WorldWideScience

Sample records for bilateral agreements

  1. CETA - BILATERAL TRADE AGREEMENT BETWEEN THE EU AND CANADA

    Directory of Open Access Journals (Sweden)

    Ludmila Borta

    2014-04-01

    Full Text Available The international trade for wide world countries in the means more growth, more jobs and access on more products at competitive prices. The European Union is a major economy and an important trading partner for many countries and regions in the world. To stimulate growth and to create jobs in the Union, this economy has concluded multilateral trade agreement (under the World Trade Organisation and a number of bilateral (preferential trade agreements. The aim of this paper is to present an example of fully elimination of tariffs and tariff lines under a bilateral trade agreement. In this case, we have analysed Comprehensive Economic and Trade Agreement (CETA negotiated by the European Union and Canada. For both sides of Atlantic, the CETA is supposed to bring the solution for today's issues concerning the important trading aspects and, also, to facilitate the EU-Canada bilateral trade by creating competition.

  2. CETA - BILATERAL TRADE AGREEMENT BETWEEN THE EU AND CANADA

    OpenAIRE

    Ludmila Borta

    2014-01-01

    The international trade for wide world countries in the means more growth, more jobs and access on more products at competitive prices. The European Union is a major economy and an important trading partner for many countries and regions in the world. To stimulate growth and to create jobs in the Union, this economy has concluded multilateral trade agreement (under the World Trade Organisation) and a number of bilateral (preferential) trade agreements. The aim of this paper is to present an e...

  3. Bilateral trade agreements and the feasibility of multilateral free trade

    OpenAIRE

    Saggi, Kamal; Yildiz, Halis Murat

    2008-01-01

    This paper compares stable Nash equilibria of two games of trade liberalization. In the FTA game, each country can form an FTA with either one of its trade partners, or both of them, or none of them. By contrast, in the No FTA game, each country must choose either no agreement or free trade. Under symmetry, free trade is uniquely stable under the No FTA game whereas the FTA game also admits a bilateral FTA as an equilibrium. However, there exist patterns of cost asymmetry for which the freedo...

  4. A Comparative Analysis of Trade Facilitation in Selected Regional and Bilateral Trade Agreement

    OpenAIRE

    Institute for International Trade

    2006-01-01

    This study compared the treatment of trade facilitation in four selected regional trade agreements, AFTA, APEC, SAFRA and PACER, and in one bilateral free trade agreement being the Australia-Singapore Free Trade Agreement (ASFTA), with a view to determining model trade facilitation principles and measures which may be instructive for developing country negotiations and policy makers.

  5. A Comparative Analysis of Trade Facilitation in Selected Regional and Bilateral Trade Agreement

    OpenAIRE

    Wille, P.; J. Redden

    2006-01-01

    This study compares the treatment of trade facilitation in four selected regional trade agreements, AFTA, APEC, SAFTA and PACER, and in one bilateral free trade agreement being the Australia-Singapore Free Trade Agreement (ASFTA), with a view to determining model trade facilitation principles and measures which may be instructive for developing country negotiators and policy makers.

  6. Implications of bilateral free trade agreements on access to medicines.

    Science.gov (United States)

    Correa, Carlos María

    2006-05-01

    The TRIPS Agreement of the World Trade Organization (WTO) mandated the introduction of protection of intellectual property rights, notably patents, for pharmaceutical products. While the implications for the access to medicines contained in the terms of this Agreement raised significant concerns, a recent new wave of free trade agreements, negotiated outside the WTO, requires even higher levels of intellectual property protection for medicines than those mandated by that Agreement. The measures involved include the extension of the patent term beyond 20 years; prohibition of use of test data on drug efficacy and safety for certain periods for the approval of generic products; the linkage between drug registration and patent protection; in some cases, limitations to the grounds for granting compulsory licences. This article reviews some of these measures that further limit the competition of generic products and discusses their possible implication for access to medicines. PMID:16710551

  7. The text of a safeguards transfer agreement relating to a bilateral agreement between Argentina and the United States of America

    International Nuclear Information System (INIS)

    The document reproduces the text of a safeguards transfer agreement of 28 August 1996 relating to a bilateral agreement between Argentina and the United States of America to suspend the application of safeguards pursuant to the agreement of 25 July 1969 between the Agency, Argentina and the United States of America in light of the provisions for the application of safeguards pursuant to the quadripartite safeguards agreement between Argentina, Brazil, the Brazilian-Argentine Agency for the Accounting and Control of Nuclear Materials and the IAEA. The Protocol entered into force on 13 January 1997

  8. Bilateral Agreements and Fair Trade Practices: A Policy Analysis of the Colombia-U.S. Free Trade Agreement (2006

    Directory of Open Access Journals (Sweden)

    Kevin J. Fandl

    2014-12-01

    Full Text Available This article brings to the attention of those public servants involved in the design and negotiation of free trade agreements between the United States and developing countries, such as Colombia, the potential benefits and drawbacks of negotiating in a bilateral forum. Rather than critiquing the free trade agreement for its particular provisions, this article examines the U.S. policy of negotiating bilaterally with developing countries as opposed to multilaterally in the world trade system and what effects such an approach might have on the economic development of the latter. Using an incremental policy analysis, the article critiques the bilateral approach in terms of economic development and fair trade negotiations using the recent Colombia-U.S. trade agreement as a case study. The article concludes that a bilateral approach that is disconnected from a broader multilateral context may be detrimental to developing countries and recommends increased oversight of such agreements by the World Trade Organization to ensure a higher degree of fairness.

  9. Core Labour Standards in Trade Agreements : From Multilateralism to Bilateralism.

    OpenAIRE

    Granger, Clotilde; Siroën, Jean-Marc

    2006-01-01

    Although discussion concerning the inclusion of core labour standards has been excluded from the Doha agenda, the question continues to be debated. In fact, on an international level, the International Labour Organization (ILO) has become increasingly active since the World Trade Organization (WTO) Singapore Ministerial Declaration. On a regional level, social clauses are now being introduced inside preferential-trade agreements. These evolutions feed the debate regarding the link between lab...

  10. The Text of the Safeguards Transfer Agreement relating to the Bilateral Agreement between Canada and Japan

    International Nuclear Information System (INIS)

    The text of the Safeguards Transfer Agreement between the Agency, Canada and Japan relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members

  11. Acceleration toward the conclusion negotiation of bilateral nuclear cooperation agreements indispensable for globalization

    International Nuclear Information System (INIS)

    According to Japan's basic policies of new growth strategy, it would be one option of the economic growth to increase exports of nuclear power plant system or its equipments. However, bilateral nuclear cooperation agreements are indispensable for business activities on nuclear power. Recently signature of agreement with Jordan, agreed conclusion negotiation with Vietnam and Korea, under negotiation with India and expected negotiation with Indonesia and Malaysia. Signed agreements with Russia and Kazakhstan will be coming into effect and contribute nuclear fuel supply at export of nuclear power system. This special article consists of four expert's papers titled as (1) necessity of conclusion negotiation of nuclear cooperation agreements with several countries simultaneously and in parallel, (2) Japan's nuclear cooperation in new era, (3) desirable acceleration of conclusion negotiation of nuclear cooperation agreements and (4) insurance of nuclear fuel supply fundamental for global business activities of Japan's nuclear industries-best choice to establish cooperative relations with US and Russia. (T. Tanaka)

  12. Bilateral and multilateral agreements and other arrangements in Europe and North America on the protection and use of transboundary waters

    International Nuclear Information System (INIS)

    The present document presents in a chronological order existing bilateral and multilateral legally binding agreements and other arrangements in Europe and North America on the protection and use of transboundary waters, which had been concluded by may 1992. These include agreements, treaties, conventions, protocols, orders and exchanges of notes. For each agreement the following information is given: title of the agreement, field of application, river basin, area of application, contracting parties, date of agreement and place of signature, joint body, and reference

  13. The bilateral trade agreements and export performance of South Asian nations with special reference to India Sri Lanka Free Trade Agreement

    OpenAIRE

    Suhail P; Sreejesh S

    2011-01-01

    The regional trade agreements (RTA) have been one of the important developments in the world trading system in 1990s. There are number of studies on the effects trade agreements in different contexts. This study is an attempt to analyse the effects of bilateral trade agreements in the intraregional trade in the SAARC region with special reference to the Free Trade Agreements (FTA) between India Sri Lanka. The study uses a panel regression analysis by using balance panel data. The study conclu...

  14. Relationships between Investor-State Arbitration and Local Remedy Procedures in Bilateral Investment Treaties/Economic Partnership Agreements (Japanese)

    OpenAIRE

    Abe, Yoshinori

    2007-01-01

    In this paper I closely scrutinize the legal relationships between investment arbitration and local remedy procedures in the global "network" of bilateral investment treaties (BITs) and free trade agreements (FTAs)/economic partnership agreements (EPAs), examining the desirable ways in which the two relationships should be regulated. When investors refer disputes to investment arbitration (procedures for international arbitration between investors and states) they are not required to exhaust ...

  15. The Text of a Safeguards Transfer Agreement relating to a Bilateral Agreement between Argentina and the United States of America

    International Nuclear Information System (INIS)

    The text of the Safeguards Transfer Agreement between the Agency, Argentina and the United States of America relating to the agreement of 25 June 1969 between the two Governments for co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members. The Safeguards Transfer Agreement entered into force on 25 July 1969.

  16. Potential Impact of TPP Trade Agreement on US Bilateral Agricultural Trade: Trade Creation or Trade Diversion?

    OpenAIRE

    Yeboah, Osei Agyeman; Shaik, Saleem; Agyekum, Afia Fosua

    2015-01-01

    Trans-Pacific Partnership (TPP) trade agreement is a trade agreement U.S is negotiating with 11 other countries in the Asia-Pacific region (Australia, Brunei Darussalam, Canada, Chile, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore, and Vietnam) to reduce or eliminate tariffs on U.S. products exported to the TPP countries. With TPP, U.S expects to expand its trade with members of the partnership; resulting in GDP growth. However, there exist large concerns about the potential negative ...

