cortex. Although the results of VBM-based comparisons between a single case and a healthy control group are generally susceptible to differences unrelated to the specific symptoms of the case, we believe that our data suggest a causal role of the cortical areas detected since the retrograde memory deficit is the preeminent neuropsychological difference between patient and controls. This was paralleled by grey matter differences in central nodes of the retrograde memory network. We therefore suggest that these subtle alterations represent structural correlates of the focal retrograde amnesia in our patient. Beyond the implications for the diagnosis and etiology of FRA, our results advocate the use of VBM in conditions that do not show abnormalities in clinical radiological assessment, but show distinct neuropsychological deficits.

  18. A prospective study of the clinical findings, treatment and histopathology of 44 cases of pyotraumatic dermatitis.

    Science.gov (United States)

    Holm, Birgit R; Rest, Joan R; Seewald, Wolfgang

    2004-12-01

    Pyotraumatic dermatitis (hot spot) is a common clinical syndrome in dogs but there are few prospective scientific studies related to it. The aim of this study was to investigate correlations among clinical pyotraumatic dermatitis, histopathology of the lesions and possible predisposing causes. The relationship of these with breed, age, sex and location of lesion was assessed statistically. A clinical diagnosis of acute pyotraumatic dermatitis was made in 44 privately owned dogs. Males exceeded females (P = 0.0348) and lesions were more common in dogs aged 4 years or less (P otitis externa was recorded and the study was conducted in an area without endemic fleas. Fourteen breeds were represented of which Rottweiler, German shepherd dog and golden retriever were most common. There was no significant seasonal incidence and no correlation among site of lesion and cause, time of year, age or sex. Histopathologically, the dogs could be separated into four patterns by the presence or absence of eosinophils and/or folliculitis. Eosinophils have not previously been recorded in pyotraumatic dermatitis but were seen in 29 cases. Acute folliculitis was seen in 20 cases. However, no correlation was seen among age, sex, breed, underlying cause or site of lesion and histopathology. Twenty-seven cases were cultured for bacteria of which 25 grew Staphylococcus intermedius and two were negative.

  19. A Recurrent Case of Pentalogy of Cantrell: A Rare Case with Sonological Findings and Review of Literature

    Science.gov (United States)

    Naren Satya, Srinivas M.; Mayilvaganan, Kamala Retnam; Prathyusha, Ivvala Sai; Gautam, Munnangi Satya; Raidu, Deepthi; Amogh, V.N.

    2017-01-01

    Summary Background Pentalogy of Cantrell (POC) is an extremely rare and complex congenital anomaly. Ultrasound is a valuable, safe, nonionizing, cost effective, widely available, and easily reproducible imaging tool and is indispensible in the diagnosis of POC. Despite the rarity of POC, it is imperative for a radiologist to be aware of its wide spectrum of presentation on ultrasound in first trimester of gestation. Most reported cases in literature till now have been sporadic. In this paper, we aimed to report for the first time in literature, a recurrent case of POC detected in the first trimester in a mother whose previous pregnancy also was terminated in the second trimester medically due to the ultrasound diagnosis of POC. We also discuss the role of ultrasound and other imaging modalities in a case of POC as well as the differential diagnoses which can mimic POC. Case Report A 23-year-old G2P0A1 (Gravida2, para0, abortion1) woman with a gestational age of around 12 weeks was referred for a routine first trimester ultrasound scan. The antenatal ultrasound scan showed a single, live, intrauterine gestation corresponding to a gestational age of 11 weeks and 5 days. The fetal heart was visualized outside the chest through a defect in the lower sternum in association with anterior diaphragmatic and ventral abdominal wall defects suggestive of thoraco-abdominal variety of ectopia cardis. There was a membrane covered, midline, abdominal wall defect at the base of the umbilical cord insertion containing the herniated abdominal organs including the liver, bowel loops and the ectopic cardia. There was a breach in the normal outline of the lower sternum indicating a sternal deficiency. The fetal pericardium was absent. The nuchal translucency was grossly increased. Pentalogy of Cantrell was diagnosed on ultrasound and the patient was explained about the poor prognosis of this condition. An informed consent was obtained after she opted for medical termination of

  20. Acute patellofemoral pain: aggravating activities, clinical examination, MRI and ultrasound findings

    DEFF Research Database (Denmark)

    Brushoj, C.; Holmich, P.; Nielsen, M.B.;

    2008-01-01

    Objective: To investigate acute anterior knee pain caused by overuse in terms of pain location, aggravating activities, findings on clinical examination and ultrasound/MRI examination. To determine if acute anterior knee pain caused by overuse should be classified as a subgroup of patellofemoral...... pain syndrome (PFPS). Methods: In a observational study design 30 army recruits with anterior knee pain (mean duration of pain 4 weeks) were examined using the PFPS pain severity scale (PSS), knee pain diagrams, standardised clinical examination, ultrasound and MRI examinations. Results: On PSS typical......%)), but other synovial covered structures including the fat pad of Hoffa (12 patients (40%)), the medial plica and the joint line (12 patients (40%)) were also involved. Only eight patients (27%) experienced pain on the patellofemoral compression test. Only discrete changes was detected on MRI...

  1. Cytologic findings in malignant myoepithelioma: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sauer Torill

    2007-01-01

    Full Text Available Abstract Background Myoepithelioma of the breast is a rare tumor and the cytologic features have only been described in one previous report. Case presentation The present case comprises a 70 year old woman with a mammographic equivocal and ultrasonographic suspicious lesion. The aspirates were cellular and consisted mainly of single spindle or polymorphic, polygonal cells. The nuclei were generally large, ranging from 2 - > 5 × RBC. Most nuclei had a distinct medium-sized nucleolus. The nuclear outlines were irregular with buds and folds. The chromatin was granular. In the background there was abundant granular metachromatic ground substance and some metachromatic stromal fragments. A few mitotic figures were found. The cytologic diagnosis was suspicious for malignancy and a metaplastic carcinoma where only the non-epithelial component had been aspirated, or a non-epithelial lesion, was suggested. Macroscopically the tumor was round, seemingly well circumscribed, firm and with a white cut surface. The lesion consisted of spindled and polygonal cells with distinct pleomorphism. There were 6–9 mitoses per high power field (HPF. The tumor infiltrated in the surrounding fatty tissue. On immunohistochemistry, tumor cells were positive for smooth muscle actin, keratin MNF 116 and vimentin. Desmin and S-100 were negative. Ultrastructurally, there were abundant tonofilaments, including globular filamentous bodies and granulated endocytoplasmic reticulum with many dilated cisterns. The histologic diagnosis was malignant myoepithelioma. Conclusion The case mirrors completely the WHO definition and the previous cytological and histological descriptions of malignant myoepitheliomas in the literature which describe a spindle cell population with unequivocal nuclear atypia, metachromatic background substance and mitoses.

  2. Acute calcific tendinitis of the rectus femoris associated with intraosseous involvement: a case report with serial CT and MRI findings.

    Science.gov (United States)

    Kim, Young Sung; Lee, Ho Min; Kim, Jong Pil

    2013-11-01

    Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the rectus femoris origin. Mostly reported cases were occurred in the reflected head of the rectus femoris, and only few cases were in the direct head of the rectus femoris. Intraosseous marrow involvement of calcific tendinitis is a more rare condition; it often goes misdiagnosed as an infection or a neoplasm. We report a rare, unusual case of acute calcific tendinitis of the direct head of the rectus femoris associated with intraosseous marrow involvement of calcification in anterior inferior iliac spine with serial CT and MRI findings. Aggressive osseous change may occur in acute calcific tendinitis of the rectus femoris as in this case which should be made an appropriate diagnosis to avoid unnecessary investigation and overtreatment like a surgery.

  3. Histopathologic findings of spontaneous osteonecrosis of the knee at an early stage: a case report.

    Science.gov (United States)

    Hatanaka, Hiroyuki; Yamamoto, Takuaki; Motomura, Goro; Sonoda, Kazuhiko; Iwamoto, Yukihide

    2016-05-01

    We histopathologically examined a surgically resected full specimen obtained from an early-stage spontaneous osteonecrosis of the knee (SPONK). On a mid-coronal cut section of the resected medial femoral condyle, a linear fracture line paralleling the subchondral bone endplate was found. Histopathologically, prominent callus formation was seen comprising of reactive woven bone and granulation tissue on both sides of the fracture. Fracture-related bone debris was focally observed at the osteochondral side of the fracture. Definitive features of antecedent bone infarction such as creeping substitution and bone marrow necrosis were not detected. These findings suggested that SPONK was the result of a subchondral fracture rather than primary osteonecrosis.

  4. Radiologic Findings of Reversed Intestinal Rotation in Adults: 3 Cases Report

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Hyeon Seok; Cho, Jae Ho; Chang, Jay Chun; Kim, Jae Woon; Kim, Kum Rae [Yeungnam University, Gyeongsan (Korea, Republic of); Park, Won Kyu [Suh Joo Mir Radiologic Clinic, Daegu (Korea, Republic of); Kim, Jong Yeol [Gumi CHA University Medical Center, Gumi (Korea, Republic of)

    2009-12-15

    Most anomalies of intestinal rotation are detected during the postneonatal period. In adults, the diagnosis and treatment of patients with a congenital anomaly of the midgut can be difficult because of their extremely rarity. Based on embryology, anomalies of intestinal rotation can be divided into non-rotation, reversed rotation and malrotation. Reversed rotation of the midgut is the rarest of all anomalies of intestinal rotation. Although this anomaly is rare, it can be diagnosed by a detailed knowledge of embryology and anatomy. We report three adult patients with reversed intestinal rotation and review the embryology, clinical presentation and radiographic findings of this disorder

  5. Bone scan findings in calcific tendinitis at the gluteus maximus insertion: some illustrative cases

    Directory of Open Access Journals (Sweden)

    Karel Van Damme

    2017-03-01

    Full Text Available We describe the bone scan and single-photon emission computed tomography/computed tomography findings in calcific tendinitis of the gluteus maximus and discuss its pathophysiology. Although this tendinopathy is mostly self-limiting, awareness of this disease is important for 2 reasons. First, it may explain acute hip symptoms in patients in the resorptive phase of the calcifications. Second, it should be considered as a differential diagnosis for bone scan hot spots in the vicinity of the gluteus maximus tendon and for cortical erosion seen in that region on X-rays or CT.

  6. Bone and gallium scan findings in malignant fibrous histiocytoma. Case report with radiographic and pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Mackey, J.K.; Alexieva-Jackson, B.; Fetters, D.V.; Edwards, S.M.; McBride, J.P.; Cole, R.L.; Trapp, W.G.

    1987-01-01

    Malignant fibrous histiocytoma (MFH) is the most common soft tissue malignancy in adults. The Ga-67 citrate scan findings of an extremity-located MFH, the most common location of this neoplasm, have never been published in English language journals to the best of the authors' knowledge. Ga-67 citrate and Tc-99m MDP scans of the thigh mass accurately depicted the tumor's local extent, including the presence of central ischemic necrosis within the tumor, and the absence of adjacent osseous involvement and distant metastases, as correlated with computed tomography, angiography, and pathologic examinations.

  7. Modelling the exposure of wildlife to radiation: key findings and activities of IAEA working groups

    Energy Technology Data Exchange (ETDEWEB)

    Beresford, Nicholas A. [NERC Centre for Ecology and Hydrology, Lancaster Environment Center, Library Av., Bailrigg, Lancaster, LA1 4AP (United Kingdom); School of Environment and Life Sciences, University of Salford, Manchester, M4 4WT (United Kingdom); Vives i Batlle, Jordi; Vandenhove, Hildegarde [Belgian Nuclear Research Centre, Belgian Nuclear Research Centre, Boeretang 200, 2400 Mol (Belgium); Beaugelin-Seiller, Karine [Institut de Radioprotection et de Surete Nucleaire (IRSN), PRP-ENV, SERIS, LM2E, Cadarache (France); Johansen, Mathew P. [ANSTO Australian Nuclear Science and Technology Organisation, New Illawarra Rd, Menai, NSW (Australia); Goulet, Richard [Canadian Nuclear Safety Commission, Environmental Risk Assessment Division, 280 Slater, Ottawa, K1A0H3 (Canada); Wood, Michael D. [School of Environment and Life Sciences, University of Salford, Manchester, M4 4WT (United Kingdom); Ruedig, Elizabeth [Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins (United States); Stark, Karolina; Bradshaw, Clare [Department of Ecology, Environment and Plant Sciences, Stockholm University, SE-10691 (Sweden); Andersson, Pal [Swedish Radiation Safety Authority, SE-171 16, Stockholm (Sweden); Copplestone, David [Biological and Environmental Sciences, University of Stirling, Stirling, FK9 4LA (United Kingdom); Yankovich, Tamara L.; Fesenko, Sergey [International Atomic Energy Agency, Vienna International Centre, 1400, Vienna (Austria)

    2014-07-01

    In total, participants from 14 countries, representing 19 organisations, actively participated in the model application/inter-comparison activities of the IAEA's EMRAS II programme Biota Modelling Group. A range of models/approaches were used by participants (e.g. the ERICA Tool, RESRAD-BIOTA, the ICRP Framework). The agreed objectives of the group were: 'To improve Member State's capabilities for protection of the environment by comparing and validating models being used, or developed, for biota dose assessment (that may be used) as part of the regulatory process of licensing and compliance monitoring of authorised releases of radionuclides.' The activities of the group, the findings of which will be described, included: - An assessment of the predicted unweighted absorbed dose rates for 74 radionuclides estimated by 10 approaches for five of the ICRPs Reference Animal and Plant geometries assuming 1 Bq per unit organism or media. - Modelling the effect of heterogeneous distributions of radionuclides in sediment profiles on the estimated exposure of organisms. - Model prediction - field data comparisons for freshwater ecosystems in a uranium mining area and a number of wetland environments. - An evaluation of the application of available models to a scenario considering radioactive waste buried in shallow trenches. - Estimating the contribution of {sup 235}U to dose rates in freshwater environments. - Evaluation of the factors contributing to variation in modelling results. The work of the group continues within the framework of the IAEA's MODARIA programme, which was initiated in 2012. The work plan of the MODARIA working group has largely been defined by the findings of the previous EMRAS programme. On-going activities of the working group, which will be described, include the development of a database of dynamic parameters for wildlife dose assessment and exercises involving modelling the exposure of organisms in the marine coastal

  8. Headache secondary to sleep-related bruxism: A case with polysomnographic findings

    Science.gov (United States)

    Das, Sourav; Gupta, Ravi; Dhyani, Mohan; Goel, Deepak

    2015-01-01

    Sleep-related bruxism may present with headache. However, in clinical practice it may be difficult to differentiate from other causes of headache, especially in subjects with substance abuse. We are presenting a case of sleep-related bruxism that presented with headache and sleep-related symptoms in the presence of substance abuse. Polysomnography was used to ascertain cause of headache. How the other possible causes of headache ruled out is also discussed in report. In short, Sleep-related bruxism can cause headache that is worse in the morning. It is associated with poor quality sleep. PMID:25883492

  9. Headache secondary to sleep-related bruxism: A case with polysomnographic findings

    Directory of Open Access Journals (Sweden)

    Sourav Das

    2015-01-01

    Full Text Available Sleep-related bruxism may present with headache. However, in clinical practice it may be difficult to differentiate from other causes of headache, especially in subjects with substance abuse. We are presenting a case of sleep-related bruxism that presented with headache and sleep-related symptoms in the presence of substance abuse. Polysomnography was used to ascertain cause of headache. How the other possible causes of headache ruled out is also discussed in report. In short, Sleep-related bruxism can cause headache that is worse in the morning. It is associated with poor quality sleep.

  10. Granulomatous renal pseudotumor in Wegener's granulomatosis: imaging findings in one case

    Energy Technology Data Exchange (ETDEWEB)

    Verswijvel, G.; Eerens, I.; Oyen, R. [Department of Radiology, University Hospitals. Catholic University of Leuven, Leuven (Belgium); Messiaen, T. [Department of Nephrology, University Hospitals. Catholic University of Leuven, Leuven (Belgium)

    2000-08-01

    Wegener's granulomatosis is a clinico-pathological entity characterized by necrotizing granulomatous angiitis involving the upper- and/or lower respiratory tract and the kidneys. Renal involvement is usually characterized by a rapidly progressive necrotizing glomerulonephritis. A case is presented of a patient who developed renal failure and presented a solitary pseudotumoral lesion in the upper pole of the left kidney. Imaging characteristics on US, CT and MR imaging are discussed. The diagnosis was confirmed with ultrasound-guided needle biopsy. (orig.)

  11. Asymptomatic cerebral involvement in Sjoegren's syndrome: MRI findings of 15 cases

    Energy Technology Data Exchange (ETDEWEB)

    Pierot, L. (Service de Neuroradiologie Charcot, G.H. Pitie-Salpetriere, Paris (France)); Sauve, C. (Service de Neurologie, G.H. Pitie-Salpetriere, Paris (France)); Leger, J.M. (Service de Neurologie, G.H. Pitie-Salpetriere, Paris (France)); Martin, N. (Service de Neuroradiologie Charcot, G.H. Pitie-Salpetriere, Paris (France)); Koeger, A.C. (Service de Rhumatologie, G.H. Pitie-Salpetriere, Paris (France)); Wechsler, B. (Service de Medecine Interne, G.H. Pitie-Salpetriere, Paris (France)); Chiras, J. (Service de Neuroradiologie Charcot, G.H. Pitie-Salpetriere, Paris (France))

    1993-05-01

    Fifteen patients with Sjoegren's syndrome without clinical evidence of central nervous system disease were studied by MRI. Signal abnormalities were observed in 9 (60%). They were always visible on T2-weighted images as small punctale areas of high signal in the basal ganglia and the white mater of the cerebral hemispheres. Abnormalities were less frequently seen on T1-weighted images. Enlargement of cerebral sulci was observed in 6 cases. The specificity and significance of these abnormalities are discussed. (orig.)

  12. Clinical, Radiologic, and Pathologic Findings of Subdural Osteoma: A Case Report

    Science.gov (United States)

    Kim, Eun Young; Hyun, Dong Keun; Park, Hyeonseon; Oh, Se Yang; Yoon, Seung Hwan

    2016-01-01

    We present a case of a subdural osteoma. A 29-year-old female presented with a 3-year history of headaches. Computed tomography scan revealed a homogeneous high-density lesion isolated from the inner table of the frontal bone (a lucent dural line) in the right frontal convexity. Magnetic resonance imaging revealed an extra-axial lesion with a broad base without dural tail sign and punctate enhancement pattern characteristic of abundant adipose tissue. Upon surgical excision, we found a hard bony mass clearly demarcated from the dura. The mass displayed characteristics of an osteoma upon histological examination. The symptom was relieved after operation. PMID:27195262

  13. Dramatic oral findings belonging to a pica patient: a case report.

    Science.gov (United States)

    Toker, Hulya; Ozdemir, Hakan; Ozan, Fatih; Turgut, Mehmet; Goze, Fahrettin; Sencan, Mehmet; Kantarci, Alpdogan

    2009-02-01

    Pica is a compulsive eating of non-nutritive substances and can have serious medical implications. The causes are not known, but the symptom is often associated iron-deficiency. Pica is an under-diagnosed problem. Although few dental problems associated with pica have been reported, because of its potential impact on blood measures, dental professionals must be aware of this common, but commonly missed, condition. This is an unusual case of a patient diagnosed with aggressive periodontitis (AgP) who had a dirt eating habit (geophagia) and was diagnosed as having pica.

  14. Novel diffusion-weighted magnetic resonance imaging findings in leptomeningeal carcinomatosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Y.F.; Chang, F.C.; Hu, H.H.; Hsu, L.C. [Taipei Veterans General Hospital, Taiwan (China). Depts. of Internal Medicine and Radiology, and Neurological Inst.

    2006-12-15

    This report presents a rare case of leptomeningeal carcinomatosis initially presenting with mental impairment and rapidly progressing to coma without any history of malignancy. In addition to highlighting the diagnostic difficulties, the linear high signal intensity along the cortex on the diffusion-weighted imaging (DWI) sequence of magnetic resonance (MR) imaging was identified accidentally. High signal change in the corresponding areas was also noted on unenhanced fluid-attenuated inversion recovery (FLAIR) MR imaging, which may be a novel method of diagnosing leptomeningeal carcinomatosis, which should be studied further.

  15. Adolescent cavitary tuberculosis. Secondary case finding using a social contact scale.

    Science.gov (United States)

    Frisch, L E

    1985-11-01

    The spread of tuberculosis in a university environment following a case of cavitary disease was studied. Six loci of potential secondary infection were ascertained and the persons at risk were identified for tuberculin screening. All named contacts were ranked by the index patient and her friends on a closeness scale for social contact. This scale proved to be an excellent predictor of tuberculin positivity, suggesting that in a noninstitutionalized setting the risk of tuberculin conversion is associated more with social contact than with mere living proximity.

  16. CT and MRI Findings of Primary Renal Angiosarcoma with Spontaneous Rupture and Venous Thrombosis: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwan; Kim, See Hyung; Kim, Young Hwan [Dept. of Radiology, Keimyung University Dongsan Hospital, Daegu (Korea, Republic of)

    2011-06-15

    Primary renal angiosarcoma is a very rare malignant mesenchymal tumor. CT shows a well-margined enhancing mass with hemorrhage, perirenal hematoma and renal vein thrombosis in the lower pole of the right kidney. MRI shows heterogeneous low- and high-signal intensities of the mass on T1- and T2-weighted images, as well as a relatively homogeneous enhancement on contrast enhanced T1-weighted images. We report here on a rare case of primary renal angiosarcoma with spontaneous rupture and venous thrombosis.

  17. Clinical, radiographic, and histological findings of florid cemento-osseous dysplasia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Hee; Song, Byeong Chul; Kimn, Sun Ho; Park, Yang Soon [Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2011-09-15

    Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissue and involve, essentially, the same pathological process. They are usually classified into three main groups: periapical, florid, and focal cemental dysplasias depending on their extent and radiographic appearances. Radiographically, florid cementoosseous dysplasia (FCOD) appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. The best management for the asymptomatic FCOD patient consists of regular recall examinations with prophylaxis. The management of the symptomatic patient is more difficult. A case of FCOD occurring in a 52-year-old edentulous Korean female is reported which is rare with regard to race and sex.

  18. MR imaging findings of orbitofacial infarction secondary to rhinoorbital mucormycosis : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Jong Kwan; Lee, Jae Hee; Jeon, Eun Ju; Kim, Kyong Mee; Kim Ki Jun; Lee, Sung Yong [Our Lady of Mercy Hospital, the Catholic University of Korea, Seoul (Korea, Republic of); Choi, Kyu H. [Kangnam' s St. Mary' s Hospital, Seoul (Korea, Republic of)

    2000-02-01

    Rhino-orbital mucormycosis is the most frequently fatal fungal infection commonly occurring in patients with poorly controlled diabetes mellitus and those who are immunocompromised, and requires prompt treatment. We describe a case of rhino-orbital mucormycosis with orbital cellulitis and paranasal sinusitis, as seen on initial MR images, which on follow-up images had evolved to orbitofacial infarction. MR imaging was useful for the demonstration of orbitofacial infarction, seen as areas of lack of enhancement and thus suggesting vascular involvement by mucor hyphae. (author)

  19. Intraosseous pneumatocyst of the ilium: CT findings in two cases and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Catalano, O. [Department of Radiology, University ``Federico II``, via F. Crispi 92, I-80 121 Naples (Italy); De Rosa, F. [Department of Radiology, Ascalesi Hospital, I-80 122 Naples (Italy); Muto, M. [Department of Neuroradiology, Loreto Nuovo Hospital, I-80 122 Naples (Italy)

    1997-12-01

    Intraosseous pneumatocyst of the ilium is a rare lesion of uncertain origin. It predilects male subjects and may be associated or not with sacroiliac joint degenerative disease, intra-articular gas, sacral pneumatocyst, and communication with the articular space. To our knowledge, only 16 observations have been reported in the literature. We have evaluated with plain radiographs and CT two additional cases. Plain films frequently identify these lesions, but CT is the method of choice in demonstrating their air density and assessing the possible abnormalities of the surrounding bone and sacroiliac joints. (orig.) With 4 figs., 1 tab., 10 refs.

  20. Imaging Finding of Malignant Melanoma of Eustachian Tube with Extension to Middle Ear Cavity: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Km Hong Chul [Dept. of Radiology, Yeungnam University College of Medicine, Daegu (Korea, Republic of); Jang, Han Won [Daekyung Radiologic Clinics, Daegu (Korea, Republic of); Lee, Hui Joong [Dept. of Radiology, Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2012-11-15

    We report a case of malignant melanoma of Eustachian tube with extension to the middle ear cavity and nasopharynx in a 51-year-old woman who presented with right ear fullness. Computed tomography showed a soft tissue mass in the middle ear cavity and caused the widening and eroding of the bony eustachian tube. Magnetic resonance imaging showed well enhancing mass in eustachian tube extending nasopharynx to middle ear cavity. A biopsy of the middle ear cavity mass revealed a malignant amelanotic melanoma.

  1. Imaging Finding of Malignant Melanoma of Eustachian Tube with Extension to Middle Ear Cavity: Case Report

    Science.gov (United States)

    Kim, Hong Chul; Jang, Han Won

    2012-01-01

    We report a case of malignant melanoma of Eustachian tube with extension to the middle ear cavity and nasopharynx in a 51-year-old woman who presented with right ear fullness. Computed tomography showed a soft tissue mass in the middle ear cavity and causedthe widening and eroding of the bony eustachian tube. Magnetic resonance imaging showed well enhancing mass in eustachian tube extending nasopharynx to middle ear cavity. A biopsy of the middle ear cavity mass revealed a malignant amelanotic melanoma. PMID:23118582

  2. Intensive Dysarthria Therapy for Older Children with Cerebral Palsy: Findings from Six Cases

    Science.gov (United States)

    Pennington, Lindsay; Smallman, Claire; Farrier, Faith

    2006-01-01

    Children with cerebral palsy often have speech, language and communication difficulties that affect their access to social and educational activities. Speech and language therapy to improve the intelligibility of the speech of children with cerebral palsy has long been advocated, but there is a dearth of research investigating therapy…

  3. Lentiform fork sign: a magnetic resonance finding in a case of acute metabolic acidosis.

    Science.gov (United States)

    Grasso, Daniela; Borreggine, Carmela; Perfetto, Francesco; Bertozzi, Vincenzo; Trivisano, Marina; Specchio, Luigi Maria; Grilli, Gianpaolo; Macarini, Luca

    2014-06-01

    We report a 33 year-old woman addicted to chronic unspecified solvents abuse with stupor, respiratory disorders, tetraplegia and severe metabolic acidosis. On admission an unenhanced cranial CT scan showed symmetrical hypodensities of both lentiform nuclei. MR imaging performed 12 hours after stupor demonstrates bilateral putaminal hemorrhagic necrosis, bilateral external capsule, corona radiata and deep cerebellar hyperintensities with right cingulate cortex involvement. DWI reflected bilateral putaminal hyperintensities with restricted water diffusion as to citotoxic edema and development of vasogenic edema in the external capsule recalling a fork. On day twenty, after specific treatments MRI demonstrated a bilateral putaminal marginal enhancement. Bilateral putaminal necrosis is a characteristic but non-specific radiological finding of methanol poisoning. Lentiform Fork sign is a rare MRI finding reported in literature in 22 patients with various conditions characterized by metabolic acidosis. Vasogenic edema may be due to the differences in metabolic vulnerability between neurons and astrocytes. We postulate that metabolic acidosis could have an important role to generate this sign.

