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Sample records for basic lymphedema management

  1. Feasibility and effectiveness of basic lymphedema management in Leogane, Haiti, an area endemic for bancroftian filariasis.

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    David G Addiss

    Full Text Available BACKGROUND: Approximately 14 million persons living in areas endemic for lymphatic filariasis have lymphedema of the leg. Clinical studies indicate that repeated episodes of bacterial acute dermatolymphangioadenitis (ADLA lead to progression of lymphedema and that basic lymphedema management, which emphasizes hygiene, skin care, exercise, and leg elevation, can reduce ADLA frequency. However, few studies have prospectively evaluated the effectiveness of basic lymphedema management or assessed the role of compressive bandaging for lymphedema in resource-poor settings. METHODOLOGY/PRINCIPAL FINDINGS: Between 1995 and 1998, we prospectively monitored ADLA incidence and leg volume in 175 persons with lymphedema of the leg who enrolled in a lymphedema clinic in Leogane, Haiti, an area endemic for Wuchereria bancrofti. During the first phase of the study, when a major focus of the program was to reduce leg volume using compression bandages, ADLA incidence was 1.56 episodes per person-year. After March 1997, when hygiene and skin care were systematically emphasized and bandaging discouraged, ADLA incidence decreased to 0.48 episodes per person-year (P<0.0001. ADLA incidence was significantly associated with leg volume, stage of lymphedema, illiteracy, and use of compression bandages. Leg volume decreased in 78% of patients; over the entire study period, this reduction was statistically significant only for legs with stage 2 lymphedema (P = 0.01. CONCLUSIONS/SIGNIFICANCE: Basic lymphedema management, which emphasized hygiene and self-care, was associated with a 69% reduction in ADLA incidence. Use of compression bandages in this setting was associated with an increased risk of ADLA. Basic lymphedema management is feasible and effective in resource-limited areas that are endemic for lymphatic filariasis.

  2. Management of Extremity Lymphedema.

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    Puleo; Luh

    1995-10-01

    Chronic lymphedema is almost always a permanent and often progressive condition. In most cases, neither medical nor surgical means can completely relieve the effects of lymphedema. Surgical management of chronic lymphedema has high morbidity and a success rate of only 30%, and many patients return to their presurgical limb girth within three to four years. Nonsurgical treatment of chronic lymphedema can decrease overall lymphatic edema. Sequential gradient compression systems, which compensate for impaired lymphatic flow, return protein-rich lymphatic fluid from the extracellular regions of the tissues back into the circulatory system where the fluid can be excreted.

  3. Lymphedema

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    Lymphedema is the name of a type of swelling. It happens when lymph builds up in your ... happens in the arms or legs. Causes of lymphedema include Infection Cancer Scar tissue from radiation therapy ...

  4. THE REHABILITATION MANAGEMENT OF LYMPHEDEMA

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    OJOGA Florina

    2015-05-01

    Full Text Available Lymphedema is an important pathology for rehabilitation medecine, especially for the patients who underwent a mastectomy for breast cancer. His frequency is higher when mastectomy is combined with lymph node disection and irradiation of the lymph nodes. Symptoms include heaviness, numbness, pain, stiffness and weakness in the affected limb. Complications of lymphedema include infections such as cellulitis, erysipelas and lymphangitis. Treatment must be instituted as soon as possible and preventive measures are essential. The rehabilitation treatment consists of skin care measures, manual lymphatic massage, elastic compression of the affected limb and kinetotherapy.

  5. Lymphaticovenular bypass surgery for lymphedema management in breast cancer patients.

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    Chang, D W

    2012-12-01

    Historically, the reported incidence of upper extremity lymphedema in breast cancer survivors who have undergone axillary lymph node dissection has ranged from 9% to 41%. In the past 2 decades, sentinel lymph node biopsy has become popular as a way to minimize the morbidity associated with axillary dissection without compromising the cure rate for breast cancer patients. However, even with sentinel node biopsy, the postoperative incidence of upper limb lymphedema in breast cancer patients remains at 4-10%. Lymphedema occasionally emerges immediately after surgery but most often appears after a latent period. Obesity, postoperative seroma, and radiation therapy have been reported as major risk factors for upper extremity lymphedema, but the etiology of lymphedema is still not fully understood. Common symptoms of upper limb lymphedema are increased volume and weight of the affected limb and increased skin tension. The increased volume of the affected limb not only causes physical impairments in wearing clothes and in dexterity but also affects patients' emotional and mental status. Surgical management of lymphedema can be broadly categorized into physiologic methods and reductive techniques. Physiologic methods such as flap interposition, lymph node transfers, and lymphatic bypass procedures aim to decrease lymphedema by restoring lymphatic drainage. In contrast, reductive techniques such as direct excision or liposuction aim to remove fibrofatty tissue generated as a consequence of sustained lymphatic fluid stasis. Currently, microsurgical variations of lymphatic bypass, in which excess lymph trapped within the lymphedematous limb is redirected into other lymphatic basins or into the venous circulation, have gained popularity.

  6. Lymphedema and Therapeutic Lymphangiogenesis

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    Yukihiro Saito

    2013-01-01

    Full Text Available Lymphedema is a disorder of the lymphatic vascular system characterized by impaired lymphatic return and swelling of the extremities. Lymphedema is divided into primary and secondary forms based on the underlying etiology. Despite substantial advances in both surgical and conservative techniques, therapeutic options for the management of lymphedema are limited. Although rarely lethal, lymphedema is a disfiguring and disabling condition with an associated decrease in the quality of life. The recent impressive expansion of knowledge on the molecular mechanisms governing lymphangiogenesis provides new possibilities for the treatment of lymphedema. This review highlights the lymphatic biology, the pathophysiology of lymphedema, and the therapeutic lymphangiogenesis using hepatocyte growth factor.

  7. Multidisciplinary Approaches to the Management of Breast-Cancer-Related Lymphedema

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    Solmaz Fakhari

    2013-07-01

    Full Text Available Breast-cancer-related lymphedema is a significant morbidity mostly observed following primary treatments for breast cancer (surgery, radiation, and chemotherapy (1. Multiple complications might accompany lymphedema including cosmetic deformity, psychological disorders, consistent pain, and consequently decreased quality of life. Treatment  mostly focuses on reducing edema and its subsequent pain; however, no definite treatment has been hitherto introduced (2. Surgical approaches in the management of lymphedema are efficient including physiologic methods (e.g. flap interposition, lymph transfer, and lymphatic bypass and reductive techniques (e.g. liposuction (3. While the former mostly targets at reducing lymphedema through restoring lymphatic drainage, the latter aims at removing fibrofatty tissues which contribute to lymph stasis. Microsurgical variation of lymphatic bypass has gained popularity, in which the accumulated lymph in the lymphedematous limb is redirected. Non-surgical approaches are also practiced in most cases. Comprehensive decongestive therapy, consisting of skin care, exercise, special bandaging and massage, is the most frequently used non-surgical approach efficacy of which could be enhanced in combination with self-management strategies (4. Recently newer techniques have been introduced to tackle lymphedema and its associated pain. Manual lymph drainage, stellate ganglion block, acupuncture, deep oscillation, and pneumatic compression have been efficiently used in several studies. Moreover, significant short-term progress has been reported following other modalities such as low-level laser therapy (5. The complexity of breast-cancer-related lymphedema and its complications necessitates a multidisciplinary approach with the primary goal of easing the burden of the disease on the breast cancer patients. In addition, developing special guidelines encompassing these multidisciplinary approaches and providing educational and

  8. Usability and feasibility of health IT interventions to enhance Self-Care for Lymphedema Symptom Management in breast cancer survivors

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    Mei R. Fu, PhD, RN, FAAN

    2016-09-01

    Conclusions: This usability study provided evidence on breast cancer survivor's acceptance and highly positive evaluation of TOLF's usability as well as feasibility of using technologically-driven delivery model to enhance self-care strategies for lymphedema symptom management.

  9. Impact of community-based lymphedema management on perceived disability among patients with lymphatic filariasis in Orissa State, India.

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    Philip J Budge

    Full Text Available BACKGROUND: Lymphatic filariasis (LF infects approximately 120 million people worldwide. As many as 40 million have symptoms of LF disease, including lymphedema, elephantiasis, and hydrocele. India constitutes approximately 45% of the world's burden of LF. The Indian NGO Church's Auxiliary for Social Action (CASA has been conducting a community-based lymphedema management program in Orissa State since 2007 that aims to reduce the morbidity associated with lymphedema and elephantiasis. The objective of this analysis is to evaluate the effects of this program on lymphedema patients' perceived disability. METHODOLOGY/PRINCIPAL FINDINGS: For this prospective cohort study, 370 patients ≥14 years of age, who reported lymphedema lasting more than three months in one or both legs, were recruited from villages in the Bolagarh sub-district, Khurda District, Orissa, India. The World Health Organization Disability Assessment Schedule II was administered to participants at baseline (July, 2009, and then at regular intervals through 24 months (July, 2011, to assess patients' perceived disability. Disability scores decreased significantly (p<0.0001 from baseline to 24 months. Multivariable analysis using mixed effects modeling found that employment and time in the program were significantly associated with lower disability scores after two years of program involvement. Older age, female gender, the presence of other chronic health conditions, moderate (Stage 3 or advanced (Stage 4-7 lymphedema, reporting an adenolymphangitis (ADL episode during the previous 30 days, and the presence of inter-digital lesions were associated with higher disability scores. Patients with moderate or advanced lymphedema experienced greater improvements in perceived disability over time. Patients participating in the program for at least 12 months also reported losing 2.5 fewer work days per month (p<0.001 due to their lymphedema, compared to baseline. SIGNIFICANCE: These results

  10. Economic Costs and Benefits of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India

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    Stillwaggon, Eileen; Sawers, Larry; Rout, Jonathan; Addiss, David; Fox, LeAnne

    2016-01-01

    Lymphatic filariasis afflicts 68 million people in 73 countries, including 17 million persons living with chronic lymphedema. The Global Programme to Eliminate Lymphatic Filariasis aims to stop new infections and to provide care for persons already affected, but morbidity management programs have been initiated in only 24 endemic countries. We examine the economic costs and benefits of alleviating chronic lymphedema and its effects through a simple limb-care program. For Khurda District, Odisha State, India, we estimated lifetime medical costs and earnings losses due to chronic lymphedema and acute dermatolymphangioadenitis (ADLA) with and without a community-based limb-care program. The program would reduce economic costs of lymphedema and ADLA over 60 years by 55%. Savings of US$1,648 for each affected person in the workforce are equivalent to 1,258 days of labor. Per-person savings are more than 130 times the per-person cost of the program. Chronic lymphedema and ADLA impose a substantial physical and economic burden on the population in filariasis-endemic areas. Low-cost programs for lymphedema management based on limb washing and topical medication for infection are effective in reducing the number of ADLA episodes and stopping progression of disabling and disfiguring lymphedema. With reduced disability, people are able to work longer hours, more days per year, and in more strenuous, higher-paying jobs, resulting in an important economic benefit to themselves, their families, and their communities. Mitigating the severity of lymphedema and ADLA also reduces out-of-pocket medical expense. PMID:27573626

  11. Breast and gynecologic cancer-related extremity lymphedema: a review of diagnostic modalities and management options

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    Tiwari, Pankaj; Coriddi, Michelle; Salani, Ritu; Povoski, Stephen P

    2013-01-01

    Lymphedema remains a poorly understood entity that can occur after lymphadenectomy. Herein, we will review the pathogenesis of lymphedema, diagnostic modalities and the natural history of extremity involvement. We will review the incidence of upper extremity lymphedema in patients treated for breast malignancies and lower extremity lymphedema in those treated for gynecologic malignancy. Finally, we will review traditional treatment modalities for lymphedema, as well as introduce new surgical ...

  12. Final program evaluation methods and results of a National Lymphedema Management Program in Togo, West Africa.

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    Ziperstein, Josh; Dorkenoo, Monique; Datagni, Michel; Drexler, Naomi; Murphy, Monica; Sodahlon, Yao; Mathieu, Els

    2014-06-01

    In order to eliminate Lymphatic Filariasis (LF) as a public health problem, the World Health Assembly recommends an approach which includes interruption of transmission of infection and the alleviation of morbidity. In 2000, the Togolese National Program to Eliminate Lymphatic Filariasis (PNELF) started the annual mass drug administrations and in 2007, the program added a morbidity component for the management of lymphedema. This manuscript describes the methods of an evaluation aimed at assessing the strengths and weaknesses of the Togolese National Lymphedema Morbidity Program. The evaluation was conducted through in-depth interviews with stakeholders at each programmatic level. Interviews focused on message dissemination, health provider training, patient self-care practices, social dynamics, and program impact. The evaluation demonstrated that the program strengths include the standardization and in-depth training of health staff, dissemination of the program's treatment message, a positive change in the community's perception of lymphedema, and successful patient recruitment and training in care techniques. The lessons learned from this evaluation helped to improve Togo's program, but may also provide guidance and strategies for other countries desiring to develop a morbidity program. The methods of program evaluation described in this paper can serve as a model for monitoring components of other decentralized national health programs in low resource settings.

  13. Lymphedema (PDQ)

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    ... caused by cancer is rarely treated with surgery . Massage therapy Massage therapy (manual therapy) for lymphedema should begin with ... trained in treating lymphedema. In this type of massage, the soft tissues of the body are lightly ...

  14. Management of unusual genital lymphedema complication after Fournier’s gangrene: a case report

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    Meyer Ganz Oanna

    2012-12-01

    Full Text Available Abstract Background Fournier’s gangrene is a bacterial infection characterized by necrotizing fasciitis, skin and soft tissue involvement, and eventually myositis of the perineal region. Aggressive debridement of devitalized tissue and overlying skin is of paramount importance, but often leaves large defects to be reconstructed. The present case reports successful extensive perineal defects coverage following Fournier’s gangrene and management of subsequent penile lymphoedema impairing sexual function in a young patient. Case presentation Following perianal abscess drainage, a healthy young man presented with scrotal pain. Fournier’s gangrene was diagnosed and treated with multiple surgical debridements. Tissue excision extended through the entire perineal area, base of the penile shaft, lower abdominal region, the inner thighs, and gluteal region, corresponding to 12% of the total body surface area. After serial debridements and negative pressure dressings, the defect was covered by two stages of skin grafting. Graft take was 90%. Healing was achieved without hypertrophic or retractile scar. However, chronic penile lymphedema remained and was first treated with compressive garments for 2 years. Upon failure of this conservative approach, we performed a circumcision, but only a “penile lift” allowed a satisfactory esthetical and functional result. Conclusion Fournier’s gangrene can be complicated by a chronic lymphedema of the penis. Conservative treatment is likely to fail in severe cases and can be treated surgically by “penile lift”.

  15. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

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    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  16. Management of sacroiliac dysfunction and lower extremity lymphedema using a comprehensive treatment approach: a case report.

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    Crane, Patricia

    2009-01-01

    Sacroiliac joint (SIJ) dysfunction, a common source of low back and buttock pain, can occur from cumulative shear or torsional forces during activities such as walking that require weight to transfer from one extremity to the other. Individuals with lower extremity lymphedema may also experience SIJ dysfunction. The purpose of this article was to describe the examination, diagnosis, and intervention for a patient with lower extremity lymphedema and sacroiliac joint dysfunction. The patient was a 50-year-old female with increased left lower extremity lymphedema and left buttock and groin pain that was previously treated unsuccessfully with physical therapy. SIJ dysfunction was attributable to an alteration in gait pattern caused by increased limb volume associated with lymphedema. The patient was treated for 19 visits over six weeks with complete decongestive therapy (CDT), muscle energy techniques, core stabilization, and the application of a pelvic support belt. Objective changes include decreased lymphedema, increased lower abdominal and lumbar extension strength, and decreased Oswetry Disability Index ratings. The patient was able to ambulate community distances without an assistive device and to resume unsupervised strength and conditioning without pain.

  17. Arm lymphedema after treatment of breast cancer: Etiology, diagnosis, and management

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    Ashish Goel

    2015-01-01

    Full Text Available Breast cancer related lymphedema (BCRL is a chronic debilitating condition seen after treatment of breast cancer. The overall incidence varies from 20% to 56% in all patients treated for breast cancer. Every patient is at a lifelong risk for BCRL and the risk goes on increasing as the followup period increases. Locoregional treatment including surgery or radiotherapy is the most common risk factor for development of arm lymphedema. There are two phases of arm lymphedema. There is increased fluid accumulation in the fluid phase of lymphedema which later on goes into the solid phase where fat and fibrotic tissue is deposited in the subcutaneous tissue. The treatment of BCRL is a challenge both for the patient and the treating surgeon and it needs multidisciplinary team work to be successful. Non-surgical treatment modalities include complete decongestive therapy (CDT and pneumatic compression therapy. Surgery for BCRL is usually undertaken as a salvage modality after failure of conservative approaches. The surgical spectrum for BCRL varies from extensive excisional operations which were commonly done in the past to newer methods like suction assisted protein lipectomy, lymphatic reconstruction and vascular lymph node transfer (VLNT using super-microsurgical techniques. There is no consensus regarding the preference of one procedure over other due to lack of randomised control trials. It is however suggested to do lymphovenous anastomosis and complete decongestive therapy for early cases in fluid phase; while patients in the solid phase may be treated with a combination of liposuction with CDT or VLNT alone.

  18. Basic Elements of Knowledge Management

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    Marcin W. Staniewski

    2007-10-01

    Full Text Available The article is a review of basic knowledge management terminology. It presents such a description as: knowledge resources levels (data, information, knowledge, and wisdom, knowledge sources (internal, external, and knowledge typology (implicit, tacit or individual, social. Moreover the article characterizes knowledge management process, knowledge management system and main knowledge management strategies (codification, personalization. At the end of the article there is mentioned the knowledge creating process (the concept of knowledge creation spiral and the role of Intelligence Technology (IT and organizational culture as main elements supporting knowledge management implementation in organizations.

  19. National Lymphedema Network

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    ... Functional Restoration for Individuals with Lymphedema and Morbid Obesity Announcing: A New Lymphedema-Specific Outcome Measure And “G” Code Calculator!! Position Paper: Screening and Measurement for Early Detection of Breast ...

  20. Self-reported information sources and perceived knowledge in individuals with lymphedema.

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    Deng, J; Fu, M R; Armer, J M; Cormier, J N; Radina, E; Thiadens, S R J; Dietrich, M S; Weiss, J; Tuppo, C M; Ridner, S H

    2013-12-01

    Currently, a limited number of studies have been conducted that examine sources of information and knowledge level in individuals with lymphedema. This study aimed (1) to examine self-reported information sources and perceived lymphedema knowledge among individuals with lymphedema; and (2) to examine differences in self-reported information sources and perceived lymphedema knowledge among individuals with primary or secondary lymphedema; and with upper or lower extremity lymphedema. The National Lymphedema Network (NLN) conducted a survey to collect self-report data from March 2006 to January 2010. Overall, participants preferred a variety of sources of information. Participants reported low levels of knowledge about the types of lymphedema, treatment approaches and methods, and self-administrated therapies. In comparison to participants with secondary or upper extremity lymphedema, participants with primary or lower extremity lymphedema reported lower knowledge level regarding causes of lymphedema, risks for and complications of lymphedema, treatment approaches and methods for lymphedema, and self-administered therapies. Opportunities exist to expand lymphedema information sources. Healthcare professionals should focus on delivering high quality information about treatment and self-care management to individuals with lymphedema.

  1. DESCRIBING LYMPHEDEMA IN FEMALES WITH TURNER SYNDROME.

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    Rothbauer, J; Driver, S; Callender, L

    2015-09-01

    Turner syndrome (TS) is a chromosomal condition affecting an estimated 1 in 2,500 girls where the second X chromosome is missing, or partially formed. This abnormality affects multiple body systems and can lead to short stature, cardiac, neural, and renal abnormalities. Due to the chronic, non-life threatening nature of lymphedema in comparison to other symptoms of TS, it is often ignored by girls and women with TS and their physicians. Consequently, little is known about how lymphedema affects girls and women with TS across the lifespan. Therefore, the objective of the study was to deliver an online survey for females with TS and caregivers in the US, UK, and Canada to provide a worldwide perspective on their current experience with lymphedema within the spectrum of TS. There were 219 participants who completed the survey, and we were able to identify incidence and characteristics of lymphedema across the lifespan. In addition, we found that females with 45,X karyotyping were more likely to report lymphedema symptoms. Lymphedema is not the most significant concern of females with TS, but education, physician evaluation, and assistance with referrals for treatment and management would improve the ease of managing lymphedema in girls and women with TS.

  2. Lymphedema Risk Reduction Practices

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    ... now! Position Paper: Lymphedema Risk Reduction Practices Category: Position Papers Tags: Risks Archives Treatment risk reduction garments surgery obesity infection blood pressure trauma morbid obesity body weight ...

  3. The 5th world symposium for lymphedema surgery-Recent updates in lymphedema surgery and setting up of a global knowledge exchange platform.

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    Loh, Charles Yuen Yung; Wu, Jerry Chih-Wei; Nguyen, Alexander; Dayan, Joseph; Smith, Mark; Masia, Jaume; Chang, David; Koshima, Isao; Cheng, Ming-Huei

    2017-01-01

    The successful completion of the 5th World Symposium for Lymphedema Surgery (WSLS) marks another milestone in the development and advancement of the management of lymphedema. We present our experience in organizing such a scientific lymphedema conference as well as a summary of seven variable live surgeries used for treating lymphedema. An update of current knowledge and determination of future direction in the treatment of lymphedema was made possible via WSLS 2016. J. Surg. Oncol. 2017;115:6-12. © 2016 Wiley Periodicals, Inc.

  4. Lymphedema as a Cancer Treatment Side Effect

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    ... Navigating Cancer Care > Side Effects > Lymphedema Request Permissions Lymphedema Approved by the Cancer.Net Editorial Board , 05/ ... years after cancer treatment has ended. Symptoms of lymphedema People with lymphedema in their arm or leg ...

  5. Inflammatory Manifestations of Lymphedema

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    Catherine L. Ly

    2017-01-01

    Full Text Available Lymphedema results from lymphatic insufficiency leading to a progressive inflammatory process that ultimately manifests as discomfort, recurrent infections, and, at times, secondary malignancy. Collectively, these morbidities contribute to an overall poor quality of life. Although there have been recent advances in microsurgical interventions, a conservative palliative approach remains the mainstay of treatment for this disabling disease. The absence of a cure is due to an incomplete understanding of the pathophysiological changes that result in lymphedema. A histological hallmark of lymphedema is inflammatory cell infiltration and recent studies with animal models and clinical biopsy specimens have suggested that this response plays a key role in the pathology of the disease. The purpose of this report is to provide an overview of the ongoing research in and the current understanding of the inflammatory manifestations of lymphedema.

  6. Inflammatory Manifestations of Lymphedema

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    Ly, Catherine L.; Kataru, Raghu P.; Mehrara, Babak J.

    2017-01-01

    Lymphedema results from lymphatic insufficiency leading to a progressive inflammatory process that ultimately manifests as discomfort, recurrent infections, and, at times, secondary malignancy. Collectively, these morbidities contribute to an overall poor quality of life. Although there have been recent advances in microsurgical interventions, a conservative palliative approach remains the mainstay of treatment for this disabling disease. The absence of a cure is due to an incomplete understanding of the pathophysiological changes that result in lymphedema. A histological hallmark of lymphedema is inflammatory cell infiltration and recent studies with animal models and clinical biopsy specimens have suggested that this response plays a key role in the pathology of the disease. The purpose of this report is to provide an overview of the ongoing research in and the current understanding of the inflammatory manifestations of lymphedema. PMID:28106728

  7. Cognitive-Affective Predictors of the Uptake & Sustained Adherence to Lymphedema Symptom Minimization Practices in Breast Cancer Survivors

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    2007-08-01

    Uptake of, & Sustained Adherence to Lymphedema Symptom Minimization Practices in Breast Cancer Survivors PRINCIPAL INVESTIGATOR: Suzanne M. Miller...SUBTITLE 5a. CONTRACT NUMBER Cognitive-Affective Predictors of the Uptake of, & Sustained Adherence to Lymphedema Symptom Minimization Practices in...SUPPLEMENTARY NOTES 14. ABSTRACT Approximately 20-30% of women develop lymphedema (LE) following breast cancer treatment. Effective symptom management

  8. Lymphedema Prophylaxis Utilizing Perloperative Education

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    2005-09-01

    AD Award Number: DAMD17-00-1-0495 TITLE: Lymphedema Prophylaxis Utilizing Perloperative Education PRINCIPAL INVESTIGATOR: Mary Ann Kosir, M.D...NUMBER Lymphedema Prophylaxis Utilizing Perloperative Education 5b. GRANT NUMBER DAM D1 7-00-1-0495 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...perioperative training for lymphedema assessment and protection. The hypothesis is that structured perioperative training in lymphedema protection will

  9. Lymphedema in tuberous sclerosis complex.

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    Geffrey, Alexandra L; Shinnick, Julianna E; Staley, Brigid A; Boronat, Susana; Thiele, Elizabeth A

    2014-06-01

    Congenital lymphedema has been described as a possible rare association of tuberous sclerosis complex (TSC), with only six previous cases reported in the literature. TSC is an autosomal dominant, multisystem disorder connected to aberrant regulation of the mammalian target of rapamycin (mTOR) pathway. The aim of this study is to review cases of lymphedema in a large cohort of TSC patients. The medical records of 268 patients seen at The Herscot Center for Children and Adults with Tuberous Sclerosis Complex at the Massachusetts General Hospital from 2002 to 2012 were retrospectively reviewed for reports of lymphedema or edema of unknown etiology. Genotypic and phenotypic data were collected in accordance with institutional review board (IRB) approval. This cohort presents two new cases of congenital lymphedema in TSC patients and acquired lymphedema was found in eight additional cases. Thus, we report 10 new cases of lymphedema in TSC (4%). The two patients with congenital lymphedema were female, as were the previous six reported cases. The frequency of lymphedema reported here (4%) is higher than the estimated prevalence in the general population (0.133-0.144%), suggesting a higher frequency of lymphedema in TSC. This study shows that patients with TSC and lymphedema are more likely to be females with renal AMLs and suggests that congenital lymphedema is a gender-specific (female) manifestation of TSC. Exploration of the potential role of mTOR antagonists may be important in treatment of lymphedema in TSC patients.

  10. Genetics Home Reference: lymphedema-distichiasis syndrome

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    ... Understand Genetics Home Health Conditions lymphedema-distichiasis syndrome lymphedema-distichiasis syndrome Enable Javascript to view the expand/ ... boxes. Download PDF Open All Close All Description Lymphedema-distichiasis syndrome is a condition that affects the ...

  11. Guide to Understanding Lymphedema

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    ... MBC Radiation Therapy for MBC Surgery for MBC Yoga and MBC Side Effects Bone Health and MBC Bone Pain and MBC ... Yoga Poses Special Situations Yoga and Lymphedema Risk Yoga and Metastatic Breast Cancer Side Effects Anemia Bone Loss Bone Pain Chemobrain Depression and ...

  12. Lymphedema secondary to filariasis.

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    Leonard, J C; Humphrey, G B; Basmadjian, G

    1985-03-01

    A 1-year-old immunodeficient boy developed brawny edema of the left foot. Lymphoscintigraphy revealed no evidence of left inguinal activity following pedal injection of Tc-99m-Sn phosphate. Over the next two months, the patient developed lymphedema on the right and repeat scintigraphy demonstrated no movement of isotope from the dorsum of either foot. Subsequent studies identified microfilaria in a nocturnal blood smear, which were thought to represent Brugia beaveri acquired by mosquito transmission in Oklahoma.

  13. Lymphedema secondary to filariasis

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    Leonard, J.C.; Humphrey, G.B.; Basmadjian, G.

    1985-03-01

    A 1-year-old immunodeficient boy developed brawny edema of the left foot. Lymphoscintigraphy revealed no evidence of left inguinal activity following pedal injection of Tc-99m-Sn phosphate. Over the next two months, the patient developed lymphedema on the right and repeat scintigraphy demonstrated no movement of isotope from the dorsum of either foot. Subsequent studies identified microfilaria in a nocturnal blood smear, which were thought to represent Brugia beaveri acquired by mosquito transmission in Oklahoma.

  14. Upper limb swelling following mastectomy: lymphedema or not?

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    Armer, Jane

    2007-04-01

    Having experienced an excisional biopsy, sentinel lymph node biopsy, and mastectomy, BH is at lifetime risk of developing post-breast cancer lymphedema in the arm on the side where her breast cancer was treated. She has two additional risk factors, among those documented in the literature: history of an infection (specifically a systemic infection, significant in that it required hospitalization for intravenous antibiotics) in the postsurgery period, and a moderate increase in bilateral limb volume and weight (body mass index) over the months and years following the breast cancer diagnosis. Further, the patient-reported transient hand swelling on the affected side and gradual weight increase are cues indicating a need for patient vigilance and careful monitoring by the health-care team. Preventing future infections, managing weight at an optimal level, and preventing trauma or injury to the affected arm and chest are important self-management precautions to reduce risk of chronic lymphedema development. BH needs continued support in reviewing evidence-based risk-reduction guidelines and understanding ways to apply them to her lifestyle. In the absence of preoperative baseline or contralateral limb measurements (with circumferences or perometry or water displacement), assessment of limb change at a level identified as diagnostic of lymphedema (commonly, 200-mL volume or 2-cm girth increase from baseline or as compared to the contralateral limb) is very challenging. Without bilateral preop limb measurements for baseline and contralateral limb comparisons, BH might have been diagnosed with lymphedema at postop or at 48 months, when both limbs increased symmetrically. Symptom assessment is also crucial, as symptom report of heaviness and swelling is found to be associated with limb volume changes indicative of lymphedema. Transient hand swelling may be evidence of latent lymphedema and cause for increased risk-reduction education and vigilance in assessment for

  15. Basic components of construction enterprises’ management marketing activities system

    OpenAIRE

    Seleznova Olha Olexandrivna

    2015-01-01

    This article investigated the basic components of construction enterprises’ management marketing activities system. It is developed the model of the construction enterprises’ management marketing activities system. The article explores the essence of the stages of forming the construction enterprises’ management marketing activities system. The article reveals the basic elements of marketing management – mission, goals, strategy. It describes the basic functions of marketing management system...

  16. A systematic review of care delivery models and economic analyses in lymphedema: health policy impact (2004-2011).

    Science.gov (United States)

    Stout, N L; Weiss, R; Feldman, J L; Stewart, B R; Armer, J M; Cormier, J N; Shih, Y-C T

    2013-03-01

    A project of the American Lymphedema Framework Project (ALFP), this review seeks to examine the policy and economic impact of caring for patients with lymphedema, a common side effect of cancer treatment. This review is the first of its kind undertaken to investigate, coordinate, and streamline lymphedema policy initiatives in the United States with potential applicability worldwide. As part of a large scale literature review aiming to systematically evaluate the level of evidence of contemporary peer-reviewed lymphedema literature (2004 to 2011), publications on care delivery models, health policy, and economic impact were retrieved, summarized, and evaluated by a team of investigators and clinical experts. The review substantiates lymphedema education models and clinical models implemented at the community, health care provider, and individual level that improve delivery of care. The review exposes the lack of economic analysis related to lymphedema. Despite a dearth of evidence, efforts towards policy initiatives at the federal and state level are underway. These initiatives and the evidence to support them are examined and recommendations for translating these findings into clinical practice are made. Medical and community-based disease management interventions, taking on a public approach, are effective delivery models for lymphedema care and demonstrate great potential to improve cancer survivorship care. Efforts to create policy at the federal, state, and local level should target implementation of these models. More research is needed to identify costs associated with the treatment of lymphedema and to model the cost outlays and potential cost savings associated with comprehensive management of chronic lymphedema.

  17. Kaposi sarcoma following postmastectomy lymphedema.

    Science.gov (United States)

    Montero Pérez, Iria; Rodríguez-Pazos, Laura; Álvarez-Pérez, Adriana; Ferreirós, M Mercedes Pereiro; Aliste, Carlos; Suarez-Peñaranda, Jose Manuel; Toribio, Jaime

    2015-11-01

    Classical Kaposi sarcoma (KS) usually appears on lower extremities accompanied or preceded by local lymphedema. However, the development in areas of chronic lymphedema of the arms following mastectomy, mimicking a Stewart-Treves syndrome, has rarely been described. We report an 81-year-old woman who developed multiple, erythematous to purple tumors, located on areas of post mastectomy lymphedema. Histopathological examination evidenced several dermal nodules formed by spindle-shaped cells that delimitated slit-like vascular spaces with some red cell extravasation. Immunohistochemically, the human herpesvirus type 8 (HHV-8) latent nuclear antigen-1 was detected in the nuclei of most tumoral cells confirming the diagnosis of KS. Lymphedema could promote the development of certain tumors by altering immunocompetence. Although angiosarcoma (AS) is the most frequent neoplasia arising in the setting of chronic lymphedema, other tumors such as benign lymphangiomatous papules (BLAP) or KS can also develop in lymphedematous limbs. It is important to establish the difference between AS and KS because their prognosis and treatment are very different. Identification by immunohistochemistry of HHV-8 is useful for the distinction between KS and AS or BLAP.

  18. Intensive treatment of leg lymphedema

    Directory of Open Access Journals (Sweden)

    Pereira de Godoy Jose

    2010-01-01

    Full Text Available Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value < 0.05 being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value < 0.001. Losses of more than 90% of the lymphedema occurred in 9 (39.13% patients; losses of more than 80% in 13 (56.52%, losses of more than 70% in 17 (73.91% and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9% of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees.

  19. Surgical treatment of recidivist lymphedema

    Science.gov (United States)

    Ferrarese, Alessia; Moggia, Elisabetta; Francone, Elisa; Sagnelli, Carlo; Martino, Maria Di; de Franciscis, Stefano; Amato, Bruno; Grande, Raffaele; Butrico, Lucia; Amato, Maurizio; Serra, Raffaele; Martino, Valter; Berti, Stefano

    2016-01-01

    Abstract Lymphedema is a chronic disease with a progressively ingravescent evolvement and an appearance of recurrent complications of acute lymphangitic type; in nature it is mostly erysipeloid and responsible for a further rapid increase in the volume and consistency of edema. The purpose of this work is to present our experience in the minimally invasive treatment for recurrence of lymphedema; adapting techniques performed in the past which included large fasciotomy with devastating results cosmetically; but these techniques have been proposed again by the use of endoscopic equipment borrowed from the advanced laparoscopy surgery, which allows a monoskin access of about one cm.

  20. Surgical treatment of recidivist lymphedema

    Directory of Open Access Journals (Sweden)

    Eretta Costantino

    2016-01-01

    Full Text Available Lymphedema is a chronic disease with a progressively ingravescent evolvement and an appearance of recurrent complications of acute lymphangitic type; in nature it is mostly erysipeloid and responsible for a further rapid increase in the volume and consistency of edema. The purpose of this work is to present our experience in the minimally invasive treatment for recurrence of lymphedema; adapting techniques performed in the past which included large fasciotomy with devastating results cosmetically; but these techniques have been proposed again by the use of endoscopic equipment borrowed from the advanced laparoscopy surgery, which allows a monoskin access of about one cm.

  1. Prospective Lymphedema Surveillance in a Clinic Setting

    Directory of Open Access Journals (Sweden)

    Janet Chance-Hetzler

    2015-08-01

    Full Text Available The potential impact of breast cancer-related lymphedema (LE is quite extensive, yet it often remains under-diagnosed until the later stages. This project examines the effectiveness of prospective surveillance in post-surgical breast cancer patients. A retrospective analysis of 49 out of 100 patients enrolled in a longitudinal prospective study at a Midwestern breast center evaluates: (1 time required for completion of bilateral limb measurements and Lymphedema Breast Cancer Questionnaire (LBCQ; (2 referral to LE management with limb volume increase (LVI and/or LBCQ symptoms; and (3 cost of LE management at lower LVI (≥5%–≤10% versus traditional (≥10%. Findings revealed a visit timeframe mean of 40.3 min (range = 25–60; 43.6% of visits were ≤30-min timeframe. Visit and measurement times decreased as clinic staff gained measurement experience; measurement time mean was 17.9 min (range = 16.9–18.9. LBCQ symptoms and LVI were significantly (p < 0.001 correlated to LE referral; six of the nine patients referred (67% displayed both LBCQ symptoms/LVI. Visits with no symptoms reported did not result in referral, demonstrating the importance of using both indicators when assessing early LE. Lower threshold referral provides compelling evidence of potential cost savings over traditional threshold referral with reported costs of: $3755.00 and $6353.00, respectively (40.9% savings.

  2. Basic concepts and definitions of clinical management

    Directory of Open Access Journals (Sweden)

    Angélica Román

    2012-06-01

    Full Text Available Management is leading, administering resources, and achieving the goals and objectives that have been set. In the Chilean health care system, management can be subdivided in three main levels – macro-management, meso-management and micro-management. Managing health care is also about epidemiological changes, information and technology innovations, patient groups demanding better services, but mostly about a huge escalation in costs that is not necessarily substantiated by evidence on more efficiency in health outcomes.Clinical management is more than a management tool. It is a cultural change that will provide new values to professional practice and to the organization as a whole. However, clinical management demands more commitment on behalf of the human teams that need to learn how to lead and to be led. These teams will be called upon to help in the decision-making process for the betterment of the institution.

  3. Lymphedema: What We Know | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Lymphedema Lymphedema: What We Know Past Issues / Fall 2016 Table ... Photo: NCI Who is at risk for getting lymphedema? Having lymph nodes removed during breast cancer surgery ...

  4. [Lymphedema: is there a treatment?].

    Science.gov (United States)

    Barrellier, M T

    1992-01-01

    More than hundred medical treatments for lymphedema have been described. This very high number shows the evidence of difficulties: lymphatics are very small vessels, under low pression and velocity respondent to spontaneous quiet lymphatic contractions. The treatments can be listed in 3 groups: 1) physiotherapeutic methods, increasing lymphatic flow: cold, field stimulation, manual lymph drainage, intermittent compression, heat; 2) drugs: venous agents (flavone, benzo-pyrone), and intraarterial lymphocytes injection, promoting lymphatic flow or increasing normal proteolysis by macrophages in order to remove trapped proteins from interstitial fluid; 3) surgical procedures subdivided in 2 groups: excisional techniques and bridging drainage techniques; radical or partial excision removes involved subcutaneous tissue, recently by the way of liposuction; Efforts to drain lymphedema by subcutaneous implants, pedical flaps, myocutaneous flaps, omental transposition and intestinal flaps are historical. Microsurgical lymphatic anastomosis to vein (nodo-venous then lymphovenous), and to lymphatic themselves are now performed: lymphatic collectors or venous autografts are interpositioned to by-pass lymphatic blockade with end-to end anastomosis. The free transplantation of a lymphatic flap with its own vascularisation from healthy inguinal nodes to axillary blockade is the last described procedure. Lymphatic anastomosis are not needed. Actually, physiotherapy is always first indicated. Benzo-pyrones are additive drugs. Excisional procedures concern monstruous lymphedema. Microsurgical bridging procedures can be attempted only for secondary lymphedemas. They could be of benefit if physiotherapy and elastic bandages, stockings or sleeves, could then be avoided. Studies assessing independently the efficiency of each procedure are needed.

  5. Gigantic Suprapubic Lymphedema: A Case Study

    Science.gov (United States)

    Tanhaeivash, Roozbeh; Franiel, Tobias; Grimm, Marc-Oliver

    2016-01-01

    We present the first case study of idiopathic gigantic suprapubic lymphedema and buried penis treated with puboscrotal reconstruction in a patient with initial extreme obesity after an extensive weight reduction (120 kg). Massive localized lymphedema of the suprapubic region should be differentiated from the scrotal type. Severe lymphedema could not resolve on its own and weight reduction does not seem to be helpful in such cases. PMID:27574599

  6. MANAGEMENT AND ORGANIZATIONAL BEHAVIOUR. SOME BASIC ASPECTS

    Directory of Open Access Journals (Sweden)

    Jaroslav NEKORANEC

    2013-01-01

    Full Text Available Experience has shown that it is necessary to focus more on organizational behaviour. This requires managers to get familiar with several social and psychological scientific disciplines which can help them answer the questions related to the impact of the organization and organizational philosophy on the behaviour of managers and employees. In addition, organizational behaviour includes knowing individual differences between people in the organization and their impact on fulfilling organization’s objectives. It also explains the relationships between people in connection to organizational culture, functioning of work teams, communication, etc. Analysis and interpretation of organizational behaviour should become part of managers’ training so that they are able to explain and predict behaviour of people in the organization they manage.

  7. Teaching Basic Probability in Undergraduate Statistics or Management Science Courses

    Science.gov (United States)

    Naidu, Jaideep T.; Sanford, John F.

    2017-01-01

    Standard textbooks in core Statistics and Management Science classes present various examples to introduce basic probability concepts to undergraduate business students. These include tossing of a coin, throwing a die, and examples of that nature. While these are good examples to introduce basic probability, we use improvised versions of Russian…

  8. Resolution of Primary Lymphedema: A Case Report

    Science.gov (United States)

    Goss, Jeremy A.; Maclellan, Reid A.; Beijnen, Usha E. A.

    2017-01-01

    Summary: Primary lymphedema is a rare, progressive disease that typically affects the lower extremity. The condition is not curable, and the limb enlarges over time because of subcutaneous fibroadipose deposition. We present a patient with clinical and radiographical evidence of resolution of primary lymphedema. This observation may provide greater insight into the pathophysiology of the disease. PMID:28280665

  9. Amendment I : Basic fur management plan : Stillwater Wildlife Management Area

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This amendment to the fur management plan for Stillwater Wildlife Management area calls for the annual trapping of beaver. The Lower Carson River is overpopulated...

  10. Basic fur management plan : Stillwater Wildlife Management Area

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This fur management plan for Stillwater Wildlife Management Area outlines methods of fur harvest, trapping territories, selection of trappers, trapping equipment,...

  11. Significant Differences in Nurses’ Knowledge of Basic Wound Management

    DEFF Research Database (Denmark)

    Zarchi, Kian; Latif, Seemab; Haugaard, Vibeke B

    2014-01-01

    Wounds represent a growing healthcare problem due to an aging population. Nurses play a key role in wound management and their theoretical understanding of basic wound management may be expected to influence the quality of wound therapy fundamentally. In this study, we evaluated the level...... of knowledge of wound management in 136 Danish nurses working in 3 different settings: advanced wound care clinics, home care and general hospital departments. We found that hospital nurses had less theoretical knowledge than home care nurses and nurses working at advanced wound care clinics. We also found...... of wound management in Denmark and suggests how improvements might be achieved....

  12. Heavy resistance training and lymphedema

    DEFF Research Database (Denmark)

    Bloomquist, Kira; Karlsmark, Tonny; Christensen, Karl Bang

    2014-01-01

    ) in this population. 'Body and Cancer' is a six-week, nine-hour weekly, supervised, multimodal exercise intervention utilizing progressive resistance training with heavy loads for cancer patients undergoing chemotherapy. The purpose of the present study was to estimate the prevalence of BCRL in former participants......BACKGROUND: There is limited knowledge regarding progressive resistance training during adjuvant chemotherapy and the risk of developing breast cancer-related lymphedema (BCRL). Furthermore, no studies have investigated the safety of resistance training with heavy loads (> 80% 1 repetition maximum...

  13. Lymphedema (PDQ®)—Health Professional Version

    Science.gov (United States)

    Expert-reviewed information summary about the anatomy, pathophysiology, clinical manifestations, diagnosis, and treatment of cancer-related lymphedema, a condition in which lymph fluid builds up in tissues and causes swelling.

  14. PERFORMANCE MANAGEMENT AND QUALITY EDUCATION IN BASIC SCHOOLS

    Directory of Open Access Journals (Sweden)

    Yarelit del Carmen Torres Hernández

    2016-06-01

    Full Text Available The research aimed to determine the relationship between management performance and quality education in the National Basic Schools Altagracia Parish, Miranda Municipality, Zulia State. Descriptive study with field design, correlational, not experimental. The population consists of 23 directors: 15 directors, 8 assistant principals, 21 teachers and 744 representatives of 6th grade, who were applied a questionnaire with closed questions five alternative answers, consisting of 29 items for managers and 19 items for teachers and representatives. The questionnaires were validated by five experts, and reliability was determined by Cronbach coefficient (0.9, both instruments being both highly reliable. The results indicate that the Performance Management and Quality Education in these schools show strengthening in the preparation and dedication to the development of their work, helping with this that these institutions are seen as role models.

  15. Lymphedema

    Science.gov (United States)

    ... development. Today, patients who have axillary lymph node dissection have a lifetime risk of 15-25%. For ... that is roughly equivalent to axillary lymph node dissection and increases the risk associated with surgery if ...

  16. Management Strategies in Basic Education and Participation of Parents

    Directory of Open Access Journals (Sweden)

    Johel Furguerle-Rangel

    2016-05-01

    Full Text Available In the educational process it is necessary to use management paradigms and active participation of parents. The objective was to determine the use of management strategies by the director of basic education and participation of parents in the educational process. It is a descriptive, transversal and field study, whose instrument was a questionnaire of 26 closed-questions.   The sample comprised 16 directors, 52 teachers and 62 parents. For most managers and faculty the technique of brainstorming, involvement in decision-making, continues knowledge management and radical change are crucial in the educational process of children.   But mothers and fathers believe that managerial groups do not use strategies properly except for reengineering.   The mother and fathers are mainly involved in education management but not in the learning process. It is recommended the deepening of policy management training teaching force, through continuous training provided by the government and the promotion of family participation in the teaching-learning process of children.

  17. Habitat Management for Wintering American Woodcock on Southeastern Bottomland Refuges: Basic Management Guidelines and Strategies

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Basic guidelines for management of habitat in winter for woodcock on refuges in the SE is presented along with consideration for use of the desired forestry conditons.

  18. Assessing local tissue edema in postmastectomy lymphedema.

    Science.gov (United States)

    Mayrovitz, H N

    2007-06-01

    Overall limb lymphedema can be assessed by several methods but none are suitable to determine local edema. Quantifying local edema could provide important information not previously available. Our goal was to determine the suitability of using the tissue dielectric constant (TDC) as and index of local tissue water to detect and quantify edema in postmastectomy patients with unilateral arm lymphedema. Segmental arm volume and TDC were measured in both arms of 18 women with unilateral lymphedema, and in 15 premenopausal and 15 postmenopausal controls. TDC was measured at a frequency of 300 MHz using open-ended coaxial probes with effective measuring depths of 0.5, 1.5, 2.5 and 5.0 mm. For patients and controls, absolute TDC depended on measurement depth but for any depth the TDC of lymphedematous segments was significantly greater than for non-affected contralateral arms (pTDC ratio between arms for patients was 1.64+/-0.30 vs.1.04+/-0.04 for both control groups (pTDC ratio was as low as 1.2 and no control subject's TDC ratio was as great as 1.2. Results suggest that this method is a good quantitative discriminator of the presence of lymphedema in patients with unilateral limb lymphedema.

  19. Diabetic foot ulcers in conjunction with lower limb lymphedema: pathophysiology and treatment procedures

    Directory of Open Access Journals (Sweden)

    Kanapathy M

    2015-08-01

    Full Text Available Muholan Kanapathy,1 Mark J Portou,1,2 Janice Tsui,1,2 Toby Richards1,21Division of Surgery and Interventional Science, University College London, 2Department of Vascular Surgery, Royal Free London NHS Foundation Trust Hospital, London, UKAbstract: Diabetic foot ulcers (DFUs are complex, chronic, and progressive wounds, and have a significant impact on morbidity, mortality, and quality of life. A particular aspect of DFU that has not been reviewed extensively thus far is its management in conjunction with peripheral limb edema. Peripheral limb edema is a feature of diabetes that has been identified as a significant risk factor for amputation in patients with DFU. Three major etiological factors in development of lymphedema with concurrent DFU are diabetic microangiopathy, failure of autonomic regulation, and recurrent infection. This review outlines the pathophysiology of lymphedema formation in patients with DFU and highlights the cellular and immune components of impaired wound healing in lymphedematous DFU. We then discuss the principles of management of DFU in conjunction with lymphedema.Keywords: diabetic foot ulcer, lymphedema, chronic wound, wound management

  20. 乳腺癌术后上肢水肿研究进展%Progress in study on lymphedema of arm after surgery of breast cancer

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Lymphedema of affected arm is a severe complication after surgery of breast cancer.Quality of life and rehabilitation of patients suffered from breast cancer receive more and more attention with increase of incidence and decrease of mortality,longation of survival time.Lymphedema of arm not only affects esthetics but produce pain,dysfunction,deprivation of work ability,and serious psychological issues.In the current paper,we reviewed progress in study on risk factors associated with surgery,evaluation,prevention and management of lymphedema in arm.

  1. Diphtheria toxin–mediated ablation of lymphatic endothelial cells results in progressive lymphedema

    Science.gov (United States)

    Gardenier, Jason C.; Hespe, Geoffrey E.; Kataru, Raghu P.; Savetsky, Ira L.; Torrisi, Jeremy S.; Nores, Gabriela D. García; Dayan, Joseph J.; Chang, David; Zampell, Jamie; Martínez-Corral, Inés; Ortega, Sagrario; Mehrara, Babak J.

    2016-01-01

    Development of novel treatments for lymphedema has been limited by the fact that the pathophysiology of this disease is poorly understood. It remains unknown, for example, why limb swelling resulting from surgical injury resolves initially, but recurs in some cases months or years later. Finding answers for these basic questions has been hampered by the lack of adequate animal models. In the current study, we used Cre-lox mice that expressed the human diphtheria toxin receptor (DTR) driven by a lymphatic-specific promoter in order to noninvasively ablate the lymphatic system of the hind limb. Animals treated in this manner developed lymphedema that was indistinguishable from clinical lymphedema temporally, radiographically, and histologically. Using this model and clinical biopsy specimens, we show that the initial resolution of edema after injury is dependent on the formation of collateral capillary lymphatics and that this process is regulated by M2-polarized macrophages. In addition, we show that despite these initial improvements in lymphatic function, persistent accumulation of CD4+ cells inhibits lymphangiogenesis and promotes sclerosis of collecting lymphatics, resulting in late onset of edema and fibrosis. Our findings therefore provide strong evidence that inflammatory changes after lymphatic injury play a key role in the pathophysiology of lymphedema.

  2. Yoga protocol for treatment of breast cancer-related lymphedema

    Science.gov (United States)

    Narahari, SR; Aggithaya, Madhur Guruprasad; Thernoe, Liselotte; Bose, Kuthaje S; Ryan, Terence J

    2016-01-01

    Introduction: Vaqas and Ryan (2003) advocated yoga and breathing exercises for lymphedema. Narahari et al. (2007) developed an integrative medicine protocol for lower-limb lymphedema using yoga. Studies have hypothesized that yoga plays a similar role as that of central manual lymph drainage of Foldi's technique. This study explains how we have used yoga and breathing as a self-care intervention for breast cancer-related lymphedema (BCRL). Methods: The study outcome was to create a yoga protocol for BCRL. Selection of yoga was based on the actions of muscles on joints, anatomical areas associated with different groups of lymph nodes, stretching of skin, and method of breathing in each yoga. The protocol was piloted in eight BCRL patients, observed its difficulties by interacting with patients. A literature search was conducted in PubMed and Cochrane library to identify the yoga protocols for BCRL. Results: Twenty yoga and 5 breathing exercises were adopted. They have slow, methodical joint movements which helped patients to tolerate pain. Breathing was long and diaphragmatic. Flexion of joints was coordinated with exhalation and extension with inhalation. Alternate yoga was introduced to facilitate patients to perform complex movements. Yoga's joint movements, initial positions, and mode of breathing were compared to two other protocols. The volume reduced from 2.4 to 1.2 L in eight patients after continuous practice of yoga and compression at home for 3 months. There was improvement in the range of movement and intensity of pain. Discussion: Yoga exercises were selected on the basis of their role in chest expansion, maximizing range of movements: flexion of large muscles, maximum stretch of skin, and thus part-by-part lymph drainage from center and periphery. This protocol addressed functional, volume, and movement issues of BCRL and was found to be superior to other BCRL yoga protocols. However, this protocol needs to be tested in centers routinely managing BCRL

  3. Systematic review: conservative treatments for secondary lymphedema

    Directory of Open Access Journals (Sweden)

    Oremus Mark

    2012-01-01

    Full Text Available Abstract Background Several conservative (i.e., nonpharmacologic, nonsurgical treatments exist for secondary lymphedema. The optimal treatment is unknown. We examined the effectiveness of conservative treatments for secondary lymphedema, as well as harms related to these treatments. Methods We searched MEDLINE®, EMBASE®, Cochrane Central Register of Controlled Trials®, AMED, and CINAHL from 1990 to January 19, 2010. We obtained English- and non-English-language randomized controlled trials or observational studies (with comparison groups that reported primary effectiveness data on conservative treatments for secondary lymphedema. For English-language studies, we extracted data in tabular form and summarized the tables descriptively. For non-English-language studies, we summarized the results descriptively and discussed similarities with the English-language studies. Results Thirty-six English-language and eight non-English-language studies were included in the review. Most of these studies involved upper-limb lymphedema secondary to breast cancer. Despite lymphedema's chronicity, lengths of follow-up in most studies were under 6 months. Many trial reports contained inadequate descriptions of randomization, blinding, and methods to assess harms. Most observational studies did not control for confounding. Many studies showed that active treatments reduced the size of lymphatic limbs, although extensive between-study heterogeneity in areas such as treatment comparisons and protocols, and outcome measures, prevented us from assessing whether any one treatment was superior. This heterogeneity also precluded us from statistically pooling results. Harms were rare ( Conclusions The literature contains no evidence to suggest the most effective treatment for secondary lymphedema. Harms are few and unlikely to cause major clinical problems.

  4. Effects of yoga on arm volume among women with breast cancer related lymphedema: A pilot study.

    Science.gov (United States)

    Fisher, Mary Insana; Donahoe-Fillmore, Betsy; Leach, Laura; O'Malley, Colleen; Paeplow, Cheryl; Prescott, Tess; Merriman, Harold

    2014-10-01

    Lymphedema affects 3-58% of survivors of breast cancer and can result in upper extremity impairments. Exercise can be beneficial in managing lymphedema. Yoga practice has been minimally studied for its effects on breast cancer related lymphedema (BCRL). The purpose of this study was to determine the effect of yoga on arm volume, quality of life (QOL), self-reported arm function, and hand grip strength in women with BCRL. Six women with BCRL participated in modified Hatha yoga 3×/week for 8 weeks. Compression sleeves were worn during yoga sessions. Arm volume, QOL, self-reported arm function, and hand grip strength were measured at baseline, half-way, and at the conclusion of yoga practice. Arm volume significantly decreased from baseline (2423.3 ml ± 597.2) to final measures (2370.8 ml ± 577.2) (p = .02). No significant changes in QOL (p = .12), self-reported arm function (p = .34), or hand grip strength (p = .26) were found. Yoga may be beneficial in the management of lymphedema.

  5. Lymphedema Precautions: Time to Abandon Old Practices?

    Science.gov (United States)

    Ahn, Soojin; Port, Elisa R

    2016-03-01

    The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.A 46-year-old premenopausal woman with a body mass index of 21 was found on screening mammography to have a new, approximately 1-cm spiculated mass with associated calcifications in the upper outer quadrant of the left breast. Stereotactic core biopsy showed a focus of invasive duct carcinoma, strongly positive for estrogen and progesterone receptors and negative for human epidermal growth factor receptor 2, with associated ductal carcinoma in situ. Clinical examination revealed no palpable mass or axillary lymphadenopathy. She underwent a left lumpectomy with seed localization and sentinel lymph node biopsy. Final pathology revealed an 8-mm well-differentiated invasive carcinoma without lymphovascular invasion and intermediate grade ductal carcinoma in situ. The margins were clear, and three sentinel lymph nodes were negative for metastasis. The 21-gene recurrence score was 10, suggesting a 7% risk of 10-year distant recurrence with adjuvant endocrine treatment. After the completion of adjuvant radiotherapy (42.50 Gy in 16 fractions to the breast), the patient has returned for a follow-up visit. She is a professional violinist and would like to know what she can do to prevent lymphedema on her upcoming flight to Vienna.

  6. With Lymphedema, Early Treatment is Key | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Lymphedema With Lymphedema, Early Treatment is Key Past Issues / Fall 2016 Table of Contents You may notice symptoms of lymphedema at the part of your body where you ...

  7. Evaluation of the effectiveness of kinesio taping application in a patient with secondary lymphedema in breast cancer: a case report.

    Science.gov (United States)

    Taradaj, Jakub; Halski, Tomasz; Zduńczyk, Małgorzata; Rajfur, Joanna; Pasternok, Małgorzata; Chmielewska, Daria; Piecha, Magdalena; Kwaśna, Krystyna; Skrzypulec-Plinta, Violetta

    2014-03-01

    Breast cancer-related lymphedema is one of the complications resulting from treatment. It is defined as arm oedema in the breast cancer patients caused by interruption of the flow of the axillary lymphatic system from surgery or radiation therapy, which results in the accumulation of fluid in the subcutaneous tissue of the arm, with a decrease in tissue distensibility around the joints and an increased weight of the extremity. Decongestive lymphatic therapy is common management for lymphedema. A program combining skin care, manual lymphatic drainage, exercise, and compression therapy (multilayer bandage or garment) is recognised as the best practice in lymphedema management. Kinesio taping (KT) for lymphatic drainage is a new choice in the field of physical therapy. The material and the original concept of the taping technique were introduced by Dr Kenso Kase in 1973. K-tape had been designed to allow 30-40% longitudinal stretch. It is composed of 100% cotton fibers and acrylic heat sensitive glue. Development of the technique for its administration is still ongoing. The paper discusses the case of a woman with breast cancer, in whom lymphedema occurred. The patient had three weeks of therapy. The treatment consisted of 12 manual lymphatic drainage, 12 pneumatic compressions and 3 applications of the KT method (due to the lack of standard multi-layer bandaging). During the measurement of oedema it was noted that KT had a significant effect on the reduction of lymphedema and accelerates healing effects compared to standard methods.