  17. INFX GUIDE: DEPARTMENT OF ENERGY BILATERAL AGREEMENTS FOR COOPERATION IN THE FIELD OF RADIOACTIVE WASTE MANAGEMENT (INFX: INTERNATIONAL INFORMATION EXCHANGE)

    Energy Technology Data Exchange (ETDEWEB)

    Harman, K. M.; Lakey, L. T.; Leigh, I. W.; Jeffs, A. G.

    1985-07-01

    As the U. S. Department of Energy (DOE) and DOE contractors have increased the magnitude and scope of their cooperative activities with other nations in the nuclear fuel cycle and waste management field, a need has developed for ready sources of information concerning foreign waste management programs, DOE technology exchange policies, bilateral fuel cycle and waste management agreements and plans and activities to implement those agreements. The INFX (International InLormation E~change) Guide is one of a series of documents that have been prepared to provide that information. The INFX Guide has been compiled under the charter of PNL's International Support Office (IPSO) to maintain for DOE a center to collect, organize, evaluate and disseminate information on foreign and international radioactive waste management programs. Because the information in this document is constantly subject to change, the document is assembled in loose-leaf form to accommodate frequent updates.

  18. Cooperation and Exchange with Different Countries and Regions within Bilateral Agreements/MOUs

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    In accordance with the cooperation agreements/MOUs signed with international science funding agen- cies and academic institutions, NSFC continues to make efforts to fund international joint research projects and to normalize and better the management of funding, review, and assessment of the results achieved by the joint research projects funded.

  19. Harmonization between a Framework of Multilateral Approaches to Nuclear Fuel Cycle Facilities and Bilateral Nuclear Cooperation Agreements

    Directory of Open Access Journals (Sweden)

    Makiko Tazaki

    2013-09-01

    Full Text Available One of primary challenges for ensuring effective and efficient functions of the multilateral nuclear approaches (MNA to nuclear fuel cycle facilities is harmonization between a MNA framework and existing nuclear cooperation agreements (NCA. A method to achieve such harmonization is to construct a MNA framework with robust non-proliferation characteristics, in order to obtain supplier states’, especially the US’s prior consents for non-supplier states’ certain activities including spent fuel reprocessing, plutonium storages and retransfers of plutonium originated in NCAs. Such robust characteristics can be accomplished by MNA member states’ compliances with International Atomic Energy Agency (IAEA Safeguards, regional safeguards agreements, international conventions, guidelines and recommendations on nuclear non-proliferation, nuclear security, safety, and export control. Those provisions are to be incorporated into an MNA founding agreement, as requirements to be MNA members in relation to NCAs. Furthermore, if an MNA facility is, (1 owned and operated jointly by all MNA member states, (2 able to conclude bilateral NCAs with non-MNA/supplier states as a single legal entity representing its all member states like an international organization, and (3 able to obtain necessary prior consents, stable, smooth, and timely supplies of nuclear fuel and services can be assured among MNA member states. In this paper, the authors will set out a general MNA framework and then apply it to a specific example of Europe Atomic Energy Community (EURATOM and then consider its applicability to the Asian region, where an establishment of an MNA framework is expected to be explored.

  20. The Text of the Safeguards Transfer Agreement relating to the Bilateral Agreement between Spain and the United States of America. Protocol of Suspension

    International Nuclear Information System (INIS)

    The text of the Protocol suspending the application of safeguards pursuant to the Safeguards Transfer Agreement of 9 December 1966, as amended, between the Agency, Spain and the United States of America is reproduced in this document for the information of all Members

  1. Claims Handling Co-operation between Nuclear Insurance Pools in a Case of Transboundary Damage - Multilateral and Bilateral Agreements in Progress

    International Nuclear Information System (INIS)

    The paper is a short progress report on matters concerning the core reason for insurance of nuclear third party liability - registration, handling, organizing and settling of claims in case of a major nuclear incident, underlining claims handling co-operation between national nuclear insurance pools when damage to health or property becomes international. The contents of this paper is in close relation to information provided on this subject during the 6th International Conference in 2006. Commercial insurance companies have gained extensive experience with handling large scale claims (e.g. after floods and other natural disasters) and are capable in gathering and organizing a high number of professional loss surveyors and adjusters in a very short period of time. In case of nuclear insurance pools co-operation between members (commercial insurance companies) is an added value and can be used practically all over the country bringing into action the network of branches and offices of all the pool members. This advantage is also used in case of cross border claims when it is necessary to gather information and claims advises from a large number of subjects and from many countries, sometimes very far apart. The international network of nuclear insurance pools is an ideal tool for this task and can be mobilized practically at once. Operators of nuclear installations, especially nuclear power plants, do not have the possibility to put aside hundreds of workers to handle claims and are also usually not sufficiently equipped with the necessary know-how. The same goes for governments and government agencies which in many countries guarantee the payments of claims to victims. National nuclear insurance pools are on the other hand well equipped for this task which usually has to be in place for many years after a nuclear incident. Multilateral and bilateral agreements between national nuclear insurance pools and other institutions should be prepared and signed before any

  2. 中国与东盟国家社会保障双边合作问题研究%Research on bilateral social security agreements on mutual exemption between China and ASEAN

    Institute of Scientific and Technical Information of China (English)

    董建; 王峰坤

    2014-01-01

    Bilateral social security agreements on mutual exemption are an important part of the international development of social security, which has a major impact in the International mobility of human resources. Bilateral social security agreements on mutual exemption develops maturely in Europe where is worth our study and learn. China is currently working with Social Security in Germany and South Korea signed a mutual free agreement, but the bilateral social security agreements on mutual exemption remains to be strengthened. China-ASEAN Free Trade Area for the trade between China and ASEAN opened a new curtain. Both economically and politically, China and ASEAN have a need for bilateral social security agreements on mutual exemption. The establishment of a free trade zone, similar cultural background and a good basis for international cooperation have made a possibility to the built of bilateral social security agreements on mutual exemption between China and ASEAN. In the process of cooperation it is bound to encounter some problems, I will have put forward their own views.%社会保障双边合作是社会保障国际化的重要组成部分,对于人力资源的国际流动有着重要的影响。欧洲是社保双边合作比较成熟的地区,值得我国学习与借鉴。中国目前与德国和韩国签署了社保互免协议,但是社保双边合作仍有待加强。中国与东盟自由贸易区的建成为中国和东盟的贸易往来拉开了新的帷幕,不管是从经济上还是政治上,中国和东盟都有必要进行社会保障的双边合作,而自贸区的成立、相似的文化背景和良好的国际合作基础都使其成为可能。在合作过程中必然会遇到一些问题,文章试着从运用国际国内的经验,衔接国际劳工公约和展开合作试点等方面提出了见解。

  3. The potential for bi-lateral agreements in medical tourism: A qualitative study of stakeholder perspectives from the UK and India

    Directory of Open Access Journals (Sweden)

    Smith Richard D

    2011-05-01

    Full Text Available Abstract Background Globalisation has prompted countries to evaluate their position on trade in health services. However, this is often done from a multi-lateral, rather than a regional or bi-lateral perspective. In a previous review, we concluded that most of the issues raised could be better addressed from a bi-lateral relationship. We report here the results of a qualitative exercise to assess stakeholders' perceptions on the prospects for such a bi-lateral system, and its ability to address concerns associated with medical tourism. Methods 30 semi-structured interviews were carried out with stakeholders, 20 in India and 10 in the UK, to assess their views on the potential offered by a bi-lateral relationship on medical tourism between both countries. Issues discussed include data availability, origin of medical tourists, quality and continuity of care, regulation and litigation, barriers to medical tourism, policy changes needed, and prospects for such a bi-lateral relationship. Results The majority of stakeholders were concerned about the quality of health services patients would receive abroad, regulation and litigation procedures, lack of continuity of care, and the effect of such trade on the healthcare available to the local population in India. However, when considering trade from a bi-lateral point of view, there was disagreement on how these issues would apply. There was further disagreement on the importance of the Diaspora and the validity of the UK's 'rule' that patients should not fly more than three hours to obtain care. Although the opinion on the prospects for an India-UK bi-lateral relationship was varied, there was no consensus on what policy changes would be needed for such a relationship to take place. Conclusions Whilst the literature review previously carried out suggested that a bi-lateral relationship would be best-placed to address the concerns regarding medical tourism, there was scepticism from the analysis provided

  4. The potential for bi-lateral agreements in medical tourism: A qualitative study of stakeholder perspectives from the UK and India

    Science.gov (United States)

    2011-01-01

    Background Globalisation has prompted countries to evaluate their position on trade in health services. However, this is often done from a multi-lateral, rather than a regional or bi-lateral perspective. In a previous review, we concluded that most of the issues raised could be better addressed from a bi-lateral relationship. We report here the results of a qualitative exercise to assess stakeholders' perceptions on the prospects for such a bi-lateral system, and its ability to address concerns associated with medical tourism. Methods 30 semi-structured interviews were carried out with stakeholders, 20 in India and 10 in the UK, to assess their views on the potential offered by a bi-lateral relationship on medical tourism between both countries. Issues discussed include data availability, origin of medical tourists, quality and continuity of care, regulation and litigation, barriers to medical tourism, policy changes needed, and prospects for such a bi-lateral relationship. Results The majority of stakeholders were concerned about the quality of health services patients would receive abroad, regulation and litigation procedures, lack of continuity of care, and the effect of such trade on the healthcare available to the local population in India. However, when considering trade from a bi-lateral point of view, there was disagreement on how these issues would apply. There was further disagreement on the importance of the Diaspora and the validity of the UK's 'rule' that patients should not fly more than three hours to obtain care. Although the opinion on the prospects for an India-UK bi-lateral relationship was varied, there was no consensus on what policy changes would be needed for such a relationship to take place. Conclusions Whilst the literature review previously carried out suggested that a bi-lateral relationship would be best-placed to address the concerns regarding medical tourism, there was scepticism from the analysis provided in this paper based on the

  5. Services and investment in the EU-South Korea free-trade area: implications of a new approach for GATS V agreements and for bilateral investment treaties