  4. Radiological findings of bronchogenic cyst - report of two cases; Cisto broncogenico - relato de dois casos

    Energy Technology Data Exchange (ETDEWEB)

    Sales, Anderson Ribeiro; Marchiori, Edson; Nogueira, Aline Silva; Martins, Renata Romano; Almeida, Fabiola Assuncao de; Santos, Teresa Cristina C.R.S. dos [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Gabetto, Marcelo Sadock de Sa [Universidade Federal, Rio de Janeiro, RJ (Brazil). Dept. de Radiologia

    1999-09-01

    In this work the authors report two cases of bronchogenic cyst. The first one, in a 69-year-old female patient, with thoracic pain and dyspnea. At the chest X-ray, a mass in the superior mediastinum was observed. Computed tomography of the thorax showed a cystic expansible formation without impregnation by the contrast agent. The patient was referred to thoracic surgery, where she had resected theexpansible formation, that presented histological characteristics of bronchogenic cyst. The other case, in a 50-year-old female patient, that presented symptoms of malaise, retrosternal pain, dry cough, dyspnea and hemoptysis. The chest X-ray evidenced mass in the posterior mediastinum, projected near the helium of the right lung. Computed tomography of the thorax showed a cystic expansible formation, without impregnation by the contrast agent, located in the posterior mediastinum. The patient was submitted to bronchoscopy, videothorascopy and, finally, to thoracotomy, in which the cystic lesion was resected, whose definitive diagnosis, after histopathological examination, was bronchogenic cyst. (author)

  5. A prenatal case with discrepant findings between non-invasive prenatal testing and fetal genetic testings.

    Science.gov (United States)

    Pan, Qiong; Sun, Baojuan; Huang, Xiaoli; Jing, Xin; Liu, Hailiang; Jiang, Fuman; Zhou, Jie; Lin, Mengmeng; Yue, Hongni; Hu, Ping; Ning, Ying

    2014-01-01

    At 17(+4) week, non-invasive prenatal testing (NIPT) results of a 24-years-old mother showed high risk of monosomy X (45, X). Abnormally shaped head and cardiac defects were observed in prenatal ultrasound scan at 19(+3) week. Amniocentesis conducted at 19(+3) week identified karyotype 47, XX, +18, which suggested that the NIPT failed to detect trisomy 18 (T18) in this case. With a further massively parallel sequencing (MPS) of maternal blood, fetal and placental tissues, we found a confined placental mosaicism (CPM) with non-mosaic T18 fetus and multiclonal placenta with high prevalence of 45, X and low level of T18 cells. FISH and SNP-array evidence from the placental tissue confirmed genetic discrepancy between the fetus and placenta. Because the primary source of the fetal cell-free DNA that NIPT assesses is mostly originated from trophoblast cells, the level of T18 placental mosaicism may cause false negative NIPT result in this rare case of double aneuploidy.

  6. Intramedullary spinal cord ganglioglioma presenting as hyperhidrosis: unique symptoms and magnetic resonance imaging findings: case report.

    Science.gov (United States)

    Murakami, Tomohiro; Koyanagi, Izumi; Kaneko, Takahisa; Yoneta, Akihiro; Keira, Yoshiko; Wanibuchi, Masahiko; Hasegawa, Tadashi; Mikuni, Nobuhiro

    2013-02-01

    Hyperhidrosis is caused by a sympathetic dysfunction of the central or peripheral nervous system. Intramedullary spinal cord lesions can be a cause of hyperhidrosis. The authors report a rare case of intramedullary thoracic spinal cord ganglioglioma presenting as hyperhidrosis. This 16-year-old boy presented with abnormal sweating on the right side of the neck, chest, and the right arm that had been occurring for 6 years. Neurological examination revealed mild motor weakness of the right lower extremity and slightly decreased sensation in the left lower extremity. Hyperhidrosis was observed in the right C3-T8 dermatomes. Magnetic resonance imaging showed an intramedullary tumor at the right side of the spinal cord at the T2-3 level. The tumor showed partial enhancement after Gd administration. The patient underwent removal of the tumor via hemilaminectomy of T2-3. Only subtotal resection was achieved because the margins of the tumor were unclear. Histopathological examination revealed ganglioglioma. Hyperhidrosis gradually improved after surgery. Hyperhidrosis is a rare clinical manifestation of intramedullary spinal cord tumors, and only a few cases have been reported in the literature. The location of the tumor origin, around the right gray matter of the lateral spinal cord, may account for the hyperhidrosis as the initial symptom in this patient. Physicians should examine the spinal cord using MRI studies when a patient has hyperhidrosis with some motor or sensory symptoms of the extremities.

  7. Market-oriented product development as an organizational learning capability: findings from two cases

    OpenAIRE

    Kok, Robert A.W.; Hillebrand, Bas; Biemans, Wim G.

    2002-01-01

    Conceptualizing market orientation at the level of the product development process is relevant, because market orientation is a highly critical factor for new product success and this conceptualization can be used as a starting-point to transform the whole organization into a more market oriented one. Market-oriented product development appears to be more than carrying out a number of marketing activities in a product development process. Using concepts from resourcebased theory and organizat...

  8. An exploration study to find important factors in market entrance: A case study of truck industry

    Directory of Open Access Journals (Sweden)

    Zoheir Khodamoradi

    2013-09-01

    Full Text Available This paper presents an empirical investigation to find important factors influencing market penetration in truck industry. The proposed study designs a questionnaire in Likert scale consists of 51 questions, distributes it among 300 people who worked for different truck industry related units and collects 262 filled ones. Cronbach alpha is calculated as 0.89. In addition, Kaiser-Meyer-Olkin Measure of Sampling Adequacy and Approx. Chi-Square are 0.845 and 3067.443, respectively. The study has implemented principal component analysis and the results have indicated that there were eight factors influencing entering truck making industry including adaptation strategies, new ideas, cost competitiveness, product capabilities, market characteristics, competition threats from external market environment and export accelerators.

  9. {sup 18}F-FDG PET/CT Finding in a Case of Xanthogranulomatous Pyelonephritis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bong Hoi; Hong, Sun Pyo; Yoon, Joon Kee; Pai, Ki Soo; Hong, Jeong; Yim, Hyun Ee [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2009-04-15

    Xanthogranulomatous pyelonephritis is an uncommon chronic renal infection, which is usually found on middle-aged women and is rare in infant. Sometimes it forms focal mass like lesion of kidney with pathologically characteristic lipid-laden macrophage. A 1-month female infant was admitted for fever and moaning sound. On work-up of urinary tract infection, abdomen ultrasonography and computed tomography revealed a large mass on the upper portion of right kidney and PET/CT showed homogeneously increased {sup 18}F-FDG uptake. The radical nephrectomy of right kidney was performed and histology revealed a focal xanthogranulomatous pyelonephritis. To our knowledge, this is the first report presenting the finding of {sup 18}F-FDG PET/CT in the childhood xanthogranulomatous pyelonephritis.

  10. CT and MRI findings in patients with hyperglycemic encephalopathy : three cases report

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Sun Hee; Choi, Hye Young [College of Medicine, Ewha Womans Unviersity, Seoul (Korea, Republic of)

    2000-03-01

    We describe the distinctive brain CT and MRI findings seen in the putamen of three patients with hyperglycemia. The chief complaint of these patients was either chorea (n=3D1) or mental change (n=3D2). They showed hyperglycemia, but physical examination and laboratory data revealed no other abnormalities. In all patients, non-enhanced CT scanning revealed high-attenuated lesions in the unilateral putamen. In two of the three patients, brain MRI performed two days after the onset of symptoms showed an abnormally high signal on T1-weighted images and a low signal on T2-weighted images. One patient had a history of diabetes mellitus, and another had acute myocardiac infarction. The third had no specific history. After the correction of hyperglycemia, the patient's symptoms subsided and diabetes mellitus was diagnosed. (author)

  11. MRI Findings of Juvenile Xanthogranuloma of the Spinal Cord: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Se Young; Park, Hee Jin; Lee, So Yeon; Chung, Eun Chul; Park, Hae Won; Kook, Shin Ho; Rho, Myung Ho; Goo, Ji Hye [Dept. of Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2013-03-15

    Juvenile xanthogranuloma (JXG) is a proliferative histiocytic disorder experienced during childhood and adolescents. JXG commonly presents as a solitary cutaneous lesion. Despite the term 'juvenile', development of the disease during adulthood is possible, although spinal JXG is extremely rare in adults. We describe a 67-year-old female patient who presented with an intradural-extramedullary (IDEM) tumor of the spinal cord. Magnetic resonance imaging (MRI) findings indicative of JXG of the spinal cord were seen, which was then confirmed pathologically. A lumbar spinal MRI with contrast enhancement showed an oval-shaped, well-defined IDEM tumor at the L1 level. This tumor had mixed signal intensity on the T1-weighted image and high signal intensity on the T2-weighted image. Central homogenous enhancement was observed after contrast administration.

  12. Worth it? Findings from a study of how academics assess students’ Web 2.0 activities

    Directory of Open Access Journals (Sweden)

    Kathleen Gray

    2012-02-01

    Full Text Available Educational commentators have offered many pedagogical rationales for using Web 2.0 to support learning in higher education, and academics are being encouraged to find ways for their students to use social web technologies. Questions arise as to the value of these activities compared to more conventional assignments, and whether implementing such changes to student assessment is worth the effort. We conducted a survey of academics’ assessment of students’ Web 2.0 activities in Australian universities and found that this form of assessment is being conducted by a small number of academics, in a range of fields of study, but mainly in Humanities and Social Sciences, with varying kinds of intended and actual learning outcomes. Blogging and wiki-writing predominate, low and medium-stakes assessment are most common, and different methods of marking and feedback are in use. Qualitative feedback from the survey and follow-up interviews gave further insights into benefits and challenges of Web 2.0 assessment in relation to pedagogy, policy and practice. It appears that academics’ conservative approaches to conducting assessment and their novice approaches to utilising social web technologies are factors which seriously limit realising the potential of Web 2.0 for medium or high-stakes assessment.

  13. A case of eosinophilic cholangitis: Imaging findings of contrast-enhanced ultrasonography, cholangioscopy, and intraductal ultrasonography

    Institute of Scientific and Technical Information of China (English)

    Naoki Matsumoto; Masahiko Sugitani; Kiyoshi Yokoyama; Kazuhiko Nakai; Toshiki Yamamoto; Takeshi Otani; Masahiro Ogawa; Naohide Tanaka; Ariyoshi Iwasaki; Yasuyuki Arakawa

    2007-01-01

    A 38-year-old woman was referred to our institution due to epigastralgia. She presented with obstructive jaundice and eosinophilia. Endoscopic retrograde cholangiopancreatography showed diffuse narrowing from the distal common bile duct to the bifurcation of the hepatic ducts. An endoscopic plastic biliary stent was inserted; the specimen obtained from the common bile duct wall revealed dense infiltration by eosinophils.Treatment was started with prednisolone 60 mg daily.The patient's biliary stenosis and eosinophilia gradually improved. Eosinophilic infiltration in the lungs or stomach is relatively common, but it is rare in the common bile dud. Most of the reported cases of eosinophilic cholangitis presented with eosinophilia; our patient's eosinophil count was over 1000/mm3. Since our patient had allergies to pollen and house dust, a relationship between the allergies and the eosinophilic cholangitis was suspected, but no cause was identified.

  14. Unusual ultrasonography findings of recurred mammary fibermatosis mimicking subareolar mastitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Hwa Sung; Kim, Young Seon; Bae, Young Kyung [College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

    2016-09-15

    Fibromatosis, also known as an extra-abdominal desmoid tumor, rarely occurs in the breast and is often mistaken for carcinoma, clinically and radiologically. Desmoid tumor is a monoclonal myofibroblastic neoplasm which is locally aggressive, but rarely metastasizes. We herein report a case of a 64-year-old woman who experienced two episodes of recurrence of mammary fibromatosis. The mass was initially detected by screening mammography. It appeared as an irregularly shaped mass which was confined within the mammary zone. Recurrences were excised from the right breast 10 and 17 months later. The second recurrence occurred in the subareolar area accompanied by skin thickening and showed an anechoic component on ultrasonography, which mimicked subareolar mastitis with an abscess.

  15. Medical-dental findings and management of a child with infantile Refsum disease: a case report.

    Science.gov (United States)

    Acharya, Bhavini S; Ritwik, Priyanshi; Velasquez, Gisela M; Fenton, Sanford J

    2012-06-01

    Infantile Refsum disease (IRD) is a peroxisome biogenesis disorder (PBD), and is part of a larger group of diseases called leukodystrophies, which are inherited conditions that damage the white matter of the brain and affect motor movements. Multiple signs and symptoms of IRD begin in infancy and progress through early childhood, including hearing and visual impairment, intellectual and growth impairment, seizures, liver involvement, and orofacial and dental abnormalities. This paper presents a case history of a 12-year-old female patient with IRD who underwent dental rehabilitation in the operating room under general anesthesia and includes a 2-year follow-up. Medical, dental, and management considerations in the care of this child's condition are presented. This paper also discusses the importance of a multidisciplinary approach in the management of children with special needs.

  16. Prenatal MR findings in a case of aneurysm of the vein of Galen

    Energy Technology Data Exchange (ETDEWEB)

    Kurihara, Nobuyoshi; Ikeda, Kazushige; Mori, Kazuhiro; Hokuto, Isamu [Dept. of Paediatrics, Keio University School of Medicine, Tokyo (Japan); Tokieda, Keisuke [Dept. of Paediatrics, Keio University School of Medicine, Tokyo (Japan); Div. of Neonatology, Department of Paediatrics, Keio University School of Medicine, Tokyo (Japan); Nishimura, Osamu; Ishimoto, Hitoshi [Dept. of Obstetrics and Gynaecology, Keio University School of Medicine, Tokyo (Japan); Yuasa, Yuji [Dept. of Diagnostic Radiology, Keio University School of Medicine, Tokyo (Japan)

    2001-03-01

    We describe a case of aneurysm of the vein of Galen (AVG), which was diagnosed by intrauterine US, MRI and MRA. The baby girl was born at 35 weeks' gestation. She had severe clinical symptoms at birth and died at 29 h of age from intractable congestive heart failure. Intrauterine US detected an intracranial aneurysm and cardiomegaly due to excessive arteriovenous shunting. Intrauterine MRI (SSFSE) confirmed the diagnosis of AVG, and intrauterine MRA (2D-TOF) successfully demonstrated the anatomical structure of the AVG. MRA may be a useful additional sequence to evaluate AVG, and 2D-TOF is thought to be an appropriate technique for scanning fetal AVG. (orig.)

  17. Coma blisters after poisoning caused by central nervous system depressants: case report including histopathological findings.

    Science.gov (United States)

    Branco, Maira Migliari; Capitani, Eduardo Mello De; Cintra, Maria Letícia; Hyslop, Stephen; Carvalho, Adriana Camargo; Bucaretchi, Fabio

    2012-01-01

    Blister formation and eccrine sweat gland necrosis is a cutaneous manifestation associated with states of impaired consciousness, most frequently reported after overdoses of central nervous system depressants, particularly phenobarbital. The case of a 45-year-old woman who developed "coma blisters" at six distinct anatomic sites after confirmed (laboratory) phenobarbital poisoning, associated with other central nervous system depressants (clonazepam, promethazine, oxcarbazepine and quetiapine), is presented. A biopsy from the left thumb blister taken on day 4 revealed focal necrosis of the epidermis and necrosis of sweat gland epithelial cells; direct immunofluorescence was strongly positive for IgG in superficial blood vessel walls but negative for IgM, IgA, C3 and C1q. The patient was discharged on day 21 with no sequelae.

  18. Peliosis hepatis as an early histological finding in idiopathic portal hypertension: A case report

    Institute of Scientific and Technical Information of China (English)

    Annalisa Berzigotti; Donatella Magalotti; Paola Zappoli; Cristina Rossi; Francesco Callea; Marco Zoli

    2006-01-01

    Peliosis hepatis is a rare condition characterized by dilatation of hepatic sinusoids and blood-filled spaces in the liver mainly observed in subjects exposed to toxic substances or estrogens, which is frequently asymptomatic. Non-cirrhotic idiopathic portal hypertension (NCIPH) is also a vascular disease of the liver rarely observed in European countries, which is usually diagnosed only when the hemorrhagic complications of portal hypertension occur. We report a case of NCIPH in a young Caucasian male who was diagnosed with liver peliosis, showing ultrasonographic and endoscopic signs of portal hypertension four years after. A second biopsy was diagnostic for NCIPH. Even if the pathogenesis remains obscure, peliosis hepatis can be considered as an early sign of vascular disease of the liver, which may progress to more definite conditions.

  19. Propilthiouracil-induced diffuse pulmonary hemorrhage: a case report with the clinical and radiologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Jun; Kim, Joung Sook; Kim, Ji Young; Choi, Soo Jeon [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2007-05-15

    Propylthiouracil (PTU) is a drug that's used to manage hyperthyroidism and it can, on rare occasions, induce antineutrophil cytoplasmic antibody-associated vasculitis that involved multiple organ systems and it can also cause extremely rare isolated or diffuse pulmonary hemorrhage. We report here on a case of a patient who develop diffuse pulmonary hemorrhage after she had been taking PTU for five years. The patient is a 33-year-old woman who presented with hemoptysis. Simple chest radiographs and the chest CT showed bilateral ground-glass opacity, consolidation and pulmonary arterial hypertension. The bronchoalveolar lavage fluid revealed alveolar hemorrhage. The laboratory values showed increased perinuclear-antineutrophil cytoplasmic antibody ({rho} - ANCA) and anti-peroxidase antibody titers.

  20. [A case of lichenoid sarcoidosis with characteristic clinical and histopathological findings].

    Science.gov (United States)

    Sanchez-Lopez, Josefa; Porriño-Bustamante, Ma Librada; Aneiros-Fernández, Jose; Naranjo-Sintes, Ramon; Fernández-Pugnaire, Ma Antonia

    2014-04-16

    Sarcoidosis is a multisystem inflammatory disease characterized by the formation of noncaseating granulomas in various organs and tissues. The majority of patients with systemic sarcoidosis will present with lung and lymph node involvement. In addition, 20% have skin involvement that may be the only manifestation of the disease or may be an important prognostic marker for involvement of other organs. There are multiple forms of presentation of cutaneous sarcoidosis, which may be a true challenge.We report a patient with a one month history of an eruption of skin colored papules. Some were grouped in a symmetrical distribution on the trunk, inner arms, and lumbar region. Pathologic examination revealed an infiltrate in the papillary dermis showing a band of noncaseating granulomas along with disruption of the basal lamina and lichenoid changes. The clinicopathological correlation confirmed the diagnosis of lichenoid sarcoidosis. We consider our case interesting owing to the clinical presentation and the lichenoid distribution of granulomas.

  1. Radiologic Findings of an Angioleiomyoma of the Finger: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Bo Seong; Shim, Jae Chan; Lee, Jae Myeong; Nam, Mi Young; Lee, Ghi Jai; Kim, Ho Kyun [Dept. of Diagnostic Radiology, Seoul Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Kim, Ji Young [Dept. of Orthopedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Kang, Yoon Kyeng [Dept. of Pathology, Seoul Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2011-06-15

    Angioleiomyomas are a rare benign smooth muscle tumor arising from vessel walls. Although angioleiomyomas are most frequently reported in the lower extremities and in middle-aged female patients, they can be found throughout the body in male and female adults of all ages. We report a rare case of an angioleiomyoma of the left 3rd digit in a 31-year-old man, which appeared as a small, well defined mass with multiple vascular structures on Doppler sonogram and MRI. The tumor was diagnosed by pathology as an angioleiomyoma. Although angioleiomyomas are relatively infrequent, they should be considered in the differential diagnosis when multiple tortuous vascular structures are seen within a well demarcated mass in extremities on Doppler sonogram and MRI.

  2. A case of adrenal tumour in a lion (Panthera leo: tomographic and ultrasonographic findings.

    Directory of Open Access Journals (Sweden)

    Maurizio Longo

    2015-07-01

    Full Text Available Adrenal gland tumors are common in humans and in several animal species. Studies concerning this neoplasia in human medicine indicate that clinical signs have a high variability. Adrenal adenomas can be occasionally observed in asymptomatic patients during tomographic studies while estrogen-secreting tumors, known as "feminizing adrenal tumors" (FATs, have been rarely reported. The aim of this study is to describe for the first time the Imaging findings of a captivity lion affected by a neoplastic secreting adrenal tumour. An 8 year-old male lion with progressive lack of secondary sex characteristics, disorexia and weight loss was referred to our Institution. The patient was chemically immobilized to undergo general clinical evaluation, hematologic, serum biochemical and hormonal profile, FIV and FeLV tests. Three months later a total body computed tomography and abdominal ultrasonography were performed. Liver and left adrenal lesions FNABs were performed. Imaging findings showed the presence of an extended expansive neoplastic lesion on the left adrenal gland (40x39x37 mm with right adrenal gland atrophy. Generalized hepatopathy associated with a suspected intrahepatic cholestasis was confirmed by ultrasonography. Cytological evaluation ruled out the presence of neuroendocrine cells without malignancy evidences compatible with the adenomatous nature of the lesion, associated with moderate degenerative hepatopathy. Blood tests reported an estradiol concentration of 462 ng/dl. To our knowledge, this is the first description of adrenal mass in a lion associated with secondary feminization, inappetence and high values of hematic estradiol, referable to a feminizing adrenal tumor (FAT. 

  3. The Problem of Finding the Maximal Multiple Flow in the Divisible Network and its Special Cases

    Directory of Open Access Journals (Sweden)

    A. V. Smirnov

    2015-01-01

    Full Text Available In the article the problem of finding the maximal multiple flow in the network of any natural multiplicity k is studied. There are arcs of three types: ordinary arcs, multiple arcs and multi-arcs. Each multiple and multi-arc is a union of k linked arcs, which are adjusted with each other. The network constructing rules are described. The definitions of a divisible network and some associated subjects are stated. The important property of the divisible network is that every divisible network can be partitioned into k parts, which are adjusted on the linked arcs of each multiple and multi-arc. Each part is the ordinary transportation network. The main results of the article are the following subclasses of the problem of finding the maximal multiple flow in the divisible network. 1. The divisible networks with the multi-arc constraints. Assume that only one vertex is the ending vertex for a multi-arc in k −1 network parts. In this case the problem can be solved in a polynomial time. 2. The divisible networks with the weak multi-arc constraints. Assume that only one vertex is the ending vertex for a multi-arc in s network parts (1 ≤ s < k − 1 and other parts have at least two such vertices. In that case the multiplicity of the multiple flow problem can be decreased to k − s. 3. The divisible network of the parallel structure. Assume that the divisible network component, which consists of all multiple arcs, can be partitioned into subcomponents, each of them containing exactly one vertex-beginning of a multi-arc. Suppose that intersection of each pair of subcomponents is the only vertex-network source x0. If k = 2, the maximal flow problem can be solved in a polynomial time. If k ≥ 3, the problem is NP-complete. The algorithms for each polynomial subclass are suggested. Also, the multiplicity decreasing algorithm for the divisible network with weak multi-arc constraints is formulated.

  4. Arthroscopic grafting of scaphoid nonunion - surgical technique and preliminary findings from 23 cases.

    Science.gov (United States)

    Cognet, J-M; Louis, P; Martinache, X; Schernberg, F

    2017-02-01

    We report our experience with the arthroscopic treatment of 23 cases of scaphoid nonunion. We explain the surgical technique and describe the different steps needed to achieve bone union. We report our initial clinical and radiological results. This was a prospective non-randomized study. Inclusion criteria were a scaphoid nonunion without radiocarpal arthritis, without any time limit and without any selection as to nonunion location. Before the operation, patients underwent an X-Ray and CT scan or MRI. Schernberg's classification was used to evaluate the location of the nonunion. Internal fixation was performed with a screw or K-wires. Bone grafts were taken from the dorsal side of the distal radius using a T-Lok™ bone marrow biopsy needle (Argon Medical Devices, Plano, TX, USA). A CT scan was performed 3 months after the operation to determine whether union was achieved. Pain, strength and range of motion were evaluated before and after the operation. The patients' smoking habits were also documented. The average follow-up was 17.3 months (4-41). There were 20 men and 3 women with an average age of 26 years (17-63). The average duration of nonunion before the operation was 17 months (6-60). Based on Schernberg's classification, there was one type I, 12 type II and 10 type III nonunions. Wrist strength increased from 32 to 41kg. Union was obtained in all patients after an average of 4 months (3-12). Numerous treatments have been described for treating scaphoid nonunion: Matti-Russe, Fisk-Fernadez bone graft, vascularized bone graft, bone substitutes, etc. The success rate varies depending on the technique and study design. We have described an arthroscopic technique for treating scaphoid nonunion with very promising preliminary results. Arthroscopic debridement is needed to ensure good quality bone at the graft site, while preserving extrinsic vascularization. Traction is used during the operation to restore the scaphoid height, once debridement has been

  5. Imaging findings of atypical teratoid/rhabdoid tumor of infancy and childhood in CNS: report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hee Jung; Park, Dong Woo; Lee, Seung Roh; Hahm, Chang Kok; Hong, Eun Kyung [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-05-01

    Atypical teratoid/rhabdoid tumor rarely occurs in the CNS, though is most common in infants under two years of age. It is characterized by unique histologic features, has an extremely aggressive natural course, and is located mainly in the infratentorial region. Radiologically, it is difficult to distinguish from primitive neuroectodermal tumor or medulloblastoma. We report the radiologic findings of two cases of atypical teratoid/rhabdoid tumor.

  6. An unusual case of disseminated toxoplasmosis in a previously healthy pregnant patient: radiographic, CT, and MRI findings.

    Science.gov (United States)

    Paruthikunnan, Samir; Shankar, Balasubramanyam; Kadavigere, Rajagopal; Prabhu, Mukhyaprana; Narayanan, Ramakrishna; Jain, Harshwardhan

    2014-11-01

    Toxoplasmosis is a ubiquitous protozoal infection that during pregnancy commonly affects the fetus severely, with maternal infection usually being mild self-limiting. Disseminated toxoplasmosis in a healthy pregnant woman has, to the best of our knowledge, not been reported before. We present a case of disseminated toxoplasmosis involving pulmonary, central nervous system, and lymph nodes in a pregnant woman and imaging findings on radiography, computed tomography, and magnetic resonance imaging.