  8. Evaluation of the effectiveness of kinesio taping application in a patient with secondary lymphedema in breast cancer: a case report

    Science.gov (United States)

    Halski, Tomasz; Zduńczyk, Małgorzata; Rajfur, Joanna; Pasternok, Małgorzata; Chmielewska, Daria; Piecha, Magdalena; Kwaśna, Krystyna; Skrzypulec-Plinta, Violetta

    2014-01-01

    Breast cancer-related lymphedema is one of the complications resulting from treatment. It is defined as arm oedema in the breast cancer patients caused by interruption of the flow of the axillary lymphatic system from surgery or radiation therapy, which results in the accumulation of fluid in the subcutaneous tissue of the arm, with a decrease in tissue distensibility around the joints and an increased weight of the extremity. Decongestive lymphatic therapy is common management for lymphedema. A program combining skin care, manual lymphatic drainage, exercise, and compression therapy (multilayer bandage or garment) is recognised as the best practice in lymphedema management. Kinesio taping (KT) for lymphatic drainage is a new choice in the field of physical therapy. The material and the original concept of the taping technique were introduced by Dr Kenso Kase in 1973. K-tape had been designed to allow 30-40% longitudinal stretch. It is composed of 100% cotton fibers and acrylic heat sensitive glue. Development of the technique for its administration is still ongoing. The paper discusses the case of a woman with breast cancer, in whom lymphedema occurred. The patient had three weeks of therapy. The treatment consisted of 12 manual lymphatic drainage, 12 pneumatic compressions and 3 applications of the KT method (due to the lack of standard multi-layer bandaging). During the measurement of oedema it was noted that KT had a significant effect on the reduction of lymphedema and accelerates healing effects compared to standard methods. PMID:26327833

  9. Kinesiology Taping reduces lymphedema of the upper extremity in women after breast cancer treatment: a pilot study

    Directory of Open Access Journals (Sweden)

    Iwona Malicka

    2014-09-01

    Full Text Available Introduction : Secondary lymphedema affects approximately 40% of women treated for breast cancer and is recognized as a major problem associated with the therapy of malignant tumors. Consequently, new therapeutic methods are constantly being sought to effectively eliminate the condition. One of the new forms of edema management, especially in the initial stages of edematous development, is Kinesiology Taping (KT. Aim of the study : The aim of the study was to assess the effects of KT applications on the extent of lymphedema of the upper extremity in women post cancer treatment. Material and methods: The study group consisted of 28 women after axillary lymphadenectomy due to breast cancer. All the patients were diagnosed with grade I secondary lymphedema. Kinesiology Taping was applied to a total of 14 randomly selected women. The remaining 14 patients constituted a control group. The extent of lymphedema was measured using a centimeter tape and Limb Volumes Professional 5.0 software. Results : A significant reduction in the extent of lymphedema (p = 0.0009 was achieved in the KT group between baseline and post-treatment assessments. No such reduction, however, was found in the control group (p = 0.36. Conclusions : Kinesiology Taping applications are an effective method of early-stage edema management. Kinesiology Taping may be a safe new therapeutic option in patients who are contraindicated for the use of other methods.

  10. Visual Basic: Pipeline SCADA and enterprise wide management

    Energy Technology Data Exchange (ETDEWEB)

    Verma, R. [Parijat Controlware, Inc., Houston, TX (United States)

    1997-02-01

    Visual Basic (VB), Microsoft`s powerful yet user friendly development environment, has steadily become more accepted and used in Man Machine Interface (MMI) and Supervisory Control and Data Acquisition (SCADA) applications. Known as an easy way to rapidly develop applications for the commercial, financial, and computer games industries, VB is now making its mark in the pipeline SCADA industry. For pipeline operating companies, employing PLCs/Flow computers/Chromatographs as a front for control and data acquisition of pumping stations, meter stations, product delivery terminals, LACT units, gas plants, gathering and production systems, VB is an ideal software package. The author has successfully applied VB for gas pipeline turbine-driven compressor station systems with over 4,000 alarms, 200+ analog inputs, 60+ PID control loops and 400+ digital I/O, with the process control being delegated to PLCs and VB performing all the MMI functions and any upstream data processing, manipulation and management functions.

  11. Basic Burns Management E-Learning: A New Teaching Tool.

    Science.gov (United States)

    Egro, Francesco M

    2016-11-11

    Burns teaching is organized only in a few medical schools in the United Kingdom. An e-learning tutorial was developed with the objective of incorporating burns teaching within the medical school curriculum. A 33-webpage e-learning was created, covering topics such as local and general response to burns, assessment of burns, first aid, primary and secondary survey, and referral guidelines. Medical student satisfaction was then evaluated using a 12-question feedback survey rated based on a Likert scale from 1 (very poor) to 5 (very good). The 12-question survey was completed by a total of 18 medical students ranging from second to fourth years (second = 17%, third = 22%, fourth = 61%). While only a couple of students had received prior burns teaching, 50% of the cohort had an interest to pursue surgery as a career. The majority of students (72%) would be interested to have an e-learning module on basic burns management in their medical curriculum. The means of all domains specific to the e-learning were rated as "good" or "very good." Students' rating for ease of use was 87%, usefulness was 88%, relevance to the medical curriculum was 90%, clarity and quality of content were 78% and 83%, respectively, design was 79%, and the overall satisfaction with this e-learning was 87%. The "Basic Burns Management" e-learning tutorial can provide an efficient and effective means of information delivery to medical students and junior doctors, allowing easy and fast incorporation of burns teaching within the medical curriculum and in other medical teaching settings.

  12. Topical tacrolimus for the treatment of secondary lymphedema

    Science.gov (United States)

    Gardenier, Jason C.; Kataru, Raghu P.; Hespe, Geoffrey E.; Savetsky, Ira L.; Torrisi, Jeremy S.; Nores, Gabriela D. García; Jowhar, Dawit K.; Nitti, Matthew D.; Schofield, Ryan C.; Carlow, Dean C.; Mehrara, Babak J.

    2017-01-01

    Secondary lymphedema, a life-long complication of cancer treatment, currently has no cure. Lymphedema patients have decreased quality of life and recurrent infections with treatments limited to palliative measures. Accumulating evidence indicates that T cells play a key role in the pathology of lymphedema by promoting tissue fibrosis and inhibiting lymphangiogenesis. Here using mouse models, we show that topical therapy with tacrolimus, an anti-T-cell immunosuppressive drug, is highly effective in preventing lymphedema development and treating established lymphedema. This intervention markedly decreases swelling, T-cell infiltration and tissue fibrosis while significantly increasing formation of lymphatic collaterals with minimal systemic absorption. Animals treated with tacrolimus have markedly improved lymphatic function with increased collecting vessel contraction frequency and decreased dermal backflow. These results have profound implications for lymphedema treatment as topical tacrolimus is FDA-approved for other chronic skin conditions and has an established record of safety and tolerability. PMID:28186091

  13. Sentinel Lymph Node Biopsy: Quantification of Lymphedema Risk Reduction

    Science.gov (United States)

    2006-10-01

    Quantification of Lymphedema Risk Reduction PRINCIPAL INVESTIGATOR: Andrea L. Cheville, M.D. CONTRACTING ORGANIZATION: University of...Biopsy: Quantification of Lymphedema Risk Reduction 5b. GRANT NUMBER DAMD17-00-1-0649 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Andrea L. Cheville...Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Lymphedema is a common complication of primary breast cancer therapy. It

  14. Lymphedema following cancer therapy in Slovenia: a frequently overlooked condition?

    OpenAIRE

    Rucigaj, Tanja Planinsek; Leskovec, Nada Kecelj; Zunter*, Vesna Tlaker

    2010-01-01

    Introduction Secondary lymphedema following cancer therapy is a frequent, often painful, quality of life disturbing condition, reducing the patients’ mobility and predisposing them to complications, e.g. infections and malignancies. The critical aspect of lymphedema therapy is to start as soon as possible to prevent the irreversible tissue damage. Patients and methods We performed a retrospective study of patients with lymphedema, treated at the Department of Dermatovenereology, University Me...

  15. Primary Upper Limb Lymphedema: Case Report of a Rare Pathology

    Science.gov (United States)

    McFarlane, Michael EC

    2017-01-01

    Introduction Lymphedema is characterized by a defect in the lymphatic system that causes limb swelling. Impaired uptake and transport of lymphatic fluid through lymphatic vessels causes accumulation of protein-rich fluid in the interstitial spaces, which leads to swelling of the limb. Primary lymphedema often presents at birth. The rare cases that arise after age 35 years are described as lymphedema tarda. The great majority of patients with lymphedema have swelling of the lower limbs—upper limb lymphedema is a rare disorder. Case Presentation An 84-year-old woman presented with a 3-year history of unilateral swelling of the right upper limb. There were no constitutional symptoms and no evidence of lymphadenopathy or systemic disease. Blood tests, carcinoembryonic antigen test, computed tomography scans, and venous Doppler ultrasound were all normal. The diagnosis was primary upper limb lymphedema. Discussion The swelling that occurs in upper limb lymphedema is permanent and usually extends to the hand. About one-third of patients with this condition also present with lower limb lymphedema. Thorough investigations are warranted in cases of unilateral upper limb lymphedema to rule out occult malignancy and systemic disease. PMID:28080951

  16. [Secondary lymphedema--the importance of a multidisciplinary team approach].

    Science.gov (United States)

    Heldenberg, Eitan; Bass, Arie

    2013-03-01

    Secondary lymphedema is the most common type of lymphedema. Malignancy, mainly breast carcinoma, is the main cause of upper extremity lymphedema, while groin dissection, irradiation and trauma are the cause of lower extremity lymphedema. Early recognition of the pathology followed by early referral to a vascular surgeon, leading a multidisciplinary team, who takes care of those patients, can prevent a miserable Life from these patients. Lifelong commitment of the patients, prolonged financial support of the health insurance supplier, as well as team work of the group taking care of the patient, is the only way to help these patients.

  17. The Health Deviation of Post-Breast Cancer Lymphedema: Symptom Assessment and Impact on Self-Care Agency.

    Science.gov (United States)

    Armer, Jane M; Henggeler, Mary H; Brooks, Constance W; Zagar, Eris A; Homan, Sherri; Stewart, Bob R

    2008-01-01

    (38-39% lymphedema occurrence), with symptom report being the earliest predictor of lymphedema occurrence than any other measurement. Findings verify the importance of subjective assessment by symptom report of limb changes and SCD following breast cancer treatment as an essential tool in early detection and treatment of lymphedema. Findings also support the importance of pre-operative baseline measurements, symptom history, and SCA for later post-op comparisons. These preliminary findings underscore the importance of strengthening SCA by educating breast cancer survivors. Self assessment, early detection, and early treatment hold the best promise for optimal management of this chronic condition, limiting detrimental effects on SCA, and improving quality of life and physiological and psychosocial well-being. These findings lay the foundation for a clinical research program in breast cancer lymphedema based on SCDNT in which education in and awareness for self-report of lymphedema-associated symptoms is a first step in screening. Increasing patient knowledge through education will increase SCA by identifying ane providing information to meet self-care requisites (SCR) related to the health deviation of lymphedema. The nurse has the opportunity to assist patients in developing self-care actions as needed to meet universal and health deviation therapeutic requisites to address self-care demands following breast cancer treatment.

  18. FILAR I AL LYMPHEDEMA LOWER LIMB DEBULKING 34 CASES

    Directory of Open Access Journals (Sweden)

    Baburao

    2015-10-01

    Full Text Available There are various treatment options in the management of filarial lymphedema of the lower extremities. The end point, regardless of the method adopted is a reduction of the girth of the limb, prevention of future increases in limb girth, prevention of recurrent episodes of streptococcal cellulitis; more important the treatment method used should not lead to any secondary problems that may far out shadow the primary co Majority of the methods adopted are mainly of the secondary prevention kind; very few of the procedures to date cure the disease condition. A few of the methods have been historically found to be more effective than the others; this may be real or apparent as the methodology of - reporting swelling in the lower limb may not have been consistent and there are too many variables to consider. This study seeks to evaluate the efficacy of one such treatment protocol for the management of filarial lymphedema of the lower limb 80 patients were admitted for filarial lymphedema of the lower limbs from 2005 to 2015 Of these 42 patients underwent surgical treatment; operative records for 8 of these patients was insufficient to analyse; among the remaining 34 patients 19 patients were unavailable for review. This left us a patient population of 15 for the final analysis . The surgical treatment of all of the 15 patients was identical, after preop preparation by using compression ba n dages to soften the edema along with a period of bed rest debulking of excess skin and subcutaneous tissue and primary closure was done. The intro operative application of Esmarch bandages helped in expelling fluid from the tissues and this ensured that closure was obtained with no tension at the margins. Patients were kept for at least 5 days post op before discharge; the routine use of compression crepe bandages postop along with bed rest ensured that we did not have a single case of skin necrosis or wound disruption in the postop period. All patients were given

  19. A case of fatal necrotizing fasciitis arising from chronic lymphedema.

    Science.gov (United States)

    Jun, Young Joon; Kang, In Sook; Lee, Jung Ho; Kim, Sue Min; Kim, Young Jin

    2013-12-01

    Chronic lymphedema and lymphangitis are common adverse effects following treatment for gynecological cancer. Because the early symptoms of necrotizing fasciitis are similar to those of lymphangitis, fatal outcome can occur if patients or physicians underestimate this condition. Here, we present a case of necrotizing fasciitis in a patient with chronic lymphedema.

  20. Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Huang Tsai-Wei

    2013-01-01

    Full Text Available Abstract Background Lymphedema is a common complication of axillary dissection for breast cancer. We investigated whether manual lymphatic drainage (MLD could prevent or manage limb edema in women after breast-cancer surgery. Methods We performed a systematic review and meta-analysis of published randomized controlled trials (RCTs to evaluate the effectiveness of MLD in the prevention and treatment of breast-cancer-related lymphedema. The PubMed, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro, SCOPUS, and Cochrane Central Register of Controlled Trials electronic databases were searched for articles on MLD published before December 2012, with no language restrictions. The primary outcome for prevention was the incidence of postoperative lymphedema. The outcome for management of lymphedema was a reduction in edema volume. Results In total, 10 RCTs with 566 patients were identified. Two studies evaluating the preventive outcome of MLD found no significant difference in the incidence of lymphedema between the MLD and standard treatment groups, with a risk ratio of 0.63 and a 95% confidence interval (CI of 0.14 to 2.82. Seven studies assessed the reduction in arm volume, and found no significant difference between the MLD and standard treatment groups, with a weighted mean difference of 75.12 (95% CI, −9.34 to 159.58. Conclusions The current evidence from RCTs does not support the use of MLD in preventing or treating lymphedema. However, clinical and statistical inconsistencies between the various studies confounded our evaluation of the effect of MLD on breast-cancer-related lymphedema.

  1. Basic HR Risk Management Principles in Digital Libraries

    OpenAIRE

    Mirembe, Florence

    2009-01-01

    Human beings are responsible for causing risk as well as mitigating risk. This paper focuses on the human resources management risk remedies for digital libraries. Risk management aims at identifying, assessing and resolving risk items before they become disasters to an organization or digital library. Effective risk management plans should include short-term and long-term risks to project schedules, costs, and the functionality, adequacy and quality of project deliverables. Risks can bec...

  2. Basic concepts of philosophy of management and corporations

    DEFF Research Database (Denmark)

    Rendtorff, Jacob Dahl

    2013-01-01

    This chapter presents some fundamental concepts of the philosophy of management and corporations by addressing the problem of corporate legitimacy and Immanuel Kant’s distinction between theoretical, practical, and aesthetic reason and judgment. This chapter begins with a general definition...... of philosophy of management and corporations and continues by presenting its ontological and epistemological underpinnings. This approach is used to address the relation between economics, business ethics, and philosophy of management. Finally, ethical and aesthetic judgment is presented as the mediator between...... theoretical, aesthetic, and practical reason in philosophy of management....

  3. Essentials of Risk Management. Strategic Decisions. Board Basics.

    Science.gov (United States)

    Sonenstein, Burton; Kumin, Laura A.

    1998-01-01

    This booklet, intended for trustees of institutions of higher education, offers some instruction on the principles of risk management. Introductory information provides a definition of risk management, which is seen as a planning and strategic function, not solely as a financial or safety assessment. Individual sections then address the following…

  4. Quantitative lymphoscintigraphy in post-mastectomy lymphedema: correlation with circumferential measurements

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Young; Lee, Kyung Han; Kim, Sang Eun; Kim, Byung Tae; Hwang, Jee Hea; Lee, Byung Boong [Samsung Medical Center, Seoul (Korea, Republic of)

    1997-07-01

    An objective measure for the severity and progression is important for the management of lymphedema. To evaluate the usefulness of lympho-scintigraphy in this regard, we compared various quantitative indices from upper extremity lymphoscintigraphy with circumferential measurements, before and after physiotheraphy. Upper extremity lymphoscintigraphy was performed in 38 patients with unilateral postmastectomy lymphedema. Tc-99m antimony sulfide colloid (37 MBq) was injected s.c. into the second and third interdigital spaces. The injection sites were imaged immediately after injection. After standardized exercise for 15 min, upper extremity images were acquired 30 min, 1 hr and 2 hr after injection. The clearance of the injection site (CL), and % uptake in regional lymph nodes (%LN) and soft tissue of the extremity (i.e., the degree of dermal backflow) (%EXT) compared to the initial injection site were calculated. Circumference of each extremity was measured at 7 levels; the severity of lymphedema was expressed as the percentage difference of total circumferential difference (TCD) between healthy and edematous extremities compared to the total circumference of healthy extremity (%TCD). In 19 patients who received physiotherapy, the therapeutic effect was measured by % decrease of TCD (%DTCD) before and after therapy (Raines. et al., 1977). The quantitative indices calculated in the image at 2 hr p.i. had better correlation with either %TCD or %DTCD than those from earlier images (Table). The CL, %LN and %EXT of edematous extremity had a significant correlation with TCD. The %EXT was correlated best with either TCD or %DTCD. The results suggest that the %EXT which corresponds to the degree of dermal backflow may be a simple and useful quantitative index for evaluating the severity and progression in lymphedema and predicting the effect of therapy.

  5. Basic Proactive DMSMS Management with Anti-Counterfeiting Considerations

    Science.gov (United States)

    2010-10-01

    Guidebook (DAG) • DOD 4140.1-R, “DOD Supply Chain Management Regulation”, 2003. • Total Life Cycle System Management (TLCSM), “ Plan of Action and... action Quantifies economic value in terms of Return on Investment (ROI) and Break Even Point ( BEP ) Generates two alternatives: reactive approach and...system’s … support capability.” • The DoD Requirement: “DoD Components shall proactively take … actions to identify and minimize the DMSMS impact

  6. [Basic research on digital logistic management of hospital].

    Science.gov (United States)

    Cao, Hui

    2010-05-01

    This paper analyzes and explores the possibilities of digital information-based management realized by equipment department, general services department, supply room and other material flow departments in different hospitals in order to optimize the procedures of information-based asset management. There are various analytical methods of medical supplies business models, providing analytical data for correct decisions made by departments and leaders of hospital and the governing authorities.

  7. Evaluation of the effectiveness of kinesio taping application in a patient with secondary lymphedema in breast cancer: a case report

    Directory of Open Access Journals (Sweden)

    Jakub Taradaj

    2014-03-01

    Full Text Available Breast cancer-related lymphedema is one of the complications resulting from treatment. It is defined as arm oedema in the breast cancer patients caused by interruption of the flow of the axillary lymphatic system from surgery or radiation therapy, which results in the accumulation of fluid in the subcutaneous tissue of the arm, with a decrease in tissue distensibility around the joints and an increased weight of the extremity. Decongestive lymphatic therapy is common management for lymphedema. A program combining skin care, manual lymphatic drainage, exercise, and compression therapy (multilayer bandage or garment is recognised as the best practice in lymphedema management. Kinesio taping (KT for lymphatic drainage is a new choice in the field of physical therapy. The material and the original concept of the taping technique were introduced by Dr Kenso Kase in 1973. K-tape had been designed to allow 30-40% longitudinal stretch. It is composed of 100% cotton fibers and acrylic heat sensitive glue. Development of the technique for its administration is still ongoing. The paper discusses the case of a woman with breast cancer, in whom lymphedema occurred. The patient had three weeks of therapy. The treatment consisted of 12 manual lymphatic drainage, 12 pneumatic compressions and 3 applications of the KT method (due to the lack of standard multi-layer bandaging. During the measurement of oedema it was noted that KT had a significant effect on the reduction of lymphedema and accelerates healing effects compared to standard methods.

  8. Maintenance information management using access/visual basic

    Energy Technology Data Exchange (ETDEWEB)

    Michael A. Memory, Brad W. Cumbia, TJNAF

    1998-05-01

    The Accelerator Electronic Support Group (AES) is the group responsible for maintaining over 100 subsystems of the Nuclear Physics Accelerator at Jefferson Lab. Presently, there are 30 employees in the AES group. It is each individual's responsibility to make entries into the AES Database. This Access/Visual Basic based database is the center for all work performed to the Accelerator by the AES group. At any time, an AES technologist can supply valuable information needed to track pending maintenance, data analysis of recurring problems, inventory tracking and the ability to export all of this information to a web based electronic log generated by Jefferson Lab Operations Group.

  9. Cancer pain management: Basic information for the young pain physicians

    Directory of Open Access Journals (Sweden)

    SPS Rana

    2011-01-01

    Full Text Available Cancer pain is multifactorial and complex. The impact of cancer pain is devastating, with increased morbidity and poor quality of life, if not treated adequately. Cancer pain management is a challenging task both due to disease process as well as a consequence of treatment-related side-effects. Optimization of analgesia with oral opioids, adjuvant analgesics, and advanced pain management techniques is the key to success for cancer pain. Early access of oral opioid and interventional pain management techniques can overcome the barriers of cancer pain, with improved quality of life. With timely and proper anticancer therapy, opioids, nerve blocks, and other non-invasive techniques like psychosocial care, satisfactory pain relief can be achieved in most of the patients. Although the WHO Analgesic Ladder is effective for more than 80% cancer pain, addition of appropriate adjuvant drugs along with early intervention is needed for improved Quality of Life. Effective cancer pain treatment requires a holistic approach with timely assessment, measurement of pain, pathophysiology involved in causing particular type of pain, and understanding of drugs to relieve pain with timely inclusion of intervention. Careful evaluation of psychosocial and mental components with good communication is necessary. Barriers to cancer pain management should be overcome with an interdisciplinary approach aiming to provide adequate analgesia with minimal side-effects. Management of cancer pain should comprise not only a physical component but also psychosocial and mental components and social need of the patient. With risk-benefit analysis, interventional techniques should be included in an early stage of pain treatment. This article summarizes the need for early and effective pain management strategies, awareness regarding pain control, and barriers of cancer pain.

  10. [Basic considerations during outsourcing of clinical data management services].

    Science.gov (United States)

    Shen, Tong; Liu, Yan

    2015-11-01

    With worldwide improvements in the regulations of international and domestic clinical trial conductions, the quality of clinical trials and trial data management are receiving a great deal of attention. To ensure the quality of clinical trials, maintain business flexibilities and effectively utilize internal and external resources, the outsourcing model is used in the management of clinical data in operation of pharmaceutical companies. The essential criteria of a successful outsourcing mode in clinical trial are selection of qualified contract research organizations (CRO); establishment of appropriate outsourcing model, and generation of effective quality control systems to ensure the authenticity, integrity and accuracy of the clinical trial data.

  11. Basic Energy Conservation and Management--Part 2: HVAC

    Science.gov (United States)

    Krueger, Glenn

    2012-01-01

    Reducing school district energy expenditures has become a universal goal, and new technologies have brought greater energy efficiencies to the school environment. In Part 1 of this two-part series, the author discussed the steps required to establish an energy conservation and management program with an emphasis on lighting. In this article, he…

  12. Seroma indicates increased risk of lymphedema following breast cancer treatment

    DEFF Research Database (Denmark)

    Toyserkani, Navid Mohamadpour; Jørgensen, Mads Gustaf; Haugaard, Karen

    2017-01-01

    Introduction Lymphedema is one of the most serious complications following breast cancer treatment. While many risk factors are well described the role of seroma formation has recently produced mixed results. Therefore, we aimed to evaluate if seroma is a risk factor for development of lymphedema...... in one of the largest retrospective cohort studies. Material and methods We included all patients with unilateral breast cancer treated in the period of 2008-2014. Data regarding treatment and breast cancer characteristics were retrieved from the national breast cancer registry. Data regarding lymphedema...... treatment and seroma aspirations were retrieved from local treatment codes. Results In total 1822 patients were included of which 291 developed lymphedema. Multivariate cox regression analysis showed that seroma was an independent risk factor (HR 1.92 CI 1.30-2.85, p= 0.001). Other independent risk factors...

  13. Lymphedema: What Every Woman with Breast Cancer Should Know

    Science.gov (United States)

    ... Signs and symptoms of this problem include redness, warmth, fever, pain, and flu-like symptoms. This is ... covered. Mild lymphedema should be treated by a physical therapist or other health care professional who has ...

  14. Quality management in radiology: historical aspects and basic definitions.

    Science.gov (United States)

    Erturk, Sukru Mehmet; Ondategui-Parra, Silvia; Ros, Pablo R

    2005-12-01

    In today's extremely competitive economic environment, the quality management processes used by industrial companies have become commonplace at hospitals and are proving successful in improving quality and controlling costs. Continuous quality improvement (CQI) methods provide a relatively new way, compared with quality assurance (QA) and quality control (QC) methods, to improve the quality of health care. Continuous quality improvement should be considered a philosophy rather than simply a methodology; it assumes no endpoints in improvement efforts and does not attempt to replace the older concepts of QA and QC but rather to reap their benefits and take them to a higher conceptual level. Continuous quality improvement has 4 foci: (1) to determine and meet the needs of patients and customers, (2) to approach quality improvement holistically on the basis of the identification of the underlying cause of poor performance, (3) to apply fact-based management and scientific methodology, and (4) to empower its practitioners to improve quality on a daily basis. Health care institutions and radiology departments use a variety of CQI systems or models, including the model of the Joint Commission on Accreditation of Healthcare Organizations, the Six Sigma model, and the Model for Business Excellence of the European Foundation for Quality Management. The International Organization for Standardization 9000, which creates a suitable organizational environment for the implementation of a CQI system, can be considered an effective QA and QC method.

  15. Future Research Priorities for Morbidity Control of Lymphedema

    Science.gov (United States)

    Narahari, S R; Aggithaya, Madhur Guruprasad; Moffatt, Christine; Ryan, T J; Keeley, Vaughan; Vijaya, B; Rajendran, P; Karalam, S B; Rajagopala, S; Kumar, N K; Bose, K S; Sushma, K V

    2017-01-01

    Background: Innovation in the treatment of lower extremity lymphedema has received low priority from the governments and pharmaceutical industry. Advancing lymphedema is irreversible and initiates fibrosis in the dermis, reactive changes in the epidermis and subcutis. Most medical treatments offered for lymphedema are either too demanding with a less than satisfactory response or patients have low concordance due to complex schedules. A priority setting partnership (PSP) was established to decide on the future priorities in lymphedema research. Methods: A table of abstracts following a literature search was published in workshop website. Stake holders were requested to upload their priorities. Their questions were listed, randomized, and sent to lymphologists for ranking. High ranked ten research priorities, obtained through median score, were presented in final prioritization work shop attended by invited stake holders. A free medical camp was organized during workshop to understand patients’ priorities. Results: One hundred research priorities were selected from priorities uploaded to website. Ten priorities were short listed through a peer review process involving 12 lymphologists, for final discussion. They were related to simplification of integrative treatment for lymphedema, cellular changes in lymphedema and mechanisms of its reversal, eliminating bacterial entry lesions to reduce cellulitis episodes, exploring evidence for therapies in traditional medicine, improving patient concordance to compression therapy, epidemiology of lymphatic filariasis (LF), and economic benefit of integrative treatments of lymphedema. Conclusion: A robust research priority setting process, organized as described in James Lind Alliance guidebook, identified seven priority areas to achieve effective morbidity control of lymphedema including LF. All stake holders including Department of Health Research, Government of India, participated in the PSP. PMID:28216723

  16. MR features in lymphedema and phlebedema of extremities

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jeong Hee; Moon, Tae Myung; Kim, Chang Soo; Chung, Chun Phil [Maryknoll Hospital, Pusan (Korea, Republic of)

    1994-10-15

    Authors analyzed the MR findings of swollen extremities to evaluate the MR features of lymphedema and phlebedema. We reviewed MR imagings of 17 cases of swollen extremities, including 12 lymphedemas and 5 phlebedemas. We obtained axial T1-, T2-, and Gd-DTPA enhanced T1WIs using 1.0 T superconducting magnet and measured cross-sectional areas of subcutaneous and subfascial tissues of a slice with grossly largest cross-sectional area using perimeter. We also analyzed change in the signal intensities of the subcutaneous and subfascial tissues on T2WI, presence of enhancement on Gd-PTDA enhanced T1WI, and presence of skin thickening. Both subcutaneous and subfascial tissues of swollen extremities were increased in the cross-sectional areas than those of contralateral normal side. The subcutaneous compartment in lymphedema was statistically significantly increased in cross-sectional area than subfascial compartment in lymphedema(p<0.005) and subcutaneous tissue in phlebedema (p<0.05). Increased signal intensities and characteristic 'honeycomb appearance' of subcutaneous tissue in the lymphedema were specific findings on T2WI. MR imaging was useful and noninvasive method in the diagnosis of swollen extremities. There were increased cross-sectional area of subcutaneous compartment with 'honeycomb appearance' in lymphedema and increased signal intensities of both subcutaneous and subfascial compartment in phlebedema on the T2WI.

  17. Insecticide Resistance: Challenge to Pest Management and Basic Research

    Science.gov (United States)

    Brattsten, L. B.; Holyoke, C. W.; Leeper, J. R.; Raffa, K. F.

    1986-03-01

    The agricultural use of synthetic insecticides usually protects crops but imposes strong selection pressures that can result in the development of resistance. The most important resistance mechanisms are enhancement of the capacity to metabolically detoxify insecticides and alterations in target sites that prevent insecticides from binding to them. Insect control methods must incorporate strategies to minimize resistance development and preserve the utility of the insecticides. The most promising approach, integrated pest management, includes the use of chemical insecticides in combination with improved cultural and biologically based techniques.

  18. Brand Evaluation - A Basic Feature in Modern Brand Management

    Directory of Open Access Journals (Sweden)

    Cosmin IRIMIEŞ

    2012-10-01

    Full Text Available Defined as the sum of features that make a subject unique, the brand has turned into one of the most important characteristics of the way products, services and institutions conduct their public relations or are presented to the contemporary consumer. Taking into consideration that branding is an extremely flexible process and can be applied to a very wide range of subjects, the brand management has become one of the most important instruments of modern marketing and is used in every selling/buying transaction. The purpose of this article is to make a comprehensive analysis of the evaluation methods of brands, to present the situations that usually need a brand evaluation as well as to see whether Romania has made any progress from this point of view.

  19. Compulsive masturbation and chronic penile lymphedema.

    Science.gov (United States)

    Calabrò, Rocco Salvatore; Galì, Alessandro; Marino, Silvia; Bramanti, Placido

    2012-06-01

    Chronic penile lymphedema arises from the abnormal retention of lymphatic fluid in the subcutaneous tissues and may be secondary to local and systemic medical conditions such as sexually transmitted diseases, filariasis, malignancy, local radiotherapy, and surgery. This case report aims to consider compulsive masturbation as a possible cause of chronic penile edema. A 40-year-old man was referred to our institute for behavioral disturbance, including compulsive masturbation. Neuropsychiatric evaluation showed moderate mental retardation, mild dysarthria and limb incoordination, anxiety, depressed mood, and impulse dyscontrol. Brain MRI pointed out diffuse white matter lesions. Urogenital examination revealed an uncircumcised penis with non-tender edema of the shaft and prepuce with areas of lichenification. Since the most common local and systemic causes of edema were excluded, chronic penile edema due to compulsive masturbation was diagnosed and the compulsive behavior treated with an antidepressant and low-dose neuroleptics. Compulsive masturbation should be taken into account when counselling patients with penile edema.

  20. Essentials of Airway Management, Oxygenation, and Ventilation: Basic Equipment and Devices.

    Science.gov (United States)

    Becker, Daniel E; Rosenberg, Morton B; Phero, James C

    2015-01-01

    Offices and outpatient dental facilities must be properly equipped with devices for airway management, oxygenation, and ventilation. Optimizing patient safety using crisis resource management involves the entire dental office team being familiar with airway rescue equipment. Basic equipment for oxygenation, ventilation, and airway management is mandated in the majority of U.S. dental offices, per state regulations. The immediate availability of this equipment is especially important during the administration of sedation and anesthesia, as well as the treatment of medical urgencies/emergencies. This article reviews basic equipment and devices essential in any dental practice, whether providing local anesthesia alone or in combination with procedural sedation.

  1. Factors Associated With External and Internal Lymphedema in Patients With Head-and-Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Deng Jie, E-mail: jie.deng@vanderbilt.edu [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Ridner, Sheila H. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States); Dietrich, Mary S. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States); Department of Biostatistics, School of Medicine, Vanderbilt University, Nashville, Tennessee (United States); Wells, Nancy; Wallston, Kenneth A. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Sinard, Robert J.; Cmelak, Anthony J.; Murphy, Barbara A. [Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States)

    2012-11-01

    Purpose: The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). Methods and Materials: The sample included 81 patients {>=}3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. Results: The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Conclusions: Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC.

  2. A Leading Role in Lymphedema Awareness | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Lymphedema A Leading Role in Lymphedema Awareness Past Issues / Fall 2016 Table of Contents ... director Kathy Bates. Photo: Keith Muryan You developed lymphedema after surgery for breast cancer. When did you ...

  3. Assesment of Lymphedema Risk Following Lymph Node Dissection and Radiation Therapy for Primary Breast Cancer

    Science.gov (United States)

    2008-09-01

    AD_________________ Award Number: DAMD17-03-1-0622 TITLE: Assesment of Lymphedema Risk Following...01-09-2008 2. REPORT TYPE Annual Summary 3. DATES COVERED (From - To) 11 AUG 2007 - 10 AUG 2008 4. TITLE AND SUBTITLE Assesment of Lymphedema ...14. ABSTRACT Lymphedema is a common, chronic, and potentially devastating complication of primary breast cancer therapy. Radiation increases

  4. Assessment of Risk Reduction for Lymphedema Following Sentinel Lymph Noded Guided Surgery for Primary Breast Cancer

    Science.gov (United States)

    2006-10-01

    Lymphedema Following Sentinel Lymph Noded Guided Surgery for Primary Breast Cancer PRINCIPAL INVESTIGATOR: Andrea L. Cheville, M.D...5a. CONTRACT NUMBER Assessment of Risk Reduction for Lymphedema Following Sentinel Lymph Noded Guided Surgery for Primary Breast Cancer 5b...14. ABSTRACT Lymphedema is a common complication of primary breast cancer therapy. It is a chronic, insidiously progressive, and potentially

  5. Complex Decongestive Physiotherapy Treats Skin Changes like Hyperkeratosis Caused by Lymphedema

    Directory of Open Access Journals (Sweden)

    Hande Kaba

    2012-01-01

    Full Text Available Lymphedema is a chronic, progressive, and often debilitating condition. Primary lymphedema is a lymphatic malformation developing during the later stage of lymph angiogenesis. Secondary lymphedema is the result of obstruction or disruption of the lymphatic system, which can occur as a consequence of tumors, surgery, trauma, infection, inflammation, and radiation therapy. Here, we report a 64-year-old woman presenting with hyperkeratosis, a lymphedema due to metastatic uterus carcinoma. In this paper, we present the effects of complex decongestive physiotherapy on lymphedema and hyperkeratosis.

  6. Analysis of theoretical basics of internal communications as a necessary condition effective management of enterprise

    Directory of Open Access Journals (Sweden)

    L.Yu. Sager

    2011-01-01

    Full Text Available The article is devoted to the use of communications in terms of management of information and interpersonal interaction in the domestic enterprise level. in the article the basic theoretical aspects of internal communications in the enterprise management system as part of its efficient functioning: clarified the essence of the concept of "communication"; systematized the advantages and disadvantages of internal communications of the enterprises, and their goals on the enterprise; systematized the barriers to effective communication process.

  7. Mutations in the VEGFR3 signaling pathway explain 36% of familial lymphedema

    DEFF Research Database (Denmark)

    Mendola, A; Schlögel, M J; Ghalamkarpour, A

    2013-01-01

    Lymphedema is caused by dysfunction of lymphatic vessels, leading to disabling swelling that occurs mostly on the extremities. Lymphedema can be either primary (congenital) or secondary (acquired). Familial primary lymphedema commonly segregates in an autosomal dominant or recessive manner. It can...... also occur in combination with other clinical features. Nine mutated genes have been identified in different isolated or syndromic forms of lymphedema. However, the prevalence of primary lymphedema that can be explained by these genetic alterations is unknown. In this study, we investigated 7...... of these putative genes. We screened 78 index patients from families with inherited lymphedema for mutations in FLT4, GJC2, FOXC2, SOX18, GATA2, CCBE1, and PTPN14. Altogether, we discovered 28 mutations explaining 36% of the cases. Additionally, 149 patients with sporadic primary lymphedema were screened for FLT4...

  8. Effect of physical therapy on breast cancer related lymphedema

    DEFF Research Database (Denmark)

    Tambour, Mette; Tange, Berit; Christensen, Robin Daniel Kjersgaard

    2014-01-01

    BACKGROUND: Physical therapy treatment of patients with lymphedema includes treatment based on the principles of 'Complete Decongestive Therapy' (CDT). CDT consists of the following components; skin care, manual lymphatic drainage, bandaging and exercises. The scientific evidence regarding what...... type of treatment is most effective is sparse. The objective of this study is to investigate whether CDT is equally effective if it includes manual lymphatic drainage or not in the treatment of arm lymphedema among patients with breast cancer. METHODS/DESIGN: A randomized, single-blind, equivalence...... trial. A total of 160 breast cancer patients with arm lymphedema will be recruited from 3 hospitals and randomized into one of two treatment groups A: Complete Decongestive Therapy including manual drainage or B: Complete Decongestive Therapy without manual lymphatic drainage. The intervention period...

  9. Transnodal Lymphangiography in the Diagnosis and Treatment of Genital Lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Gomez, F. M., E-mail: gomez_fermun@gva.es; Martinez-Rodrigo, J.; Marti-Bonmati, L. [Hospital Universitario y Politecnico La Fe, Servicio de Radiologia (Spain); Santos, E. [University of Pittsburgh, Department of Radiology (United States); Forner, I. [Hospital Universitario y Politecnico La Fe, Servicio de Medicina Fisica y Rehabilitacion (Spain); Lloret, M.; Perez-Enguix, D.; Garcia-Marcos, R. [Hospital Universitario y Politecnico La Fe, Servicio de Radiologia (Spain)

    2012-12-15

    Purpose: To report the success of groin nodal lymphography in the diagnosis and treatment of genital lymphedema. Methods and Materials: We present one female (8 years old [patient no. 1]) and two male (69 and [patient no. 2] 31 years old [patient no. 3], respectively) patients with genital lymphedema in whom conservative treatment failed. The girl also had lymphorrhagia. Genital lymphedema was caused by radical cystectomy (patient no. 2), lymphatic hyperplasia (patient no. 1), and idiopathic lymphangitis (patient no. 3). All of them underwent ultrasound-guided bilateral groin lymph node puncture. Afterward, 4-8 ml Lipiodol Ultra-Fluide (Guerbet) were injected at a rate of 0.2 ml/s. Lipiodol progression was assessed by fluoroscopy. Computed tomography scan of the abdomen and pelvis was performed immediately after and again at 24 h after the procedure to confirm the leak. The follow-up period was 15, 13, and 9 months, respectively. Technical success was considered as bilateral pelvic and abdominal filling of lymphatic vessels. Therapeutic success was considered as improvement or disappearance of genital lymphedema and/or lymphorrhagia. Results: Lipiodol leak to the scrotum was observed in patients no. 2 and 3. Lymphaticopelvic fistula and genital lymphatic hyperplasia were seen in patient no. 1. Genital lymphedema diminished within 1 week and almost disappeared in two cases (patients no. 1 and 3) or significantly improved (patient no. 2). lymphorrhagia also resolved in patient no. 1. No recurrence or worsening was detected during follow-up. Conclusion: Therapeutic lymphangiography by lymph node injection seems to be effective to treat genital lymphedema. Lymph node puncture lymphangiography is feasible and less cumbersome than pedal lymphangiography.

  10. Essentials of airway management, oxygenation, and ventilation: part 1: basic equipment and devices.

    Science.gov (United States)

    Becker, Daniel E; Rosenberg, Morton B; Phero, James C

    2014-01-01

    Offices and outpatient dental facilities must be properly equipped with devices for airway management, oxygenation, and ventilation. Optimizing patient safety using crisis resource management (CRM) involves the entire dental office team being familiar with airway rescue equipment. Basic equipment for oxygenation, ventilation, and airway management is mandated in the majority of US dental offices per state regulations. The immediate availability of this equipment is especially important during the administration of sedation and anesthesia as well as the treatment of medical urgencies/emergencies. This article reviews basic equipment and devices essential in any dental practice whether providing local anesthesia alone or in combination with procedural sedation. Part 2 of this series will address advanced airway devices, including supraglottic airways and armamentarium for tracheal intubation and invasive airway procedures.

  11. Role of physiotherapy and patient education in lymphedema control following breast cancer surgery

    Directory of Open Access Journals (Sweden)

    Lu SR

    2015-02-01

    Full Text Available Shiang-Ru Lu,1 Rong-Bin Hong,2 Willy Chou,3,4 Pei-Chi Hsiao3,4 1Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 2Departments of Physical Medicine and Rehabilitation, Chi-Mei Medical Center Liouying Campus, Tainan, Taiwan; 3Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, Taiwan; 4Department of Recreation and Health Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan Introduction: This retrospective cohort study evaluated whether education in combination with physiotherapy can reduce the risk of breast cancer-related lymphedema (BCRL. Methods: We analyzed 1,217 women diagnosed with unilateral breast cancer between January 2007 and December 2011 who underwent tumor resection and axillary lymph node dissection. The patients were divided into three groups: Group A (n=415, who received neither education nor physiotherapy postsurgery; Group B (n=672, who received an educational program on BCRL between Days 0 and 7 postsurgery; and Group C (n=130, who received an educational program on BCRL between Days 0 and 7 postsurgery, followed by a physiotherapy program. All patients were monitored until October 2013 to determine whether BCRL developed. BCRL risk factors were evaluated using Cox proportional hazards models. Results: During the follow-up, 188 patients (15.4% developed lymphedema, including 77 (18.6% in Group A, 101 (15.0% in Group B, and 10 (7.7% in Group C (P=0.010. The median period from surgery to lymphedema was 0.54 years (interquartile range =0.18–1.78. The independent risk factors for BCRL included positive axillary lymph node invasion, a higher (>20 number of dissected axillary lymph nodes, and having undergone radiation therapy, whereas receiving an educational program followed by physiotherapy was a protective factor against BCRL (hazard ratio =0.35, 95% confidence interval =0.18–0.67, P=0.002. Conclusion: Patient education that begins

  12. Teaching Management and Implementation of Pedagogical Classroom Projects in Basic Education

    Directory of Open Access Journals (Sweden)

    Waldemar Antonio Guerrero Matos

    2006-11-01

    Full Text Available The present article diffuses the results of the oriented study to determine the relationship between the administration of the educational one and the execution of the pedagogic projects of classroom in Basic Education. Theoretically it was based on the constructivismo and the contributions of the National Basic Curriculum. The investigation type was descriptive. The results allowed to corroborate in the teachers, weaknesses in the execution of the Pedagogic Projects of Classroom, evidencing difficulties to the moment to apply the pedagogic abilities. Therefore it is recommended to carry out courses of upgrade to manage with effectiveness this strategy of planning constructivist.

  13. Managing complex, high risk projects a guide to basic and advanced project management

    CERN Document Server

    Marle, Franck

    2016-01-01

    Maximizing reader insights into project management and handling complexity-driven risks, this book explores propagation effects, non-linear consequences, loops, and the emergence of positive properties that may occur over the course of a project. This book presents an introduction to project management and analysis of traditional project management approaches and their limits regarding complexity. It also includes overviews of recent research works about project complexity modelling and management as well as project complexity-driven issues. Moreover, the authors propose their own new approaches, new methodologies and new tools which may be used by project managers and/or researchers and/or students in the management of their projects. These new elements include project complexity definitions and frameworks, multi-criteria approaches for project complexity measurement, advanced methodologies for project management (propagation studies to anticipate potential behaviour of the project, and clustering approaches...

  14. Bridging the divide between pathogenesis and detection in lymphedema.

    Science.gov (United States)

    Dixon, J Brandon; Weiler, Michael J

    2015-02-01

    While our understanding of the lymphatic system has improved substantially in the past few decades, the translation of this knowledge into improved healthcare solutions for patients suffering from secondary lymphedema has been severely limited. The challenge facing clinicians is two-fold. First, there is no reliable, affordable, diagnostic capable of detecting the disease before symptoms of the lymphedema develop and the efficacy of treatment options becomes limited. Second, our understanding of the disease pathogenesis, its risk factors, and the underlying physiologic mechanisms is still in its infancy. These two challenges go hand in hand as limited diagnostic options have hindered our ability to understand lymphedema progression, and the lack of known underlying mechanisms involved in the disease prohibits the development of new diagnostic targets. This review serves to discuss the recent developments in clinical and lab research settings of both lymphedema diagnostic technologies and our understanding of the mechanisms driving disease risk and progression. We will show how these two lines of research are synergistically working with the ultimate goal of improving patient outcomes for those suffering from this horrible disease, identifying key areas of further research that are warranted to move the field forward and provide clinical relief for this neglected patient population.

  15. Adaptive Immune Responses Regulate the Pathophysiology of Lymphedema

    Science.gov (United States)

    2012-09-01

    Center, New York, NY 10065 2. Division of Cardiology , Department of Medicine, Stanford University Medical Center, Stanford, CA 94305-2200 3...supported by those reported by Galkowska and Olszewsk using Giemsa staining of cell smears on lymphatic fluid collected from dogs with chronic lymphedema

  16. MR imaging of primary, secondary, and mixed forms of lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Aastroem, K.G.O.; Abdsaleh, S.; Ahlstroem, K.H. [Univ. Hospital, Uppsala (Sweden). Dept. of Radiology; Brenning, G.C. [Univ. Hospital, Uppsala (Sweden). Dept. of Internal Medicine

    2001-03-01

    Purpose: To describe the pathological features and assess the diagnostic information of different MR sequences in patients with primary, secondary, and mixed (phlebo-, lipophlebo-, or lipolymphedema) forms of lymphedema of the lower leg. Material and Methods: In 26 patients with clinical diagnoses of primary (n=10), pure secondary (n=4), mixed (n=9) and combined secondary and mixed forms of lymphedema (n=3), MR imaging was performed with coronal and axial T1 SE, T2 TSE, fat-suppressed (SPIR) T2 sequences and axial T1 SE after i.v. injection of Gd-DTPA. Results: In 24 patients there was a honeycomb pattern in the subcutis with a signal intensity corresponding to fluid (n=11), fibrosis (n=3), or both (n=10). Five patients with primary lymphedema showed subfascial fluid accumulation. Dermal edema was noted in 23 patients. Fat or edema components in the muscles were mostly seen in patients with phlebolymphedema. The honeycomb pattern was best seen on coronal T1 images, and fluid accumulations on axial SPIR-T2 images. Fibrosis was only assessable from the T2 TSE sequence. Gd-DTPA did not improve the diagnostic information. Conclusion: For evaluation of lymphedema and its mixed forms, an axial T2-weighted SPIR sequence in conjunction with a coronal T1 SE sequence are sufficient.

  17. Breast Cancer-Related Lymphedema: Implications for Family Leisure Participation

    Science.gov (United States)

    Radina, M. Elise

    2009-01-01

    An estimated 20% of breast cancer survivors face the chronic condition of breast cancer-related lymphedema. This study explored the ways in which women with this condition experienced changes in their participation in family leisure as one indicator of family functioning. Participants (N = 27) were interviewed regarding lifestyles before and after…

  18. Lymphaticovenous Anastomosis Releases the Lower Extremity Lymphedema-associated Pain

    Science.gov (United States)

    Hara, Hisako; Zhou, Han Peng; Tange, Shuichi; Kikuchi, Kazuki

    2017-01-01

    Background: We investigate the effectiveness of lymphaticovenous anastomosis (LVA) in releasing lymphedema-associated pain. Methods: We performed a retrospective analysis. Subjects of this study included lower extremity lymphedema patients who presented persistent and constant degrees of pain in their lower limbs. LVA was performed under local anesthesia. The preoperative lower extremity pain and postoperative lower extremity pain were surveyed using the visual analog scale on a score from 0 to 10. The circumferences of the limbs were also recorded. Results: A total of 8 patients (16 lower limbs) were included. The subjects included 1 man and 7 women, and their average age was 72 years. The average follow-up period was 17 months. The average preoperative and postoperative visual analog scale scores were 5.3 and 1.8, respectively. Moreover, 7 patients who had records of their lower extremity circumference observed an average changing rate of −4.7% in lower extremity lymphedema index after the surgery. Conclusion: LVA can release the pain in the affected limbs of lymphedema. PMID:28203506

  19. Shoulder Pain after Fall, Septic Shock, and Pyomyositis Associated with Breast Cancer Chemotherapy and Lymphedema

    Directory of Open Access Journals (Sweden)

    Hiromitsu Kitayama

    2016-11-01

    Full Text Available Background: As a symptom of pyomyositis, sepsis usually follows local inflammation signs. Here, we report pyomyositis with lymphedema of upper extremity in which septic shock and poor local findings initially presented during chemotherapy for breast cancer. Case Report: An 80-year-old woman presented with chronic right shoulder pain during chemotherapy for the recurrent disease. She had a history of postmastectomy lymphedema, diabetes mellitus, and repeated hyaluronic acid injections to the shoulder joint. The pain suddenly worsened with septic shock and no apparent local signs. Magnetic resonance imaging revealed myonecrosis, and no pus was yielded by ultrasound-guided needle aspiration. After 2 weeks of recovery by conservative medical management, surgical drainage was performed. Late formulated massive intramuscular pus showed severe neutrophil infiltration and myonecrosis. Conclusion: Pyomyositis can develop into septic shock with poor local signs. Myelosuppression after chemotherapy can cause myonecrosis without macroabscess, and magnetic resonance imaging was useful for the diagnosis of this condition. When unspecified local pain appears during cancer chemotherapy we should consider this disease, too.

  20. A basic strategy to manage global health with reference to livestock production in Asia.

    Science.gov (United States)

    Hall, David C; Le, Quynh Ba

    2011-01-01

    Newly emerging infectious diseases (nEIDs) have increased rapidly presenting alarming challenges to global health. We argue that for effective management of global health a basic strategy should include at least three essential tactical forms: actions of a directly focused nature, institutional coordination, and disciplinary integration in approaches to health management. Each level of action is illustrated with examples from the livestock sector in Asia. No clear example of all three tactical forms in place can be found from developing countries where food security is a significant threat although Vietnam is developing a comprehensive strategy. Finally, an ecosystem health approach to global health management is advocated; such an approach moves away from the traditional single disciplinary approach. Stronger guidance is needed to direct ecohealth research and application in the management of global health.

  1. A Basic Strategy to Manage Global Health with Reference to Livestock Production in Asia

    Directory of Open Access Journals (Sweden)

    David C. Hall

    2011-01-01

    Full Text Available Newly emerging infectious diseases (nEIDs have increased rapidly presenting alarming challenges to global health. We argue that for effective management of global health a basic strategy should include at least three essential tactical forms: actions of a directly focused nature, institutional coordination, and disciplinary integration in approaches to health management. Each level of action is illustrated with examples from the livestock sector in Asia. No clear example of all three tactical forms in place can be found from developing countries where food security is a significant threat although Vietnam is developing a comprehensive strategy. Finally, an ecosystem health approach to global health management is advocated; such an approach moves away from the traditional single disciplinary approach. Stronger guidance is needed to direct ecohealth research and application in the management of global health.

  2. Providing Basic Needs and Encouragement as Strategies in Managing Aggression in Dementia Clients

    Directory of Open Access Journals (Sweden)

    Retno Lestari

    2014-01-01

    Full Text Available Purpose: The experiences of caregivers in managing dementia clients with aggressive behaviour have been an issue in nursing homes. This study utilized the fact that there is no significant strategy for managing aggression effectively. The aim of the study is to explore the experiences of caregivers in managing dementia clients with aggressive behaviour in nursing home in Jakarta, Indonesia.Method: This study employed a hermeneutic phenomenological approach so that caregivers were able to explore the phenomenon of aggression by dementia residents in the nursing home. Six experienced caregivers were interviewed in this study to uncover caregivers’ strategies they use in managing aggression in dementia residents.Result: The findings in this study were several strategies that have been used by caregivers to manage aggressive behaviour among dementia residents in the nursing home: providing basic needs and encouragement.Conclusion: The findings suggested caregivers to implement the strategies for managing aggression in dementia residents. Due to a limited number of related studies in Indonesia, this study recommended for further research to other nursing homes in Indonesia to determine if other strategies to manage aggression exist.

  3. Liposuction normalizes - in contrast to other therapies - lymphedema-induced adipose tissue hypertrophy.

    Science.gov (United States)

    Brorson, H

    2012-12-01

    The various types of treatment of lymphedema are under discussion and there has been some controversy regarding liposuction for lymphedema. Although it is clear that conservative therapies such as complex decongestive therapy (CDT) and controlled compression therapy (CCT) should be tried in the first instance, options for the treatment of late-stage lymphedema that is not responding to such treatment is not so clear. Improvements in technique, patient preparation, and patient follow-up have led to a greater and a wider acceptance of liposuction as a treatment for lymphedema. This paper outlines the benefits of using liposuction and presents the evidence to support its use.

  4. Regulatory T cell transfer ameliorates lymphedema and promotes lymphatic vessel function

    Science.gov (United States)

    Gousopoulos, Epameinondas; Proulx, Steven T.; Bachmann, Samia B.; Scholl, Jeannette; Dionyssiou, Dimitris; Demiri, Efterpi; Halin, Cornelia; Dieterich, Lothar C.

    2016-01-01

    Secondary lymphedema is a common postcancer treatment complication, but the underlying pathological processes are poorly understood and no curative treatment exists. To investigate lymphedema pathomechanisms, a top-down approach was applied, using genomic data and validating the role of a single target. RNA sequencing of lymphedematous mouse skin indicated upregulation of many T cell–related networks, and indeed depletion of CD4+ cells attenuated lymphedema. The significant upregulation of Foxp3, a transcription factor specifically expressed by regulatory T cells (Tregs), along with other Treg-related genes, implied a potential role of Tregs in lymphedema. Indeed, increased infiltration of Tregs was identified in mouse lymphedematous skin and in human lymphedema specimens. To investigate the role of Tregs during disease progression, loss-of-function and gain-of-function studies were performed. Depletion of Tregs in transgenic mice with Tregs expressing the primate diphtheria toxin receptor and green fluorescent protein (Foxp3-DTR-GFP) mice led to exacerbated edema, concomitant with increased infiltration of immune cells and a mixed TH1/TH2 cytokine profile. Conversely, expansion of Tregs using IL-2/anti–IL-2 mAb complexes significantly reduced lymphedema development. Therapeutic application of adoptively transferred Tregs upon lymphedema establishment reversed all of the major hallmarks of lymphedema, including edema, inflammation, and fibrosis, and also promoted lymphatic drainage function. Collectively, our results reveal that Treg application constitutes a potential new curative treatment modality for lymphedema. PMID:27734032

  5. An Agent-Based Approach for Evaluating Basic Design Options of Management Accounting Systems

    Directory of Open Access Journals (Sweden)

    Friederike Wall

    2013-12-01

    Full Text Available This paper investigates the effectiveness of reducing errors in management accounting systems with respect to organizational performance. In particular, different basic design options of management accounting systems of how to improve the information base by measurements of actual values are analyzed in different organizational contexts. The paper applies an agent-based simulation based on the idea of NK fitness landscapes. The results provide broad, but no universal support for conventional wisdom that lower inaccuracies of accounting information lead to more effective adaptation processes. Furthermore, results indicate that the effectiveness of improving the management accounting system subtly interferes with the complexity of the interactions within the organization and the coordination mode applied

  6. Imaging findings of adiposis dolorosa vs. massive localized lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Petscavage-Thomas, Jonelle M.; Bernard, Stephanie A.; Bennett, Jennifer [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Walker, Eric A. [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Uniformed Services University of the Health Sciences, Department of Radiology and Nuclear Medicine, Bethesda, MD (United States)

    2015-06-01

    Adiposis dolorosa (Dercum's disease) is a condition of benign, painful subcutaneous lipomatous lesions associated with weakness, endocrine and lipid abnormalities, and mental disturbances. There is little information documenting the cross-sectional imaging findings that differentiate it from lipomatous and neoplastic soft tissue masses, or massive localized lymphedema. The purpose of this study was to provide a radiological case series of adiposis dolorosa. A 10-year retrospective review of the picture archiving and communications system was performed. Two musculoskeletal radiologists reviewed images to confirm and document imaging features, location, size, and patient demographics. Medical records were reviewed to characterize patients into three groups: one group met at least three of the four criteria of Dercum's syndrome, the second group met less than three criteria, and the third group had clinical diagnosis of cellulitis of the lower extremity. Seventeen cases (25 masses) of adiposis dolorosa were found, nine cases of which met at least three criteria of Dercum's syndrome. All cases in the first two groups demonstrated skin thickening and lymphedema of subcutaneous fat, which was fluid attenuation on CT and low or intermediate T1-weighted and high STIR/T2-weighted MR signal. Two cases with pathology showed mild fatty infiltration with fibrous septa, and the third case showed massive localized lymphedema. The third group of ten cellulitis patients demonstrated non-mass-like subcutaneous edema with similar CT attenuation and MR signal characteristics to the first two groups, but differed by the presence of post-contrast enhancement and non-mass-like appearance in 90 %. Imaging findings of adiposis dolorosa and massive localized lymphedema overlap, as do the symptoms and pathological features. Due to the mass-like engorgement of the soft tissues and pain, patients will often undergo imaging to exclude neoplasm or infection. Knowledge of these

  7. Fourth annual workshop on management in basic and applied research environments

    Energy Technology Data Exchange (ETDEWEB)

    Bodnarczuk, M.W. [ed.