    NARCIS (Netherlands)

    J. Mathis; E. Laurenza

    2012-01-01

    This paper focuses on the services and investment features of the recently concluded free trade agreement between the European Union and its Member States, of the one part, and the Republic of Korea, of the other part. This agreement is an early example of a new scheduling approach adopted by the Eu

  6. Acordos bilaterais de comércio como estratégia de inserção regional e internacional do Chile Bilateral trade agreements as Chile's strategy for regional and international insertion

    Directory of Open Access Journals (Sweden)

    Renata Rossetto Lopes

    2010-12-01

    Full Text Available O trabalho analisa a mudança na estratégia de inserção regional e internacional do Chile no começo dos anos 1990, com ênfase em acordos comerciais bilaterais, depois de ter praticado a abertura comercial generalizada desde meados da década de 1970. A opção por acordos bilaterais foi adotada pelo primeiro governo democrático, como parte da orientação de manter e aprofundar a abertura externa empreendida pela ditadura, e conseguiu ampliar as vendas externas e diversificar produtos e destinos. As exportações têm papel decisivo na economia chilena, aberta e pequena, e os 24 acordos bilaterais de comércio com diferentes países e regiões, além de outros em negociação, podem ser explicados pelo esgotamento das possibilidades de ampliar o comércio por meio de reduções adicionais da tarifa externa unilateral, hoje em 6% para quase todos os produtos. A formação de uma rede de acordos bilaterais ampla e diversificada, contudo, tem também interesses políticos, estratégicos e de segurança em relação a vizinhos e a países próximos, além de evitar que o Chile precise se integrar, como membro pleno, a blocos regionais para garantir seus interesses, o que amplia as possibilidades de lidar com diferentes e importantes parceiros no âmbito internacional.The paper analysis the change of Chile's regional and international strategy of insertion through bilateral trade agreements in the beginning of the 90s, after a generalized trade opening since the middle of the 70s. The bilateral trade agreements strategy was set up by the democratic governments as part of the direction of maintaining and deepening the unilateral trade liberalization undertaken by the dictatorship, enlarging exports and diversifying products and markets. Exports have a decisive role in Chile's economy, open and small. The 24 bilateral trade agreements already signed with different countries and regions (besides others under negotiation can be explained by the

  7. Bilateral anterior shoulder dislocation

    OpenAIRE

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  8. THE EUROPEAN UNION’S BILATERAL APPROACH

    Directory of Open Access Journals (Sweden)

    Ludmila BORTA

    2014-12-01

    Full Text Available The EU is a world economic power and a major trading partner for most countries. All the time, this region has been interested and has acted towards a free and fair trade. The decrease and even the elimination of tariff and non-tariff barriers in the world trade are among the main objectives of the EU strategy for international trade. At the moment, the elusive outcome of the WTO Doha Round has led to the proliferation of bilateral trade agreements worldwide. Although the EU remains committed to further development of the multilateral trading system, however, the EU still has appealed also to the development of bilateral trade relations. The aim of this paper is to illustrate the current bilateral dimension of the common commercial policy of the EU. In conclusion, to describe this bilateral approach of the EU we are using one word, namely “diversity”.

  9. 77 FR 58592 - Modified Norway Post Agreement

    Science.gov (United States)

    2012-09-21

    ... Modified Norway Post Agreement AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request to include a modified Norway Post Agreement... existing bilateral agreement for inbound competitive services with Posten Norge AS (Modified Norway...

  10. Trade Agreements

    OpenAIRE

    Kowalczyk, Carsten; Riezman, Raymond

    2009-01-01

    This paper reviews the most significant recent developments in the theory of trade agreements. The paper offers an integrated approach to evaluating trade agreements, and uses the approach to present results on preferential and multilateral trade agreements. The paper identifies also several questions for further research.

  11. Bilateral FTAs in South Asia: Recasting the Regionalism Debate

    OpenAIRE

    Dushni Weerakoon

    2009-01-01

    The slow pace of progress of the South Asian regional trade integration process under SAARC has prompted many countries to seek bilateral agreements. Sri Lanka is a casein point with bilateral agreements with both India and Pakistan. While the former is acknowledged to have yielded positive results, the latter hasremained of limited interest. Given that India remains the single most important trading partner for almost all other South Asian countries, regionalism in South Asia essentially ent...

  12. Pregnancy following bilateral salpingectomy

    DEFF Research Database (Denmark)

    Oturai, Annette Bang

    2008-01-01

    This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy...... was unwanted, and the woman decided to terminate the pregnancy. She was offered diagnostic examination to localise a potential fistula, but she declined. In a MEDLINE search of English literature this is only the second case of spontaneous pregnancy following bilateral salpingectomy Udgivelsesdato: 2008/4/21...

  13. Bilateral Primary Intraocular Lymphoma

    OpenAIRE

    Mehrdad Karimi; Masoud Soheilian; Mozhgan Rezaei Kanavi

    2011-01-01

    Purpose: To report a case of bilateral primary intraocular lymphoma. Case report: A 33-year-old man presented with bilateral blurred vision since two years ago. Examination revealed large keratic precipitates, anterior chamber reaction, posterior subcapsular cataracts, and vitreous infiltration. After a short trial of topical and periocular steroids, diagnostic 25-gauge pars plana vitrectomy was performed and cytologic evaluation of the aspirate confirmed a diagnosis of intraocular lympho...

  14. Escleritis posterior bilateral Bilateral posterior scleritis

    Directory of Open Access Journals (Sweden)

    A. Zurutuza

    2011-08-01

    Full Text Available La escleritis posterior es un proceso inflamatorio de la parte posterior de la esclera. Su prevalencia es muy baja y el diagnóstico puede resultar complicado por la ausencia de signos oculares externos. Es más frecuente en mujeres. Cuando aparece en pacientes jóvenes no suele tener otras patologías asociadas, pero en mayores de 55 años hasta un tercio de los casos tienen relación con alguna enfermedad sistémica, sobre todo la artritis reumatoide. El diagnóstico de esta patología puede requerir un abordaje multidisciplinar y la colaboración de oftalmólogos con neurólogos, internistas o reumatólogos. En este artículo se describe un caso de escleritis posterior bilateral idiopática.Posterior scleritis is an inflammatory process of the posterior part of the sclera. Its prevalence is very low and its diagnosis can be complicated due to the absence of external ocular signs. It is more frequent in women. In young patients it does not usually have other associated pathologies, but in those over 55 years nearly one-third of the cases have a relation with some systemic disease, above all rheumatoid arthritis. The diagnosis of this pathology can require a multidisciplinary approach and the collaboration of ophthalmologists with neurologists, internists or rheumatologists. This article describes a case of idiopathic bilateral posterior scleritis.

  15. Bilateral inferior turbinate osteoma

    Science.gov (United States)

    Sahemey, R.; Warfield, A.T.; Ahmed, S.

    2016-01-01

    Osteomas are the most common benign osteoclastic tumours of the paranasal sinuses. However, nasal cavity and turbinate osteomas are extremely rare. Only nine middle turbinate, three inferior turbinate and one inferior turbinate osteoma cases have been reported to date. The present case report describes the management and follow-up of symptomatic bilateral inferior turbinate osteoma. A 60-year-old female presented with symptoms of bilateral nasal obstruction and right-sided epiphora. Radiological investigation found hypertrophic bony changes involving both inferior turbinates. The patient was managed successfully by endoscopic inferior turbinectomies in order to achieve a patent airway, with no further recurrence of tumour after 3 months postoperatively. To the best of our knowledge, this is the first reported case of bilateral inferior turbinate osteoma. We describe a safe and minimally invasive method of tumour resection, which has a better cosmetic outcome compared with other approaches. PMID:27534890

  16. Bilateral Primary Intraocular Lymphoma

    Directory of Open Access Journals (Sweden)

    Mehrdad Karimi

    2011-01-01

    Full Text Available Purpose: To report a case of bilateral primary intraocular lymphoma. Case report: A 33-year-old man presented with bilateral blurred vision since two years ago. Examination revealed large keratic precipitates, anterior chamber reaction, posterior subcapsular cataracts, and vitreous infiltration. After a short trial of topical and periocular steroids, diagnostic 25-gauge pars plana vitrectomy was performed and cytologic evaluation of the aspirate confirmed a diagnosis of intraocular lymphoma. The patient was subsequently managed with intravitreal methotrexate in both eyes and responded favorably. Central nervous system workup for lymphoma was negative. Conclusion: Primary intraocular lymphoma should be considered in young adults suffering from chronic recalcitrant panuveitis.

  17. BILATERAL IMMATURE OVARIAN TERATOMA

    OpenAIRE

    Vinay; Aditya Pratap; Chetan; Ramesh; Rajlaxmi Jaysing

    2014-01-01

    : Immature teratoma (IMT) is tumor composed of tissues from ectoderm, mesoderm and endoderm and is considered the second most common germ cell tumor. IMT account for 10-20% of all ovarian neoplasias in women less than 20 years of age, with peak incidence between 15 and 19 years old. IMT rarely occurs during menopause. We herein reporting a rare case in a 3 years old girl with bilateral immature ovarian teratoma which is very rare in bilateralism of tumor as well as the fac...

  18. BILATERAL IMMATURE OVARIAN TERATOMA

    Directory of Open Access Journals (Sweden)

    Vinay

    2014-10-01

    Full Text Available : Immature teratoma (IMT is tumor composed of tissues from ectoderm, mesoderm and endoderm and is considered the second most common germ cell tumor. IMT account for 10-20% of all ovarian neoplasias in women less than 20 years of age, with peak incidence between 15 and 19 years old. IMT rarely occurs during menopause. We herein reporting a rare case in a 3 years old girl with bilateral immature ovarian teratoma which is very rare in bilateralism of tumor as well as the fact that the patient age is below the average for the occurrence of these tumors.