  7. Prevalence of patients with respiratory symptoms through active case finding and diagnosis of pulmonary tuberculosis among prisoners and related predictors in a jail in the city of Carapicuíba, Brazil Prevalência de sintomáticos respiratórios através da busca ativa, diagnóstico de tuberculose pulmonar entre pessoas privadas de liberdade e fatores associados em uma cadeia pública no município de Carapicuíba, Brasil

    Directory of Open Access Journals (Sweden)

    Amadeu A. Vieira

    2010-12-01

    Full Text Available BACKGROUND: Prisons offer a fertile setting for the transmission of tuberculosis due to the presence of many classic risk factors for both infection and disease: overcrowding, poor ventilation, and little sunlight. Prisoners are often malnourished and have poor hygiene and are more likely to have a background of alcohol and drug abuse. OBJECTIVES: To determine the prevalence of prisoners with respiratory symptoms and pulmonary tuberculosis (PTB through active case finding in a prisoner population of the county jail of Carapicuíba, and to study possible related variables. METHODS: This was a cross-sectional study, and respiratory symptomatic individuals (RSI were detected through active case finding. Socio-demographic data were collected from inmates' judicial history using a specific questionnaire. The RSI provided sputum specimens for detection of acid fast bacilli and culture for mycobacterium identification. RESULTS: Among the 397 prisoners studied, 154 reported respiratory symptoms for more than three weeks, and were considered RSI; the variables associated with RSI were: having already been tried and incarcerated for more than six months and seven were diagnosed as PTB (1,763 cases/ 100,000 inhabitants. CONCLUSIONS: The prevalence of RSI and PTB cases were respectively 39 and 35 times greater than the general population.INTRODUÇÃO: Estabelecimentos prisionais são um campo favorável para a transmissão de tuberculose (TB, devido a presença de vários fatores de risco clássicos, tanto para a infecção como para a doença: aglomeração, falta de ventilação e de iluminação, como também o fato de os detentos receberem uma nutrição deficitária e os locais possuí-rem condições de higiene precárias; uma grande proporção dos detentos apresentam história pregressa de alcoolismo e uso de drogas ilícitas nas dependências desses estabelecimentos. OBJETIVOS: Determinar a prevalência de sintomáticos respiratórios (RSI e casos

  8. A case of radiation sigmoiditis diagnosed by a characteristic pathological finding

    Energy Technology Data Exchange (ETDEWEB)

    Kamata, Noriko; Oshitani, Nobuhide; Oiso, Ryuta [Osaka City Univ. (Japan). Graduate School of Medicine] (and others)

    2002-05-01

    A 65-year-old woman was referred to our hospital because of an intractable sigmoid colon ulcer. She had undergone a right nephrectomy for kidney stones, at age 33, and a uterectomy at age 39, followed by radiation therapy. Lower abdominal pain and hematochezia developed suddenly, following a few days of constipation, in September 1999, when she was admitted to the previous hospital because of left hydronephrosis. A punched-out oval ulcer was found in the sigmoid colon, on colonoscopic examination. She was treated with total parenteral nutrition, prednisolone, and mesalazine administration. Although her hematochezia and abdominal pain disappeared, diarrhea and abdominal pain occurred after she began eating, and she was referred to our hospital for further examination. Although intestinal lavage solution was used for bowel preparation, stercoromas were found in the rectum, which had to be manually removed before colonoscopic examination, and a stercoral-ulcer was suspected. The sigmoid colonic ulcer was intractable. A biopsy specimen, taken from the bottom of the ulcer, revealed bizarre interstitial cells, each with a large oval nucleus, showing the so-called ''owl-eye-appearance.'' Although the diagnosis of radiation sigmoiditis is sometimes difficult, owl-eye-appearance'' is a useful pathological finding in the diagnosis of late-phase radiation-induced colitis. (author)

  9. Prenatal Diagnosis and Postnatal Ultrasound Findings of Cloacal Anomaly: A Case Report

    Directory of Open Access Journals (Sweden)

    Lívia Teresa Moreira Rios

    2012-01-01

    Full Text Available Cloacal malformation is an extremely rare fetal pathological condition that presents as a variety of defects. It predominantly affects females, with prevalence of 1 in 50,000 births. Prenatal ultrasonography on a 20-year-old caucasian woman (G4P1A2 at 33 weeks of pregnancy showed the fetus having a large cystic mass in the lower abdomen with a single septum, bilateral hydronephrosis, ambiguous genitalia, and a single umbilical artery. The pregnancy developed accentuated oligohydramnios, and presence of a fetal brain-sparing effect was diagnosed using arterial Doppler velocimetry. The newborn showed abdominal distension, ambiguous genitalia, and rectal atresia, with a single perineal opening. Pelvic ultrasound done on the first day after delivery revealed the presence of a large retrovesical septated cystic mass of dense content in the fetal abdomen, and bilateral hydronephrosis. Hysterotomy was performed, and 70 mL of dense liquid was drained through an abdominal colostomy. The infant died on the 27th day of life as a result of infectious complications. Prenatal diagnosing of female urogenital anomalies is usually difficult because of their rarity, different types of manifestation, and lack of characteristic ultrasound signs. Presence of a septated cyst with dense content in the fetal abdomen confirms the finding of hydrometrocolpos, thus raising clinical suspicion of a cloacal anomaly.

  10. An empirical study to find important factors on building national brand: An Iranian tourism case study

    Directory of Open Access Journals (Sweden)

    Abolghasem Hakimipour

    2012-09-01

    Full Text Available Building national brand plays an important role on today's economy to attract interested tourists in visiting various countries. There are different factors impacting national brand such as advertisement, natural attraction, etc. In this paper, we perform an empirical investigation to find the impact of ten most important factors on building brand. The study designs and distributes a questionnaire among 384 international tourists who visited Iran during the year of 2010 and it uses factor analysis to group important factors. The results extract four groups; the first factor includes three most important components including satellite advertisement programs, public awareness on economical power and public awareness on specialized symposium and conferences. The second factor includes three other important factors, which are public awareness on human right, advertisement programs through distribution brushers and internet advertisement. The third factor includes two variables, which are public awareness on education and access to educational services and introducing cultural heritage. Finally, the last factor includes introducing natural attraction and advertisement programs through distribution brushers.

  11. From struggles to resource gains in interprofessional service networks: Key findings from a multiple case study.

    Science.gov (United States)

    Toiviainen, Hanna; Kira, Mari

    2017-04-07

    In interprofessional service networks, employees cross professional boundaries to collaborate with colleagues and clients with expertise and values different from their own. It can be a struggle to adopt shared work practices and deal with "multivoicedness." At the same time, networks allow members to engage in meaningful service provision, gain a broader understanding of the service provided, and obtain social support. Intertwined network struggles and resource gains have received limited attention in the interprofessional care literature to date. The aim of the study was to investigate the learning potential of the co-existing struggles and resource gains. This article reports findings from two interprofessional networks. Interviews were conducted with 19 employees and thematically analysed. Three types of struggles and six types of resource gains of networking were identified. The struggles relate, first, to the assumptions of networking following similar practices to those in a home organisation; second, to the challenges of dealing with the multivoicedness of networking; and, third, to the experienced gap between the networking ideals and the reality of cooperation. At the same time, the network members experience gains in emotional resources (e.g., stronger sense of meaningfulness at work), cognitive resources (e.g., understanding the customer needs from alternative perspectives), and social resources (e.g., being able to rely on other professionals' competence). Learning potential emerged from the dynamics between coexisting struggles and resource gains.

  12. Diagnostic imaging, preautopsy imaging and autopsy findings of 8 AIDS cases: a comparative study

    Institute of Scientific and Technical Information of China (English)

    LI Hong-jun; GAO Yan-qing; CHENG Jing-liang; ZHANG Yu-zhong

    2009-01-01

    Background Aquired immune deficiency syndrome (AIDS) presents a challenge to medical researchers because of its unique pathological and clinical picture. The clinical data, particularly autopsy evidence, from China have failed to provide enough pathological and etiological evidence for AIDS diagnosis, which impairs the reliability of the diagnosis and our full understanding of the occurrence and development of AIDS complications. The purpose of this study was to investigate the imaging and pathologic characteristics of AIDS.Methods Autopsy, imaging and pathological data from 8 cases of AIDS were retrospectively analyzed. Routine CT scanning of different body parts was performed during their periods of hospitalization. Transverse CT scanning was conducted from the skull to the pelvis immediately after the occurrence of death. After routine formalin fixing, 7 cardevers were cross sectioned for autopsy in freezing state and 1 for gross autopsy. Tissues were obtained from each section and organs for pathological examinations.Results The autopsy data indicated the presence of parasitic infections, bacterial infections, fungal infections, and virus infections in AIDS patients. Pneumocystis pneumonia, pulmonary tuberculosis, coccobacteria pneumonia, Aspergillus pneumonia, cytomegalovirus pneumonia, toxoplasma encephalitis, lymphoma and cerebrovascular diseases were found in these patients.Conclusions During the course of AIDS progression, the concurrent multiple infections as well as tumor development may result in multiple organ pathological changes and clinically complex symptoms that further complicate the imaging and pathological manifestations, thus resulting in difficult differential diagnosis. A combination of imaging data and autopsy data can help to clarify the diagnosis.

  13. Complex Odontoma: A Case Report with Micro-Computed Tomography Findings.

    Science.gov (United States)

    Santos, L A N; Lopes, L J; Roque-Torres, G D; Oliveira, V F; Freitas, D Q

    2016-01-01

    Odontomas are the most common benign tumors of odontogenic origin. They are normally diagnosed on routine radiographs, due to the absence of symptoms. Histopathologic evaluation confirms the diagnosis especially in cases of complex odontoma, which may be confused during radiographic examination with an osteoma or other highly calcified bone lesions. The micro-CT is a new technology that enables three-dimensional analysis with better spatial resolution compared with cone beam computed tomography. Another great advantage of this technology is that the sample does not need special preparation or destruction in the sectioned area as in histopathologic evaluation. An odontoma with CBCT and microtomography images is presented in a 26-year-old man. It was first observed on panoramic radiographs and then by CBCT. The lesion and the impacted third molar were surgically excised using a modified Neumann approach. After removal, it was evaluated by histopathology and microtomography to confirm the diagnostic hypothesis. According to the results, micro-CT enabled the assessment of the sample similar to histopathology, without destruction of the sample. With further development, micro-CT could be a powerful diagnostic tool in future research.

  14. Complex Odontoma: A Case Report with Micro-Computed Tomography Findings

    Directory of Open Access Journals (Sweden)

    L. A. N. Santos

    2016-01-01

    Full Text Available Odontomas are the most common benign tumors of odontogenic origin. They are normally diagnosed on routine radiographs, due to the absence of symptoms. Histopathologic evaluation confirms the diagnosis especially in cases of complex odontoma, which may be confused during radiographic examination with an osteoma or other highly calcified bone lesions. The micro-CT is a new technology that enables three-dimensional analysis with better spatial resolution compared with cone beam computed tomography. Another great advantage of this technology is that the sample does not need special preparation or destruction in the sectioned area as in histopathologic evaluation. An odontoma with CBCT and microtomography images is presented in a 26-year-old man. It was first observed on panoramic radiographs and then by CBCT. The lesion and the impacted third molar were surgically excised using a modified Neumann approach. After removal, it was evaluated by histopathology and microtomography to confirm the diagnostic hypothesis. According to the results, micro-CT enabled the assessment of the sample similar to histopathology, without destruction of the sample. With further development, micro-CT could be a powerful diagnostic tool in future research.

  15. Complex Odontoma: A Case Report with Micro-Computed Tomography Findings

    Science.gov (United States)

    Santos, L. A. N.; Roque-Torres, G. D.; Oliveira, V. F.; Freitas, D. Q.

    2016-01-01

    Odontomas are the most common benign tumors of odontogenic origin. They are normally diagnosed on routine radiographs, due to the absence of symptoms. Histopathologic evaluation confirms the diagnosis especially in cases of complex odontoma, which may be confused during radiographic examination with an osteoma or other highly calcified bone lesions. The micro-CT is a new technology that enables three-dimensional analysis with better spatial resolution compared with cone beam computed tomography. Another great advantage of this technology is that the sample does not need special preparation or destruction in the sectioned area as in histopathologic evaluation. An odontoma with CBCT and microtomography images is presented in a 26-year-old man. It was first observed on panoramic radiographs and then by CBCT. The lesion and the impacted third molar were surgically excised using a modified Neumann approach. After removal, it was evaluated by histopathology and microtomography to confirm the diagnostic hypothesis. According to the results, micro-CT enabled the assessment of the sample similar to histopathology, without destruction of the sample. With further development, micro-CT could be a powerful diagnostic tool in future research. PMID:27293913

  16. Pathological and toxicological findings in glyphosate-surfactant herbicide fatality: a case report.

    Science.gov (United States)

    Sribanditmongkol, Pongruk; Jutavijittum, Prapan; Pongraveevongsa, Pattaravadee; Wunnapuk, Klintean; Durongkadech, Piya

    2012-09-01

    Glyphosate herbicide is promoted by the manufacturer as having no risks to human health, with acute toxicity being very low in normal use. In Thailand, however, poisoning from glyphosate agricultural herbicides has been increasing. A case of rapid lethal intoxication from glyphosate-surfactant herbicide involved a 37-year-old woman, who deliberately ingested approximately 500 mL of concentrated Roundup formulation (41% glyphosate as the isopropylamine salt and 15% polyoxyethylene amine; Mosanto Company). The postmortem examination revealed that the stomach contained 550 mL of yellow fluid. The gastric mucosa of anterior fundus revealed hemorrhage and the small intestines had marked dilatation and thin walls. We used the high-performance liquid chromatography method for determination of serum and gastric content levels of glyphosate. The glyphosate levels of serum and gastric content were 3.05 and 59.72 mg/mL, respectively. Toxic effects of polyoxyethylene amine and Roundup were caused by their ability to erode tissues including mucous membranes and linings of the gastrointestinal and respiratory tracts. A mild degree of pulmonary congestion and edema was observed in both lungs. We proposed that the characteristic picture of microvesicular steatosis of the hepatocytes, seen predominantly in centrilobular zones of the liver, resembled drug-induced hepatic toxicity or secondary hypoxic stress.

  17. [Tumors of the vaterian region indications, findings and prognosis : about 49 cases].

    Science.gov (United States)

    Beyrouti, Mohamed Issam; Beyrouti, Ramez; Louhichi, Skander; Ben Amar, Mohamed; Gargouri, Faouzi; Frikha, Foued; Bouaziz, Mounir; Karoui, Abdelhamid; Boudawara, Tahia; Krichen, Mohamed Salah; Sellami, Abdelhafidh

    2006-04-01

    This retrospective study is about 49 cases of tumors of the vaterian region collected between 1976 and 2001. Tumors of the vaterian region represented 7% of the bilio-pancreatic tumors. The study was about 18 women and 31 men, with sex-ratio of 1.7. The mean age was 61 years. Treatment was surgical : cephalic duodeno-pancreatectomy (28 patients) or ampullectomy (5 patients). Rate of tumor resectability was 69.4%. Bilio-digestive derivation was practiced on 13 patients and therapeutic abstention was decided for 3 patients. Age over 65 years, rate of bilirubine superior to 120 mmol/l and surgery done in emergency were elements of bad prognosis that increased post-operative mortality of following cephalic duodeno-pancreatectomy. Global mortality and morbidity were respectively 16% and 24%. Factors of poor prognosis were essentially: Tumor of large size, infiltration of the surrounding structures and tumor with metastases. The survival after bilio-digestive derivation didn't pass the 8 months. Five year survivals cephalic duodeno-pancréatectomy represented 20%. It depended on the degree of the local invasion. This 5 years survival rate to was 85% for stage I (classification of Martin) and 10% for stage IV.

  18. Biochemical and pathological findings of pregnancy toxemia in Saanen doe: A case report

    Directory of Open Access Journals (Sweden)

    Yusuf Abba

    2015-06-01

    Full Text Available A pregnant Saanen doe aging 1.5-year and weighing 40 kg was presented to the Large Animal Unit of Universiti Putra Malaysia Veterinary Hospital with history of inability to stand up. Transabdominal ultrasonography of the animal revealed two live fetuses at late pregnancy. Blood examination revealed decreased lymphocyte numbers, and increased monocytes count. Biochemical analyses showed marked decrease in glucose level and elevated level of aspartate aminotransferase (AST and creatine kinase (CK. The goat was administered with 200 mL 20% Dextrose (G-20, NaCl solution (at 1.3 mL/animal, Flunixine meglumine (at 2.2 mg/kg bwt, and Vitavet multivitamin (at 1 mL/10 kg bwt. The prognosis of the case was grave, and the goat was sacrificed in order to save the fetuses. However, the fetuses were died within 10 min. Necropsy of the doe showed pale, yellow and friable liver and congested lungs, while histopathological evaluation of the liver showed diffuse hepatic lipidosis. Pregnancy toxemia in doe can be prevented by providing proper nutrition.

  19. Narratives, memorable cases and metaphors of night nursing: findings from an interpretative phenomenological study.

    Science.gov (United States)

    Zannini, Lucia; Ghitti, Maria Grazia; Martin, Sonia; Palese, Alvisa; Saiani, Luisa

    2015-09-01

    The aim of the study was to explore the experiences of night nurses. An interpretative phenomenological study was undertaken, and 35 nurses working in Italian medical, surgical and intensive care units were purposely recruited. Data were gathered in 2010 by semi-structured interviews, collecting nurses' narratives, memorable cases and metaphors, aimed at summarising the essence of work as a nurse during the night. The experience of night nursing is based on four interconnected themes: (i) working in a state of alert, (ii) growing by expanding autonomy and responsibility, (iii) assuring sensitive surveillance and (iv) experiencing deep intimacy. Memorable episodes were polarised along (i) expected/unexpected events; (ii) positive/negative epilogues; and (iii) life/death issues. Many of the emergent metaphors described working during the night as being in the middle of a space where an apparent calm scene takes place, but unpredictable factors may suddenly change the order of events and the outcomes, creating chaos. Working during the night alerts nurses, who increase autonomy, expanding their role and assuming more responsibility with respect to that assumed during daily shifts. The nurses' clinical reasoning is based on data they carefully listen to, and on the meaning that nurses give time by time to different noises and silence. While in the past a sense of companionships was reported, a loneliness or a 'neutral' experience concerning the relationships with colleagues seems to prevail during night nursing. Working night shifts is a complex task, and specific training must be assured to students/novices.

  20. Epiphyseal involvement in Erdheim-Chester disease: radiographic and scintigraphic findings in a case with lytic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz-Hernandez, G.; Tajahuerce-Romera, G.M.; Latorre-Ibanez, M.D.; Lara-Pomares, A. [Servicio de Medicina Nuclear, Hospital Provincial de Castellon (Spain); Vila-Fayos, V. [Servicio de Reumatologia, Hospital Comarcal de Vinaroz (Spain)

    2000-08-01

    We reported a symmetric increase of activity in lower links secondary to Erdheim-Chester disease and demonstrated by bone scans and radiographs. An inusual scintigraphic and radiographic appearance with epiphyseal involvement and lytic lesions is described. Differential diagnosis of bone scan and radiographic findings is discussed. (orig.)

  1. Intracranial meningiomas: magnetic resonance imaging findings in 78 cases; Meningiomas intracranianos: achados de ressonancia magnetica em 78 casos

    Energy Technology Data Exchange (ETDEWEB)

    Gasparetto, Emerson L.; Leite, Claudia da Costa; Lucato, Leandro T.; Barros, Cristiano Ventorin de [University of Sao Paulo (USP), SP (Brazil). School of Medicine. Dept. of Radiology]. E-mail: egasparetto@gmail.com; Marie, Sueli K.N.; Santana, Pedro; Aguiar, Paulo Henrique Pires de [University of Sao Paulo (USP), SP (Brazil). School of Medicine. Dept. of Neurology; Rosemberg, Sergio [University of Sao Paulo (USP), SP (Brazil). School of Medicine. Dept. of Pathology

    2007-09-15

    Objective: To present the magnetic resonance (MR) imaging findings of 78 patients with meningiomas diagnosed in a single institution. Method: 78 patients with histological proven intracranial meningioma were studied. There were 52 female and 26 male patients (median=56 years). All MR imaging examinations were performed with 1.5-T MR imaging unit with standard protocol. The images were studied by two neuroradiologists, who reached the decisions regarding the findings by consensus. Results: Most of the tumors showed low signal on T1- (60%) and high signal on T2- (68%) and FLAIR (69%) weighted images. Also, the lesions showed heterogeneous signal on T1 (60%), T2 (68%) and FLAIR (64%) sequences. After contrast administration, 83% (n=65) of the tumors presented accentuated and 17% (n=13) showed moderate enhancement. The tumors were located in the frontal lobe in 44% of the cases, in the parietal lobe in 35%, the occipital lobe in 19% and the temporal lobe in 12% of the patients. Areas of vasogenic edema around the tumors were seen in 90% of the cases. Twenty six per cent of the cases showed bone infiltration, and the dural tail sign was seen in 59% of the tumors. Conclusion: Intracranial meningiomas usually show heterogeneous low signal on T1- and high signal on T2-weighted and FLAIR images, with intense enhancement after contrast administration. The frontal and parietal lobes are commonly affected. In addition, brain edema, dural tail sign and bone infiltration are the most frequent associated findings. (author)

  2. Validation of case-finding algorithms derived from administrative data for identifying adults living with human immunodeficiency virus infection.

    Directory of Open Access Journals (Sweden)

    Tony Antoniou

    Full Text Available OBJECTIVE: We sought to validate a case-finding algorithm for human immunodeficiency virus (HIV infection using administrative health databases in Ontario, Canada. METHODS: We constructed 48 case-finding algorithms using combinations of physician billing claims, hospital and emergency room separations and prescription drug claims. We determined the test characteristics of each algorithm over various time frames for identifying HIV infection, using data abstracted from the charts of 2,040 randomly selected patients receiving care at two medical practices in Toronto, Ontario as the reference standard. RESULTS: With the exception of algorithms using only a single physician claim, the specificity of all algorithms exceeded 99%. An algorithm consisting of three physician claims over a three year period had a sensitivity and specificity of 96.2% (95% CI 95.2%-97.9% and 99.6% (95% CI 99.1%-99.8%, respectively. Application of the algorithm to the province of Ontario identified 12,179 HIV-infected patients in care for the period spanning April 1, 2007 to March 31, 2009. CONCLUSIONS: Case-finding algorithms generated from administrative data can accurately identify adults living with HIV. A relatively simple "3 claims in 3 years" definition can be used for assembling a population-based cohort and facilitating future research examining trends in health service use and outcomes among HIV-infected adults in Ontario.

  3. [Intracranial chondroma arising from the skull base: two case reports featuring the image findings for differential diagnosis].

    Science.gov (United States)

    Higashida, Tetsuhiro; Sakata, Katsumi; Kanno, Hiroshi; Tanabe, Yutaka; Kawasaki, Takashi; Yamamoto, Isao

    2007-05-01

    We reported two cases of intracranial skull base chondroma and discussed the differential diagnosis and the treatment strategies. The first case was a 39-year-old male who presented with left exophtalmos, visual loss and oculomotor disturbance. MRI showed a huge tumor occupying the bilateral cavernous sinus. Partial removal of the tumor was performed through the left orbitozygomatic subtemporal approach. The second case was a 54-year-old male who presented with left hemiparesis. MRI showed a brain stem infarction with a huge tumor located at the right middle fossa. Partial removal was performed through the right orbitozygomatic subtemporal approach. In these two cases, the histopathological diagnosis of the tumors was benign chondroma and the size of residual tumors have not changed for one year without any additional therapy. Although preoperative definite diagnosis for skull base chondromas is difficult, strategies for diagnosis and treatment without any complication are essential. In our cases, chondromas showed low uptake in PET images, which might be useful for differentiation between chondromas and chordomas. The current popular surgical approach for parasellar tumors is transcranial such as the orbitozygomatic subtemporal approach. In surgical removal of skull base chondromas, it is advisable to try to confirm the diagnosis preoperatively with characteristic image findings and to consider the best approach in each case to decompress the involved nerves without any complications.

  4. Intensified tuberculosis case finding among malnourished children in nutritional rehabilitation centres of Karnataka, India: missed opportunities.

    Directory of Open Access Journals (Sweden)

    Prashant G Bhat

    Full Text Available BACKGROUND: Severe acute malnutrition (SAM is the most serious form of malnutrition affecting children under-five and is associated with many infectious diseases including Tuberculosis (TB. In India, nutritional rehabilitation centres (NRCs have been recently established for the management of SAM including TB. The National TB Programme (NTP in India has introduced a revised algorithm for diagnosing paediatric TB. We aimed to examine whether NRCs adhered to these guidelines in diagnosing TB among SAM children. METHODS: A cross-sectional study involving review of records of all SAM children identified by health workers during 2012 in six tehsils (sub-districts with NRCs (population: 1.8 million of Karnataka, India. RESULTS: Of 1927 identified SAM children, 1632 (85% reached NRCs. Of them, 1173 (72% were evaluated for TB and 19(2% were diagnosed as TB. Of 1173, diagnostic algorithm was followed in 460 (37%. Among remaining 763 not evaluated as per algorithm, tuberculin skin test alone was conducted in 307 (41%, chest radiography alone in 99 (13% and no investigations in 337 (45%. The yield of TB was higher among children evaluated as per algorithm (4% as compared to those who were not (0.3% (OR: 15.3 [95%CI: 3.5-66.3]. Several operational challenges including non-availability of a full-time paediatrician, non-functioning X-ray machine due to frequent power cuts, use of tuberculin with suboptimal strength and difficulties in adhering to a complex diagnostic algorithm were observed. CONCLUSION: This study showed that TB screening in NRCs was sub-optimal in Karnataka. Some children did not reach the NRC, while many of those who did were either not or sub-optimally evaluated for TB. This study pointed to a number of operational issues that need to be addressed if this collaborative strategy is to identify more TB cases amongst malnourished children in India.

  5. Can prion disease suspicion be supported earlier? Clinical, radiological and laboratory findings in a series of cases.

    Science.gov (United States)

    González-Duarte, Alejandra; Medina, Zaira; Balaguer, Rainier Rodriguez; Calleja, Jesus Higuera

    2011-01-01

    The subacute spongiform encephalopathies are prion diseases characterized by acute and rapid neurodegeneration that lead to the death of the patient within months to a few years. The epidemiology of CJD is complicated and the frequency in Mexico is unknown. We aim to describe the cases of prion disease in Mexico. Consecutive patients who met the diagnostic criteria by the WHO were enrolled. We describe 26 patients with clinical manifestations, imaging and laboratory studies compatible with prion disease. The mean age at onset was 52 years old. The main clinical manifestations were cognitive alterations (69%) followed by extrapyramidal movements (50%), abnormal cerebellar function (46%), behavioral alterations (46%), myoclonus (46%), and mood depression (23%), among other features. Half of the patients progressed rapidly to a state of akinetic mutism (53%). Only 2 (7.6%) patients had a family history of a similar disease. Time interval between onset and diagnosis varied between 71 days to 24 months, with a median of 6 months. The classical bilateral basal ganglia hyperintensities were present in the very early stage of the disease. Protein 14-3-3 immuneassay in the CSF was positive in all measured cases. Bilateral basal ganglia hyperintensities was the most important early finding, while protein 14-3-3 was a late finding and the results were usually obtained after the patient was discharged. Around 1.5 cases of CJD cases per year are reported in our country. When suspected, MRI can support the diagnosis earlier than other studies.

  6. False Positive Findings on I-131 WBS and SPECT/CT in Patients with History of Thyroid Cancer: Case Series

    Science.gov (United States)

    Hannoush, Zeina C.; Palacios, Juan D.; Kuker, Russ A.

    2017-01-01

    Introduction. Although whole body scan (WBS) with I-131 is a highly sensitive tool for detecting normal thyroid tissue and metastasis of differentiated thyroid cancer (DTC), it is not specific. Additional information, provided by single photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) and by the serum thyroglobulin level, is extremely useful for the interpretation of findings. Case Presentation. We report four cases of false positive WBS in patients with DTC: ovarian uptake corresponding to an endometrioma, scrotal uptake due to a spermatocele, rib-cage uptake due to an old fracture, and hepatic and renal uptake secondary to a granuloma and simple cyst, respectively. Conclusions. Trapping, organification, and storage of iodine are more prominent in thyroid tissue but not specific. Physiologic sodium-iodine symporter expression in other tissues explains some, but not all, of the WBS false positive cases. Other proposed etiologies are accumulation of radioiodine in inflamed organs, metabolism of radiodinated thyroid hormone, presence of radioiodine in body fluids, and contamination. In our cases nonthyroidal pathologies were suspected since the imaging findings were not corroborated by an elevated thyroglobulin level, which is considered a reliable tumor marker for most well-differentiated thyroid cancers. Clinicians should be aware of the potential pitfalls of WBS in DTC to avoid incorrect management. PMID:28246564

  7. Incidental finding of unilateral isolated aplasia of serratus anterior muscle and winged scapula on chest radiograph: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Sung; Park, Hyun Jin; Ko, Jeong Min [Dept. of Radiology, St. Vincent' s Hospital, College of Medicine, The Catholic University of Korea, Suwon (Korea, Republic of)

    2014-10-15

    The isolated aplasia of the serratus anterior muscle with winging of scapula is very rare, and only a few cases are reported. Here, we present a case of a 30-year-old Korean male who initially presented with a left flank pain. His physical exam did not show any significant finding in his right shoulder. However, his chest radiograph showed absence of right serratus anterior muscle and slightly elevated and medially rotated right scapula. Subsequent CT scan showed the right serratus anterior muscle aplasia and medial winging of the right scapula. This case is unique in two aspects. First, the combination of abnormalities is different from the typical congenital abnormalities involving shoulder girdle, such as Sprengel deformity or Poland syndrome. Secondly, this was incidentally diagnosed with chest radiograph, without clinical impression. Careful reading of chest radiograph can help the radiologists to detect such clinically silent abnormalities.