    1993-11-01

    The struggle to develop quality management concepts that ``map`` onto the cultural and work practices found in basic and applied research environments has been (for better or for worse) an attempt to differentiate basic and applied research from the nuclear industry. In the first (1990) edition of this ``Music Book`` proceedings, almost every laboratory that participated had a quality program that was traceable to, based on, influenced by, or in reaction to the nuclear quality standard ASME-NQA-1. This 1993 edition of the ``Music Book`` is very different in that almost every laboratory has developed a quality program that is based on, traceable to, or heavily influenced by DOE 5700.6C (Quality Assurance) and the DOE Standard; Implementation Guide for Quality Assurance Programs for Basic and Applied Research (DOE-ER-STD-6001-92). In order to construct a context for what follows and properly introduce the contents of this book, we want to briefly recount some of the highlights of the events that brought about this change, from the perspective of one who participated in the process.

  8. The use of a basic safety investment model in a practical risk management context

    Energy Technology Data Exchange (ETDEWEB)

    Aven, Terje, E-mail: terje.aven@uis.no [University of Stavanger (Norway); Hiriart, Yolande [University of Franche-Comte, Besancon (France)

    2011-11-15

    We consider a basic model in economic safety analysis: a firm is willing to invest an amount x in safety measures to avoid an accident A, which in the case of occurrence, leads to a loss of size L. The probability of an accident is a function of x. The optimal value of x is determined by minimizing the expected costs. In the paper, we re-examine this model by adopting a practical risk/safety management perspective. We question how this model can be used for guiding the firm and regulators in determining the proper level of investment in safety. Attention is given to issues like how to determine the probability of an accident and how to take into account uncertainties that extend beyond the expected value. It is concluded that the model, with suitable extensions and if properly implemented, provides a valuable decision support tool. By focusing on investment levels and stimulating thereby the generation of alternative risk-reducing measures, the model is considered particularly useful in risk reduction (ALARP) processes. - Highlights: > It is shown how to use a basic investment model in a practical risk management setting. > The model may be a valuable decision support tool if properly implemented. > It guides decision makers on risk reduction and how to determine what is ALARP. > The model stimulates the generation of alternative risk-reducing measures.

  9. Mutations in KIF11 cause autosomal-dominant microcephaly variably associated with congenital lymphedema and chorioretinopathy

    NARCIS (Netherlands)

    Ostergaard, P.; Simpson, M.A.; Mendola, A.; Vasudevan, P.; Connell, F.C.; Impel, A. van; Moore, A.T.; Loeys, B.L.; Ghalamkarpour, A.; Onoufriadis, A.; Martinez-Corral, I.; Devery, S.; Leroy, J.G.; Laer, L. van; Singer, A.; Bialer, M.G.; McEntagart, M.; Quarrell, O.; Brice, G.; Trembath, R.C.; Schulte-Merker, S.; Makinen, T.; Vikkula, M.; Mortimer, P.S.; Mansour, S.; Jeffery, S.

    2012-01-01

    We have identified KIF11 mutations in individuals with syndromic autosomal-dominant microcephaly associated with lymphedema and/or chorioretinopathy. Initial whole-exome sequencing revealed heterozygous KIF11 mutations in three individuals with a combination of microcephaly and lymphedema from a mic

  10. The Lymphedema and Gynecologic Cancer (LEG) Study: Incidence, Risk Factors, and | Division of Cancer Prevention

    Science.gov (United States)

    DESCRIPTION (provided by applicant): The proposed study, "Lymphedema and Gynecologic cancer (LEG): Incidence, Risk Factors and Impact", will innovatively utilize the cooperative group setting of the GOG (Gynecologic Oncology Group) to prospectively study 1300 women newly diagnosed with cervical, endometrial, or vulvar cancer to determine the incidence and impact of lower extremity lymphedema following surgical treatment of these diseases. |

  11. EFFECTS OF MICROWAVE TREATMENT ON THE LYMPHOCYTESUBSETS IN CASES OF CHRONIC LYMPHEDEMA OF EXTREMITIES

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To determine the immune status of T lymphocyte subsets of patients with chronic lymphedema of extremities and the effects of microwave treatment. Methods Patients with lymphedema of extremities (n=20) and normal volunteers (n=10) were studied by fluorescein isothiocyanate (FITC) or phycoerythrin (PE)-conjugated monoclonal antibo dies (MoAbs) and dual color flow cytometry to examine the changes of lymphocyte phenotypes in them before and after treat ment. Results The percentage of CD4+ T lymphocytes and CD4+ /CD8+ T cell ratios in lymphedema group were less than those in control group before treatment. They increased significantly and restored to nearly normal level after microwave treatment. The percentage of CD8+ and HLA-DR + T lymphocytes in lymphedema group also demonstrated significant decline after treat ment. Conclusion Disorder of T lymphocyte subsets existed in patients with chronic lymphedema of extremities, and mi crowave treatment can improve the states and enhance the cellular immunity of the patients.

  12. Waste management plan for pipeline construction works: basic guideline for its preparation

    Energy Technology Data Exchange (ETDEWEB)

    Serricchio, Claudio; Caldas, Flaviana V. [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil); Souza, Izabel C.A. de; Araujo, Ronaldo G. de [TELSAN, Rio de Janeiro, RJ (Brazil); Souza, Tania Mara [IMC-SASTE, Sao Paulo,SP (Brazil); Veronez, Fernanda A. [Bourscheid, Porto Alegre, RS (Brazil)

    2009-07-01

    During the stage of implementation of the land pipes enterprise, one of the main environmental aspects to be considered was the creation of solid and liquid waste. To mitigate the possible impacts to the environment, the main adopted mitigate measure was the implementation of a Waste Management Plan - WMP. Thus, the management of waste from pipes construction has the challenge of a great variety of stages and phases for the implementation of pipes and the diversity of local situations related to the topographic and hydro-geologic conditions. Considering the peculiarity of the pipes activities, this article proposes the elaboration of a Basic Guide to be used as reference for the creation of WMP's for similar enterprises, using as foundation the data from the three Gas Pipelines: Cabiunas - Vitoria; Vitoria - Cacimbas and Cacimbas - Catu. After the analysis of the three mentioned enterprises, it was verified that the waste management generated on the building and assembling of the land pipes normally occurs in accord with previous planning, but there's no systematization for the waste to be better recycled and reutilized, thus mitigating their creation. (author)

  13. The Basic Framework for Robot Applicability Enhancement of Nuclear Risk Management in Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young; Jeong, Kungmin [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kim, Inn Seock [bISSA Technology, Inc., Germantown (United States)

    2015-05-15

    Beyond-design-basis external events such as the one having occurred at the Fukushima Daiichi Nuclear Power Plant typically pose considerable challenges to the plant personnel because of the harsh environments caused by the events (e.g., extreme terrains, high radiation, radioactive rubbles, high heat, and explosive environment). Therefore, remote response techniques by use of robotic systems are needed to help the plant personnel cope with the extreme events. In this study the basic framework for enhancing robotic applicability to disaster management was developed using the analytic technique of Master Logic Diagram (MLD) and Goal-Tree Success-Tree (GTST). The users of robots have to devise a sound maintenance program, otherwise their unscheduled downtime may increase beyond limit, consequently defeating the purpose of robot applications. In addition, maintainability could be enhanced by designing for ease of diagnosis, and ease of access and repair. Ways to upgrade maintainability could be devised by evaluating maintainability in the design stage. The basic framework discussed herein shall be used by the KAERI's robotics team as a fundamental framework in enhancing the applicability of disaster robots in the hazardous environment caused by extreme events.

  14. The needs of basic chemistry studies for nuclear waste management issues

    Energy Technology Data Exchange (ETDEWEB)

    Guillaumont, R

    2004-07-01

    There are several strategies to manage the radioactive matter which has taken the status of 'ultimate radwaste'. They are based on combinations of the three primary strategies: 'Wait for Decay', 'Concentrate and Confine' and 'Disperse and Dilute' the radio-toxic radionuclides and chemo-toxic elements. They are, or will be used for safe storage (interim and long term) or safe disposal of nuclear wastes. The chemical needs to apply these strategies are on materials for isolation, matrices for confinement and on the numerous aspects of the migration of the elements, both in the lithosphere and in the biosphere. According to the ultimate fate of long lived radionuclides which will be finally released into the environment, migration studies of elements are, or should be, the driving force of research in nuclear wastes management. The chemical needs for improving our present basic knowledge related to this field will be reviewed, with emphasis on some new topics and on the effects of concentration of the elements when they migrate. The necessity to open some 'dark boxes' will be outlined. The paper does not intend to give programs of researches but only tracks for future research. (authors)

  15. Effect of basic prehospital trauma life support program on cognitive and trauma management skills.

    Science.gov (United States)

    Ali, J; Adam, R; Josa, D; Pierre, I; Bedsaysie, H; West, U; Winn, J; Ali, E; Haynes, B

    1998-12-01

    We tested the effectiveness of a basic prehospital trauma life support (PHTLS) program by assessing cognitive performance and trauma management skills among prehospital trauma personnel. Fourteen subjects who completed a standard PHTLS course (group I) were compared to a matched group not completing a PHTLS program (group II). Cognitive performance was assessed on 50-item multiple choice examinations, and trauma skills management was assessed with four simulated trauma patients. Pre-PHTLS multiple choice questionnaire scores were similar (45.8 +/- 9.4% vs. 48.8 +/- 8.9% for groups I and II, respectively), but the post-PHTLS scores were higher in group I (80.4 +/- 5.9%) than in group II (52.6 +/- 4.9%). Pre-PHTLS simulated trauma patient performance scores (standardized to a maximum total of 20 for each station) were similar at all four stations for both groups, ranging from 7.9 to 10.4. The post-PHTLS scores were statistically significantly higher at all four stations for group I (range 16.0-19.0) compared to those for group II (range 8.0-11.1). The overall mean pre-PHTLS score for all four stations was 8.3 +/- 2.1 for group I and 8.8 +/- 2.0 (NS) for group II; the group I post-PHTLS mean score for the four stations was 17.1 +/- 2.7 (p PHTLS Adherence to Priority scores on a scale of 1 to 7 were similar (1.1 +/- 0.9 for group I and 1.2 +/- 1.0 for group II). Post-PHTLS group I Priority scores increased to 5.9 +/- 1.1. Group II (1.1 +/- 1.0) did not improve their post-PHTLS scores. The pre-PHTLS Organized Approach scores in the simulated trauma patients on a scale of 1 to 5 were 2.1 +/- 1.0 for group I and 1.9 +/- 1.2 for group II (NS) compared to 4.2 +/- 0.9 (p PHTLS. This study demonstrates improved cognitive and trauma management skills performance among prehospital paramedical personnel who complete the basic PHTLS program.

  16. Excess Lymphangiogenesis Cooperatively Induced by Macrophages and CD4(+) T Cells Drives the Pathogenesis of Lymphedema.

    Science.gov (United States)

    Ogata, Fusa; Fujiu, Katsuhito; Matsumoto, Sahohime; Nakayama, Yukiteru; Shibata, Munehiko; Oike, Yuichi; Koshima, Isao; Watabe, Tetsuro; Nagai, Ryozo; Manabe, Ichiro

    2016-03-01

    Lymphedema is a debilitating progressive condition that severely restricts quality of life and is frequently observed after cancer surgery. The mechanism underlying lymphedema development remains poorly understood, and no effective pharmacological means to prevent or alleviate the ailment is currently available. Using a mouse model of lymphedema, we show here that excessive generation of immature lymphatic vessels is essential for initial edema development and that this early process is also important for later development of lymphedema pathology. We found that CD4(+) T cells interact with macrophages to promote lymphangiogenesis, and that both lymphangiogenesis and edema were greatly reduced in macrophage-depleted mice, lymphocyte-deficient Rag2(?/?) mice or CD4(+) T-cell-deficient mice. Mechanistically, T helper type 1 and T helper type 17 cells activate lesional macrophages to produce vascular endothelial growth factor-C, which promotes lymphangiogenesis, and inhibition of this mechanism suppressed not only early lymphangiogenesis, but also later development of lymphedema. Finally, we show that atorvastatin suppresses excessive lymphangiogenesis and lymphedema by inhibiting T helper type 1 and T helper type 17 cell activation. These results demonstrate that the interaction between CD4(+) T cells and macrophages is a potential therapeutic target for prevention of lymphedema after surgery.

  17. Clinical Significance of Lymphoscintigraphy Findings in the Evaluation of Lower Extremity Lymphedema

    Directory of Open Access Journals (Sweden)

    Seyhan Karaçavuş

    2015-06-01

    Full Text Available Objective: The purpose of this study was to investigate the clinical significance of lymphoscintigraphy imaging in the evaluation of lower extremity lymphedema. Methods: Technetium-99m-labeled nanocolloid was injected subcutaneously in the first web spaces of both feet of 123 patients (M/F: 43/80, mean age 57.5±13.1 years, range 16-78 years who had clinical evidence of lower extremity swelling with suspicion of lymphedema, and were referred for routine lymphoscintigraphy. Lymphoscintigraphy scan was started as dynamic viewing followed by static whole body imaging at 10 minute, 1 hour and 4 hours after injection. Results: Eighty-seven patients had lymphedema. Patients who had lymphedema were divided into two groups according to their scintigraphy findings: Group I included 58 patients without uptake in the popliteal nodes, and group II included 29 patients with positive popliteal nodes. The rate of popliteal node visualization was higher in patients with dermal backflow as compared to those without dermal backflow (p<0.001. The duration of lymphedema was also longer in patients with dermal backflow and popliteal nodes (p<0.004. Conclusion: Lymphoscintigraphy is a reliable, easily applied and well-tolerated objective method to diagnose lower extremity lymphedema. Uptake by popliteal lymph nodes and the presence of dermal backflow on lymphoscintigraphy, which is performed for evaluation of the lower limb lymphedema, were important signs indicating longer disease duration and higher severity of lymphatic dysfunction.

  18. Ultrasonografic changes in the axillary vein of patients with lymphedema after mastectomy

    Directory of Open Access Journals (Sweden)

    Gilberto Ferreira de Abreu Junior

    2015-04-01

    Full Text Available OBJECTIVE: To determine the prevalence of sonographic abnormalities (SA in the axillary vein of patients with and without post-mastectomy lymphedema. METHODS: We studied a sample of 80 women, divided into two equal groups, with and without lymphedema, with B mode ultrasound, color and pulsed Doppler. The primary variable, SA, is defined as change in the venous diameter, parietal thickening, intraluminal images, compressibility, parietal collapse at inspiration and feature of the axillary venous flow on the operated side. Secondary variables were: stage of lymphedema, surgical technique, number of radio and chemotherapy sessions, limb volume, weight and age. The differences between the proportions in the groups were determined using the Chi-square test and / or Fisher's test. For continuous variables, we used the Mann-Whitney Test. To estimate the magnitude of the associations, we used the prevalence rate of SA in both groups as a measure of frequency, and as a measure of association, the prevalence ratio (PR obtained as a function of relative risk (RR and estimated by the test Mantel-Haenszel homogeneity test. We adopted the statistical significance level of 5% (p < 0.05. RESULTS: only the criterion "parietal thickening" was strongly associated with the lymphedema group (p = 0.001. The prevalence of SA was 55% in patients with lymphedema and 17.5% in the group without it, with difference in prevalence of 37.5%. CONCLUSION: the prevalence of SA was higher in patients undergoing mastectomy with lymphedema than in those without lymphedema.

  19. Sotos syndrome: An unusual presentation with intrauterine growth restriction, generalized lymphedema, and intention tremor.

    Science.gov (United States)

    McClelland, Jessie; Burgess, Bronwyn; Crock, Patricia; Goel, Himanshu

    2016-04-01

    Sotos syndrome is a childhood overgrowth syndrome characterized clinically by a distinctive facial gestalt, advanced bone age, childhood overgrowth, and non-progressive developmental delay; and genetically by haploinsufficiency of the Nuclear receptor binding SET Domain 1 (NSD1) gene. Generalized lymphedema has not previously been associated with Sotos syndrome. Generalized lymphedema has been associated with mutations in several genes including FLT4. This gene is involved in the regulation of VEGFR3, a key governor of lymphatic-endothelial cell development and function. We report on a 28-year-old Caucasian female with a de novo NSD1 intragenic mutation, c.5841_5848dup: p.Leu1950Serfs*22, who presented with characteristic clinical features of Sotos syndrome. Unusually this case includes atypical features of intrauterine growth retardation and post-pubertal onset of primary lymphedema. To our knowledge, no link between Sotos syndrome and generalized lymphedema has previously been described in the literature. We propose a mechanism by which disruptions in NSD1 gene may lead to generalized lymphedema. Aberrations of the mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK)-signaling pathway has been identified in both Sotos syndrome and lymphedema. This finding extends the known phenotype of Sotos syndrome through the inclusion of lymphedema. This case also indicates that presence of low birth weight does not exclude the possibility of Sotos syndrome.

  20. Yellow Nail Syndrome: Dystrophic Nails, Peripheral Lymphedema and Chronic Cough

    Directory of Open Access Journals (Sweden)

    Christian Dornia

    2011-01-01

    Full Text Available A case involving a 41-year-old man with yellow nail syndrome (YNS is reported. YNS is a rare disorder characterized by yellow, dystrophic nails, peripheral lymphedema and bronchiectasis with recurrent lower respiratory tract infections. YNS is often misdiagnosed because the syndrome is not well known. An interdisciplinary approach is required to recognize and collate the components of the syndrome accurately. Correct diagnosis is of utmost clinical importance because YNS can occur secondary to malignancies and autoimmune disorders. Hence, the diagnosis of YNS must prompt further investigation.

  1. From lymph to fat: liposuction as a treatment for complete reduction of lymphedema.

    Science.gov (United States)

    Brorson, Håkan

    2012-03-01

    There is some controversy regarding liposuction for late-stage lymphedemas. Although it is clear that conservative therapies such as complex decongestive therapy and controlled compression therapy should be tried in the first instance, options for the treatment of late-stage lymphedema that is not responding to treatment is not so clear. Liposuction has been used for many years to treat lipodystrophy. Some results have been far from optimal; however, improvements in technique, patient preparation, and patient follow-up have led to a greater and a wider acceptance of liposuction as a treatment for lymphedema. This article outlines the benefits of using liposuction and presents the evidence to support its use.

  2. Stewart-Treves syndrome: MR imaging of a postmastectomy upper-limb chronic lymphedema with angiosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Schindera, S.T.; Anderson, S.E. [University Hospital of Bern, Department of Diagnostic Radiology, Inselspital, Bern (Switzerland); Streit, M.; Kaelin, U. [University Hospital of Bern, Department of Dermatology, Inselspital, Bern (Switzerland); Stauffer, E. [University Hospital of Bern, Department of Pathology, Inselspital, Bern (Switzerland); Steinbach, L. [University of California San Francisco, Department of Radiology, San Francisco, CA (United States)

    2005-03-01

    The rare occurrence of angiosarcoma in postmastectomy upper-limb lymphedema with magnetic resonance (MR) imaging is discussed. Unfamiliarity with this aggressive vascular tumor and its harmless appearance often leads to delayed diagnosis. Angiosarcoma complicating chronic lymphedema may be low in signal intensity on T2-weighting and short tau inversion recovery (STIR) imaging reflecting the densely cellular, fibrous stroma, and sparsely vascularized tumor histology. Additional administration of intravenous contrast medium revealed significant enhancement of the tumorous lesions. Awareness of angiosarcoma and its MR imaging appearance in patients with chronic lymphedema may be a key to early diagnosis or allow at least inclusion in the differential diagnosis. (orig.)

  3. Streptococcal toxic shock syndrome occurred during postoperative radiotherapy in a cancer patient with preexisting lymphedema and chronic illness -case report-

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ji Young; Oh, Yoon Kyeong; Kim, Dong Min [Chosun University College of Medicine, Gwangju (Korea, Republic of)

    2006-12-15

    A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

  4. Development of consensus International Classification of Functioning, Disability and Health (ICF) core sets for lymphedema

    NARCIS (Netherlands)

    Viehoff, P.B.; Heerkens, Y.F.; Ravensberg, C.D. van; Hidding, J.; Damstra, R.J.; Napel, H. ten; Neumann, H.A.

    2015-01-01

    To understand the challenges of patients with lymphedema it is important to describe functioning and to measure the effectiveness of treatment in changing functioning. The International Classification of Functioning, Disability and Health (ICF) offers an international framework to classify functioni

  5. Coding of meaningful concepts in lymphedema-specific questionnaires with the ICF

    NARCIS (Netherlands)

    Viehoff, P.B.; Hidding, J.T.; Heerkens, Y.F.; Ravensberg, C.D. van; Neumann, H.A.

    2013-01-01

    Abstract Purpose: To identify and quantify the meaningful concepts within questionnaires focusing on lymphedema using the International Classification of Functioning, Disability and Health (ICF). Methods: Electronic searches of Medline, EMBASE, CINAHL, CENtral and Pedro (2005-2010) were conducted. T

  6. Lymphatic Reprogramming of Adult Endothelial Stem Cells for a Cell-Based Therapy for Lymphedema in Breast Cancer Patients

    Science.gov (United States)

    2008-09-01

    Therapy for Lymphedema inBreast Cancer Patients PRINCIPAL INVESTIGATOR: Young Kwon Hong, Ph.D. CONTRACTING ORGANIZATION...5a. CONTRACT NUMBER 4. TITLE AND SUBTITLE Lymphatic Reprogramming of Adult Endothelial Stem Cells for a Cell-Based Therapy for Lymphedema in... lymphedema patients. The key significance of our proposal is to utilize the elusive circulating adult stem cells to avoid the ethical and immunological

  7. Improvement of Upper Extremity Lymphedema after Delayed Breast Reconstruction with an Extended Latissimus Dorsi Myocutaneous Flap

    Directory of Open Access Journals (Sweden)

    Kyeong Tae Lee

    2012-03-01

    Full Text Available Lymphedema is a common complication after mastectomy in breast cancer patients. Manytreatment options are available, but no treatment results in a complete cure. We report acase of lymphedema that occurred after modified radical mastectomy in a breast cancerpatient who showed objective improvement after delayed breast reconstruction with anlatissimus dorsi myocutaneous flap. A 41-year-old female patient with left breast cancer hadundergone modified radical mastectomy with axillary lymph node dissection and postoperativeradiotherapy 12 years previously. Four years after surgery, lymphedema developed andincreased in aggravation despite conservative treatment. Eight years after the first operation,the patient underwent delayed breast reconstruction using the extended latissimus dorsimyocutaneous flap method. After reconstruction, the patient’s lymphedema symptomsshowed dramatic improvement by subjective measures including tissue softness and feeling oflightness, and by objective measures of about 7 mL per a week, resulting in near normal rangesof volume. At a postoperative follow-up after 3 years, no recurrence was observed. Delayedbreast reconstruction with extended latissimus dorsi myocutaneous flaps may be helpful topatients with lymphedema after mastectomy. This may be a good option for patients who areworried about the possibility of the occurrence or aggravation of secondary lymphedema.

  8. Efficacy and safety of far infrared radiation in lymphedema treatment: clinical evaluation and laboratory analysis.

    Science.gov (United States)

    Li, Ke; Zhang, Zheng; Liu, Ning Fei; Feng, Shao Qing; Tong, Yun; Zhang, Ju Fang; Constantinides, Joannis; Lazzeri, Davide; Grassetti, Luca; Nicoli, Fabio; Zhang, Yi Xin

    2017-01-26

    Swelling is the most common symptom of extremities lymphedema. Clinical evaluation and laboratory analysis were conducted after far infrared radiation (FIR) treatment on the main four components of lymphedema: fluid, fat, protein, and hyaluronan. Far infrared radiation is a kind of hyperthermia therapy with several and additional benefits as well as promoting microcirculation flow and improving collateral lymph circumfluence. Although FIR therapy has been applied for several years on thousands of lymphedema patients, there are still few studies that have reported the biological effects of FIR on lymphatic tissue. In this research, we investigate the effects of far infrared rays on the major components of lymphatic tissue. Then, we explore the effectiveness and safety of FIR as a promising treatment modality of lymphedema. A total of 32 patients affected by lymphedema in stage II and III were treated between January 2015 and January 2016 at our department. After therapy, a significant decrease of limb circumference measurements was noted and improving of quality of life was registered. Laboratory examination showed the treatment can also decrease the deposition of fluid, fat, hyaluronan, and protein, improving the swelling condition. We believe FIR treatment could be considered as both an alternative monotherapy and a useful adjunctive to the conservative or surgical lymphedema procedures. Furthermore, the real and significant biological effects of FIR represent possible future applications in wide range of the medical field.

  9. Indirect magnetic resonance lymphangiography in patients with lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Lohrmann, Christian [Division of Diagnostic Radiology, Department of Radiology, University Hospital of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg (Germany)]. E-mail: lohrmann@mrs1.ukl.uni-freiburg.de; Foeldi, Etelka [Foeldi Clinic for Lymphology, Hinterzarten, Roesslehofweg 2-6, D-79856 Hinterzarten (Germany); Langer, Mathias [Division of Diagnostic Radiology, Department of Radiology, University Hospital of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg (Germany)

    2006-09-15

    Purpose: To assess the feasibility of indirect magnetic resonance (MR) lymphangiography with intracutaneous injection of gadodiamide, a commercially available, non-ionic, extracellular paramagnetic contrast agent for the detection of lymphatic vessels in patients with lymphedema. Materials and methods: In 2005, three patients with lymphedema of the lower extremities (1 primary, 2 secondary) were referred by the Foeldi Clinic for Lymphology for indirect magnetic resonance lymphangiography. 4.5 mL of gadodiamide and 0.5 mL of mepivacainhydrochloride 1% were injected intracutaneously into the dorsal aspect of each foot. MR imaging was performed with a 1.5-T system equipped with high-performance gradients. For indirect magnetic resonance lymphangiography, a 3D Fast Low Angle Shot (FLASH) sequence (TR/TE: 5.1/1.23; flip angle: 25; matrix: 448 x 448; bandwidth: 330 Hz/pixel; 6/8 rectangular field of view with a maximum dimension of 500 mm; slices: 88; voxel size: 2.0 mm x 1.0 mm x 1.0 mm; acquisition time: 0 min 31 s) was used. Results: Indirect magnetic resonance lymphangiography depicted lymphatic vessels of the lower and upper leg, and inguinal lymph nodes in all three patients. After 5 min of contrast material application, concomitant venous enhancement was detected. Collateral vessels with dermal back-flow were seen in two patients. A lymphocele in the inguinal region with the afferent lymphatic vessel was depicted in one patient. Conclusion: In the presented small study group, indirect magnetic resonance lymphangiography was technically feasible, and no complications were observed after intracutaneous injection of gadodiamide. Visualizing the lymphatic vessels and accompanying complications non-invasively and without the use of radiation, the presented method has the capability to become a routine diagnostic imaging tool in patients with primary and secondary lymphedema. The method is not able to characterize lymph node morphology, but could provide additional

  10. Basic diagnosis of solid waste generated at Agua Blanca State Park to propose waste management strategies.

    Science.gov (United States)

    Laines Canepa, José Ramón; Zequeira Larios, Carolina; Valadez Treviño, Maria Elena Macías; Garduza Sánchez, Diana Ivett

    2012-03-01

    State parks are highly sensitive areas of great natural importance and tourism value. Herein a case study involving a basic survey of solid waste which was carried out in 2006 in Agua Blanca State Park, Macuspana, Tabasco, Mexico with two sampling periods representing the high and low tourist season is presented. The survey had five objectives: to find out the number of visitors in the different seasons, to consider the daily generation of solid waste from tourist activities, to determine bulk density, to select and quantify sub-products; and to suggest a possible treatment. A daily average of 368 people visited the park: 18,862 people in 14 days during the high season holiday (in just one day, Easter Sunday, up to 4425 visitors) and 2092 visitors in 43 days during the low season. The average weight of the generated solid waste was 61.267 kg day(-1) and the generated solid waste average per person was 0.155 kg person(-1 ) day(-1). During the high season, the average increased to 0.188 kg person(-1 ) day(-1) and during the low season, the average decreased to 0.144 kg person(-1 ) day(-1). The bulk density average was 75.014 kg m(-3), the maximum value was 92.472 kg m(-3) and the minimum was 68.274 kg m(-3). The sub-products comprised 54.52% inorganic matter; 32.03% organic matter, 10.60% non-recyclable and 2.85% others. Based on these results, waste management strategies such as reuse/recycling, aerobic and anaerobic digestion, the construction of a manual landfill and the employment of a specialist firm were suggested.

  11. Behavioral data management using Visual Basics for Applications to automate data capture and analysis.

    Science.gov (United States)

    Sipos, Maurice L; Sweeney, Richard E

    2003-09-30

    Many researchers are familiar with the spreadsheet capabilities of Microsoft Excel, but have never explored using customized VISUAL BASIC FOR APPLICATIONS (VBA) macros embedded in the program. At the United States Army Medical Research Institute of Chemical Defense (USAMRICD), the implementation of VBA program code to carry out repetitive operations has resulted in a tremendous savings in both the time and manpower required to reliably capture, analyze, and plot data from research protocols. A set of "template" workbooks was developed and is used to organize data from different types of studies. At the heart of the concept is a "setup information" worksheet onto which the user enters information about the study (i.e. the number of subjects, groups, graphs). Clicking a control button on this worksheet launches the VBA code that creates worksheets for each subject, group and chart specified. A "pairmatch" function allows the user to create groups either randomly or by pair matching based on user-specified variables. Controls are provided that run VBA program code to parse subject data files into the proper worksheets and perform group averages. Charts are updated automatically whenever group averages change so that the researcher always has an up-to-date plot available. The ability to reformat the captured data onto a "statistical output" worksheet allows data to be imported easily to statistical software packages. The concept is being used for several different types of studies at USAMRICD and has significantly reduced not only amount of time spent on data management, but also the number of data entry errors. Readers interested in acquiring an electronic copy of the startle workbook example, which contains the complete VBA code, should send the request to the authors at reseco@erols.com or maurice.sipos@us.army.mil.

  12. Profilometry and subsurface imaging in point of care diagnosis in ocular disease and lymphedema after breast cancer treatment

    Science.gov (United States)

    Sayegh, Samir I.; Taghian, Alphonse

    2013-02-01

    Breast cancer-related lymphedema (BCRL) can be irreversible with profound negative impact on patients' quality of life. Programs that provide screening and active surveillance for BCRL are essential to determine whether early detection and intervention influences the course of lymphedema development. Established methods of quantitatively assessing lymphedema at early stages include "volume" methods such as perometry and bioimpedance spectroscopy. Here we demonstrate 1) Use of topographical techniques analogous to those used in corneal topography 2) Development of point-of-care lymphedema detection and characterization based on off-the-shelf hardward 3) The role of subsurface imaging 4) Multimodal diagnostics and integration yielding higher sensitivity/ specificity.

  13. Project Basic and School Library Media Programs. Issues in Media Management: 1980 Series.

    Science.gov (United States)

    Maryland State Dept. of Education, Baltimore. Div. of Library Development and Services.

    The seven papers in this collection, which were presented at a workshop for library media supervisors, focus on competency-based education and the role of media centers in implementing Maryland's Project Basic. Papers included are: "Project Basic Instructional Guides: A Resource for Teachers," by Margaret Trader; "Scope and Sequence Charts for the…

  14. "You're naked, you're vulnerable": Sexual well-being and body image of women with lower limb lymphedema.

    Science.gov (United States)

    Winch, Caleb J; Sherman, Kerry A; Smith, Katriona M; Koelmeyer, Louise A; Mackie, Helen; Boyages, John

    2016-09-01

    Lower-limb lymphedema is an incurable illness manifesting as visible swelling enlarging the leg(s) and/or feet, buttocks, and genitals. This study used semi-structured interviews and thematic analysis to explore sexual well-being among women with primary (congenital) lymphedema (n=11) or secondary lymphedema associated with gynecological cancer (n=8). Five themes (subthemes) summarized women's responses, with Attractiveness and Confidence (Publicly Unattractive, Privately Unconfident, Lymphedema or Aging?) describing women's central concern. These body image-related concerns accounted for sexual well-being in association with Partner Support (Availability of Support, Languages of Support, Fears About Support) and the degree of Functional Interruptions (Lymphedema in Context, Enduring Impacts, Overcoming Interruptions). Successful Lymphedema Coping (Control, Acceptance) and self-perceived ability to fulfill a valued Sexual Role also affected sexual well-being. Few differences between women with primary versus secondary lymphedema were evident. Lymphedema clinicians should screen for sexual concerns and have referral options available.

  15. MRI of lymphedema using short-TI-IR (STIR)

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Koichi; Ishida, Osamu; Mabuchi, Norihisa; Shindou, Hiroshi; Yoshioka, Hiroyasu; Kumano, Machiko; Hamada, Tatsumi; Ohkuma, Moriya (Kinki Univ., Osaka (Japan). School of Medicine)

    1990-01-01

    Thirty four cases with lymphedema of the extremities were examined with MRI at 0.5 tesla. On T1-weighted image, the enlarged subcutaneous tissue and the subcutaneous trabecular structures were seen in all cases. Moreover, the trabecular structures in the enlarged subcutaneous tissue showed low signal intensity on T1-weighted image and high signal intensity on T2-weighted image in all cases. Additionally, in 12 of 15 cases examined by Short-TI-IR (STIR) image, the trabecular structures and fluid collections in the subcutaneous tissue were shown more definitely in high signal intensity than by T2-weighted image. We consider MRI using STIR is to be useful in the evaluation of edematous disease. (author).

  16. Virtual patients: an effective educational intervention to improve paediatric basic specialist trainee education in the management of suspected child abuse?

    LENUS (Irish Health Repository)

    McEvoy, M M

    2011-09-01

    Child abuse is a particularly difficult subject to teach at both undergraduate and postgraduate level. Most doctors are dissatisfied with their training in child abuse recognition and management. We developed an interactive video based Virtual Patient to provide formal training for paediatric Basic Specialist Trainees in the recognition of suspected child abuse. The Virtual Patient case revolves around the management of suspected physical abuse in a seven month old child, who initially presents to the Emergency Department with viral upper respiratory tract symptoms. This Virtual Patient was used to facilitate a case discussion with Basic Specialist Trainees. A questionnaire was developed to determine their perception of the value of the Virtual Patient as an educational tool. Twenty five Basic Specialist Trainees completed the questionnaire. Upon completion of the case, 23\\/25 (92%) participants reported greater self confidence in their ability to recognize cases of suspected child abuse and 24\\/25 (96%) of participants reported greater self confidence in their ability to report cases of suspected child abuse. Basic Specialist Trainees perceived the Virtual Patient to be a useful educational tool. Virtual Patients may have a role to play in enhancing postgraduate training in the recognition of suspected child abuse.

  17. Lymphedema of the lower limbs - a lymphoscintigraphic approach; Linfedemas dos membros inferiores: estudo linfocintilografico

    Energy Technology Data Exchange (ETDEWEB)

    Cestari, S.C.P.; Petri, V.; Castiglioni, M.L.V.; Lederman, H. [Escola Paulista de Medicina, Sao Paulo, SP (Brazil)

    1994-12-31

    Patients with lymphedema of the lower limbs (LLL) are usually affected by recurrent erysipelas. This bacterial infection is usually admitted as an aetiological factor, but it can be a consequence of some previous lymphatic abnormality. Classically, the commonest causative factors of LLL are bacterial infection, venous ulcers, trauma (leading to secondary lymphedema) and congenital disorders of the lymphatic system primary lymphedema praecox or tarda. To identify previous lymphatics abnormalities in patients with LLL, admitted as having secondary lymphatic lymphedema - as consequences of infection, trauma or other factors -, by using lymphoscintigraphic method. To observe advantages of this approach in practical assistance and evaluation of LLL cases. Twelve patients with LLL, supposed to have primary (congenital) or secondary disorder affecting one or both lower extremities were submitted to lymphoscintigraphy at the Escola Paulista de Medicina of Sao Paulo, Brazil. Each patient received an intra dermal injection of labelled Dextran (Dx{sup 99m} Tc) at the first interdigital space of each foot and , after one to three hours, images of lower extremities, pelvic and abdominal areas were obtained with Gammatome CGR. Examination of all 24 lower extremities disclosed clinical diagnosis of lymphedema in 17 (70.8%), being five (41.6%) with clinical signs of lymphedema of both lower limbs and seven (58.3%) of a single one. The lymphoscintigraphic images revealed lymphatic disordersin 22 of the 24 extremities (91.7%). Lymphoscintigraphic abnormalities in clinically normal lower extremities were observed in five cases (41.3%). Lymphoscintigraphy is a non-invasive useful method to study LLL, with involvement of one or both limbs. It does not differentiate between primary and secondary lymphedema, but makes possible to detect cases of normal appearance of the limbs with previous lymphatic defect(s), changing aetiological diagnosis. (Abstract Truncated)

  18. Identification of relevant ICF (International Classification of Functioning, Disability and Health) categories in lymphedema patients: A cross-sectional study

    NARCIS (Netherlands)

    Viehoff, P.B.; Potijk, F.; Damstra, R.J.; Heerkens, Y.F.; Ravensberg, C.D. van; Berkel, D.M. van; Neumann, H.A.

    2015-01-01

    BACKGROUND: To describe functioning and health of lymphedema patients and to identify their most common problems using the International Classification of Functioning, Disability and Health (ICF) as part of the preparatory studies for the development of ICF Core Sets for lymphedema. METHODS: Cross-s

  19. Identification of relevant ICF (International Classification of Functioning, Disability and Health) categories in lymphedema patients: A cross-sectional study

    NARCIS (Netherlands)

    P.B. Viehoff (Peter); F. Potijk; R.J. Damstra (Robert); Y.F. Heerkens (Yvonne); C.D. van Ravensberg (Dorine); D.M. Van Berkel; H.A.M. Neumann (Martino)

    2015-01-01

    textabstractBackground. To describe functioning and health of lymphedema patients and to identify their most common problems using the International Classification of Functioning, Disability and Health (ICF) as part of the preparatory studies for the development of ICF Core Sets for lymphedema.Metho

  20. Refractory lymphedema of the hand: an unusual presentation of recurrent herpes simplex virus infection

    Directory of Open Access Journals (Sweden)

    Ali Majdzadeh

    2016-07-01

    Full Text Available Introduction: Herpes Simplex Virus (HSV infection of the hand resulting in lymphatic complications such as lymphangitis and lymphedema is exceedingly uncommon. Although these complications typically resolve in 21 days, they can be persistent and may not resolve even with antiviral use, thereby mimicking dyshidrotic eczema or a bacterial event and often being misdiagnosed and inappropriately treated as such. We report a case of frequently recurring HSV infection of the hand over a long period of time resulting in refractory lymphedema which did not resolve with antiviral treatment. We further endeavor to raise awareness about this highly unusual presentation of HSV infection. A comprehensive review of the literature was conducted for similar cases using PubMed and Medline. Case Report: This is the first reported case with nearly a decade-long interval between the onset of primary HSV infection and the development of chronic lymphedema. Although valacyclovir significantly reduced the episodic aggravation of the lymphedema, it did not entirely resolve it. Similar cases of persistent lymphedema also included a long history of untreated and recurrent HSV infection of the hand, suggesting that this lymphatic outcome may be circumvented by prompt treatment with antivirals. Conclusion: This case report not only presents a highly uncommon lymphatic manifestation and unusual timeline of exacerbation of the very common HSV infection, but also highlights the importance and benefits of early initiation of antiviral therapy and the prevention of reactivation.

  1. Lesson Plans for Teaching Basic Vocational Agriculture. Section III. Introduction to Soil Management and Classification.

    Science.gov (United States)

    McCully, James S., Jr., Comp.

    This publication, one of five sections, was developed for use in first and second year basic agriculture courses in secondary schools in Mississippi. The five lessons focus on the measurement and description of property and the classification of land. The purposes of the lessons are to (1) introduce the units and methods used to measure distance…

  2. The Efficacy of Interactive Video for Teaching Basic Classroom Management Skills to Pre-Service Teachers.

    Science.gov (United States)

    Overbaugh, Richard C.

    1995-01-01

    Describes a study that examined the effects of an interactive video computer-aided simulation program on instructing preservice education majors in classroom management issues. Topics include student achievement, class rank, stages of concern, computer anxiety, learning modality, the Classroom Management Achievement Test, and student reactions.…

  3. Acupotomy and venesection in Upper Limb Lymphedema and Peripheral neuropathy following Breast Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Jang Eun-ha

    2009-12-01

    Full Text Available Purpose: In order to estimate clinical effects of acupotomy and venesection in a patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery. Methods: From 17th August, 2009 to 29th August 2009, 1 female patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery was treated with general oriental medicine therapy(acupuncture, moxibustion, cupping, physical therapy, herbal medication and acupotomy with venesection. Results: The patient's chief complaints- Lt hand numbness, Lt arm edema, Lt. wrist flexion limitation - were notably improved. Conclusions : This study demonstrates that oriental medical treatment with acupotomy and venesection therapy has significant effect in improving symptoms of peripheral neuropathy and upper limb lymphedema following breast cancer surgery, as though we had not wide experience in this treatment, more research is needed.

  4. Basic criteria for a sustainable water management at the U.S.-México border: the case of ambos Nogales

    Directory of Open Access Journals (Sweden)

    Luis Ernesto Cervera Gómez

    2003-01-01

    Full Text Available This article aims to analyze some basic criteria for a sustainable use of water in an international watershed shared by Mexico and the United States. The study area comprises the region of Ambos Nogales, which is located inside the Upper Santa Cruz River Basin. This portion of the watershed represents the main ecosystem and the main source of water for urban and rural populations located in this region. Following criteria of sustainability the authors revise and adapt to the case of Ambos Nogales, a set of guidelines proposed by the Pacific Institute for Studies in Development, Environment, and Security. These guidelines include the following elements: basic water requirements needed to maintain quality of life in the population and the health of ecosystems; water quality that meets certain minimum standards; human actions and their impact on long-term renewability of freshwater stocks and flows; collection of data concerning water resources, use and quality of water; institutional mechanisms to prevent and resolve conflicts; and a democratic process of water-planning and decision-making. These twin cities have a long history of cooperation and conflict linked to water resources, which makes available enough information to create a diagnostic about the water management inside a binational arena, and allowing to explore possibilities for a better water resources management under a sustainable regime and from an international perspective. Keywords: Sustainability, binational water management, ambos Nogales region.

  5. Upper extremity function and quality of life in patients with breast cancer related lymphedema

    Directory of Open Access Journals (Sweden)

    Bojinović-Rodić Dragana

    2016-01-01

    Full Text Available Background/Aim. Upper limb lymphedema is one of the most frequent chronic complications after breast cancer treatment with a significant impact on the upper extremity function and quality of life (QoL. The aim of this study was to estimate health-related quality of life (HRQoL in patients with breast-cancer-related lymphedema and its correlation with upper limb function and the size of edema. Methods. The cross-sectional study included 54 breast-cancer-related lymphedema patients. The quality of life was evaluated by the Short Form 36-Item Health Survey (SF-36. Upper limb function was assessed by the Quick Disability of the Arm, Shoulder and Hand questionnaire (Quick DASH. The size of lymphedema was determined by the arm circumference. Results. The higher HRQoL score was assessed for mental health (47.0 ± 12.2 than for physical one (42.2 ± 7.5. The highest values of SF-36 were found in the domains of Mental Health (67.7 ± 22.9 and Social Function (70.1 ± 23.1. The lowest scores were registered in the domains of Role Physical (46.9 ± 39.1 and General Health (49.3 ± 20.1. Upper extremity function statistically significantly correlated with the domains Role Physical, Bodily Pain and Physical Composite Summary and also, with the domain Role Emotional (p 0.05. Conclusions. Physical disability in patients with breast cancer-related lymphedema influences quality of life more than mental health. Upper limb function has a significant impact on quality of life, not only on the physical, but also on the mental component. The presence of breast-cancer-related lymphedema certainly affects upper limb function and quality of life, but in this study no significant correlation between the size of edema and quality of life was found.

  6. Phototherapeutic treatment of lymphedema and other complications after mastectomy

    Science.gov (United States)

    Zharov, Vladimir P.; Kalinin, Konstantin L.; Borisov, Andrei A.; Velsher, Leonid Z.; Stakhanov, Mikhail L.; Eskin, Vadim G.; Savin, Alexei A.; Shihkerimov, Raphiz K.

    2000-05-01

    One of the possible consequences of mastectomy is lymphedema of soft tissues of upper extremities on the side of ablated breast as result of cutting and trauma of multiple nerves, lymphatic and blood vessels. This phenomenon is often accompanied by deterioration of blood and lymphatic microcirculation, increasing of stagnation and aggregation ability of thrombocities, limitation of humeral and ulnar joint activity, severe pain and decreasing of myotonus. The developing of new phototherapeutic method based on using of light-emitting diodes (LED) arrays is attempted. This method is just directed on improvement of patient's condition in combination with other traditional methods such as drug therapy, pressure bandaging etc. The main parameters of LED arrays fixed inside cylindrical tube covering pathology region are: wavelength -- 660 nm, intensity range -- 0.5 mW/sm2. To control and study efficiency of phototreatment ultrasonic dopplerography, thermography, electromyography and viscosimetry have been used. During clinical trials in oncology department of Moscow State University of Medicine and Dentistry 128 patients have been treated with following results: patients felt complete disappearance of pain and weightiness sensation in arm, restoration of skin sensitivity and muscle strength. There were statistically proved amelioration of excitation spreading velocity on radial nerve, decreasing of blood viscosity, increasing of blood velocity in main arteries of shoulder and symmetry of temperature distribution.

  7. Microcephaly/lymphedema and terminal deletion of the long arm of chromosome 13

    Energy Technology Data Exchange (ETDEWEB)

    Fryns, J.P. [Univ. of Leuven (Belgium)

    1995-07-03

    Recently, we examined a 2-year-old boy with the association of microcephaly and significant pedal edema that extended to the distal parts of the legs. Prometaphase chromosome studies showed a small terminal deletion in the long arm of chromosome 13 of band 13q34, karyotype 46,XY,del(13)(q34{yields}qter). The present finding of a small terminal 13q34 deletion in this young boy with microcephaly/lymphedema is a first indication that the lymphedema/microcephaly association can be due to a small terminal 13q deletion. 2 refs.

  8. Translation of basic science into clinical medicine in man-agement for neurogenic bladder

    Institute of Scientific and Technical Information of China (English)

    Limin Liao; Guoqing Chen; Fan Zhang

    2016-01-01

    Neurogenic bladder ( NB) dysfunction caused by spinal cord injury ( SCI ) or diseases of the central nervous system or peripheral nerves is a major medical and social problem. Traditional treatments to NB include medication, injection of Botulinum toxin A into the detrusor, neuromodulation and surgery. There are also emerging approaches, such as tissue en-gineering, stem cell transplantation and gene therapy. In recent years, we have carried out explorations in both therapeutic areas and tried to translate basic re-search into clinical practice. This paper reviews our work in this regard, and provides references for future research.

  9. Animal Science Basic Core Curriculum. Kansas Postsecondary Farm and Ranch Management Project.

    Science.gov (United States)

    Albracht, James, Ed.

    Thirty-six units of instruction are included in this core curriculum in animal science for postsecondary farm and ranch management programs. Units of instruction are divided into seven instructional areas: (1) Livestock Types, (2) Livestock Programs, (3) Nutrition, (4) Animal Health, (5) Animal Breeding, (6) Animal Improvement, and (7) Livestock…

  10. Application of an Online Reference for Reviewing Basic Statistical Principles of Operating Room Management

    Science.gov (United States)

    Dexter, Franklin; Masursky, Danielle; Wachtel, Ruth E.; Nussmeier, Nancy A.

    2010-01-01

    Operating room (OR) management differs from clinical anesthesia in that statistical literacy is needed daily to make good decisions. Two of the authors teach a course in operations research for surgical services to anesthesiologists, anesthesia residents, OR nursing directors, hospital administration students, and analysts to provide them with the…

  11. The Impact of Radiation Therapy on the Risk of Lymphedema After Treatment for Breast Cancer: A Prospective Cohort Study

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Laura E.G.; Miller, Cynthia L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Horick, Nora [Department of Biostatistics, Massachusetts General Hospital, Boston, Massachusetts (United States); Skolny, Melissa N.; Jammallo, Lauren S.; Sadek, Betro T.; Shenouda, Mina N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); O' Toole, Jean A. [Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, Massachusetts (United States); MacDonald, Shannon M. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle C. [Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-03-01

    Purpose/Objective: Lymphedema after breast cancer treatment can be an irreversible condition with a negative impact on quality of life. The goal of this study was to identify radiation therapy-related risk factors for lymphedema. Methods and Materials: From 2005 to 2012, we prospectively performed arm volume measurements on 1476 breast cancer patients at our institution using a Perometer. Treating each breast individually, 1099 of 1501 patients (73%) received radiation therapy. Arm measurements were performed preoperatively and postoperatively. Lymphedema was defined as ≥10% arm volume increase occurring >3 months postoperatively. Univariate and multivariate Cox proportional hazard models were used to evaluate risk factors for lymphedema. Results: At a median follow-up time of 25.4 months (range, 3.4-82.6 months), the 2-year cumulative incidence of lymphedema was 6.8%. Cumulative incidence by radiation therapy type was as follows: 3.0% no radiation therapy, 3.1% breast or chest wall alone, 21.9% supraclavicular (SC), and 21.1% SC and posterior axillary boost (PAB). On multivariate analysis, the hazard ratio for regional lymph node radiation (RLNR) (SC ± PAB) was 1.7 (P=.025) compared with breast/chest wall radiation alone. There was no difference in lymphedema risk between SC and SC + PAB (P=.96). Other independent risk factors included early postoperative swelling (P<.0001), higher body mass index (P<.0001), greater number of lymph nodes dissected (P=.018), and axillary lymph node dissection (P=.0001). Conclusions: In a large cohort of breast cancer patients prospectively screened for lymphedema, RLNR significantly increased the risk of lymphedema compared with breast/chest wall radiation alone. When considering use of RLNR, clinicians should weigh the potential benefit of RLNR for control of disease against the increased risk of lymphedema.

  12. Development in self-reported arm-lymphedema in Danish women treated for early-stage breast cancer in 2005 and 2006 – A nationwide follow-up study

    DEFF Research Database (Denmark)

    Gärtner, Rune; Mejdahl, Mathias Kvist; Andersen, Kenneth Geving

    2014-01-01

    The main purpose of this nationwide follow-up study was to examine the development of self-reported lymphedema in the population of women with early-stage breast cancer in Denmark. In 2008 and 2012 two identical questionnaires were sent to the women aged 18-70 years treated for unilateral primary...... breast cancer in 2005 and 2006. 2293 women (87%) reported on lymphedema in 2008 and 2012. Overall 37% reported lymphedema in 2008 while 31% reported lymphedema in 2012 and severity of symptoms decreased. 50% of women treated with SLNB and reporting lymphedema in 2008 did not report symptoms by 2012...... in contrast to 30% treated with ALND. However, 19% of women treated with ALND and not reporting lymphedema in 2008 had developed lymphedema by 2012. In conclusion lymphedema remains a frequent problem, years after treatment for breast cancer, though, number of women reporting lymphedema and overall severity...

  13. [In search of the ideal surgical treatment for lymphedema. Report of 2nd European Conference on supermicrosurgery (Barcelona - March 2012)].

    Science.gov (United States)

    Rausky, J; Robert, N; Binder, J-P; Revol, M

    2012-12-01

    Since more than 50 years, many surgeons all around the world try to find the perfect surgical technique to treat limb lymphedemas. Decongestive physiotherapy associated with the use of a compressive garment has been the primary choice for lymphedema treatment. Many different surgical techniques have been developed, however, to date, there is no consensus on surgical procedure. Most surgical experts of lymphedema met in the second European Conference on supermicrosurgery, organized on March 1st and 2nd 2012, in San Pau Hospital, Barcelona. Together they tried to clarify these different options and ideally a strategy for using these techniques.

  14. Bioelectrical impedance for detecting and monitoring lymphedema in patients with breast cancer. Preliminary results of the florence nightingale breast study group.

    Science.gov (United States)

    Erdogan Iyigun, Zeynep; Selamoglu, Derya; Alco, Gul; Pilancı, Kezban Nur; Ordu, Cetin; Agacayak, Filiz; Elbüken, Filiz; Bozdogan, Atilla; Ilgun, Serkan; Guler Uysal, Fusun; Ozmen, Vahit

    2015-03-01

    The aim of this study was to evaluate the efficacy of bioimpedance spectroscopy for the follow-up of patients with lymphedema in Turkey and its benefits in the diagnosis of stage 0, 1, and 2 lymphedema in patients who are under treatment for breast cancer. Thirty-seven female patients with breast cancer who underwent surgical procedures in our Breast Health Centre were followed up for lymphedema using bioimpedance, and clinical measurements were taken for a minimum period of 1 year at 3-month intervals. Patients who had been monitored regularly between November, 2011, and September, 2013, were enrolled to the study. In total, 8 patients developed lymphedema with an overall rate of 21.6%. Among the 8 patients who developed lymphedema, 4 had Stage 2, 1 had Stage 1, and 3 had Stage 0 lymphedema. Stage 0 lymphedema could not be detected with clinical measurements. During the patients' 1-year follow-up period using measurements of bioimpedance, a statistically significant relationship was observed between the occurrence of lymphedema and the disease characteristics. including the number of the extracted and remaining lymph nodes and the region of radiotherapy (p=0.042, p=0.024, p=0.040). Bioimpedance analysis seems to be a practical and reliable method for the early diagnosis of lymphedema. It is believed that regular monitoring of patients in the high-risk group using bioimpedance analyses increases the ability to treat lymphedema.

  15. The Nephrologist's Tumor: Basic Biology and Management of Renal Cell Carcinoma.

    Science.gov (United States)

    Hu, Susie L; Chang, Anthony; Perazella, Mark A; Okusa, Mark D; Jaimes, Edgar A; Weiss, Robert H

    2016-08-01

    Kidney cancer, or renal cell carcinoma (RCC), is a disease of increasing incidence that is commonly seen in the general practice of nephrology. However, RCC is under-recognized by the nephrology community, such that its presence in curricula and research by this group is lacking. In the most common form of RCC, clear cell renal cell carcinoma (ccRCC), inactivation of the von Hippel-Lindau tumor suppressor is nearly universal; thus, the biology of ccRCC is characterized by activation of hypoxia-relevant pathways that lead to the associated paraneoplastic syndromes. Therefore, RCC is labeled the internist's tumor. In light of this characterization and multiple other metabolic abnormalities recently associated with ccRCC, it can now be viewed as a metabolic disease. In this review, we discuss the basic biology, pathology, and approaches for treatment of RCC. It is important to distinguish between kidney confinement and distant spread of RCC, because this difference affects diagnostic and therapeutic approaches and patient survival, and it is important to recognize the key interplay between RCC, RCC therapy, and CKD. Better understanding of all aspects of this disease will lead to optimal patient care and more recognition of an increasingly prevalent nephrologic disease, which we now appropriately label the nephrologist's tumor.

  16. Low-level laser therapy in secondary lymphedema after breast cancer: systematic review.

    Science.gov (United States)

    E Lima, Mariana Toledo Biscaia Raposo Mourão; E Lima, Januário Gomes Mourão; de Andrade, Mauro Figueiredo Carvalho; Bergmann, Anke

    2014-05-01

    Complex physical therapy is the main treatment for the secondary lymphedema after breast cancer. The low-level laser therapy (LLLT) has been used in order to stimulate lymphangiogenesis, encourage lymphatic motility, and reduce lymphostatic fibrosis. However, these factors could also favor the development of recurrence and metastasis. The objective of this study is to discuss the use of LLLT in the treatment of lymphedema after breast cancer. This study utilized a systematic review on the use of LLLT in the treatment of lymphedema after breast cancer. Evaluating quality of articles was conducted through the PEDro scale. Of the 41 articles identified, four were considered to be of high methodological quality (score ≥ 5). The low-level laser in the axillary region was performed in all studies. The control group was not similar across studies. The results presented showed that there was a reduction in limb volume in the group subjected to low-power laser when compared with other treatments. No studies have evaluated the risk of metastasis or relapse in the irradiated areas. Because no studies have included the complex physical therapy as the comparison group, we cannot claim that laser treatment is the best efficacy or effectiveness in lymphedema treatment after breast cancer. No studies have evaluated the hypothesis that the LLLT can increase the risk of recurrence or metastasis. Therefore, the questions about the safety of this procedure in cancer patients remain.