  19. Bilateral endogenous fungal endophthalmitis

    OpenAIRE

    Michal, Wilczynski; Olena, Wilczynska; Wojciech, Omulecki

    2013-01-01

    Endogenous endophthalmitis is a rare and severe intraocular infection which can be vision-threatening. We describe a case of bilateral fungal endogenous endophthalmitis in a 64-year-old male which was successfully treated with systemic administration of fluconazole followed by pars plana vitrectomy with an intravitreous injection of amphotericin B.

  20. Bilateral akillesseneruptur hos nyretransplanterede

    DEFF Research Database (Denmark)

    Skovgaard, D; Feldt-Rasmussen, B F; Nimb, L;

    1996-01-01

    Increased incidence of tendinitis and tendon ruptures is reported in recipients of a kidney transplant. Two cases of bilateral achilles tendon rupture after minimal trauma are described. Tendon ruptures are more frequent in individuals with kidney disease in dialysis or after transplantation comp...

  1. Bilateral chronic subdural hematoma

    DEFF Research Database (Denmark)

    Andersen-Ranberg, Nina Christine; Poulsen, Frantz Rom; Bergholt, Bo;

    2016-01-01

    ) surgery. The overall retreatment rate was 21.6% (57 of 264 patients). Cases treated with unilateral surgery had twice the risk of retreatment compared with cases undergoing bilateral surgery (28.7% vs 14.1%, respectively, p = 0.002). In accordance with previous studies, the data also showed...

  2. Bilateral meandering pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Thupili, Chakradhar R.; Udayasankar, Unni [Pediatric Imaging, Imaging Institute Cleveland Clinic, Cleveland, OH (United States); Renapurkar, Rahul [Imaging Institute Cleveland Clinic, Thoracic Imaging, L10, Cleveland, OH (United States)

    2015-06-15

    Meandering pulmonary veins is a rare clinical entity that can be mistaken for more complex congenital syndromes such as hypogenetic lung syndrome. We report imaging findings in a rare incidentally detected case of bilateral meandering pulmonary veins. We briefly discuss the role of imaging in diagnosing this condition, with particular emphasis on contrast-enhanced CT. (orig.)

  3. Agreement Highlights

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Chen Yunlin, President of the mainland’s Association for Relations Across the Taiwan Straits and Chiang Pinkung, Chairman of Taiwan-based Straits Exchange Foundation, signed agreements on direct air, shipping and postal services and food safety cooperation during their summit in Taipei on November 4. Direct Flights——The two sides agree to launch a cargo charter flight service between two mainland terminals, Pudong in Shanghai and Guangzhou airports, and two Taiwan ones, Taoyuan and Kaohsiung.

  4. Bilateral matrix-exponential distributions

    DEFF Research Database (Denmark)

    Bladt, Mogens; Esparza, Luz Judith R; Nielsen, Bo Friis

    2012-01-01

    In this article we define the classes of bilateral and multivariate bilateral matrix-exponential distributions. These distributions have support on the entire real space and have rational moment-generating functions. These distributions extend the class of bilateral phasetype distributions of [1]...

  5. Cooperative monitoring of regional security agreements

    Energy Technology Data Exchange (ETDEWEB)

    Pregenzer, A.L.; Vannoni, M.; Biringer, K.L. [Sandia National Labs., Albuquerque, NM (United States). Nonproliferation and Arms Control Analysis Dept.

    1996-11-01

    This paper argues that cooperative monitoring plays a critical role in the implementation of regional security agreements and confidence building measures. A framework for developing cooperative monitoring options is proposed and several possibilities for relating bilateral and regional monitoring systems to international monitoring systems are discussed. Three bilateral or regional agreements are analyzed briefly to illustrate different possibilities. These examples illustrate that the relationship of regional or bilateral arms control or security agreements to international agreements depends on a number of factors: the overlap of provisions between regional and international agreements; the degree of interest in a regional agreement among the international community; efficiency in implementing the agreement; and numerous political considerations. Given the importance of regional security to the international community, regions should be encouraged to develop their own infrastructure for implementing regional arms control and other security agreements. A regional infrastructure need not preclude participation in an international regime. On the contrary, establishing regional institutions for arms control and nonproliferation could result in more proactive participation of regional parties in developing solutions for regional and international problems, thereby strengthening existing and future international regimes. Possible first steps for strengthening regional infrastructures are identified and potential technical requirements are discussed.

  6. [Spontaneous bilateral Petit hernia].

    Science.gov (United States)

    Fontoura, Rodrigo Dias; Araújo, Emerson Silveira de; Oliveira, Gustavo Alves de; Sarmenghi Filho, Deolindo; Kalil, Mitre

    2011-01-01

    Petit's lumbar hernia is an uncommon defect of the posterior abdominal wall that represents less than 1% of all abdominal wall hernias. It is more often unilateral and founded in young females, rarely containing a real herniated sac. There are two different approaches to repair: laparoscopy and open surgery. The goal of this article is to report one case of spontaneous bilateral lumbar Petit's hernia treated with open surgery.

  7. Bilateral intraocular dirofilariasis

    Directory of Open Access Journals (Sweden)

    Viney Gupta

    2014-01-01

    Full Text Available Ocular dirofilariasis mostly presents as a subconjunctival or eyelid lesion. [1] Intraocular dirofilarial infestation is rare. [2],[3] We report a case of a young woman who was accidentally detected to have a live motile worm in the anterior segment in one eye and a cystic lesion on the optic disc in the other eye. To our knowledge, bilateral intraocular dirofilariasis has never been reported.

  8. Compressive Bilateral Filtering.

    Science.gov (United States)

    Sugimoto, Kenjiro; Kamata, Sei-Ichiro

    2015-11-01

    This paper presents an efficient constant-time bilateral filter that produces a near-optimal performance tradeoff between approximate accuracy and computational complexity without any complicated parameter adjustment, called a compressive bilateral filter (CBLF). The constant-time means that the computational complexity is independent of its filter window size. Although many existing constant-time bilateral filters have been proposed step-by-step to pursue a more efficient performance tradeoff, they have less focused on the optimal tradeoff for their own frameworks. It is important to discuss this question, because it can reveal whether or not a constant-time algorithm still has plenty room for improvements of performance tradeoff. This paper tackles the question from a viewpoint of compressibility and highlights the fact that state-of-the-art algorithms have not yet touched the optimal tradeoff. The CBLF achieves a near-optimal performance tradeoff by two key ideas: 1) an approximate Gaussian range kernel through Fourier analysis and 2) a period length optimization. Experiments demonstrate that the CBLF significantly outperforms state-of-the-art algorithms in terms of approximate accuracy, computational complexity, and usability. PMID:26068315

  9. Cooperative monitoring of regional security agreements

    Energy Technology Data Exchange (ETDEWEB)

    Pregenzer, A.L.; Vannoni, M.; Biringer, K.L.

    1995-08-01

    This paper argues that cooperative monitoring plays a critical role in the implementation of regional security agreements and confidence building measures. A framework for developing cooperative monitoring options is proposed and several possibilities for relating bilateral and regional monitoring systems to international monitoring systems are discussed. Three bilateral or regional agreements are analyzed briefly to illustrate different possibilities: (1) the demilitarization of the Sinai region between Israel and Egypt in the 1970s; (2) the 1991 quadripartite agreement for monitoring nuclear facilities among Brazil, Argentina, The Argentine-Brazilian Agency for Accounting and Control of Nuclear Materials and the International Atomic Energy Agency; and (3) a bilateral Open Skies agreement between Hungary and Romania in 1991. These examples illustrate that the relationship of regional or bilateral arms control or security agreements to international agreements depends on a number of factors: the overlap of provisions between regional and international agreements; the degree of interest in a regional agreement among the international community; efficiency in implementing the agreement; and numerous political considerations.Given the importance of regional security to the international community, regions should be encouraged to develop their own infrastructure for implementing regional arms control and other security agreements. A regional infrastructure need not preclude participation in an international regime. On the contrary, establishing regional institutions for arms control and nonproliferation could result in more proactive participation of regional parties in developing solutions for regional and international problems, thereby strengthening existing and future international regimes. Possible first steps for strengthening regional infrastructures are identified and potential technical requirements are discussed.

  10. International bilateral and multilateral arrangements in energy technologies

    International Nuclear Information System (INIS)

    This document, the second report in the series, outlines current DOE international commitments under bilateral and multilateral arrangements, as of January 1, 1978. Included are bilateral agreements for cooperation in the civil uses of atomic energy with countries and international organizations, bilateral and multilateral technical exchanges in all energy technology areas, and multilateral agreements under the auspices of the International Energy Agency (IEA). In addition to outlining the terms, scope, and status of these agreements, this document describes DOE's participation in the work of the major international energy organizations. IEA, the International Atomic Energy Agency (IAEA), and the Nuclear Energy Agency (NEA). Future reports will update the status of ongoing cooperative projects and provide information on new energy R and D activities

  11. Multilateral, regional and bilateral energy trade governance

    Energy Technology Data Exchange (ETDEWEB)

    Leal-Arcas, Rafael; Grasso, Costantino; Rios, Juan Alemany (Queen Mary Univ. of London (United Kingdom))

    2014-12-01

    The current international energy trade governance system is fragmented and multi-layered. Streamlining it for greater legal cohesiveness and international political and economic cooperation would promote global energy security. The current article explores three levels of energy trade governance: multilateral, regional and bilateral. Most energy-rich countries are part of the multilateral trading system, which is institutionalized by the World Trade Organization (WTO). The article analyzes the multilateral energy trade governance system by focusing on the WTO and energy transportation issues. Regionally, the article focuses on five major regional agreements and their energy-related aspects and examines the various causes that explain the proliferation of regional trade agreements, their compatibility with WTO law, and then provides several examples of regional energy trade governance throughout the world. When it comes to bilateral energy trade governance, this article only addresses the European Union’s (EU) bilateral energy trade relations. The article explores ways in which gaps could be filled and overlaps eliminated whilst remaining true to the high-level normative framework, concentrating on those measures that would enhance EU energy security.