  8. Epithelioid angiomyolipoma of the liver: Cross-sectional imaging findings of 10 immunohistochemically-verified cases

    Institute of Scientific and Technical Information of China (English)

    PengJu Xu; Yan Shan; Fu-Hua Yan; Yuan Ji; Ying Ding; Mei-Lin Zhou

    2009-01-01

    AIM: To retrospectively evaluate the computed tomography (CT)/magnetic resonance imaging (MRI) imaging features of epithelioid angiomyolipoma of the liver (Epi-HAML), with pathology as a reference. METHODS: The CT/MRI findings (number, diameter,lobar location, and appearance of lesions) in a series of 10 patients with 12 pathologically proven epithelioid angiomyolipomas of the liver were retrospectively analyzed. The imaging features, including attenuation/signal intensity characteristics, presence of fat,hypervascular, outer rim, and vessels within lesion,were evaluated and compared with that of non-Epi-HAML in 11 patients (13 lesions). The Fisher exact test was used to compare difference in probability of imaging features between the two types.RESULTS: For 21 patients, CT images of 15 patients and MR images of six patients were available. No patient underwent two examinations. For the 15 patients with a CT scan, all HAML lesions in the two groups (10 Epi-HAML and seven non-Epi-HAML) manifested as hypoattenuation. For the six patients with MRI, all lesions (two Epi-HAML and six non-Epi-HAML) were hypointense on T1WI (fat suppression) and hyperintense on T2WI. There were 10 non-Epi-HAML,but only two Epi-HAML lesions showed the presence of fat, which significantly different between the two types (P = 0.005). On the dynamic contrast enhancement (DCE) imaging, eight Epi-HAML, and 13 non-Epi lesions manifested as hypervascular. Punctate or curved vessels were displayed in 10 Epi-HAML as well as in nine non-Epi lesions and outer rim enhancement could be found with eight Epi-HAML as well as six non-Epi lesions.CONCLUSION: Little or no presence of adipose tissue was found to be an imaging feature of Epi-HAML, compared with the non-Epi type. In addition,hypervascularity with opacification of central punctiform or filiform vessels on DCE would be a characteristic enhancement pattern for Epi-HAML.

  9. A case of radiation myelopathy with characteristic findings of thermoregulatory sweat distribution and magnetic resonance images

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Katsumasa; Sannomiya, Kunihiro; Nagao, Shinichiro; Nakazato, Okifumi; Tsuda, Tomiyasu (Oita Medical University, Hazama (Japan))

    1993-09-01

    A 73-year-old man had undergone resection of a lung carcinoma of the right upper lobe in 1987. Post-operative irradiation (40 Gy) was given to the right hilus. In November 1988, recurrence was detected in the trachea. Laser therapy was done in December 1988. From January 9 to February 13 in 1989, irradiation (50 Gy) was given to the mediastinum. From the beginning of 1991, the patient developed muscle weakness in the right lower extremity and pain temperature sensations were impaired below the Th12 level on the left side. On October 3, 1991, he was admitted to our hospital. Neurological examination revealed mild muscle weakness in the right lower extremity. Superficial sensations were impaired below the Th6 level bilaterally. Deep tendon reflexes were hyperactive in the lower extremities. A bilateral Babinski sign was positive. The T1 weighted MRI showed a low signal intensity in the spinal cord at the level of thoracic vertebra (TV)2-TV6. T2 weighted images revealed a high signal intensity area of the spinal cord from TV4-TV6. A gadolinium-DTPA injection revealed an enhancement on the left side of the spinal cord at the TV2-3 level, and right side of the spinal cord at the TV4-5 level on the sagittal and axial images. A thermal sweating test revealed hypohidrosis below the Th8 level on the right side, and the Th11 level on the left side. Sweating was delayed at the Th7-8 levels on the right side and Th10-11 levels on the left side. An irradiated field on the chest revealed hypohidrosis. There were differences between spinal lesions in MRI and thermoregulatory sweat distribution. Sweat distribution of this case could not be explained by damage of intermediolateral nucleus of the spinal cord. We speculated that the sympathetic sudomotor pathways were partially disturbed at the upper thoracic cord. But the exact mechanism could not been elucidated. (author).

  10. Problematic Incinerator Ash: A Case Study of Finding a Successful Treatment Approach

    Energy Technology Data Exchange (ETDEWEB)

    K. L. Gering

    1999-03-01

    The Idaho National Engineering and Environmental Laboratory (INEEL) produces incinerator flyash and bottom ash as a consequence of burning low-level radioactive waste materials at the Waste Experimental Reduction Facility (WERF). The incineration process greatly reduces original waste volumes but concentrates the metals that are present, such as toxic metals (most notably cadmium, lead, and antimony) and nuisance metals (e.g., zinc). Anion species also become predominant in flyash produced by INEEL incineration, where chloride and sulfate are at concentrations that can approach 15-20 wt% each. In addition, treatment of the WERF flyash is further complicated by a significant fraction of ignitables composed of carbon soot and various hydrocarbon species that have been measured in some cases at 30% net by Loss-on-Ignition tests. Bottom ash produced at the WERF site is generally much less toxic, if not nontoxic, as compared to the flyash. Due to the complex composition of the flyash material, stabilization attempts at the INEEL have been only partly successful, causing the effectiveness and viability of treatment methods to be revisited. Breakthroughs in flyash stabilization came in 1998 when more complete characterization data gave us further insight into the chemical and physical nature of the flyash. These breakthroughs were also facilitated by the use of a computer model for electrolytes that allowed us to simulate stabilization options prior to started laboratory studies. This paper summarizes efforts at the INEEL, spanning the past three years, that have focused on stabilizing flyash. A brief history of INEEL treatability studies is given, showing that the degree of effective flyash stabilization was proportional to the amount of meaningful characterization data that was available. Various binders have been used in these treatability studies, including Portland cement type I/II, Portland cement type V, JGC Super Cement (blast furnace slag cement), a Fluid Tech

  11. Physical activity and blood pressure in childhood: findings from a population-based study.

    Science.gov (United States)

    Leary, Sam D; Ness, Andy R; Smith, George Davey; Mattocks, Calum; Deere, Kevin; Blair, Steven N; Riddoch, Chris

    2008-01-01

    The pathological processes associated with development of cardiovascular disease begin early in life. For example, elevated blood pressure (BP) can be seen in childhood and tracks into adulthood. The relationship between physical activity (PA) and BP in adults is well-established, but findings in children have been inconsistent, with few studies measuring PA mechanically. Children aged 11 to 12 years were recruited from the Avon Longitudinal Study of Parents and Children. 5505 had systolic and diastolic BP measurements, plus valid (at least 10 hours for at least 3 days) accelerometer measures of PA; total PA recorded as average counts per minute (cpm) over the period of valid recording, and minutes per day spent in moderate to vigorous PA (MVPA). Data on a number of possible confounders were also available. Small inverse associations were observed; for systolic BP, beta=-0.44 (95% confidence interval -0.59, -0.28) mm Hg per 100 cpm, and beta=-0.66 (95% CI -0.92, -0.39) mm Hg per 15 minutes/d MVPA, adjusting for child's age and gender. After adjustment for potential confounders, associations were weakened but remained. When PA variables were modeled together, associations with total PA were only a little weaker, whereas those with MVPA were substantially reduced; for systolic BP, beta=-0.42 (95% CI -0.71, -0.13) mm Hg per 100 cpm, and beta=-0.03 (95% CI -0.54, 0.48) mm Hg per 15 minutes/d MVPA. In conclusion, higher levels of PA were associated with lower BP, and results suggested that the volume of activity may be more important than the intensity.

  12. Psychological findings in early treated cases of female pseudohermaphroditism caused by virilizing congenital adrenal hyperplasia.

    Science.gov (United States)

    Hurtig, A L; Rosenthal, I M

    1987-06-01

    Nine female adolescents with female pseudohermaphroditism resulting from virilizing congenital adrenocortical hyperplasia (CAH) were studied in terms of gender identity, sex-role behavior, psychological adjustment, and psychosexual development. A group of adolescents with chronic illness was used as a control. The Draw-A-Person, the Bem Sex-Role Inventory, Rorschach, TAT, and a questionnaire reviewing peer and romantic activities were administered to both groups. The two groups were comparable on measures of general personality adjustment, with the CAH girls showing a trend toward greater bodily concerns. Sex-role identity for both groups was near the adolescent girl norms for both Femininity and Masculinity, with virilized CAH girls showing slightly higher Androgyny scores. Significant differences were found on gender identity as measured by greater differentiation of the drawn male figure as well as a trend toward drawing the male figure first. The CAH females also showed consistent patterns of psychosocial delay in dating and sexual relations as compared to the control group. Gender identity in this group appears to be mediated by body image. The resulting ambivalence may be evidence of feelings of incompetence, leading to resistance to social interactions and goals involving intimacy and nurturance.

  13. The US, CT and MR findings of cubital bursitis: a report of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Liessi, G. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Cesari, S. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Spaliviero, B. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Dell`Antonio, C. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Avventi, P. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy)

    1996-07-01

    Objective. The purpose of the study was to evaluate the appearance of ``cubital bursitis`` on ultrasonography and CT and MR imaging. ``Cubital bursitis`` is a rare pathological condition involving a large swelling of the bicipito-radial or interosseous bursae located at the insertion of the distal biceps tendon on the radial tuberosity. Design and patients. We report on five patients with ``cubital bursitis`` resulting from their work or sporting activities. All patients underwent an ultrasound and MR examination. CT scans were performed on two patients before and after contrast enhancement. Results. Ultrasound studies showed a fusiform anechoic or hypoechoic lesion. CT images showed the lesions but there were some difficulties in determining the exact extent of the bursae. MR imaging showed the enlarged bursae and their fluid content. Four patients each underwent a surgical procedure. Conclusion. Ultrasound and CT were effective in the evaluation of ``cubital bursitis``, but with some diagnostic difficulties. MR imaging is probably the method of choice for determining both the development of the bursae and their fluid content. (orig.)

  14. Objective evaluation of fourth ventricle displacement in brain CT findings. 4 cases of brain stem tumor

    Energy Technology Data Exchange (ETDEWEB)

    Okino, Fumiko; Eguchi, Tsuyako; Shinohara, Teruo; Hatano, Mitsunori (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1983-11-01

    Distance between the ridge of the sella turcica and the anterior wall of the fourth ventricle (a) and the distance between the ridge of the sella and the posterior pole in the occipital region (b) were measured on the slice visualizing the fourth ventricle and sella. The location of the fourth ventricle was expressed by a/b, and its normal value was calculated for comparison with that in a patient group. The a/b values of the control group were in the range of 0.33 and 0.48 with a mean +- SD of 0.41+-0.3 and was not subject to the influences of age, sex distinction, cranial shape or slicing direction. The a/b values of the patient group were all abnormal (more than mean +- 2SD of the control group) on initial CT and showed an increase with progress of the disease activity. Measurement of the a/b on brain CT was thought to serve as a useful indicator for early detection and follow-up of the course of lesions occupying the brain stem (especially brain stem tumors).

  15. Post-mortem computed tomography findings of the lungs: Retrospective review and comparison with autopsy results of 30 infant cases

    Energy Technology Data Exchange (ETDEWEB)

    Kawasumi, Yusuke, E-mail: ssu@rad.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Usui, Akihito, E-mail: t7402r0506@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosokai, Yoshiyuki, E-mail: hosokai@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Igari, Yui, E-mail: igari@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosoya, Tadashi [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hayashizaki, Yoshie, E-mail: yoshie@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Saito, Haruo, E-mail: hsaito@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Ishibashi, Tadashi, E-mail: tisibasi@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Funayama, Masato, E-mail: funayama@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan)

    2015-04-15

    Highlights: •Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). •In this study, twenty-two of the thirty sudden infant death cases showed increasing concentration in the entire lung field. •Based on the autopsy results, the lungs simply collapsed and no other abnormal lung findings were identified. •The radiologist should not consider increasing concentration in all lung fields as simply a pulmonary disorder when diagnosing the cause of infant death using PMCT. -- Abstract: Objectives: Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). However, the lungs often show simply atelectasis at autopsy in the absence of any other abnormal changes. Thus, we retrospectively reviewed the PMCT findings of lungs following sudden infant death and correlated them with the autopsy results. Materials and methods: We retrospectively reviewed infant cases (0 year) who had undergone PMCT and a forensic autopsy at our institution between May 2009 and June 2013. Lung opacities were classified according to their type; consolidation, ground-glass opacity and mixed, as well as distribution; bilateral diffuse and areas of sparing. Statistical analysis was performed to assess the relationships among lung opacities, causes of death and resuscitation attempt. Results: Thirty infant cases were selected, which included 22 sudden and unexplained deaths and 8 other causes of death. Resuscitation was attempted in 22 of 30 cases. Bilateral diffuse opacities were observed in 21 of the 30 cases. Of the 21 cases, 18 were sudden and unexplained deaths. Areas of sparing were observed in 4 sudden and unexplained deaths and 5 other causes of death. Distribution of opacities was not significantly associated with causes of death or resuscitation attempt. The 21 cases with bilateral diffuse opacities included 6 consolidations (4 sudden and unexplained

  16. Why Are Girls Less Physically Active than Boys? Findings from the LOOK Longitudinal Study

    Science.gov (United States)

    Telford, Rohan M.; Telford, Richard D.; Olive, Lisa S.; Cochrane, Thomas; Davey, Rachel

    2016-01-01

    Background A gender-based disparity in physical activity (PA) among youth, whereby girls are less active than boys is a persistent finding in the literature. A greater understanding of the mechanisms underlying this difference has potential to guide PA intervention strategies. Methods Data were collected at age 8 and 12 years (276 boys, 279 girls) from 29 schools as part of the LOOK study. Multilevel linear models were fitted separately for boys and girls to examine effects of individual, family and environmental level correlates on pedometer measured PA. Cardio-respiratory fitness (multi-stage run), percent fat (DEXA), eye-hand coordination (throw and catch test) and perceived competence in physical education (questionnaire) were used as individual level correlates. At the family level, parent’s support and education (questionnaire) were used. School attended and extracurricular sport participation were included as environmental level correlates. Results Girls were 19% less active than boys (9420 vs 11360 steps/day, p<0.001, 95%CI [1844, 2626]). Lower PA among girls was associated with weaker influences at the school and family levels and through lower participation in extracurricular sport. School attended explained some of the variation in boys PA (8.4%) but not girls. Girls compared to boys had less favourable individual attributes associated with PA at age 8 years, including 18% lower cardio-respiratory fitness (3.5 vs 4.2, p<0.001, CI [0.5,0.9]), 44% lower eye-hand coordination (11.0 vs 17.3, p<0.001, CI [5.1,9.0]), higher percent body fat (28% vs 23%, p<0.001, CI [3.5,5.7]) and 9% lower perceived competence in physical education (7.7 vs 8.4, p<0.001, CI [0.2,0.9]). Participation in extracurricular sport at either age 8 or 12 years was protective against declines in PA over time among boys but not girls. Conclusion Girls PA was less favourably influenced by socio-ecological factors at the individual, family, school and environmental levels. These factors

  17. Why Are Girls Less Physically Active than Boys? Findings from the LOOK Longitudinal Study.

    Directory of Open Access Journals (Sweden)

    Rohan M Telford

    Full Text Available A gender-based disparity in physical activity (PA among youth, whereby girls are less active than boys is a persistent finding in the literature. A greater understanding of the mechanisms underlying this difference has potential to guide PA intervention strategies.Data were collected at age 8 and 12 years (276 boys, 279 girls from 29 schools as part of the LOOK study. Multilevel linear models were fitted separately for boys and girls to examine effects of individual, family and environmental level correlates on pedometer measured PA. Cardio-respiratory fitness (multi-stage run, percent fat (DEXA, eye-hand coordination (throw and catch test and perceived competence in physical education (questionnaire were used as individual level correlates. At the family level, parent's support and education (questionnaire were used. School attended and extracurricular sport participation were included as environmental level correlates.Girls were 19% less active than boys (9420 vs 11360 steps/day, p<0.001, 95%CI [1844, 2626]. Lower PA among girls was associated with weaker influences at the school and family levels and through lower participation in extracurricular sport. School attended explained some of the variation in boys PA (8.4% but not girls. Girls compared to boys had less favourable individual attributes associated with PA at age 8 years, including 18% lower cardio-respiratory fitness (3.5 vs 4.2, p<0.001, CI [0.5,0.9], 44% lower eye-hand coordination (11.0 vs 17.3, p<0.001, CI [5.1,9.0], higher percent body fat (28% vs 23%, p<0.001, CI [3.5,5.7] and 9% lower perceived competence in physical education (7.7 vs 8.4, p<0.001, CI [0.2,0.9]. Participation in extracurricular sport at either age 8 or 12 years was protective against declines in PA over time among boys but not girls.Girls PA was less favourably influenced by socio-ecological factors at the individual, family, school and environmental levels. These factors are potentially modifiable suggesting

  18. The fetal MR appearance of 'nutmeg lung': findings in 8 cases linked to pulmonary lymphangiectasia

    Energy Technology Data Exchange (ETDEWEB)

    Victoria, Teresa [The Children' s Hospital of Philadelphia, Radiology Department, Center for Fetal Diagnosis and Treatment, Philadelphia, PA (United States); Andronikou, Savvas [University of the Witwatersrand, Department of Radiology, Faculty of Health Sciences, Cape Town (South Africa)

    2014-10-15

    A pattern of abnormal signal at fetal MRI may be seen in the setting of primary or secondary congenital lymphangiectasia, manifested as a heterogeneous appearance of the lung parenchyma and the presence of subtle T2-hyperintense branching tubular structures that emanate from the hila. We have named this pattern the nutmeg lung. We describe the nutmeg lung appearance seen in fetal MRI scans, with discussion of possible etiologies and outcomes in a series of eight fetuses. We retrospectively reviewed imaging from a database of patients demonstrating features of nutmeg lung on fetal MRI. Medical records were used to determine the postnatal diagnosis, clinical course and outcome. Among the eight fetal cases of nutmeg lung, two had postnatal confirmation of primary lymphangiectasia and the remaining six had secondary lymphangiectasia, presumably secondary to congenital cardiac anomalies. There were various-size pleural effusions in all cases. Only one of the cases demonstrated hydrops fetalis. We present the description of the nutmeg lung sign on fetal MRI as T2-hyperintense heterogeneous lungs with fluid-filled, serpiginous branching structures that extend from the pulmonary hila to the periphery of the lung, often accompanied by pleural effusions. The sign denotes findings of primary or secondary lymphangiectasia. Findings of secondary lymphangiectasia in our series were a result of cardiac insufficiency. Recognizing this sign might be helpful in the diagnostic algorithm of the fetus with abnormal lung parenchyma. (orig.)

  19. Signet-ring cell carcinoma of the appendix: A case report with an emphasis on sonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Jong; Kim, Hyuk Jung; Jang, Suk Ki; Yeon, Jae Woo; Kim, Ki Ho; Paik, So Ya [Daejin Medical Center, Bundang Jesaeng General Hospital, Seongnam (Korea, Republic of)

    2016-03-15

    In this report, we present a rare case of primary signet-ring cell carcinoma of the appendix in a 51-year-old woman with right lower quadrant pain. Since non-specific concentric appendiceal wall thickening was found in a radiologic evaluation, it was misdiagnosed as non-tumorous appendicitis. An in-depth examination of the correlation between sonographic and histopathologic findings demonstrated that a single markedly thickened hypoechoic layer was well correlated with the diffuse infiltration of tumor cells in both the submucosal and muscle layers. If this sonographic finding is observed in certain clinical settings, such as potential ovarian and peritoneal metastasis, submucosal infiltrative tumors, including signet-ring cell carcinoma, should be considered in the differential diagnosis.

  20. [Teniasis in a child with finding of Taenia saginata proglottids in the school environment: a case report].

    Science.gov (United States)

    Dutto, M; Giovanetti, F; Pellegrino, A

    2009-01-01

    We describe a case of teniasis in a child, associated to the finding of Taenia proglottids in a classroom of a primary school in the area of Cuneo (Local Health Unit Cn-1, Piedmont Region, Italy). Several proglottids had been repeatedly found by cleaners on the bookbox of several schooldesks in the same classroom. Laboratory investigation was able to identify Taenia saginata proglottids and cooperation of the local Public Health Unit with the school management allowed to identify and treat the affected child. Laboratory investigation was crucial to exclude a Taenia solium infection, which should have had important public health implications. In fact, infection among humans can follow the ingestion of Taenia solium eggs and in this case larval forms in several tissues can occur (cysticercosis). Moreover the disease can be particularly severe when cysticerci invade the brain, causing seizures and hydrocephalia.

  1. Pleural-based neuroblastoma-like schwannoma: a case report with cytologic findings and review of literature.

    Science.gov (United States)

    Adams, Kristen; Liu, Xuehui Susan; Akhtar, Israh; Flowers, Rhyne; Baliga, Mithra

    2015-08-01

    We report a rare case of a 45-year-old African American woman with Neuroblastoma-like Schwannoma (Neurilemmoma) occurring in the posterior mediastinum as a pleural-based mass noted on computed tomography (CT) scan. A CT-guided core biopsy of the mass was performed and core biopsy imprints were prepared during the procedure. A Diff-Quik stain was performed for on-site evaluation of specimen adequacy. The hematoxylin and eosin (H&E) staining was evaluated subsequently. Immunohistochemistry panels were applied to the same specimen. The cytologic findings of the core biopsy imprints showed hypercellular smears with a predominance of small cells with atypical features including hyperchromatic, round nuclei and occasional nucleoli. Neurocytic rosettes were particularly appreciated on H&E stain. The immunohistochemical results exhibited strong and diffuse immunoreactivity for S-100 and vimentin. This case enriches the cytopathology literature by providing awareness of this tumor presenting as a posterior mediastinal mass.

  2. Abdominal and pelvic CT in cases of suspected abuse: can clinical and laboratory findings guide its use?

    Energy Technology Data Exchange (ETDEWEB)

    Trout, Andrew T.; Strouse, Peter J. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Mohr, Bethany A. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Pediatrics, Ann Arbor, MI (United States); Khalatbari, S.; Myles, Jamie D. [University of Michigan, Michigan Institute for Clinical and Health Research, Ann Arbor, MI (United States)

    2011-01-15

    Incomplete history and concern for occult injury in suspected child abuse occasionally results in CT screenings of the abdomen and pelvis. At our institution, we noted that these exams were infrequently positive. To identify clinical or laboratory criteria that may predict intra-abdominal injury and guide the use of abdominal and pelvic CT in this population. This retrospective review involved 68 children older than 36 months who had a CT of the abdomen/pelvis for suspected abuse. CT results and patient charts were reviewed for physical exam and historical and laboratory variables. CTs were positive in 16% of patients (11/68). Hypoactive/absent bowel sounds (P = 0.01, specificity = 94.7%) and AST and ALT values greater than twice normal (P = 0.004 and P = 0.003 respectively, NPV = 93.6%) were significantly associated with positive CTs. Multiple abnormal physical exam or laboratory findings were also significantly associated with positive CTs (P = 0.03 and P = 0.002 respectively, specificity = 91.3% and NPV = 93.6% respectively). CTs of the abdomen and pelvis are infrequently positive in cases of suspected abuse. To reduce radiation exposure, CTs should only be ordered if there are findings indicating that they may be positive. In our population, these findings include absent/hypoactive bowel sounds, LFTs greater than twice normal and {>=}2 abnormal labs or physical exam findings. (orig.)

  3. A fatal case of middle east respiratory syndrome corona virus infection in South Korea: Cheat radiography and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Eun; Kim, Hyo Lim; Choi, Su Mi [Dept. of Internal Medicine, Yeouido St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    The outbreak of Middle East Respiratory Syndrome Corona Virus (MERS-CoV) infection in South Korea originated from Saudi Arabia. This virus shows high infectivity, and causes outbreaks of severe febrile respiratory infections in health care-associated settings. Herein, we reported a fatal case of MERS-CoV infection with a focus on the pulmonary radiologic findings. The initial chest computed tomography and radiographs of our patient showed ground-glass opacity in patchy distribution, followed by rapid progression of consolidation and pleural effusion in serial studies.

  4. WHAT HAS GONE WRONG?: FINDINGS ON THE IMPLEMENTATION OF PUBLIC POLICIES FOR TRANSPARENCY STARTING FROM AN INSTRUMENTAL CASE

    Directory of Open Access Journals (Sweden)

    Víctor S. Peña

    2013-12-01

    Full Text Available What happens once a public decision is put into practice? The answer to this question lies in the field of public policy implementation, an area studied in a discontinuous manner over time. After a theoretical account, this article explores - starting from an instrumental case set in a Mexican subnational government which has implied bringing a legislative decision related to transparency to reality. Among the findings it is prominent situations of a political nature, agreements between groups and concentration of power in few actors, for example, as contributing elements to the gap between what was planned and executed.

  5. CT and Magnetic Resonance Imaging Findings of Psammomatoid Juvenile Ossifying Fibroma of the Middle Turbinate: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Kwon; Choe, Mi Sun [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2013-06-15

    Ossifying fibroma of the middle turbinate is extremely rare. We report a case of psammomatoid juvenile ossifying fibroma (PsJOF) of the middle turbinate in an 18-year-old adolescent female along with its CT, MRI and pathologic features. PsJOF of the middle turbinate may present a well-demarcated, expansile, solidly enhancing mass with focal bony destruction, which may mimic various benign and malignant neoplasms of the sinonasal area. A combination of clinical, imaging and pathologic findings is prerequisite for establishing an accurate diagnosis.

  6. Hallervorden Spatz syndrome: magnetic resonance findings. Case report; Sindrome de Hallervorden Spatz: achados na ressonancia magnetica. Relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Farage, Luciano; Castro, Mario Augusto Padula; Macedo, Tulio Augusto Alves [Universidade Federal de Uberlandia, MG (Brazil). Hospital de Clinicas. Setor de Radiologia; Assis, Marcelo Cardoso de [Universidade Federal de Uberlandia, MG (Brazil). Faculdade de Medicina. Dept. de Cirurgia; Souza, Lincoln Pereira de; Freitas, Luiz Oliveira de [Universidade Federal de Uberlandia, MG (Brazil). Dept. de Clinica Medica

    2004-09-01

    Hallervorden-Spatz syndrome is a neuro degenerative disease, autosomic recessive with two clinical features: early and late onset. Psychiatric, pyramidal and extrapyramidal signs are present in the late subtype. We report the case of a 41-old woman with extrapyramidal signs. Magnetic resonance imaging (MRI) showed the eye-of-the-tiger sign in the medial globus pallidus. This is due to a gliosis (increased signal) and accumulation of surrounding iron (decreased signal intensity) in long T R sequences. There is a strong relationship between MRI findings and the gene mutation responsible for this disease. It makes the MRI sensible for diagnosing this syndrome. (author)

  7. Case-finding of dementia in general practice and effects of subsequent collaborative care; design of a cluster RCT

    Directory of Open Access Journals (Sweden)

    van den Dungen Pim

    2012-08-01

    Full Text Available Abstract Background In the primary care setting, dementia is often diagnosed relatively late in the disease process. Case finding and proactive collaborative care may have beneficial effects on both patient and informal caregiver by clarifying the cause of cognitive decline and changed behaviour and by enabling support, care planning and access to services. We aim to improve the recognition and diagnosis of individuals with dementia in general practice. In addition to this diagnostic aim, the effects of case finding and subsequent care on the mental health of individuals with dementia and the mental health of their informal carers are explored. Methods and design Design: cluster randomised controlled trial with process evaluation. Participants: 162 individuals ≥ 65 years, in 15 primary care practices, in whom GPs suspect cognitive impairment, but without a dementia diagnosis. Intervention; case finding and collaborative care: 2 trained practice nurses (PNs invite all patients with suspected cognitive impairment for a brief functional and cognitive screening. If the cognitive tests are supportive of cognitive impairment, individuals are referred to their GP for further evaluation. If dementia is diagnosed, a comprehensive geriatric assessment takes place to identify other relevant geriatric problems that need to be addressed. Furthermore, the team of GP and PN provide information and support. Control: GPs provide care and diagnosis as usual. Main study parameters: after 12 months both groups are compared on: 1 incident dementia (and MCI diagnoses and 2 patient and caregiver quality of life (QoL-AD; EQ5D and mental health (MH5; GHQ 12 and caregiver competence to care (SSCQ. The process evaluation concerns facilitating and impeding factors to the implementation of this intervention. These factors are assessed on the care provider level, the care recipient level and on the organisational level. Discussion This study will provide insight

  8. Bamboo Leaf Sign as a Sensitive Magnetic Resonance Imaging Finding in Spinal Subependymoma: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Hiroyuki Toi

    2016-01-01

    Full Text Available Background and Importance. Subependymoma occurs very rarely in the spinal cord. We report another case of spinal subependymoma along with a review of the literature and discussion of a radiological finding that is useful for preoperative diagnosis of this tumor. Clinical Presentation. A 51-year-old man presented with a 2-year history of progressive muscle weakness in the right lower extremity. Sagittal magnetic resonance imaging (MRI showed spinal cord expansion at the Th7–12 vertebral level. Surgical resection was performed and the tumor was found to involve predominantly subpial growth. Histological diagnosis was subependymoma, classified as Grade I according to criteria of World Health Organization. We made an important discovery of what seems to be a characteristic appearance for spinal subependymoma on sagittal MRI. Swelling of the spinal cord is extremely steep, providing unusually large fusiform dilatation resembling a bamboo leaf. We have termed this characteristic MRI appearance as the “bamboo leaf sign.” This characteristic was apparent in 76.2% of cases of spinal subependymoma for which MRI findings were reported. Conclusion. The bamboo leaf sign on spinal MRI is useful for differentiating between subependymoma and other intramedullary tumors. Neurosurgeons encountering the bamboo leaf sign on spinal MRI should consider the possibility of subependymoma.