  17. Biomarker and Phenotypic Risk Factors for Breast Cancer Lymphedema | Division of Cancer Prevention

    Science.gov (United States)

    DESCRIPTION (provided by applicant): Lymphedema (LE) following treatment for breast cancer is the most common form of secondary LE in the industrialized world. It occurs in 20% to 87% of patients following treatment for breast cancer and results in significant disability. At the |

  18. Microsurgical techniques for the treatment of breast cancer-related lymphedema: a systematic review

    NARCIS (Netherlands)

    Penha, T.R.; Ijsbrandy, C.; Hendrix, N.A.; Heuts, E.M.; Voogd, A.C.; Meyenfeldt, M.F. von; Hulst, R.R. van der

    2013-01-01

    BACKGROUND: Upper limb lymphedema is one of the most underestimated and debilitating complications of breast cancer treatment. The aim of this review is to summarize the recent literature for evidence of the effectiveness of lymphatic microsurgery for the treatment of breast cancer-related lymphedem

  19. Modification of a Rodent Hindlimb Model of Secondary Lymphedema: Surgical Radicality versus Radiotherapeutic Ablation

    Directory of Open Access Journals (Sweden)

    Hyung Sub Park

    2013-01-01

    Full Text Available Secondary lymphedema is an intractable disease mainly caused by damage of the lymphatic system during surgery, yet studies are limited by the lack of suitable animal models. The purpose of this study was to create an improved model of secondary lymphedema in the hindlimbs of rodents with sustained effects and able to mimic human lymphedema. This was achieved by combining previously reported surgical methods and radiation to induce chronic lymphedema. Despite more radical surgical destruction of superficial and deep lymphatic vessels, surgery alone was not enough to sustain increased hindlimb volume. Radiotherapy was necessary to prolong these effects, with decreased lymphatic flow on lymphoscintigraphy, but hindlimb necrosis occurred after 4 weeks due to radiation toxicity. The applicability of this model for studies of therapeutic lymphangiogenesis was subsequently tested by injecting muscle-derived stem cells previously cocultured with the supernatant of human lymphatic endothelial cells in vitro. There was a tendency for increased lymphatic flow which significantly increased lymphatic vessel formation after cell injection, but attenuation of hindlimb volume was not observed. These results suggest that further refinement of the rodent hindlimb model is needed by titration of adequate radiation dosage, while stem cell lymphangiogenesis seems to be a promising approach.

  20. 3D stereophotogrammetry in upper-extremity lymphedema: An accurate diagnostic method

    NARCIS (Netherlands)

    Hameeteman, M.; Verhulst, A.C.; Vreeken, R.D.; Maal, T.J.; Ulrich, D.J.

    2016-01-01

    BACKGROUND: Upper-extremity lymphedema is a frequent complication in patients treated for breast cancer. Current diagnostic methods for the upper-extremity volume measurements are cumbersome or time consuming. The purpose of this study was to assess the validity and reliability of three-dimensional

  1. Recurrent furunculosis as a cause of isolated penile lymphedema: a case report

    Directory of Open Access Journals (Sweden)

    Sood Suneet

    2010-06-01

    Full Text Available Abstract Introduction Isolated lymphedema of the penis is extremely rare: combined involvement of the scrotum and penis is the norm. Furunculosis as a cause is not, to our knowledge, previously reported. We present a case of isolated penile lymphedema that responded to excision of lymphedematous tissue and reconstruction with flaps. Case presentation A 32-year-old Arab man presented with a three-year history of a gradually increasing, painless penile swelling. Our patient's main complaint was non-erectile sexual dysfunction. The swelling was preceded by at least three prior episodes of severe furunculosis at the penile root. He had no other contributory past medical or family history. On examination there was gross penile enlargement, maximally at the mid shaft, associated with thickened skin at the sites of prior furunculosis. The glans and scrotum were normal. Both testes were palpable. Serology for filariasis, and urinary tract ultrasound and computed tomography scan were normal. The clinical diagnosis was lymphedema following recurrent penile furunculosis. At operation the lymphedematous tissues were removed. Closure of the penile shaft was accomplished by bilateral advancement of flaps from both ends of the penis. He resumed normal sexual activity one month after surgery. At 12 months, he had a good cosmetic result, with no signs of recurrence. Conclusions Furunculosis at the penile root may result in lymphedema confined to the penile shaft, sparing the scrotum. Excision of abnormal tissue and cover with a skin flap gave excellent cosmetic results, and allowed satisfactory sexual activity.

  2. Breast Cancer Survivors Coping with Lymphedema: What All Counselors Need to Know

    Science.gov (United States)

    Heppner, P. Paul; Tierney, Candece Glauser; Wang, Yu-Wei; Armer, Jane M.; Whitlow, Natalie M.; Reynolds, Alysia

    2009-01-01

    The purpose of this study was to promote greater understanding among counselors and other helping professionals regarding the stressors associated with lymphedema, how women cope with the stressors, and the role of social support. An intensive qualitative study was conducted; data were analyzed using a consensual qualitative research approach. The…

  3. Risk assessment of dermatolymphangioadenitis by lymphoscintigraphy in patients with lower extremity lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Young; Hwang, Ji Hye; Park, Jung Mi; Lee, Kyung Han; Kim, Sang Eun; Kim, Dong Ik; Lee, Byung Boong; Kim, Byung Tae [College of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    1999-02-01

    Dermatolymphangioadenitis (DLA) is a common and serious complication of lymphedema which deteriorates lymphatic function. The purpose of this study was to assess the risk of DLA by lymphoscintigraphy in patients with lower extremity lymphedema. The subjects were 59 edematous lower extremities of 50 patients without previous episode of DLA and 12 lower extremities of 6 controls. Whole body images were acquired 1 min and 2 hr after subcutaneous injection of 37 MBq of Tc-99m-antimony sulfide colloid into interdigital spaces of both feet before therapy for lymphedema. The lymphoscintigrapic and clinical variables were compared between groups with or without occurrence of DLA during clinical follow up. There were 20 episodes of DLA in 12 extremities during clinical follow-up (19{+-}6 months). On univariate analysis, there were significant differences in ilioinguinal lymph node uptake, uptake pattern of main lymphatic vessel, clinical stage and therapy compliance between the two groups. After multivariate analysis, only the uptake pattern of main lymphatic vessel and therapy compliance were confirmed to be independent variables. In other words, non-visualized main lymphatic vessel and poor compliance to therapy were more frequent in extremities with subsequent occurrence of DLA. Lymphoscintigraphy can be used to predict the risk of DLA and may thus be helpful for determining the initial therapeutic plan in patients with lower extremity lymphedema.

  4. Lymphedema After Surgery in Patients With Endometrial Cancer, Cervical Cancer, or Vulvar Cancer

    Science.gov (United States)

    2014-12-23

    Lymphedema; Stage IA Cervical Cancer; Stage IA Uterine Corpus Cancer; Stage IA Vulvar Cancer; Stage IB Cervical Cancer; Stage IB Uterine Corpus Cancer; Stage IB Vulvar Cancer; Stage II Uterine Corpus Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVB Vulvar Cancer

  5. Microvascular filtration is increased in the forearms of patients with breast cancer-related lymphedema

    DEFF Research Database (Denmark)

    Jensen, Mads Radmer; Simonsen, Lene; Karlsmark, Tonny

    2013-01-01

    Breast cancer-related lymphedema (BCRL) is a frequent and debilitating complication of breast cancer treatment. The pathophysiology is complex and remains poorly understood; however, data suggest that changes in the peripheral circulation may contribute to edema formation. In 13 volunteers...

  6. Measurement Issues in Anthropometric Measures of Limb Volume Change in Persons at Risk for and Living with Lymphedema: A Reliability Study

    Directory of Open Access Journals (Sweden)

    Dorit Tidhar

    2015-09-01

    Full Text Available Understanding whether a true change has occurred during the process of care is of utmost importance in lymphedema management secondary to cancer treatments. Decisions about when to order a garment, start an exercise program, and begin or end therapy are based primarily on measurements of limb volume, based on circumferences taken by physiotherapists using a flexible tape. This study aimed to assess intra-rater and inter-rater reliability of measurements taken by physiotherapists of legs and arms with and without lymphedema and to evaluate whether there is a difference in reliability when measuring a healthy versus a lymphedematous limb. The intra-rater reliability of arm and leg measurements by trained physiotherapist is very high (scaled standard error of measurements (SEMs for an arm and a leg volume were 0.82% and 0.64%, respectively and a cut-point of 1% scaled SEM may be recommended as a threshold for acceptable reliability. Physiotherapists can rely on the same error when assessing lymphedematous or healthy limbs. For those who work in teams and share patients, practice is needed in synchronizing the measurements and regularly monitoring their inter-rater reliability.

  7. Microzonation in Urban Areas, Basic Element for Land-Use Planning, Risk Management and Sustainable Development

    Science.gov (United States)

    Torres Morales, G. F.; Dávalos Sotelo, R.; Castillo Aguilar, S.; Mora González, I.; Lermo Samaniego, J. F.; Rodriguez, M.; García Martínez, J.; Suárez, M. Leonardo; Hernández Juan, F.

    2013-05-01

    This paper presents the results of microzonification of the natural hazards for different metropolitan areas and highlights the importance of integrating these results in urban planning. The cities that have been covered for the definition of danger in the state of Veracruz are: Orizaba, Veracruz and Xalapa, as part of the production of a Geological and Hydrometeorology Hazards Atlas for the state of Veracruz, financed by the Funds for the Prevention of Natural Disasters FOPREDEN and CONACYT. The general data of each metropolitan area was integrated in a geographic information system (GIS), obtaining different theme maps, and maps of dynamic characteristics of soils in each metropolitan area. For the planning of an urban area to aspire to promote sustainable development, it is essential to have a great deal of the details on the pertinent information and the most important is that that has to do with the degree of exposure to natural phenomena. In general, microzonation investigations consider all natural phenomena that could potentially affect an area of interest and hazard maps for each of potential hazards are prepared. With all the data collected and generated and fed into a SIG, models were generated which define the areas most threatened by earthquake, flood and landslide slopes. These results were compared with maps of the main features in the urban zones and a qualitative classification of areas of high to low hazard was established. It will have the basic elements of information for urban planning and land use. This information will be made available to the authorities and the general public through an Internet portal where people can download and view maps using free software available online.;

  8. What are the basic self-monitoring components for cardiovascular risk management?

    Directory of Open Access Journals (Sweden)

    Nunan David

    2010-11-01

    Full Text Available Abstract Background Self-monitoring is increasingly recommended as a method of managing cardiovascular disease. However, the design, implementation and reproducibility of the self-monitoring interventions appear to vary considerably. We examined the interventions included in systematic reviews of self-monitoring for four clinical problems that increase cardiovascular disease risk. Methods We searched Medline and Cochrane databases for systematic reviews of self-monitoring for: heart failure, oral anticoagulation therapy, hypertension and type 2 diabetes. We extracted data using a pre-specified template for the identifiable components of the interventions for each disease. Data was also extracted on the theoretical basis of the education provided, the rationale given for the self-monitoring regime adopted and the compliance with the self-monitoring regime by the patients. Results From 52 randomized controlled trials (10,388 patients we identified four main components in self-monitoring interventions: education, self-measurement, adjustment/adherence and contact with health professionals. Considerable variation in these components occurred across trials and conditions, and often components were poorly described. Few trials gave evidence-based rationales for the components included and self-measurement regimes adopted. Conclusions The components of self-monitoring interventions are not well defined despite current guidelines for self-monitoring in cardiovascular disease management. Few trials gave evidence-based rationales for the components included and self-measurement regimes adopted. We propose a checklist of factors to be considered in the design of self-monitoring interventions which may aid in the provision of an evidence-based rationale for each component as well as increase the reproducibility of effective interventions for clinicians and researchers.

  9. Interleukin-8 reduces post-surgical lymphedema formation by promoting lymphatic vessel regeneration.

    Science.gov (United States)

    Choi, Inho; Lee, Yong Suk; Chung, Hee Kyoung; Choi, Dongwon; Ecoiffier, Tatiana; Lee, Ha Neul; Kim, Kyu Eui; Lee, Sunju; Park, Eun Kyung; Maeng, Yong Sun; Kim, Nam Yun; Ladner, Robert D; Petasis, Nicos A; Koh, Chester J; Chen, Lu; Lenz, Heinz-Josef; Hong, Young-Kwon

    2013-01-01

    Lymphedema is mainly caused by lymphatic obstruction and manifested as tissue swelling, often in the arms and legs. Lymphedema is one of the most common post-surgical complications in breast cancer patients and presents a painful and disfiguring chronic illness that has few treatment options. Here, we evaluated the therapeutic potential of interleukin (IL)-8 in lymphatic regeneration independent of its pro-inflammatory activity. We found that IL-8 promoted proliferation, tube formation, and migration of lymphatic endothelial cells (LECs) without activating the VEGF signaling. Additionally, IL-8 suppressed the major cell cycle inhibitor CDKN1C/p57(KIP2) by downregulating its positive regulator PROX1, which is known as the master regulator of LEC-differentiation. Animal-based studies such as matrigel plug and cornea micropocket assays demonstrated potent efficacy of IL-8 in activating lymphangiogenesis in vivo. Moreover, we have generated a novel transgenic mouse model (K14-hIL8) that expresses human IL-8 in the skin and then crossed with lymphatic-specific fluorescent (Prox1-GFP) mouse. The resulting double transgenic mice showed that a stable expression of IL-8 could promote embryonic lymphangiogenesis. Moreover, an immunodeficient IL-8-expressing mouse line that was established by crossing K14-hIL8 mice with athymic nude mice displayed an enhanced tumor-associated lymphangiogenesis. Finally, when experimental lymphedema was introduced, K14-hIL8 mice showed an improved amelioration of lymphedema with an increased lymphatic regeneration. Together, we report that IL-8 can activate lymphangiogenesis in vitro and in vivo with a therapeutic efficacy in post-surgical lymphedema.

  10. Congenital segmental lymphedema in tuberous sclerosis complex with associated subependymal giant cell astrocytomas treated with Mammalian target of rapamycin inhibitors.

    Science.gov (United States)

    Prato, Giulia; Mancardi, Maria Margherita; Baglietto, Maria Giuseppina; Janis, Sara; Vercellino, Nadia; Rossi, Andrea; Consales, Alessandro; Raso, Alessandro; Garrè, Maria Luisa

    2014-09-01

    Tuberous sclerosis complex is a genetic, multisystemic disorder characterized by circumscribed benign lesions (hamartomas) in several organs, including brain. This is the result of defects in the TSC1 and/or TSC2 tumor suppressor genes, encoding the hamartin-tuberin complex that inhibits the mammalian target of rapamycin pathway. Specific inhibitors of this pathway have been shown to reduce the volume of subependymal giant cell astrocytomas associated with tuberous sclerosis. Congenital lymphedema is rarely seen in association with tuberous sclerosis, with only a few reported cases. Although this association can be coincidental, the dysgenetic lymphatic system can represent a hamartia as a consequence of gene mutation. We describe a child with congenital lymphedema in tuberous sclerosis and associated subependymal giant cell astrocytoma who experienced lymphangitis under treatment with mammalian target of rapamycin inhibitors. Because our patient did not show worsening of lymphedema, congenital lymphedema does not seem to be a contraindication for this therapy.

  11. Functioning in lymphedema from the patients' perspective using the International Classification of Functioning, Disability and health (ICF) as a reference

    NARCIS (Netherlands)

    Viehoff, P.B.; Gielink, P.D.; Damstra, R.J.; Heerkens, Y.F.; Ravensberg, C.D. van; Neumann, M.H.

    2015-01-01

    Abstract Purpose. To identify and quantify meaningful concepts in lymphedema from the patients' perspectives using the International Classification of Functioning, Disability and Health (ICF). Methods. Six focus group interviews in five different centers were organized, audiotaped, transcribed verba

  12. ZIKA VIRUS: A REVIEW FROM THE VIRUS BASICS TO PROPOSED MANAGEMENT STRATEGIES

    Directory of Open Access Journals (Sweden)

    Lorenzo Zammarchi

    2016-11-01

    Full Text Available This review aims to summarize the body of knowledge available on Zika virus to date. A comprehensive review of the scientific literature on Zika virus was performed with the aim to stress relevant aspects for healthcare professionals in non-endemic area. For several years, the Zika virus infection was considered an extremely rare exotic disease with poor clinical relevance. However, Zika virus has recently gained the attention of the scientific community and public opinion since the virus spread to the Pacific islands and the South America in an unprecedented epidemic, and additionally due to the definitive evidence that the infection could be complicated by Guillain-Barré syndrome, passed through vertical transmission, and result in central nervous system abnormalities (including microcephaly of the fetus. Studies and scientific evidences on the complications associated with Zika virus infection are growing day by day. It is advisable that the healthcare professionals working in non-endemic areas maintain full awareness on this issue in order to practice proper management of the imported cases of Zika virus infection.

  13. Basic Education Management Informatization Standard Ideas%关于基础教育管理信息化功能标准思路

    Institute of Scientific and Technical Information of China (English)

    张为民

    2011-01-01

    Higher education in the social structure of the transition,facing new opportunities and challenges,basic educational information in the education management information can become an important strategy for the reform of education and management trends.Basic teaching of management information to further improve the quality of basic education management and the absolute need.%高等教育在社会结构的转型期面临新的机遇和挑战,基础教育信息化在教育管理信息化中能够成为教育管理改革的重要战略发展趋势。基础教学管理信息化能进一步提高基础教学管理水平和质量的绝对需要

  14. Study Regarding the Effectiveness of Manual Lymphatic Drainage in the Case of Patients with Breast Cancer that Present Lymphedema

    Directory of Open Access Journals (Sweden)

    Alexandru MIOC

    2013-06-01

    Full Text Available Lymphedema is defined as a persistent increase of tissue volume caused by the blocked or absent lymphatic drainage. The purpose of this study is to analyse the effectiveness of lymphatic drainage in the treatment of lymphedema after a mastectomy, with the aim of reducing the volume of the lymphedema and improving overall symptomatology, as well as providing information regarding the impact of this treatment on quality-of-life and the physical limitations of these patients. With these objectives in mind, a series of articles evaluating the effectiveness of manual lymphatic drainage in the case of patients with breast cancer and lymphedema have been studied. The parameters under observation were: duration of lymphedema reduction and improved symptomatology (pain, a feeling of swelling of the upper limb, functional limitation, and patient dissatisfaction towards their body image. Following this analysis, one can conclude that the association of manual lymphatic drainage to physical exercise and physiotherapy has produced changes in the volume of the limb affected by the lymphedema; however, its isolated use has not resulted in significant changes.

  15. Transcriptome datasets supply basic gene information for RNAi pest management and gene functional studies inNephotettix cincticeps (Uhler)

    Institute of Scientific and Technical Information of China (English)

    CHEN Tai-yu; HOU Ji-xiang; LIN Yong-jun

    2016-01-01

    RNA interference (RNAi) technology has the potential to be used in pest management in crop production. Here, the transcriptome ofNephotettix cincticeps(Uhler) was deeply sequenced to investigate the systematic RNAi mechanism and candidate genes for dsRNA feeding. In our datasets, a total of 81225 transcripts were obtained with the length from 150 bp to about 4.2 kb. Almost al the genes related to the RNAi core pathway were proved to be present inN. cincticeps transcriptome. Two transcripts that respectively encode a systemic interference defective (SID) were identiifed in our da-tabase, indicating that the systematic RNAi pathway can function effectively inN. cincticeps. Our datasets not only supply basic gene information for the studies of gene expression and functions in N. cincticeps, such as the control genes for gene expression analysis, but also provide candidate genes for RNAi pest management, such as the genes that encode P450 monooxygenase, V-ATPase and chitin synthase.

  16. Measuring and managing progress in the establishment of basic health services: the Afghanistan health sector balanced scorecard.

    Science.gov (United States)

    Hansen, Peter M; Peters, David H; Niayesh, Haseebullah; Singh, Lakhwinder P; Dwivedi, Vikas; Burnham, Gilbert

    2008-01-01

    The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, health worker training, use of clinical guidelines, monitoring of tuberculosis treatment, and provision of delivery care. For three of the priority indicators-drug availability, health worker training and provider knowledge-scores remained unchanged or decreased between 2005 and 2006. This highlights the need to ensure that early gains achieved in establishment of health services in Afghanistan are maintained over time. The use of a coherent and balanced monitoring framework to identify priority areas for improvement and measure performance over time reflects an objectives-based approach to management of health services that is proving to be effective in a difficult environment.

  17. [Clinical experiences in the use of lymphovenous anastomoses in secondary lymphedema].

    Science.gov (United States)

    Ingianni, G; Holzmann, T

    1985-01-01

    Secondary lymphedema of the arm after therapy for breast cancer has a frequency of about 30% in the Federal Republic of Germany. Many authors have performed lympho-venous anastomoses to release lymphostatic edema, most using microsurgical technique. In this paper the authors present microlympho-venous anastomoses done in a telescope-like manner and using fibrin glue. First this technique was applied to dogs, later to patients. Measurement of the limb and of the limb volume at different levels were done pre- and postoperatively. Investigations with radionucleides were undertaken in some cases to measure lymphatic clearance. The operations were performed under local anaesthesia with perioperative antibiotic prophylaxis. The procedure was well tolerated by the patients, achieving a reduction of the swelling of about 30%. Despite the short follow-up of only six months and the limited number of cases we feel that this type of therapy should be offered to patients with secondary lymphedema.

  18. [Current wound care in patients with elephantiasis--third-stage lymphedema].

    Science.gov (United States)

    Rucigaj, Tanja Planinsek; Slana, Ana; Leskovec, Nada Kecelj

    2012-10-01

    Lymphedema resulting from fluid accumulation due to impairment in the lymphatic system drainage leads to enlargement of the body part involved. If left untreated, in its third stage it results in elephantiasis. Elephantiasis is frequently accompanied by papillomatosis and lymphocutaneous fistulas with lymphorrhoea, erosions and ulcers, frequently with the loss of function in the respective part of the body. Unlike other chronic wounds, wound healing in lymphedema is highly dependent on the use of combined therapies because local treatment with modern supportive dressings and compression therapy with adhesive and non-adhesive short-stretch systems is only part of the complete treatment. This treatment also includes sub-bandage foamy materials, kinesitherapy with tapes (kinesiotaping), intermittent local application of high-pressure oxygen, breathing exercise, and manual lymph drainage and exercises.

  19. THE EFFECT OF MICROWAVE AND BANDAGING TREATMENT ON SKIN IMMUNOLOGICAL CELLS IN CHRONIC LIMB LYMPHEDEMA

    Institute of Scientific and Technical Information of China (English)

    曹卫刚; 张涤生; 干季良

    2000-01-01

    Objective To clarify the characteristics of immunological reactions in skin tissues of non - filarial lymphedema patients with or without skin bacterial infection. Methods Avidin-biotin peroxidase (ABC)immunohistochemical method was used to examine the local skin tissue infiltrating inflammatory cells in 16chronic limb lymphedema patients before and after two courses of microwave and bandaging treatment. Results There was a significant increase of T lymphocyte infiltration in lymphedematous skin tissues; after two courses of microwave treatment, T lymphocyte infiltration was greatly resolved whereas the number of macrophages, which can lyse the stagnant proteins in lymphedematous tissues through proteolysis increased. Conclusion Microwave and bandaging treatment can promote regression of extremity edema by reducing chronic inflammation and enhancing the stagnant protein lysis capability in lymphedematous skin tissues.

  20. [Lymphedema secondary to breast cancer treatment: possibility of diagnostic and therapeutic prevention].

    Science.gov (United States)

    Campisi, C; Boccardo, F; Zilli, A; Maccio, A; Napoli, F; Ferreira Azevedo, W; Fulcheri, E; Taddei, G

    2002-01-01

    We performed a prospective randomized study upon 50 patients who had undergone a breast cancer treatment, considering particularly the possibility of appearance of arm secondary lymphedema. The patients were divided in two groups of 25 patients each. In the 1st group, we performed only a clinical follow-up, whilst in the 2nd one, we used also lymphoscintigraphy. The aim of the study was to compare the incidence of arm secondary lymphedema in the two groups, and relate the data with those of the international literature, in order to identify diagnostic procedures indicative of the risk of development of lymphedema and find proper therapeutic preventive measures. It is certainty complex to foresee the appearance of arm lymphedema due to breast cancer treatment. No specific preventive therapeutic methods based upon particular diagnostic investigations were ever reported. Patients had undergone surgery and radiation for breast cancer in the period between April 1992 and June 1994, and controlled at over 5 years after operation. Upper limb lymphoscintigraphy was performed only in one of the two groups of 25 patients, before operation and, furthermore, after 1-3-6 months and 1-3 years from the treatment. Patients who presented lymphoscintigraphic alterations (dermal back flow, diffused or delayed transit of the tracer, etc.), before edema appeared clinically, underwent physical and rehabilitative therapy (bandages, manual lymphatic drainage, mechanical lymph drainage, elastic garments, etc.) and microsurgery (lymphatic-venous anastomoses at the arm), performed early (stages Ib and II) in patients not responsive to physical therapy. In the first group followed only clinically, secondary arm lymphedema occurred in 9 cases (36%), and appeared after a period variable from 1 week to 2 years (3-6 months averagely). In the second group, lymphoscintigraphy, performed preoperatively, permitted to find lymphatic impairment (absence of deltoid way, reduced axillary lymph nodal

  1. EXPERIMENTAL TREATMENT FOR OBSTRUCTIVE LYMPHEDEMA BY TRANSPLANTATION OF FASCIAL FLAP RICHED IN LYMPH VESSELS

    Institute of Scientific and Technical Information of China (English)

    SUN Feng; CAO Wei-gang; LI Sheng-li; WANG Shan-liang; ZHANG Di-sheng

    2008-01-01

    Objective To provide a more effective microsurgical treatment for obstructive lymphedema.Methods Sixty models of rabbits with lymphedema in right hindlimb were devided into three groups: 20 for fascial flap transplantation (group A), 20 for no treatment (group B) and 20 for anastomosis of lymph vessels and vein (group C) as control. For group A, the posterior branch of medial vein in the normal hindlimb was cut down together with the fascial strip (about 3 cm wide) around it and concomitant lymph vessels, then transferred through the block region of the affected limb. The two broken tips of the vein were anastomosed respectively to normal veins beside the block region. Subcutaneous tissue and skin were sutured at last. For group B, no treatment was carried out. But traditional anastomosis of lymph vessels and vein was used for group C. Postoperative variation of volume was observed and lymphoscintigraphy was made.Results The volume curve of the affected limb in group A kept declining after 2 weeks and nearing to that of the normal hindlimb in group B but away from that of the affected limb in group B. The curve of donor limb in group A was similar to that of the normal limb of group B, which meant no secondary lymphedema occurred in donor limb. The volume of the affected limb of group A had significant difference to that of group C at postoperative 24 weeks, which meant the effect of group A was better than C. The lymphatic drainage of the affected limb of group A was obviously better than B and C in lymphoscintigraphic image. Deposit of nuclein was lessened.Conclusion It was verified that the transplantation of vein-lymph vessels-fatty fascial flap had following advantages: decreased technical difficulty, better long-term effect, aost no chronic lymphedema occurred in donor site, extensive adaptation.

  2. A Woman with Unilateral Rash and Fever: Cellulitis in the Setting of Lymphedema

    Directory of Open Access Journals (Sweden)

    Melissa Joseph

    2015-01-01

    Full Text Available Cellulitis in the setting of lymphedema is an uncommon but clinically important presentation to the emergency department. Stagnant lymph is an ideal medium for bacterial growth and progression can be rapid due to decreased ability to fight infection in the affected area. Infections are commonly caused by gram-positive cocci, though blood cultures are often negative. Treatment should be aimed at rapid initiation of antibiotics targeting these species. There may be a role for antibiotic prophylaxis in recurrent cases.

  3. Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis

    Science.gov (United States)

    Kong, Benjamin Y.; Chou, Shaun; Wakade, Deepal; Carlino, Matteo S.; Fernandez-Penas, Pablo

    2017-01-01

    There are reported cases of diphencyprone used in treating cutaneous metastases of melanoma. Here, we report a patient with previous primary melanoma on his left back treated with surgical excision and lymphadenectomy, followed by radiotherapy for the recurrent tumor on the primary site. Despite radiotherapy and treatment with dabrafenib and trametinib, in-transit metastases have developed and topical diphencyprone was applied to these metastases. Six weeks later, the patient developed fever and a spreading erythematous tender indurated plaque covering the left side of the body including axillae, back, and flank, clinically suggestive of cellulitis. Systemic antibiotic therapy did not improve the condition and a biopsy showed sparse lymphocytic infiltrate. With the diagnosis of possible acute lymphedema, a CT scan was requested that showed significant axillary lymph node metastasis. The fever was considered secondary to dabrafenib and trametinib therapy. This case highlights that, in patients with lymphadenectomy, atypical forms of lymphedema on the body may appear. Truncal lymphedema is an infrequent event. PMID:28182109

  4. Immediate Changes to Skin and Subcutaneous Tissue Strains Following Manual Lymph Drainage in Legs with Lymphedema

    Science.gov (United States)

    Kakutani, Hiromi; Nakamura, Kaori; Morikage, Noriyasu; Yamashita, Osamu; Harada, Takasuke; Ueda, Koshiro; Samura, Makoto; Tanaka, Yuya; Takeuchi, Yuriko; Hamano, Kimikazu

    2016-01-01

    Objectives: To study the immediate impact of manual lymph drainage (MLD) on skin and subcutaneous tissue strains in legs with lymphedema using free-hand real-time tissue elastography (RTE). Methods: Skin and subcutaneous tissue strain measurements were taken at the middle of the inner thigh and calf by RTE in 20 legs with lymphedema of 18 patients (stage II: 11, late stage II: 7, stage III: 2) and in 70 legs of 35 normal subjects. In patients with lymphedema, the same measurements were repeated immediately following MLD. Results: Significant negative correlations were found between pre-MLD strains and the MLD-induced changes in thigh and calf skin strains (thigh skin: p <0.01, calf skin: p = 0.05), but not in subcutaneous tissue strains. Pre-MLD intercepts of these regression lines were closer to normal values as compared to mean pre-MLD values (normal thigh skin: 0.54% ± 0.30%, calf skin: 0.25% ± 0.18%, Pre-MLD thigh skin: 0.39% ± 0.20%, calf skin: 0.17% ± 0.12%, Pre-MLD intercept of thigh skin: 0.48%, Pre-MLD intercept of calf skin: 0.31%). Conclusions: It appears that MLD did not simply soften the skin, but rather normalized it in terms of strain. However, this was not confirmed in the subcutaneous tissue. PMID:27087870

  5. Lymphedema of the arm after surgery for breast cancer: new physiotherapy.

    Science.gov (United States)

    Marcos, A L; El Gaaied, A B Ammar; Ayed, F B; Hassen, S B; Zervoudis, S; Navrozoglou, I; Pechlivani, F; Iatrakis, G

    2012-01-01

    Secondary lymphedema of the upper limb is a complication which can be found in patients who have undergone surgical breast cancer treatment with an axillary dissection. Lymphedema following breast cancer treatment remains a long-term disabling complication which cannot be treated in a decisive and radical manner. The objective of the treatment is to limit complications, to try to preserve the remaining lymphatic system and to develop new anastomosis. It consists of a specific decongestive physiotherapy, which may include a specific lymphatic drainage and skin mobilization, reducing bandages including Mobiderm (Thuasne), and sub-bandage muscular exercises. However variations in the therapy have been recorded by different teams. Our experience in treating lymphedema in Tunisia takes into consideration the epidemiological, climatic, cultural and socio-economic conditions of the country. The difference in our treatment compared to what is being advocated elsewhere essentially consists of the no muscular exercise while wearing a bandage. This is compensated for by daily domestic activities, by prolonging the first two phases of treatment (the intensive phase and the stabilization phase), and by the use of the hydro gel dressing Hydrosob (Hartmann) to prevent blisters induced by the pressure imposed by Mobiderm studs of the bandage on the skin, and also by the superimposition of two types of Mobiderm bandages (small and large blocks).

  6. Lymphedema in Klippel-Trenaunay Syndrome: Is It Possible to Normalize?

    Directory of Open Access Journals (Sweden)

    Jose Maria Pereira de Godoy

    2016-01-01

    Full Text Available The aim of this study is to report the results of intensive therapy of lymphedema associated with Klippel-Trenaunay syndrome. A 24-year-old female patient reported that her family had observed edema in her right leg and port wine stains from birth. For ten years, they consulted with different specialists in the region but the prognosis did not change and no specific treatment was found. In 2014, at the age of 24, with massive lymphedema, a leg ulcer, and recurrent infections, she started treatment at the Clínica Godoy in São José do Rio Preto. She was evaluated by clinical history, physical examination, water displacement volumetry, and bioimpedance. Intensive therapy (8 hours daily was proposed using Manual Lymphatic Therapy (Godoy & Godoy, Cervical Stimulation Therapy, Mechanical Lymphatic Therapy, a grosgrain stocking adjusted several times a day, and the use of Unna boot in the region of the ulcer. The volume of edema was reduced by about 44% within the first week with further reductions in the following weeks and healing of the ulcer. Subsequently, it was possible to control and maintain the reduction in swelling with less intense treatment. It is possible to reduce and maintain the treatment results of lymphedema associated with Klippel-Trenaunay syndrome.

  7. 强化会计基础工作提升财务管理水平%Strengthening Basic Accounting Work and Improving Financial Management Level

    Institute of Scientific and Technical Information of China (English)

    隋昕

    2013-01-01

      The enterprise accounting work and financial management is based on accounting basic work for reference, the accounting work is the important foundation of economic management. Through expounding the present situation and the problems of the accounting basic work, the paper analyzes the reasons of nonstandard accounting basic work, puts forward policies and suggestions to strengthen the accounting basis work and constantly enhance the level of financial management. It provides reference to strengthen the accounting basic work and enhance the level of financial management.%  企业进行会计工作和财务管理工作都是以会计基础工作为参考依据的,会计基础工作是经济管理的重要基础。本文通过阐述会计基础工作的现状及会计基础工作中存在的问题,分析产生会计基础工作不规范的原因,对加强会计基础工作、不断提升财务管理水平,提出建议。为强化会计基础工作,提升财务管理水平提供参考依据。

  8. Prevalence of lymphedema in women undergoing treatment for breast cancer in a referral center in southeastern Brazil

    Directory of Open Access Journals (Sweden)

    Paiva Daniella MF

    2013-02-01

    Full Text Available Abstract Background Lymphedema is a highly prevalent condition in women who have undergone treatment for breast cancer. Lymphedema negatively affects the quality of life. The objective of this study was to estimate the prevalence of lymphedema and associated factors in women treated for breast cancer in the municipality of Juiz de Fora. Methods We performed a cross-sectional study that evaluated 250 women who were being treated for breast cancer. Pre-screening of the sample by analysis of medical records was performed to select women who met the inclusion criteria as follows: women who had an operation more than 6 months ago; absence of active disease, locoregional or distant; the absence of functional change in the affected limb before surgery, which could lead to swelling of the limb; and simulating or masking symptoms of lymphedema, such as bursitis, tendonitis, and work-related musculoskeletal disorders. Women with bilateral breast cancer, absence of axillary intervention (partial or complete axillary dissection and/or SLN biopsy, active disease in the region, or lympho-venous alteration of the limb before surgery were excluded. Data were collected from the medical records of the selected cases, and they subsequently underwent an interview and a physical assessment. Results The prevalence of lymphedema was 44.8%. There were medical records on the presence of this condition in 5.4% of cases. With regard to shoulder joint mobility, restrictions on abduction movements, internal and external rotation, and anterior shoulder adduction were significantly associated with lymphedema. Variables, including the presence of seroma, vascular changes, time elapsed after surgery, episodes of redness in the extremities, and cuticle removal from the hand with pliers were considered as major associated factors for lymphedema (p Conclusions The prevalence of 44.8% for lymphedema found in this study is considered to be relevant because it is a morbidity that

  9. Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs

    Directory of Open Access Journals (Sweden)

    Larissa Louise Campanholi

    2015-03-01

    Full Text Available BACKGROUND: The diagnosis of lymphedema can be obtained objectively by measurement methods, and also by subjective methods, based on the patient's complaint. OBJECTIVE: To evaluate inter-rater reliability of objective and subjective criteria used for diagnosis of lymphedema and to propose a lymphedema cut-off for differences in volume between affected and control limbs. METHODS: We studied 84 patients who had undergone lymphadenectomy for treatment of cutaneous melanoma. Physical measures were obtained by manual perimetry (MP. The subjective criteria analyzed were clinical diagnosis of lymphedema in patients' medical records and self-report of feelings of heaviness and/or increase in volume in the affected limb. RESULTS: For upper limbs, the subjective criteria clinical observation (k 0.754, P<0.001 and heaviness and swelling (k 0.689, P<0.001 both exhibited strong agreement with MP results and there was moderate agreement between MP results and swelling (k 0.483 P<0.001, heaviness (k 0.576, P<0.001 and heaviness or swelling (k 0.412, P=0.001. For lower limbs there was moderate agreement between MP results and clinical observation (k 0.423, P=0.003 and regular agreement between MP and self-report of swelling (k 0.383, P=0.003. Cut-off values for diagnosing lymphedema were defined as a 9.7% difference between an affected upper limb and control upper limb and a 5.7% difference between lower limbs. CONCLUSION: Manual perimetry, medical criteria, and self-report of heaviness and/or swelling exhibited better agreement for upper limbs than for lower limbs for diagnosis of lymphedema.

  10. Basic Science Training Program.

    Science.gov (United States)

    Brummel, Clete

    These six learning modules were developed for Lake Michigan College's Basic Science Training Program, a workshop to develop good study skills while reviewing basic science. The first module, which was designed to provide students with the necessary skills to study efficiently, covers the following topics: time management; an overview of a study…

  11. Penile and scrotal lymphedema as an unusual presentation of Crohn's disease: case report and review of the literature.

    Science.gov (United States)

    Reitsma, W; Wiegman, M J; Damstra, R J

    2012-03-01

    Crohn's disease is an inflammatory intestinal disease that primarily causes abdominal pain and diarrhea. We report a male patient who presented with penile and scrotal lymphedema and inguinal fistulas as the first manifestations of Crohn's disease. Extraintestinal or metastatic Crohn's disease initially presenting as genital lymphedema with fistula formation is rare. Skin lesions in extraintestinal Crohn's disease typically show non-caseating, sarcoidal granulomas with numerous foreign body- and Langhans-type multinucleated giant cells, which are separated from intestinal involvement by normal skin. Treatment options are limited and include multi-immunosuppressant medications.

  12. Asthma Basics

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Asthma Basics KidsHealth > For Parents > Asthma Basics A A ... Asthma Categories en español Asma: aspectos fundamentales About Asthma Asthma is a common lung condition in kids ...

  13. Classroom Management Issues in Information and Communication Technology (ICT)-Mediated Learning Environments: Back to the Basics

    Science.gov (United States)

    Lim, Cher Ping; Pek, Meow Sien; Chai, Ching Sing

    2005-01-01

    Research studies have shown that effective classroom management is a necessary condition for successful ICT integration in schools. Drawing upon the classroom management practices of teachers in a Singapore primary school, this article describes how the elements of classroom management facilitate the creation of a conducive learning environment to…

  14. Composing hope through collage: A community-based intervention for cancer survivors living with lymphedema

    Directory of Open Access Journals (Sweden)

    Roanne Thomas

    2016-07-01

    Full Text Available Secondary lymphedema after cancer may result in distress, yet few interventions exist to support coping skills in this population. As part of a community-based intervention, we piloted the use of creative practices to promote active orientations to hope. A total of 19 participants completed the workshops; 11 collaged. The main themes address the collage processes as well as their content. The former addresses sub-themes such as selecting/composing. The latter includes sub-themes related to movement depicted in the collages. Collages and their associated discussions concretized hoping as an active and accessible process for participants living with two chronic illnesses.

  15. Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature

    NARCIS (Netherlands)

    Damstra, R. J.; Voesten, H. G. J.; van Schelven, W. D.; van der Lei, B.

    2009-01-01

    Objective The incidence of breast cancer related lymphedema (BCRL) varies between 7-35% depending on the combination of treatment modalities. Early detection of BCRL is crucial in order to start an effective non-operative treatment program. Because of the lack of prospective research on this topic,

  16. Severe lymphedema, intestinal lymphangiectasia, seizures and mild mental retardation: further case of Hennekam syndrome with a severe phenotype.

    Science.gov (United States)

    Forzano, F; Faravelli, F; Loy, A; Di Rocco, M

    2002-07-22

    We report on an Italian patient affected by severe lymphedema of lower limbs, genitalia and face, intestinal lymphangiectasia, seizures, and moderate mental retardation. He has a flat face, flat nasal bridge, and hypertelorism. We propose that he presents with a severe form of Hennekam syndrome.

  17. Effect of Kinesiology Taping on Breast Cancer-Related Lymphedema: A Randomized Single-Blind Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    A. Smykla

    2013-01-01

    Full Text Available The aim of the study was to assess the efficacy of Kinesiology Taping (KT for treating breast cancer-related lymphedema. Sixty-five women with unilateral stage II and III lymphedema were randomly grouped into the KT group (K-tapes, n=20, the Quasi KT group (quasi K-tapes, n=22, or the MCT group (multilayered compression therapy group, n=23. Skin care, 45 min pneumatic compression therapy, 1 h manual lymphatic drainage, and application of K-tape/Quasi K-tapes/multilayered short-stretch bandages were given every treatment session, 3 times per week for 1 month. Patient evaluation items included limb size and percentage edema. Comparing the changes in K-tapes with quasi K-tapes changes, there were no significant differences (P>0.05. The edema reduction of multilayered bandages was much better than in results observed in taping groups. The KT appeared to be ineffective at secondary lymphedema after breast cancer treatment. The single-blind, controlled pilot study results suggest that K-tape could not replace the bandage, and at this moment it must not be an alternative choice for the breast cancer-related lymphedema patient. The trial is registered with ACTRN12613001173785.

  18. A Mutation in VEGFC, a Ligand for VEGFR3, is Associated with Autosomal Dominant Milroy-like Primary Lymphedema

    NARCIS (Netherlands)

    Gordon, K.; Schulte, D.; Brice, G.; Simpson, M.A.; Roukens, M.G.; Impel, Van A.; Connell, F.; Kalidas, K.; Jeffery, S.; Mortimer, P.S.; Mansour, S.; Schulte-Merker, S.; Ostergaard, P.

    2013-01-01

    Rationale: Mutations in vascular endothelial growth factor (VEGF) receptor-3 (VEGFR3 or FLT4) cause Milroy disease, an autosomal dominant condition that presents with congenital lymphedema. Mutations in VEGFR3 are identified in only 70% of patients with classic Milroy disease, suggesting genetic het

  19. Quantitative evaluation of leg lymphedema by MR imaging. Estimation of therapeutic effect by intra-arterial injection of lymphocytes

    Energy Technology Data Exchange (ETDEWEB)

    Makimoto, Yumi; Harada, Masafumi; Matsuzaki, Kenji; Hayashi, Yoshinori; Nishitani, Hiromu; Yoshizumi, Masanori; Yoshida, Osamu; Katoh, Itsuo [Tokushima Univ. (Japan). School of Medicine

    1994-12-01

    The purpose of this study was to obtain characteristic findings of lymphedema and reactions after intra-arterial lymphocytes injection therapy by MRI and to evaluate quantitatively effect of intra-arterial lymphocytes injection. Five patients were treated by several intra-arterial lymphocytes injections. We measured T{sub 2} value on edematous tissue using triple echo sequence and shot TI IR (STIR) images to assess the extent of lymphedema. MRI was measured before and after each intra-arterial lymphocytes injection. Mean T{sub 2} and standard deviation (SD) of T{sub 2} distribution were obtained from T{sub 2}-calculated images. Characteristic findings of lymphedema were the thickening of subcutaneous, meshed pattern of fluid, thickening of skin, and fluid on the fascia. After therapy, thickness of subcutaneous tissue and meshed pattern were greatly decreased, but thickening of skin and fluid on the fascia still remained. Mean T{sub 2} and SD of T{sub 2} in edematous tissue were much higher than those of normal tissue. Both of them decreased extremely after therapy on improved cases but did not change on less effective cases. STIR could differentiate water from adipose tissue and clearly indicated the distribution of water. Mean T{sub 2} and SD of T{sub 2} distribution were useful to indicate evaluation of lymphedema and assessment of therapy. (author).

  20. Validity and intra- and interobserver reliability of an indirect volume measurements in patients with upper extremity lymphedema

    NARCIS (Netherlands)

    Meijer, R.S.; Rietman, J.S.; Geertzen, J.H.B.; Bosmans, J.C.; Dijkstra, P.U.

    2004-01-01

    We investigated a method of indirect volume measurement that utilized surface measurements and a simplified formula derived from the formula for a frustum (Sitzia's method) to determine limb volumes in patients with breast cancer-related lymphedema of the upper extremity. Repeated measurements of up

  1. PENILE AND SCROTAL LYMPHEDEMA AS AN UNUSUAL PRESENTATION OF CROHN'S DISEASE : CASE REPORT AND REVIEW OF THE LITERATURE

    NARCIS (Netherlands)

    Reitsma, W.; Wiegman, M. J.; Damstra, R. J.

    2012-01-01

    Crohn's disease is an inflammatory intestinal disease that primarily causes abdominal pain and diarrhea. We report a male patient who presented with penile and scrotal lymphedema and inguinal fistulas as the first manifestations of Crohn's disease. Extraintestinal or metastatic Crohn's disease initi

  2. Indocyanine green (ICG lymphography is superior to lymphoscintigraphy for diagnostic imaging of early lymphedema of the upper limbs.

    Directory of Open Access Journals (Sweden)

    Makoto Mihara

    Full Text Available BACKGROUND: Secondary lymphedema causes swelling in limbs due to lymph retention following lymph node dissection in cancer therapy. Initiation of treatment soon after appearance of edema is very important, but there is no method for early diagnosis of lymphedema. In this study, we compared the utility of four diagnostic imaging methods: magnetic resonance imaging (MRI, computed tomography (CT, lymphoscintigraphy, and Indocyanine Green (ICG lymphography. PATIENTS AND METHODS: Between April 2010 and November 2011, we examined 21 female patients (42 arms with unilateral mild upper limb lymphedema using the four methods. The mean age of the patients was 60.4 years old (35-81 years old. Biopsies of skin and collecting lymphatic vessels were performed in 7 patients who underwent lymphaticovenous anastomosis. RESULTS: The specificity was 1 for all four methods. The sensitivity was 1 in ICG lymphography and MRI, 0.62 in lymphoscintigraphy, and 0.33 in CT. These results show that MRI and ICG lymphography are superior to lymphoscintigraphy or CT for diagnosis of lymphedema. In some cases, biopsy findings suggested abnormalities in skin and lymphatic vessels for which lymphoscintigraphy showed no abnormal findings. ICG lymphography showed a dermal backflow pattern in these cases. CONCLUSIONS: Our findings suggest the importance of dual diagnosis by examination of the lymphatic system using ICG lymphography and evaluation of edema in subcutaneous fat tissue using MRI.

  3. Results of surgical treatment of massive localized lymphedema in severely obese patients

    Directory of Open Access Journals (Sweden)

    Wilson Cintra Júnior

    2014-01-01

    Full Text Available OBJECTIVE: to evaluate the importance of treatment of deformities caused by massive localized lymphedema (MLL in the severely obese. METHODS: in a period of seven years, nine patients with morbid obesity and a mean age of 33 years underwent surgical resection of massive localized lymphedema with primary synthesis. This is a retrospective study on the surgical technique, complication rates and improved quality of life. RESULTS: all patients reported significant improvement after surgery, with greater range of motion, ambulation with ease and more effective hygiene. Histological analysis demonstrated the existence of a chronic inflammatory process marked by lymphomonocitary infiltrate and severe tissue edema. We observed foci of necrosis, formation of microabscesses, points of suppuration and local fibrosis organization, and pachydermia. The lymphatic vessels and some blood capillaries were increased, depicting a framework of linfangiectasias. CONCLUSION: surgical treatment of MLL proved to be important for improving patients' quality of life, functionally rehabilitating them and optimizing multidisciplinary follow-up of morbid obesity, with satisfactory surgical results and acceptable complication rates, demonstrating the importance of treatment and awareness about the disease.

  4. Active exercises utilizing a facilitating device in the treatment of lymphedema resulting from breast cancer therapy

    Directory of Open Access Journals (Sweden)

    de Fátima Guerreiro Godoy, Maria

    2010-01-01

    Full Text Available The aim of this study was to evaluate the reduction in volume of arm lymphedema secondary to breast cancer therapy utilizing an exercise facilitating device. Twenty-one women with arm lymphedema resulting from the surgical and radiotherapeutic treatment of breast cancer were randomly selected. Evaluation was made by water-displacement volumetry before and after each session. The patients were submitted to a series of active exercises using a facilitating device for four 12-minute sessions with intervals of 3 minutes between sessions in the sitting position with alignment of the spinal column. The lymphedematous arm was maintained under compression using a cotton-polyester sleeve. The active exercising device used was a mobile flexion bar fixed on a metal base at a height of 30 cm from the tabletop and at a distance of 10 cm from the patient’s body. The paired t-test was utilized for statistical analysis with an alpha error of 5% (p-value ≤0.05 being considered significant. The initial mean volume of the arms was 2,089.9 and the final volume was 2,023.0 mL with a mean loss of 66.9 mL (p-value <0.001. In conclusion, active exercises utilizing facilitating devices can contribute to a reduction in size of lymphedematous limbs.

  5. Basic electrotechnology

    CERN Document Server

    Ashen, R A

    2013-01-01

    BASIC Electrotechnology discusses the applications of Beginner's All-purpose Symbolic Instruction Code (BASIC) in engineering, particularly in solving electrotechnology-related problems. The book is comprised of six chapters that cover several topics relevant to BASIC and electrotechnology. Chapter 1 provides an introduction to BASIC, and Chapter 2 talks about the use of complex numbers in a.c. circuit analysis. Chapter 3 covers linear circuit analysis with d.c. and sinusoidal a.c. supplies. The book also discusses the elementary magnetic circuit theory. The theory and performance of two windi

  6. Clinical significance of a proposed lymphoscintigrpahic functional grade system in patients with extremity lymphedema of stage i

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joan Young; Hwang, Ji Hye; Kim, Dong Ik; Cho, Young Seok; Lee, Su Jin; Choi, Yong; Choe, Yeam Seong; Lee, Kyung Han; Kim, Byung Tae [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-07-01

    We proposed a new lymphoscintigrpahic functional grade (LGr) system in extremity lymphedema, and investigated the association between the LGr and a long-term response to physical therapy in patients with extremity lymphedema of stage I. The subjects were 20 patients with unilateral extremity lymphedema of stage I, who underwent pre-treatment extremity lymphoscintigraphy using Tc-99m antimony sulfur colloid, and were treated by complex decongestive physical therapy (CDPT). A proposed lymphoscintigrpahic functional grade system consisted of LGr 0 to LGr 4 according to the ilioinguinal nodal uptake, amount of dermal backflow, and uptake pattern of main and collateral lymphatics : LGr 0 = normal, LGr 1 = decreased lymphatic function without dermal backflow, LGr 2 = decreased lymphatic function with dermal backflow, LGr 3 = non - visualization of main lymphatics with dermal backflow, and LGr 4 = no significant lymphatic transport from injection site. LGr 2 was divided into 2A and 2B based on the amount of dermal backflow. A physician who is a lymphedema specialist determined the long-term outcome to CDPT with normalized response (NR), good response (GR) and poor response (PR) based on the change of edema volume reduction, skin status and occurrence of dermatolymphangioadenitis after the clinical follow-up for more than 1 year. Therapeutic responses were NR in 2 patients. GR in 9 patients and PR in 9 patients. Baseline LGrs were 1 in 7 patients, 2A in 4 patients, 2B in 5 patients, 3 in 2 patients, and 4 in 2 patients. There was a significant relationship between therapeutic response and LGr (p=0.003). In other words, 10 of 11 patients (91%) with LGr 1 or 2A showed NR. or GR. On the contrary, 8 of 9 patients (89%) with LGr 2B, 3 or 4 showed PR. Patients with unilateral extremity lymphedema of stage I had different lymphoscintigrpahic functional grades. This grade system may be useful to predict the response to physical therapy in such patients.

  7. MANAGERS AND BASIC EDUCATION TEACHERS : THE IMPLICATIONS OF ITS ROLE WITH THE EFFECTIVENESS OF TECHNICAL SCHOOL BOARDS

    Directory of Open Access Journals (Sweden)

    Manuel Ortega Muñoz

    2015-06-01

    Full Text Available This letter is part of a broader investigation that deals with the functioning of the School Technical Councils in the elementary schools in the state of Durango, Mexico. In this part, they were raised the following objectives: a Identify what level of implications of the role of principals and teachers in the effective functioning of the School Technical Councils, b Identify the implications of the role of principals and teachers are regarding compliance with the objectives of the School Technical Councils in schools of basic education in the state of Durango and c Identify the implications of the role of principals and teachers regarding the exercise of the powers of the Technical School Councils in schools are Basic education in the state of Durango, Mexico. To achieve the objectives was carried out an exploratory, descriptive, correlational, cross-sectional non-experimental study. Information gathering was conducted by survey method using a questionnaire applied to 1243 principals, group teachers, support teachers and of basic education in the State of Durango, México. Its main results support the conclusion that the gender implications regarding the effective functioning of the School Technical Councils in the elementary schools in the state of Durango have a low level, analyzing its dimensions: achievement of objectives and exercise of powers.

  8. Decision support basics

    CERN Document Server

    Power, Daniel J

    2009-01-01

    This book is targeted to busy managers and MBA students who need to grasp the basics of computerized decision support. Some of the topics covered include: What is a DSS? What do managers need to know about computerized decision support? And how can managers identify opportunities to create innovative DSS? Overall the book addresses 35 fundamental questions that are relevant to understanding computerized decision support.

  9. Brain Basics

    Medline Plus

    Full Text Available ... Basics will introduce you to some of this science, such as: How the brain develops How genes and the environment affect the brain The basic structure of the brain How different parts of the brain communicate and work with each other How changes in the brain ...

  10. Bioimpedance Spectroscopy in Detecting Lower-Extremity Lymphedema in Patients With Stage I, Stage II, Stage III, or Stage IV Vulvar Cancer Undergoing Surgery and Lymphadenectomy

    Science.gov (United States)

    2016-02-09

    Lymphedema; Perioperative/Postoperative Complications; Stage IA Vulvar Cancer; Stage IB Vulvar Cancer; Stage II Vulvar Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVA Vulvar Cancer; Stage IVB Vulvar Cancer

  11. Managing radioactive waste produced at secret basic nuclear facilities; La gestion des dechets radioactifs issus des installations nucleaires de base secretes

    Energy Technology Data Exchange (ETDEWEB)

    Elluard, M.P. [Chef de projet a l' Autorite de Surete Nucleaire de Defense - Ministere de la Defense, 75 - Paris (France)

    2011-02-15

    The Delegate for Nuclear Safety and Radiation Protection for National Defence Installations and Activities (DSND) is attached to the French Minister of Defence and the Minister for Industry. The DSND's task is to study and propose to the relevant ministers the specific nuclear safety and radiation protection policy applicable to secret basic nuclear installations (SBNI) classified as such by decision of the Prime Minister. He supervises application of this policy. The DSND draws up the regulations relative to managing waste present within the boundaries of SBNIs in accordance with the guidelines set out in the Environmental Code. Thus, the Title VI of the Order of 26 September 2007 setting out the general technical regulations designed to prevent and limit pollution and external risks resulting from the operation of secret basic nuclear installations recalls the requirement for all SBNI operators to take every precaution necessary to reduce the volume and the radiological, chemical and biological toxicity of all waste produced at its installations and to optimise its management, whilst giving priority to recycling and processing rather than final disposal, which is to be reserved for final waste. The DSND supervises and monitors safety at every stage in radioactive waste management: production, processing, storage, transportation and disposal. (author)

  12. Dehydrated Human Amnion/Chorion Grafts May Accelerate the Healing of Ulcers on Free Flaps in Patients With Venous Insufficiency and/or Lymphedema

    OpenAIRE

    Miranda, Edward P.; Friedman, Alex

    2016-01-01

    Objective: Ulceration of free flaps in patients with venous insufficiency and/or lymphedema is an uncommon but challenging problem. We hypothesized that dehydrated human amnion/chorion membrane (Epifix) grafts would accelerate healing of these challenging ulcers. Methods: Retrospective analysis of prospectively acquired data identified 8 lower extremity free flaps with ulcerations in the context of venous insufficiency and/or lymphedema. The first 4 were flaps that had been treated with conse...