  12. Agreement technologies

    CERN Document Server

    Ossowski, Sascha

    2013-01-01

    More and more transactions, whether in business or related to leisure activities, are mediated automatically by computers and computer networks, and this trend is having a significant impact on the conception and design of new computer applications. The next generation of these applications will be based on software agents to which increasingly complex tasks can be delegated, and which interact with each other in sophisticated ways so as to forge agreements in the interest of their human users. The wide variety of technologies supporting this vision is the subject of this volume. It summarises

  13. Bilateral accessory thoracodorsal artery.

    Science.gov (United States)

    Natsis, Konstantinos; Totlis, Trifon; Tsikaras, Prokopios; Skandalakis, Panagiotis

    2006-09-01

    The subscapular artery arises from the third part of the axillary artery and gives off the circumflex scapular and the thoracodorsal arteries. Although anatomical variations of the axillary artery are very common, the existence of a unilateral accessory thoracodorsal artery has been described in the literature only once. There are no reports of bilateral accessory thoracodorsal artery, in the literature. In the present study, a bilateral accessory thoracodorsal artery, originating on either side of the third part of the axillary artery, is described in a 68-year-old female cadaver. All the other branches of the axillary artery had a typical origin, course, distribution and termination. This extremely rare anatomical variation apart from the anatomical importance also has clinical significance for surgeons in this area. Especially, during the dissection or mobilization of the latissimus dorsi that is partly used for coverage problems in many regions of the body and also in dynamic cardiomyoplasty, any iatrogenic injury of this accessory artery may result in ischemia and functional loss of the graft.

  14. A Bilateral Slam Dunk

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    New Zealand became the first developed country to sign a free trade agreement with China The three years of hard work on nego- tiating a free trade agreement finally paid off for China and New Zealand. Chinese Commerce Minister Chen Deming and Trade Minister of New Zealand Phil Goff formally signed a free trade agree- ment (FTA) on April 7 in Beijing.It was the first FTA that the Chinese Government signed with a developed country.

  15. Bilateral Antepartum Mastitis

    Directory of Open Access Journals (Sweden)

    Peyman Alibeigi

    2010-12-01

    Full Text Available Antepartum mastitis is a rare condition, whereas postpartum orlactation mastitis is a common problem. This report introducesa case of complicated bilateral antepartum mastitis, which wastreated successfully by drain insertion and antibiotic therapy.The patient was a 23-year-old woman in the 23rd week of herfirst pregnancy. Her chief complaint was progressive swelling,redness and radicular pain in both breasts, which had beenstarted gradually from the 18th week of pregnancy. The patientwas admitted to hospital, and received oral and intravenous antibioticsempirically, which was not effective. The patient wastreated by drainage and oral antibiotic therapy. Based on theapproaches employed and the outcomes achieved it is suggestedthat early surgical insertion in the presence of fluid collection inantepartum mastitis will shorten hospitalization and course ofintravenous antibiotic therapy.Iran J Med Sci 2010; 35(4: 327-330.

  16. Idiopathic Bilateral Bloody Tearing

    Directory of Open Access Journals (Sweden)

    Emrullah Beyazyıldız

    2015-01-01

    Full Text Available Bloody tear is a rare and distinct clinic phenomenon. We report a case presenting with the complaint of recurrent episodes of bilateral bloody tearing. A 16-year-old girl presented to our clinic with complaint of bloody tearing in both eyes for 3 months. Bloody tearing was not associated with her menses. A blood-stained discharge from the punctum was not observed during the compression of both nasolacrimal ducts. Nasolacrimal passage was not obstructed. Imaging studies such as dacryocystography and gradient-echo magnetic resonance imaging (MRI of nasolacrimal canal were normal. Intranasal endoscopic evaluation was normal. We collected samples from bloody tears two times and pathological examination was performed. Pathological analysis showed lots of squamous cells and no endometrial cells; dysplastic cells were found. Further evaluations for underlying causes were unremarkable. No abnormalities were found in ophthalmologic, radiologic, and pathologic investigations. This condition is likely a rare abnormality and the least recognized aetiology for the idiopathic phenomenon.

  17. Isolated bilateral ectopic microspherophakia

    Directory of Open Access Journals (Sweden)

    André Omgbwa Eballe

    2010-02-01

    Full Text Available André Omgbwa Eballe1, Godefroy Koki2, Emilienne Epée2, Didier Owono2, Lucienne Bella Asumpta2, Côme Ebana Mvogo21Faculty of Medicine and Pharmaceuticals Sciences, University of Douala Cameroon; 2Faculty of Medicine and Biomedical Sciences, University of Yaoundé CameroonSummary: An eight-year-old school girl presented to us with a bilateral ectopic microspherophakia. She was surgically managed in the ophthalmology unit of the Gynaeco-Obstetric and Pediatric Hospital of Yaoundé in Cameroon. The postoperative follow up was uneventful, and the patient returned to school with a best corrected visual acuity of 4/10 in both eyes to the great satisfaction of her parents.Keywords: ectopic, microspherophakia, surgery

  18. Bilateral acute corneal calcification.

    Science.gov (United States)

    Freddo, T F; Leibowitz, H M

    1985-04-01

    A 38-year-old man with brittle, juvenile onset diabetes mellitus and bilateral severe dry eyes with recurrent corneal ulcers developed atypical band-shaped calcifications of both corneas during a 24-hour period. Serum calcium, phosphate, and carbon dioxide levels all were within normal limits. The patient was mildly uremic but was not in renal failure. When EDTA chelation failed to clear the deposits, partial keratectomies were performed in both eyes and the specimens were examined by light and electron microscopy, including energy dispersive x-ray analysis. Microscopic studies revealed an atypical calcific keratopathy which involved neither Bowman's layer nor the most superficial stromal lamellae. The deposits were confined to deeper lamellae in the anterior stroma and by electron microscopy were composed of extracellular crystalline aggregates. Energy dispersive x-ray analysis of these aggregates confirmed the presence of calcium and phosphate. Corneal dessication appeared to be a major contributing factor in the rapid formation of these deposits.

  19. Bilateral Social Security Instruments Concluded between European Socialist Countries.

    Science.gov (United States)

    Popescu, Andrei

    1982-01-01

    Presents a review of existing bilateral treaties, conventions, and agreements in the field of social policy concluded between European socialist countries. It summarizes their basic principles, their social security provisions (old-age benefit, employment injury benefits, cash benefits for sickness and maternity), and the provisions concerning…

  20. Pediatric isolated bilateral iliac aneurysm.

    Science.gov (United States)

    Chithra, R; Sundar, R Ajai; Velladuraichi, B; Sritharan, N; Amalorpavanathan, J; Vidyasagaran, T

    2013-07-01

    Aneurysms are rare in children. Isolated iliac artery aneurysms are very rare, especially bilateral aneurysms. Pediatric aneurysms are usually secondary to connective tissue disorders, arteritis, or mycotic causes. We present a case of a 3-year-old child with bilateral idiopathic common iliac aneurysms that were successfully repaired with autogenous vein grafts.

  1. Silicosis with bilateral spontaneous pneumothorax

    OpenAIRE

    Fotedar Sanjay; Chaudhary Dhruva; Singhla Vikas; Narang Rajat

    2010-01-01

    Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax. The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

  2. Silicosis with bilateral spontaneous pneumothorax

    Directory of Open Access Journals (Sweden)

    Fotedar Sanjay

    2010-01-01

    Full Text Available Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax.The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

  3. Acute silicosis with bilateral pneumothorax.

    Science.gov (United States)

    Srivastava, G N; Prasad, Rajniti; Meena, Manoj; Hussain, Moosa

    2014-01-01

    We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of acute silicosis as bilateral pneumothorax. PMID:24862410

  4. Links between the Philippines and Spain: migration and bilateral relations

    Directory of Open Access Journals (Sweden)

    Rogelia Pe-Pua

    2005-01-01

    Full Text Available This paper analyses the implications which Spanish policy regarding foreign workers has on the living and working conditions of the Filipino community in Spain. The author pays special attention to bilateral relations between the Philippines and Spain in issues suchas Spanish investment in the Philippines, the trade balance between the two countries and labour relations. In conclusion the article considers the necessity of reaching a bilateral labour agreement which would be beneficial to both countries and which at the same time would improve the working conditions and the integration of Philippine nationals living in Spain.

  5. Bilateral, independent juvenile nasopharyngeal angiofibroma

    DEFF Research Database (Denmark)

    Mørkenborg, Marie-Louise; Frendø, M; Stavngaard, T;

    2015-01-01

    BACKGROUND: Juvenile nasopharyngeal angiofibroma is a benign, vascular tumour that primarily occurs in adolescent males. Despite its benign nature, aggressive growth patterns can cause potential life-threatening complications. Juvenile nasopharyngeal angiofibroma is normally unilateral, originating...... from the sphenopalatine artery, but bilateral symptoms can occur if a large tumour extends to the contralateral side of the nasopharynx. This paper presents the first reported case of true bilateral extensive juvenile nasopharyngeal angiofibroma involving clinically challenging pre-surgical planning...... embolisation. Radical removal performed as one-step, computer-assisted functional endoscopic sinus surgery was performed. The follow-up period was uncomplicated. CONCLUSION: This case illustrates the importance of suspecting bilateral juvenile nasopharyngeal angiofibroma in patients presenting with bilateral...

  6. Bilateral Polydactyly in a foal

    OpenAIRE

    Carstanjen, Bianca; Abitbol, Marie; Desbois, Christophe

    2007-01-01

    The following case report describes the diagnosis and surgery of bilateral polydactyly of unknown origin in a colt. A 7-month-old Berber colt was referred for cosmetic and curative excision of supernumerary digits. Radiographic examination revealed bilateral polydactyly and well-developed first carpal bones. Surgery consisted of an osteotomy of both second metacarpal bones combined with an amputation of the supernumerary digits. The follow-up at 18 months after surgery revealed a sound horse ...

  7. Bilateral cleft lip nasal deformity

    OpenAIRE

    Singh Arun; Nandini R.

    2009-01-01

    Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the li...