  9. Malignant lymphoma in central nervous system (CNS). Report of a case with characteristic CT finding and amnesia

    Energy Technology Data Exchange (ETDEWEB)

    Fujiyoshi, Kenji; Fukuyama, Hidenao; Akiguchi, Ichiro; Kameyama, Masakuni (Kyoto Univ. (Japan). Faculty of Medicine); Nishimura, Toshio

    1984-07-01

    A 71-year-old male was admitted to Kohka Public Hospital on January 4, 1980, because of frequent vomiting and recent memory loss. Two weeks before admission upper G-I series showed no abnormalities. Physical and neurological examinations revealed no abnormalities except for slightly apathetic appearance and recent memory loss. Mild pleocytosis and marked increase of protein in CSF were observed. CT scan on January 17 showed high density areas in both medial sides of temporal lobes with remarkable contrast enhancement. His memory and, consciousness disturbances gradually aggravated, accompanied by abnormal density spreading around the ventricle walls like ventriculitis. He was transfered to Kyoto University Hospital on March 17, and malignant lymphoma was diagnosed on the basis of CSF cytology. Radiation and chemotherapy alleviated the CNS involvement and he regained normal mental function. On June 16, he developed pneumonia followed by status epilepticus. Autopsy findings revealed no lymphoid cell infiltration, but fibrous tissues in both hippocampal gyri and lymphomatous cells in the liver, which could not be suspected on clinical examinations. Apparent malignant lymphoma cells were not found in lymph nodes. This case indicated peculiar evolution of malignant lymphoma from liver to CNS or vice versa. We could not decide which organ was primary. CT findings of this case was very interesting; they resembled ventriculitis, which simulate tumors such as medulloblastoma or ependymoma spreading under ependymal lining.

  10. A Brazilian experience of the self transglutaminase-based test for celiac disease case finding and diet monitoring

    Institute of Scientific and Technical Information of China (English)

    Lorete Maria da Silva Kotze; Ana Paula Brambila Rodrigues; Luiz Roberto Kotze; Renato Mitsunori Nisihara

    2009-01-01

    AIM: To evaluate the effectiveness of a rapid and easy fingertip whole blood point-of-care test for celiac disease (CD) case finding and diet monitoring.METHODS: Three hundred individuals, 206 females (68.7%) and 94 males (31.3%), were submitted to a rapid and easy immunoglobulin-A-class fingertip whole blood point-of-care test in the doctor's office in order to make immediate clinical decisions: 13 healthy controls, 6 with CD suspicion, 46 treated celiacs, 84 relatives of the celiac patients, 69 patients with dyspepsia, 64 with irritable bowel syndrome (IBS), 8 with Crohn's disease and 9 with other causes of diarrhea.RESULTS: Upper gastrointestinal endoscopy with duodenal biopsies was performed in patients with CD suspicion and in individuals with positive test outcome: in 83.3% (5/6) of the patients with CD suspicion, in 100% of the patients that admitted gluten-free diet transgressions (6/6), in 3.8% of first-degree relatives (3/79) and in 2.9% of patients with dyspepsia (2/69). In all these individuals duodenal biopsies confirmed CD (Marsh's histological classification). The studied test showed good correlation with serologic antibodies, endoscopic and histological findings.CONCLUSION: The point-of-care test was as reliable as conventional serological tests in detecting CD cases and in CD diet monitoring.

  11. Imaging Findings of Central Nervous System Vasculitis Associated with Goodpasture's Syndrome: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jee Young; Ahn, Kook Jin; Jung, Jung Im; Jung, So Lyung; Kim, Bum Soo; Hahn, Seong Tae [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-12-15

    We report a rare case of CNS vasculitis associated with Goodpasture's syndrome in a 34-year-old man, who presented with a seizure and sudden onset of right sided weakness. He also had recurrent hemoptysis of one month's duration. Goodpasture's syndrome is histologically diagnosed by intense linear deposits of IgG along the glomerular basement membrane in both renal and lung tissues. oodpasture's syndrome is a rare disease, characterized by rapidly progressive glomerulonephritis, diffuse pulmonary hemorrhage and circulating antiglomerular basement membrane antibody (anti-GBM antibody). Central nervous system (CNS) manifestations in Goodpasture's syndrome are extremely rare, with only a few cases having been reported in the literature (8 10). Therefore, we present our imaging findings of CNS vasculitis associated with Goodpasture's syndrome, together with a review of the relevant literature. In summary, CNS vasculitis associated with Goodpasture's syndrome is extremely rare. Awareness of the imaging findings, as well as the clinical significance of CNS vasculitis associated with Goodpasture's syndrome, can be helpful in making the correct diagnosis and subsequent management of this rare condition.

  12. Rock Finding

    Science.gov (United States)

    Rommel-Esham, Katie; Constable, Susan D.

    2006-01-01

    In this article, the authors discuss a literature-based activity that helps students discover the importance of making detailed observations. In an inspiring children's classic book, "Everybody Needs a Rock" by Byrd Baylor (1974), the author invites readers to go "rock finding," laying out 10 rules for finding a "perfect" rock. In this way, the…

  13. Implementation and effect of intensified case finding on diagnosis of tuberculosis in a large urban HIV clinic in Uganda: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Hermans Sabine

    2012-08-01

    Full Text Available Abstract Background Increased detection of tuberculosis (TB using intensified or active case finding (ICF is one of the cornerstones of the Stop TB Strategy, and contrasts with passive case finding (PCF which relies on self-reported symptoms. There is no clear guidance on implementation strategies. We implemented ICF in addition to ongoing PCF in our large urban HIV clinic in July 2010 using a twice-daily announcement screen method by a trained peer educator, asking waiting patients to self-refer to a trained peer supporter for screening of TB symptoms. We sought to determine the associated effect on TB case detection. Methods Suspects were investigated by sputum smear, chest X-ray and ultrasound, if indicated. Routinely collected clinical and laboratory data were merged with the ICF register and TB clinic data for patients attending the clinic in 2010. We compared the yield of TB cases (defined as the prevalence of newly diagnosed TB cases in the screened population, the type of TB diagnosed and the total cost per TB case identified (in United States Dollars [USD] for the period before and after ICF implementation. Results Of the 20,456 patients who visited the clinic in 2010, 614 were identified as TB suspects, 220 pre-ICF and 394 post-ICF (229 via PCF and 165 via ICF. The proportion diagnosed with TB dropped from 66% to 48% (60% in suspects identified through PCF and 31% through ICF. During the post-ICF period, TB suspects identified through ICF compared to PCF identification were more likely to be female, older, on ART and to have been enrolled in HIV care for a longer duration. The yield of combined PCF and ICF screening was 1.4% pre-ICF and 1.7% post-ICF with a cost per TB case identified of 12.29 USD and 21.80 USD, respectively. Conclusions Implementation of ICF in a large HIV clinic yielded more TB suspects and cases, but substantially increased costs and was unable to capture the majority of TB suspects who were referred for diagnosis

  14. Risk factors, microbiological findings, and clinical outcomes in cases of microbial keratitis admitted to a tertiary referral center in ireland.

    LENUS (Irish Health Repository)

    Saeed, Ayman

    2012-02-01

    AIM: To identify the risk factors for, and to report the microbiological findings and clinical outcomes of, severe microbial keratitis (MK). METHODS: This was a retrospective study of all cases of presumed MK admitted to a tertiary referral center over a 2-year period (September 2001 to August 2003). Data recorded included demographic data, details relating to possible risk factors, results of microbiological studies, clinical findings at presentation, and clinical and visual outcomes. RESULTS: Ninety patients were admitted with a diagnosis of presumed MK during the study period. The mean age of patients was 45 +\\/- 32 years, and the male to female ratio was 47:43 (52.2%:47.7%). Predisposing risk factors for MK included contact lens wear (37; 41.1%), anterior segment disease (19; 21.1%), ocular trauma (13; 14.4%), systemic disease (5; 5.6%), and previous ocular surgery (1; 1.1%). Cultured organisms included gram-negative bacteria (17; 51.5%), gram-positive bacteria (11, 33.3%), acanthamoeba (2; 6.1%), and fungi (1; 3%). Visual acuity improved significantly after treatment [mean best-corrected visual acuity (+\\/-standard deviation) at presentation: 0.76 (+\\/-0.11); mean best-corrected visual acuity at last follow-up: 0.24 (+\\/-0.07); P < 0.001]. Secondary surgical procedures were required in 18 (20%) cases, and these included punctal cautery (1; 1.1%), tissue glue repair of corneal perforation (2; 2.2%), tarsorrhaphy (9; 9.9%), Botulinum toxin-induced ptosis (1; 1.1%), penetrating keratoplasty (3; 3.3%), and evisceration (2; 2.2%). CONCLUSIONS: Contact lens wear remains a significant risk factor for severe MK. MK remains a threat to vision and to the eye, but the majority of cases respond to prompt and appropriate antimicrobial therapy.

  15. Estimating the joint disease outbreak-detection time when an automated biosurveillance system is augmenting traditional clinical case finding.

    Science.gov (United States)

    Shen, Yanna; Adamou, Christina; Dowling, John N; Cooper, Gregory F

    2008-04-01

    The goals of automated biosurveillance systems are to detect disease outbreaks early, while exhibiting few false positives. Evaluation measures currently exist to estimate the expected detection time of biosurveillance systems. Researchers also have developed models that estimate clinician detection of cases of outbreak diseases, which is a process known as clinical case finding. However, little research has been done on estimating how well biosurveillance systems augment traditional outbreak detection that is carried out by clinicians. In this paper, we introduce a general approach for doing so for non-endemic disease outbreaks, which are characteristic of bioterrorist induced diseases, such as respiratory anthrax. We first layout the basic framework, which makes minimal assumptions, and then we specialize it in several ways. We illustrate the method using a Bayesian outbreak detection algorithm called PANDA, a model of clinician outbreak detection, and simulated cases of a windborne anthrax release. This analysis derives a bound on how well we would expect PANDA to augment clinician detection of an anthrax outbreak. The results support that such analyses are useful in assessing the extent to which computer-based outbreak detection systems are expected to augment traditional clinician outbreak detection.

  16. Physical activity and energy expenditure: findings from the Ibadan Pregnant Women's Survey.

    Science.gov (United States)

    Adeniyi, Ade F; Ogwumike, Omoyemi O

    2014-06-01

    Physical activity, if there are no medical caveats, is beneficial to all people including pregnant women. This study examined the level of physical activity in a group of pregnant Nigerian women. Pregnancy Physical Activity Questionnaire was used to assess the physical activity of 453 pregnant women. The mean age of participants was 30.89 +/- 4.44 years, 222 (49.0%) were sedentary, and only 46 (10.2%) presented with moderate activity level. The highest amount of energy (75.9 MET-h x wk(-1)) was expended on household activities. Women in the third trimester of pregnancy had more than three times the risk of being sedentary (OR = 3.26, 95% CI = 2.11-4.56) but the risk reduced by 58% in gravid > or = 5 women. Most of the pregnant women recorded physical activity that was lower than the recommended level, which could lead to unfavourable health outcomes for mother and child. Efforts to promote physical activity in pregnant women in this environment are desirable.

  17. Dynamic CT and MRA findings of a case of portopulmonary venous anastomosis (PPVA) in a patient with portal hypertension: a case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Jeong Min; Ahn, Myeong Im; Han, Dae Hee; Jung, Jung Im; Park, Seog Hee (Dept. of Radiology, Seoul St Mary' s Hospital, College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)), email: ami@catholic.ac.kr

    2011-06-15

    Portopulmonary venous anastomosis (PPVA), which has been rarely reported in conventional CT and MR studies, is an unusual collateral pathway in patients with portal hypertension. It has clinical implications related to right-to-left shunt that are different from the clinical implications related to other more usual portosystemic shunts in portal hypertensive patients. Here, we report the dynamic CT and MRA findings of a case of PPVA in a patient with portal hypertension, directly demonstrating the shunt flow from the paraesophageal varix to the left atrium via the right inferior pulmonary vein

  18. Mixed methods evaluation of targeted case finding for cardiovascular disease prevention using a stepped wedged cluster RCT

    Directory of Open Access Journals (Sweden)

    Marshall Tom

    2012-10-01

    Full Text Available Abstract Background A pilot project cardiovascular prevention was implemented in Sandwell (West Midlands, UK. This used electronic primary care records to identify untreated patients at high risk of cardiovascular disease then invited these high risk patients for assessment by a nurse in their own general practice. Those found to be eligible for treatment were offered treatment. During the pilot a higher proportion of high risk patients were started on treatment in the intervention practices than in control practices. Following the apparent success of the prevention project, it was intended to extend the service to all practices across the Sandwell area. However the pilot project was not a robust evaluation. There was a need for an efficient evaluation that would not disrupt the planned rollout of the project. Methods/design Project nurses will sequentially implement targeted cardiovascular case finding in a phased way across all general practices, with the sequence of general practices determined randomly. This is a stepped wedge randomised controlled trial design. The target population is patients aged 35 to 74, without diabetes or cardiovascular disease whose ten-year cardiovascular risk, (determined from data in their electronic records is ≥20%. The primary outcome is the number of high risk patients started on treatment, because these data could be efficiently obtained from electronic primary care records. From this we can determine the effects of the case finding programme on the proportion of high risk patients started on treatment in practices before and after implementation of targeted case finding. Cost-effectiveness will be modelled from the predicted effects of treatments on cardiovascular events and associated health service costs. Alongside the implementation it is intended to interview clinical staff and patients who participated in the programme in order to determine acceptability to patients and clinicians. Practical

  19. Finding Biomass Degrading Enzymes Through an Activity-Correlated Quantitative Proteomics Platform (ACPP)

    Science.gov (United States)

    Ma, Hongyan; Delafield, Daniel G.; Wang, Zhe; You, Jianlan; Wu, Si

    2017-01-01

    The microbial secretome, known as a pool of biomass (i.e., plant-based materials) degrading enzymes, can be utilized to discover industrial enzyme candidates for biofuel production. Proteomics approaches have been applied to discover novel enzyme candidates through comparing protein expression profiles with enzyme activity of the whole secretome under different growth conditions. However, the activity measurement of each enzyme candidate is needed for confident "active" enzyme assignments, which remains to be elucidated. To address this challenge, we have developed an Activity-Correlated Quantitative Proteomics Platform (ACPP) that systematically correlates protein-level enzymatic activity patterns and protein elution profiles using a label-free quantitative proteomics approach. The ACPP optimized a high performance anion exchange separation for efficiently fractionating complex protein samples while preserving enzymatic activities. The detected enzymatic activity patterns in sequential fractions using microplate-based assays were cross-correlated with protein elution profiles using a customized pattern-matching algorithm with a correlation R-score. The ACPP has been successfully applied to the identification of two types of "active" biomass-degrading enzymes (i.e., starch hydrolysis enzymes and cellulose hydrolysis enzymes) from Aspergillus niger secretome in a multiplexed fashion. By determining protein elution profiles of 156 proteins in A. niger secretome, we confidently identified the 1,4-α-glucosidase as the major "active" starch hydrolysis enzyme (R = 0.96) and the endoglucanase as the major "active" cellulose hydrolysis enzyme (R = 0.97). The results demonstrated that the ACPP facilitated the discovery of bioactive enzymes from complex protein samples in a high-throughput, multiplexing, and untargeted fashion.

  20. Answering the Call for Accountability: An Activity and Cost Analysis Case Study

    Science.gov (United States)

    Carducci, Rozana; Kisker, Carrie B.; Chang, June; Schirmer, James

    2007-01-01

    This article summarizes the findings of a case study on the creation and application of an activity-based cost accounting model that links community college salary expenditures to mission-critical practices within academic divisions of a southern California community college. Although initially applied as a financial management tool in private…

  1. A case of monomelic amyotrophy of the upper limb: MRI findings and the implication on its pathogenesis.

    Science.gov (United States)

    Li, Yuebing; Remmel, Krista

    2012-06-01

    Monomelic amyotrophy of the upper limb or Hirayama disease is mostly considered as an anterior horn disorder resulting from local ischemia, triggered by arterial compression from an anterior shifting of the posterior cervical dura upon neck flexion. However, such a dural shifting is not universally seen. We report on a Caucasian male patient who developed a slowly progressive unilateral distal hand weakness in his teens. His clinical and electromyographic findings were consistent with Hirayama disease. Local anterior cervical cord atrophy was observed without dural shifting on the dynamic magnetic resonance imaging. Axial magnetic resonance imaging demonstrated signal changes of "snake-eye" appearance in the cervical anterior horn region, similar to ischemic myelopathies caused by various etiologies. This case illustrated that even without dural shifting, a mechanism of anterior spinal cord ischemia could still be responsible for the pathogenesis of Hirayama disease.

  2. Multidetector computed tomography findings of mesenteroaxial gastric volvulus combined with torsion of wandering spleen: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Youn, In Kyung; Ku, Young Mi; Lee, Su Lim [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of)

    2016-05-15

    Gastric volvulus, defined as an abnormal rotation of stomach, may be idiopathic or secondary to abnormal fixation of intraperitoneal visceral ligaments. Wandering spleen is a movable spleen resulting from absence or underdevelopment of the splenic supporting ligaments that suspend the spleen to its normal position in the left part of the supramesocolic compartment of the abdomen. Wandering spleen increases the risk of splenic torsion. Both gastric volvulus and splenic torsion are potentially life-threatening if not urgently managed with surgery. Prompt and accurate diagnosis based on multidetector computed tomography (MDCT) is crucial to prevent unforeseen complications. Gastric volvulus and coexistent torsion of wandering spleen is a very rare condition. Herein, we described a case of gastric volvulus associated with wandering spleen and intestinal non-rotation in a 15-year-old girl focusing on MDCT findings.

  3. Cholesteatoma of the external ear canal: etiological factors, symptoms and clinical findings in a series of 48 cases

    DEFF Research Database (Denmark)

    Gaihede, Michael Lyhne

    2006-01-01

    ABSTRACT: BACKGROUND: To evaluate symptoms, clinical findings, and etiological factors in external ear canal cholesteatoma (EECC). METHOD: Retrospective evaluation of clinical records of all consecutive patients with EECC in the period 1979 to 2005 in a tertiary referral centre. Main outcome...... measures were incidence rates, classification according to causes, symptoms, extensions in the ear canal including adjacent structures, and possible etiological factors. RESULTS: Forty-five patients were identified with 48 EECC. Overall incidence rate was 0.30 cases per year per 100,000 inhabitants. Twenty...... into nearby structures. Whereas the aetiology of secondary EECC can be explained, the origin of primary EECC remains uncertain; smoking and minor trauma of the ear canal may predispose....

  4. ULTRASONOGRAPHIC AND COMPUTED TOMOGRAPHIC FINDINGS IS DEFINITIVE IMAGING IN BILATERAL SYMMETRICAL PERIRENAL PERIPELVIC LYMPHANGIOMATOSIS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Amit

    2014-06-01

    Full Text Available Perinephric peripelvic lymphangiomatosis is a rare benign malformation of lymphatic system; that may be confused with various forms of renal cystic diseases and urinomas. In this disorder a developmental malformation results in failure of developing lymphatic channels to establish normal communication with the rest of lymphatic systems and restrict/ failure drainage of lymphatic fluid, dilate the channels to form cystic masses that may be unilocular or multilocular and may be seen unilaterally or bilaterally. This condition presents with various signs and symptoms or can be just incidental findings which in presence of misleading clinical history may be confused with other diseases. Definitive diagnosis is possible with USG and CT scan. Here we report a case of bilateral perirenal and peripelvic involvement with a normal excretory function

  5. Findings on magnetic resonance imaging of the spine and femur in a case of McCune-Albright syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Inamo, Y. (Department of Pediatrics, Nihon Univ. School of Medicine, Tokyo (Japan)); Hanawa, Y. (Department of Pediatrics, Nihon Univ. School of Medicine, Tokyo (Japan)); Kin, H. (Department of Pediatrics, Nihon Univ. School of Medicine, Tokyo (Japan)); Okuni, M. (Department of Pediatrics, Nihon Univ. School of Medicine, Tokyo (Japan))

    1993-03-01

    Polyostotic fibrous dysplasia, a major osseous change in McCune-Albright syndrome, is seen in the cranium, facial bones, of the extremeties, and ribs, but rarely in the spine. Spinal X-rays revealed no abnormalities in an 8-year-old girl with this syndrome, but [sup 99m]Tc-methylene diphosphonate bone scintigraphy disclosed high-density areas in the thoracic and lumbar vertebrae. Multiple well-circumscribed areas of low signal intensity were seen on T1-weighted magnetic resonance imaging (MRI) of the spine. Although MRI spine scans in this disease have never been reported, our findings in this case proved for evaluating osseous lesions. MRI made it possible to differentiate between fibrous lesions (low signal intensity on T1- und T2- weighted MRI) and cartilaginous lesions (low signal intensity on T1-weighted MRI and high signal intensity on T2-weighted MRI). (orig.)

  6. A Case Report of Breast Sparganosis in a Patient with Ipsilateral Breast Cancer: MRI and Ultrasonographic Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yoo Jin; Bae, Young Tae; Kim, Jee Yeon [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Choo, Ki Seok [Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2010-12-15

    Sparganosis of the breast is a quite rare parasitic infection of humans and presents as soft tissue masses that mimic breast malignancy or benign tumor, such as fibroadenoma. We present here a case of histologically confirmed breast sparganosis in the upper inner quadrant of the right breast with coexisting breast cancer in the ipsilateral breast upper outer quadrant. Ultrasonography of breast sparganosis showed a well defined, tubular hypoechoic mass with discrete multilayered wall and tubule-in tubule appearance, surrounded by heterogenous hyperechoic areas in the subcutaneous fat layer of the breast. MRI revealed an elongated tubular structure with persistent and progressive enhancement. This is the second report concerned with the MRI and ultrasonographic findings of breast sparganosis and the first report of breast sparganosis in a patient with ipsilateral breast cancer

  7. Synchronized Babinski and Chaddock signs preceded the MRI findings in a case of repetitive transient ischemic attack.

    Science.gov (United States)

    Matsuzono, Kosuke; Yoshiki, Takao; Wakutani, Yosuke; Manabe, Yasuhiro; Yamashita, Toru; Deguchi, Kentaro; Ikeda, Yoshio; Abe, Koji

    2013-01-01

    We herein report a 53-year-old female with repeated transient ischemic attack (TIA) symptoms including 13 instances of right hemiparesis that decreased in duration over 4 days. Two separate examinations using diffusion weighted image (DWI) in magnetic resonance imaging (MRI) revealed normal findings, but we observed that both Babinski and Chaddock signs were completely synchronized with her right hemiparesis. We were only able to diagnose this case of early stage TIA using clinical signs. This diagnosis was confirmed 4 days after the onset by the presence of abnormalities on the MRI. DWI-MRI is generally useful when diagnosing TIA, but a neurological examination may be more sensitive, especially in the early stages.

  8. Benign incidental findings of osteopoikilosis on Tc-99m MDP bone SPECT/CT: A case report and literature review.

    Science.gov (United States)

    Tsai, Szu-Ying; Wang, Shan-Ying; Shiau, Yu-Chien; Wu, Yen-Wen

    2016-06-01

    Osteopoikilosis is a benign but rare condition characterized by bone islands throughout the osseous tissue, which could be easily confused with bone metastasis. We present a case of a 37-year-old man presented to orthopedic outpatient clinic with right hip pain for 2 weeks. There were multiple, small punctate lesions scattered throughout the skeleton on radiograph. Subsequent Tc-99m methylene diphosphonate (MDP) bone scan with pelvic single-photon emission computed tomography (SPECT)/computed tomography (CT) showed multiple enostoses without abnormal focal MDP uptake. Therefore, clinical diagnosis was compatible with osteopoikilosis while bone metastasis was unlikely. The symptoms then improved by conservative treatments. Osteopoikilosis is usually an incidental finding on radiograph or CT, and a normal MDP confirmed the diagnosis by excluding bone metastasis. It is important for clinicians to recognize the specific image features to prevent further unnecessary interventions. In addition, bone SPECT/CT could also make the diagnosis in one step.

  9. Multidetector-Row CT Findings of a Preduodenal Portal Vein Associated with Polysplenic Syndrome in an Adult: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Song, Hyun; Lee, Su Lim; Ku, Young Mi; Chun, Chang Woo [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Uijeongbu (Korea, Republic of)

    2012-03-15

    Preduodenal portal vein (PDPV) is a rare developmental anomaly in which the portal vein runs at the ventral side of the duodenum instead of at an intrapancreatic location. Understanding of this anomaly is of considerable surgical importance, because it may cause unintended portal vein injury during operations involving the gall bladder or duodenum. We recently experienced PDPV associated with polysplenia syndrome in a 49-year-old male patient who complained of persistent epigastric pain. CT portal venography with thin slab maximal intensity projection and volume rendering demonstrated the unique feature of convex anastomosis between the L-shaped mesenterico-portal vein and mesenterico-splenic vein in the mid abdomen. We report here the Multidetector-row CT findings of a rare case of PDPV.

  10. Antipsychotic medication and prefrontal cortex activation : A review of neuroimaging findings

    NARCIS (Netherlands)

    Liemburg, Edith J.; Knegtering, Henderikus; Klein, Hans C.; Kortekaas, Rudie; Aleman, Andre

    2012-01-01

    Decreased prefrontal activation (hypofrontality) in schizophrenia is thought to underlie negative symptoms and cognitive impairments, and may contribute to poor social outcome. Hypofrontality does not always improve during treatment with antipsychotics. We hypothesized that antipsychotics, which sha

  11. A Neuroanatomy Teaching Activity Using Case Studies and Collaboration.

    Science.gov (United States)

    Sheldon, Jane P.