  13. Basic hydraulics

    CERN Document Server

    Smith, P D

    1982-01-01

    BASIC Hydraulics aims to help students both to become proficient in the BASIC programming language by actually using the language in an important field of engineering and to use computing as a means of mastering the subject of hydraulics. The book begins with a summary of the technique of computing in BASIC together with comments and listing of the main commands and statements. Subsequent chapters introduce the fundamental concepts and appropriate governing equations. Topics covered include principles of fluid mechanics; flow in pipes, pipe networks and open channels; hydraulic machinery;

  14. Discussion on the Basic Principle of Food Safety Risk Management%食品安全风险管理基本理论探析

    Institute of Scientific and Technical Information of China (English)

    刘为军; 魏益民; 郭波莉; 魏帅

    2011-01-01

    本文就食品安全风险管理的概念、原则和实施框架等基本理论问题进行了探讨.食品安全风险管理是风险分析体系的重要组成部分,是在风险评估结果基础上的政策选择过程,包括选择实施适当的控制理念以及法规管理措施.食品安全风险管理包括风险评价、选择评估、执行评估、监控和回顾4个要素.%This paper discussed the basic principle of food safety risk management, which includes the concept, principles and implement framework. Risk management is one of the important components of risk analysis. Risk management is defined as the process of weighing policy alternatives in the light of the results of risk assessment and selecting and implementing appropriate control options, including regulatory measures. The framework includes 4 elements: risk evaluation, risk management option assessment, implementation of management decision, and monitoring and review.

  15. BASIC ACTIVITIES OF THE HUMAN RESOURCE MANAGEMENT IN ENSURING STAFF FOR S.C. ROMLUX S.A.

    Directory of Open Access Journals (Sweden)

    SECARĂ CARMEN-GABRIELA

    2014-08-01

    Full Text Available Within the analysis conducted, the main activities in the field of human resource management has been assessed, such as: human resource planning; recruitment and selection of staff; assessment of individual professional performances; initial and continuing training; evaluation of human resources management costs; motivation. However, there have also been reviewed with a lower degree of detailing, other issues of interest, such as: human resources assessment; promotion of staff. Following the integration of conclusions of analysis conducted for the business areas listed, it resulted the picture of the most important elements with generalizing value.

  16. Brain Basics

    Medline Plus

    Full Text Available ... depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are the basic working unit of ... but sometimes give rise to disabilities or diseases. neural circuit —A network of neurons and their interconnections. ...

  17. Brain Basics

    Medline Plus

    Full Text Available ... Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah is a ... blues" from time to time. In contrast, major depression is a serious disorder that lasts for weeks. ...

  18. Schizophrenia Basics

    Science.gov (United States)

    ... I know with schizophrenia? For More Information Share Schizophrenia Basics Download PDF Download ePub Order a free hardcopy What is schizophrenia? Schizophrenia is a serious mental disorder that affects ...

  19. Brain Basics

    Medline Plus

    Full Text Available ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  20. Brain Basics

    Science.gov (United States)

    ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  1. Fluoridation Basics

    Science.gov (United States)

    ... Page Basic Information About Fluoride Benefits: Strong Teeth History of Fluoride in Water Cost: Saves Money, Saves Teeth Fluoride in the Water Today The mineral fluoride occurs naturally on earth and is released from rocks into the soil, ...

  2. Basic Finance

    Science.gov (United States)

    Vittek, J. F.

    1972-01-01

    A discussion of the basic measures of corporate financial strength, and the sources of the information is reported. Considered are: balance sheet, income statement, funds and cash flow, and financial ratios.

  3. Brain Basics

    Medline Plus

    Full Text Available ... science, such as: How the brain develops How genes and the environment affect the brain The basic ... that with brain development in people mental disorders. Genes and environmental cues both help to direct this ...

  4. Brain Basics

    Medline Plus

    Full Text Available ... in the anatomy, physiology, and chemistry of the nervous system. When the brain cannot effectively coordinate the billions ... the basic working unit of the brain and nervous system. These cells are highly specialized for the function ...

  5. 基层血库工作管理研究%Study on the Basic Blood Bank Management

    Institute of Scientific and Technical Information of China (English)

    李建屏

    2015-01-01

    Blood banks are very important parts of the hospital, and hospital treatment has a very close relationship, to normalize their management are very necessary. The special nature of the blood bank, its management and other departments of the essential difference. Management in grass-roots hospital blood bank will be carried out in this paper simple Exposition, designed to provide reference for primary blood bank management.%血库是医院中非常重要的部门,与医院的救治工作有着非常密切的联系,对其进行规范化管理也是非常必要的。血库的性质较为特殊,其管理工作也与其他部门有着本质性的区别。该研究将对基层医院血库的管理工作进行简单的阐述,旨在为基层血库管理工作提供可参考依据。

  6. Qualitative and quantitative lymphoscintigraphy in the evaluation of lower limbs lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Dalia, Roberta Maria; Martins, Glaucia Ribeiro P.; Barbosa, Rodolfo [Uniao Educacional do Vale do Aco, Belo Horizonte, MG (Brazil); Lima, Carla Flavia de; Siqueira, Cristiano Ferrari [Ecograf Medicina Nuclear, Belo Horizonte, MG (Brazil)

    2005-10-15

    The purpose of this study was to prove the efficiency of qualitative and quantitative lymphoscintigraphy in the diagnosis of the lower extremity lymphedema. Seventy-seven patients had been studied, most of then (85.7%) were female. Patients' ages ranged from 18 to 82 years. All patients underwent a bilateral lymphoscintigraphy. Images were recorded with a dual-detector instrument in the whole-body scanning mode. Feet and inguinal static views were acquired within 15 minutes and three hours after radiopharmaceutical injection. Two nuclear doctors evaluated the lymphoscintigrams qualitatively. Quantitative studies of the radiopharmaceutical absorption and the lymph node chain uptake were also obtained. Of the 154 evaluated members, 21.44% (n = 33) were classified as normal, 61.68% (n = 95) as mildly altered and 16.88% (n = 26) much altered. Quantitation of lymphatic chain uptake may be a more sensitive approach to the diagnosis of lymphatic impairment than the qualitative analysis. (author)

  7. Lymphoscintigraphic evaluation of intra-arterial lymphocyte injection in patients with leg lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Suga, Kazuyoshi; Uchisako, Hiroji; Yoneshiro, Shu; Fujita, Takefumi; Nakanishi, Takashi; Wakamatsu, Takafumi; Esato, Kensuke (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1992-05-01

    Three patients with chronic leg lymphedema were treated by intra-arterial lymphocyte injection and the effect was evaluated by lymphoscintigraphy using intradermal injection of {sup 99m}Tc-HSA. In all of the patients, the followed-up lymphoscintigraphy showed disappearance of the abnormalities of dermal back flow and/or collateral pathways observed before treatment and these findings were thought to indicate reduced load of dermal lymphatics induced by the treatment. These results indicated the usefulness of imaging with intradermal injection of {sup 99m}Tc-HSA for assessing the effect of treatment with intra-arterial lymphocyte injection. In addition, in two patients of them, analysis of lymph flow after treatment was underwent by time-activity curves obtained by lymphoscintigraphy using a load produced by standing. We also described the significance of the load test with standing. (author).

  8. Development of the short version of the Gynecologic Cancer Lymphedema Questionnaire: GCLQ-7

    Science.gov (United States)

    Kim, Namjoo; Lee, Seonjoo; Lee, Sujung; Seo, Sang-Soo; Chung, Seung Hyun

    2017-01-01

    Objective The Gynecologic Cancer Lymphedema Questionnaire (GCLQ) was designed to identify gynecologic cancer patients with lower limb lymphedema (LLL). The questionnaire consists of 20 items distributed over 7 symptom clusters. The present study aimed to develop an abridged form of the GCLQ for simpler screening and more effective follow-up of LLL. Methods Data that had been collected for the development and validation of the Korean version of the GCLQ (GCLQ-K) were used in this study. Receiver-operating characteristic (ROC) curves were drawn according to the individual items of the GCLQ-K. Based on discrimination ability, the candidate items were selected in each symptom cluster. After combining the items, the best model was identified and named GCLQ-7. The area under the ROC curve (AUC) was compared between the GCLQ-7 and the original GCLQ-K. Results In total, 11 candidate items were selected from the original GCLQ-K. Among the models made with the candidate items, GCLQ-7, the best model, was constructed with 7 items as follows: 1) limited knee movement, 2) general swelling, 3) redness, 4) firmness/tightness, 5) groin swelling, 6) heaviness, and 7) aching. This model exhibited an AUC of 0.945 (95% confidence interval [CI], 0.900–0.991), which is comparable with that of the original GCLQ-K (AUC, 0.867; 95% CI, 0.779–0.956). The best cutoff value was 2 points, at which the sensitivity and specificity were 97.0% and 76.5%, respectively. Conclusion The newly developed short version model, GCLQ-7, showed acceptable discrimination ability as compared with the original GCLQ-K. PMID:27819411

  9. Basic electronics

    CERN Document Server

    Holbrook, Harold D

    1971-01-01

    Basic Electronics is an elementary text designed for basic instruction in electricity and electronics. It gives emphasis on electronic emission and the vacuum tube and shows transistor circuits in parallel with electron tube circuits. This book also demonstrates how the transistor merely replaces the tube, with proper change of circuit constants as required. Many problems are presented at the end of each chapter. This book is comprised of 17 chapters and opens with an overview of electron theory, followed by a discussion on resistance, inductance, and capacitance, along with their effects on t

  10. Enhance Marketing Basic Management Ability by Optimizing Process Management%以流程管理提升营销基础管理能力

    Institute of Scientific and Technical Information of China (English)

    荆慧; 孙明霞; 云笑杰; 岳玉先; 韩元凯

    2013-01-01

    目前相对国网公司的“大营销”运作模式,做为营销工作中的基础---抄核收业务,更需要优化管理流程,突出过程控制和层级监督,改变各大经济指标的实现靠政令层层下达,信息层层传递的被动局面。将管理重点下移,实现从“职能分割型管理”向“流程协同化管理”地转变,以流程管理提升抄核收业务管理能力,建立抄表、核算、收费等各部门“流程清晰、指标精细、职责明确、协同高效”的管理模式,为“大营销”的实施奠定坚实的基础。%In the Big Marketing operation mode, reading-check-billing service of state grid company as the foundation of marketing needs to optimize management process, emphasize process control and hierarchical supervision, and change the passive situation of multi-level assignment and multi-level transmission. We should change key management points, such as changing from Functional Division Based Management to Process -collaborative Management, enhancing reading -check -billing service management by optimizing process management, building the management model of clear process, fine index, and specific responsibility and efficient collaboration among the department of reading, check and billing, laying foundation for the implementation of Big Marketing mode.

  11. Ethanol Basics

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-01-30

    Ethanol is a widely-used, domestically-produced renewable fuel made from corn and other plant materials. More than 96% of gasoline sold in the United States contains ethanol. Learn more about this alternative fuel in the Ethanol Basics Fact Sheet, produced by the U.S. Department of Energy's Clean Cities program.

  12. Body Basics

    Science.gov (United States)

    ... more about how the body works, what basic human anatomy is, and what happens when parts of the body don't function properly. Blood Bones, Muscles, and Joints Brain and Nervous System Digestive System Endocrine System Eyes Female Reproductive System Heart and Circulatory System Immune ...

  13. Brain Basics

    Medline Plus

    Full Text Available ... such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are the basic working unit ... final destination. Chemical signals from other cells guide neurons in forming various brain structures. Neighboring neurons make connections with each other ...

  14. Insulin Basics

    Science.gov (United States)

    ... Honor Become a Member En Español Type 1 Type 2 About Us Online Community Meal Planning Sign In Search: Search More Sites Search ≡ Are You At Risk? Diabetes Basics Living with Diabetes Food & Fitness In My ... Diabetes and Learning About Prediabetes Type 2 Diabetes Risk Test Lower Your Risk Healthy ...

  15. A plant resource and experiment management system based on the Golm Plant Database as a basic tool for omics research

    Directory of Open Access Journals (Sweden)

    Selbig Joachim

    2008-05-01

    Full Text Available Abstract Background For omics experiments, detailed characterisation of experimental material with respect to its genetic features, its cultivation history and its treatment history is a requirement for analyses by bioinformatics tools and for publication needs. Furthermore, meta-analysis of several experiments in systems biology based approaches make it necessary to store this information in a standardised manner, preferentially in relational databases. In the Golm Plant Database System, we devised a data management system based on a classical Laboratory Information Management System combined with web-based user interfaces for data entry and retrieval to collect this information in an academic environment. Results The database system contains modules representing the genetic features of the germplasm, the experimental conditions and the sampling details. In the germplasm module, genetically identical lines of biological material are generated by defined workflows, starting with the import workflow, followed by further workflows like genetic modification (transformation, vegetative or sexual reproduction. The latter workflows link lines and thus create pedigrees. For experiments, plant objects are generated from plant lines and united in so-called cultures, to which the cultivation conditions are linked. Materials and methods for each cultivation step are stored in a separate ACCESS database of the plant cultivation unit. For all cultures and thus every plant object, each cultivation site and the culture's arrival time at a site are logged by a barcode-scanner based system. Thus, for each plant object, all site-related parameters, e.g. automatically logged climate data, are available. These life history data and genetic information for the plant objects are linked to analytical results by the sampling module, which links sample components to plant object identifiers. This workflow uses controlled vocabulary for organs and treatments. Unique

  16. Health Insurance Basics

    Science.gov (United States)

    ... members at a lower cost. The four basic types of managed care plans are: HMO (Health Maintenance Organization). When you join an HMO, you choose a ... may have to pay more. EPO (Exclusive Provider Organization). An EPO is like a PPO, only ... Health Plan (CDHP) This type of plan is fairly new. It lets you ...

  17. Four Basic Problems of the Kindergarten Archive Management Research%论幼儿园档案管理的四个基本问题

    Institute of Scientific and Technical Information of China (English)

    时松

    2014-01-01

    Kindergarten archives management is an important part of kindergarten standardized man-agement.This research expounds four basic questions:where the archives of the kindergarten come from;what is the value of archives management in kindergarten;how to classify kindergarten archives;how to manage the kindergarten archives.%幼儿园档案管理工作是幼儿园规范化管理的重要组成部分。其档案管理必须厘清四个基本问题:幼儿园档案从哪里来、幼儿园档案管理有何价值、幼儿园档案怎么分类、幼儿园档案如何管理。明确了这四个问题的答案,幼儿园档案管理工作必然井井有条,服务到位。

  18. Effects of proprioceptive neuromuscular facilitation stretching and deep-breathing exercises on upper extremity lymphedema in stroke patients.

    Science.gov (United States)

    Hwang, Woon Taek; Jeong, Yeon-Jae; Kim, Seong-Yeol; Jeong, Yeon-Gyu

    2016-12-01

    [Purpose] The purpose of this study was to determine the effects of deep-breathing and proprioceptive neuromuscular facilitation stretching exercises on upper limb lymphedema in stroke patients. [Subjects and Methods] The study consisted of 10 patients with lymphedema that had occurred after stroke. Neurodevelopmental treatment was applied in the same manner as that used for the existing treatment. The subjects performed deep-breathing and stretching exercises three times per week for 4 weeks (12 sessions total). Body water volume in the upper limbs was measured before and after exercise by using an InBody S10 analyzer. [Results] Performance of deep-breathing and stretching exercises significantly reduced body water volume in both the affected and unaffected arms. The extracellular-to-total cellular fluid volume ratio in the affected arm improved to 0.379 after exercise, although this change was not significant. [Conclusion] The results of the present study show that deep-breathing and proprioceptive neuromuscular facilitation stretching exercises reduce upper extremity lymphedema in stroke patients.

  19. Effects of proprioceptive neuromuscular facilitation stretching and deep-breathing exercises on upper extremity lymphedema in stroke patients

    Science.gov (United States)

    Hwang, Woon Taek; Jeong, Yeon-Jae; Kim, Seong-Yeol; Jeong, Yeon-Gyu

    2016-01-01

    [Purpose] The purpose of this study was to determine the effects of deep-breathing and proprioceptive neuromuscular facilitation stretching exercises on upper limb lymphedema in stroke patients. [Subjects and Methods] The study consisted of 10 patients with lymphedema that had occurred after stroke. Neurodevelopmental treatment was applied in the same manner as that used for the existing treatment. The subjects performed deep-breathing and stretching exercises three times per week for 4 weeks (12 sessions total). Body water volume in the upper limbs was measured before and after exercise by using an InBody S10 analyzer. [Results] Performance of deep-breathing and stretching exercises significantly reduced body water volume in both the affected and unaffected arms. The extracellular-to-total cellular fluid volume ratio in the affected arm improved to 0.379 after exercise, although this change was not significant. [Conclusion] The results of the present study show that deep-breathing and proprioceptive neuromuscular facilitation stretching exercises reduce upper extremity lymphedema in stroke patients. PMID:28174433

  20. Cervical Stimulation in the Treatment of Children with Lymphedema of All Four Extremities: A Case Report and Literature Review

    Science.gov (United States)

    Pereira de Godoy, Livia Maria; Pereira de Godoy Capeletto, Paula

    2017-01-01

    Aim. The aim of this study is to report on the use of cervical stimulation as monotherapy to reduce swelling and normalize the size of limbs in two children with lymphedema of all four extremities. Case Presentation. One child also had hemifacial edema. In both cases, the mothers were trained to perform cervical stimulation under professional supervision. The cases of two girls, one of eight months and the other of six months, with primary congenital lymphedema are described. Outcome. After clinical diagnosis, the patients started treatment with cervical stimulation three times per week. The mothers were trained in cervical stimulation and, when the therapy team was confident about the mothers' ability to perform the technique, the children began to be treated at home. The Godoy & Godoy cervical stimulation technique consists of around 20 to 30 light stroking movements per minute in the cervical region which stimulate the lymphatics. Perimetric measurements were made of the feet, legs, and the hands. Only two points (3 and 6 cm) along the dorsum of the feet and hands and points at 5 cm intervals up the legs starting at the ankle were considered. Today, the children are 5 and 6 years of age, without edema and with a normal life, without limitations, except with respect to precautions against injuries to the limbs and against infections particularly erysipelas. Conclusion. Cervical Lymphatic Therapy as monotherapy is an option in the treatment of primary congenital lymphedema.

  1. EPOC: Propuesta de manejo simple del paciente estable COPD: A PROPOSAL OF BASIC MANAGEMENT OF THE STABLE PATIENT

    Directory of Open Access Journals (Sweden)

    MÓNICA GUTIÉRREZ C.

    2002-07-01

    Full Text Available Considerando la frecuencia con que la EPOC estable debe ser enfrentada en el nivel primario, en esta exposición se propone en forma esquemática a través de texto y diagramas de flujo una secuencia simplificada para el diagnóstico, etapificación, evaluación funcional y tratamiento de esta condición en sus diversas etapas. Las recomendaciones se circunscriben a los métodos y procedimientos cuya eficacia tiene un respaldo adecuado en la experiencia clínica y en las publicaciones y que, además, son factibles de aplicar en nuestro medioConsidering that COPD usually seen and frequently managed at the primary level this proposal schematically summarizes through text and diagrams a simplified sequence for the diagnosis, staging, functional evaluation and treatment of this condition in its different stages. Recommendations are cicumscribed to the methods and procedures whose efficiency is adequately backed by clinical experience and publications and which can be feasibly applied in our medium

  2. Wavelet basics

    CERN Document Server

    Chan, Y T

    1995-01-01

    Since the study of wavelets is a relatively new area, much of the research coming from mathematicians, most of the literature uses terminology, concepts and proofs that may, at times, be difficult and intimidating for the engineer. Wavelet Basics has therefore been written as an introductory book for scientists and engineers. The mathematical presentation has been kept simple, the concepts being presented in elaborate detail in a terminology that engineers will find familiar. Difficult ideas are illustrated with examples which will also aid in the development of an intuitive insight. Chapter 1 reviews the basics of signal transformation and discusses the concepts of duals and frames. Chapter 2 introduces the wavelet transform, contrasts it with the short-time Fourier transform and clarifies the names of the different types of wavelet transforms. Chapter 3 links multiresolution analysis, orthonormal wavelets and the design of digital filters. Chapter 4 gives a tour d'horizon of topics of current interest: wave...

  3. Basic principles of knowledge management and its application to the industrial company in tactical operations of maintenance and operational exploitation: A qualitative study

    Directory of Open Access Journals (Sweden)

    Francisco Javier Cárcel Carrasco

    2013-01-01

    Full Text Available Purpose: Although knowledge and its management is, and has been, studied in depth, particularly since the 90’s decade of the past century, especially for the strategic management, innovation, trade, or business administration, there are still many questions on how it articulates or transfers and the barriers to its management, especially when we talk about internal tactical activities that affect staff that we could call "offices", such as maintenance and industrial assembly or exploitation and conduction of the facilities. Because of the peculiarities normally seen in this kind of activity in the industrial companies, the knowledge of these people is strongly based on their experience (strong tacit component, difficult to measure and articulate, and on many occasions, however, this rupture of information-knowledge, can represent a high cost for the company (often assumed to be something inevitable due to the increase in production and service downtime, loss of efficiency, or tuning time of new staff to these areas.Design/methodology/approach: After a description of the State of the art and the basic principles of knowledge management, a qualitative study in an industrial company has been carried out, within the areas of operation and maintenance, in order to know the barriers and facilitators that such involved personnel finds in order to achieve an adequate transmission and use of that knowledge.Findings and Originality/value: Learn about barriers, facilitators and impact that offers the knowledge management in the areas of industrial maintenance, especially among professionals in offices which operate with a high degree of tacit knowledge and with a heavy dependence on the company on these professionals.Research limitations/implications: Those characteristics of a qualitative study in a particular area and within a geographical area, although it can be extrapolated to other types of companies and regional areas.Practical implications: Learn

  4. Emergency medicine: beyond the basics.

    Science.gov (United States)

    Malamed, S F

    1997-07-01

    Medical emergencies can arise in the dental office. Preparedness for these emergencies is predicated on an ability to rapidly recognize a problem and to effectively institute prompt and proper management. In all emergency situations, management is based on implementation of basic life support, as needed. The author describes the appropriate management of two common emergency situations: allergy and chest pain.

  5. Effect Analysis of PDCA Circulation in the PICU Basic Nursing Manage-ment%浅析PDCA循环在PICU基础护理管理中的效果

    Institute of Scientific and Technical Information of China (English)

    马洁

    2016-01-01

    Objective To research and study the application effect of PDCA circulation in the PICU basic nursing manage-ment. Methods PDCA circulation model has been implemented in the basic nursing management in the pediatric intensive care unit of our hospital since January 2014, the patients admitted and treated in the pediatric intensive care unit of our hospital from January 2014 to December 2014 were selected as the observation group, and the patients admitted and treated in the pediatric intensive care unit of our hospital without PDCA circulation model from January 2013 to December 2013 were selected as the control group, and the incidence rates of nursing error events, nursing management quality score and satisfactory degree of nursing services of the two phases were compared. Results The incidence rates of nursing error events in the observation group was obviously decreased after the implementation of PDCA circulation model compared with that in the observation group (P<0.05), but the nursing management quality score and satisfactory degree of nursing services in the observation group were obviously increased(P<0.05). Conclusion The implementation of PDCA circulation model in the ba-sic nursing management of pediatric intensive care unit can effectively improve the nursing management quality, reduce the nursing error event and improve the satisfactory degree of nursing services. With the constant progress of living standards and medical technology, people’s requirement for medical services is stricter and stricter, and the hospital nursing manage-ment has also been widely concerned, especially with the constant occurrence of nurse-patient disputes and nursing safety event in recent years, nursing service quality draws attention to the nursing workers, enhancing nursing management has al-ready been a pressing issue today. It is necessary to enhance the nursing management of the pediatric intensive care unit because the patient’s condition in the pediatric

  6. The basic concept of library crisis management and content analysis%图书馆危机管理的基本概念及内容分析

    Institute of Scientific and Technical Information of China (English)

    李荣

    2014-01-01

    the library crisis means of library system security threat and destruction, so that the library into a state of high volatility. The emergence of library crisis management is to prevent the crisis after crisis has the correct effectively solve the corresponding strategy and so on the basic concept and content of library crisis management is necessary to in-depth study.%图书馆危机指的是对图书馆系统安全造成威胁和破坏从而使图书馆进入高度震荡的状态。图书馆危机管理就是为了防范危机的出现概率,出现危机后能有正确有效的对应解决策略,所以对图书馆危机管理的基本概念以及内容进行深入研究是非常有必要的。

  7. Basic electronics

    CERN Document Server

    Tayal, DC

    2010-01-01

    The second edition of this book incorporates the comments and suggestions of my friends and students who have critically studied the first edition. In this edition the changes and additions have been made and subject matter has been rearranged at some places. The purpose of this text is to provide a comprehensive and up-to-date study of the principles of operation of solid state devices, their basic circuits and application of these circuits to various electronic systems, so that it can serve as a standard text not only for universities and colleges but also for technical institutes. This book

  8. Regression Basics

    CERN Document Server

    Kahane, Leo H

    2007-01-01

    Using a friendly, nontechnical approach, the Second Edition of Regression Basics introduces readers to the fundamentals of regression. Accessible to anyone with an introductory statistics background, this book builds from a simple two-variable model to a model of greater complexity. Author Leo H. Kahane weaves four engaging examples throughout the text to illustrate not only the techniques of regression but also how this empirical tool can be applied in creative ways to consider a broad array of topics. New to the Second Edition Offers greater coverage of simple panel-data estimation:

  9. Orofacial pain: basic mechanisms and implication for successful management Dores orofaciais: mecanismos básicos e implicações para um tratamento efetivo

    Directory of Open Access Journals (Sweden)

    Paulo César Rodrigues Conti

    2003-03-01

    Full Text Available Orofacial Pain is the field of dentistry devoted to the diagnosis and management of chronic, complex, facial pain and oromotor disorders. This specialty in dentistry has developed over a number of years out of the need for better understanding of a group of patients who somehow were not clearly suffering from dental pain disorders, but still did not seem to have a clearly defined medical problem. After a long period of treating patients based on the mechanicist aspect of the disease, our profession has realized the importance of basic knowledge and differencial diagnosis in order to proper manage these patients. This modification in the approach has caused severe changes in education as well as in clinical activities. Historically considered as a problem of occlusion, Orofacial Pain, including Temporomandibular Disorders (TMD has recently reached the status of "Specialty" in Brazil. Therefore, this paper aims to discuss the main differences between musculoskeletal and neuropathic pain and the importance of basic knowledge to perform successful management.Dor Orofacial é um campo da odontologia dedicado ao diagnóstico e tratamento de dores orofaciais crônicas e complexas, além d e desordens motoras. Essa especialidade odontológica tem se desenvolvido por vários anos com o objetivo de prover um melhor entendimento de um grupo de pacientes que, de alguma forma, não tinham dores de origem dentária e nem condições óbvias médicas que explicassem suas dores na face. Depois de um longo período propondo tratamentos baseados apenas no aspecto mecanicista da doença, nossa profissão percebeu a importância de entender mecanismos básicos de diagnóstico diferencial para melhor controlar esses casos. Essa mudança de mentalidade tem levado a modificações na educação em odontologia, assim como nos procedimentos clínicos executados. Historicamente considerada como um "problema de oclusão", as dores orofaciais obtiveram recentemente o

  10. Lymphoscintigraphic evaluation of leg lymphedema using intradermal injection of technetium 99m-labeled human serum albumin; Assessment of the effect of standing

    Energy Technology Data Exchange (ETDEWEB)

    Uchisako, Hiromichi; Suga, Kazuyoshi; Ito, Katsuyoshi; Kuramitsu, Tatsuya; Tanaka, Nobuyuki; Nakaki, Hiroji; Nakanishi, Takashi; Esato, Kensuke (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1993-11-01

    Twenty-four patients with lymphedema of the lower limbs and seven normal subjects were examined by lymphoscintigraphy following an intradermal injection of [sup 99m]Tc-HSA. The effect of changing to a standing position was determined. In normal subjects, a large spiking wave and a rapid stepwise increase in tracer activity frequently occurred on standing, although a decreased phase appeared less often on time-activity curves. These findings indicated that lymphatic flow was increased after the load produced by standing. The frequency of these changes was decreased in the patients with lymphedema, indicating that lymphatic disruption was responsible for their edema. Thus, lymphoscintigraphy using a load produced by standing can provide useful information in patients with lymphedema of the legs. (author).

  11. Case report: Manual lymphatic drainage and kinesio taping in the secondary malignant breast cancer-related lymphedema in an arm with arteriovenous (A-V) fistula for hemodialysis.

    Science.gov (United States)

    Chou, Ya-Hui; Li, Shu-Hua; Liao, Su-Fen; Tang, Hao-Wei

    2013-08-01

    Lymphedema is a dreaded complication of breast cancer treatment. The standard care for lymphedema is complex decongestive physiotherapy, which includes manual lymphatic drainage (MLD), short stretch bandaging, exercise, and skin care. The Kinesio Taping could help to improve lymphatic uptake. We reported a patient with unilateral secondary malignant breast cancer-related lymphedema and arteriovenous (A-V) fistula for hemodialysis happened in the same arm, and used kinesio taping, MLD, and exercise to treat this patient because no pressure could be applied to the A-V fistula. The 12-session therapy created an excellent effect. We do not think the kinesio taping could replace short stretch bandaging, but it could be another choice for contraindicating pressure therapy patients, and we should pay attention to wounds induced by kinesio tape.

  12. Illustrating the (invisible: Understanding the impact of loss in adults living with secondary lymphedema after cancer

    Directory of Open Access Journals (Sweden)

    Roanne Thomas

    2014-08-01

    Full Text Available Life with a disability is often riddled with paradoxes, one of which is being visibly marked, while personal experiences, losses, and challenges remain hidden. Our article draws attention to this paradox among people who live with secondary lymphedema after cancer (SLC. SLC is a relatively unfamiliar chronic condition within medical and lay discourses of cancer, which proves challenging for the many cancer survivors who are in search of information and understanding. Thirteen men and women with SLC were recruited from two research sites (Fredericton, NB, and Ottawa, ON, Canada to participate in semi-structured interviews about the physical and psychosocial aspects of SLC. Using a methodology of interpretive description, our analysis of participant interviews reveals the complex ways in which men and women felt both visible and invisible within various contexts. We discuss three majors themes: (invisibility and appearance related to material losses; (invisibility and action connected to visible losses in function, as well as invisible struggles to care for oneself; and the loss of present and future well-being, as SLC renders some limitations visible while potentially obscuring a hopeful future indefinitely. Our research indicates that timely diagnosis of SLC would be an immediate first step in recognizing the physical and emotional dimensions of the condition. To accomplish this, increased awareness is needed. To enhance quality of life for those living with SLC, the development of new resources and psychosocial supports is also required.

  13. Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft.

    Science.gov (United States)

    Thompson, Michael; Mathuram Thiyagarajan, Umasankar; Akoh, Jacob A

    2014-07-01

    Prosthetic arteriovenous grafts (AVGs) are associated with greater morbidity than autogenous arteriovenous fistulas (AVFs), but their use is indicated when AVF formation is not possible. This report adds to the literature a case of lower limb gigantism, painful varicosities, and lymphedema following long-term use of AVG in the upper thigh. The patient's past medical history included renal transplantation on the same side well before the AVG was inserted and right leg deep vein thrombosis. Suspicion of AVG thrombosis was excluded by Doppler ultrasound, which demonstrated an access flow of 1700 mL/min. A computed tomography (CT) scan of the abdomen and pelvis did not identify the cause of her symptoms. Whereas functional incompetence of the iliac vein valve might be responsible for the varicosities, the extent of hypertrophy in this case raises the suspicion of lymphatic blockage possibly secondary to groin dissection undertaken at the time of graft insertion, in addition to the previous dissection at the time of transplantation. This case highlights the need for minimal groin dissection during AVG insertion, particularly in patients with a history of previous abdominopelvic surgery.

  14. Skin and Subcutaneous Tissue Ultrasonography Features in Breast Cancer-Related Lymphedema

    Science.gov (United States)

    Morikage, Noriyasu; Yamashita, Osamu; Harada, Takasuke; Samura, Makoto; Takeuchi, Yuriko; Mizoguchi, Takahiro; Nakamura, Kaori; Hamano, Kimikazu

    2016-01-01

    Objective: To investigate skin, subepidermal low echogenic band (SELEB), and subcutaneous tissue (SCT) thickness as well as the degree of increase in subcutaneous echogenicity (SEG) and subcutaneous echo-free space (SEFS) in arms with lymphedema (LE). Materials and Methods: The skin and SCT of both arms of 30 patients with unilateral stage II breast cancer-related LE were scanned at five points (medial/lateral upper arm/forearm and dorsum of the hand). SEG and SEFS grades were determined according to severity (range: 0–2). Results: All measured parameters, except the SEFS in the medial upper arm, were significantly higher on the LE side than on the normal (N) side. The parameters differed most remarkably in the medial forearm (MFA; skin: LE 1.7 ± 0.8 mm vs. N 0.8 ± 0.2 mm; SELEB: LE 1.0 ± 0.6 mm vs. N 0.3 ± 0.1 mm; SCT: LE 8.7 ± 3.4 mm vs. N 3.8 ± 2.0 mm; SEG: LE 0.9 ± 0.5 vs. N 0.1 ± 0.3; and SEFS: LE 0.5 ± 0.7 vs. N 0). Conclusion: The differences in the thickness of the skin, SELEB, and SCT and the SEG and SEFS grades between the LE and N arms seemed most evident in the MFA. PMID:28018504

  15. 浅议基层保险公司财务如何做好服务与管控%On Financing Service and Management of Basic-level Insurance Company

    Institute of Scientific and Technical Information of China (English)

    张爱华

    2013-01-01

    This article analyzes the service and management way of basic-level insurance company financing. The financing of basic-level insurance company is expounded from three aspects:way of service, way of refining and way of management.%分析基层保险公司财务如何服务与管控。分别从如何服务、如何细化、如何管控的角度,来阐述基层保险的财务行为。

  16. Paediatric airway management: basic aspects

    DEFF Research Database (Denmark)

    Holm-Knudsen, R J; Rasmussen, L S

    2009-01-01

    . Airway obstruction can be avoided by paying close attention to the positioning of the head of the child and by keeping the mouth of the child open during mask ventilation. The use of oral and nasopharyngeal airways, laryngeal mask airways, and cuffed endotracheal tubes is discussed with special reference...... to the circumstances in infants. A slightly different technique during laryngoscopy is suggested. The treatment of airway oedema and laryngospasm is described....

  17. Basics of soil fertility management

    OpenAIRE

    Berner, Alfred

    2013-01-01

    The brochure highlights the soil fertility from various scientific and farming perspectives. Its aims to supplement practical observations of farmers, to encourage them to reconsider their relation to their soil and to practice a truly sustainable soil culture. The booklet tries to achieve this goal by providing information on soil matter such as important soil organisms and soil characteristics like root density, soil structure and alkalinity and by showing possibilities of how to ass...

  18. Self-reported arm-lymphedema and functional impairment after breast cancer treatment--a nationwide study of prevalence and associated factors

    DEFF Research Database (Denmark)

    Gärtner, Rune; Jensen, Maj-Britt; Kronborg, Lise

    2010-01-01

    Lymphedema and impairment of function are well-established sequelae to breast cancer treatment and affect an increasing number of women due to continually improved survival. The aim of the present nationwide questionnaire study was to examine the impact of breast cancer treatment on perceived...... swelling/sensation of heaviness (lymphedema) and on function, reporting prevalence in 12 subgroups of modern treatment and offering estimates for treatment-related associated factors. 3253 Women (87%) returned the study questionnaire. Depending on treatment group prevalence of perceived swelling...

  19. Inflation Basics

    Energy Technology Data Exchange (ETDEWEB)

    Green, Dan [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States)

    2014-03-01

    inflation since metrical fluctuations, both scalar and tensor, are also produced in inflationary models. Thus, the time appears to be appropriate for a very basic and simple exposition of the inflationary model written from a particle physics perspective. Only the simplest scalar model will be explored because it is easy to understand and contains all the basic elements of the inflationary model.

  20. Inflation Basics

    Energy Technology Data Exchange (ETDEWEB)

    Green, Dan [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States)

    2014-03-01

    inflation since metrical fluctuations, both scalar and tensor, are also produced in inflationary models. Thus, the time appears to be appropriate for a very basic and simple exposition of the inflationary model written from a particle physics perspective. Only the simplest scalar model will be explored because it is easy to understand and contains all the basic elements of the inflationary model.

  1. ERT basics

    Energy Technology Data Exchange (ETDEWEB)

    Butters, M. [MBC Energy and Environment, Ottawa, ON (Canada)]|[National Round Table on the Environment and the Economy, Ottawa, ON (Canada)

    2002-07-01

    ERT is an economic instrument which helps power companies achieve emission reduction compliance cost-effectively. This paper presents the basics of ERT with reference to trading concepts, types of systems and types of emissions. The paper also describes the state of the Canadian energy market regarding greenhouse gases (GHG), nitrogen oxides, sulphur dioxide and volatile organic compounds. The association between ERT and district energy is also explained. By 2010, the global market for GHG trading is expected to be worth $10 billion to $3 trillion U.S. Canada has committed to reducing its GHG to 6 per cent below 1990 levels by 2012, but currently emits 705 Mt per year. This is expected to increase to 770 Mt by 2010. Therefore, in order to meet its commitment, GHGs will have to be reduced 200 Mt per year. Canada is currently considering ratifying the Kyoto agreement and a trading system is being developed. There are several abatement technologies currently under consideration for district energy systems, including adding scrubbers, improving efficiency, and fuel switching. The marginal cost of abatement was also discussed. tabs., figs.

  2. 仓储管理基础课程教学改革研究%Reform about basic course of Warehouse Management

    Institute of Scientific and Technical Information of China (English)

    韩庆田

    2014-01-01

    Choice of teaching methods of teaching effectiveness had played a crucial role, the article analyzes the basic situation,"Base Of Warehouse Management"course teaching, application of modern educational concepts, combined with the characteristics of the course, teaching guide gives a willingness to stimulate active learning, simulation teaching method exercises to improve the ability to post office, individualized learning to explore business potential, develop self study method and other aspects of learning.%教学方法的选择对课程教学效果过起到至关重要的作用,文章分析了《仓储管理基础》课程教学基本情况,应用现代教育理念,结合课程特点,给出了教学引导激发主动学习意愿、模拟演练提高岗位任职能力、因材施教发掘业务学习潜能、学法指导培养自我学习能力等方面的教学改革方法。

  3. Changes in Antibody Levels during and following an Episode of Acute Adenolymphangitis (ADL among Lymphedema Patients in Leogane, Haiti.

    Directory of Open Access Journals (Sweden)

    Katherine E Mues

    Full Text Available Episodes of acute adenolymphangitis (ADL are often the first clinical sign of lymphatic filariasis (LF. They are often accompanied by swelling of the affected limb, inflammation, fever, and general malaise and lead to the progression of lymphedema. Although ADL episodes have been studied for a century or more, questions still remain as to their etiology. We quantified antibody levels to pathogens that potentially contribute to ADL episodes during and after an episode among lymphedema patients in Léogâne, Haiti. We estimated the proportion of ADL episodes hypothesized to be attributed to specific pathogens.We measured antibody levels to specific pathogens during and following an ADL episode among 41 lymphedema patients enrolled in a cohort study in Léogâne, Haiti. We calculated the absolute and relative changes in antibody levels between the ADL and convalescent time points. We calculated the proportion of episodes that demonstrated a two-fold increase in antibody level for several bacterial, fungal, and filarial pathogens.Our results showed the greatest proportion of two-fold changes in antibody levels for the carbohydrate antigen Streptococcus group A, followed by IgG2 responses to a soluble filarial antigen (BpG2, Streptococcal Pyrogenic Exotoxin B, and an antigen for the fungal pathogen Candida. When comparing the median antibody level during the ADL episode to the median antibody level at the convalescent time point, only the antigens for Pseudomonas species (P-value = 0.0351 and Streptolysin O (P-value = 0.0074 showed a significant result.Although our results are limited by the lack of a control group and few antibody responses, they provide some evidence for infection with Streptococcus A as a potential contributing factor to ADL episodes. Our results add to the current evidence and illustrate the importance of determining the causal role of bacterial and fungal pathogens and immunological antifilarial response in ADL episodes.

  4. A pilot, prospective evaluation of a novel alternative for maintenance therapy of breast cancer-associated lymphedema [ISRCTN76522412

    Directory of Open Access Journals (Sweden)

    Rockson Stanley G

    2006-03-01

    Full Text Available Abstract Background Prospective investigations of complete decongestive lymphatic physiotherapy (CDPT, including manual lymphatic drainage (MLD, have validated the efficacy of these interventions for the initial reduction of edema and long-term maintenance of limb volume in lymphedema. However, CDPT demands substantial time and effort from patients to maintain these benefits; the treatments are not always well-accepted, and patients may suffer from a deterioration in quality-of-life or a time-dependent loss of initial treatment benefits. A new device designed for home use by the patient, the Flexitouch™, has been developed to mechanically simulate MLD. We have undertaken a prospective, randomized, crossover study of the efficacy of the Flexitouch™, when compared to massage, in the self-administered maintenance therapy of lymphedema. Methods A prospective, randomized, crossover study of maintenance therapy was performed in 10 patients with unilateral breast cancer-associated lymphedema of the arm. Each observation phase included self-administered treatment with the Flexitouch™ or massage, 1 hour daily for 14 days, respectively, followed by crossover to the alternate treatment phase. Each treatment phase was preceded by a 1 week treatment washout, with use of garment only. The sequence of treatment was randomly assigned. The potential impact of treatment modality on quality of life was assessed with serial administration of the SF-36. Results Statistical analysis disclosed that the order of treatment had no outcome influence, permitting 10 comparisons within each treatment group. Post-treatment arm volume reduced significantly after the Flexitouch™, but not after self-administered massage. The patients' mean weight decreased significantly with Flexitouch™ use, but not with massage. The Flexitouch™ device was apparently well-tolerated and accepted by patients. Serial SF-36 administration showed no deterioration in physical or

  5. Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag; Wilkinson, John Ben; Baschnagel, Andrew [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ghilezan, Mihai [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Riutta, Justin; Dekhne, Nayana; Balaraman, Savitha [Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Mitchell, Christina; Wallace, Michelle [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank, E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States)

    2012-07-15

    Purpose: To determine the rates of breast cancer-related lymphedema (BCRL) in patients undergoing whole-breast irradiation as part of breast-conserving therapy (BCT) and to identify clinical, pathologic, and treatment factors associated with its development. Methods and Materials: A total of 1,861 patients with breast cancer were treated at William Beaumont Hospital with whole-breast irradiation as part of their BCT from January 1980 to February 2006, with 1,497 patients available for analysis. Determination of BCRL was based on clinical assessment. Differences in clinical, pathologic, and treatment characteristics between patients with BCRL and those without BCRL were evaluated, and the actuarial rates of BCRL by regional irradiation technique were determined. Results: The actuarial rate of any BCRL was 7.4% for the entire cohort and 9.9%, 14.7%, and 8.3% for patients receiving a supraclavicular field, posterior axillary boost, and internal mammary irradiation, respectively. BCRL was more likely to develop in patients with advanced nodal status (11.4% vs. 6.3%, p = 0.001), those who had a greater number of lymph nodes removed (14 nodes) (9.5% vs. 6.0%, p = 0.01), those who had extracapsular extension (13.4% vs. 6.9%, p = 0.009), those with Grade II/III disease (10.8% vs. 2.9%, p < 0.001), and those who received adjuvant chemotherapy (10.5% vs. 6.7%, p = 0.02). Regional irradiation showed small increases in the rates of BCRL (p = not significant). Conclusions: These results suggest that clinically detectable BCRL will develop after traditional BCT in up to 10% of patients. High-risk subgroups include patients with advanced nodal status, those with more nodes removed, and those who receive chemotherapy, with patients receiving regional irradiation showing a trend toward increased rates.

  6. Near-infrared fluorescence imaging of lymphatics in head and neck lymphedema

    Science.gov (United States)

    Tan, I.-Chih; Maus, Erik A.; Rasmussen, John C.; Marshall, Milton V.; Fife, Caroline E.; Smith, Latisha A.; Sevick-Muraca, Eva M.

    2011-03-01

    Treatment of lymphatic disease is complicated and controversial, due in part to the limited understanding of the lymphatic system. Lymphedema (LE) is a frequent complication after surgical resection and radiation treatment in cancer survivors, and is especially debilitating in regions where treatment options are limited. Although some extremity LE can be effectively treated with manual lymphatic drainage (MLD) therapy or compression devices to direct proximal lymph transport, head and neck LE is more challenging, due to complicated geometry and complex lymphatic structure in head and neck region. Herein, we describe the compassionate use of an investigatory technique of near-infrared (NIR) fluorescence imaging to understand the lymphatic anatomy and function, and to help direct MLD in a patient with head and neck LE. Immediately after 9 intradermal injections of 25 μg indocyanine green each around the face and neck region, NIR fluorescence images were collected using a custom-built imaging system with diffused excitation light illumination. These images were then used to direct MLD therapy. In addition, 3-dimensional (3D) surface profilometry was used to monitor response to therapy. NIR fluorescence images of functioning lymphatic vessels and abnormal structures were obtained. Precise geometries of facial structures were obtained using 3D profilometry, and detection of small changes in edema between therapy sessions was achieved. NIR fluorescence imaging provides a mapping of lymphatic architecture to direct MLD therapy and thus improve treatment efficacy in the head and neck LE, while 3D profilometry allowed longitudinal assessment of edema to evaluate the efficacy of therapy.

  7. Tissue dielectric constant (TDC) measurements as a means of characterizing localized tissue water in arms of women with and without breast cancer treatment related lymphedema.

    Science.gov (United States)

    Mayrovitz, H N; Weingrad, D N; Davey, S

    2014-09-01

    Quantitative measurements to detect lymphedema early in persons at-risk for breast cancer (BC) treatment-related lymphedema (BCRL) can aid clinical evaluations. Since BCRL may be initially manifest in skin and subcutis, the earliest changes might best be detected via local tissue water (LTW) measurements that are specifically sensitive to such changes. Tissue dielectric constant (TDC) measurements, which are sensitive to skin-to-fat tissue water, may be useful for this purpose. TDC differences between lymphedematous and non-lymphedematous tissue has not been fully characterized. Thus we measured TDC values (2.5 mm depth) in forearms of three groups of women (N = 80/group): 1) healthy with no BC (NOBC), 2) with BC but prior to surgery, and 3) with unilateral lymphedema (LE). TDC values for all arms except LE affected arms were not significantly different ranging between 24.8 ± 3.3 to 26.8 ± 4.9 and were significantly less (p TDC ratios, dominant/non-dominant for NOBC, were 1.001 ± 0.050 and at-risk/ contralateral for BC were 0.998 ± 0.082 with both significantly less (p TDC ratio of 1.2 and above could be a possible threshold to detect pre-clinical lymphedema. Further prospective measurement trial are needed to confirm this value.

  8. Localized tissue water changes accompanying one manual lymphatic drainage (MLD) therapy session assessed by changes in tissue dielectric constant inpatients with lower extremity lymphedema.

    Science.gov (United States)

    Mayrovitz, H N; Davey, S; Shapiro, E

    2008-06-01

    Previous reports described the utility of assessing local tissue water via tissue dielectric constant (TDC) measurements. Our goal was to determine the suitability of this method to evaluate lymphedema changes. For this purpose, we measured changes in TDC produced by one MLD treatment in 27 legs of 18 patients with lower extremity lymphedema. TDC values were measured to a depth of 2.5 mm at the greatest leg swelling site before and after one MLD treatment. Girth at the target site was measured with a calibrated tape measure. TDC values, which range from 1 for zero water to 78.5 for all water within the sampled volume, were measured four times and the average used to estimate local changes. Results showed that in every case the posttreatment TDC was reduced from its pretreatment value with percentage reductions (mean SD) of -9.8 +/- 5.64% (p TDC measurements reflect changes to a depth of about 2.5 mm whereas girth measurements reflect conditions of the entire cross-section, TDC assessment may be more sensitive to localized lymphedema changes. This finding suggests that TDC measurements are useful as complementary and perhaps as independent assessment methods of edema/lymphedema and treatment-related changes.

  9. Higher vascular endothelial growth factor-C concentration in plasma is associated with increased forearm capillary filtration capacity in breast cancer-related lymphedema

    DEFF Research Database (Denmark)

    Jensen, Mads Radmer; Simonsen, Lene; Karlsmark, Tonny

    2015-01-01

    Breast cancer-related lymphedema (BCRL) is a frequent, chronic and debilitating swelling that mainly affects the ipsilateral arm and develops as a complication to breast cancer treatment. The pathophysiology is elusive opposing development of means for prediction and treatment. We have earlier...

  10. Assessment of Volume Measurement of Breast Cancer-Related Lymphedema by Three Methods: Circumference Measurement, Water Displacement, and Dual Energy X-Ray Absorptiometry

    DEFF Research Database (Denmark)

    Gjørup, Caroline; Zerahn, B.; Hendel, Helle Westergren

    2010-01-01

    Background: Following treatment for breast cancer 12%-60% develop breast cancer-related lymphedema (BCRL). There are several ways of assessing BCRL. Circumference measurement (CM) and water displacement (WD) for volume measurements (VM) are frequently used methods in practice and research...

  11. Therapeutic Effects of Saireito (Chai-Ling-Tang, a Traditional Japanese Herbal Medicine, on Lymphedema Caused by Radiotherapy: A Case Series Study

    Directory of Open Access Journals (Sweden)

    Aiko Nagai

    2013-01-01

    Full Text Available Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced lymphedema. Saireito (SRT is a traditional Japanese herbal medicine that has been used for treating edema and inflammation in conditions such as nephritic disease. This study investigated the effect of SRT on lymphedema caused by radiotherapy. Four patients were treated with SRT at a dose of 9 g/day. The severity of lymphedema was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale before and after SRT treatment. After the treatment with SRT, 2 of 4 patients (50% showed apparent improvement in lymphedema. One of the cases had difficulty in wearing the custom-made thermoplastic cast, but after SRT administration, he could wear the mask easily. One case decided to stop taking SRT 3 days after initiation because cough and fever appeared. In conclusion, it is important to control the side effects of radiotherapy, which leads to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.

  12. THEORETICAL ASPECTS OF BASIC PROVISIONS OF THE ENERGY SAVING MANAGEMENT SYSTEM IN THE FIELD OF HOUSING AND PUBLIC UTILITIES THROUGH INTRODUCTION OF SMALL INNOVATIVE ENTERPRISES

    Directory of Open Access Journals (Sweden)

    Kiseleva Ekaterina Alexandrovna

    2012-10-01

    Full Text Available The author addresses solutions to problems of the housing and utilities sector (including a substantial depreciation of fixed assets of the municipal infrastructure, a gap between domestic utilities management technologies and those employed worldwide, and the fund raising problem through power saving actions to be facilitated by small innovative enterprises. The proposed solutions contribute to formation of new jobs in the regions, reduction of power consumption and higher efficiency of regional economies due to reduced costs and rates (prices set for utilities-related services, and improvement of the standard and quality of living. The principal objective is to develop a set of procedures and criteria to serve as the basis for the selection of tools of power saving innovations in the housing and utilities sector of regions and municipalities. The above actions are to be implemented through the involvement of small innovative enterprises. The basic tools (instruments of the state social and economic (including innovation-related policy, that are to stimulate subjects of innovative activities to implement innovative projects in this sector stimulate energy efficiency innovations in the housing and utilities sector. The proposed set of tools includes tax holidays, subsidies, grants, soft loans, concessional loans, state and municipal orders, etc. The procedure of selection of instruments of state-initiated innovations designated for the improvement of the power efficiency of the housing and public utilities sector to be implemented by regional and municipal authorities is proposed by the author. The author identifies several types of energy saving innovations in the housing and utilities sector, based on their systemic effects. Upon identification of the top-priority recipients of state support, financial resources are to be distributed. Advantages of innovative energy saving projects in the housing and utilities sector, developed and implemented

  13. The articulated action plan (par in municipalities in Mato Grosso do Sul State and its implications for the democratic management of basic education - doi: 10.4025/actascieduc.v34i2.17546

    Directory of Open Access Journals (Sweden)

    Regina Tereza Cestari de Oliveira

    2012-11-01

    Full Text Available The paper analyzes the implications of the Articulated Action Plan (PAR, a component of the Education Development Plan (PDE, to the democratic management of basic education, within the context of the educational policy, during President Luiz Inácio Lula da Silva’s second government term (2007-2010. It presents research findings through the examination of documentary sources, focusing on the actions defined by the municipalities in the state of Mato Grosso do Sul, within PAR’s Educational Management Dimension. These actions, in alignment with the guidelines of the plan called All for Education, indicate the limits and possibilities of building a democratic management of basic education, depending on the implementation by the municipalities, as they exercise their autonomy.  

  14. Correlation among bioimpedance analysis, sonographic and circumferential measurement in assessment of breast cancer-related arm lymphedema.

    Science.gov (United States)

    Choi, Y H; Seo, K S

    2014-09-01

    New approaches for assessment of lymphedema using ultrasonography (US) have been introduced recently and are reported to be reliable and simple. Ultrasonography provides detailed information about physical properties of the tissue in addition to volume and size. There have been only limited studies comparing bioimpedance analysis (BIA), US, and circumferential measurement (CM), which is considered a standard measurement. The aim of this study was to determine the relationship between US, BIA, and CM. Twenty-eight patients with lymphedema after breast cancer surgery underwent BIA, US, and CM. Impedance, which reflects the amount of extracellular fluid, was measured with 1 kHz frequency in affected and unaffected arms. Circumferences were measured at 10cm proximal and distal to the elbow and a truncated cone method used to calculate estimated volumes for upper arm and forearm. We found that interlimb forearm subcutis thickness differences measured by US were highly correlated with CM measurements and that interlimb upper arm subcutis thickness differences measured by US were moderately correlated with CM measurements and BIA ratios. However, the interlimb ratio of compressibility measured by US showed no or only weak correlation with impedance measurements and circumferential measurements. Our results also show that compressibility measured by US could not be predicted from BIA or CM measurements despite a high degree of concordance among subcutis thickness measured by US, CM, and BIA.

  15. Synergic Effect of Compression Therapy and Controlled Active Exercises Using a Facilitating Device in the Treatment of Arm Lymphedema

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Guerreiro Godoy, Maria Regina Pereira, Antonio Helio Oliani, Jose Maria Pereira de Godoy

    2012-01-01

    Full Text Available Trial design: A randomized controlled trial was performed to evaluate the effect of the combination of compression therapy with active exercising using a facilitating apparatus on arm lymphedema. Method: Twenty women with a mean age of 63.3 years were evaluated; all had lymphedema resulting from breast cancer treatment. The inclusion criterion was a difference of 200 mL in size between arms. The apparatus used, called 'pulley system', is a vertical iron wheel fixed on a support at a distance of 10 cm from the patient's body. Participants were submitted to two series of active exercises using this facilitating device, one series using a compression sleeve and the other without. Each series consisted of four 12-minute sessions of exercises separated by 3-minute rest intervals. Volumetry was performed before and after each series of exercises. The paired t-test was utilized for statistical analysis (p-value < 0.05. Results: A significant mean reduction (p-value < 0.007 and non-significant mean increase (p-value < 0.2 in volumes were observed during exercising with and without compression, respectively. Conclusion: Controlled active exercising utilizing a facilitating apparatus while wearing a compression sleeve reduces the size of lymphedematous arms.

  16. Primary lymphedema of the lower limb: The clinical utility of single photon emission computed tomography/CT

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, Mayo; Baumeister, Ruedinger G. H.; Frick, Andreas; Wallmichrath, Jens; Bartenstein, Peter; Rominger, Axel [Ludwig-Maximilians-University of Munich, Muenchen (Germany)

    2015-02-15

    The aim of this prospective study was to determine whether the additional use of the single photon emission computed tomography/CT (SPECT/CT) technique improves the diagnostic value of planar lymphoscintigraphy in patients presenting with primary lymph edema of the lower limb. For a defined period of three years (April 2011-April 2014) a total of 34 consecutive patients (28 females; age range, 27-83 years) presenting with swelling of the leg(s) suspicious of (uni- or bilateral, proximal or distal) primary lymphedema were prospectively examined by planar lymphoscintigraphy (lower limbs, n = 67) and the tomographic SPECT/CT technique (anatomical sides, n = 65). In comparison to pathological planar scintigraphic findings, the addition of SPECT/CT provided relevant additional information regarding the presence of dermal backflow (86%), the anatomical extent of lymphatic disorders (64%), the presence or absence of lymph nodes (46%), and the visualization of lymph vessels (4%). As an adjunct to planar lymphoscintigraphy, SPECT/CT specifies the anatomical correlation of lymphatic disorders and thus improves assessment of the extent of pathology due to the particular advantages of tomographic separation of overlapping sources. The interpretation of scintigraphic data benefits not only in baseline diagnosis, but also in physiotherapeutical and microsurgical treatments of primary lymphedema.