  8. Point Climat no. 11 'Japan's Bilateral Offset Crediting Mechanism: A Bilateral Solution to a Global Issue?'

    International Nuclear Information System (INIS)

    Among the publications of CDC Climat Research, 'Climate Briefs' presents, in a few pages, hot topics in climate change policy. This issue addresses the following points: In order to achieve its long-term emission reduction target following the Fukushima incident, Japan would rely more heavily on international offsetting activities. Concurrent to vigorous proposals to reform the CDM, Japan is also promoting an offset crediting scheme through bilateral agreements with developing countries as a post-2012 market mechanism. Despite potential benefits, issues relating to the accounting rules, environmental integrity and implications to carbon markets warrant further consideration prior to international recognition

  9. 38 CFR 4.26 - Bilateral factor.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Bilateral factor. 4.26... DISABILITIES General Policy in Rating § 4.26 Bilateral factor. When a partial disability results from disease... disability. The bilateral factor will be applied to such bilateral disabilities before other combinations...

  10. Several Issues regarding the Mutual Agreement Procedures (Japanese)

    OpenAIRE

    Ito, Tsuyoshi

    2010-01-01

    Mutual agreement procedures refer to an international tax dispute resolution mechanism, in which tax authorities of countries party to bilateral tax conventions (or treaties) negotiate. In recent years, the importance of the mutual agreement procedures has been growing, as the number of cases in which taxpayers request that their governments initiate mutual agreement procedures has been increasing. The reasons behind this are an increase in international trade, an enhancement of tax enforceme...

  11. Paralisia facial bilateral Bilateral facial paralysis: a case report

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1976-03-01

    Full Text Available É apresentado um caso de diplegia facial surgida após meningite meningocócica e infecção por herpes simples. Depois de discutir as diversas condições que o fenômeno pode apresentar-se, o autor inclina-se por uma etiologia herpética.A case of bilateral facial paralysis following meningococcal meningitis and herpes simplex infection is reported. The author discusses the differential diagnosis of bilateral facial nerve paralysis which includes several diseases and syndromes and concludes by herpetic aetiology.

  12. Bilateral spontaneous hemotympanum: Case report

    Directory of Open Access Journals (Sweden)

    Economou Nicolas C

    2006-10-01

    Full Text Available Abstract Background The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. Case presentation A 72-year-old male presented with acute deterioration of hearing. In the patient's medical history aortic valve replacement 1 year before presentation was reported. Since then he had been administered regularly coumarinic anticoagulants, with INR levels maintained between 3.4 and 4.0. Otoscopy revealed the presence of bilateral hemotympanum. The audiogram showed symmetrical moderately severe mixed hearing loss bilaterally, with the conductive component predominating. Tympanograms were flat bilaterally with absent acoustic reflexes. A computerized tomography scan showed the presence of fluid in the mastoid and middle ear bilaterally. Treatment was conservative and consisted of a 10-day course of antibiotics, anticongestants and temporary interruption of the anticoagulant therapy. After 3 weeks, normal tympanic membranes were found and hearing had returned to previous levels. Conclusion Anticoagulant intake should be included in the differential diagnosis of hemotympanum, because its detection and appropriate treatment may lead to resolution of the disorder.

  13. Free Trade Agreements Are Cause for Hope

    Institute of Scientific and Technical Information of China (English)

    Financial Times

    2011-01-01

    @@ On October 21, three bilateral trade agreements have passed the US House of Representatives and Senate.But the votes came with a sense of relief rather than celebration from their supporters, and resignation rather than anger from their opponents. Very occasionally, common sense soars above political partisanship and economic short-termism to inspire hopeeven in the most jaded investor.The passing by US Congress of free trade agreements between America and Colombia, Panama and South Korea would be cause for celebration at the best of times.

  14. Acute silicosis with bilateral pneumothorax

    OpenAIRE

    Srivastava, G. N.; Prasad, Rajniti; Meena, Manoj; Hussain, Moosa

    2014-01-01

    We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of...

  15. Agreement Workflow Tool (AWT)

    Data.gov (United States)

    Social Security Administration — The Agreement Workflow Tool (AWT) is a role-based Intranet application used for processing SSA's Reimbursable Agreements according to SSA's standards. AWT provides...

  16. Primary synchronous bilateral breast cancer

    Directory of Open Access Journals (Sweden)

    R Krishnappa

    2014-01-01

    Full Text Available Background: Primary synchronous bilateral breast cancer (PSBBC is a rare clinical entity. The reported incidence ranges between 0.3% and 12%. There are several controversial issues regarding PSBBC pertaining to the diagnostic criteria, nomenclature, and management policies. Materials and Methods: Fourteen cases of PSBBC treated between 2001 to 2010 at our institute were retrospectively analysed in regards to demographic data, management and follow up. Results: PSBBC constituted 0.19% of total breast cancer patients at our institute. Age ranged from 28 to 78 years. PSBBC were detected by clinical examination in eight cases and by mammography in six cases. Twelve patients underwent bilateral modified radical mastectomy, one had unilateral mastectomy on one side and breast conservation on the other side and one patient has bilateral breast conservation. Majority of patients belonged to stage 2 and stage 3. All patients were found to have invasive ductal carcinoma. Five cases were ER/PR positive and 8 patients were triple hormone receptor negative. Eight patients received unilateral and six received bilateral adjuvant radiotherapy. Nine patients received adjuvant chemotherapy. 5 patients received adjuvant hormonal therapy. Median follow up of patients was 15.4 months. Conclusion: PSBBC is a rare event warranting awareness and screening of the contralateral breast in patients with unilateral breast cancer. These patients require individualized treatment planning based on the tumor factors of the index lesion. Further multi institutional prospective studies are needed for adequate understanding of management of PSBBC.

  17. Spontaneous bilateral quadriceps tendon rupture.

    Science.gov (United States)

    Vigneswaran, N; Lee, K; Yegappan, M

    2007-11-01

    Spontaneous bilateral quadriceps tendon ruptures are uncommon. We present a 30-year-old man with end-stage renal failure, who sustained this injury, and subsequently had surgical repair of both tendons on separate occasions. He has since regained full range of movement of both knees.

  18. Bilateral familial nevus of Ota.

    Science.gov (United States)

    Goyal, Sunali; Uwaydat, Sami H; Phillips, Paul H; Schaefer, G Bradley

    2014-12-01

    Nevus of Ota is a benign congenital melanocytic lesion found most commonly in people of Asian ancestry. It is associated with an increased risk of glaucoma and uveal melanomas. Most cases are sporadic and unilateral. We present the first reported case of a brother and sister with familial, bilateral nevus of Ota.

  19. Agreement among 2 x 2 Agreement Indices.

    Science.gov (United States)

    Conger, Anthony J.; Ward, David G.

    1984-01-01

    Sixteen measures of reliability for two-category nominal scales are compared. Upon correcting for chance agreement, there are only five distinct indices: Fleiss's modification of A-sub-1, the phi coefficient, Cohen's kappa, and two intraclass coefficients. Recommendations for choosing an agreement index are made based on definitions, magnitude,…

  20. Foreign investment issues in the Australia-United States Free Trade Agreement

    OpenAIRE

    Thomas Westcott

    2005-01-01

    This article looks at the investment chapter of the Australia-United States Free Trade Agreement (AUSFTA) and discusses the bilateral investment relationship, the AUSFTA negotiating process and the investment policy outcomes. The article concludes that the investment chapter in AUSFTA will be an important influence on future bilateral, plurilateral and multilateral treaty negotiations on investment.

  1. Tratamiento conservador en pacientes con retinoblastoma bilateral

    OpenAIRE

    Juan C. Suárez; Mabel C. Ospina; Sandra A. Arias; González, María E

    2008-01-01

    OBJETIVO: comparar el tratamiento convencional del retinoblastoma bilateral, usado hasta hace algunos años, consistente en radioterapia o enucleación bilateral, con el tratamiento conservador actual que incluye termoterapia transpupilar (TTT) o TTT/quimioterapia al menos en un ojo, en niños con diagnóstico de retinoblastoma bilateral. DISEÑO: estudio retrospectivo descriptivo. MUESTRA: 20 pacientes con diagnóstico de retinoblastoma bilateral que consultaron al Hospital Universitario San Vicen...

  2. Laparoscopic Adrenalectomy for Bilateral Metachronous Aldosteronomas

    OpenAIRE

    Rizek, Philippe; Gorecki, Piotr; Lindenmayer, Aristid; Moktan, Sabita

    2011-01-01

    Introduction: Primary aldosteronism affects 5% to 13% of patients with hypertension. Idiopathic bilateral hyperplasia (IHA) and unilateral aldosterone-producing adenoma (APA) are the most common types of primary aldosteronism. Bilateral APA is a very rare entity with only a few reports in the literature. We present the case of a patient with metachronous bilateral APA treated with metachronous bilateral total and near total adrenalectomy. Case Report: A 66-year-old female was evaluated for hy...