    2000-01-01

    Describes an activity for use in an introductory psychology course in which students collaborate and apply their neuroanatomy knowledge to three case studies. Provides a table with descriptions of and possible answers for the three case studies and discusses the students' responses. (CMK)

  12. Finding strategic communication & diverse leadership in the ancient world: The case of Queen Cleopatra VII, the last pharaoh of Egypt

    Directory of Open Access Journals (Sweden)

    Shannon A. Bowen

    2016-12-01

    Full Text Available The reign of Queen Cleopatra VII of Egypt offers a rare historical glimpse into ancient communication activities and how communication was used by the world’s last pharaoh. This historical research reveals how Cleopatra used public relations and strategic communication activities to advance both her reign as a lone woman sovereign and the interests of the Egyptian empire. Cleopatra was perhaps the first woman sovereign in history to rule alone for a period of over a decade. Her leadership showed skilled use of public communication and diplomacy with which she forestalled the fall of Egypt to Rome. A grounded theory approach allowed data to emerge naturally, surrounding communication activities, and then for a theoretical framework to be imposed that could explain the common themes in that data. This research compares Cleopatra’s activities with public relations theory using the classic four models of public relations to classify public communication. Findings show that Cleopatra used research in asymmetrical public relations and symmetrical relationship building, also including public diplomacy, public information, and press agentry/pseudo-event mastery. Careful examination of literature sources led to the conclusion that Cleopatra was a truly advanced, research-based, relationship-focused, and international policy-oriented lone woman ruler who was a supremely strategic communicator.

  13. Hoff Mann′s syndrome with unusually long duration: Report on clinical, laboratory and muscle imaging findings in two cases

    Directory of Open Access Journals (Sweden)

    Atchayaram Nalini

    2014-01-01

    Full Text Available Two adult men presented with the rare Hoffmann′s syndrome (HS. Case 1: A 35-year-old male patient had progressive stiffness of lower limbs of 13 years and generalized muscle hypertrophy and myalgia of 3 years duration. Had periorbital edema, dry skin, generalized muscle hypertrophy and spastic dysarthria with hoarseness. Muscle power was normal. Jaw jerk and deep tendon reflexes were exaggerated. Case 2: A 24-year-old male patient presented with muscle hypertrophy from childhood, slowness in motor activities and hearing impairment. For 6 months, he had severe muscle pains, cramps and further increase in hypertrophy. He had yellow tinged, dry skin, hoarseness of voice, gross muscle hypertrophy and minimal weakness. Both had markedly elevated serum creatine kinase (CK levels and high thyroid stimulating hormone, low free triiodothyronine and free thyroxine levels. Levothyroxine treatment demonstrated remarkable reduction in muscle bulk at 2 months in both and no symptoms at 6 months. Magnetic resonance imaging of lower limbs in both cases revealed almost identical features with involvement of the muscles of posterior and adductor compartment of thighs and posterior and lateral compartments of the legs. Differential diagnosis of long duration muscle pseudohypertrophy and elevated CK levels should include HS.

  14. Radiological and pathological findings of a metastatic composite paraganglioma with neuroblastoma in a man: a case report

    Directory of Open Access Journals (Sweden)

    Koch Sonja

    2010-11-01

    Full Text Available Abstract Introduction Composite tumors of the adrenal medulla or paraganglia are extremely rare and present a diagnostic dilemma. These tumors consist of a neuroendocrine component mixed with a neural component. We describe the imaging characteristics together with the corresponding pathological findings of a composite tumor. Apart from any component-specific imaging findings, the hallmark of this entity is the presence of histologically distinguishable components. Case presentation A 61-year-old Caucasian man was referred to our hospital due to a suspect lesion found on chest computed tomography carried out for unclear thoracic pain. An abdominal computed tomography scan and ultrasound examination detected a retroperitoneal tumor comprising two different tumor components. Twenty-four-hour urine revealed high levels of normetanephrine, characteristic of a neuroendocrine tumor. An octreoscan prior to surgical procedures revealed multiple osseous and intra-hepatic metastases. The final histopathological workup revealed a composite paraganglioma with neuroblastoma. Our patient died ten months after the initial diagnosis from tumor-associated complications. Conclusions Composite paragangliomas with neuroblastoma are rare tumors of the retroperitoneum. Such tumors should be considered in the differential diagnosis of retroperitoneal masses.

  15. Calcifying Aponeurotic Fibroma with Osseous Involvement of the Finger: a Case Report with Radiologic and US Findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Jung; Ahn, Jae Hong; Kang, Gil Hyun; Lee, Jong Hyeog; Park, Man Soo; Ryu, Dae Sik; Jung, Seung Moon [GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2008-02-15

    Calcifying aponeurotic fibroma is a rare soft tissue tumor that occurs in the distal extremities of children and adolescents. We report ultrasound and X-ray findings of a calcifying aponeurotic fibroma in the finger of a 36-year-old woman, associated with distal phalangeal bone involvement. Calcifying aponeurotic fibroma is a rare, locally aggressive fibroblastic lesion occurring primarily in the palms of the hands and soles of the feet in young children and adolescents under 20 years of age. Clinical presentation is a unique, hard, and painless palpable mass. This soft tissue tumor typically infiltrates into the surrounding fascia or muscle and has a predilection for recurrence after surgical removal. However, bone involvement in calcifying aponeurotic fibroma is a very rare condition and we found only three pediatric cases in the literature. We present the ultrasound and radiographic findings of a calcifying aponeurotic fibroma in the finger of a 36-year-old woman, associated with erosive bone destruction of the distal phalanx. In summary, calcifying aponeurotic fibroma is a rare soft tissue tumor that presents as a painless mass primarily on the volar surface of the hands and plantar aspects of the feet in juveniles, but this tumor should be also included in differential diagnoses of any mass with calcification and adjacent bone involvement in the distal phalanx of the finger. In addition, US could be useful for the preoperative evaluation of digital calcifying aponeurotic fibroma.

  16. Spectrum of clinicoradiological findings in spinal cord infarction: Report of three cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Ajith Sivadasan

    2013-01-01

    Full Text Available Spinal cord infarction (SCI often remains undiagnosed due to infrequent occurrence and lack of established diagnostic procedures. The unique pattern of blood supply explains the heterogeneity of clinical presentation. We present three cases of SCI to highlight the varied spectrum of clinicoradiological findings. The first patient had posterior spinal artery infarction, and spine imaging showed infarction of adjacent vertebral body, which is usually rare. The second patient had anterior spinal artery infarction and the cANCA titers were elevated. The third patient had a pure motor quadriparesis. Initial imaging did not show any cord infarction, but signal changes were noted on serial imaging. Fibrocartilagenous embolism (FCE seems the most likely etiology in the first and third cases. A high index of clinical suspicion is necessary for prompt diagnosis. Sensitivity of the initial magnetic resonance imaging remains limited, necessitating serial follow-up scans. Infarction of the adjacent vertebral body is a useful confirmatory sign. Fat suppression images can delineate the marrow signal changes better. Elderly patients with vascular risk factors and degenerative discs need to avoid mechanical triggers that predispose to FCE. Younger patients with SCI will need evaluation for cardioembolic source and vasculitis.

  17. Preliminary Findings of The Brief Everyday Activities Measurement (BEAM) in Older Adults

    Science.gov (United States)

    Scharaga, Elyssa A.; Holtzer, Roee

    2017-01-01

    Objectives Functional losses are common in healthy and cognitively impaired older adults. However, subtle declines in instrumental activities of daily living (IADLs) are not always detected in self-reports. Performance IADL measurements are financially and time burdensome, restricting their use in varied settings. To address these limitations, we developed the Brief Everyday Activities Measure (BEAM), a short (speed. Conclusions Medication and finance management can be efficiently assessed within five minutes. The BEAM may be a valuable screening tool to evaluate these functional abilities. PMID:26482695

  18. Risk prediction in the community: A systematic review of case-finding instruments that predict adverse healthcare outcomes in community-dwelling older adults.

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2015-09-01

    Few case-finding instruments are available to community healthcare professionals. This review aims to identify short, valid instruments that detect older community-dwellers risk of four adverse outcomes: hospitalisation, functional-decline, institutionalisation and death. Data sources included PubMed and the Cochrane library. Data on outcome measures, patient and instrument characteristics, and trial quality (using the Quality In Prognosis Studies [QUIPS] tool), were double-extracted for derivation-validation studies in community-dwelling older adults (>50 years). Forty-six publications, representing 23 unique instruments, were included. Only five were externally validated. Mean patient age range was 64.2-84.6 years. Most instruments n=18, (78%) were derived in North America from secondary analysis of survey data. The majority n=12, (52%), measured more than one outcome with hospitalisation and the Probability of Repeated Admission score the most studied outcome and instrument respectively. All instruments incorporated multiple predictors. Activities of daily living n=16, (70%), was included most often. Accuracy varied according to instruments and outcomes; area under the curve of 0.60-0.73 for hospitalisation, 0.63-0.78 for functional decline, 0.70-0.74 for institutionalisation and 0.56-0.82 for death. The QUIPS tool showed that 5\\/23 instruments had low potential for bias across all domains. This review highlights the present need to develop short, reliable, valid instruments to case-find older adults at risk in the community.

  19. Overcoming disparities in organized physical activity: findings from Australian community strategies.

    Science.gov (United States)

    Smith, Ben J; Thomas, Margaret; Batras, Dimitri

    2016-09-01

    Organized physical activity through sport and recreational activities is beneficial for physical and psychosocial well-being and community connectedness. However, many who could gain significantly from this have lower participation, especially the socioeconomically disadvantaged, Indigenous people, culturally diverse communities and people with a disability. This study examined barriers to participation by these underserved groups and the success of strategies for overcoming these used in 22 community projects over 3 years in the VicHealth Participation in Community Sport and Recreation Program, in Victoria, Australia. Each year, in-depth interviews were undertaken with 50-60 activity providers and 30-40 project partners. Major barriers to participation were cost, lack of transport, cultural differences, the environment of sporting groups and inaccessible facilities for people with disabilities. Projects that overcame these selected one or two priority groups, put significant effort into communication and building partnerships with community organizations, provided training to staff and volunteers and created new or modified forms of activity. Strategies were put in place to reduce cost and provide transport, but these did not appear to be sustainable. Many organizations found engaging the underserved was more difficult than anticipated and require information and support about how to develop acceptable, accessible and flexible opportunities for disadvantaged groups. Cost and lack of transport are persistent barriers to participation that need to be addressed by the sport and recreation sector and policy-makers.

  20. Post-mortem findings in 54 cases of anesthetic associated death in cats from two spay-neuter programs in New York State.

    Science.gov (United States)

    Gerdin, Jodie A; Slater, Margaret R; Makolinski, Kathleen V; Looney, Andrea L; Appel, Leslie D; Martin, Nicole M; McDonough, Sean P

    2011-12-01

    Anesthetic-associated death (AAD) in cats is infrequent, but occurs far more frequently than in people. Post-mortem investigations of AAD in cats are uncommon, and results only sporadically published. Here we report the findings in 54 cases of AAD in cats. Significant gross and/or microscopic pre-existing disease, including pulmonary, cardiac, and systemic disease, was detected in 33% of cases. Pulmonary disease was most frequently diagnosed (24% of cases), and included cases of Aelurostrongylus abstrusus infection (9% of cases). Heart disease, including two cases of hypertrophic cardiomyopathy, was less frequent (11% of cases). Four percent died from surgical complications. No significant gross or microscopic disease was detected in 63% of cases. Additional studies are needed to determine if these findings are representative of AAD in cats in other geographic areas or with access to veterinary care. This study demonstrates that post-mortem investigation of AADs is an important and worthwhile endeavor.

  1. Seizure-like activity during fentanyl anesthesia. A case report.

    OpenAIRE

    Webb, M. D.

    1990-01-01

    Fentanyl induced seizures have been described previously in the literature. Clinical observations has labeled the movements seen in fentanyl anesthesia as seizure activity but electroencephalographic studies have not supported this. A case of seizure-like activity after the administration of fentanyl in a 20-year-old female is reported.

  2. Active case finding of tuberculosis in Europe: a Tuberculosis Network European Trials Group (TBNET) survey

    DEFF Research Database (Denmark)

    Bothamley, G.H.; Ditiu, L.; Migliori, G.B.;

    2008-01-01

    countries do not, even if the chest radiograph suggests tuberculosis. Nearly all countries (49 out of 50) use tuberculin skin testing (TST); 27 (54%) out of 50 countries also perform chest radiography irrespective of the TST result. Interpretation of the TST varies widely. All countries use 6-9 months...

  3. Depressive Symptoms and Inductive Reasoning Performance: Findings from the ACTIVE Reasoning Training Intervention

    OpenAIRE

    Parisi, Jeanine M.; Franchetti, Mary Kathryn; Rebok, George W.; Spira, Adam P.; Carlson, Michelle C.; Willis, Sherry L.; Gross, Alden L.

    2014-01-01

    Within the context of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, we examined the longitudinal association of baseline depressive symptoms on inductive reasoning performance over a ten-year period between the reasoning training and control conditions (N = 1,375). At baseline, 322 participants (23%) reported elevated depressive symptoms, defined by a score ≥ 9 on the Center for Epidemiological Studies Depression scale (12-item). Differences in baseline dep...

  4. Epithelial cells as active player in fibrosis: findings from an in vitro model.

    Directory of Open Access Journals (Sweden)

    Solange Moll

    Full Text Available Kidney fibrosis, a scarring of the tubulo-interstitial space, is due to activation of interstitial myofibroblasts recruited locally or systemically with consecutive extracellular matrix deposition. Newly published clinical studies correlating acute kidney injury (AKI to chronic kidney disease (CKD challenge this pathological concept putting tubular epithelial cells into the spotlight. In this work we investigated the role of epithelial cells in fibrosis using a simple controlled in vitro system. An epithelial/mesenchymal 3D cell culture model composed of human proximal renal tubular cells and fibroblasts was challenged with toxic doses of Cisplatin, thus injuring epithelial cells. RT-PCR for classical fibrotic markers was performed on fibroblasts to assess their modulation toward an activated myofibroblast phenotype in presence or absence of that stimulus. Epithelial cell lesion triggered a phenotypical modulation of fibroblasts toward activated myofibroblasts as assessed by main fibrotic marker analysis. Uninjured 3D cell culture as well as fibroblasts alone treated with toxic stimulus in the absence of epithelial cells were used as control. Our results, with the caveats due to the limited, but highly controllable and reproducible in vitro approach, suggest that epithelial cells can control and regulate fibroblast phenotype. Therefore they emerge as relevant target cells for the development of new preventive anti-fibrotic therapeutic approaches.

  5. Baroreflex Activation Therapy in Congestive Heart Failure: Novel Findings and Future Insights.

    Science.gov (United States)

    Grassi, Guido; Brambilla, GianMaria; Pizzalla, Daniela Prata; Seravalle, Gino

    2016-08-01

    Congestive heart failure is characterized by hemodynamic and non-hemodynamic abnormalities, the latter including an activation of the sympathetic influences to the heart and peripheral circulation coupled with an impairment of baroreceptor control of autonomic function. Evidence has been provided that both these alterations are hallmark features of the disease with a specific relevance for the disease progression as well as for the development of life-threatening cardiac arrhythmias. In addition, a number of studies have documented in heart failure the adverse prognostic role of the sympathetic and baroreflex alterations, which both are regarded as major independent determinants of cardiovascular morbidity and mortality. This represents the pathophysiological and clinical background for the use of carotid baroreceptor activation therapy in the treatment of congestive heart failure. Promising data collected in experimental animal models of heart failure have supported the recent performance of pilot small-scale clinical studies, aimed at providing initial information in this area. The results of these studies demonstrated the clinical safety and efficacy of the intervention which has been tested in large-scale clinical studies. The present paper will critically review the background and main results of the published studies designed at defining the clinical impact of baroreflex activation therapy in congestive heart failure patients. Emphasis will be given to the strengths and limitations of such studies, which represent the background for the ongoing clinical trials testing the long-term effects of the device in heart failure patients.

  6. Inventory of U.S.-led International Activities on Building Energy Efficiency Initial Findings

    Energy Technology Data Exchange (ETDEWEB)

    Delgado, Alison; Evans, Meredydd

    2010-04-01

    Several U.S. Government agencies promote energy efficiency in buildings internationally. The types and scope of activities vary by agency. Those with the largest role include the U.S. Agency for International Development (USAID), the U.S. Department of State and the Environmental Protection Agency (EPA). Both USAID and the Department of State have a substantial presence overseas, which may present some complementarities with the Department of Energy’s efforts to reach out to other countries. Generally speaking, USAID focuses on capacity building and policy issues; the Department of State focuses on broad diplomatic efforts and some targeted grants in support of these efforts, and EPA has more targeted roles linked to ENERGY STAR appliances and a few other activities. Several additional agencies are also involved in trade-related efforts to promote energy efficiency in buildings. These include the Department of Commerce, the Export-Import Bank, the Overseas Private Investment Corporation and the Trade and Development Agency (TDA). This initial synthesis report is designed to summarize broad trends and activities relating to international cooperation on energy efficiency in buildings, which can help the U.S. Department of Energy (DOE) in developing its own strategy in this area. The Pacific Northwest National Laboratory will develop a more complete synthesis report later in 2010 as it populates a database on international projects on building energy efficiency.

  7. Welfare effects of deterrence-motivated activation policy: the case of distinct activation-disutility

    DEFF Research Database (Denmark)

    Rasmussen, Martin

    . We consider a distinct disutility for participating in activation programmes. One motivation for this approach is that the choice of concrete activation programmes may affect how people are exposed to activation-disutility. We describe a principle for the choice of optimal activation programmes......, but find it hard to give real-world examples that meet the principle....

  8. Sexual Activity and Urological Morbidities Among Nigerian Menopausal Women: Findings from a Community Based Survey

    Science.gov (United States)

    Adedokun, BO; Morhason-Bello, IO; Okonkwo, SN; Ojengbede, OA

    2014-01-01

    Background: Menopause represents the end of women reproductive career and it is at this time they begin to manifest morbidities such as urinary incontinence. Aim: To document proximate determinants of sexual activity and urological morbidities of menopausal women. Subjects and Methods: This was a community survey conducted among 254 menopausal women Mokola in Ibadan, Nigeria in 2008. Respondents were selected using cluster sampling technique. Interviewer administered questionnaires were used to obtain information on their characteristics, pattern of urological and sexual activities. Descriptive, bivariate and multivariable tests were performed with Statistical Package for the Social Sciences 15.0 (Chicago, IL USA) and statistical significance was set at P value less than 0.05. Results: The mean age of subjects was 60.3 (standard deviation = 10.2 years). About 33.5% (85/254) was still sexually active. About 68% (173/254) reported a reduction in sexual frequency since menopause while 31.5% (80/254) reported no change. The mean self-rated sexual performance score was 4.3 based on a numerical scale where 10 is the maximum obtainable. Significant predictors of reduction in sexual activity were age at menopause and education. Those between 45 and 49 years were less likely than those at 55 years or more (odds ratio [OR] = 0.21; 95% confidence interval OR = 0.05-0.87) while women with at least secondary education were thrice less likely than those with none to report a reduction in sexual activity after menopause. Less than a tenth reported urinary incontinence as a complaint. Urge incontinence was the most commonly reported followed by dysuria and stress incontinence. Less than a quarter of them had requested for a form of treatment. Conclusion: Sexual performance of Nigerian menopausal women is associated with age at menopause and education. Non-fistulous urinary incontinence is now being mentioned as a complaint contrary to the widely held view that it is part of the

  9. Methoxetamine, a novel psychoactive substance with serious adverse pharmacological effects: a review of case reports and preclinical findings.

    Science.gov (United States)

    Zanda, Mary T; Fadda, Paola; Chiamulera, Cristiano; Fratta, Walter; Fattore, Liana

    2016-09-01

    An increasing number of novel psychoactive substances are currently available and sold as 'legal highs' or 'research chemicals' accompanied by the indication that they are 'not for human consumption'. Among those that have emerged in the last few years, methoxetamine (MXE) owes its wide popularity to its easy access on the Internet and its reputation of being a 'safe' drug. MXE is an arylcyclohexylamine with a chemical structure analogous to ketamine and phencyclidine, and similar noncompetitive glutamate N-methyl D-aspartate receptor antagonist properties. Yet, very recent preclinical data highlighted a stimulatory effect of MXE on dopamine neurotransmission within the mesolimbic pathway. The aim of this review is to provide an updated review of the behavioral and toxicological effects of MXE as well as the latest findings on its pharmacology that might explain sought effects and frequent occurrence of adverse effects. In light of the growing number of intoxications induced by MXE, knowledge of its short-term and long-term effects is urgently needed. However, the hypothetical rapid antidepressant activity of MXE suggested by its chemical analogy with ketamine and supported by recent preclinical findings deserves further investigation.

  10. Sleep-related eating disorder in a 29 year-old man: a case report with diagnostic polysomnographic findings.

    Science.gov (United States)

    Yeh, Shih-Bin; Schenck, Carlos H

    2007-06-01

    This is a case of a 29-year-old man with a 6 year history of sleep-related eating disorder (SRED) that occurred with partial consciousness on a nightly basis. His family or wife witnessed up to 5 episodes every night, with each eating episode lasting 8-16 minutes. Polysomnography documented 4 episodes of sleep-related eating arising from stage 2 Non-REM sleep, when he consumed cookies that he had brought to the sleep lab that night. While eating, his EEG remained in stage 2 sleep or else was a wakeful EEG, and the eating episodes lasted for a mean 13.3 minutes. There was no epileptiform EEG activity during the polysomnogrphic study with a seizure montage and fast paper speed. Therapy with clonazepam, 0.5 mg bedtime, did not control the nocturnal eating. The patient tried to limit access to food in his home before bedtime, and this had modest benefit. This case of SRED has both typical and atypical features, which are discussed.

  11. Gliosarcoma: report of four cases with immunohistochemical findings Gliossarcoma: relato de quatro casos com achados imuno-histoquímicos

    Directory of Open Access Journals (Sweden)

    Tiago Noguchi Machuca

    2004-09-01

    Full Text Available Gliosarcoma (GSa is a rare primary central nervous system neoplasm (CNS characterized by biphasic histological pattern with both glial and sarcomatous components. Our objective is to describe the clinical, morphological and immunohistochemical features of four cases of GSa and to discuss its pathogenetic mechanisms. The male:female ratio was 3:1. The mean age was 39 years, ranging from 19 to 48. Headache was the commonest clinical symptom. All patients underwent craniotomy with microsurgery and total resection of the tumor. Diagnosis was suspected due to microscopic architecture and confirmed by detection of reticulin fibers through histochemical techniques. Immunohistochemical analysis was positive for p53 in both glial and sarcomatous cells in all four cases. EGFR was focally positive in glial cells in one case. Our findings support monoclonal origin of GSa involving the TP53 tumor-suppressor gene. However, alternative pathways cannot be ruled out.Gliossarcoma (GSa é uma neoplasia primária rara do sistema nervoso central, caracterizada por padrão histológico bifásico incluindo componentes tanto glial como sarcomatoso. São discutidos os aspectos clínicos, morfológicos e imunohistoquímicos de quatro casos de GSa e seus mecanismos patogêneticos. A relação masculino/feminino foi 3:1. A média de idade foi 39 anos, variando de 19 a 48. Cefaléia foi a manifestação predominante. Todos os pacientes foram submetidos a craniotomia com microcirurgia e ressecção total do tumor. O diagnostico foi suspeitado devido à arquitetura microscópica e foi confirmada por presença de fibras de reticulina através de técnicas de histoquímica. A análise imuno-histoquímica foi positiva para p53 tanto em células gliais como em células sarcomatosas nos quatro casos. EGFR foi localmente positivo em células gliais em apenas um caso. Esses achados apoiam uma origem monoclonal do GSa relacionada com alteração no Tp53, gene supressor de tumor. No

  12. Laminitis and dermatitis in heifers associated with excessive carbohydrate intake : skin lesions and biochemical findings : case report

    Directory of Open Access Journals (Sweden)

    I. Yeruham

    1999-07-01

    Full Text Available The effects of a sudden addition of a large quantity of readily fermentable carbohydrate to the feed ration of pregnant heifers are described. Clinical and pathological changes caused by the resulting disease were confined to the digits and skin. The 4 acutely affected heifers were reluctant to get up or move (group II. They tended to lie down or stand with feet bunched together and the back arched, often shifting weight from limb to limb. They walked stiffly with great tenderness and pain in the digits. Extreme pain was noticed when the digits were examined. In 4 of 8 heifers, separation of the sole at the heel, with leakage of exudate, and under-running of the sole were observed. Necrotic dermatitis of the legs, alopecia and hyperkeratosis of the tail were noticed in all 8 heifers. Skin lesions appeared simultaneously. Four of the heifers (group I recovered, and the other 4 (group II were sent to slaughter. No post mortem examination was performed. The biochemical findings revealed a significantly higher concentration of total serum globulins and sodium, and increased activity, in CK, LDH and AST. A significantly decreasing pattern was noted in blood urea concentration, cholesterol, triglycerides, albumin and calcium. No significant differences among the various groups were found in the activities of amylase, GGT, and concentration of creatinine, total bilirubin, inorganic phosphorus, magnesium and potassium.

  13. Depressive symptoms and inductive reasoning performance: findings from the ACTIVE reasoning training intervention.

    Science.gov (United States)

    Parisi, Jeanine M; Franchetti, Mary Kathryn; Rebok, George W; Spira, Adam P; Carlson, Michelle C; Willis, Sherry L; Gross, Alden L

    2014-12-01

    Within the context of the Advanced Cognitive Training for Independent and Vital Elderly study (ACTIVE; Ball et al., 2002; Jobe et al., 2001; Willis et al., 2006), we examined the longitudinal association of baseline depressive symptoms on inductive reasoning performance over a 10-year period between the reasoning training and control conditions (N = 1,375). At baseline, 322 participants (23%) reported elevated depressive symptoms, defined by a score ≥9 on the 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D; Mirowsky & Ross, 2003; Radloff, 1977). Differences in baseline depressive status were not associated with immediate posttraining gains or with subsequent annual change in reasoning performance, suggesting that the presence of elevated baseline depressive symptoms does not impact the ability to benefit from reasoning training.

  14. Radiological findings of Currarino's triad - a case report and review of the literature; Triade de Currarino - relato de um caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Machado Junior, Marcos Alberto; Barbosa, Veronica Aline de Oliveira [Fundacao Monte Tabor, Salvador, BA (Brazil). Hospital Sao Rafael. Servico de Bioimagem; Rocha, Josilton Antonio; Ferreira, Eliane Fiuza; Maximo, Marcia Andrade [Fundacao Monte Tabor, Salvador, BA (Brazil). Hospital Sao Rafael; Castro, Luiz Eduardo [Hospital Prof. Jorge Valente, Salvador, BA (Brazil). Servico de Tomografia Computadorizada; Vieira, Lauro Conceicao [Fundacao Monte Tabor, Salvador, BA (Brazil). Hospital Sao Rafael. Servico de Ressonancia Magnetica

    1998-12-01

    The authors report a child case with congenital malformation Currarino triad characterized by a rare complex of a congenital sacral bonyabnormality, anorectal malformation and a presacral mass. A bibliographic review was done, focusing the radiological and tomographic findings. (author)

  15. A case report concerning the importance of the patients’ symptoms and clinical findings in the management of patients

    Directory of Open Access Journals (Sweden)

    Bodil Ohlsson

    2010-01-01

    Full Text Available The gastrointestinal tract has always been difficult to visualize in its entire length. New technology such as magnetic resonance imaging enterography, computed tomography ente­ro­­graphy, single- and double-balloon entero­scopy, and video capsule enteroscopy have improved the possibilities for visualizing mucosal changes and pathology in the small intestine. We describe here a case of a patient with gastrointestinal signs and symptoms suggesting recurrent intestinal obstruction over a period of several years, who had mostly normal morphology on endoscopic examination. Nonetheless, after some delay, the patient underwent explorative surgery because of his accelerating symptoms. Abdominal exploration revealed a Meckel’s diverticulum, which had led to inflammatory adhesions of the small intestine with a sharp bend and proximal intestinal dilation. After the operation the patient’s health was restored. We concluded that in certain situations the clinician should rely on the patients’ symptoms and clinical findings more than on technological examinations and the clinical picture should guide clin­icians’ interventions, even though we live in a high-technique era.