  17. CCBE1 mutation in two siblings, one manifesting lymphedema-cholestasis syndrome, and the other, fetal hydrops.

    Directory of Open Access Journals (Sweden)

    Sohela Shah

    Full Text Available BACKGROUND: Lymphedema-cholestasis syndrome (LCS; Aagenaes syndrome is a rare autosomal recessive disorder, characterized by 1 neonatal intrahepatic cholestasis, often lessening and becoming intermittent with age, and 2 severe chronic lymphedema, mainly lower limb. LCS was originally described in a Norwegian kindred in which a locus, LCS1, was mapped to a 6.6cM region on chromosome 15. Mutations in CCBE1 on chromosome 18 have been reported in some cases of lymphatic dysplasia, but not in LCS. METHODS: Consanguineous parents of Mexican ancestry had a child with LCS who did not exhibit extended homozygosity in the LCS1 region. A subsequent pregnancy was electively terminated due to fetal hydrops. We performed whole-genome single nucleotide polymorphism genotyping to identify regions of homozygosity in these siblings, and sequenced promising candidate genes. RESULTS: Both siblings harbored a homozygous mutation in CCBE1, c.398 T>C, predicted to result in the missense change p.L133P. Regions containing known 'cholestasis genes' did not demonstrate homozygosity in the LCS patient. CONCLUSIONS: Mutations in CCBE1 may yield a phenotype not only of lymphatic dysplasia, but also of LCS or fetal hydrops; however, the possibility that the sibling with LCS also carries a homozygous mutation in an unidentified gene influencing cholestasis cannot be excluded.

  18. The aesthetic rationality of the popular expressive arts: Lifeworld communication among breast cancer survivors living with lymphedema.

    Science.gov (United States)

    Quinlan, Elizabeth; Thomas, Roanne; Ahmed, Shahid; Fichtner, Pam; McMullen, Linda; Block, Janice

    2014-08-01

    The use of popular expressive arts as antidotes to the pathologies of the parallel processes of lifeworld colonization and cultural impoverishment has been under-theorized. This article enters the void with a project in which breast cancer survivors used collages and installations of everyday objects to solicit their authentic expression of the psycho-social impacts of lymphedema. The article enlists Jurgen Habermas' communicative action theory to explore the potential of these expressive arts to expand participants' meaningful engagement with their lifeworlds. The findings point to the unique non-linguistic discursivity of these non-institutional artistic forms as their liberating power to disclose silenced human needs: the images 'spoke' for themselves for group members to recognize shared subjectivities. The authenticity claims inherent in the art forms fostered collective reflexivity and spontaneous, affective responses and compelled the group to create new collective understandings of the experience of living with lymphedema. The article contributes theoretical insights regarding the emancipatory potential of aesthetic-expressive rationality, an under-developed area of Habermasian theory of communicative action, and to the burgeoning literature on arts-based methods in social scientific research.

  19. Surgical treatment of lymphedema of the penis and scrotum Tratamento cirúrgico do linfedema peno-escrotal

    Directory of Open Access Journals (Sweden)

    Miguel Modolin

    2006-08-01

    Full Text Available PURPOSE: Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by removing affected tissues and correcting the penoscrotal region. MATERIALS AND METHODS: Seventeen patients with lymphedema of the penis and scrotum were treated with a modified Charles procedure, which consists of the excision of the affected skin followed by scrotoplasty and midline suture simulating the scrotal raphe. The penis is covered with a split-thickness skin graft by means of a zigzag suture on its ventral surface. RESULTS: Regression of symptoms and improvement of previous clinical conditions were verified in the follow-up which ranged from 6 months to 6 years. One patient who had undergone lymphadenectomy with radiation therapy due to penile cancer had recurrent scrotum lymphedema. CONCLUSIONS: The modified Charles procedure for the treatment of penoscrotal lymphedema is easily reproducible and allows better local hygiene, easier ambulation, voiding in the standing position, resuming sexual intercourse, and finally, better cosmetic results in the affected area with remarkable improvement in quality of life.INTRODUÇÃO: O linfedema peno-escrotal, independentemente da etiologia, é determinado pela redução do fluxo linfático com conseqüente aumento do volume do escroto e pênis. A evolução clínica da doença é caracterizada com extremo desconforto ao paciente, limitando a higiene local, a deambulação, o intercurso sexual e a micção em posição ortostática. OBJETIVO: Apresentar a experiência e resultados no tratamento da patologia com

  20. 不同护理干预方法在乳腺癌术后上肢淋巴水肿的应用价值%Application value of different of nursing intervention methods for upper extremity lymphedema of post-operative breast cancer patients

    Institute of Scientific and Technical Information of China (English)

    颜巍; 刘晓舟; 周岩; 张婧; 刘宝利; 孔孟琼

    2014-01-01

    目的:探讨不同的护理干预方法对乳腺癌术后上肢淋巴水肿的应用价值。方法对180例乳腺癌术后患者进行护理干预,分为三组,每组60例。即常规组(常规护理及心理护理)、按摩组(在常规组的基础上,增加手法按摩)和加压组(在按摩组的基础上,增加空气波压力治疗仪)。观察术后3个月,6个月,9个月,12个月患肢水肿的护理效果。结果3~12个月加压组明显降低了上肢淋巴水肿发展程度及发生率,并提高了上肢功能康复的程度,且在常规组的基础上增加手法按摩和\或空气波压力治疗仪后,患者的上肢淋巴水肿发展程度及发生率下降,上肢功能康复提高。结论采用手法按摩加空气波压力治疗仪的护理干预方式,能够更好地预防及治疗术后上肢淋巴水肿,提高疗效及患者生活质量。%Objective To study the application value of different nursing intervention methods for upper limb lymphedema of positive-operation breast cancer patients .Method 180 patients with post-operative routine nursing of breast cancer was selected and divided into 3 groups .60 patients in each group .The conventional group( routine nursing and psychological nursing ) ,massage group (routine nursing ,psychological nursing and massage) and Com-pression group (basic therapy as massage plus air pressure wave therapeutic apparatus ) .The nursing effect for limb lymphedema was observed and compared for 3 months ,6 months ,9 months ,12 months after operation among the three groups .Result The development of lymphedema incidence was decreased ,and upper limb function was im-proved in compression group 12 month after operation .The development of lymphedema incidence was decreased and upper limb function improved remarkably for patient treated by routine nursing plus massage or air pressure wave therapeutic apparatus .Conclusion The 3 kinds of nursing intervention for prevention

  1. Implementation status and improvement recommendations of HSE system management in basic units of petrochemical enterprise%HSE体系管理在炼化企业基层单位实施现状及改进建议

    Institute of Scientific and Technical Information of China (English)

    陶卫君; 秦丽娟; 朱焱松; 邢新华

    2012-01-01

    对当前炼化企业基层单位HSE管理体系现状进行了分析.指出了基层单位HSE管理理念没有真正转变、HSE管理制度执行力差、HSE管理职责落实不到位、HSE培训缺乏针对性、HSE绩效考核重结果轻过程、企业安全文化建设重形式轻根基等问题.提出基层单位HSE体系管理改进建议,真正落实“以人为本”的HSE管理理念、强化HSE管理制度的执行力、真正将HSE管理职责落实到位、强化HSE培训需求分析,增强培训的针对性、加强HSE绩效考核过程管理、推进安全文化建设.%The implementation status of HSE management system in basic units of petrochemical enterprise was analyzed. The problems in HSE management system were pointed out, such as HSE management idea was not really changed, HSE management system implementation power was weak, HSE management responsibilities were not implemented, HSE training was not targeted, HSE performance appraisal emphasis on results than process. Improvement recommendations of HSE system management in basic units were proposed. We should real implementation the ideas of "people-oriented" in HSE management, and strengthen the HSE management system execution power, strengthen HSE management responsibilities, intensify training needs analysis, enhance training target, enhance HSE performance evaluate process management, and promote HSE safety culture Construction.

  2. Qualitative and quantitative lymphoscintigraphy in the evaluation of lower limbs lymphedema

    Directory of Open Access Journals (Sweden)

    Roberta Maria Dalia

    2005-10-01

    Full Text Available The purpose of this study was to prove the efficiency of qualitative and quantitative lymphoscintigraphy in the diagnosis of the lower extremity lymphedema. Seventy-seven patients had been studied, most of then (85.7% were female. Patients’ ages ranged from 18 to 82 years. All patients underwent a bilateral lymphoscintigraphy. Images were recorded with a dual-detector instrument in the whole-body scanning mode. Feet and inguinal static views were acquired within 15 minutes and three hours after radiopharmaceutical injection. Two nuclear doctors evaluated the lymphoscintigrams qualitatively. Quantitative studies of the radiopharmaceutical absorption and the lymph node chain uptake were also obtained. Of the 154 evaluated members, 21.44% (n = 33 were classified as normal, 61.68% (n = 95 as mildly altered and 16.88% (n = 26 much altered. Quantitation of lymphatic chain uptake may be a more sensitive approach to the diagnosis of lymphatic impairment than the qualitative analysis.O objetivo do estudo foi comprovar a eficiência da linfocintilografia qualitativa e quantitativa no diagnóstico e na classificação da gravidade do linfedema de membros inferiores. Foram estudados 77 pacientes, sendo 66 (85,7% do sexo feminino, na faixa etária entre 18 e 82 anos. Todos os pacientes foram submetidos a uma linfocintilografia bilateral, com um equipamento de dois detectores, na qual se adquiriu imagens dos pés, da região inguinal e uma varredura dos membros, após 15 minutos e três horas da injeção do radiofármaco. Os exames foram avaliados qualitativamente por 2 médicos nucleares. Também foram feitos estudos quantitativos da absorção do radiofármaco e da captação em cadeia inguinal. Dos 154 membros avaliados classificaram-se como normais 21,44% (n=33, pouco alterados 61,68% (n=95 e muito alterados 16,88% (n=26. A quantificação da captação da cadeia linfática pode ser um método mais sensível para o diagnóstico do linfedema em rela

  3. Identifying gaps in the locoregional management of early breast cancer: highlights from the kyoto consensus conference.

    OpenAIRE

    Toi, Masakazu; Winer, Eric P.; INAMOTO, TAKASHI; BENSON, JOHN R.; Forbes, John F.; Mitsumori, Michihide; Robertson, John F. R.; Sasano, Hironobu; von Minckwitz, Gunter; Yamauchi, Akira; KLIMBERG, V. SUZANNE

    2011-01-01

    A consensus conference was held to investigate issues related to the local management of early breast cancer. Here, we highlight the major topics discussed at the conference and propose ideas for future studies. Regarding axillary management, we examined three major issues. First, we discussed whether the use of axillary reverse mapping could clarify the lymphatic system of breast and whether the ipsilateral arm might help avoid lymphedema. Second, the use of an indocyanine green fluorescent ...

  4. Quality of life, urogynecological morbidity, and lymphedema after radical vaginal trachelectomy for early-stage cervical cancer

    DEFF Research Database (Denmark)

    Frøding, Ligita Paskeviciute; Ottosen, Christian; Mosgaard, Berit Jul

    2015-01-01

    OBJECTIVE: Radical vaginal trachelectomy (RVT) offers a possibility for future childbearing for young women with early-stage cervical cancer. However, the literature on quality of life and self-reported morbidity in patients undergoing RVT is scarce. The aim of this study was to prospectively...... assess quality of life after RVT with focus on urogynecological morbidity and lymphedema. Furthermore, the aim of this study was to compare results with those in women treated with radical abdominal hysterectomy (RAH) and with age-matched control women from the general population. METHODS AND MATERIALS......, whereas an age-matched control group of 30 healthy women was assessed once. RESULTS: Fifty percent of the RVT group and 41% of the RAH reported any grade of incomplete bladder emptying problems at 1 year postsurgery assessment. Eleven percent of the RVT patients and 12.5% of the RAH patients reported...

  5. Establishing and Sustaining a Prospective Screening Program for Breast Cancer-Related Lymphedema at the Massachusetts General Hospital: Lessons Learned

    Directory of Open Access Journals (Sweden)

    Cheryl Brunelle

    2015-05-01

    Full Text Available There has been an increasing call to prospectively screen patients with breast cancer for the development of breast cancer-related lymphedema (BCRL following their breast cancer treatment. While the components of a prospective screening program have been published, some centers struggle with how to initiate, establish, and sustain a screening program of their own. The intent of this manuscript is to share our experience and struggles in establishing a prospective surveillance program within the infrastructure of our institution. It is our hope that by sharing our history other centers can learn from our mistakes and successes to better design their own prospective screening program to best serve their patient population.

  6. Chronic lower extremity lymphedema: A comparative study of high-resolution interstitial MR lymphangiography and heavily T2-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lu Qing [Department of Radiology, Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dong Fang Rd, Shanghai 200127 (China)], E-mail: luqingshan@sjtu.edu.cn; Xu Jianrong [Department of Radiology, Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dong Fang Rd, Shanghai 200127 (China)], E-mail: jiangrongx@hotmail.com; Liu Ningfei [Department of Plastic and Reconstructive Surgery, Shanghai 9th People' s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Second Medical University, 639 Zhi Zao Ju Rd, Shanghai 200011 (China)], E-mail: luqing_1973@163.com

    2010-02-15

    Purpose: To assess the role of heavily T2-weighted image and interstitial MR lymphangiography (MRL) for the visualization of lymphatic vessels in patients with disorders of the lymphatic circulation. Methods: Forty lower extremities in 31 patients (9 bilateral and 22 unilateral) with primary lymphedema were examined by heavily T2-weighted image and indirect MRL. Maximum-intensity projection (MIP) was used to reconstruct the images of the lymphatic system. Two experienced radiologists analyzed the images with regard to the differences in image quality, number of lymphatic vessels, its maximum diameter and two other findings: accumulated lymph fluid in the tissue and honeycombing pattern. Results: The beaded appearance of the affected vessels in 73 leg segments of 40 lower extremities were present on both modalities 3D MIP. Larger amount of the dilated lymphatic vessels were visualized on heavily T2-weighted image than that on MRL (p = 0.003) and the maximum diameter of it was 4.28 {+-} 1.53 mm on heavily T2-weighted image, whereas 3.41 {+-} 1.05 mm on MRL (p < 0.01). The dilated lymphatic vessels on MRL showed better image quality and greater SNR and CNR than that on heavily T2-weighted image (p < 0.01). The regions of accumulated lymph fluid and the honeycombing pattern extent were identified on heavily T2-weighted image scored statistically higher than that on MRL (p < 0.01). Conclusion: The heavily T2-weighted imaging has greater sensitivity and the MRL image has higher legibility for detecting the pathologically modified lymphatic vessels and accompanying complications non-invasively. Combining these two MR techniques can accurately access the pathological changes in the lower extremity with lymphedema.

  7. Stem Cell Basics

    Science.gov (United States)

    ... Tips Info Center Research Topics Federal Policy Glossary Stem Cell Information General Information Clinical Trials Funding Information Current ... Basics » Stem Cell Basics I. Back to top Stem Cell Basics I. Introduction: What are stem cells, and ...

  8. Basics of SCI Rehabilitation

    Science.gov (United States)

    ... Donate Experts \\ The Basics of Spinal Cord Injury Rehabilitation Topics Adult Injuries Spinal Cord Injury 101 Spinal ... Injury 101 The Basics of Spinal Cord Injury Rehabilitation The Basics of Spinal Cord Injury Rehabilitation Preventing ...

  9. Dental Health: The Basic Facts

    Science.gov (United States)

    ... difficult to manage. The basic fact is healthy teeth and gums are essential for: n Preventing infections which may cause MS symptoms to increase n ... person clenches his or her jaws or “grinds” teeth, usually during the night n ... and periodontitis are infections, each of which can be made worse by ...

  10. 文物保护工程全面质量管理的基础技术工作%The Basic Technical Work for the Total Quality Management of Relic Conservation Project

    Institute of Scientific and Technical Information of China (English)

    黄文铮; 郑力鹏

    2011-01-01

    The important approach for improving the quality of conservation project is to implement the total quality management. To carry out total quality management, good jobs are necessary to be done on quality education, standardization, measurement, information management, quality information,quality responsibility and other aspects of the basic technical work.%推行全面质量管理是提高文物保护工程质量水平的重要途径,开展全面质量管理必须做好质量教育、标准化与计量工作、信息管理与质量情报、质量责任制等几个方面的基础技术工作.

  11. Free lymph node flap transfer and laser-assisted liposuction: a combined technique for the treatment of moderate upper limb lymphedema.

    Science.gov (United States)

    Nicoli, Fabio; Constantinides, Joannis; Ciudad, Pedro; Sapountzis, Stamatis; Kiranantawat, Kidakorn; Lazzeri, Davide; Lim, Seong Yoon; Nicoli, Marzia; Chen, Pei-Yu; Yeo, Matthew Sze-Wei; Chilgar, Ram M; Chen, Hung-Chi

    2015-05-01

    Upper limb lymphedema following breast cancer surgery is a challenging problem for the surgeon. Lymphatico-venous or lymphatico-lymphatic anastomoses have been used to restore the continuity of the lymphatic system, offering a degree of improvement. Long-term review indicates that lumen obliteration and occlusion at the anastomosis level commonly occurs with time as a result of elevated venous pressure. Lymph node flap transfer is another microsurgical procedure designed to restore lymphatic system physiology but does not provide a complete volume reduction, particularly in the presence of hypertrophied adipose tissue and fibrosis, common in moderate and advanced lymphedema. Laser-assisted liposuction has been shown to effectively reduce fat and fibrotic tissues. We present preliminary results of our practice using a combination of lymph node flap transfer and laser-assisted liposuction. Between October 2012 and May 2013, ten patients (mean 54.6 ± 9.3 years) with moderate (stage II) upper extremity lymphedema underwent groin or supraclavicular lymph node flap transfer combined with laser-assisted liposuction (high-power diode pulsed laser with 1470-nm wavelength, LASEmaR 1500-EUFOTON, Trieste, Italy). A significant decrease of upper limb circumference measurements at all levels was noted postoperatively. Skin tonicity was improved in all patients. Postoperative lymphoscintigraphy revealed reduced lymph stasis. No patient suffered from donor site morbidity. Our results suggest that combining laser liposuction with lymph node flap transfer is a safe and reliable procedure, achieving a reduction of upper limb volume in treated patients suffering from moderate upper extremity lymphedema.

  12. Self-reported arm-lymphedema and functional impairment after breast cancer treatment--a nationwide study of prevalence and associated factors

    DEFF Research Database (Denmark)

    Gärtner, Rune; Jensen, Maj-Britt; Ewertz, Marianne;

    2010-01-01

    swelling/sensation of heaviness (lymphedema) and on function, reporting prevalence in 12 subgroups of modern treatment and offering estimates for treatment-related associated factors. 3253 Women (87%) returned the study questionnaire. Depending on treatment group prevalence of perceived swelling....../heaviness, younger age, ALND, chemotherapy, time elapsed since surgery, and surgery on the dominant side. Radiotherapy and type of breast surgery were of no importance....

  13. Verrucous lesions arising in lymphedema and diabetic neuropathy: Elephantiasis nostras verrucosa or verrucous skin lesions on the feet of patients with diabetic neuropathy?

    Science.gov (United States)

    Hotta, Eri; Asai, Jun; Okuzawa, Yasutaro; Hanada, Keiji; Nomiyama, Tomoko; Takenaka, Hideya; Katoh, Norito

    2016-03-01

    Verrucous skin lesions on the feet in diabetic neuropathy (VSLDN) develop in areas with sensory loss in diabetic patients. Although various types of chronic stimulation, such as pressure or friction, are considered an important factor in the development of such lesions, the precise pathogenesis of VSLDN remains obscure, and there is currently no established treatment for this disease. Here, we present a case of VSLDN on the dorsum of the right foot. However, because lymphedema was also observed at the same site, this lesion could also be diagnosed as elephantiasis nostras verrucosa arising in diabetic neuropathy. The lesion was successfully treated with a combination of elastic stocking and mixed killed bacterial suspension and hydrocortisone ointment, which suggested that VSLDN might have been exacerbated by the pre-existing lymphedema. Because various types of chronic stimulation can trigger VSLDN, treatment plans should be devised on a case-by-case basis. Therefore, it is important to investigate the presence of factors that can induce or exacerbate chronic inflammatory stimulation, such as lymphedema in our case, in each patient with VSLDN.

  14. The study of college basic construction project non-bidding procurement management risk%高校基建工程非招标采购管理廉政风险刍议

    Institute of Scientific and Technical Information of China (English)

    李丽霞

    2011-01-01

    通过对高校基建工程零星项目非招标采购现实状态的分析,指出了其潜在风险。并进行了相应的风险防范措施探讨,为高校基建工程采购非招标管理决策提供了参考依据。%Through the analysis non-bidding procurement of college basic construction project practical condition, this paper studies nonbidding procurement of potential risks and measures to prevent risks. The study provides reference basis for college basic construction nonbidding management decision.

  15. 基层医院提高基础护理质量的管理策略%Management strategies of improving the quality of basic nursing care in the grass - roots hospital

    Institute of Scientific and Technical Information of China (English)

    郑珊红

    2011-01-01

    Objective: To explore the management strategies of improving the quality of basic nursing care in the grass -roots hospital. Methods: The new strategies of basic nursing care was applied to 40 patients in the observation group in accordance with the requirements of high quality nursing engineering and basic nursing care was given to the 40 patients in the control group by following the traditional method of nursing care management. The quality of nursing care, patient's satisfaction and complaints, adverse events and the rate of nosocomial infection were analyzed in both groups. Results: The quality of basic nursing care and patient's satisfaction was significantly higher and the number of complaints, adverse events and the rate of noscomial infection were obviously fewer and lower in the observation group than those in the control group ( P < 0.05 ). Conclusion: The effective quality control strategies of basic nursing care are the effective measures to improve the quality of basic nursing care.%目的:探讨基层医院提高基础护理质量的管理对策.方法:将观察组40例患者按照优质护理服务工程要求,实施新的基础护理质量控制策略,强化落实基础护理.将对照组40例按照传统的护理管理方法实施基础护理.分析两组患者基础护理质量、护理工作满意度、护理投诉、不良事件、医院感染率等情况.结果:实验组基础护理质量、患者满意度明显高于对照组,护理投诉和不良事件例数、医院感染率明显低于对照组(P<0.05).结论:有效的基础护理质量控制策略,是提高基础护理质量的有效措施.

  16. 我国知识管理研究学派、知识基础及热点的可视化分析%Visualization Analysis of Domestic Knowledge Management Genre, Basics and Hotspots

    Institute of Scientific and Technical Information of China (English)

    陈琴; 蒋合领

    2016-01-01

    Purpose/significance] In order to explore domestic knowledge management research situation, sum up experience, inspire innovation. These research subjects will make further studies of knowledge management in China. [ Method/process] Taking the CSSCI papers as sample, this paper analyzed the situation of domestic knowledge management research using the mainstream visualization methods which are VOSviewer and CiteSpace. [ Result/conclusion] The results showed that the schools of thought of domestic knowledge manage-ment research are divided into 4 genres;the basic knowledge is composed of ten articles and books;the research topics include enterprise knowledge management, knowledge sharing and knowledge innovation, enterprise knowledge management system, tacit knowledge and explicit knowledge, knowledge service and knowledge organization, knowledge management and competitive intelligence.%[目的/意义]为了探析我国知识管理研究动态,认知现状,启迪创新,将知识管理研究引向深入。[方法/过程]以CSSCI收录的论文为样本,利用VOSviewer和CiteSpace软件,对我国知识管理研究进行可视化分析。[结果/结论]结果表明:企业管理学派、图书情报学派、综合学派和科技管理学派是四大学术流派;知识基础主要由国内外的10篇(部)文献构成;研究热点包括:企业知识管理、知识共享与知识创新、企业知识管理系统、隐性知识与显性知识、知识服务与知识组织、知识管理与竞争情报。

  17. The Basic Strategy and Path Selection of the Standardized Management of State Treasury and Accounting%国库会计规范化管理的基本策略与路径选择

    Institute of Scientific and Technical Information of China (English)

    罗万金

    2014-01-01

    Starting from the meaning of implementing the standardized management of state treasury and accounting, the paper an-alyzes the current situation of the standardized management of the grassroots state treasury and accounting, puts forward basic ideas and specific measures of standardized management of the state treasury and accounting such as establishing standardized system and setting up the new management platform, training staff to improve the ability of achieving goals, and implementing target management and strengthening the process control etc.%本文从实施国库会计规范化管理的意义入手,分析了基层国库会计规范化管理的现状,提出了建立标准化体系,搭建新的管理平台;开展人员培训,提高实现目标的能力;推行目标管理,强化过程控制等实现国库会计规范化管理的基本思路和具体措施。

  18. Study on the Quality Management of Basic Level Inspection and Testing Laboratory of Agricultural Product Quality and Safety%基层农产品质量安全检测实验室质量管理研究

    Institute of Scientific and Technical Information of China (English)

    李尧琴; 杨丽军; 张乃华

    2012-01-01

    The basic level inspection and testing laboratory of agricultural product quality and safety plays an important role in managing agricultural product quality and safety.In order to ensure and further improve the testing capability and standard,the laboratory should establish and document a comprehensive quality management system,focused on the essential aspects for enhancing the quality management,including the starting point of quality management,quality policy and objective,professional training,organizational culture,instrument acquisition and record management.%基层农产品质量安全检测实验室在农产品质量安全监督管理中具有重要的作用。为了保证和提高检测能力和水平,实验室应当建立完善的质量管理体系并形成文件,抓住质量管理的起点、质量方针和目标、教育培训、组织文化、仪器配置、记录管理等重点环节,加强质量管理。

  19. DISCUSSION ON THE SPECIAL MANAGEMENT OF BASIC SCIENTIFIC RESEARCH FUNDS IN CENTRAL AGRICULTRAL SCIENTIFIC RESEARCH INSTITUTIONS%中央级农业科研院所基本科研业务费专项管理探析

    Institute of Scientific and Technical Information of China (English)

    石明桢

    2012-01-01

    该文回顾了基本科研业务费专项的设立背景,对专项特点以及中央级农业科研院所的专项管理实践情况和成效进行了归纳总结,并在借鉴科研项目现行主要管理模式的基础上,提出常设学位委员会指导下的PDCA关键点控制过程管理模式,是符合中央级农业科研院所的专项项目管理模式选择,对进一步加强基本科研业务费管理、充分发挥基本科研业务费专项作用,具有重要的参考价值。%This paper reviewed the background of the establishment of special basic scientific research funds in central agricultural scientific research institute,summarized the management and effectiveness on the special funds,and on the basis of the main management modes put forward the management mode of PDCA under the guide of permanent academic degrees committee,which corresponded with the management mode of special funds in central agricultural scientific research institute.The results may provide the important reference value for further strengthening management and improving the role of special funds.

  20. Myelin management by the 18.5-kDa and 21.5-kDa classic myelin basic protein isoforms.

    Science.gov (United States)

    Harauz, George; Boggs, Joan M

    2013-05-01

    The classic myelin basic protein (MBP) splice isoforms range in nominal molecular mass from 14 to 21.5 kDa, and arise from the gene in the oligodendrocyte lineage (Golli) in maturing oligodendrocytes. The 18.5-kDa isoform that predominates in adult myelin adheres the cytosolic surfaces of oligodendrocyte membranes together, and forms a two-dimensional molecular sieve restricting protein diffusion into compact myelin. However, this protein has additional roles including cytoskeletal assembly and membrane extension, binding to SH3-domains, participation in Fyn-mediated signaling pathways, sequestration of phosphoinositides, and maintenance of calcium homeostasis. Of the diverse post-translational modifications of this isoform, phosphorylation is the most dynamic, and modulates 18.5-kDa MBP's protein-membrane and protein-protein interactions, indicative of a rich repertoire of functions. In developing and mature myelin, phosphorylation can result in microdomain or even nuclear targeting of the protein, supporting the conclusion that 18.5-kDa MBP has significant roles beyond membrane adhesion. The full-length, early-developmental 21.5-kDa splice isoform is predominantly karyophilic due to a non-traditional P-Y nuclear localization signal, with effects such as promotion of oligodendrocyte proliferation. We discuss in vitro and recent in vivo evidence for multifunctionality of these classic basic proteins of myelin, and argue for a systematic evaluation of the temporal and spatial distributions of these protein isoforms, and their modified variants, during oligodendrocyte differentiation.

  1. Fatores associados ao linfedema em pacientes com câncer de mama Associated factors of lymphedema in breast cancer patients

    Directory of Open Access Journals (Sweden)

    Daniella Marta Ferreira de Paiva

    2011-02-01

    Full Text Available OBJETIVO: determinar a prevalência e os fatores associados ao linfedema em pacientes com câncer de mama. MÉTODOS: este estudo de corte transversal incluiu 250 mulheres com mais de seis meses de tratamento para o câncer de mama, que compareceram ao Ambulatório de Mastologia e Oncologia para consulta de seguimento em um Centro de Referência em Oncologia, em Juiz de Fora, Minas Gerais. Elas foram entrevistadas e submetidas à avaliação física. Foram colhidos dados de prontuário relacionados ao tratamento da neoplasia, à intervenção axilar e ao tumor. Diagnosticou-se linfedema quando a diferença entre os membros superiores foi maior ou igual a 2 cm pela perimetria. Os grupos de mulheres com e sem linfedema foram comparados em relação aos possíveis fatores de risco, e as medidas de tendência central, dispersão e prevalência foram obtidas admitindo o nível de significância de 95%. RESULTADOS: Cento e doze mulheres (44,8% apresentaram linfedema. Foi encontrada diferença significativa entre os grupos de mulheres com e sem linfedema em relação à mediana de linfonodos retirados (p=0,02; apresentação de trombose linfática superficial no braço homolateral à cirurgia (pPURPOSE: to determine the prevalence of lymphedema and its associated factors in breast cancer patients. METHODS: Two hundred and fifty women that had undergone more than six months of breast cancer treatment and were being treated at an oncology reference hospital in Juiz de Fora, Minas Gerais, Brazil. They were interviewed and submitted to physical evaluation. Data from the patients' medical records regarding the treatment of breast cancer, the extent of axillary intervention and the tumor were analyzed. Lymphedema was diagnosed when the difference between both upper limbs was 2 cm or more by perimetry. The groups of women with and without lymphedema were compared regarding the possible risk factors, and central tendency, dispersion, and prevalence were

  2. Basic research for environmental restoration

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-01

    The Department of Energy (DOE) is in the midst of a major environmental restoration effort to reduce the health and environmental risks resulting from past waste management and disposal practices at DOE sites. This report describes research needs in environmental restoration and complements a previously published document, DOE/ER-0419, Evaluation of Mid-to-Long Term Basic Research for Environmental Restoration. Basic research needs have been grouped into five major categories patterned after those identified in DOE/ER-0419: (1) environmental transport and transformations; (2) advanced sampling, characterization, and monitoring methods; (3) new remediation technologies; (4) performance assessment; and (5) health and environmental effects. In addition to basic research, this document deals with education and training needs for environmental restoration. 2 figs., 6 tabs.

  3. 5 CFR 551.401 - Basic principles.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Basic principles. 551.401 Section 551.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Hours of Work General Provisions § 551.401 Basic principles. (a) All...

  4. Information management in the Basic Services to the Urban Poor (BUSP) scheme in Kalyan Dombivili (Maharashtra, India) and implications for Geographic Information System (GIS) development

    NARCIS (Netherlands)

    C. Richter

    2014-01-01

    Urban poverty alleviation schemes in India continue to target mainly slum areas. An important aspect in the planning, implementation, and monitoring of such government schemes pertains to the procedure and practices of spatial and socio-spatial information management in municipal administration. Cri

  5. The Sophia-Antipolis Conference: General presentation and basic documents. [remote sensing for agriculture, forestry, water resources, and environment management in France

    Science.gov (United States)

    1980-01-01

    The procedures and techniques used in NASA's aerospace technology transfer program are reviewed for consideration in establishing priorities and bases for joint action by technicians and users of remotely sensed data in France. Particular emphasis is given to remote sensing in agriculture, forestry, water resources, environment management, and urban research.

  6. Benchmarking polish basic metal manufacturing companies

    Directory of Open Access Journals (Sweden)

    P. Pomykalski

    2014-01-01

    Full Text Available Basic metal manufacturing companies are undergoing substantial strategic changes resulting from global changes in demand. During such periods managers should closely monitor and benchmark the financial results of companies operating in their section. Proper and timely identification of the consequences of changes in these areas may be crucial as managers seek to exploit opportunities and avoid threats. The paper examines changes in financial ratios of basic metal manufacturing companies operating in Poland in the period 2006-2011.

  7. Basic Research Firing Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Basic Research Firing Facility is an indoor ballistic test facility that has recently transitioned from a customer-based facility to a dedicated basic research...

  8. Body Basics Library

    Science.gov (United States)

    ... of Healthy Breakfasts Shyness About the Body Basics Library KidsHealth > For Teens > About the Body Basics Library A A A Did you ever wonder what ... system, part, and process works. Use this medical library to find out about basic human anatomy, how ...

  9. Body Basics Library

    Science.gov (United States)

    ... of Healthy Breakfasts Shyness About the Body Basics Library KidsHealth > For Teens > About the Body Basics Library Print A A A Did you ever wonder ... system, part, and process works. Use this medical library to find out about basic human anatomy, how ...

  10. Basic Cake Decorating Workbook.

    Science.gov (United States)

    Bogdany, Mel

    Included in this student workbook for basic cake decorating are the following: (1) Drawings of steps in a basic way to ice a layer cake, how to make a paper cone, various sizes of flower nails, various sizes and types of tin pastry tubes, and special rose tubes; (2) recipes for basic decorating icings (buttercream, rose paste, and royal icing);…

  11. Knowledge management

    OpenAIRE

    Jarošová, Milena

    2008-01-01

    Theoretical part: Basic terms of knowledge management, knowledge worker, knowledge creation and conversion process, prerequisites and benefits of knowledge management. Knowledge management and it's connection to organizational culture and structure, result measurements of knowledge management, learning organization and it's connection to knowledge management. Tacit knowledge management tools -- stories -- types, how to create, practical use, communities, coaching. Value Based Organization. Pr...

  12. In the Basic Procuratorial Room to Participate in Social Management Innovation System Construction Research%派驻基层检察室参与社会管理创新机制建设研究

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Profound understanding and accurate grasp of social management innovation is the innovation of procuratorial work to the new requirement;to give full play to the procuratorial organ in the innovation of social management function of the procuratorial organ,is placed in front of a major issue.The room is in basic level power sinking,extending legal supervision antenna is a kind of social management innovation to realize a way.This paper defined the presence of local procuratorial room and social management innovation concepts,analyzes the room in participation in social management innovation in the real obstacle,discussed the chamber based on the procuratorial organ,to focus the functions and role in the innovation of social management.%深刻认识和准确把握社会管理创新是对检察工作提出的新要求;充分发挥检察机关在社会管理创新中的职能作用,是摆在检察机关面前的一项重大课题。派驻基层检察室是实现检力下沉、延伸法律监督触角的一种社会管理创新实现方式。本文从界定派驻基层检察室和社会管理创新的概念入手,分析了检察室在参与社会管理创新中的现实障碍,探讨了检察室立足于检察机关、坚持重心下移的职能定位及其在社会管理创新中的作用。

  13. Illustrating the (in)visible: understanding the impact of loss in adults living with secondary lymphedema after cancer.

    Science.gov (United States)

    Thomas, Roanne; Hamilton, Ryan

    2014-01-01

    Life with a disability is often riddled with paradoxes, one of which is being visibly marked, while personal experiences, losses, and challenges remain hidden. Our article draws attention to this paradox among people who live with secondary lymphedema after cancer (SLC). SLC is a relatively unfamiliar chronic condition within medical and lay discourses of cancer, which proves challenging for the many cancer survivors who are in search of information and understanding. Thirteen men and women with SLC were recruited from two research sites (Fredericton, NB, and Ottawa, ON, Canada) to participate in semi-structured interviews about the physical and psychosocial aspects of SLC. Using a methodology of interpretive description, our analysis of participant interviews reveals the complex ways in which men and women felt both visible and invisible within various contexts. We discuss three majors themes: (in)visibility and appearance related to material losses; (in)visibility and action connected to visible losses in function, as well as invisible struggles to care for oneself; and the loss of present and future well-being, as SLC renders some limitations visible while potentially obscuring a hopeful future indefinitely. Our research indicates that timely diagnosis of SLC would be an immediate first step in recognizing the physical and emotional dimensions of the condition. To accomplish this, increased awareness is needed. To enhance quality of life for those living with SLC, the development of new resources and psychosocial supports is also required.

  14. Quality Management of Repairing the Old and Utilizing the Waste in Basic Units of Oilfields%油田基层单位修旧利废的质量管理

    Institute of Scientific and Technical Information of China (English)

    马德勇; 杨晓存; 袁忠芹; 陈素萍

    2011-01-01

    围绕油田基层单位所开展的修旧利废工作,针对组成修旧不同主体、构成修旧配套设施、集成修旧操作技法、形成修旧管理机制4个质量管理环节,展开油田基层修旧利废质量管理课题的探讨,得出的结论是:要持续开展油田基层修旧利废质量管理活动,需要组建具有修旧高质量的管理机构与操作主体,需要研制应用符合修旧实际的操作工具与配套设施,需要研发推广具有修旧技术支撑作用的操作技法与技术手段,需要探索创新具有规范管理特点的质量标准与管理机制。作为大庆油田优良传统的修旧利废,不但需要持续传承,更需要在质量管理上不断创新与持续发展。%The paper mainly focuses on the work of repairing the old and utilizing waste in basic units of oilfields.In view of four quality management links: organizing different bodies of repairing the old,constituting the matching facilities of repairing the old,collecting the operational techniques of repairing the old,and forming the management mechanism of repairing the old,the discussion is carried out on the topic: quality management of repairing the old and utilizing the waste in basic units of oilfields.It is concluded that in order to undertake the quality management activities of repairing the old and utilizing the waste in basic units of oilfields continuously,it is necessary to organize the management organization and operational body with high quality of repairing the old,to research,produce and apply the operational tools and matching facilities suitable for repairing practice,to develop and popularize the operational methods and technological means based on the technology of repairing the old,and to explore and innovate the quality standards and management mechanism with normalized management characteristics.Therefore,repairing the old and utilizing the waste,regarded as one excellent tradition of Daqing oilfields,not only needs

  15. Improved wound management by regulated negative pressure-assisted wound therapy and regulated, oxygen- enriched negative pressure-assisted wound therapy through basic science research and clinical assessment

    Directory of Open Access Journals (Sweden)

    Moris Topaz

    2012-01-01

    Full Text Available Regulated negative pressure-assisted wound therapy (RNPT should be regarded as a state-of-the-art technology in wound treatment and the most important physical, nonpharmaceutical, platform technology developed and applied for wound healing in the last two decades. RNPT systems maintain the treated wound′s environment as a semi-closed, semi-isolated system applying external physical stimulations to the wound, leading to biological and biochemical effects, with the potential to substantially influence wound-host interactions, and when properly applied may enhance wound healing. RNPT is a simple, safe, and affordable tool that can be utilized in a wide range of acute and chronic conditions, with reduced need for complicated surgical procedures, and antibiotic treatment. This technology has been shown to be effective and safe, saving limbs and lives on a global scale. Regulated, oxygen-enriched negative pressure-assisted wound therapy (RO-NPT is an innovative technology, whereby supplemental oxygen is concurrently administered with RNPT for their synergistic effect on treatment and prophylaxis of anaerobic wound infection and promotion of wound healing. Understanding the basic science, modes of operation and the associated risks of these technologies through their fundamental clinical mechanisms is the main objective of this review.

  16. Theoretical Discussion of Coordinated Fund Management of Basic Public Health and Basic Medical Services Based on the Principle of Labour Voucher%基于工分制原理的基本公共卫生与基本医疗服务经费统筹管理的理论探讨

    Institute of Scientific and Technical Information of China (English)

    李明; 张韬; 王洪兴; 厉勤; 李幼子

    2016-01-01

    While the coordinated management of fund for basic public health and basic medical services provides an opportunity for the integration of content and resources of basic public health and basic medical services,the principle of labour voucher creates technical conditions for this opportunity:the principle of labour voucher has resolved the financial accounting issues,eliminating the following problems of community health services;the building of the mechanism of funds allocation by the principle of labor voucher could ensure the transparency of information and is conducive to the establishment of performance appraisal system for community health service settings and their staffs,effectively guiding supply - side behavior;the fund allocation mechanism could also guide residents′ health seeking behavior indirectly through the supply side,and promote residents and medical staffs to improve their health and save fund together by price leverage and reward allocation. The study is still at theoretical stage,thus the feasibility of the research result needs to be further tested.%基本公共卫生和基本医疗服务经费的统筹管理,为基本公共卫生和基本医疗服务内容整合和资源整合提供了契机,而工分制原理则为这种契机创造了技术条件:工分制原理首先解决了经费核算问题,为社区卫生服务机构解决了后顾之忧;通过工分制原理构建经费分配机制,保证了信息透明性,有利于社区卫生服务机构绩效考核和机构内员工绩效考核机制的建立,从而有效引导供方行为;基于工分制原理构建的经费分配机制,可以通过供方间接引导居民就医行为,也可以通过价格杠杆和分配奖励促使居民与医务人员一起为提高自身健康水平和节约经费努力。本研究尚处于理论阶段,研究成果的可行性还有待实践的检验。

  17. Basics of Bayesian Learning - Basically Bayes

    DEFF Research Database (Denmark)

    Larsen, Jan

    Tutorial presented at the IEEE Machine Learning for Signal Processing Workshop 2006, Maynooth, Ireland, September 8, 2006. The tutorial focuses on the basic elements of Bayesian learning and its relation to classical learning paradigms. This includes a critical discussion of the pros and cons...

  18. Modern surgical management of breast cancer therapy related upper limb and breast lymphoedema.

    Science.gov (United States)

    Leung, Nelson; Furniss, Dominic; Giele, Henk

    2015-04-01

    Breast cancer is the commonest cancer in the UK. Advances in breast cancer treatment means that the sequelae of treatment are affecting more women and for a longer duration. Lymphoedema is one such sequela, with wide-ranging implications, from serious functional and psychological effects at the individual level to wider economic burdens to society. Breast cancer-related lymphoedema is principally managed by conservative therapy comprising compression garments and manual decongestive massage. This approach is effective for early stages of lymphoedema, but it is not curative and the effectiveness depends on patient compliance. Early surgical approaches were ablative, gave significant morbidity and hence, reserved for the most severe cases of refractory lymphoedema. However, recent non-ablative reconstructive surgical approaches have seen a revival of interest in the prevention or surgical management of breast cancer-related lymphoedema. This review examines the modern surgical techniques for the treatment of breast cancer-related lymphoedema. Liposuction reduces the volume and symptoms of lymphedema, but requires continual compressive therapy to avoid recurrence. Lymphatic reconstruction or bypass techniques including lymph node transfer (inguinal nodes are transferred to the affected limb), lymphatico-lymphatic bypass (lymphatics bypass the axilla using a lymph vessel graft reconstructing lymphatic flow from arm to neck) and lymphaticovenous anastomoses (lymphatics in the arm are joined to the venous system aiding lymph drainage) show promise in reducing lymphedema significantly. Further research is required, including into the role of primary lymphaticovenous anastomoses in the prevention of lymphedema at the time of axillary dissection.

  19. Dynamic analysis of muscular lymphokinetic activities in the treatment of lymphedema of the upper limbs - doi:10.5020/18061230.2007.p233

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Guerreiro Godoy

    2012-01-01

    Full Text Available The aim of the present study was to evaluate the resting and working pressures associated to a restrain mechanism, in patients suffering from lymphedema of the upper limbs, postbreast cancer treatment, whilst performing occupational and day-to-day self-care activities. Six female patients under treatment of lymphedema due to surgical, radiotherapeutic and chemotherapeutic treatment of breast cancer, in the age group between 32 and 76 years (mean 54 years old, ± 31.11 were selected. A compression sleeve of “gorgurão” (cotton-polyester material was applied as a restrain mechanism. The occupational and daily personal care activities evaluated were those common to all participants. These activities included washingup, cooking in a small pan, sweeping the floor using the affected arm, brushing the teeth, brushing the hair, washing small items of clothes, ironing clothes and making the bed. For statistical analysis, mean and standard deviation between resting pressures and minimum and maximum working pressures were determined. The two-tailed student t-test and variance analysis were used for repeated measurements. The Bonferroni limit was used in the analysis of the variables to calculate the alpha error, with a value of 5%, considered statistically significant. All of the analyzed activities associated to the “gorgurão” compression sleeve generated both resting and working pressures (p <0.005. In conclusion, the occupational daily life tasks used in the present study generate resting and working pressures and can be used as a form of treatment of the lymphedema.

  20. The Impact of L-Dex® Measurements in Assessing Breast Cancer Related Lymphedema (BCRL as Part of Routine Clinical Practice

    Directory of Open Access Journals (Sweden)

    Alison L. Laidley, MD

    2016-09-01

    Full Text Available Purpose: With improved survivorship, the prevalence of breast cancer related lymphedema (BCRL continues to increase, leading to impairment of a patients’ quality of life. While traditional diagnostic methods are limited by an inability to detect BCRL until clinically apparent, bioimpedance spectroscopy (BIS has been shown to detect subclinical BCRL. The purpose of this study is to evaluate the role of BIS in the early detection of BCRL as well as assessment of response to BCRL treatment. Methods: A retrospective review of 1,133 patients treated between November 2008 and July 2013 at two surgical practices was performed. Eligible patients (n=326 underwent pre-operative and post-operative L-Dex measurements. Patients were identified as having subclinical lymphedema if they were asymptomatic and the L-Dex score increased > 10 units above baseline and were monitored following treatment. Patients were stratified by lymph node dissection technique (SLNB vs. ALND and receipt of BCRL treatment.Results: The average age of the cohort was 56.2 years old and mean follow-up was 21.7 months. Of the 326 patients, 210 underwent SLNB and 116 underwent ALND. BCRL was identified by L-Dex in 40 patients (12.3%. The cumulative incidence rate of subclinical lymphedema was 4.3% for SLNB (n=9 and 26.7% for ALND (n=31. Of those diagnosed with BCRL, 50% resolved following treatment, 27.5% underwent treatment without resolution, and 22.5% had resolution without treatment. The prevalence of persistent, clinical BCRL was 0.5% for SLNB and 8.6% for ALND.Conclusions: This study demonstrates both the feasibility and clinical utility of implementing L-Dex measurements in routine breast cancer care. L-Dex identified patients with possible subclinical BCRL and allowed for assessment of response to therapy.

  1. 浅谈基层体委体育产业经营开发的基本环节%Simple Discussions about the Basic Links of Management and Development of Physical Training Estate of Primary Phyical Education Committee

    Institute of Scientific and Technical Information of China (English)

    杨海龙

    2001-01-01

    According to Document Material Law, and my personal investigation. The article points out that under the condition of the market economy system, the management and development of primary physical training estate is at the preliminary stage. Combined with the case of primary physical education committee, the article analyses both internal and external causes of management and develpoment of physical training estate, advancing the basic links of management and development of primary P.E. Committee%通过实地走访和文献资料法,发现在市场经济体制条件下,基层体育产业经营开发正处在起步阶段,结合基层体委的实际情况,分析体育产业经营开发的内外因,提出基层体委体育产业经营开发的基本环节。

  2. 上海试行养老金基本账户个人账户差异化管理探讨%Shanghai can Trial the Differentiated Management of the Individual Account of Pension Basic Account

    Institute of Scientific and Technical Information of China (English)

    蔡明超

    2012-01-01

    养老金基本账户包括统筹账户和个人账户,个人缴纳部分及单位缴纳的部分资金进入个人账户。由于年龄不一样、职业不一样、个人承受风险的意愿不一样,因此金融资产的配置也不一样,不同的个体需要不同的账户管理政策,进而形成养老金个人账户的差异化管理。上海养老金个人账户逐步做实,这为个人账户的管理创造了一定条件。%Pension service's basic account include social pooling accounts and individual account, the part of the funds paid by individual and unit enter into the individual account, because of the difference of age, occupation and individual willingness of tolerance for risk, the configuration of the financial assets are not the same, different individuals require different account management policies so that the differentiated management of the individual account of pension should be formed. The individual account of pension in Shanghai do real step by step, which create conditions for the management of individual accounts.

  3. Basic molecular spectroscopy

    CERN Document Server

    Gorry, PA

    1985-01-01

    BASIC Molecular Spectroscopy discusses the utilization of the Beginner's All-purpose Symbolic Instruction Code (BASIC) programming language in molecular spectroscopy. The book is comprised of five chapters that provide an introduction to molecular spectroscopy through programs written in BASIC. The coverage of the text includes rotational spectra, vibrational spectra, and Raman and electronic spectra. The book will be of great use to students who are currently taking a course in molecular spectroscopy.

  4. Basic digital signal processing

    CERN Document Server

    Lockhart, Gordon B

    1985-01-01

    Basic Digital Signal Processing describes the principles of digital signal processing and experiments with BASIC programs involving the fast Fourier theorem (FFT). The book reviews the fundamentals of the BASIC program, continuous and discrete time signals including analog signals, Fourier analysis, discrete Fourier transform, signal energy, power. The text also explains digital signal processing involving digital filters, linear time-variant systems, discrete time unit impulse, discrete-time convolution, and the alternative structure for second order infinite impulse response (IIR) sections.

  5. Bacteriological studies of blood, tissue fluid, lymph and lymph nodes in patients with acute dermatolymphangioadenitis (DLA) in course of 'filarial' lymphedema.

    Science.gov (United States)

    Olszewski, W L; Jamal, S; Manokaran, G; Pani, S; Kumaraswami, V; Kubicka, U; Lukomska, B; Tripathi, F M; Swoboda, E; Meisel-Mikolajczyk, F; Stelmach, E; Zaleska, M

    1999-10-15

    Filarial lymphedema is complicated by frequent episodes of dermatolymphangioadenitis (DLA). Severe systemic symptoms during attacks of DLA resemble those of septicemia. The question we asked was whether bacterial isolates can be found in the peripheral blood of patients during the episodes of DLA. Out of 100 patients referred to us with 'filarial' lymphedema 14 displayed acute and five subacute symptoms of DLA. All were on admission blood microfilariae negative but had a positive test in the past. Blood bacterial isolates were found in nine cases, four acute (21%) and five subacute (26%). In 10 acute cases blood cultures were found negative. Six blood isolates belonged to Bacilli, four to Cocci and one was Sarcina. To identify the sites of origin of bacterial dissemination, swabs taken from the calf skin biopsy wounds and tissue fluid, lymph and lymph node specimens were cultured. Swabs from the calf skin biopsy wound contained isolates in nine (47%) cases. They were Bacilli in nine, Cocci in three, Acinetobacter and Erwinia in two cases. Tissue fluid was collected from 10 patients and contained Bacilli in four (40%) and Staphylococci in three (30%). Lymph was drained in four patients and contained isolates in all samples (100%). They were Staphylococcus epidermis, xylosus and aureus, Acinetobacter, Bacillus subtilis and Sarcina. Three lymph nodes were biopsied and contained Staphylococcus chromogenes, xylosus, Enterococcus and Bacillus cereus. In six cases the same phenotypically defined species of bacteria were found in blood and limb tissues or fluids. In the 'control' group of patients with lymphedema without acute or subacute changes all blood cultures were negative. Interestingly, swabs from biopsy wound of these patients contained isolates in 80%, tissue fluid in 68%, lymph in 70% and lymph nodes in 58% of cases. In healthy controls, tissue fluid did not contain bacteria, and lymph isolates were found only in 12% of cases. This study demonstrates that

  6. Influence of adjuvant irradiation on the development of late arm lymphedema and impaired shoulder mobility after mastectomy for carcinoma of the breast

    DEFF Research Database (Denmark)

    Ryttov, N; Holm, N V; Qvist, N

    1988-01-01

    The influence of postoperative radiation therapy on development of late arm lymphedema and shoulder joint disability following mastectomy was evaluated from a series of 57 women with operable carcinoma of the breast. The patients were divided into three groups. Common for all three groups......%/38% in the group of patients receiving adjuvant irradiation and 6%/12% in the group of patients receiving adjuvant systemic therapy. It is concluded that adjuvant irradiation to the axilla in patients with metastatic lymph nodes highly increases the risk of late physical sequelae following modified radical...

  7. Impacto dos marcadores socioeconômicos na gravidade do linfedema das extremidades inferiores Impact of socioeconomic markers in severity of lower extremity lymphedema

    Directory of Open Access Journals (Sweden)

    Aquiles Tadashi Ywata de Carvalho

    2011-12-01

    Full Text Available No Brasil, a incidência do linfedema é pouco conhecida e poucas são as documentações científicas reportando a associação do linfedema com os fatores sociais e econômicos na nossa região. O objetivo do estudo foi analisar o impacto dos marcadores socioeconômicos na gravidade do linfedema das extremidades inferiores conforme a classificação de Mowlem, na região metropolitana de Salvador (BA. Dos 324 pacientes estudados, 200 (62% eram do gênero feminino. A idade variou entre 14 e 69 anos, com mediana de 48 anos. Analisando comparativamente as variáveis: gravidade do linfedema versus grau de escolaridade e gravidade versus renda familiar, observou-se que 93,8% dos pacientes classificados como Mowlem III estavam incluídos no grupo dos pacientes sem escolaridade e/ou com renda familiar de até três salários-mínimos. Não houve registro de doença avançada em pacientes com renda familiar acima de sete salários-mínimos e/ou com terceiro grau completo.In Brazil, the incidence of lymphedema is poorly known, and there is little scientific documentation reporting the association of lymphedema with the social and economic factors in our region. The objective was to analyze the impact of socioeconomic markers on the severity of lymphedema of the lower extremities according to the classification of Mowlem in the metropolitan region of Salvador (BA, Brazil. Of the 324 patients studied, 200 (62% were female. The age ranged between 14 and 69 years, median 48 years. Comparatively analyzing the varying severity of lymphedema versus education level and severity versus family income, it showed that 93.8% of patients classified as Mowlem III were included in the group of patients without education and/or with income up to three minimum wages. There was no record of advanced disease in patients with family incomes greater than seven minimum wages and/or graduate.

  8. Research on Basic Elements and Theoretical Model of Enterprise Management Innovation%企业管理创新的基本要素与理论模型研究

    Institute of Scientific and Technical Information of China (English)

    陆园园

    2009-01-01

    Its meaning and value for the enterprise reflect the significant role in the development of enterprise,which is also the meaning and value of the paper.With the reviewing of the literatures on the problem of enterprise management innovation at home and abroad,traditional categorical definition is used to bring forward the definition of management innovation and the analytical framework of concept.With practice of management on twelve "Most Admired Enterprises in China" as an example,the paper uses integrated case studies and KJ method to carry out comparative studies on twelve cases.According to the four key dimensions of the framework,the paper analyses management innovation activities of the twelve enterprises and concludes basic elements of enterprise management innovation.Moreover,it puts forward the theoretical model of enterprise management innovation combining with the theoretical research and cross case-study.The paper concludes by introducing the further research direction of enterprise management innovation.%在分析总结国内外有关企业管理创新问题研究现状的基础上,运用属加种差的方法给出管理创新的定义和概念的分析框架.以12家"中国最受尊敬企业"为例,运用整体性多案例研究方法和KJ法,通过对理论研究和案例研究所得的影响要素进行综合归并,归纳出企业管理创新的基本要素,并结合文献与理论研究和跨案例研究分析提出企业管理创新理论模型.在此基础上,指出了企业管理创新方面进一步研究的方向.

  9. 拉丁美洲基础教育公校民营现象探析*%A Probe into the Phenomenon of Private Management of Public Schools in Basic Education of Latin America

    Institute of Scientific and Technical Information of China (English)

    原青林

    2013-01-01

    In the case of the state’s inability to provide basic education for all due to shortage of ifnancial fund to education, the state governments of Latin America is active in carrying out public-private partnerships (PPP) like private management of public schools, using private resources to broaden the scope of basic education provision to the population and promote the quality of schooling, with noticeable effectiveness. The speciifc practices include Management contracts-Professional services or curriculum design, Operational Contracts, Education Service Contracts, Provision of Infrastructure Services Contracts, and Provision of Infrastructure Contract with Education Services Contracts, which are worth learning.%在教育投入不足,难以保证全民基础教育供给量的情况下,拉丁美洲各国政府在基础教育领域积极推行公办民营等公私合作办学模式,利用民间资源,扩大基础教育的惠民范围,优化教学质量,其成效十分明显。具体做法包括管理承包-专业服务或课程设计、经营承包、教育服务承包、学校建筑服务承包、学校建筑与教育服务承包等,值得借鉴。

  10. Health insurance basic actuarial models

    CERN Document Server

    Pitacco, Ermanno

    2014-01-01

    Health Insurance aims at filling a gap in actuarial literature, attempting to solve the frequent misunderstanding in regards to both the purpose and the contents of health insurance products (and ‘protection products’, more generally) on the one hand, and the relevant actuarial structures on the other. In order to cover the basic principles regarding health insurance techniques, the first few chapters in this book are mainly devoted to the need for health insurance and a description of insurance products in this area (sickness insurance, accident insurance, critical illness covers, income protection, long-term care insurance, health-related benefits as riders to life insurance policies). An introduction to general actuarial and risk-management issues follows. Basic actuarial models are presented for sickness insurance and income protection (i.e. disability annuities). Several numerical examples help the reader understand the main features of pricing and reserving in the health insurance area. A short int...

  11. Positron emission tomography basic sciences

    CERN Document Server

    Townsend, D W; Valk, P E; Maisey, M N

    2003-01-01

    Essential for students, science and medical graduates who want to understand the basic science of Positron Emission Tomography (PET), this book describes the physics, chemistry, technology and overview of the clinical uses behind the science of PET and the imaging techniques it uses. In recent years, PET has moved from high-end research imaging tool used by the highly specialized to an essential component of clinical evaluation in the clinic, especially in cancer management. Previously being the realm of scientists, this book explains PET instrumentation, radiochemistry, PET data acquisition and image formation, integration of structural and functional images, radiation dosimetry and protection, and applications in dedicated areas such as drug development, oncology, and gene expression imaging. The technologist, the science, engineering or chemistry graduate seeking further detailed information about PET, or the medical advanced trainee wishing to gain insight into the basic science of PET will find this book...