  3. Simultaneous and staged bilateral total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik;

    2013-01-01

    Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

  4. Bilateral pallidotomy for generalized dystonia Palidotomia bilateral para distonias generalizadas

    Directory of Open Access Journals (Sweden)

    Hélio A. G. Teive

    2001-06-01

    Full Text Available OBJECTIVE: To evaluate the efficacy and safety of bilateral pallidotomies in five patients with generalized dystonia. BACKGROUND: Generalized dystonias are frequently a therapeutic challenge, with poor responses to pharmacological treatment. GPi (globus pallidus internus pallidotomies for Parkinson's disease ameliorate all kinds of dyskinesias/dystonia, and recent studies reported a marked improvement of refractory dystonias with this procedure. METHODS: Five patients with generalized dystonias refractory to medical treatment were selected; one posttraumatic and four idiopathic. The decision to perform bilateral procedures was based on the predominant axial involvement in these patients. Dystonia severity was assessed with the Burke-Fahn-Marsden Dystonia Scale (BFM. Simultaneous procedures were performed in all but one patient, who had a staged procedure. They were reevaluated with the same scale (BFM by an unblinded rater at 1, 2, 3, 30, 60, 90, 120 and 180 days post-operatively. RESULTS: The four patients with idiopathic dystonia showed a progressive improvement up to three months; the patient with posttraumatic dystonia relapsed at three months. One patient had a marked improvement, being able to discontinue all the medications. A mean decrease in the BFM scores of 52,58% was noted. One patient had a trans-operative motor seizure followed by a transient hemiparesis secondary to rack hemorrhage; other was lethargic up to three days after the procedure. CONCLUSIONS: Our results show that bilateral GPi pallidotomies may be a safe and effective approach to medically refractory generalized dystonias; it can also be speculated that the posttraumatic subgroup may not benefit with this procedure.As distonias generalizadas são freqüentemente um desafio terapêutico, com pobres respostas aos tratamentos farmacológicos. As cirurgias estereotáxicas, como a palidotomia, têm sido utilizadas com êxito no tratamento da doença de Parkinson e estudos

  5. Bilateral Lhermitte-Duclos disease

    Directory of Open Access Journals (Sweden)

    Bozbuga Mustafa

    2010-01-01

    Full Text Available Lhermitte-Duclos disease (LDD is a pathologic entity with progrediating, diffuse hypertrophy chiefly of the stratum granulosum of the cerebellum. Typically LDD is a unilateral lesion of the cerebellum or in vermis. Here we report a case of LDD with bilateral lesions of cerebellar hemispheres managed surgically. A 28-year-old woman presented with one-year history of progressive headache, nausea, vomiting, and blurred vision. Neurologic examination revealed a bilateral mild papilledema, mild dysmetria, and dysdiadochokinesia. The cerebellar lesions caused moderate mass effect in posterior fossa with hydrocephalus, and Chiari type I malformation. We performed the suboccipital-retrosigmoid approach, and removed completely the left intracerebellar mass. Symptoms related to elevated intracranial pressure disappeared in a short period postoperatively.

  6. Immediate Sequential Bilateral Cataract Surgery

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte;

    2015-01-01

    The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence......-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were...... performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery...

  7. Bilateral Molariform Mandibular Second Premolars

    OpenAIRE

    Sonu Acharya; Pradip Kumar Mandal; Chiranjit Ghosh

    2015-01-01

    Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side ...

  8. Compensation following bilateral vestibular damage

    Directory of Open Access Journals (Sweden)

    Bill J Yates

    2011-12-01

    Full Text Available Bilateral loss of vestibular inputs affects far fewer patients than unilateral inner ear damage, and thus has been understudied. In both animal subjects and human patients, bilateral vestibular hypofunction (BVH produces a variety of clinical problems, including impaired balance control, inability to maintain stable blood pressure during postural changes, difficulty in visual targeting of images, and disturbances in spatial memory and navigational performance. Experiments in animals have shown that nonlabyrinthine inputs to the vestibular nuclei are rapidly amplified following the onset of BVH, which may explain the recovery of postural stability and orthostatic tolerance that occurs within 10 days. However, the loss of the vestibulo-ocular reflex and degraded spatial cognition appear to be permanent in animals with BVH. Current concepts of the compensatory mechanisms in humans with BVH are largely inferential, as there is a lack of data from patients early in the disease process. Translation of animal studies of compensation for BVH into therapeutic strategies and subsequent application in the clinic is the most likely route to improve treatment. In addition to physical therapy, two types of prosthetic devices have been proposed to treat individuals with bilateral loss of vestibular inputs: those that provide tactile stimulation to indicate body position in space, and those that deliver electrical stimuli to branches of the vestibular nerve in accordance with head movements. The relative efficacy of these two treatment paradigms, and whether they can be combined to facilitate recovery, is yet to be ascertained.

  9. Struggles Against Bilateral FTAs: Challenges for Transnational Global Justice Activism

    Directory of Open Access Journals (Sweden)

    Aziz Choudry

    2012-11-01

    Full Text Available The past decade has seen major movements and mobilizations against the new crop of bilateral free trade and investment agreements being pursued by governments in the wake of the failure of global (World Trade Organization and regional (e.g. Free Trade Area of the Americas negotiations, and the defeat of an attempted Multilateral Agreement on Investment in the 1990s.  However, in spite of much scholarly, non-governmental organization (NGO and activist focus on transnational global justice activism, many of these movements, such as the major multi-sectoral popular struggle over the recently-concluded US-Korea Free Trade Agreement, are hardly acknowledged in North America and Europe.  With a shift in emphasis pushing liberalization and deregulation of trade and investment increasingly favouring lower-profile bilateral agreements, this article maps the resistance movements to these latest shifts in global free market capitalist relations and discusses the disconnect between these (mainly Southern struggles and dominant scholarly and NGO conceptions of global justice and the global justice movement as well as questions of knowledge production arising from these movements.

  10. Transatlantic Cooperation in Space: Eu-Canada Free Trade Agreement

    Directory of Open Access Journals (Sweden)

    Luise Weber-Steinhaus

    2014-12-01

    Full Text Available National governments are keenly aware of the need for investment in space. Canada, as a formal cooperating state in the European Space Agency (ESA, and Germany, as a leading member state of ESA, are interlinked in Europe’s space endeavours. Beyond ESA, Germany and Canada additionally have a strong history of bilateral cooperation on a range of space projects. This paper discusses the novel interdependencies between clear national and now supranational space policies, using the examples of the Canada-European Union (EU Comprehensive Economic and Trade Agreement (CETA. The agreement covers most aspects of the EU-Canada bilateral economic relationship and includes space. The paper focuses on international space policies, strategic bilateral co-operation, and technical accomplishments. It takes a closer look at German-Canadian collaboration in space programs and offers some reflection on the effect of both the EU and ESA’S transatlantic involvement in space.

  11. Agreement in Bloomfield.

    Science.gov (United States)

    Langendoen, D. Terence; McDaniel, Dana S.

    A discussion of Leonard Bloomfield's theory on grammatical agreement examines agreement within Bloomfield's overall scheme of syntactic analysis and relates it to current work in syntax. Bloomfield's three types of agreement (concord, government, and cross-reference) are outlined and compared to the contemporary distinction between pro-drop and…

  12. Bilateral ECT induces bilateral increases in regional cortical thickness.

    Science.gov (United States)

    van Eijndhoven, P; Mulders, P; Kwekkeboom, L; van Oostrom, I; van Beek, M; Janzing, J; Schene, A; Tendolkar, I

    2016-01-01

    Electroconvulsive therapy (ECT) is the most effective treatment for patients suffering from severe or treatment-resistant major depressive disorder (MDD). Unfortunately its underlying neurobiological mechanisms are still unclear. One line of evidence indicates that the seizures produced by ECT induce or stimulate neuroplasticity effects. Although these seizures also affect the cortex, the effect of ECT on cortical thickness is not investigated until now. We acquired structural magnetic resonance imaging data in 19 treatment-resistant MDD patients before and after a bilateral ECT course, and 16 healthy controls at 2 time points, and compared changes in cortical thickness between the groups. Our results reveal that ECT induces significant, bilateral increases in cortical thickness, including the temporal pole, inferior and middle temporal cortex and the insula. The pattern of increased cortical thickness was predominant in regions that are associated with seizure onset in ECT. Post hoc analyses showed that the increase in thickness of the insular cortex was larger in responders than in non-responders, which may point to a specific relationship of this region with treatment effects of ECT. PMID:27552587

  13. Bilateral cleft lip nasal deformity

    Directory of Open Access Journals (Sweden)

    Singh Arun

    2009-01-01

    Full Text Available Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it′s management both at the time of cleft lip repair

  14. Shareholders' agreements in Denmark

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2010-01-01

    The article warns that with effect from 1 March 2010, the new Danish Companies Act (on public and private limited companies) has seriously weakened the effect of shareholders’ agreements which have been entered into on Danish companies. These agreements (in the act’s new terminology: “owners......’ agreements”) cannot bind the company within the sense of company law under the new state of law, and voting rights agreements, agreements on right of pre-emption etc. will therefore only apply at the level of contract law between the parties to the agreement. This article for European Business Law Review...... analyses the consequences of this. Rights and duties in the owners’ agreements must now be reiterated to the greatest possible extent in the company’s articles of association so that the precepts become binding on the company and its management. Whether the parties to the owners’ agreement can be required...

  15. BILATERAL DUPLICATION OF RENAL ARTERIES

    Directory of Open Access Journals (Sweden)

    Prajkta A Thete

    2014-09-01

    Full Text Available Routine dissection of a male cadaver revealed the presence of bilateral double renal arteries. On the right side the accessory renal artery originated from the abdominal aorta just above the main renal artery. On the left side the accessory renal artery originated from the abdominal aorta about 1 cm above the main renal artery. Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, surgery for abdominal aortic aneurysm and conservative or radical renal surgery

  16. Bilateral molariform mandibular second premolars.

    Science.gov (United States)

    Acharya, Sonu; Kumar Mandal, Pradip; Ghosh, Chiranjit

    2015-01-01

    Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side and erupted macrodontic premolar on the other side and their distinct morphological appearance, characterized by large, multitubercular, and molariform crowns and tapering, single roots. PMID:25685564

  17. Bilateral Monteggia fracture in adults

    Directory of Open Access Journals (Sweden)

    Ristić Dejan

    2011-01-01

    Full Text Available Introduction. In 1814 Giovanni Monteggia first described two cases of fractures of the proximal third of ulna with dislocation of the radial head. These fractures are more common in children than in adults, and mutual Monteggia fracture is a rare complication. This study presents a treatment course of a patient with bilateral Monteggia fracture. Case report. A 55- year-old patient was injured by falling in the yard. Radiography showed bilateral Monteggia fracture type II (by the Badon classification. Operative treatment of fracture was done by a compression plate on the right side and by the zuggurtung technique on the left one. Closed repositioning of the radial head was done on both sides. The patient was wearing a plaster splint for the upper arm for 21 days. After removing the fixation, the function of the elbow was determined by the Broberg Morrey score (BM which was on the right side 45.5 and on the left side 47.5. After the proper physical therapy, four months after the surgery, BM score was 100 on the right side, and 93 on the left one. Conclusion. Surgical treatment and early rehabilitation is the key for the return of good function of both elbows.