  16. Diffuse Infantile Hepatic Hemangioendothelioma With Early Central Enhancement in an Adult: A Case Report of CT and MRI Findings.

    Science.gov (United States)

    Dong, Aisheng; Dong, Hui; Zuo, Changjing; He, Tianlin

    2015-12-01

    Infantile hepatic hemangioendothelioma (IHH) is the most common vascular tumor of the liver in infancy. Adult with IHH is extremely rare. We presented a diffuse IHH in an adult patient with computed tomography (CT) and magnetic resonance image (MRI) findings.A 39-year-old man was admitted to our hospital because of a 2-year history of abnormal liver function tests and a 7-day history of jaundice. Physical examination revealed enlarged liver. Unenhanced abdominal CT showed enlargement of the liver with diffuse hypodensity. Enhanced CT on the arterial phase revealed multiple centrally enhanced lesions diffusely involved the enlarged liver. The enhanced areas of the lesions became larger on the portal phase and all the lesions became homogeneous enhanced on the delayed phase. These lesions showed heterogeneously hyperintense on T2-weighted image, hypointense on T1-weighted image, and early centrally enhanced on dynamic gadolinium-enhanced MRI, with complete tumor enhancement after 180 s. The patient underwent orthotopic liver transplantation. IHH type 2 was confirmed by pathology. The patient died of tumor recurrence in the liver 4 months after transplantation.Unlike the previously described imaging appearances of IHH, this case showed diffuse nodules with early central enhancement on CT and MRI. Considering the importance of the ability to differentiate IHH from other hepatic tumors, radiologists should be aware of these imaging appearances to establish knowledge of the entire spectrum of IHH.

  17. Medical leadership arrangements in English healthcare organisations: findings from a national survey and case studies of NHS trusts.

    Science.gov (United States)

    Dickinson, Helen; Ham, Chris; Snelling, Iain; Spurgeon, Peter

    2013-11-01

    This project sought to describe the involvement of doctors in leadership roles in the NHS and the organisational structures and management processes in use in NHS trusts. A mixed methods approach was adopted combining a questionnaire survey of English NHS trusts and in-depth case studies of nine organisations who responded to the survey. Respondents identified a number of challenges in the development of medical leadership, and there was often perceived to be an engagement gap between medical leaders and doctors in clinical roles. While some progress has been made in the development of medical leadership in the NHS in England, much remains to be done to complete the journey that started with the Griffiths Report in 1983. We conclude that a greater degree of professionalism needs to be brought to bear in the development of medical leadership. This includes developing career structures to make it easier for doctors to take on leadership roles; providing training, development and support in management and leadership at different stages of doctors' careers; and ensuring that pay and other rewards are commensurate with the responsibilities of medical leaders. The time commitment of medical leaders and the proportion of doctors in leadership roles both need to increase. The paper concludes considering the implications of these findings for other health systems.

  18. Sonographic Findings of Benign Breast Diseases, A Study of 111 Cases in Iranian Center for Breast Cancer

    Directory of Open Access Journals (Sweden)

    N. sedighi

    2005-08-01

    Full Text Available Introduction & Background: Benign lesions are very common in breast. The most important consideration for physicians is to differentiate benign processes from malignant ones .Hence the clinicians and radi-ologists both wish to differentiate them even before surgical procedures. The Iranian Center for Breast Cancer linked to Jahad Daneshgahi Center is a referral place for patients with breast complaints. Patients & Methods: Retrospective study of sonographic findings of 111 patients with benign patho-logic diagnosis revealed 72.1% accuracy for sonogra-phy in diagnosing benign masses. In 31 cases (27.9%, the sonographic diagnosis was incorrect. Among the different benign lesions, the most common lesions were cysts, fibradenomas, and fibrocystic changes with respective sonographic accuracy of 100%, 90%, and 62.5%. Results: It shows that sonography has a high sensitiv-ity for diagnosis of benign breast lesions and this sen-sitivity is higher in cysts and fibradenomas which are the most common benign pathologies of breast. Conclusion: As a result, in this center sonography is an imaging modality for evaluating benign breast le-sion especially in young patients with dense breasts and palpable masses. Its unique role in diagnosis of the cysts is valuable especially to avoid repeated biopsies.

  19. An autopsy case of neuroleptic malignant syndrome (NMS) and its immunohistochemical findings of muscle-associated proteins and mitochondria.

    Science.gov (United States)

    Kubo, S; Orihara, Y; Kitamura, O; Ikematsu, K; Tsuda, R; Nakasono, I

    2001-01-01

    Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal disorder. In forensic cases, post-mortem diagnosis of NMS is sometimes difficult if ante-mortem information, such as neuroleptic ingestion or signs and symptoms, cannot be obtained. A 39-year-old Japanese male on a neuroleptic treatment regimen suddenly became agitated and died. Autopsy revealed muscle rigidity and hyperthermia. Post-mortem examination of blood revealed elevation of creatine phosphokinase-MM (CK-MM) and lactate dehydrogenase-4 and dehydrogenase-5 (LDH-4 and LDH-5). In renal glomeruli and tubules, myoglobin was stained immunohistochemically. From these findings, the cause of death was considered to be NMS. To support the diagnosis of NMS, both skeletal and cardiac muscles were stained with actin, myoglobin, desmin and mitochondria antibodies immunohistochemically. Actin, myoglobin, desmin, and mitochondria had been lost from skeletal, but not from the cardiac muscle, which suggested that only the skeletal muscle was damaged. Moreover, because mitochondria had disappeared only from the skeletal muscle, it was considered that skeletal muscle degeneration was caused by mitochondrial damage. Therefore, it is suggested that immunostaining of skeletal muscle by antibodies for muscle-associated proteins and mitochondria is useful to corroborate a diagnosis of NMS.

  20. Interstitial pneumonia with autoimmune features (IPAF) and radiological findings suggestive of lymphocytic interstitial pneumonia (LIP) - case report.

    Science.gov (United States)

    Płóciniczak, Alicja; Goździk-Spychalska, Joanna; Batura-Gabryel, Halina Batura-Gabryel

    2017-01-01

    Interstitial pneumonia with autoimmune features (IPAF) is a term to describe individuals with both interstitial lung disease (ILD) and combinations of other clinical, serologic, and/or pulmonary morphologic features, which presumably originate from an underlying systemic autoimmune condition, but do not meet current rheumatologic criteria for a defined connective tissue disease (CTD). Predominantly, interstitial pneumonia arises in the course of an established CTD, but it is not so rare for the ILD to be the first, and possibly the one and only manifestation of a latent CTD. Lymphocytic Interstitial Pneumonia (LIP) is an uncommon disease, characterized by infiltration of the interstitium and alveolar spaces of the lung by lymphocytes, plasma cells and other lymphoreticular elements. The cause of LIP is still unknown but it could be also a manifestation of CTD. Clinically, it is highly variable, from spontaneous resolution to progressive respiratory failure and death despite glucocorticoid treatment. Since there are no recent standards for the management of LIP, the disease is treated empirically. We report a case of a HIV-negative 54-year-old woman, who was suspected of LIP according to clinical features and radiological findings. Positive laboratory results were highly suggestive of underlying autoimmune process, but did not fulfil the criteria of any particular CTD. Because of severe general condition of the patient, immunosuppressive treatment was started immediately, without further invasive diagnostics including lung biopsy, which is required for a definitive diagnosis. We present two-year observation of the patient with all our doubts concerning clinical proceedings.

  1. Intervening to alleviate word-finding difficulties in children: case series data and a computational modelling foundation.

    Science.gov (United States)

    Best, W; Fedor, A; Hughes, L; Kapikian, A; Masterson, J; Roncoli, S; Fern-Pollak, L; Thomas, M S C

    2015-01-01

    We evaluated a simple computational model of productive vocabulary acquisition, applied to simulating two case studies of 7-year-old children with developmental word-finding difficulties across four core behavioural tasks. Developmental models were created, which captured the deficits of each child. In order to predict the effects of intervention, we exposed the computational models to simulated behavioural interventions of two types, targeting the improvement of either phonological or semantic knowledge. The model was then evaluated by testing the predictions from the simulations against the actual results from an intervention study carried out with the two children. For one child it was predicted that the phonological intervention would be effective, and the semantic intervention would not. This was borne out in the behavioural study. For the second child, the predictions were less clear and depended on the nature of simulated damage to the model. The behavioural study found an effect of semantic but not phonological intervention. Through an explicit computational simulation, we therefore employed intervention data to evaluate our theoretical understanding of the processes underlying acquisition of lexical items for production and how they may vary in children with developmental language difficulties.

  2. MRI and N-isopropyl(I-123)p-iodoamphetamine SPECT findings in cases of moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Yuji; Kato, Terumi; Ohta, Yoshio (Tottori Univ., Yonago (Japan). School of Medicine); Caner, B.E.

    1993-07-01

    Six patients with moyamoya disease underwent magnetic resonance imaging (MRI), and in 4 of 6 cases, MRI findings were compared with N-isopropyl(I-123)p-iodoamphetamine (IMP) single-photon emission computed tomography (SPECT) brain scans to determine if there was a correlation between the morphology, as seen on MRI, and cerebral perfusion and/or metabolic changes detected by IMP-SPECT. MRI clearly revealed abnormalities secondary to moyamoya disease: nonvisualization of a signal void flow sign in the arteries, moyamoya vessels, and cerebral atrophy. All the perfusion abnormalities of the cortex, except a small one, observed on MR images were also detected on IMP-SPECT images, but small white matter abnormalities demonstrated on MR images could not be revealed by IMP-SPECT. Interestingly, in 2 patients, 2 additional cortical defects that were not observed on MR images were revealed by IMP-SPECT. Moreover, 3 areas with perfusion defects were larger on the IMP-SPECT scans than on the MR images. The cortical defects observed on the IMP-SPECT images but not on the MR images may reflect mild ischemia and/or certain metabolic abnormalities that lead to low tracer accumulation. Overall, IMP-SPECT and MRI may play complementary roles in the evaluation of this disease. (author).

  3. GM2-Gangliosidosis (Sandhoff and Tay Sachs disease: Diagnosis and Neuroimaging Findings (An Iranian Pediatric Case Series

    Directory of Open Access Journals (Sweden)

    Parvaneh KARIMZADEH

    2014-07-01

    Full Text Available How to Cite This Article: Karimzadeh P, Jafari N, Nejad Biglari H, Jabbeh Dari S, Ahmad Abadi F, Alaee MR, Nemati H, Saket S,Tonekaboni SH, Taghdiri MM, Ghofrani M. GM2-Gangliosidosis (Sandhoff and Tay Sachs disease: Diagnosis and Neuroimaging Findings (An Iranian Pediatric Case Series Iran J Child Neurol. 2014 Summer;8(3: 55-60. AbstractObjectiveGM2-Gangliosidosis disease is a rare autosomal recessive genetic disorder that includes two disorders (Tay–Sachs and Sandhoff disease.These disorders cause a progressive deterioration of nerve cells and inherited deficiency in creatinghexosaminidases A, B, and AB.Materials & MethodsPatients who were diagnosed withGM2-Gangliosidosis in the Neurology Department of Mofid Children’s Hospital in Tehran, Iran from October 2009 to February 2014were included in our study. The disorder was confirmed by neurometabolic and enzyme level detection of hexosaminidases A, B, and ABin reference to Wagnester Laboratory in Germany. We assessed age, gender, past medical history, developmental status, clinical manifestations, and neuroimaging findings of 9 patients with Sandhoff disease and 9 with Tay Sachs disease.Results83% of our patients were the offspring of consanguineous marriages. All of them had a developmental disorder as a chief complaint.38%of patients had a history of developmental delay or regression and 22% hadseizures. The patients with Sandhoff and Tay Sachs disease were followed for approximately 5 years and the follow-up showed all patients were bedridden or had expired due to refractory seizures, pneumonia aspiration, or swallowingdisorders.Neuro-imaging findings included bilateral thalamic involvement, brain atrophy, and hypo myelination in near half of our patients (48%. ConclusionAccording to the results of this study, we suggest that cherry-red spots, hyperacusis, refractory seizures, and relative parents in children with developmental delay and/or regression should be considered

  4. Finding of polysaccharide-peptide complexes in Cordyceps militaris and evaluation of its acetylcholinesterase inhibition activity

    Directory of Open Access Journals (Sweden)

    Cheng-Han Tsai

    2015-03-01

    Full Text Available Acetylcholinesterase (AChE inhibition enhances learning and cognitive ability for treatment of Alzheimer's disease. Polysaccharide–peptide complexes were identified in Cordyceps militaris (CPSPs and characterized for their AChE inhibitory properties. Three polymers (CPSP-F1, -F2, and -F3 were extracted and separated by ultrasound-assisted extraction and diethylaminoethanol (DEAE–Sepharose CL-6B column chromatography. Polysaccharide–peptide complexes were identified by DEAE–Sepharose CL-6B column chromatography and high-performance gel-filtration chromatography, Fourier transform infrared spectra, amino sugar composition analysis, and β-elimination reaction to identify polysaccharide–peptide bond categories. Separation of CPSP can increase AChE inhibitory activity from the crude polysaccharide of C. militaris. CPSP-F1 and CPSP-F2 exhibited half maximal inhibitory concentrations of 32.2 ± 0.2 mg/mL and 5.3 ± 0.0 mg/mL. Thus, we identified polysaccharide–peptide complexes from C. militaris and suggest CPSP has great potential in AChE inhibition bioassay.

  5. Polyphenols with antiglycation activity and mechanisms of action: A review of recent findings

    Directory of Open Access Journals (Sweden)

    Wan-Ju Yeh

    2017-01-01

    Full Text Available Advanced glycation end products (AGEs are substances composed of amino groups of proteins and reducing sugars. The initial and propagation phases of the glycation process are accompanied by the production of a large amount of free radicals, carbonyl species, and reactive dicarbonyl species, of which, methylglyoxal (MG is the most reactive and can cause dicarbonyl stress, influencing normal physiological functions. In the advanced phase, the production of AGEs and the interaction between AGEs and their receptor, RAGE, are also considered to be among the causes of chronic diseases, oxidative stress, and inflammatory reaction. Till date, multiple physiological activities of polyphenols have been confirmed. Recently, there have been many studies discussing the ability of polyphenols to suppress the MG and AGEs formation, which was also confirmed in some in vivo studies. This review article collects recent literatures concerning the effects of polyphenols on the generation of MG and AGEs through different pathways and discusses the feasibility of the inhibition of glycative stress and dicarbonyl stress by polyphenols.

  6. Concomitant Superior Mesenteric, Celiac, Renal, and Aortoiliac Aneurysm; Ultrasonography, CT and MRA Findings in A Case Report

    Directory of Open Access Journals (Sweden)

    S. A. Nabavizadeh

    2008-01-01

    Full Text Available Introduction: Visceral artery aneurysms are rare vas-cular diseases whose pathogenesis and natural history remain incompletely understood. Herein we describe an 80 year-old man with concomitant superior mes-enteric, celiac, renal, and aorto-iliac aneurysms. To the best of our knowledge this constellation of arte-rial aneurysms has not been described yet."nCase Presentation: An 80-year-old man was referred to our institution due to presence of tarry stool and one episode of vomiting of coffee ground material. The patient underwent an upper GI endoscopy which revealed esophageal varicosities. Due to presence of esophageal varicosities and clinical suspicion of portal vein thrombosis an ultrasonographic Doppler study of portal venous system was performed in this patient which revealed normal diameter and flow in portal and splenic veins with no evidence of thrombosis; however incidentally aneurismal dilatation of celiac and superior mesenteric arteries and lower part of abdominal aorta and both iliac arteries were found during the ultrasonographic examination. Abdominal CT scan was performed in this patient, which re-vealed aneurismal dilatation of main celiac artery and its main branches. There was also aneurismal dilata-tion of superior mesenteric artery. Aneurismal dilata-tion of distal abdominal aorta with extension to both side common, external, and internal iliac arteries was also seen. MRA of abdomen was also performed which revealed the previous findings plus apparent dilatation of proximal part of right main renal artery which was not considered in previous abdominal CT scan. Since then; he has remained asymptomatic and stable, with no evidence of further expansion of his aneurysms in routine sonographic examinations."nDiscussion: Our patient was a hypertensive hyperlip-idemic old man with history of previous TIA and atherosclerotic carotid plaques, so the most important predisposing factor seemed to be atherosclerosis. Sev-eral work

  7. Relationship between Urinary N-Desmethyl-Acetamiprid and Typical Symptoms including Neurological Findings: A Prevalence Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Jemima Tiwaa Marfo

    Full Text Available Neonicotinoid insecticides are nicotinic acetylcholine receptor agonists used worldwide. Their environmental health effects including neurotoxicity are of concern. We previously determined a metabolite of acetamiprid, N-desmethyl-acetamiprid in the urine of a patient, who exhibited some typical symptoms including neurological findings. We sought to investigate the association between urinary N-desmethyl-acetamiprid and the symptoms by a prevalence case-control study. Spot urine samples were collected from 35 symptomatic patients of unknown origin and 50 non-symptomatic volunteers (non-symptomatic group, NSG, 4-87 year-old. Patients with recent memory loss, finger tremor, and more than five of six symptoms (headache, general fatigue, palpitation/chest pain, abdominal pain, muscle pain/weakness/spasm, and cough were in the typical symptomatic group (TSG, n = 19, 5-69 year-old; the rest were in the atypical symptomatic group (ASG, n = 16, 5-78 year-old. N-desmethyl-acetamiprid and six neonicotinoids in the urine were quantified by liquid chromatography-tandem mass spectrometry. The detection of N-desmethyl-acetamiprid was the most frequent and highest in TSG (47.4%, 6.0 ppb (frequency, maximum, followed by in ASG (12.5%, 4.4 ppb and in NSG (6.0%, 2.2 ppb, however acetamiprid was not detected. Thiamethoxam was detected in TSG (31.6%, 1.4 ppb, in ASG (6.3%, 1.9 ppb, but not in NSG. Nitenpyram was detected in TSG (10.5%, 1.2 ppb, in ASG (6.3%, not quantified and in NSG (2.0%, not quantified. Clothianidin was only detected in ASG (6.3%, not quantified, and in NSG (2.0%, 1.6 ppb. Thiacloprid was detected in ASG (6.3%, 0.1 ppb. The cases in TSG with detection of N-desmethyl-acetamiprid and thiamethoxam were aged 5 to 62 years and 13 to 62 years, respectively. Detection of N-desmethyl-acetamiprid was associated with increased prevalence of the symptoms (odds ratio: 14, 95% confidence interval: 3.5-57. Urinary N-desmethyl-acetamiprid can be used as a

  8. Identification of Active Faults by Aerial Photograph Interpretation and Case

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J.R.; Chang, C.J.; Choi, W.H.; Yun, K.H.; Park, D.H.; Shin, S.H. [Korea Electric Power Research Institute, Taejon (Korea)

    2002-07-01

    This report is the technical memo of the research project entitled ''Development of Technology of Advanced Seismic Safety Assessment for NPP sites''. The purposes of this report are to describe analysis methods of photographic characteristics related with active faults, to identify active faults by aerial photograph interpretation and to review case studies. (author). 27 refs., 165 figs., 8 tabs.

  9. Concerns About Climate Change Mitigation Projects: Summary of Findings from Case Studies in Brazil, India, Mexico, and South Africa

    Energy Technology Data Exchange (ETDEWEB)

    Sathaye, Jayant A.; Andrasko, Kenneth; Makundi, Willy; La Rovere, Emilio Lebre; Ravinandranath, N.H.; Melli, Anandi; Rangachari, Anita; Amaz, Mireya; Gay, Carlos; Friedmann, Rafael; Goldberg, Beth; van Horen, Clive; Simmonds, Gillina; Parker, Gretchen

    1998-11-01

    The concept of joint implementation as a way to implement climate change mitigation projects in another country has been controversial ever since its inception. Developing countries have raised numerous issues at the project-specific technical level, and broader concerns having to do with equity and burden sharing. This paper summarizes the findings of studies for Brazil, India, Mexico and South Africa, four countries that have large greenhouse gas emissions and are heavily engaged in the debate on climate change projects under the Kyoto Protocol. The studies examine potential or current projects/programs to determine whether eight technical concerns about joint implementation can be adequately addressed. They conclude that about half the concerns were minor or well managed by project developers, but concerns about additionality of funds, host country institutions and guarantees of performance (including the issues of baselines and possible leakage) need much more effort to be adequately addressed. All the papers agree on the need to develop institutional arrangements for approving and monitoring such projects in each of the countries represented. The case studies illustrate that these projects have the potential to bring new technology, investment, employment and ancillary socioeconomic and environmental benefits to developing countries. These benefits are consistent with the goal of sustainable development in the four study countries. At a policy level, the studies' authors note that in their view, the Annex I countries should consider limits on the use of jointly implemented projects as a way to get credits against their own emissions at home, and stress the importance of industrialized countries developing new technologies that will benefit all countries. The authors also observe that if all countries accepted caps on their emissions (with a longer time period allowed for developing countries to do so) project-based GHG mitigation would be significantly

  10. Granulocyte colony-stimulating factor-producing ascending colon cancer as indicated by histopathological findings: report of a case.

    Science.gov (United States)

    Fujiwara, Yushi; Yamazaki, Osamu; Takatsuka, Satoshi; Kaizaki, Ryoji; Inoue, Takeshi

    2011-12-01

    Various types of granulocyte colony-stimulating factor (G-CSF)-producing malignant tumors have been reported. However, a G-CSF-producing colorectal cancer is rare. We present a case of G-CSF-producing ascending colon cancer. An 81-year-old man was referred to our hospital with right lower abdominal pain. A colon fiberscopy revealed an ascending colon tumor, and histological examination revealed tubular adenocarcinoma. He was admitted due to worsening abdominal pain. Although laboratory data showed an elevated white blood cell (WBC) count of 17000/mm3 with 77.8% neutrophils, elevated C-reaction protein (CRP) was insignificant (1.06 mg/dL), and he was afebrile. Because computed tomography indicated that the tumor penetrated into surrounding tissue, a semi-urgent ileocecal resection was performed. An abscess was not located. The tumor was staged as T3N2aM0 and as stage IIB according to the TNM classification. Microscopically, significant neutrophil infiltration between cancer cells was observed, suggesting the presence of a G-CSF-producing tumor. Immunohistochemical staining using a G-CSF antibody revealed cytoplasmic staining in cancer cells. The serum concentration of G-CSF upon admission was 334 pg/mL. After surgical resection, the WBC count decreased to within a normal range. These findings confirmed the diagnosis of G-CSF-producing ascending colon cancer. The prognosis of G-CSF-producing tumors is considered to be poor. Early diagnosis and surgical treatment are needed for patients with G-CSF-producing tumors, and continuous careful follow-up is required.

  11. Gang Activity on Campus: A Crisis Response Case Study

    Science.gov (United States)

    Shaw, Mahauganee; Meaney, Sarah

    2015-01-01

    This case study challenges readers to consider a contemporary issue for campus threat assessment and emergency preparedness: gang presence on college campuses. A body of research examining the presence of gangs and gang activity on college campuses has developed, revealing that gangs pose a viable threat for institutions of higher education. The…

  12. Acute HIV infection (AHI in a specialized clinical setting: case-finding, description of virological, epidemiological and clinical characteristics

    Directory of Open Access Journals (Sweden)

    Adriana Ammassari

    2014-11-01

    , 42.66–249.80], p=0.01. Overall, median HIV-1 RNA was 5.44 log copies/mL (IQR, 4.29–6.18 and the value observed in Fiebig phase II-IV was higher than that found in Fiebig stage V (6.10 [IQR, 5.49–7.00] vs 4.69 [3.71–5.44], p<0.001. Median CD4+ cell count was 596/mmc (IQR, 410–737. cART was started in 26 patients: TDF/FTC/DRV/r/RAL=18; TDF/FTC/DRV/r=2; TDF/FTC/ATV/r=2; TDF+FTC+EFV=2; TDF/FTC/RAL=1; DRV/r+RAL=1. Conclusions: Integration of careful epidemiological investigation, partner notification, and technical advances in virological testing are key elements in AHI case-finding. Significant differences were found between Fiebig stages II–IV and Fiebig V with regard to virological exams.

  13. Characteristic endoscopic findings and risk factors for cytomegalovirus-associated colitis in patients with active ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Yutaka Hirayama; Takafumi Ando; Yoshiki Hirooka; Osamu Watanabe; Ryoji Miyahara; Masanao Nakamura; Takeshi Yamamura; Hidemi Goto

    2016-01-01

    AIM: To identify characteristic endoscopic findings and risk factors for cytomegalovirus(CMV)-associated colitis in patients with active ulcerative colitis(UC).METHODS: A total of 149 UC patients admitted to the Department of Gastroenterology, Nagoya University Hospital, from January 2004 to December 2013 with exacerbation of UC symptoms were enrolled in this retrospective study. All medical records, including colonoscopy results, were reviewed. CMV infection was determined by the presence of CMV antigen, CMV inclusion bodies in biopsy specimens, or positive specific immunohistochemical staining for CMV. Multivariate analysis was used to identify independent risk factors for CMV colitis.RESULTS: Multivariate analysis indicated independent associations with the extent of disease(pancolitis) anduse of > 400 mg corticosteroids for the previous 4 wk. In contrast, no association was seen with sex, age at UC diagnosis, immunomodulator use, or infliximab use. Punched-out ulceration was also significantly associated with CMV infection in patients with active UC(odds ratio = 12.672, 95%CI: 4.210-38.143).CONCLUSION: Identification of a total corticosteroid dose > 400 mg for 4 wk, extensive colitis and a specific endoscopic finding of punched-out ulcer might facilitate the more rapid diagnosis and timely initiation of antiviral therapy for CMV-associated colitis in patients with active UC.

  14. Triosephosphate isomerase of Taenia solium (TTPI): phage display and antibodies as tools for finding target regions to inhibit catalytic activity.

    Science.gov (United States)

    Sanabria-Ayala, Víctor; Belmont, Iaraset; Abraham, Landa

    2015-01-01

    Previous studies demonstrated that antibodies against triosephosphate isomerase of Taenia solium (TTPI) can alter its enzymatic catalysis. In the present study, we used antibodies produced against the NH2-terminal region of TTPI (1/3NH2TTPI) and the phage display technology to find target regions to inhibit TTPI activity. As a first step, we obtained polyclonal antibodies against non-conserved regions from the 1/3NH2TTPI, which had an inhibitory effect of about 74 % on catalytic activity. Afterward, they were used to screen a library of phage-displayed dodecapeptides; as a result, 41 phage mimotope clones were isolated and grouped according to their amino acid sequence, finding the consensus A1 (VPTXPI), A2 (VPTXXI), B (LTPGQ), and D (DPLPR). Antibodies against selected phage mimotope clones were obtained by rabbit's immunization; these ones clearly recognized TTPI by both Western blot and ELISA. However, only the mimotope PDTS16 (DSVTPTSVMAVA) clone, which belongs to the VPTXXI consensus, raised antibodies capable of inhibiting the TTPI catalytic activity in 45 %. Anti-PDTS16 antibodies were confronted to several synthetic peptides that encompass the 1/3NH2TTPI, and they only recognized three, which share the motif FDTLQK belonging to the helix-α1 in TTPI. This suggests that this motif is the main part of the epitope recognized by anti-PDTS16 antibodies and revealed its importance for TTPI catalysis.