  12. Basic Research Objectives Reaffirmed

    Institute of Scientific and Technical Information of China (English)

    Guo Haiyan; Zhao Baohua

    2002-01-01

    @@ As a national institution for scientific research and a component of the national innovation system, CAS should and must make key contributions to the great national rejuvenation of the country. Keeping this in mind, CAS has developed four developmental targets for its basic research. This was revealed at a CAS conference on basic research held June 11-12 in Beijing.

  13. Cycles in basic innovations

    NARCIS (Netherlands)

    Groot, de E.A. (Bert); Franses, P.H.P.H.

    2005-01-01

    Basic innovations are often believed to be the drivers of economic growth. It has been widely documented that economic growth follows cyclical patterns of varying length. In this paper we examine if such patterns are also present in basic innovations. For an annual time series of count data covering

  14. Basic principle of superconductivity

    OpenAIRE

    De Cao, Tian

    2007-01-01

    The basic principle of superconductivity is suggested in this paper. There have been two vital wrong suggestions on the basic principle, one is the relation between superconductivity and the Bose-Einstein condensation (BEC), and another is the relation between superconductivity and pseudogap.

  15. 公司财务管理基本原则及目标探析%An Analysis and Research on the Basic Principles and Management Goals of Finance Management in Corporations

    Institute of Scientific and Technical Information of China (English)

    武小华; 周燕; 胥清

    2009-01-01

    财务管理是一个企业经济管理工作中的主要内容之一,有着非常重要的意义.目标利润的最大化,每股利润或资本利润率最大化,企业价值的最大化等都与财务管理有着十分密切的关联.本文主要通过对财务管理原则及目标的分析,来揭示财务管理在整个企业管理过程中的作用和地位.%Finance management is of significance in the economy management of an enterprise. And there is a high correlation between finance management and the maxmization of the goal profits, of every stockholder's profits,of the whoh capitalization and of the values of the enterprise. This paper has conducted an analysis of the goals and principles of finance management, and discussed about the roles of finance management played in the management of the enterprise.

  16. 基层微生物实验室的菌种管理与保存探讨%Study on the management and preservation of strains in basic microbiology laboratories

    Institute of Scientific and Technical Information of China (English)

    杜蓉; 秦夏蕾; 王功军; 向昌舜

    2012-01-01

    Standardized management of strains is an important aspect of ensuring bio-safety and controlling the quality of bacteriological testing in microbiology laboratories. Management of strains is also highly significant in terms of ensuring public health and safety and facilitating disease control and prevention. Combining actual work with study and reasonable techniques commensurate with work experience. the authors explore appropriate methods of preserving strains that are inexpensive and suited to basic microbiology laboratories.%规范管理菌种是微生物实验室细菌检验质量控制和生物安全的重要保障,对于疾病防控、保证公共卫生安全具有重要意义.结合工作实际,学习并合理运用同行的工作经验,探索出成本低廉,能满足工作需求,适于基层微生物实验室菌种保存的方法.

  17. Gestão da educação básica e o fortalecimento dos Conselhos Escolares Management of the basic education and the empowerment of the School Councils

    Directory of Open Access Journals (Sweden)

    Márcia Angela da S. Aguiar

    2008-01-01

    Full Text Available Examina-se a estratégia de implementação do Programa Nacional de Fortalecimento dos Conselhos Escolares adotada pela Secretaria de Educação Básica do Ministério da Educação com o objetivo de identificar os mecanismos utilizados para a inscrição da temática da gestão democrática na agenda das secretarias de educação e das escolas, bem como o envolvimento dos gestores e conselheiros escolares nos processos de formação promovidos pelo MEC, no período de 2004 a 2006.The strategy of implementation of the Programa Nacional de Fortalecimento dos Conselhos Escolares has been examined and adopted by the Secretary of Basic Education of the Department of Education (MEC with the objective to identify the mechanisms used for the registration of the themes - democratic management - in the agenda of the secretaries of education and the schools, as per the involvement of the managers and the school council members in the processes of formation promoted by the MEC, during the period of 2004 to 2006.

  18. Therapeutic strategy for lower limb lymphedema and lymphatic fistula after resection of a malignant tumor in the hip joint region: a case report.

    Science.gov (United States)

    Hara, H; Mihara, M; Hayashi, A; Kanemaru, M; Todokoro, T; Yamamoto, T; Iida, T; Hino, R; Koshima, I

    2014-03-01

    Lymphatic fistula complicating lymphedema is thought to occur due to communication between lymph vessels and the skin, which has yet to be shown objectively. The objective of this case report is to show the pathology and treatment using simultaneous lymphatic fistula resection and lymphatico-venous anastomosis (LVA). A 40-year-old woman underwent extended resection and total hip arthroplasty for primitive neuroectodermal tumor in the right proximal femur 23 years ago. Right lower limb lymphedema developed immediately after surgery and lymphatic fistula appeared in the posterior thigh. On ICG lymphography, lymph reflux toward the distal side dispersing in a fan-shape reticular pattern from the lymphatic fistula region was noted after intracutaneous injection of ICG into the foot. We performed simultaneous lymphatic fistula resection and of LVA. Pathological examination showed that the epidermis and stratum corneum of the healthy skin were lost in the lymphatic fistula region. Dilated lymph vessels were open in this region. The examinations provide the first objective evidence that the cause of lymphatic fistula may be lymph reflux from lymphatic stems to precollectors through lymphatic perforators.

  19. The latissimus dorsi-groin-lymph node compound flap: A comprehensive technique with three features including skin coverage, restoration of motor function, and prevention of upper limb lymphedema.

    Science.gov (United States)

    Nicoli, Fabio; Orfaniotis, Georgios; Lazzeri, Davide; Lim, Seong Yoon; Kiranantawat, Kidakorn; Chen, Pei-Yu; Ciudad, Pedro; Chilgar, Ram M; Sapountzis, Stamatis; Sacak, Bulent; Chen, Hung-Chi

    2016-11-01

    Reconstruction of complex upper extremity defects requires a need for multiple tissue components. The supercharged latissimus dorsi (LD)-groin compound flap is an option that can provide a large skin paddle with simultaneous functional muscle transfer. It is necessary to supercharge the flap with the superficial circumflex iliac pedicle to ensure the viability of its groin extension. In this report, we present a case of a supercharged LD-groin flap in combination with vascularized inguinal lymph nodes, which was used for upper limb reconstruction in a young male patient, following excision of high-grade liposarcoma. Resection resulted in a 28 cm × 15 cm skin defect extending from the upper arm to the proximal forearm, also involving the triceps muscle, a segment of the ulnar nerve and the axillary lymph nodes. Restoration of triceps function was achieved with transfer of the innervated LD muscle. Part of the ulnar nerve was resected and repaired with sural nerve grafts. Post-operatively, the flap survived fully with no partial necrosis, and no complications at both the recipient and donor sites. At 1-year follow up, the patient had a well-healed wound with good elbow extension (against resistance), no tumor recurrence, and no signs of lymphedema. We believe this comprehensive approach may represent a valuable technique, for not only the oncological reconstruction of upper extremity, but also for the prevention of lymphedema. © 2015 Wiley Periodicals, Inc. Microsurgery 36:689-694, 2016.

  20. {sup 99m}Tc-DTPA-HSA lymphoscintigraphy in lymphedema of the lower extremities. Diagnostic significance of dynamic study and muscular exercise

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Yoji; Hayashi, Kuniaki [Nagasaki Univ. (Japan). School of Medicine

    1999-01-01

    The efficacy of lymphoscintigraphy was evaluated in 25 cases to clarify the diagnostic significance of dynamic study and muscular exercise in the diagnosis of lymphedema. {sup 99m}Tc-diethylene triamine pentaacetic acid-human serum albumin (DTPA-HSA) was injected subcutaneously, and dynamic imaging was performed in 18 cases. Thirteen patients were asked to walk for 3 minutes. Qualitative evaluation of static images had sensitivity of 90% and specificity of 97%. Diagnostic criteria including qualitative evaluation of dynamic images were less specific (sensitivity 95%, specificity 76%). Interpretation of static images obtained at one hour after injection in the patients without muscular exercise had sensitivity of 89% and specificity of 67%, whereas sensitivity was 92% and specificity was 100% in the patients with muscular exercise. Lympho-scintigraphy was reliable in diagnosis of lymphedema. Dynamic study was limited usefulness because of some false-positive cases. Muscular exercise accelerated migration of the tracer in normal extremities, and improved positive predictive value. (author)

  1. Anger Management

    Science.gov (United States)

    ... Managing your anger. Australian Psychological Society. http://www.psychology.org.au/publications/tip_sheets/anger/. Accessed March ... procedures/anger-management/basics/definition/PRC-20014603 . Mayo Clinic Footer Legal Conditions and Terms Any use of ...

  2. Basic stress analysis

    CERN Document Server

    Iremonger, M J

    1982-01-01

    BASIC Stress Analysis aims to help students to become proficient at BASIC programming by actually using it in an important engineering subject. It also enables the student to use computing as a means of learning stress analysis because writing a program is analogous to teaching-it is necessary to understand the subject matter. The book begins by introducing the BASIC approach and the concept of stress analysis at first- and second-year undergraduate level. Subsequent chapters contain a summary of relevant theory, worked examples containing computer programs, and a set of problems. Topics c

  3. Quantum electronics basic theory

    CERN Document Server

    Fain, V M; Sanders, J H

    1969-01-01

    Quantum Electronics, Volume 1: Basic Theory is a condensed and generalized description of the many research and rapid progress done on the subject. It is translated from the Russian language. The volume describes the basic theory of quantum electronics, and shows how the concepts and equations followed in quantum electronics arise from the basic principles of theoretical physics. The book then briefly discusses the interaction of an electromagnetic field with matter. The text also covers the quantum theory of relaxation process when a quantum system approaches an equilibrium state, and explai

  4. Universal Basic Income versus Unemployment Insurance

    OpenAIRE

    2014-01-01

    In this paper we compare the welfare effects of unemployment insurance (UI) with a universal basic income (UBI) system in an economy with idiosyncratic shocks to employment. Both policies provide a safety net in the face of idiosyncratic shocks. While the unemployment insurance program should do a better job at protecting the unemployed, it suffers from moral hazard and substantial monitoring costs, which may threaten its usefulness. The universal basic income, which is simpler to manage and ...

  5. Development of International Air Transport Management System and It’ s Basic Trend%论国际航空运输管理体制发展历程及基本走向

    Institute of Scientific and Technical Information of China (English)

    贺富永; 王盛蕾

    2015-01-01

    国际航空运输管理体制是国家间通过签订航空运输协定,规范它们之间国际航空运输活动所形成的结构和组成方式。在第一次世界大战前,国际航空运输管理体制单边主义盛行;第一次世界大战结束到20世纪70年代末,多边主义和双边主义并存是国际航空运输管理体制的主要表现形式;从20世纪70年代末开始,国际航空运输管理体制呈现出区域化和全球化的倾向。通过对双边管理体制和多边管理体制的利弊分析,预测在未来较长时期内,二者并存依然是国际航空运输管理体制发展的基本走向。%International air management system is structural rules forthe standardization of international air transport activities by the air transport agreements signed by different countries.Before the First World War,the unilateralism of international air transport management system prevailed.From the First World War to the end of the 1970s, multi-lateralism became the main mode.From the end of 1970s, the international air transport management system showed a tendency of regionalization and globalization.Through the analysis of the advantages and disadvantages of bilateral and multilateral management system, the paper predicts that the coexistence of the bilateral and multilateral systems remains the basic trend of international air transport management system.

  6. Video Screen Capture Basics

    Science.gov (United States)

    Dunbar, Laura

    2014-01-01

    This article is an introduction to video screen capture. Basic information of two software programs, QuickTime for Mac and BlueBerry Flashback Express for PC, are also discussed. Practical applications for video screen capture are given.

  7. HIV Treatment: The Basics

    Science.gov (United States)

    HIV Treatment HIV Treatment: The Basics (Last updated 2/24/2017; last reviewed 2/24/2017) Key Points Antiretroviral therapy (ART) ... reduces the risk of HIV transmission . How do HIV medicines work? HIV attacks and destroys the infection- ...

  8. Kidney Disease Basics

    Science.gov (United States)

    ... Links Take the first step Alternate Language URL Kidney Disease Basics Page Content Your kidneys filter extra ... blood pressure are the most common causes of kidney disease. ​These conditions can slowly damage the kidneys ...

  9. Health Literacy Basics

    Science.gov (United States)

    ... have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. 1 Health literacy is dependent on individual and systemic factors: Communication skills of lay persons and professionals Lay and professional ...

  10. Basic Financial Accounting

    DEFF Research Database (Denmark)

    Wiborg, Karsten

    This textbook on Basic Financial Accounting is targeted students in the economics studies at universities and business colleges having an introductory subject in the external dimension of the company's economic reporting, including bookkeeping, etc. The book includes the following subjects...

  11. Basic Concurrency Theory

    DEFF Research Database (Denmark)

    Løvengreen, Hans Henrik

    2002-01-01

    In this set of notes, we present some of the basic theory underlying the discipline of programming with concurrent processes/threads. The notes are intended to supplement a standard textbook on concurrent programming.......In this set of notes, we present some of the basic theory underlying the discipline of programming with concurrent processes/threads. The notes are intended to supplement a standard textbook on concurrent programming....

  12. On the close-to-natural management of basic coppice of Shanwanzi Forest Farm%山湾子林场基本矮林的近自然经营研究

    Institute of Scientific and Technical Information of China (English)

    李相成; 陈志刚

    2015-01-01

    In order to improve the quality of Shanwanzi Farm Stand basic coppice ,and maxi‐mize the creation of their ecological and economic value ,drawing close‐to‐natural forest man‐agement methods for Natural Forest Farm of Shanwanzi basic coppice ,the business transfor‐mation was conducted .With two comparative designed managements of Natural management and traditional operation ,the comparative analysis of stand DBH ,the stand volume and soil chemical properties showed the stand DBH increased by 20% ,volume increased by 46% and soil organic matter and N ,P ,K content increased in varying degrees .Close‐to‐natural man‐agement of forests proved to be more rational in the stand structure ,significantly increasing the forest value ,with stands eventually developing into a high‐quality conifer .%为了提高山湾子林场基本矮林的林分质量,最大程度发挥其生态价值和经济价值,借鉴适合天然次生林的近自然森林经营方法,对山湾子林场基本矮林进行经营改造。设计近自然经营和传统经营2种经营方法的对比,通过对不同方法经营的林分胸径、蓄积和土壤化学性质的调查分析,结果显示,采用近自然方法经营的林分胸径平均提高了20%,蓄积平均提高了46%,土壤有机质和氮磷钾含量均有不同程度的增加。近自然经营使森林结构更加合理,森林价值大幅提升,最终使林分发展成为高质量的针阔混交林。

  13. Hemorrhoids: From basic pathophysiology to clinical management

    Institute of Scientific and Technical Information of China (English)

    Varut Lohsiriwat

    2012-01-01

    This review discusses the pathophysiology,epidemiology,risk factors,classification,clinical evaluation,and current non-operative and operative treatment of hemorrhoids.Hemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions.The most common symptom of hemorrhoids is rectal bleeding associated with bowel movement.The abnormal dilatation and distortion of the vascular channel,together with destructive changes in the supporting connective tissue within the anal cushion,is a paramount finding of hemorrhoids.It appears that the dysregulation of the vascular tone and vascular hyperplasia might play an important role in hemorrhoidal development,and could be a potential target for medical treatment.In most instances,hemorrhoids are treated conservatively,using many methods such as lifestyle modification,fiber supplement,suppositorydelivered anti-inflammatory drugs,and administration of venotonic drugs.Non-operative approaches include sclerotherapy and,preferably,rubber band ligation.An operation is indicated when non-operative approaches have failed or complications have occurred.Several surgical approaches for treating hemorrhoids have been introduced including hemorrhoidectomy and stapled hemorrhoidopexy,but postoperative pain is invariable.Some of the surgical treatments potentially cause appreciable morbidity such as anal stricture and incontinence.The applications and outcomes of each treatment are thoroughly discussed.

  14. Perfil dos gerentes de unidades básicas de saúde Perfil de los gerentes de las unidades basicas de la salud Manager's profile of basic unit of health

    Directory of Open Access Journals (Sweden)

    Marilia Alves

    2004-08-01

    Full Text Available Estudo descritivo com objetivo de delimitar o perfil dos gerentes das UBS de Belo Horizonte. Coletaram-se dados a partir de um roteiro básico de uma amostra de 46,45% de gerentes de 127 UBS. O quadro gerencial é composto na maioria por mulheres, enfermeiras, com idade entre 36 e 50 anos, exercendo a gerência há mais de 5 anos, com conhecimento adquirido na graduação. Para o alcance da resolutividade o gerenciamento demanda atributos individuais que extrapolam os conhecimentos adquiridos em programas formais de capacitação. Atenta-se para a necessidade do município assumir o compromisso com a capacitação de seus gerentes, respaldando-os com conhecimentos complementares em face às exigências da política de gestão do SUS.Estudio descriptivo con objetivo de delimitar el perfil de los gerentes de las *UBS de Belo Horizonte. Los datos fueron obtenidos a partir de un guión básico de una muestra del 46,45% de gerentes de 127 UBS. El cuadro gerencial es compuesto en la mayoría por mujeres, enfermeras, con edad entre 36 y 50 años, ejerciendo la gerencia hay más de 5 años, con conocimiento adquirido en la graduación. La administración de los problemas demanda atributos individuales que extrapolan los conocimientos adquiridos en programas formales de capacitación. Se Atenta para la necesidad del municipio asumir el compromiso con la capacitación de sus gerentes, respaldándolos con conocimientos complementes en faz a las exigencias de la política de gestión del SUS.Descriptive study with objective to delimit the profile of the manager of the UBS of Belo Horizonte. They had been collected given from a basic script of a sample of 46,45% of controlling of 127 UBS. The managemental picture is composed in the majority for women, nurses, with age between 36 and 50 years, exerting the management has more than 5 years, with knowledge acquired in the graduation. For the reach of the resolution the management demand individual attributes

  15. Back to Basics.

    Science.gov (United States)

    May, Abigail

    1998-01-01

    Offers some key business principles with the hope of helping educational facilities managers improve their operations. Looks at customer service, disparate databases, technological concerns, the mission of facility management, how to improve the bottom line, staffing ideas, future planning, and management suggestions. Lists seven habits of…

  16. Radiation Therapy Risk Factors for Development of Lymphedema in Patients Treated With Regional Lymph Node Irradiation for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chandra, Ravi A. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Miller, Cynthia L. [Harvard Medical School, Boston, Massachusetts (United States); Skolny, Melissa N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Warren, Laura E.G. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Horick, Nora [Department of Biostatistics, Massachusetts General Hospital, Boston, Massachusetts (United States); Jammallo, Lauren S.; Sadek, Betro T.; Shenouda, Mina N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); O' Toole, Jean [Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle C. [Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2015-03-15

    Purpose: We previously evaluated the risk of breast cancer-related lymphedema (LE) with the addition of regional lymph node irradiation (RLNR) and found an increased risk when RLNR is used. Here we analyze the association of technical radiation therapy (RT) factors in RLNR patients with the risk of LE development. Methods and Materials: From 2005 to 2012, we prospectively screened 1476 women for LE who underwent surgery for breast cancer. Among 1507 breasts treated, 172 received RLNR and had complete technical data for analysis. RLNR was delivered as supraclavicular (SC) irradiation (69% [118 of 172 patients]) or SC plus posterior axillary boost (PAB) (31% [54 of 172]). Bilateral arm volume measurements were performed pre- and postoperatively. Patients' RT plans were analyzed for SC field lateral border (relative to the humeral head), total dose to SC, RT fraction size, beam energy, and type of tangent (normal vs wide). Cox proportional hazards models were used to analyze associated risk factors for LE. Results: Median postoperative follow-up was 29.3 months (range: 4.9-74.1 months). The 2-year cumulative incidence of LE was 22% (95% confidence interval [CI]: 15%-32%) for SC and 20% (95% CI: 11%-37%) for SC plus PAB (SC+PAB). None of the analyzed variables was significantly associated with LE risk (extent of humeral head: P=.74 for <1/3 vs >2/3, P=.41 for 1/3 to 2/3 vs >2/3; P=.40 for fraction size of 1.8 Gy vs 2.0 Gy; P=.57 for beam energy 6 MV vs 10 MV; P=.74 for tangent type wide vs regular; P=.66 for SC vs SC+PAB). Only pretreatment body mass index (hazard ratio [HR]: 1.09; 95% CI: 1.04-1.15, P=.0007) and the use of axillary lymph node dissection (HR: 7.08, 95% CI: 0.98-51.40, P=.05) were associated with risk of subsequent LE development. Conclusions: Of the RT parameters tested, none was associated with an increased risk of LE development. This study underscores the need for future work investigating alternative RLNR risk factors for LE.

  17. The Value-added Management of the Basic Old-age Insurance Personal Account for Urban enterprise Workers%城镇企业职工基本养老保险个人账户的增值管理

    Institute of Scientific and Technical Information of China (English)

    于晓丽

    2012-01-01

    着我国城镇企业职工基本养老保险个人账户“实账化”改革的不断深入,个人账户基金积累的规模越来越大。养老保险基金贬值风险的影响,使个人账户增值成为保障个人养老水平的重要问题。针对个人账户基金的管理模式和操作细节,国内学者分别提出不同甚至相反的意见。结合国际经验,实行“三权分立”的个人账户管理体制在理论上能够保证个人账户增值的实现。%With the deepening of the reform of the basic old-age insurance personal accounts of China's urban enterprise workers "Real Account" personal account funds accumulated increasing scale. The impact of the devaluation of the pension fund risk, personal accounts add value to the important issue of the protection of personal pension level. Management model and operational details of the funds for personal accounts, domestic scholars proposed a different and even opposite opinions. In theory, the personal account management system combined with international experience in the implementation of the " separation of powers" can ensure that the value-added implementation of personal accounts.

  18. The Value of Skin Fibro Meter in the Diagnosis of Lymphedema Disease%皮肤纤维化测量仪对淋巴水肿疾病的诊断价值

    Institute of Scientific and Technical Information of China (English)

    韩凌华; 刘宁飞; 于子优; 汪立; 陈佳佳

    2015-01-01

    Objective To explore the diagnostic value of Skin Fibro Meter (SFM) in lymphedema diseases. Methods Sixteen cases of lymphedema patients and twenty cases of healthy people were included in this study as lymphedema group and control group respectively. With Skin Fibro Meter (Delfin company, Finland), SFM test was performed on bilateral limbs of lymphedema group and control group. In addition, bilateral tissue moisture content of each segment of patients in lym-phedema group was also measured. Results In lymphedema group, the average fibrosis value of healthy side was (0.07±0.01) and (0.13±0.05) of affected side (P<0.000 1). In lymphedema group, the average tissue moisture content was (4.47±2.09) in healthy side, and (6.4±3.76) in affected side (P=0.002). The moisture ratio was 43.2%and it presented a tendency of positive correlation with the D-value of fibrosis between the healthy side and affected side. The average fibrosis value was (0.06±0.02) in control group, and (0.13±0.05) in lymphedema group (P<0.000 1). Conclusion Skin Fibro Meter provides reliable basis for the diagnosis of lymphedema disease, its diagnostic value is worth further research and exploration.%目的:探索皮肤纤维化测量仪(Skin Fibro Meter,SFM)对淋巴水肿疾病的诊断价值。方法将16例淋巴水肿患者和20例健康成人,分别设为淋巴水肿组和正常对照组。采用SFM对淋巴水肿组患者分别进行健、患肢测试,另外还对淋巴水肿组患者进行健、患肢分段组织水肿(水分)测量,并与正常对照组进行比较。结果淋巴水肿组患者健侧纤维化平均值为(0.07±0.01),患侧纤维化平均值为(0.13±0.05),两者差异显著(P<0.0001);淋巴水肿组患者患肢水分平均值为(6.4±3.76),健侧平均值为(4.47±2.09),健、患侧水分平均值差异显著(P=0.002),水分比率值为43.2%,水分比率和纤维化差值呈现正相关趋势。

  19. Basic Electromagnetism and Materials

    CERN Document Server

    Moliton, André

    2007-01-01

    Basic Electromagnetism and Materials is the product of many years of teaching basic and applied electromagnetism. This textbook can be used to teach electromagnetism to a wide range of undergraduate science majors in physics, electrical engineering or materials science. However, by making lesser demands on mathematical knowledge than competing texts, and by emphasizing electromagnetic properties of materials and their applications, this textbook is uniquely suited to students of materials science. Many competing texts focus on the study of propagation waves either in the microwave or optical domain, whereas Basic Electromagnetism and Materials covers the entire electromagnetic domain and the physical response of materials to these waves. Professor André Moliton is Director of the Unité de Microélectronique, Optoélectronique et Polymères (Université de Limoges, France), which brings together three groups studying the optoelectronics of molecular and polymer layers, micro-optoelectronic systems for teleco...

  20. Nuclear multifragmentation: Basic concepts

    Indian Academy of Sciences (India)

    G Chaudhuri; S Mallik; S Das Gupta

    2014-05-01

    We present a brief overview of nuclear multifragmentation reaction. Basic formalism of canonical thermodynamical model based on equilibrium statistical mechanics is described. This model is used to calculate basic observables of nuclear multifragmentation like mass distribution, fragment multiplicity, isotopic distribution and isoscaling. Extension of canonical thermodynamical model to a projectile fragmentation model is outlined. Application of the projectile fragmentation model for calculating average number of intermediate mass fragments and the average size of the largest cluster at different bound, differential charge distribution and cross-section of neutron-rich nuclei of different projectile fragmentation reactions at different energies are described. Application of nuclear multifragmentation reaction in basic research as well as in other domains is outlined.

  1. Professional groups practice in nursing quality management in basic-level hospital%基层医院建立专业小组参与护理质量管理的实践

    Institute of Scientific and Technical Information of China (English)

    邹爱华; 马玲

    2014-01-01

    目的:探讨基层医院建立护理专业小组在护理质量管理中的应用效果。方法建立9个护理专业小组,参与护理质量管理,每组设置组长1名及组员2名,制定小组职责,按照PDCA循环法开展护理质量管理工作。结果建立专业小组参与护理质量管理后,各项护理质量指标包括基础护理、文件书写、消毒隔离、急救物品、危重护理、技术操作合格率逐年提高,2009年基础护理、文件书写、消毒隔离、急救物品、危重护理、技术操作6个项目的合格率分别为90.6%,93.1%,93.7%,95.8%,92.5%,93.0%;2010年分别为95.8%,95.3%,95.0%,98.5%,94.5%,96.5%;2011年分别为97.2%,97.9%,98.3%,99.6%,96.8%,98.9%;2012年分别为98.9%,99.2%,99.2%,99.8,99.0%,99.1%;各年质量指标比较,差异有统计学意义(χ2值分别为8.993,7.391,4.784,6.615,6.584,6.987;P <0.05)。结论基层医院建立专业小组参与护理质量管理,有利于护理质量科学持续改进;减轻护理部管理人员工作压力,提高了管理效率;有利于护理质量的提高;提升了护理人员的工作成就感;有利于储备护理管理人才。%Objective To explore the effects of professional groups on the nursing quality management . Methods Totals of 9 nursing groups were established to participate in nursing quality management .One group leader and 2 group members were assigned to each group ,and job responsibilities of group was set up , PDCA circulation method was used to work .Results After professional groups participated in nursing quality management , the nursing quality indicators such as the qualified rate of basic nursing , document writing , disinfection and emergency , critical care and technical operations was improved .From 2009 to 2012, the qualified rate of basic

  2. Reconstrucción en linfedema peneano y escrotal secundario a hernia inguinal bilateral gigante Reconstruction in penile and scrotal lymphedema secondary to billateral giant inguinal hernia

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2009-12-01

    Full Text Available El linfedema peneano y escrotal tiene consecuencias funcionales, estéticas, sociales y psicológicas significativas para el paciente que lo padece. Es una enfermedad infrecuente en los países desarrollados, aunque relativamente prevalente en los países tropicales. Su causa más común es la filariasis, aunque en nuestra práctica diaria se asocia más frecuentemente a cirugía, radioterapia, procesos inflamatorios y neoplásicos. Presentamos un caso singular de linfedema penoescrotal secundario a cirugía por hernia inguinal gigante bilateral que persistía un año después de la intervención. El tratamiento quirúrgico consistió en la exéresis de toda la piel linfedematosa del escroto involucrada y el uso de colgajos de piel escrotal posterior para la cobertura testicular. En un segundo tiempo quirúrgico se llevó a cabo una extirpación total de la piel del pene y del tejido subcutáneo superficial a la fascia de Buck. Empleamos injertos de piel de grosor parcial para cubrir el pene denudado. El resultado estético postoperatorio fue aceptable y los resultados funcionales y psicológicos son satisfactorios para el paciente 3 años después de la cirugía.Lymphedema of the penis and scrotum has important functional, cosmetic, social, psychological consequences for the affected patient. It is a rare disease in the developed countries, although it is relatively frequent in tropical countries. Globally, the most common cause is filariasis, although in our practice it is most frecuently associated to surgery, radiotherapy, inflammatory and neoplasic diseases. We report one rare case of penoscrotal lymphedema due to billateral giant inguinal hernia reconstrction. The lymphedema was persistent one year after the repair of the billateral hernia. The technique of reconstruction consisted of excision of all involved lymphedematous skin of the scrotum, and use of posterior scrotal flaps for testicular coverage. In a second surgical time, a total

  3. Discussion on Waste Liquid Management of College's Basic Chemistry Laboratory%关于高校基础化学实验室废弃物管理的探讨

    Institute of Scientific and Technical Information of China (English)

    贺宝灵; 詹欢

    2014-01-01

    The College's basic chemistry laboratory is the important place to implement practical education, to cultivate practice capability and research ability for students. Some waste liquid, waste solid and poisonous gases are always produced to pollute the environment, to endanger the health and bring unpredicted potential security risk for the lack of deliberated disposal. The proper dispose methods are proposed on the base of waste classification which can promote the standardization and scientific of the laboratory management.%高校化学实验室是开展实践教学、培养学生实践能力乃至学问探究能力的重要场所,但在日常运行中常常产生废液、废渣以及有害气体等,且极易被忽视,几乎不经处理就直接排放或丢弃,这不仅污染了环境,危害了人体健康,还造成了不可预料的安全隐患。结合工作体会,对基础化学实验室产生的废弃物进行了较为系统的分类,并提出了合理的处理措施,从而推进实验室管理的规范化、科学化。

  4. Decontamination: back to basics.

    Science.gov (United States)

    Meredith, Susan J; Sjorgen, Geoff

    2008-07-01

    My invitation from this Journal's Editor, Felicia Cox, to provide a paper for this themed issue, included the sentence 'I was wondering if you or a colleague would like to contribute a back to basics article on the relevant standards and guidelines for decontamination, including what is compliance?'. The reason it is so interesting to me is that the term 'back to basics' implies reverting to a simpler time in life - when by just sticking to the rules, life became easier. However, with decontamination this is not actually true.

  5. Comprehensive basic mathematics

    CERN Document Server

    Veena, GR

    2005-01-01

    Salient Features As per II PUC Basic Mathematics syllabus of Karnataka. Provides an introduction to various basic mathematical techniques and the situations where these could be usefully employed. The language is simple and the material is self-explanatory with a large number of illustrations. Assists the reader in gaining proficiency to solve diverse variety of problems. A special capsule containing a gist and list of formulae titled ''REMEMBER! Additional chapterwise arranged question bank and 3 model papers in a separate section---''EXAMINATION CORNER''.

  6. Basic set theory

    CERN Document Server

    Levy, Azriel

    2002-01-01

    An advanced-level treatment of the basics of set theory, this text offers students a firm foundation, stopping just short of the areas employing model-theoretic methods. Geared toward upper-level undergraduate and graduate students, it consists of two parts: the first covers pure set theory, including the basic motions, order and well-foundedness, cardinal numbers, the ordinals, and the axiom of choice and some of it consequences; the second deals with applications and advanced topics such as point set topology, real spaces, Boolean algebras, and infinite combinatorics and large cardinals. An

  7. Basic research championed

    Science.gov (United States)

    Friebele, Elaine

    In April, the Office of National Science and Technology Policy released its biennial report to Congress. Science and Technology: Shaping the Twenty-First Century addresses the President's policy for maintaining U.S. leadership in science and technology, significant developments, and important national issues in science, and opportunities to use science and technology in federal programs and national goals. The administration strongly supports basic research as a sound investment and an inspiration to society. As corporate laboratories increasingly favor applied R&D projects, the federal government is becoming the dominant sponsor of long-term, basic research.

  8. Basic properties of semiconductors

    CERN Document Server

    Landsberg, PT

    2013-01-01

    Since Volume 1 was published in 1982, the centres of interest in the basic physics of semiconductors have shifted. Volume 1 was called Band Theory and Transport Properties in the first edition, but the subject has broadened to such an extent that Basic Properties is now a more suitable title. Seven chapters have been rewritten by the original authors. However, twelve chapters are essentially new, with the bulk of this work being devoted to important current topics which give this volume an almost encyclopaedic form. The first three chapters discuss various aspects of modern band theory and the

  9. Basic Financial Accounting

    DEFF Research Database (Denmark)

    Wiborg, Karsten

    This textbook on Basic Financial Accounting is targeted students in the economics studies at universities and business colleges having an introductory subject in the external dimension of the company's economic reporting, including bookkeeping, etc. The book includes the following subjects: busin......: business entities, the transformation process, types of businesses, stakeholders, legislation, the annual report, the VAT system, double-entry bookkeeping, inventories, and year-end cast flow analysis.......This textbook on Basic Financial Accounting is targeted students in the economics studies at universities and business colleges having an introductory subject in the external dimension of the company's economic reporting, including bookkeeping, etc. The book includes the following subjects...

  10. Mastectomy -- The Surgical Procedure

    Science.gov (United States)

    ... your arm and there is some risk of lymphedema. Lymphedema is a condition where fluid collects in the ... management of surgery-related pain . Learn more about lymphedema . Transportation, lodging, child care and elder care assistance ...

  11. Construction and Application of Basic Data Acquisition and Management System for Fujian Province's Alien Invasive Species%福建外来入侵生物基础数据采集管理系统构建与应用

    Institute of Scientific and Technical Information of China (English)

    陈宏; 赵健; 池美香; 邱荣洲; 翁启勇

    2011-01-01

    针对福建外来入侵生物防控工作中对历史数据管理、部门调查数据协同与交换、数据分析与展示中存在的实际问题,结合“3S”技术(地理信息系统技术、遥感技术和全球定位技术)、移动智能终端、3G移动通信网络等现代信息技术,设计了福建外来入侵生物数据采集与管理的协同工作模式,并开发了福建外来入侵生物基础数据采集管理系统与采集设备.实现了不同的用户对外来入侵生物信息的采集、传输、管理、查询和发布等完整的信息处理流程.在建设过程中完成了156种福建主要外来入侵生物基础数据的收集、整理和数据入库,以期为福建省外来入侵生物风险分析和预警监测提供基础数据来源和技术支撑.%In order to solve the problem about the historical data management, collaboration and exchange department of survey data, data analysis and display of prevention and control of alien invasive species in Fujian province, geographic information systems technology, remote sensing and global positioning systems (the 3S technology), personal digital assistant and third generation mobile communication system were applied to design the data acquisition and management team work model of alien invasive species for Fujian province in this study, and realize the information system and develop data acquisition devices. For different user needs, the system realizes the alien invasive species information processing flow, such as data acquisition, data transmission, data management, data query and publish information. This study has completed to acquire, collate and store 156 alien invasive species records in Fujian province. Implementation and operation of system could provide basic data sources, technology and devices supports for risk assessment and early warning monitor with alien invasive species in Fujian province.

  12. Ethanol Basics (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2015-01-01

    Ethanol is a widely-used, domestically-produced renewable fuel made from corn and other plant materials. More than 96% of gasoline sold in the United States contains ethanol. Learn more about this alternative fuel in the Ethanol Basics Fact Sheet, produced by the U.S. Department of Energy's Clean Cities program.

  13. Korean Basic Course.

    Science.gov (United States)

    Defense Language Inst., Washington, DC.

    These 11 volumes of the Korean Basic Course comprise 112 lesson units designed to train native English language speakers to Level 3 proficiency in comprehension and speaking and Level 2 proficiency in reading and writing Korean. (Level 5 on this scale is native-speaker level.) Intended for classroom use in the Defense Language Institute intensive…

  14. Basic physics for all

    CERN Document Server

    Kumar, B N

    2012-01-01

    This is a simple, concise book for both student and non-physics students, presenting basic facts in straightforward form and conveying fundamental principles and theories of physics. This book will be helpful as a supplement to class teaching and to aid those who have difficulty in mastering concepts and principles.

  15. Vaccine Basics (Smallpox)

    Science.gov (United States)

    ... this page: About CDC.gov . Smallpox About Smallpox History of Smallpox Spread and Eradication of Smallpox Transmission Signs and Symptoms Prevention and Treatment Smallpox Vaccine Basics Vaccine Safety Side Effects of Vaccination Who Should Get a Smallpox Vaccination? Bioterrorism The ...

  16. FULA BASIC COURSE.

    Science.gov (United States)

    SWIFT, LLOYD B.; AND OTHERS

    THIS BEGINNING COURSE IS AN INTRODUCTION TO FULA (KNOWN VARIOUSLY AS FULANI, FUL, PEUL, OR PHEUL), A NIGER-CONGO LANGUAGE SPOKEN THROUGHOUT THE GRASSLAND AREAS OF WEST AFRICA FROM THE ATLANTIC TO CAMEROUN. THE TEXT IS ONE OF A SERIES OF SHORT BASIC COURSES IN SELECTED AFRICAN LANGUAGES BEING PREPARED BY THE FOREIGN SERVICE INSTITUTE. IT IS…

  17. Basic Library List.

    Science.gov (United States)

    Duren, William L., Jr.

    Reported is an initial attempt to define a minimal college mathematics library. Included is a list of some 300 books, from which approximately 170 are to be chosen to form a basic library in undergraduate mathematics. The areas provided for in this list include Algebra, Analysis, Applied Mathematics, Geometry, Topology, Logic, Foundations and Set…

  18. Lippincott Basic Reading Program.

    Science.gov (United States)

    Monterey Peninsula Unified School District, Monterey, CA.

    This program, included in "Effective Reading Programs...," serves 459 students in grades 1-3 at 15 elementary schools. The program employs a diagnostic-prescriptive approach to instruction in a nongraded setting through the use of the Lippincott Basic Reading program. When a child enters the program, he is introduced to a decoding…

  19. Basic Drafting: Book Two.

    Science.gov (United States)

    Davis, Ronald; And Others

    The second of a two-book course in drafting, this manual consists of 12 topics in the following units: sketching techniques, geometric constructions, orthographic views, dimensioning procedures, basic tolerancing, auxiliary views, sectional views, inking tools and techniques, axonometrics, oblique, perspective, and computer-aided drafting.…

  20. Basic bioreactor design.

    NARCIS (Netherlands)

    Riet, van 't K.; Tramper, J.

    1991-01-01

    Based on a graduate course in biochemical engineering, provides the basic knowledge needed for the efficient design of bioreactors and the relevant principles and data for practical process engineering, with an emphasis on enzyme reactors and aerated reactors for microorganisms. Includes exercises.

  1. Basic Nuclear Physics.

    Science.gov (United States)

    Bureau of Naval Personnel, Washington, DC.

    Basic concepts of nuclear structures, radiation, nuclear reactions, and health physics are presented in this text, prepared for naval officers. Applications to the area of nuclear power are described in connection with pressurized water reactors, experimental boiling water reactors, homogeneous reactor experiments, and experimental breeder…

  2. Canadian Adult Basic Education.

    Science.gov (United States)

    Brooke, W. Michael, Comp.

    "Trends," a publication of the Canadian Association for Adult Education, is a collection of abstracts on selected subjects affecting adult education; this issue is on adult basic education (ABE). It covers teachers and teacher training, psychological factors relating to the ABE teacher and students, manuals for teachers, instructional…

  3. Basic Microfluidics Theory

    DEFF Research Database (Denmark)

    Svendsen, Winnie Edith

    2015-01-01

    ,000 m−1, which is a huge difference and has a large impact on flow behavior. In this chapter the basic microfluidic theory will be presented, enabling the reader to gain a comprehensive understanding of how liquids behave at the microscale, enough to be able to engage in design of micro systems...

  4. Basic Tuberculosis Facts

    Centers for Disease Control (CDC) Podcasts

    2012-03-12

    In this podcast, Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, discusses basic TB prevention, testing, and treatment information.  Created: 3/12/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/12/2012.

  5. Collections Care: A Basic Reference Shelflist.

    Science.gov (United States)

    de Torres, Amparo R., Ed.

    This is an extensive bibliography of reference sources--i.e., books and articles--that relate to the care and conservation of library, archival, and museum collections. Bibliographies are presented under the following headings: (1) General Information; (2) Basic Collections Care; (3) Architectural Conservation; (4) Collections Management: Law,…

  6. Current Events in Basic Business Education

    Science.gov (United States)

    Van Hook, Barry L.

    1974-01-01

    The author suggests the use of current events to stimulate student interest in basic business courses. Suggested topics described are monetary devaluation, interest rate adjustments, Illinois no-fault automobile insurance, labor-management disputes, Dow-Jones average, Picasso's death, energy crisis, sale of surplus wheat, local consumer assistance…

  7. Total Quality Management in a Knowledge Management Perspective.

    Science.gov (United States)

    Johannsen, Carl Gustav

    2000-01-01

    Presents theoretical considerations on both similarities and differences between information management and knowledge management and presents a conceptual model of basic knowledge management processes. Discusses total quality management and quality control in the context of information management. (Author/LRW)

  8. Basic electronic circuits

    CERN Document Server

    Buckley, P M

    1980-01-01

    In the past, the teaching of electricity and electronics has more often than not been carried out from a theoretical and often highly academic standpoint. Fundamentals and basic concepts have often been presented with no indication of their practical appli­ cations, and all too frequently they have been illustrated by artificially contrived laboratory experiments bearing little relationship to the outside world. The course comes in the form of fourteen fairly open-ended constructional experiments or projects. Each experiment has associated with it a construction exercise and an explanation. The basic idea behind this dual presentation is that the student can embark on each circuit following only the briefest possible instructions and that an open-ended approach is thereby not prejudiced by an initial lengthy encounter with the theory behind the project; this being a sure way to dampen enthusiasm at the outset. As the investigation progresses, questions inevitably arise. Descriptions of the phenomena encounte...

  9. Basics of statistical physics

    CERN Document Server

    Müller-Kirsten, Harald J W

    2013-01-01

    Statistics links microscopic and macroscopic phenomena, and requires for this reason a large number of microscopic elements like atoms. The results are values of maximum probability or of averaging. This introduction to statistical physics concentrates on the basic principles, and attempts to explain these in simple terms supplemented by numerous examples. These basic principles include the difference between classical and quantum statistics, a priori probabilities as related to degeneracies, the vital aspect of indistinguishability as compared with distinguishability in classical physics, the differences between conserved and non-conserved elements, the different ways of counting arrangements in the three statistics (Maxwell-Boltzmann, Fermi-Dirac, Bose-Einstein), the difference between maximization of the number of arrangements of elements, and averaging in the Darwin-Fowler method. Significant applications to solids, radiation and electrons in metals are treated in separate chapters, as well as Bose-Eins...

  10. Basic linear algebra

    CERN Document Server

    Blyth, T S

    2002-01-01

    Basic Linear Algebra is a text for first year students leading from concrete examples to abstract theorems, via tutorial-type exercises. More exercises (of the kind a student may expect in examination papers) are grouped at the end of each section. The book covers the most important basics of any first course on linear algebra, explaining the algebra of matrices with applications to analytic geometry, systems of linear equations, difference equations and complex numbers. Linear equations are treated via Hermite normal forms which provides a successful and concrete explanation of the notion of linear independence. Another important highlight is the connection between linear mappings and matrices leading to the change of basis theorem which opens the door to the notion of similarity. This new and revised edition features additional exercises and coverage of Cramer's rule (omitted from the first edition). However, it is the new, extra chapter on computer assistance that will be of particular interest to readers:...

  11. Basic Semiconductor Physics

    CERN Document Server

    Hamaguchi, Chihiro

    2010-01-01

    This book presents a detailed description of the basic semiconductor physics. The reader is assumed to have a basic command of mathematics and some elementary knowledge of solid state physics. The text covers a wide range of important phenomena in semiconductors, from the simple to the advanced. The reader can understand three different methods of energy band calculations, empirical pseudo-potential, k.p perturbation and tight-binding methods. The effective mass approximation and electron motion in a periodic potential, Boltzmann transport equation and deformation potentials used for full band Monte Carlo simulation are discussed. Experiments and theoretical analysis of cyclotron resonance are discussed in detail because the results are essential to the understanding of semiconductor physics. Optical and transport properties, magneto-transport, two dimensional electron gas transport (HEMT and MOSFET), and quantum transport are reviewed, explaining optical transition, electron phonon interactions, electron mob...

  12. Basics of RF electronics

    CERN Document Server

    Gallo, A

    2011-01-01

    RF electronics deals with the generation, acquisition and manipulation of high-frequency signals. In particle accelerators signals of this kind are abundant, especially in the RF and beam diagnostics systems. In modern machines the complexity of the electronics assemblies dedicated to RF manipulation, beam diagnostics, and feedbacks is continuously increasing, following the demands for improvement of accelerator performance. However, these systems, and in particular their front-ends and back-ends, still rely on well-established basic hardware components and techniques, while down-converted and acquired signals are digitally processed exploiting the rapidly growing computational capability offered by the available technology. This lecture reviews the operational principles of the basic building blocks used for the treatment of high-frequency signals. Devices such as mixers, phase and amplitude detectors, modulators, filters, switches, directional couplers, oscillators, amplifiers, attenuators, and others are d...

  13. Basic plasma physics

    CERN Document Server

    Ghosh, Basudev

    2014-01-01

    Basic Plasma Physics is designed to serve as an introductory compact textbook for advanced undergraduate, postgraduate and research students taking plasma physics as one of their subject of study for the first time. It covers the current syllabus of plasma physics offered by the most universities and technical institutions. The book requires no background in plasma physics but only elementary knowledge of basic physics and mathematics. Emphasis has been given on the analytical approach. Topics are developed from first principle so that the students can learn through self-study. One chapter has been devoted to describe some practical aspects of plasma physics. Each chapter contains a good number of solved and unsolved problems and a variety of review questions, mostly taken from recent examination papers. Some classroom experiments described in the book will surely help students as well as instructors.

  14. Emulsion Science Basic Principles

    CERN Document Server

    Leal-Calderon, Fernando; Schmitt, Véronique

    2007-01-01

    Emulsions are generally made out of two immiscible fluids like oil and water, one being dispersed in the second in the presence of surface-active compounds.They are used as intermediate or end products in a huge range of areas including the food, chemical, cosmetic, pharmaceutical, paint, and coating industries. Besides the broad domain of technological interest, emulsions are raising a variety of fundamental questions at the frontier between physics and chemistry. This book aims to give an overview of the most recent advances in emulsion science. The basic principles, covering aspects of emulsions from their preparation to their destruction, are presented in close relation to both the fundamental physics and the applications of these materials. The book is intended to help scientists and engineers in formulating new materials by giving them the basics of emulsion science.

  15. Menstrual Cycle: Basic Biology

    OpenAIRE

    2008-01-01

    The basic biology of the menstrual cycle is a complex, coordinated sequence of events involving the hypothalamus, anterior pituitary, ovary, and endometrium. The menstrual cycle with all its complexities can be easily perturbed by environmental factors such as stress, extreme exercise, eating disorders, and obesity. Furthermore, genetic influences such as fragile X premutations (Chapter X), X chromosome abnormalities (Chapter X), and galactose-1-phosphate uridyltransferase (GALT) point mutati...

  16. Risk communication basics

    Energy Technology Data Exchange (ETDEWEB)

    Corrado, P.G. [Lawrence Livermore National Laboratory, CA (United States)

    1995-12-31

    In low-trust, high-concern situations, 50% of your credibility comes from perceived empathy and caring, demonstrated in the first 30 s you come in contact with someone. There is no second chance for a first impression. These and other principles contained in this paper provide you with a basic level of understanding of risk communication. The principles identified are time-tested caveats and will assist you in effectively communicating technical information.

  17. Visual Basic educational programme

    OpenAIRE

    Pranaitis, Arūnas

    2005-01-01

    Visual basic educational programme Informational Technologies has become such a popular subject that they are applied in all works of life. However, Informational Technologies are still rarely used in the lessons at school. There are such reasons of the mentioned issue: · Insufficient base of computers, · The old software and its disadvantages, · The lack of computerized educational programmes. The aim of the work was to prove that it is actual to create computerized educat...

  18. Basics of Computer Networking

    CERN Document Server

    Robertazzi, Thomas

    2012-01-01

    Springer Brief Basics of Computer Networking provides a non-mathematical introduction to the world of networks. This book covers both technology for wired and wireless networks. Coverage includes transmission media, local area networks, wide area networks, and network security. Written in a very accessible style for the interested layman by the author of a widely used textbook with many years of experience explaining concepts to the beginner.

  19. Thermodynamics - basic conception

    Energy Technology Data Exchange (ETDEWEB)

    Wee, Eul Bok

    1979-08-15

    This book tells of basic conception of thermodynamics, condition and property of matter, work and power, thermal efficiency, the principle of the conservation of energy, relationship between work and heat, enthalpy, Jouel's law, complete gasification, the second low of thermodynamics such as thermal efficiency and quality factor, carnot cycle, and entropy, condensation of gas like press of internal combustion engine, vapor, steam power plant and structure, internal combustion cycle, freeze cycle, flow of fluid, combustion and heat transfer.

  20. The basic anaesthesia machine.

    Science.gov (United States)

    Gurudatt, Cl

    2013-09-01

    After WTG Morton's first public demonstration in 1846 of use of ether as an anaesthetic agent, for many years anaesthesiologists did not require a machine to deliver anaesthesia to the patients. After the introduction of oxygen and nitrous oxide in the form of compressed gases in cylinders, there was a necessity for mounting these cylinders on a metal frame. This stimulated many people to attempt to construct the anaesthesia machine. HEG Boyle in the year 1917 modified the Gwathmey's machine and this became popular as Boyle anaesthesia machine. Though a lot of changes have been made for the original Boyle machine still the basic structure remains the same. All the subsequent changes which have been brought are mainly to improve the safety of the patients. Knowing the details of the basic machine will make the trainee to understand the additional improvements. It is also important for every practicing anaesthesiologist to have a thorough knowledge of the basic anaesthesia machine for safe conduct of anaesthesia.

  1. Uma nova opção para contenção no tratamento do linfedema em crianças A new option for compression in the treatment of lymphedema in children

    Directory of Open Access Journals (Sweden)

    Maria Elisa Simões Artíbale

    2005-09-01

    Full Text Available Um das principais dificuldades encontradas no tratamento do linfedema em crianças são os mecanismos de contenção. O objetivo do presente estudo é relatar uma experiência inicial com meias de gorgurão em criança. Descrevem-se as dificuldades encontradas no tratamento do linfedema em uma criança e mostra-se uma alternativa de contenção, que é a meia de gorgurão.One of the main difficulties found in the treatment of lymphedema in children is the mechanism of compression that should be used. The objective of present study was to report an initial experience with infant gorgurão (cotton-polyester textile stockings. The difficulties found in the treatment of infant lymphedema are described and an alternative method of compression using a gorgurão stocking is provided.

  2. Linfedema primário congênito em bovinos Red Angus Primary congenital lymphedema in Red Angus cattle

    Directory of Open Access Journals (Sweden)

    Juliana Targino S.A. Macêdo

    2009-09-01

    Full Text Available Casos de linfedema congênito foram observados acometendo 12 terneiros cruza Red Angus na região Central do Rio Grande do Sul. Os terneiros afetados apresentavam graus variáveis de edema subcutâneo ao nascimento, envolvendo principalmente os membros pélvicos, mas também outras regiões do corpo. A injeção de solução a 5% de azul de metileno no espaço interdigital dos membros pélvicos de três terneiros afetados e um controle, indicaram uma interrupção no fluxo da linfa, sugerindo uma falha dos linfáticos periféricos distais em contactar os troncos centrais. Na necropsia de três terneiros afetados, edema subcutâneo foi observado de modo variável nos membros pélvicos, prepúcio e abdômen ventral. Não foi observado edema nas cavidades orgânicas. Em dois casos, observou-se hipoplasia dos linfonodos poplíteos associadas à dilatação dos vasos linfáticos. Testes de DNA demonstraram que todos os terneiros afetados nasceram de vacas inseminadas pelo mesmo touro, sugerindo uma base genética para a doença. Levando em consideração que uma pequena porcentagem de terneiros nasceram de vacas inseminadas pelo touro suspeito, é provável que um modo autossômico recessivo esteja envolvido na hereditariedade da doença.Cases of congenital lymphedema were observed affecting 12 cross Red Angus calves from the central region of the state of Rio Grande do Sul, Brazil. Affected calves presented variable degrees of subcutaneous edema at birth, involving mainly the hind limbs but also other body regions. The injection of methylene blue dye in 5% solution into the interdigital space of the hind limbs of three affected calves and one normal control indicated an interruption of the lymph flow in the affected calves; this suggests a failure of the distal peripheral lymphatics to connect with the central trunks. At necropsy of three affected calves subcutaneous edema was variably observed in the hind limbs, prepuce and ventral abdomen. Edema

  3. Basic Principles - Chapter 6

    Data.gov (United States)

    National Aeronautics and Space Administration — This chapter described at a very high level some of the considerations that need to be made when designing algorithms for a vehicle health management application....

  4. Take control of iPhone basics

    CERN Document Server

    Anderson, Karen G

    2011-01-01

    You can take control of iPhone basics (and beyond) with former Apple writer Karen G. Anderson. Join Karen as she helps you decide which iPhone - including the Verizon iPhone 4 - to purchase, discusses common accessories, and explains how to handle basic startup tasks. You'll learn about power management, and how to connect to the Internet, set up a Bluetooth headset, transfer songs and other media from a computer, create a security passcode, and make folders to hold an expanding app collection. You'll also receive help with syncing calendar events and contacts, and buying apps. Karen takes y

  5. Catalyst in Basic Oleochemicals

    Directory of Open Access Journals (Sweden)

    Eva Suyenty

    2007-10-01

    Full Text Available Currently Indonesia is the world largest palm oil producer with production volume reaching 16 million tones per annum. The high crude oil and ethylene prices in the last 3 – 4 years contribute to the healthy demand growth for basic oleochemicals: fatty acids and fatty alcohols. Oleochemicals are starting to replace crude oil derived products in various applications. As widely practiced in petrochemical industry, catalyst plays a very important role in the production of basic oleochemicals. Catalytic reactions are abound in the production of oleochemicals: Nickel based catalysts are used in the hydrogenation of unsaturated fatty acids; sodium methylate catalyst in the transesterification of triglycerides; sulfonic based polystyrene resin catalyst in esterification of fatty acids; and copper chromite/copper zinc catalyst in the high pressure hydrogenation of methyl esters or fatty acids to produce fatty alcohols. To maintain long catalyst life, it is crucial to ensure the absence of catalyst poisons and inhibitors in the feed. The preparation methods of nickel and copper chromite catalysts are as follows: precipitation, filtration, drying, and calcinations. Sodium methylate is derived from direct reaction of sodium metal and methanol under inert gas. The sulfonic based polystyrene resin is derived from sulfonation of polystyrene crosslinked with di-vinyl-benzene. © 2007 BCREC UNDIP. All rights reserved.[Presented at Symposium and Congress of MKICS 2007, 18-19 April 2007, Semarang, Indonesia][How to Cite: E. Suyenty, H. Sentosa, M. Agustine, S. Anwar, A. Lie, E. Sutanto. (2007. Catalyst in Basic Oleochemicals. Bulletin of Chemical Reaction Engineering and Catalysis, 2 (2-3: 22-31.  doi:10.9767/bcrec.2.2-3.6.22-31][How to Link/DOI: http://dx.doi.org/10.9767/bcrec.2.2-3.6.22-31 || or local: http://ejournal.undip.ac.id/index.php/bcrec/article/view/6

  6. Basic heat transfer

    CERN Document Server

    Bacon, D H

    2013-01-01

    Basic Heat Transfer aims to help readers use a computer to solve heat transfer problems and to promote greater understanding by changing data values and observing the effects, which are necessary in design and optimization calculations.The book is concerned with applications including insulation and heating in buildings and pipes, temperature distributions in solids for steady state and transient conditions, the determination of surface heat transfer coefficients for convection in various situations, radiation heat transfer in grey body problems, the use of finned surfaces, and simple heat exc

  7. Electrical installation calculations basic

    CERN Document Server

    Kitcher, Christopher

    2013-01-01

    All the essential calculations required for basic electrical installation workThe Electrical Installation Calculations series has proved an invaluable reference for over forty years, for both apprentices and professional electrical installation engineers alike. The book provides a step-by-step guide to the successful application of electrical installation calculations required in day-to-day electrical engineering practice. A step-by-step guide to everyday calculations used on the job An essential aid to the City & Guilds certificates at Levels 2 and 3Fo

  8. Back to basics audio

    CERN Document Server

    Nathan, Julian

    1998-01-01

    Back to Basics Audio is a thorough, yet approachable handbook on audio electronics theory and equipment. The first part of the book discusses electrical and audio principles. Those principles form a basis for understanding the operation of equipment and systems, covered in the second section. Finally, the author addresses planning and installation of a home audio system.Julian Nathan joined the audio service and manufacturing industry in 1954 and moved into motion picture engineering and production in 1960. He installed and operated recording theaters in Sydney, Austra

  9. Basic genetics for dermatologists

    Directory of Open Access Journals (Sweden)

    Muthu Sendhil Kumaran

    2013-01-01

    Full Text Available During the past few decades, advances in the field of molecular genetics have enriched us in understanding the pathogenesis of diseases, their identification, and appropriate therapeutic interventions. In the last 20 years, genetic basis of more than 350 monogenic skin diseases have been elucidated and is counting. The widespread use of molecular genetics as a tool in diagnosis is not practiced routinely due to genetic heterogenicity, limited access and low sensitivity. In this review, we have presented the very basics of genetics so as to enable dermatologists to have working understanding of medical genetics.