  15. Findings for the implementation of a foresight process. Case: NCE Smart Energy Markets; Funn etter gjennomfoering av en foresightprosess. Case: NCE Smart Energy Markets

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, Frode Ramstad

    2011-07-01

    NCE Smart Energy Markets conducted in the period 2009 - 2010 a foresight process in which it was conducted a preliminary meeting, a kick-off meeting, four major collections and a 'recovery meeting' way for players who would enter the process. As a result, they decided to continue a joint process management meetings under the name of the cluster with new collections 2010 - 2011 with the same external process manager. VRI Oestfold; Oestfold Research helped with follow-up evaluation of the process and presented in this report findings from the evaluation of the process. The purpose of the evaluation was, among other things, to contribute to a good process flow, documentation of experiences and achievements and contributions to better understanding and discussion about the direction and emphasis on the way. The evaluation aimed to answer the following three questions: Are the expected results achieved? Is the process complete successfully?Is foresight appropriate instrument in the given situation?The findings indicate that participants perceive that they are on course to reach the goals that are related to the community; common cluster strategy for growth and renewal, carving out the correct goals for the future, the process for getting into a committed relationship, and develop an innovative environment that can stay ahead of the market. At the same time they perceive that they are not close to having achieved the one goal that is directly related to the individual company - to contribute to the individual company's strategy will be more successful. Process management is perceived as a distinct and developing well underway, while project management is perceived as not quite so obvious, but in a better development. When we look at the core businesses consisting of few active businesses and some of the original have reduced their participation, while a number new have come to the last two workshops. It also appears that there is a potential to increase

  16. The evaluation of the clinical, laboratory and the radiological findings of the fifty-five cases diagnosed with tuberculous, Brucellar and pyogenic spondylodiscitis

    Directory of Open Access Journals (Sweden)

    Kadriye Yasar

    2012-01-01

    Full Text Available Objective: In this study, the evaluation of the clinical, laboratory and radiological findings belonging to 55 cases that were hospitalized in our clinic to be followed-up and were diagnosed with tuberculous, brucellar and pyogenic spondylodiscitis (SD was aimed. Materials and Methods: The cases with SD were evaluated retrospectively. Hematological, serological, biochemical laboratory tests and imaging technics were used for diagnosis. Results: Of 55 cases aged ranging between 25 to 79, 33 (59% were female. The cases with tuberculous SD (TBSD, brucellar SD (BSD and pyogenic SD (PSD were found in 24 (43%, 12 (21% and in 19 (34% patients.Erytrocyte sedimentation rate, increased C-reactive protein, and leucocytosis were present in 51 (91%, 22 (39% and 8 (14% cases. The number of the cases with history of previous surgery or trauma was 14 (25%. Diagnosis of TBSD was established by acid fast bacilli positiveness and Löwenstein Jensen culture positiveness, in two and seven patients, respectively. While all 12 cases with BSD had positive standard tube aglutination test, only 3 (25% had hemoculture positivity. In PSDs, diagnosis was confirmed with culture positivity in 9 of 19 cases.Of the cases in our study, 89% responded to medical treatment while three required surgery and three died (5.5% and 5.5%, respectively. Conclusion: SD may develop secondary to infections or following spinal surgical procedures and traumas. Also, the importance of endemicity should be kept in mind, beside the helpful diagnostic findings while treatment regulation.

  17. Serial CT Findings of Resolving Extramedullary Hematopoiesis as Unilateral Posterior Mediastinal Mass after Splenectomy in Hereditary Spherocytosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Mi Yeon; Lee, Ju Won; Kim, Yeo Ju; Kim, Youn Jeong; Kang, Young Hye; Lee, Kyung Hee [Dept. of Radiology, Inha University Hospital, Incheon (Korea, Republic of)

    2012-03-15

    Intrathoracic extramedullary hematopoiesis (EMH) is a rare condition of the hereditary spherocytosis. EMH usually regresses or disappears after treatment; such as splenectomy in the case of spherocytosis. We report a case of hereditary spherocytosis. It is presented with an unilateral paravertebral posterior mediastinal mass. After splenectomy, it revealed shrinkage and fatty replacement on serial CT scans.

  18. F-18 Fluorodeoxy Glucose Positron Emission Tomography/Computed Tomography Findings in a Rare Case of Penile Leiomyosarcoma

    Directory of Open Access Journals (Sweden)

    Kuruva Manohar

    2011-01-01

    Full Text Available Penile cancer is a rare entity accounting for only 0.4% all male malignancies. Penile leiomyosarcomas are even rarer with only around 35 cases reported in literature. We report a rare case of penile leiomyosarcoma illustrating F-18 Fluorodeoxy glucose (FDG positron emission tomography/computed tomography (PET/CT features and histopathology correlation.

  19. PSYCHOMETRIC PROPERTIES AND INITIAL FINDINGS OF THE PHYSICAL ACTIVITY STAGES OF CHANGE QUESTIONNAIRE AMONG TURKISH MIDDLE SCHOOL STUDENTS

    Directory of Open Access Journals (Sweden)

    Cevdet

    2014-04-01

    Full Text Available The purpose of this study is twofold: (1 to determine the concurrent validity and reliability of the Physical Activity Stages of Change Questionnaire among Turkish 6th to 8th grade students, and (2 to examine 6th to 8th grade students’ stages of change for physical activity (PA by sex. Participants (n=334 completed the Physical Activity Stages of Change Questionnaire and One-Week Physical Activity Recall questionnaire. The Pearson chi-square distribution was used to evaluate concurrent validity, and the test-retest calculation was used for reliability. The chi-square findings revealed a significant difference in PA scores at different stages of change. The test-retest value was also calculated as acceptable. Regarding the second research question, results indicated a significant difference by sex in stages of change. Further analysis revealed that a lower percentage of girls were in the maintenance stage than boys. Girls had a problem maintaining PA behavior compared to boys. It can be stated that the Turkish Physical Activity Stages of Change Questionnaire has indicated concurrent validity and reliability of evidence among Turkish 6th to 8th graders. Future intervention studies on girls’ PA behaviors should be structured using the stages of change levels, and more PA opportunities should be made available to them.

  20. Clinical features and imaging findings in pulmonary capillary hemangiomatosis: report of two cases and a pooled analysis

    Institute of Scientific and Technical Information of China (English)

    XIE Wan-mu; DAI Hua-ping; JIN Mu-lan; WANG Zhen; YANG Yuan-hua; ZHAI Zhen-guo; WANG Chen

    2012-01-01

    Background Pulmonary capillary hemangiomatosis (PCH) is a rare disease and no Chinese case has been reported yet.The disease is often misdiagnosed and its clinical characteristics are incompletely described.The aim of this study was to describe two Chinese cases and to clarify the clinical and radiographic parameters of patients with PCH.Methods Two PCH cases were presented and other cases were searched from the English literature.All available clinical and radiographic data were collected from 62 literature reported PCH cases.A pooled analysis of total 64 cases was made.Results Dyspnea and hemoptysis were the most common clinical symptoms of PCH.Pulmonary hypertension (PH)was found in 78% of the reported cases.PCH typically showed characteristic diffuse or patchy ground-glass opacities (GGOs) and/or multiple ill-defined centrilobular nodules in the computed tomography.Conclusions The diagnosis of PCH requires a high clinical suspicion.However,both clinical presentations and radiographic studies often provide clues to the diagnosis,which may prompt early lung biopsy for a definite diagnosis.

  1. CT Findings of Intrarenal Yolk Sac Tumor with Tumor Thrombus Extending into the Inferior Vena Cava: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Shao Chun; Li, Xue Hua; Sun, Can Hui; Feng, Shi Ting; Peng, Zhen Peng; Huang, Si Yun; Li, Zi Ping [Dept. of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou (China)

    2014-10-15

    Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement.

  2. Bell’s palsy in a case of Darier’s disease – a rare disease association or coincidental finding?

    Directory of Open Access Journals (Sweden)

    Kritika Pandey

    2016-01-01

    Full Text Available Darier’s disease (DD is a rare acantholytic dyskeratotic autosomal dominant genodermatosis characterized by the presence of warty, brown papules and plaques affecting the seborrhoeic areas. Frequent bacterial, fungal and viral particularly herpes simplex virus (HSV infections complicate DD. Bell’s palsy is an acute onset, idiopathic facial paralysis resulting from a dysfunction anywhere along the peripheral part of the facial nerve. Reactivation of HSV is considered to be the main cause of Bell’s palsy. This case represents, to the best of our knowledge, the first case of DD presenting with Bell’s palsy. This case underlines the importance of recognizing HSV infection in DD.

  3. Multimodality imaging in cranial blastomycosis, a great mimicker: Case-based illustration with review of clinical and imaging findings

    Directory of Open Access Journals (Sweden)

    Puneet S Kochar

    2016-01-01

    Full Text Available We describe the clinical, laboratory, and imaging data of three patients who are proven cases of blastomycosis with cranial involvement. In this review, we discuss the imaging features of cranial blastomycosis with relevant clinical case examples including computed tomography (CT, magnetic resonance imaging (MRI, and advanced MR imaging techniques like magnetic resonance spectroscopy (MRS and MR perfusion. Literature is reviewed for modern-day diagnosis and treatment of this fatal intracranial infection, if not diagnosed promptly and managed effectively.

  4. Multimodal imaging findings of SAPHO syndrome with no skin lesions: A report of three cases and review of the literature.

    Science.gov (United States)

    Duan, Na; Chen, Xiao; Liu, Yongkang; Wang, Jianhua; Wang, Zhongqiu

    2016-10-01

    Synovitis, acne, palmoplantar pustulosis, hyperostosis and osteitis syndrome (SAPHO) is a rare syndrome that affects the skin, bones and joints. Diagnosis of SAPHO syndrome is established on clinical appearance and imaging features. The present case report described the imaging features of three cases of SAPHO with sternoclavicular joint arthritis but without skin manifestations using multiple imaging modalities, including computed tomography (CT), magnetic resonance imaging (MRI) and bone scintigraphy. The first case was a 52-year-old male who suffered from progressive sternoclavicular arthritis for 2 years. The second case was a 62-year-old female with arthritis in the larger joints for 5 years, particularly on the right thoracic area. The third case was a 44-year-old male who exhibited a slight bulge accompanied by pain in the upper anterior chest wall for 4 years. All of them lacked cutaneous lesions. CT demonstrated sclerosis and hyperostosis with subchondral erosions in the sternocostoclavicular joints. MRI revealed bone marrow edema that was slightly hypointense on T1-weighted imaging, and hyperintense on T2-weighted imaging. Typical 'bull head' signs were observed in bone scintigraphy images. The present case study demonstrated that SAPHO syndrome should be suspected in patients with multifocal osteitis or arthritis affecting the chest wall that lack skin manifestations. Multimodal imaging modalities in combination are helpful for SAPHO diagnosis.

  5. Novel microstructural findings in M. plantaris and their impact during active and passive loading at the macro level.

    Science.gov (United States)

    Böl, Markus; Leichsenring, Kay; Ernst, Michael; Wick, Carolin; Blickhan, Reinhard; Siebert, Tobias

    2015-11-01

    There are several studies dealing with experimental and structural analyses of skeletal muscles that are aimed at gaining a better understanding of three-dimensional muscle deformation and force generation. A variety of these contributions have performed structural or mechanical analyses, but very few have combined these approaches at different levels. To fill this gap, the present study aims to bring together three-dimensional micro-structural and mechanical findings in rabbit M. plantaris to study load transfer mechanisms inside the muscle during passive loading and active muscle contraction. During these two deformation states, the three-dimensional surface of the aponeurosis-tendon complex was recorded using optical measurement systems. In this way, the strain distribution on the muscle can be calculated to interpret the load transfer mechanisms inside the muscle. The results show that the three-dimensional strain distribution during muscle activation is completely different from the distribution during passive loading. Under both loading conditions, the strain distribution is irregular. To interpret these findings, the gross try and the fascicle architecture of the M. plantaris were determined. In doing so, a highly complex microstructure featuring tube- and sail-like structure was identified. Moreover, a compartmentalisation of the muscle into two compartments was detected. The smaller, bipennated muscle compartment was embedded into the larger, unipennated compartment. To the authors' knowledge, this type of inner structure has never been previously documented in single-headed muscles.

  6. Cost-effectiveness of physical activity among women with menopause symptoms: findings from a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Päivi Kolu

    Full Text Available Menopause is a period that may predispose one to a decrease in muscle strength, cardiorespiratory fitness, and quality of life. A study was carried out to evaluate the cost-effectiveness of physical activity among women displaying symptoms of menopause. The cost-effectiveness analysis was based on data from a six-month randomised controlled trial (n = 151. The women in the intervention group engaged in an unsupervised session of at least 50 minutes of physical activity four times a week. The control group continued their physical activity as before. An incremental cost-effectiveness ratio (ICER was calculated in terms of maximal oxygen consumption, lean muscle mass, and quality-adjusted life years (QALYs gained. A bootstrap technique was utilised to estimate uncertainty around the point estimate for ICER associated with the intervention. The mean total cost in the intervention group was €1,307 (SEM: €311 and in the control group was €1,253 (SEM: €279, p = 0.10 per person. The mean intervention cost was €208 per person. After six months of the behaviour-change intervention, the ICER was €63 for a 1 ml/kg/min improvement in cardiorespiratory fitness, the additional cost per one-gram increase in lean muscle mass was €126, and the cost per QALY gained was €46. According to the findings, physical activity among menopausal women was cost-effective for cardiorespiratory fitness, for lean muscle mass, and for QALYs gained, since the intervention was more effective than the actions within the control group and the additional effects of physical activity were gained at a very low price. From the societal perspective, the intervention used may promote ability to work and thereby save on further costs associated with early retirement or disability pension if the physical-activity level remains at least the same as during the intervention.

  7. Reduction in ventral striatal activity when anticipating a reward in depression and schizophrenia: a replicated cross-diagnostic finding

    Directory of Open Access Journals (Sweden)

    Gonzalo eArrondo

    2015-08-01

    Full Text Available In the research domain framework (RDoC, dysfunctional reward expectation has been proposed to be a cross-diagnostic domain in psychiatry, which may contribute to symptoms common to various neuropsychiatric conditions, such as anhedonia or apathy/avolition. We used a modified version of the Monetary Incentive Delay (MID paradigm to obtain functional MRI images from 22 patients with schizophrenia, 24 with depression and 21 controls. Anhedonia and other symptoms of depression, and overall positive and negative symptomatology were also measured. We hypothesized that the two clinical groups would have a reduced activity in the ventral striatum when anticipating reward (compared to anticipation of a neutral outcome and that striatal activation would correlate with clinical measures of motivational problems and anhedonia. Results were consistent with the first hypothesis: two clusters in both the left and right ventral striatum were found to differ between the groups in reward anticipation. Post-hoc analysis showed that this was due to higher activation in the controls compared to the schizophrenia and the depression groups in the right ventral striatum, with activation differences between depression and controls also seen in the left ventral striatum. No differences were found between the two patient groups, and there were no areas of abnormal cortical activation in either group that survived correction for multiple comparisons. Reduced ventral striatal activity was related to greater anhedonia and overall depressive symptoms in the schizophrenia group, but not in the participants with depression. Findings are discussed in relation to previous literature but overall are supporting evidence of reward system dysfunction across the neuropsychiatric continuum, even if the specific clinical relevance is still not fully understood. We also discuss how the RDoC approach may help to solve some of the replication problems in psychiatric fMRI research.

  8. Electronic Support for Public Health: Validated Case Finding and Reporting for Notifiable Diseases Using Electronic Medical Data

    Science.gov (United States)

    Lazarus, Ross; Klompas, Michael; Campion, Francis X.; McNabb, Scott J.N.; Hou, Xuanlin; Daniel, James; Haney, Gillian; DeMaria, Alfred; Lenert, Leslie; Platt, Richard

    2009-01-01

    Health care providers are legally obliged to report cases of specified diseases to public health authorities, but existing manual, provider-initiated reporting systems generally result in incomplete, error-prone, and tardy information flow. Automated laboratory-based reports are more likely accurate and timely, but lack clinical information and treatment details. Here, we describe the Electronic Support for Public Health (ESP) application, a robust, automated, secure, portable public health detection and messaging system for cases of notifiable diseases. The ESP application applies disease specific logic to any complete source of electronic medical data in a fully automated process, and supports an optional case management workflow system for case notification control. All relevant clinical, laboratory and demographic details are securely transferred to the local health authority as an HL7 message. The ESP application has operated continuously in production mode since January 2007, applying rigorously validated case identification logic to ambulatory EMR data from more than 600,000 patients. Source code for this highly interoperable application is freely available under an approved open-source license at http://esphealth.org. PMID:18952940

  9. Odontogenic Sinusitis Caused by an Inflammation of a Dentigerous Cyst and Subsequent Finding of a Fibrous Dysplasia. A Case Report

    Science.gov (United States)

    López-Carriches, Carmen; López-Carriches, Inmaculada; Bryan, Rafael Baca-Perez

    2016-01-01

    We report the case of a 38-year old male patient with sinusitis caused by an infected follicular cyst due to an ectopic impacted third molar in the right maxillary sinus. A 10-day antibiotherapy regimen was administered; subsequently, the cyst and the third molar were removed achieving complete recovery. Fibrous dysplasia was diagnosed at follow-up examination (occupation of the maxillary sinus by bone tissue was observed in a radiographic examination) and confirmed by biopsy. In cases of odontogenic sinusitis, thorough examination is crucial, as evidenced by the case reported in this study. A Literature review was performed in order to identify the diagnostic methods currently available and the clinical features, complications and treatment for both, odontogenic maxillary sinusitis and fibrous dysplasia. PMID:28077969

  10. CT Findings of Foreign Body Reaction to a Retained Endoloop Ligature Plastic Tube Mimicking Acute Appendicitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jae Hong; Kang, Chae Hoon; Choi, Soo-Jung; Park, Man Soo; Jung, Seung Mun; Ryu, Dae Shick; Shin, Dong Rock [Department of Radiology, Asan Foundation, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440 (Korea, Republic of)

    2016-11-01

    Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.

  11. CT findings of foreign body reaction to retained endoloop ligature plastic tube mimicking acute appendicitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jae Hong; Kang, Chae Hoon; Choi, Soo Jung; Park, Man Soo; Jung, Seung Mun; Ryu, Dae Shick; Shin, Dong Rock [Dept. of Radiology, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2016-07-15

    Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.

  12. Sequential Magnetic Resonance Imaging Finding of Intramedullary Spinal Cord Abscess including Diffusion Weighted Image: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Jae Eun; Lee, Seung Young; Cha, Sang Hoon; Cho, Bum Sang; Jeon, Min Hee; Kang, Min Ho [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)

    2011-04-15

    Intramedullary spinal cord abscess (ISCA) is a rare infection of the central nervous system. We describe the magnetic resonance imaging (MRI) findings, including the diffusion-weighted imaging (DWI) findings, of ISCA in a 78-year-old man. The initial conventional MRI of the thoracic spine demonstrated a subtle enhancing nodule accompanied by significant edema. On the follow-up MRI after seven days, the nodule appeared as a ring-enhancing nodule. The non-enhancing central portion of the nodule appeared hyperintense on DWI with a decreased apparent diffusion coefficient (ADC) value on the ADC map. We performed myelotomy and surgical drainage, and thick, yellowish pus was drained

  13. Revision Stapedotomy : Operative Findings and Hearing Results. A Prospective Study of 652 Cases From the Otology-Neurotology Database

    NARCIS (Netherlands)

    Vincent, Robert; Rovers, Maroeska; Zingade, Narayan; Oates, John; Sperling, Neil; Deveze, Arnaud; Grolman, Wilko

    2010-01-01

    Objective: To identify the causes of failure of primary stapes surgery and to evaluate the hearing results of revision stapes surgery in a consecutive series of 652 cases. Study Design: Prospective nonrandomized clinical study. Setting: Tertiary referral center. Patients: Six hundred thirty-four pat

  14. Paget's disease of the breast: Clinical, mammographic, sonographic and pathologic findings in 52 cases

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil [Ege University Hospital, Department of Radiology, Bornova 35100, Izmir (Turkey)]. E-mail: isilbilgen@hotmail.com; Oktay, Aysenur [Ege University Hospital, Department of Radiology, Bornova 35100, Izmir (Turkey)

    2006-11-15

    Purpose: To determine and quantitate radiologic characteristics of Paget's disease of the breast and to report clinical and pathologic findings. Materials and methods: A retrospective review of records of 2872 women who received a diagnosis of breast carcinoma between January 1988 and January 2006 revealed 52 histologicallly proved Paget's disease of the breast. Analysis included history, findings at physical examination, mammography and sonography (US) and histologic type of Paget's disease. Results: At physical examination, palpable mass (n = 33, 63%), nipple erythema-eczema-ulceration (n = 17, 33%) and blood-stained nipple discharge (n = 5, 10%) were noted. Among 17 patients who had clinically evident Paget's disease, the mammographic findings were isolated microcalcifications in 3 (18%), mass associated with microcalcifications in 5 (29%), mass in 2 (12%) and negative in 7 (41%) patients. In the 35 patients with clinically inevident Paget's disease, these mammographic findings were 43% (n = 15), 34% (n = 12), 20% (n = 7) and 3% (n = 1), respectively. US depicted 43 masses in 35 patients, all of which were lobulated or irregularly contoured, mostly (n = 41, 95%) without posterior acoustic shadowing. The cancer was clinically occult in 10% (n = 5), mammographically occult in 15% (n = 8) and radiologically occult in 13% (n = 7) of the 52 patients. Histologically, the tumor was multifocal and/or multicentric in 11 (21%) patients. Conclusion: The clinical features of Paget's disease are characteristic and should alert the clinician to the likelihood of an underlying carcinoma, which should be evaluated radiologically. However, as Paget's disease is primarily a clinical diagnosis and mammograms may be negative, screening programs without clinical examination may result with delay in diagnosis. As a result, both clinical and imaging findings are complementary and should be correlated to confirm or exclude a diagnosis of Paget

  15. Accelerated active case detection of visceral leishmaniasis patients in endemic villages of Bangladesh.

    Directory of Open Access Journals (Sweden)

    Jahanara Khatun

    Full Text Available BACKGROUND: The visceral leishmaniasis (VL elimination program in Bangladesh is in its attack phase. The primary goal of this phase is to decrease the burden of VL as much as possible. Active case detection (ACD by the fever camp method and an approach using past VL cases in the last 6-12 months have been found useful for detection of VL patients in the community. We aimed to explore the yield of Accelerated Active Case Detection (AACD of non-self reporting VL as well as the factors that are associated with non-self reporting to hospitals in endemic communities of Bangladesh. METHODS: Our study was conducted in the Trishal sub-district of Mymensingh, a highly VL endemic region of Bangladesh. We used a two-stage sampling strategy from 12 VL endemic unions of Trishal. Two villages from each union were selected at random. We looked for VL patients who had self-reported to the hospital and were under treatment from these villages. Then we conducted AACD for VL cases in those villages using house-to-house visit. Suspected VL cases were referred to the Trishal hospital where diagnosis and treatment of VL was done following National Guidelines for VL case management. We collected socio-demographic information from patients or a patient guardian using a structured questionnaire. RESULTS: The total number of VL cases was 51. Nineteen of 51 (37.3% were identified by AACD. Poverty, female gender and poor knowledge about VL were independent factors associated with non self-reporting to the hospital. CONCLUSION: Our primary finding is that AACD is a useful method for early detection of VL cases that would otherwise go unreported to the hospital in later stage due to poverty, poor knowledge about VL and gender inequity. We recommend that the National VL Program should consider AACD to strengthen its early VL case detection strategy.

  16. Endoscopic findings can predict the efficacy of leukocytapheresis for steroid-naive patients with moderately active ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Yasushi Umehara; Masatoshi Kudo; Masanori Kawasaki

    2008-01-01

    AIM:To investigate the therapeutic usefulness of leukocytapheresis (LCAP;Cellsoba) in steroid-naive patients with moderately active ulcerative colitis (UC).METHODS:Eighteen steroid-naive patients with moderately active UC received one LCAP session every week for five consecutive weeks.RESULTS:The remission rate 8 weeks after the last LCAP session was 61.1% (11/18).All three patients with deep ulcers showed worsening after LCAP.For the remaining 15 patients,who had erosions or geographic ulcers,the average clinical activity index (CAI) score dropped significantly from 9.4 to 3.8eight weeks after the last LCAP session (t=4.89,P=0.001).The average C-reactive protein (CRP) levels before and after LCAP were 1.2 mg/dL and 1.0 mg/dL,respectively.Of the patients with erosions,geographic ulcers,and deep ulcers,100% (9/9),33.3% (2/6),and 0% (0/3) were in remission 8 weeks after the last LCAP session,respectively (x2=7.65,P < 0.005).Fortyeight weeks after the last LCAP session,the remission rates for patients with erosions and geographic ulcers were 44.4% (4/9) and 16.7% (1/6),respectively.Only one patient suffered a mild adverse event after LCAP (nausea).CONCLUSION:LCAP is a useful and safe therapy for steroid-naive UC patients with moderate disease activity.Moreover,the efficacy of the treatment can be predicted on the basis of endoscopic findings.

  17. Two cases of pediatric bone disease (eosinophilic granuloma and Brodie's abscess) showing similar scintigraphic and radiographic findings.

    Science.gov (United States)

    Yoshikawa, M; Sugawara, Y; Kikuchi, T; Nakata, S; Mochizuki, T; Ikezoe, J; Sakayama, K

    2000-12-01

    Two 9-year-old patients with femoral bone lesions were referred to the authors' institution within a few days of each other. Both showed similar radiographic, magnetic resonance imaging, and scintigraphic findings. The radiographs showed osteolytic lesions in the right femoral diaphyses, and gadolinium-DTPA-enhanced magnetic resonance imaging revealed inhomogeneous enhancement. Tc-99m HMDP showed marked linear accumulation with relatively low central uptake in the right femoral shafts, and TI-201 scintigraphy showed considerable uptake corresponding to the area seen with Tc-99m HMDP. Histologic analysis confirmed eosinophilic granuloma in the first patient and Brodie's abscess in the second. The radiographic and scintigraphic findings in Brodie's abscess may be similar to those in eosinophilic granuloma.

  18. ANALYSING JOURNALISTIC DISCOURSE AND FINDING OPINIONS SEMI-AUTOMATICALLY? : A CASE STUDY OF THE 2007 AND 2012 PRESIDENTIAL FRENCH CAMPAIGNS

    OpenAIRE

    2014-01-01

    Chapitre de 20 pages consacrés aux emplois de logiciels pour aider aux analyses semi-automatiques de discours; This research study tested three different NLP technologies to analyze representative journalistic discourse used in the 2007 and 2012 presidential campaigns in France. The analysis focused on the discourse in relation to the candidate's gender and/ or political party. Our findings suggest that using specific software to examine a journalistic corpus can reveal linguistic patterns an...

  19. CT and MR imaging findings of subdural dermoid cyst extending into right foramen ovale: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, You Cheol; Park, Cheol Min; Lee, Si Kyeong [Seoul Medical Center, Seoul (Korea, Republic of)

    2006-12-15

    Intracranial dermoid cyst is a rare congenital benign disease, representing less than 0.5% of primary brain tumors. Nevertheless, if ruptured spontaneously or during surgery, it has a poor prognosis due to chemical meningitis. Therefore, it is essential to perform accurate diagnosis and proper treatment. We report an intracranial subdural dermoid cyst that may be misdiagnosed as extracranial or epidural lesion because of extension into the right foramen ovale, and describe the CT and MR imaging findings.

  20. Radiologic Findings of Oral Bisphosphonate-Related Osteonecrosis of the Maxilla, Complicated by Actinomycosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yi Kyung; Kim, Hyung Jin; Kim, Eun Hee; Chung, Seung Kyu; Hong, Jong Rak [Samsung Medical Center, Seoul (Korea, Republic of)

    2010-01-15

    Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare, but serious complication, which has recently been more frequently reported. However, this entity is unfamiliar to radiologists. We report a case of BRONJ complicated by actinomycosis following a tooth extraction in a 68-year-old woman who has been treated with oral bisphosphonate for treatment of osteoporosis over the last 3 years and 3 months