  10. Machine shop basics

    CERN Document Server

    Miller, Rex

    2004-01-01

    Use the right tool the right wayHere, fully updated to include new machines and electronic/digital controls, is the ultimate guide to basic machine shop equipment and how to use it. Whether you're a professional machinist, an apprentice, a trade student, or a handy homeowner, this fully illustrated volume helps you define tools and use them properly and safely. It's packed with review questions for students, and loaded with answers you need on the job.Mark Richard Miller is a Professor and Chairman of the Industrial Technology Department at Texas A&M University in Kingsville, T

  11. C# Database Basics

    CERN Document Server

    Schmalz, Michael

    2012-01-01

    Working with data and databases in C# certainly can be daunting if you're coming from VB6, VBA, or Access. With this hands-on guide, you'll shorten the learning curve considerably as you master accessing, adding, updating, and deleting data with C#-basic skills you need if you intend to program with this language. No previous knowledge of C# is necessary. By following the examples in this book, you'll learn how to tackle several database tasks in C#, such as working with SQL Server, building data entry forms, and using data in a web service. The book's code samples will help you get started

  12. Menstrual Cycle: Basic Biology

    Science.gov (United States)

    Hawkins, Shannon M.; Matzuk, Martin M.

    2010-01-01

    The basic biology of the menstrual cycle is a complex, coordinated sequence of events involving the hypothalamus, anterior pituitary, ovary, and endometrium. The menstrual cycle with all its complexities can be easily perturbed by environmental factors such as stress, extreme exercise, eating disorders, and obesity. Furthermore, genetic influences such as fragile X premutations (Chapter X), X chromosome abnormalities (Chapter X), and galactose-1-phosphate uridyltransferase (GALT) point mutations (galactosemia) also contribute to perturbations of the menstrual cycle. Although not perfect, mouse model have helped to identify and confirm additional components and pathways in menstrual cycle function and dysfunction in humans. PMID:18574203

  13. Basic structural dynamics

    CERN Document Server

    Anderson, James C

    2012-01-01

    A concise introduction to structural dynamics and earthquake engineering Basic Structural Dynamics serves as a fundamental introduction to the topic of structural dynamics. Covering single and multiple-degree-of-freedom systems while providing an introduction to earthquake engineering, the book keeps the coverage succinct and on topic at a level that is appropriate for undergraduate and graduate students. Through dozens of worked examples based on actual structures, it also introduces readers to MATLAB, a powerful software for solving both simple and complex structural d

  14. Treatment of Lymphedema

    Science.gov (United States)

    ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Contacts Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training ...

  15. Basic and clinical immunology

    Science.gov (United States)

    Chinen, Javier; Shearer, William T.

    2003-01-01

    Progress in immunology continues to grow exponentially every year. New applications of this knowledge are being developed for a broad range of clinical conditions. Conversely, the study of primary and secondary immunodeficiencies is helping to elucidate the intricate mechanisms of the immune system. We have selected a few of the most significant contributions to the fields of basic and clinical immunology published between October 2001 and October 2002. Our choice of topics in basic immunology included the description of T-bet as a determinant factor for T(H)1 differentiation, the role of the activation-induced cytosine deaminase gene in B-cell development, the characterization of CD4(+)CD25(+) regulatory T cells, and the use of dynamic imaging to study MHC class II transport and T-cell and dendritic cell membrane interactions. Articles related to clinical immunology that were selected for review include the description of immunodeficiency caused by caspase 8 deficiency; a case series report on X-linked agammaglobulinemia; the mechanism of action, efficacy, and complications of intravenous immunoglobulin; mechanisms of autoimmunity diseases; and advances in HIV pathogenesis and vaccine development. We also reviewed two articles that explore the possible alterations of the immune system caused by spaceflights, a new field with increasing importance as human space expeditions become a reality in the 21st century.

  16. Basic research projects

    Energy Technology Data Exchange (ETDEWEB)

    1979-04-01

    The research programs under the cognizance of the Office of Energy Research (OER) are directed toward discovery of natural laws and new knowledge, and to improved understanding of the physical and biological sciences as related to the development, use, and control of energy. The ultimate goal is to develop a scientific underlay for the overall DOE effort and the fundamental principles of natural phenomena so that these phenomena may be understood, and new principles, formulated. The DOE-OER outlay activities include three major programs: High Energy Physics, Nuclear Physics, and Basic Energy Sciences. Taken together, these programs represent some 30 percent of the Nation's Federal support of basic research in the energy sciences. The research activities of OER involve more than 6,000 scientists and engineers working in some 17 major Federal Research Centers and at more than 135 different universities and industrial firms throughout the United States. Contract holders in the areas of high-energy physics, nuclear physics, materials sciences, nuclear science, chemical sciences, engineering, mathematics geosciences, advanced energy projects, and biological energy research are listed. Funding trends for recent years are outlined. (RWR)

  17. Basic principles of stability.

    Science.gov (United States)

    Egan, William; Schofield, Timothy

    2009-11-01

    An understanding of the principles of degradation, as well as the statistical tools for measuring product stability, is essential to management of product quality. Key to this is management of vaccine potency. Vaccine shelf life is best managed through determination of a minimum potency release requirement, which helps assure adequate potency throughout expiry. Use of statistical tools such a least squares regression analysis should be employed to model potency decay. The use of such tools provides incentive to properly design vaccine stability studies, while holding stability measurements to specification presents a disincentive for collecting valuable data. The laws of kinetics such as Arrhenius behavior help practitioners design effective accelerated stability programs, which can be utilized to manage stability after a process change. Design of stability studies should be carefully considered, with an eye to minimizing the variability of the stability parameter. In the case of measuring the degradation rate, testing at the beginning and the end of the study improves the precision of this estimate. Additional design considerations such as bracketing and matrixing improve the efficiency of stability evaluation of vaccines.

  18. 32 CFR Appendix A to Part 272 - Principles for the Conduct and Support of Basic Research

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Principles for the Conduct and Support of Basic... DEPARTMENT OF DEFENSE Pt. 272, App. A Appendix A to Part 272—Principles for the Conduct and Support of Basic Research 1. Basic research is an investment. The DoD Components are to view and manage basic...

  19. Fatores de risco para linfedema após câncer de mama: uma revisão da literatura Risk factors of arm lymphedema after breast cancer: a literature review

    Directory of Open Access Journals (Sweden)

    Anke Bergmann

    2008-01-01

    Full Text Available O linfedema representa uma das principais seqüelas do câncer de mama. Esta revisão da literatura visou discutir os principais fatores associados ao linfedema após o tratamento do câncer de mama. Foram selecionados 26 artigos publicados entre janeiro de 2000 e março de 2008 nas bases Medline e Lilacs, utilizando os descritores breast neoplasms, lymphedema, upper extremity, arm e risk factors. Sua revisão permitiu discutir os fatores relacionados ao linfedema, quanto a: clínica e paciente (tabagismo, escolaridade, etnia, comorbidades, hipertensão arterial, diabetes melito, menopausa, idade, peso corporal, índice de massa corporal, atividade física, membro dominante, restrição articular, infecção, seroma e trauma no membro superior; tratamento do câncer de mama (cirurgia, reconstrução mamária, número de linfonodos retirados, nível da linfadenectomia axilar, radioterapia, quimioterapia, hormonioterapia e tempo transcorrido após o tratamento; tumor (tamanho, grau, localização, comprometimento dos linfonodos axilares e estadiamento. A revisão feita indica que a linfadenectomia axilar, a radioterapia em cadeias de drenagem e a obesidade são fatores preponderantes do risco para desenvolvimento do linfedema.Arm lymphedema is one of the most frequent sequelae of breast cancer treatment. The purpose of this literature review was to discuss main risk factors of lymphedema after breast cancer treatment. The search in Medline and Lilacs databases, by means of key words breast neoplasms, lymphedema, upper extremity, arm, and risk factors, allowed selecting 26 studies published between January, 2000, and March, 2008. This review discusses factors linked to: clinic and the patient (smoking, education level, race/ethnicity, comorbidity, hypertension, diabetes, menopause, age, weight, body mass index, physical activity, handedness, impaired range of motion, infection, seroma and arm injuries; breast cancer treatment (type of surgery

  20. Basic real analysis

    CERN Document Server

    Sohrab, Houshang H

    2014-01-01

    This expanded second edition presents the fundamentals and touchstone results of real analysis in full rigor, but in a style that requires little prior familiarity with proofs or mathematical language. The text is a comprehensive and largely self-contained introduction to the theory of real-valued functions of a real variable. The chapters on Lebesgue measure and integral have been rewritten entirely and greatly improved. They now contain Lebesgue’s differentiation theorem as well as his versions of the Fundamental Theorem(s) of Calculus. With expanded chapters, additional problems, and an expansive solutions manual, Basic Real Analysis, Second Edition, is ideal for senior undergraduates and first-year graduate students, both as a classroom text and a self-study guide. Reviews of first edition: The book is a clear and well-structured introduction to real analysis aimed at senior undergraduate and beginning graduate students. The prerequisites are few, but a certain mathematical sophistication is required. ....

  1. Basics of plasma astrophysics

    CERN Document Server

    Chiuderi, Claudio

    2015-01-01

    This book is an introduction to contemporary plasma physics that discusses the most relevant recent advances in the field and covers a careful choice of applications to various branches of astrophysics and space science. The purpose of the book is to allow the student to master the basic concepts of plasma physics and to bring him or her up to date in a number of relevant areas of current research. Topics covered include orbit theory, kinetic theory, fluid models, magnetohydrodynamics, MHD turbulence, instabilities, discontinuities, and magnetic reconnection. Some prior knowledge of classical physics is required, in particular fluid mechanics, statistical physics, and electrodynamics. The mathematical developments are self-contained and explicitly detailed in the text. A number of exercises are provided at the end of each chapter, together with suggestions and solutions.

  2. Anisotropic hydrodynamics -- basic concepts

    CERN Document Server

    Florkowski, Wojciech; Ryblewski, Radoslaw; Strickland, Michael

    2013-01-01

    Due to the rapid longitudinal expansion of the quark-gluon plasma created in relativistic heavy ion collisions, potentially large local rest frame momentum-space anisotropies are generated. The magnitude of these momentum-space anisotropies can be so large as to violate the central assumption of canonical viscous hydrodynamical treatments which linearize around an isotropic background. In order to better describe the early-time dynamics of the quark gluon plasma, one can consider instead expanding around a locally anisotropic background which results in a dynamical framework called anisotropic hydrodynamics. In this proceedings contribution we review the basic concepts of the anisotropic hydrodynamics framework presenting viewpoints from both the phenomenological and microscopic points of view.

  3. Cloud computing basics

    CERN Document Server

    Srinivasan, S

    2014-01-01

    Cloud Computing Basics covers the main aspects of this fast moving technology so that both practitioners and students will be able to understand cloud computing. The author highlights the key aspects of this technology that a potential user might want to investigate before deciding to adopt this service. This book explains how cloud services can be used to augment existing services such as storage, backup and recovery. Addressing the details on how cloud security works and what the users must be prepared for when they move their data to the cloud. Also this book discusses how businesses could prepare for compliance with the laws as well as industry standards such as the Payment Card Industry.

  4. Atomic Basic Blocks

    Science.gov (United States)

    Scheler, Fabian; Mitzlaff, Martin; Schröder-Preikschat, Wolfgang

    Die Entscheidung, einen zeit- bzw. ereignisgesteuerten Ansatz für ein Echtzeitsystem zu verwenden, ist schwierig und sehr weitreichend. Weitreichend vor allem deshalb, weil diese beiden Ansätze mit äußerst unterschiedlichen Kontrollflussabstraktionen verknüpft sind, die eine spätere Migration zum anderen Paradigma sehr schwer oder gar unmöglich machen. Wir schlagen daher die Verwendung einer Zwischendarstellung vor, die unabhängig von der jeweils verwendeten Kontrollflussabstraktion ist. Für diesen Zweck verwenden wir auf Basisblöcken basierende Atomic Basic Blocks (ABB) und bauen darauf ein Werkzeug, den Real-Time Systems Compiler (RTSC) auf, der die Migration zwischen zeit- und ereignisgesteuerten Systemen unterstützt.

  5. Teacher Effectiveness as Correlate of Students' Cognitive Achievement at Upper Basic Education in Basic Technology

    Science.gov (United States)

    Owoh, Titus M.

    2016-01-01

    This study sought to find out the relationship between students perception of their teacher effectiveness and academic achievement in Basic Technology. Teacher's personality, teaching techniques/classroom management strategy and appearance, all integrate to make for teacher effectiveness. To carry out this research, two research questions and one…

  6. Basic Research in Microplasmas

    Science.gov (United States)

    2012-03-29

    Lopez Dr. WeiDong Zhu Saint Peter’s College - Applied Science and Technology 2641 Kennedy Boulevard, Gannon Hall Jersey City, NJ 07306 AFOSR / RSE 875...North Randolph Street, Suit 325 | Room 3112 Arlington, Virginia 22203-1768 AFOSR / RSE 1) DISTRIBUTION STATEMENT A: Approved for public release...John W. Luginsland, RSE (Program Manager) 703.588.1775 AFRL-OSR-VA-TR-2012-0932 FINAL REPORT Air Force Office of Scientific Research Grant

  7. 高职经管类微积分基本概念蕴含的思想方法%On the Thinking Methods Embodied in the Basic Con-cepts of Calculus for Higher Vocational Economic Man-agement Majors

    Institute of Scientific and Technical Information of China (English)

    贺金兰

    2015-01-01

    本文阐述高职经管类微积分中函数、极限、导数、定积分四个基本概念蕴含的思想方法。%This paper elaborates the thinking methods embodied in the four basic concepts of calculus for higher vocational eco-nomic management majors, including function, limit, derivative and definite integral.

  8. Upper extremity lymphatic function at rest and during exercise in breast cancer survivors with and without lymphedema compared with healthy controls.

    Science.gov (United States)

    Lane, Kirstin N; Dolan, Lianne B; Worsley, Dan; McKenzie, Don C

    2007-09-01

    Lymphoscintigraphy was used to measure lymphatic function at rest and during exercise in breast cancer survivors with lymphedema (BCRL, n = 10), breast cancer survivors (BC, n = 10), and controls (Cont, n = 10). After injection of (99m)Tc-antimony colloid to the hands, subjects rested or performed 12 repeated sets of arm cranking for 2.5 min at 0.6 W/kg followed by 2.5 min of rest. One-minute spot views were taken with a gamma-radiation camera immediately postinjection and every 10 min over 60 min to calculate clearance rate. As well, an upper body scan was taken at 65 min postinjection to measure radiopharmaceutical uptake in the axilla (Ax) and forearm (Fore). All groups displayed similar increases in clearance rate with exercise (P = 0.000). Ax significantly increased with exercise in Cont only [Cont: (mean +/- SD) 4.9 +/- 2.6 vs. 7.9 +/- 4.2%, P = 0.000; BCRL: 1.4 +/- 1.2 vs. 1.7 +/- 2.1%, P = 0.531; BC: 3.9 +/- 3.4 vs. 5.2 +/- 3.2%, P = 0.130], whereas Fore, indicating dermal backflow, significantly increased in BCRL only (BCRL: 2.4 +/- 0.87 vs. 4.4 +/- 2.0%, P = 0.004; BC: 1.1 +/- 0.25 vs. 1.1 +/- 0.31%, P = 0.784; Cont: 0.93 +/- 0.26 vs. 1.0 +/- 0.20%, P = 0.296). The results indicate that, in women with BCRL, exercise causes radiopharmaceuticals to clear from the hand at the same rate as BC and Cont, but, instead of reaching the axilla, a greater amount of activity gets trapped in the dermis of the forearm. BC, meanwhile, have similar lymphatic function as Cont; however, there is a highly variable response that may suggest that some BC subjects may be at risk for developing lymphedema.

  9. Basics of aerothermodynamics

    CERN Document Server

    Hirschel, Ernst Heinrich

    2015-01-01

    This successful book gives an introduction to the basics of aerothermodynamics, as applied in particular to winged re-entry vehicles and airbreathing hypersonic cruise and acceleration vehicles. The book gives a review of the issues of transport of momentum, energy and mass, real-gas effects as well as inviscid and viscous flow phenomena. In this second, revised edition the chapters with the classical topics of aerothermodynamics more or less were left untouched. The access to some single topics of practical interest was improved. Auxiliary chapters were put into an appendix. The recent successful flights of the X-43A and the X-51A indicate that the dawn of sustained airbreathing hypersonic flight now has arrived. This proves that the original approach of the book to put emphasis on viscous effects and the aerothermodynamics of radiation-cooled vehicle surfaces was timely. This second, revised edition even more accentuates these topics. A new, additional chapter treats examples of viscous thermal surface eff...

  10. [Basic research in pulmonology].

    Science.gov (United States)

    Gea, Joaquim

    2008-11-01

    This is a review of the articles dealing with basic science published in recent issues of Archivos de Bronconeumología. Of particular interest with regard to chronic obstructive pulmonary disease were an article on extrapulmonary inflammation and oxidative stress and another on bronchial remodeling. The articles relating to asthma included a review on the use of drugs that block free immunoglobulin-E and an article about the contribution of experimental models to our knowledge of this disease. Two of the most interesting articles on the topic of lung cancer dealt with gene therapy and resistance to chemotherapy. Also notable were 2 studies that investigated ischemia-reperfusion injury. One evaluated tissue resistance to injury while the other analyzed the role played by interleukin-8 in this process. On the topic of pulmonary fibrosis, an article focused on potential biomarkers of progression and prognosis; others dealt with the contribution of experimental models to our understanding of this disorder and the fibrogenic role of transforming growth factor b. In the context of both sleep apnea syndrome and pulmonary infection, studies investigating the role of oxidative stress were published. Finally, 2 studies analyzed the diagnosis and treatment of tuberculosis and other pulmonary infections.

  11. Gastric cancer: basic aspects.

    Science.gov (United States)

    Resende, Carlos; Thiel, Alexandra; Machado, José C; Ristimäki, Ari

    2011-09-01

    Gastric cancer (GC) is a world health burden, ranging as the second cause of cancer death worldwide. Etiologically, GC arises not only from the combined effects of environmental factors and susceptible genetic variants but also from the accumulation of genetic and epigenetic alterations. In the last years, molecular oncobiology studies brought to light a number of genes that are implicated in gastric carcinogenesis. This review is intended to focus on the recently described basic aspects that play key roles in the process of gastric carcinogenesis. Genetic variants of the genes IL-10, IL-17, MUC1, MUC6, DNMT3B, SMAD4, and SERPINE1 have been reported to modify the risk of developing GC. Several genes have been newly associated with gastric carcinogenesis, both through oncogenic activation (GSK3β, CD133, DSC2, P-Cadherin, CDH17, CD168, CD44, metalloproteinases MMP7 and MMP11, and a subset of miRNAs) and through tumor suppressor gene inactivation mechanisms (TFF1, PDX1, BCL2L10, XRCC, psiTPTE-HERV, HAI-2, GRIK2, and RUNX3). It also addressed the role of the inflammatory mediator cyclooxygenase-2 (COX-2) in the process of gastric carcinogenesis and its importance as a potential molecular target for therapy.

  12. Nanodesign: some basic questions

    CERN Document Server

    Schommers, Wolfram

    2013-01-01

    There is no doubt that nanoscience will be the dominant direction for technology in this century, and that this science will influence our lives to a large extent as well as open completely new perspectives on all scientific and technological disciplines. To be able to produce optimal nanosystems with tailor-made properties, it is necessary to analyze and construct such systems in advance by adequate theoretical and computational methods. Since we work in nanoscience and nanotechnology at the ultimate level, we have to apply the basic laws of physics. What methods and tools are relevant here? The book gives an answer to this question. The background of the theoretical methods and tools is critically discussed, and also the world view on which these physical laws are based. Such a debate is not only of academic interest but is of highly general concern, and this is because we constantly move in nanoscience and nanotechnology between two extreme poles, between infinite life and total destruction . On the one ...

  13. Basic operator theory

    CERN Document Server

    Gohberg, Israel

    2001-01-01

    rii application of linear operators on a Hilbert space. We begin with a chapter on the geometry of Hilbert space and then proceed to the spectral theory of compact self adjoint operators; operational calculus is next presented as a nat­ ural outgrowth of the spectral theory. The second part of the text concentrates on Banach spaces and linear operators acting on these spaces. It includes, for example, the three 'basic principles of linear analysis and the Riesz­ Fredholm theory of compact operators. Both parts contain plenty of applications. All chapters deal exclusively with linear problems, except for the last chapter which is an introduction to the theory of nonlinear operators. In addition to the standard topics in functional anal­ ysis, we have presented relatively recent results which appear, for example, in Chapter VII. In general, in writ­ ing this book, the authors were strongly influenced by re­ cent developments in operator theory which affected the choice of topics, proofs and exercises. One ...

  14. Basic Social Processes

    Directory of Open Access Journals (Sweden)

    Barney G. Glaser, PhD, Hon. PhD

    2005-06-01

    Full Text Available The goal of grounded theory is to generate a theory that accounts for a pattern of behavior that is relevant and problematic for those involved. The goal is not voluminous description, nor clever verification. As with all grounded theory, the generation of a basic social process (BSP theory occurs around a core category. While a core category is always present in a grounded research study, a BSP may not be.BSPs are ideally suited to generation by grounded theory from qualitative research because qualitative research can pick up process through fieldwork that continues over a period of time. BSPs are a delight to discover and formulate since they give so much movement and scope to the analyst’s perception of the data. BSPs such as cultivating, defaulting, centering, highlighting or becoming, give the feeling of process, change and movement over time. They also have clear, amazing general implications; so much so, that it is hard to contain them within the confines of a single substantive study. The tendency is to refer to them as a formal theory without the necessary comparative development of formal theory. They are labeled by a “gerund”(“ing” which both stimulates their generation and the tendency to over-generalize them.

  15. Basic science of osteoarthritis.

    Science.gov (United States)

    Cucchiarini, Magali; de Girolamo, Laura; Filardo, Giuseppe; Oliveira, J Miguel; Orth, Patrick; Pape, Dietrich; Reboul, Pascal

    2016-12-01

    Osteoarthritis (OA) is a prevalent, disabling disorder of the joints that affects a large population worldwide and for which there is no definitive cure. This review provides critical insights into the basic knowledge on OA that may lead to innovative end efficient new therapeutic regimens. While degradation of the articular cartilage is the hallmark of OA, with altered interactions between chondrocytes and compounds of the extracellular matrix, the subchondral bone has been also described as a key component of the disease, involving specific pathomechanisms controlling its initiation and progression. The identification of such events (and thus of possible targets for therapy) has been made possible by the availability of a number of animal models that aim at reproducing the human pathology, in particular large models of high tibial osteotomy (HTO). From a therapeutic point of view, mesenchymal stem cells (MSCs) represent a promising option for the treatment of OA and may be used concomitantly with functional substitutes integrating scaffolds and drugs/growth factors in tissue engineering setups. Altogether, these advances in the fundamental and experimental knowledge on OA may allow for the generation of improved, adapted therapeutic regimens to treat human OA.

  16. Basic Data on Biogas

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    Renewable gases such as biogas and biomethane are considered as key energy carrier when the society is replacing fossil fuels with renewable alternatives. In Sweden, almost 80 % of the fossil fuels are used in the transport sector. Therefore, the focus in Sweden has been to use the produced biogas in this sector as vehicle gas. Basic Data on Biogas contains an overview of production, utilisation, climate effects etc. of biogas from a Swedish perspective. The purpose is to give an easy overview of the current situation in Sweden for politicians, decision makers and interested public. 1.4 TWh of biogas is produced annually in Sweden at approximately 230 facilities. The 135 wastewater treatment plants that produce biogas contribute with around half of the production. In order to reduce the sludge volume, biogas has been produced at wastewater treatment plants for decades. New biogas plants are mainly co-digestion plants and farm plants. The land filling of organic waste has been banned since 2005, thus the biogas produced in landfills is decreasing.

  17. Psychodermatology: Basics Concepts.

    Science.gov (United States)

    Jafferany, Mohammad; Franca, Katlein

    2016-08-23

    Psychodermatology is a relatively new field of medicine. It encompasses the interaction of mind and skin. The role of psychoneuroimmunology in the causation of psychocutaneous disorders and psychosocial aspects of skin disease have gained momentum lately. The treatment of psychodermatological disorders focus on improving function, reducing physical distress, diagnosing and treating depression and anxiety associated with skin disease, managing social isolation and improving self esteem of the patient. Both pharmacological and psychological interventions are used in treating psychocutaneous disorders. The interest in Psychodermatology around the world is increasing and there are several organizations holding their regular meetings.

  18. Development of a pressure-measuring device to optimize compression treatment of lymphedema and evaluation of change in garment pressure with simulated wear and tear.

    Science.gov (United States)

    Brorson, Håkan; Hansson, Emma; Jense, Erik; Freccero, Carolin

    2012-06-01

    The use of compression garments in treating lymphedema following treatment of genital (penis, testes, uterus, cervical) and breast cancer treatment is a well-established practice. Although compression garments are classified in compression classes, little is known about the actual subgarment pressure exerted along the extremity. The aims of this study were to establish an in vitro method for measuring subgarment pressure along the extremity and to analyze initial and over time subgarment pressure of compression garments from three manufacturers. The measurements were performed with I-scan(®) (Tekscan Inc.) pressure measuring equipment once a week during a period of 4 weeks. Wear and tear was simulated by washing and putting on the garments on plastic legs every day. There was a statistically significant difference between the garments of some of manufacturers. There was no difference between garments from the same manufacturer. No significant decrease of subgarment pressure was observed during the trial period. The study demonstrated that Tekscan pressure-measuring equipment could measure subgarment pressure in vitro. The results may indicate that there was a difference in subgarment pressure exerted by garments from different manufacturers and that there was no clear decrease in subgarment pressure during the first four weeks of usage.

  19. Race or Resource? BMI, Race, and Other Social Factors as Risk Factors for Interlimb Differences among Overweight Breast Cancer Survivors with Lymphedema

    Directory of Open Access Journals (Sweden)

    Lorraine T. Dean

    2016-01-01

    Full Text Available Introduction. High BMI is a risk factor for upper body breast cancer-related lymphedema (BCRL onset. Black cancer survivors are more likely to have high BMI than White cancer survivors. While observational analyses suggest up to 2.2 times increased risk of BCRL onset for Black breast cancer survivors, no studies have explored race or other social factors that may affect BCRL severity, operationalized by interlimb volume difference (ILD. Materials and Methods. ILD was measured by perometry for 296 overweight (25 > BMI 6 months from treatment in the WISER Survivor trial. Multivariable linear regression examined associations between social and physical factors and ILD. Results. Neither Black race (−0.26, p=0.89 nor BMI (0.22, p=0.10 was associated with ILD. Attending college (−4.89, p=0.03 was the strongest factor associated with ILD, followed by having more lymph nodes removed (4.75, p=0.01, >25% BCRL care adherence (4.10, p=0.01, and years since treatment (0.55, p<0.001. Discussion. Neither race nor BMI was associated with ILD among overweight cancer survivors. Education, a proxy for resource level, was the strongest factor associated with greater ILD. Tailoring physical activity and weight loss interventions designed to address BCRL severity by resource rather than race should be considered.

  20. Lymphatic microsurgical preventing healing approach (LYMPHA) for primary surgical prevention of breast cancer-related lymphedema: over 4 years follow-up.

    Science.gov (United States)

    Boccardo, Francesco; Casabona, Federico; De Cian, Franco; DeCian, Franco; Friedman, Daniele; Murelli, Federica; Puglisi, Maria; Campisi, Corrado C; Molinari, Lidia; Spinaci, Stefano; Dessalvi, Sara; Campisi, Corradino

    2014-09-01

    Breast cancer-related lymphedema (LE) represents an important morbidity that jeopardizes breast cancer patients' quality of life. Different attempts to prevent LE brought about improvements in the incidence of the pathology but LE still represents a frequent occurrence in breast cancer survivors. Over 4 years ago, Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) was proposed and long-term results are reported in this study. From July 2008 to December 2012, 74 patients underwent axillary nodal dissection for breast cancer treatment together with LYMPHA procedure. Volumetry was performed preoperatively in all patients and after 1, 3, 6, 12 months, and once a year. Lymphoscintigraphy was performed in 45 patients preoperatively and in 30 also postoperatively after at least over 1 year. Seventy one patients had no sign of LE, and volumetry was coincident to preoperative condition. In three patients, LE occurred after 8-12 months postoperatively. Lymphoscintigraphy showed the patency of lymphatic-venous anastomoses at 1-4 years after operation. LYMPHA technique represents a successful surgical procedure for primary prevention of arm LE in breast cancer patients.

  1. Basic mathematics for biochemists

    CERN Document Server

    Cornish-Bowden, Athel

    1981-01-01

    Some teachers of biochemistry think it positively beneficial for students to struggle with difficult mathematics. I do not number myself among these people, although I have derived much personal pleasure from the study of mathematics and from applying it to problems that interest me in biochemistry. On the contrary, I think that students choose courses in biochemistry out of interest in biochemistry and that they should not be encumbered with more mathematics than is absolutely required for a proper understanding of biochemistry. This of course includes physical chemistry, because a biochemist ignorant of physical chemistry is no biochemist. I have been guided by these beliefs in writing this book. I have laid heavy emphasis on those topics, such as the use of logarithms, that play an important role in biochemistry and often cause problems in teaching; I have ignored others, such as trigonometry, that one can manage without. The proper treatment of statistics has been more difficult to decide. Although it cle...

  2. Visual Basic 2012 programmer's reference

    CERN Document Server

    Stephens, Rod

    2012-01-01

    The comprehensive guide to Visual Basic 2012 Microsoft Visual Basic (VB) is the most popular programming language in the world, with millions of lines of code used in businesses and applications of all types and sizes. In this edition of the bestselling Wrox guide, Visual Basic expert Rod Stephens offers novice and experienced developers a comprehensive tutorial and reference to Visual Basic 2012. This latest edition introduces major changes to the Visual Studio development platform, including support for developing mobile applications that can take advantage of the Windows 8 operating system

  3. Anal Health Care Basics.

    Science.gov (United States)

    Chang, Jason; Mclemore, Elisabeth; Tejirian, Talar

    2016-01-01

    Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy.The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate.Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area.Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases.In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists.

  4. Jaundice: a basic review

    Directory of Open Access Journals (Sweden)

    Muhammad Waseem Abbas

    2016-05-01

    Full Text Available Jaundice is a complex disease. Jaundice is actually the high bilirubin level in the body. Yellowing of skin, mucous membranes and skin are common presentations of jaundice. Jaundice has various variants including pre-hepatic jaundice (due to hemolysis of red blood cells, hepatic jaundice (due to defect in capture, conjugation and excretion of bilirubin by liver and post hepatic jaundice (due to the obstruction of extra hepatobiliary system. The causes of various variants of Jaundice is either acquired or congenital. High plasma bilirubin level can cause various manifestations involving satiety, gastrointestinal bleeding, diarrhea, anemia, edema, weight-loss and can be fatal because it can cause psychosis, lethargy, seizures, coma or even death. High bilirubin level can help in the diagnosis of Jaundice. Differential diagnosis of various variants of Jaundice can be carried out on the basis of bilirubin level (conjugated and unconjugated, ultrasonography and other radiological techniques. The proper management of Jaundice is high water intake and low fat diet. The primary effective treatment for pre-hepatic jaundice and neonatal physiological jaundice is phototherapy. Infusion of immunoglobulins is also used for treatment of pre-hepatic jaundice. Proper nutrition, steroids and immunosuppressant are used for treatment of hepatic jaundice. The treatment for post hepatic jaundice is decompression and surgery. [Int J Res Med Sci 2016; 4(5.000: 1313-1319

  5. Anal Health Care Basics

    Science.gov (United States)

    Chang, Jason; McLemore, Elisabeth; Tejirian, Talar

    2016-01-01

    Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy. The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate. Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area. Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases. In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists. PMID:27723447

  6. 《企业质量诚信管理实施规范》国家标准系列解析(上)--有关标准的基本定位%Series Interpretation of National Standard Implement Specifications for Enterprise Quality Credit Management -- Basic Position of Relevant Standards(part A)

    Institute of Scientific and Technical Information of China (English)

    周莉

    2014-01-01

    Quality credit system construction is an important component of social credit system. Implementing enterprise quality credit management is the core content of advancing quality credit system construction. By analyzing the basic conception of quality credit and quality credit, discussing the interrelation of quality credit system and social credit system, quality credit management and quality credit system, quality credit management and quality management system, and identifying the basic position of national standards Implement Specifications for Enterprise Quality Credit Management to offer the directional guide for effectively implementing enterprise quality credit management.%质量诚信体系建设是社会信用体系建设的重要组成部分。开展企业质量诚信管理是推进质量诚信体系建设的核心内容。通过分析质量诚信与质量信用的基本概念,探讨质量诚信体系与社会信用体系,质量诚信管理与质量诚信体系,质量诚信管理与质量管理体系的相互关系,明确《企业质量诚信管理实施规范》国家标准的基本定位,为有效开展企业质量诚信管理提供方向指导。

  7. Safety research basic plan of JNC

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    Japan Nuclear Cycle Development Institute (JNC) formally succeeded to Power Reactor and Nuclear Fuel Development Corporation (PNC) on October, 1 1998. This report describes the basic plan for major program of JNC which consists of two parts: management philosophy of the new institute and the latest revised medium term program. In the first part, the primary mission of JNC is to perform its R and D concentrating on fast breeder reactor and its fuel cycle, and treatment and disposal of high-level radioactive wastes, while at the same time giving special consideration to safety. In the second, individual programs in the new basic plan are discussed in detail. The outline and schedule of each program are also attached in the table form. (H. Itami)

  8. A randomized cross-over trial to detect differences in arm volume after low- and heavy-load resistance exercise among patients receiving adjuvant chemotherapy for breast cancer at risk for arm lymphedema

    DEFF Research Database (Denmark)

    Bloomquist, Kira; Hayes, Sandi; Adamsen, Lis

    2016-01-01

    changes after resistance exercise with heavy loads in this population. The purpose of this study is to determine acute changes in arm volume after a session of low- and heavy-load resistance exercise among women undergoing adjuvant chemotherapy for breast cancer at risk for arm lymphedema. METHODS/DESIGN......: This is a randomized cross-over trial. PARTICIPANTS: Women receiving adjuvant chemotherapy for breast cancer who have undergone axillary lymph node dissection will be recruited from rehabilitation centers in the Copenhagen area. INTERVENTION: Participants will be randomly assigned to engage in a low- (two sets of 15...

  9. Fatores de risco para linfedema após câncer de mama: uma revisão da literatura Risk factors of arm lymphedema after breast cancer: a literature review

    OpenAIRE

    Anke Bergmann; Inês Echenique Mattos; Rosalina Jorge Koifman

    2008-01-01

    O linfedema representa uma das principais seqüelas do câncer de mama. Esta revisão da literatura visou discutir os principais fatores associados ao linfedema após o tratamento do câncer de mama. Foram selecionados 26 artigos publicados entre janeiro de 2000 e março de 2008 nas bases Medline e Lilacs, utilizando os descritores breast neoplasms, lymphedema, upper extremity, arm e risk factors. Sua revisão permitiu discutir os fatores relacionados ao linfedema, quanto a: clínica e paciente (taba...

  10. Avaliação de técnicas fisioterapêuticas no tratamento do linfedema pós-cirurgia de mama em mulheres Evaluation of physiotherapeutic techniques for treating lymphedema following breast cancer surgery in women

    Directory of Open Access Journals (Sweden)

    MCCC Meirelles

    2006-12-01

    Full Text Available OBJETIVO GERAL: Verificar, em um grupo de mulheres submetidas à cirurgia por câncer de mama, a efetividade do tratamento do linfedema, por um período de até dois anos. OBJETIVO ESPECÍFICO: Avaliar o volume do braço tratado aos 6, 12, 18 e 24 meses após o tratamento do linfedema. MÉTODO: As participantes foram atendidas em um serviço de reabilitação especializado e submetidas ao tratamento do linfedema, com drenagem linfática manual, enfaixamento compressivo funcional, orientações de autocuidado, automassagem, uso da braçadeira elástica e exercício. Pelas medidas do volume dos membros, nos períodos determinados, 36 mulheres foram avaliadas após a fase intensiva, 22 após 6 meses, 15 após 12 meses, 6 após 18 meses e 11 aos 24 meses. A adesão às estratégias de autocuidado e exercícios foi avaliada através de um questionário. Testes estatísticos foram usados para buscar correlação entre redução do linfedema e alguns fatores como idade, escolaridade, grau do linfedema, tipo de cirurgia, entre outros. RESULTADOS: Houve redução do linfedema e essa se manteve ao longo dos períodos estudados. Não houve correlação entre redução do linfedema e fatores como idade, estado civil, escolaridade, tipo de cirurgia, índice de massa corporal, grau do linfedema, radioterapia, circunferência, hipertensão arterial ou limitação articular e não houve adesão às estratégias de autocuidado com o braço, realização de exercícios, automassagem e uso de braçadeira elástica pela maioria das mulheres. CONCLUSÕES: É importante realizar novas pesquisas que analisem o papel de cada uma dessas orientações na evolução do linfedema após a fase intensiva do tratamento, de forma sistemática e controlada.GENERAL OBJECTIVE: To verify the effectiveness of lymphedema treatment over a two-year period, in a group of women who underwent breast cancer surgery. Specific objective: To evaluate the volume of the treated arm at 6, 12

  11. Basic Learning Processes in Childhood.

    Science.gov (United States)

    Reese, Hayne W.

    This book is an introduction to the psychological study of basic learning processes in children. Written for students who are not majors in psychology and who do not have much familiarity with the technical vocabulary of psychology, it has two themes: even the most basic kinds of learning are included by cognitive processes or mental activities;…

  12. Basics for Handling Food Safely

    Science.gov (United States)

    ... 888-MPHotline (1-888-674-6854) Basics for Safe Food Handling dishes in bowls of ice or use ... 9 months Do not freeze 2 Basics for Safe Food Handling Product Refrigerator Freezer (40 °F) (0 °F) ...

  13. Japanese Basic Course: Exercise Book.

    Science.gov (United States)

    Defense Language Inst., Washington, DC.

    This exercise book, prepared for use after Lesson 121 of the Defense Language Institute Basic Course in Japanese, provides for instruction in the use of Kanji dictionaries, familiarizes students with useful phrases and expressions that are not included in the Basic Course, and allows for greater variety in the classroom. The ten lessons, in the…

  14. Public Marketing as a Strategic Component of Public Management. A Pilot Study in Cluj County on the Existence of Basic Marketing Contidions in the Local Pulbic Administration in Romania

    Directory of Open Access Journals (Sweden)

    Tudor ŢICLĂU

    2010-10-01

    Full Text Available Public Marketing has grown to be an everincreasing part of the general concept of marketing, especially after the late 1970s when a series of fundamental changes occurred concerning the structure and functioning of the welfare state. Since then, public marketing has been constantly expanding as a field of study and has becoming ever more important especially with the new managerial paradigms that emphasize the role and needs of the citizens-clients in developing public policy. The present paper aims to put together a general picture regarding the concept, its development and characteristics, challenges posed by the specific conditions of the public sector and some basic conditions necessary for adopting public marketing as a managerial component of any public organization. In the second part of the paper, we present the results of a qualitative pilot study that aims to identify whether the local public authorities from Cluj County, Romania have the basic conditions for implementing a strategic public marketing component. The results show that the institutions analyzed are far from offering a framework needed to encourage and eventually adopt public marketing as a regular and necessary activity of any modern public organization.

  15. Basic principles of concrete structures

    CERN Document Server

    Gu, Xianglin; Zhou, Yong

    2016-01-01

    Based on the latest version of designing codes both for buildings and bridges (GB50010-2010 and JTG D62-2004), this book starts from steel and concrete materials, whose properties are very important to the mechanical behavior of concrete structural members. Step by step, analysis of reinforced and prestressed concrete members under basic loading types (tension, compression, flexure, shearing and torsion) and environmental actions are introduced. The characteristic of the book that distinguishes it from other textbooks on concrete structures is that more emphasis has been laid on the basic theories of reinforced concrete and the application of the basic theories in design of new structures and analysis of existing structures. Examples and problems in each chapter are carefully designed to cover every important knowledge point. As a basic course for undergraduates majoring in civil engineering, this course is different from either the previously learnt mechanics courses or the design courses to be learnt. Compa...

  16. Basic properties of Fedosov supermanifolds

    CERN Document Server

    Geyer, B

    2004-01-01

    Basic properties of even (odd) supermanifolds endowed with a connection respecting a given symplectic structure are studied. Such supermanifolds can be considered as generalization of Fedosov manifolds to the supersymmetric case.

  17. Value-Based Inventory Management

    OpenAIRE

    Michalski, Grzegorz

    2008-01-01

    The basic financial purpose of a firm is to maximize its value. An inventory management system should also contribute to realization of this basic aim. Many current asset management models currently found in financial management literature were constructed with the assumption of book profit maximization as basic aim. However these models could lack what relates to another aim, i.e., maximization of enterprise value. This article presents a modified value-based inventory management model.

  18. Complementary Basic Education in Tanzania

    OpenAIRE

    大津, 和子

    2001-01-01

    This paper discusses current development in the Complementary Basic Education program (COBET), which aims to contribute to the provision of alternative learning opportunities for out-of-school children, particularly girls in a non-formal setting. The Ministry of Education and Culture started the program as part of the Basic Education Master Plan (BEMP) in 1999. Unlike traditional primary schools, the COBET centers have no school fees, no uniforms, no corporal punishment and no child labou...

  19. Clinical result of intra-arterial lymphocyte injection therapy for treatment of lymphedema and the evaluation of the efficacy of the therapy. Quantitative analysis by an injection of {sup 111}In-labeled lymphocytes and by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yoshizumi, Masanori; Kitagawa, Tetsuya; Hori, Takaki; Katoh, Itsuo; Harada, Masashi; Matsumoto, Takahiro; Nishitani, Hiromu [Tokushima Univ. (Japan). School of Medicine

    1995-11-01

    We have employed the intra-arterial lymphocytes injection therapy for treatment of lymphedema of the limbs with various causes. In the present study, we observed the clinical outcome of our therapy in 38 patients with lymphedema of the limbs. Results showed that the therapy was effective in 26 of 38 patients (68% of the total). Moreover, a marked efficacy was obtained in 13 of 38 patients (34% of the total). In the latest 5 patients, to evaluate the efficacy of our therapy, we examined the distribution of the {sup 111}In-oxine labeled lymphocytes injected into the proximal artery of the affected limb. The radioactivities of the affected limbs were apparently higher than that of the healthy limbs in effective cases. Moreover, MR imaging showed that the reduction of STIR ratio and T{sub 2} ratio well correlate with the results of clinical course. Thus, the efficacy of the lymphocyte injection therapy is able to be evaluated by radiolabeled lymphocytes and MR imaging. (author).

  20. Monitoring the post-operative lymphedema in prefabricated flap after resurfacing for facial scar%预构皮瓣修复头面部瘢痕术后淋巴水肿的监测

    Institute of Scientific and Technical Information of China (English)

    李科; 冯少清; 李华; 闵沛如; 喜雯婧; 刘宁飞; 章一新

    2015-01-01

    Objective Currently, the prefabricated flap is used for reconstructing the post-burn scar in head and face.The aim is to analyze the nature of the post-op edema in the prefabricated flaps, to determine whether it is lymphedema, and to study the prognosis of the edema.Methods From January, 2011 to March, 2015, 18 cases of post-operation edema in superficial temporal fascia prefabricated flaps were studied and each case was followed for 5 months.We used ultrasound and indocyanine green (ICG) fluorescent imaging to study the nature of the edema.Apart from that, we monitored the recovery process of the post-operation edema by a) measuring the horizontal diameter of the flap by a tape, b) measuring the thickness of the flap by the ultrasound, c) monitoring the condition of edema by ICG and d) monitoring the reconstruction and recanalization of the lymphatic system by ICG.Results Pitting edema always occurred in the prefabricated flap from the first day after operation.These patients were diagnosed as mild lymphedema (7 cases), moderate lymphedema (10 cases), and severe lymphedema (1cases) by ultrasound and ICG florescent imaging.The degree of flap lymphedema improved gradually and it improved significantly from 3 days to 6 days post-op eration.The condition of flap lymphedema became stable from the 12 days post-operation.The fluorescence image of ICG showed that the stage of flap lymphedema improved from 3 weeks post-operation and the transportation capability of lymphatic vessels increased most from the 3 days to 6 days post-op eration.We also found lymphatic vessels reconnected from the 6 days post-operation and lymphatic system reconstructed following the direction to lymph nodes.We could discover the collecting lymphatic vessels from 2 months post-operation and the lymphatic system in prefabricated flap matured from 5 months post-operation.Conclusion The post-operation edema in the prefabricated flaps is lymphedema, the incidence rate of which is high.The lymphatic

  1. Construction management

    CERN Document Server

    Pellicer, Eugenio; Teixeira, José C; Moura, Helder P; Catalá, Joaquín

    2014-01-01

    The management of construction projects is a wide ranging and challenging discipline in an increasingly international industry, facing continual challenges and demands for improvements in safety, in quality and cost control, and in the avoidance of contractual disputes. Construction Management grew out of a Leonardo da Vinci project to develop a series of Common Learning Outcomes for European Managers in Construction. Financed by the European Union, the project aimed to develop a library of basic materials for developing construction management skills for use in a pan-European context. Focused exclusively on the management of the construction phase of a building project from the contractor's point of view, Construction Management covers the complete range of topics of which mastery is required by the construction management professional for the effective delivery of new construction projects. With the continued internationalisation of the construction industry, Construction Management will be required rea...

  2. 肌内效贴治疗乳腺癌根治术患者放疗后上肢肿胀的疗效观察%Kinesio taping can relieve upper extremity lymphedema after breast cancer surgery

    Institute of Scientific and Technical Information of China (English)

    严鹏; 宫晨; 黄燕; 胡广原

    2016-01-01

    目的 观察肌内效贴治疗乳腺癌根治术患者放疗后上肢肿胀的疗效.方法 选取乳腺癌根治术接受放疗后出现上肢淋巴水肿的患者68例,按照随机数字表法将其分为实验组和对照组,每组34例.2组均采用常规手法康复治疗,实验组在此基础上行肌内效贴贴扎,对照组接受相同形状和颜色的无弹性肌内效贴贴扎,共治疗3周.治疗前、治疗3周后(治疗后),采用上肢周径测量法、上肢功能评定量表(DASH)、世界卫生组织生活质量量表-100(WHOQOL-100)对2组患者的淋巴水肿程度、上肢肢体功能及生活质量进行评价.结果 2组患者淋巴水肿的程度及DASH评分均较治疗前有所改善(P<0.05),且观察组优于对照组(P<0.05).结论 在常规手法康复基础上辅以肌内效贴治疗,能进一步减轻乳腺癌术后淋巴水肿,改善上肢功能.%Objective To observe the effect of kinesio taping on upper extremity lymphedema among postoperative breast cancer patients.Methods Sixty-eight post-operative breast cancer patients with lymphedema were randomly divided into an experimental group and a control group,each of 34.Both groups received traditional physical therapy,while the experiment group additionally received kinesio taping.Before and 3 weeks after the treatment,the degree of lymphedema,upper extremity function and life quality in both groups were evaluated using the Disability of Arm,Shoulder and Hand (DASH) evaluation together with the World Health Organization's Quality of Life-100 scale.Results Lymphedema decreased in both groups and the average DASH score improved,but the experimental group showed significantly greater improvement.Conclusion Kinesio taping can supplement traditional rehabilitation in relieving lymphedema,improving upper extremity function and improving the quality of life after breast cancer surgery.

  3. Basic Training: A 1-Day Education Module for New Clientele in the Turf Industry

    Science.gov (United States)

    Patton, Aaron J.; Reicher, Zachary J.

    2011-01-01

    It is important that Extension education programs be directed at clientele new to the turfgrass industry. A 1-day Basic Training: Turf Management seminar was created in 2006 to provide education to those new to the turfgrass industry. The seminar covered the basics of turfgrass management including growth, physiology, fertilization, cultural…

  4. Pressure ulcers: Back to the basics

    Directory of Open Access Journals (Sweden)

    Karoon Agrawal

    2012-01-01

    Full Text Available Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of "prevention is better than cure" suits this condition the most.

  5. 41 CFR 102-76.10 - What basic design and construction policy governs Federal agencies?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What basic design and... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL... must be timely, efficient, and cost effective. (b) Use a distinguished architectural style and form...

  6. 41 CFR 102-77.10 - What basic Art-in-Architecture policy governs Federal agencies?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What basic Art-in... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL..., and artistic work in other media, must reflect the national cultural heritage and emphasize the...

  7. E-Basics: Online Basic Training in Program Evaluation

    Science.gov (United States)

    Silliman, Ben

    2016-01-01

    E-Basics is an online training in program evaluation concepts and skills designed for youth development professionals, especially those working in nonformal science education. Ten hours of online training in seven modules is designed to prepare participants for mentoring and applied practice, mastery, and/or team leadership in program evaluation.…

  8. Basic Operational Robotics Instructional System

    Science.gov (United States)

    Todd, Brian Keith; Fischer, James; Falgout, Jane; Schweers, John

    2013-01-01

    The Basic Operational Robotics Instructional System (BORIS) is a six-degree-of-freedom rotational robotic manipulator system simulation used for training of fundamental robotics concepts, with in-line shoulder, offset elbow, and offset wrist. BORIS is used to provide generic robotics training to aerospace professionals including flight crews, flight controllers, and robotics instructors. It uses forward kinematic and inverse kinematic algorithms to simulate joint and end-effector motion, combined with a multibody dynamics model, moving-object contact model, and X-Windows based graphical user interfaces, coordinated in the Trick Simulation modeling environment. The motivation for development of BORIS was the need for a generic system for basic robotics training. Before BORIS, introductory robotics training was done with either the SRMS (Shuttle Remote Manipulator System) or SSRMS (Space Station Remote Manipulator System) simulations. The unique construction of each of these systems required some specialized training that distracted students from the ideas and goals of the basic robotics instruction.

  9. Electronic imaging fundamentals: basic theory.

    Science.gov (United States)

    Vizy, K N

    1983-01-01

    Introduction of the computer into the field of medical imaging, as typified by the extensive use of digital subtraction angiography (DSA), created an important need for a basic understanding of the principles of digital imaging. This paper reviews these fundamental principles, starting with the definition of images and the interaction of these images with television display systems, then continuing with a detailed description of the way in which imaging systems are specified. This work defines the basic terms and concepts that will be used throughout the contents of this issue.

  10. Stereochemistry basic concepts and applications

    CERN Document Server

    Nógrádi, M

    2013-01-01

    Stereochemistry: Basic Concepts and Applications is a three-chapter text that introduces the basic principles and concepts of stereochemistry, as well as its application to organic chemistry application.Chapter 1 describes first the stereochemistry of the ground state, specifically the configuration and conformation of organic compounds, as well as the most important methods for its investigation. This chapter also deals with the kinetics of conformational changes and provides an overview of the so-called ""applied stereochemistry"". Chapter 2 focuses on the analysis of the internal motions of

  11. Basic linear partial differential equations

    CERN Document Server

    Treves, Francois

    2006-01-01

    Focusing on the archetypes of linear partial differential equations, this text for upper-level undergraduates and graduate students features most of the basic classical results. The methods, however, are decidedly nontraditional: in practically every instance, they tend toward a high level of abstraction. This approach recalls classical material to contemporary analysts in a language they can understand, as well as exploiting the field's wealth of examples as an introduction to modern theories.The four-part treatment covers the basic examples of linear partial differential equations and their

  12. The chemisorptive bond basic concepts

    CERN Document Server

    Clark, Alfred

    1974-01-01

    The Chemisorptive Bond: Basic Concepts describes the basic concepts of the chemisorptive bond on solid surfaces from the simple analogies with ordinary chemical bonds to the quantum-mechanical approaches.This book is composed of 10 chapters and begins with discussions of simple formulas for correlating measurable quantities in chemisorptions and catalysis. The succeeding chapters deal with theories based on quantum-mechanical principles that describe the mutual interactions of atoms of the solid and foreign atoms on the surface. The remaining chapters consider the possible arrangements

  13. 基于战略管理导向的平衡计分卡理论基础研究%Balanced Scorecard Theory Basic Research Based on Strategic Management Orientation

    Institute of Scientific and Technical Information of China (English)

    许敏; 李东旭

    2012-01-01

    本文从探讨平衡计分卡作为一种战略管理系统的根基问题出发,从与战略管理领域密切相关的企业理论出发,论证了发展中的企业利益相关者理论是平衡计分卡的理论基础,平衡计分卡正是因为全面考虑了企业的主要利益相关者的利益,有效地确保了企业战略的实施,从而取得较高的绩效.%The balanced scorecard is the foundation of a strategic management system. Starting from the enterprise theory which is close related to strategic management field, this paper discussed that developing enterprise stakeholder theory is the theoretical basis of the balanced scorecard. Considering the main enterprise stakeholder's benefit, the balanced scorecard effectively ensures the implementation of the strategy of the enterprise, so as to achieve a higher performance.

  14. 完善法人单位基础信息数据库索引平台服务社会管理创新--组织机构代码工作的实践与思考%Complete Basic Information Database Indexing Platform of Legal Unit to Serve Social Management Innovation--Practice and Consideration of Organization Code

    Institute of Scientific and Technical Information of China (English)

    孟魁荣

    2013-01-01

    本文总结了全国组织机构代码中心继续承担法人基础信息库建设工程的优势,分析了社会管理创新对组织机构代码工作提出的要求,把现在以组织机构代码为主体标识的代码数据库定位于全国法人单位基础信息库的索引平台。提出了坚持“解放思想、改革创新、凝聚人心、科学发展”的工作方针,在全系统倡导大局、大气、大度之风;在服务社会管理创新中把握好代码工作的总布局;进一步完善信用法律法规体系;兼容并蓄主动改进代码工作;着力抓好法人单位基础数据库的建设;积极推进法人业务数据库的建设;促进法人单位信息资源库的推广应用等的7条建议。%This paper concludes the advantages of NACAO’s continuous undertaking of the construction of legal basic information database, analyzes the social management innovation’s requirements for organization code work, takes code database with the main body of organization code as the national legal unit basic information indexing platform, as well as puts forward the working guideline of insisting emancipating mind, reform and innovation, solidarity, and scientific development;It also proposes 7 suggestions including insisting the working style of overall thought to hold the whole situation in serving social management innovation, to be inclusive and creative to further code work;pay effort on construction of legal unit basic database construction, further promoting the legal person basic information database, and promoting the application of the database.

  15. Predicting Grades in Basic Algebra.

    Science.gov (United States)

    Newman, Elise

    1994-01-01

    Data from (n=470) students at Owens Technical College in Fall 1991 showed that high school GPA was the best predictor of grades in Basic Algebra, followed by high school rank, college GPA, ACT natural sciences, ASSET numerical skills, and ASSET elementary algebra scores. (11 references) (SW)

  16. Basic DTU Wind Energy controller

    DEFF Research Database (Denmark)

    Hansen, Morten Hartvig; Henriksen, Lars Christian

    This report contains a description and documentation, including source code, of the basic DTU Wind Energy controller applicable for pitch-regulated, variable speed wind turbines. The controller features both partial and full load operation capabilities as well as switching mechanisms ensuring...

  17. Unions: Bread, Butter & Basic Skills.

    Science.gov (United States)

    BCEL Newsletter for the Business Community, 1987

    1987-01-01

    Unions are natural providers of basic skills instruction. They are in daily workplace contact with their membership, are trusted to work on members' behalf, and speak the language of the worker. Unions are trying to address the needs of illiterate workers through collective bargaining arrangements in which employers contribute a percentage of…

  18. Basic HIV/AIDS Statistics

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... Statistics Center . How many people are diagnosed with HIV each year in the United States? In 2015, ...

  19. Guarani Basic Course, Part II.

    Science.gov (United States)

    Blair, Robert W.; And Others

    This volume of the basic course in Guarani (the indigenous language of Paraguay) contains the core stage, or class-instructional phase, of the ten units presented in Volume One. These units contain explanations, exercises, dialogues, various types of pattern drills, suggestions for games and communication activities, and various types of…

  20. Guarani Basic Course, Part I.

    Science.gov (United States)

    Blair, Robert W.; And Others

    This is the first in a two-volume basic course in Guarani, the indigenous language of Paraguay. The volume consists of an introduction to the Guarani language, some general principles for adult language-learning, and ten instructional units. Because the goal of the course is to encourage and lead the learner to communicate in Guarani in class and…