  18. [Simultaneous bilateral pneumothorax. Case report].

    Science.gov (United States)

    Paolini, A; Caminiti, F; Tosato, F; Ruggieri, M; Paolini, G; Carnevale, L; Corsini, F; Marano, S; Monsellato, I

    2001-04-01

    A case report of a 44 year-old white man admitted to the surgical unit for a bilateral simultaneous pneumothorax is presented. The pneumothorax occurred on day one after a surgical operation for discal hernia; in the past the patient already presented a right spontaneous pneumothorax at 32 years of age and a left pneumothorax at 37 years of age, both treated with a pleural drainage. A thoracic drain was bilaterally positioned with a good result only in the right side. The persistence of the left pneumothorax induced the authors to perform a postero-lateral thoracotomy bullae excision and pleurectomy with a good postoperative course. After a few months a new right pneumothorax occurred and the patient was treated with a right postero-lateral thoracotomy, bullae resection and pleurectomy. On the basis of the case reported, the authors consider the different opportunities in the treatment of spontaneous pneumothorax in relation to the present knowledges and technologies. Surgical procedure is to be preferred in case of persistence of pneumothorax despite a pleural drain and in case of pneumothorax in high risk subjects. Even if thoracoscopy seems to give better results regarding postoperative pain, it is not always possible with such a method to perform a careful pleurectomy neither to obtain it in all cases (above all in secondary pneumothorax). Every case must then be carefully studied to choose the best treatment at present available. PMID:11353349

  19. Danish Exports and Danish Bilateral Aid

    DEFF Research Database (Denmark)

    Hansen, Henrik; Rand, John

    Danish bilateral development assistance is aimed at reducing poverty in the partner countries. Even so, bilateral assistance may have secondary, or knock-on, effects, which are beneficial for Denmark. An important secondary effect is the prospect of increased export from Denmark to the partner...... countries. This Evaluation Study presents an econometric analysis of Danish exports to 144 countries over the period from 1981 to 2010. The analysis is based on the gravity model of bilateral trade; a structural model developed over decades and now the central model in analyses of bilateral trade flows...... and trade policies. The main result of the study is that Danish bilateral aid has a positive and statistically significant impact on Danish exports to the recipient countries. Bilateral development assistance may affect exports through several channels. Three of the main channels are direct aid tying...

  20. Evaluation of the Mexico-European Union Free Trade Agreement using a gravity model

    OpenAIRE

    Jordi Bacaria-Colom; María Isabel Osorio-Caballero; Andrés Artal-Tur

    2013-01-01

    The Free Trade Agreement between the European Union and Mexico (EUMFTA) was enforced in 2000, becoming one of the most important transatlantic trade agreements. The goal of this research is to analyze the results of this agreement a decade after the signature. A gravity model is estimated for a sample of 60 countries along the period 1994-2011. The results indicate that such an agreement has given rise to an increase in the bilateral trade flows between these two commercial partners.

  1. New Curious Bilateral q-Series Identities

    Directory of Open Access Journals (Sweden)

    Frédéric Jouhet

    2012-10-01

    Full Text Available By applying a classical method, already employed by Cauchy, to a terminating curious summation by one of the authors, a new curious bilateral q-series identity is derived. We also apply the same method to a quadratic summation by Gessel and Stanton, and to a cubic summation by Gasper, respectively, to derive a bilateral quadratic and a bilateral cubic summation formula.

  2. Bilateral Clavicle Fracture in Two Newborn Infants

    Directory of Open Access Journals (Sweden)

    Esra Arun Ozer

    2011-12-01

    Full Text Available Background: The fracture of clavicle is the most frequently observed bone fracture as birth trauma and it is usually unilateral. It is seen following shoulder dystocia deliveries or breech presentation of macrosomic newborns.Case Presentation: We report two macrosomic newborns with bilateral clavicle fracture and brachial plexus palsy due to birth trauma. Chest X-rays confirmed bilateral fracture of clavicles. Both patients were recovered without any sequel.Conclusion: Bilateral clavicular fracture should be considered in any neonate with bilateral absent Moro reflexes.

  3. Bilateral metachronous breast cancer with bilateral recurrences: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Hyun; Sohn, Yu Mee [Dept. of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Kim, Eun Kyung [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-05-15

    The incidence of bilateral breast cancer has been reported to range from 0.4% to 14%, and it increases gradually as a result of improved early detection capabilities and longer survival times. We report a rare case where the bilateral breast cancers occurred as a metachronous bilateral breast cancer with bilateral recurrences, detected by mammography, and the rapid growth of tumor that manifested as microcalcification and skin thickening within 3 months.

  4. A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

    Directory of Open Access Journals (Sweden)

    Gultekin Gulbahar

    2015-01-01

    Full Text Available First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

  5. Bilateral fracture in atrophic mandible

    Directory of Open Access Journals (Sweden)

    Luciana SIGNORINI

    2006-11-01

    Full Text Available The increase of the elderly population in Brazil has brought a higher number of patients of this age level for dental treatment in several areas of dentistry.Elderly patients are exposed to many kinds of aggressor agents, such as falling down and accidents that cause maxillofacial fractures, which require the specialized assistance of a maxillofacial surgeon. The elderly present a differentiated condition involving systemic changes and use of several drugs that must be taken into consideration when planning the therapeutics ofeach case. The treatment of facial trauma must aim fast recovery along with minimal morbidity. The authors present a case of mandible bilateral fracture in edentulous elderly patient with severe atrophy, treated with titanium plate and screws osteosynthesis. The healing period was satisfactory, without postoperative complications in 18 months follow up.

  6. The Helsinki Agreement

    Science.gov (United States)

    Babel: Journal of the Australian Federation of Modern Language Teachers' Associations, 1977

    1977-01-01

    A reprint of sections of the Helsinki agreement dealing with foreign languages and civilization, and cooperation and exchanges in the field of education. The agreement supports wider knowledge of foreign languages and promotes exchanges, cooperation, lexicography, and specialized programs in adult education. (AMH)

  7. Agreement on African Venture

    Institute of Scientific and Technical Information of China (English)

    LAN XINZHEN

    2010-01-01

    @@ China's biggest aluminum producer Aluminum Corp.China Ltd.(Chalco) signed a binding agreement with the world's second largest mining company,Rio Tinto,on July 29 in Beijing.The agreement will establish a joint venture to develop and operate the Simandou iron ore project in Guinea,Africa.

  8. The Homomorphic Key Agreement

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    There are various challenges that are faced in group communication, so it is necessary to ensure session key. Key agreement is the fundamental cryptographic primitive for establishing a secure communication. It is a process of computing a shared secret contributed by two or more entities such that no single node can predetermine the resulting value. An authenticated key agreement is attained by combining the key agreement protocol with digital signatures. After a brief introduction to existing key agreement in group communication, Making use of the additive-multiplicative homomorphism in the integer ring defined by Sander and Tschudin: A new protocols, called the homomorphism key agreement, was designed, which can be self-contributory, robust, scalable and applicable in group communication.

  9. Marfan's syndrome presenting as bilateral spontaneous pneumothorax.

    OpenAIRE

    Gawkrodger, D J

    1981-01-01

    A case of bilateral spontaneous pneumothorax in a 14-year-old girl with previously undiagnosed Marfan's syndrome is described. The pulmonary abnormalities of Marfan's syndrome are not commonly encountered and bilateral pneumothorax is itself a rare event which, in most instances, has been reported following invasive procedures.

  10. Bilateral failure of adduction following orbital decompression.

    OpenAIRE

    Kinsella, F; Kyle, P.; Stansfield, A

    1990-01-01

    We report a case of bilateral complete failure of adduction following bilateral translid antralethmoidal orbital decompression. We believe the probable mechanism is neuropraxia (temporary dysfunction) of the third cranial nerves' supply to the medial recti, owing to these nerves' occupying an anatomically abnormal position. Partial recovery of adduction occurred over the ensuing six months.

  11. Secondary polycythaemia associated with bilateral renal lymphocoeles.

    OpenAIRE

    Burton, I E; Sambrook, P.; McWilliam, L J

    1994-01-01

    A patient with a 15 year history of secondary polycythaemia due to renal erythropoietin hypersecretion is presented. Subsequent spontaneous development of bilateral renal lymphocoeles, which contained high erythropoietin levels, was shown by computerized tomography. The lymphocoeles were successfully treated by bilateral peritoneal marsupialization. No cause for the persistent polycythaemia or lymphocoeles was found at laparotomy or on renal biopsy.

  12. Simultaneous and spontaneous bilateral quadriceps tendons rupture.

    Science.gov (United States)

    Celik, Evrim Coşkun; Ozbaydar, Mehmet; Ofluoglu, Demet; Demircay, Emre

    2012-07-01

    Simultaneous and spontaneous bilateral quadriceps tendon rupture is an uncommon injury that is usually seen in association with multiple medical conditions and some medications. We report a case of simultaneous and spontaneous bilateral quadriceps tendon rupture that may be related to the long-term use of a statin.

  13. Bilateral spontaneous adrenal haemorrhage complicating acute pancreatitis

    International Nuclear Information System (INIS)

    Bilateral adrenal haemorrhage is an event that mandates prompt diagnosis and treatment to prevent primary adrenocortical insufficiency and potential death. Presentation can be non-specific and incidentally diagnosed with imaging alone, primarily CT. We present a case of acute pancreatitis with spontaneous bilateral adrenal haemorrhage and briefly discuss imaging and treatment implications

  14. Bilateral breast involvement in acute myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Hakeem A, Mandakini BT, Asif K, Firdaus, Shagufta RC

    2013-04-01

    Full Text Available Breast involvement by leukemic infiltration is usually bilateral, but may be unilateral. Clinically patients can present with either single or multiple masses, or with diffuse breast engorgement, with or without nodularity. The affected patients are predominantly young adults. We present a case of an adolescent girl with acute myeloid leukemia having bilateral breast infiltration by leukemic cells.

  15. Concurrent bilateral ectopic pregnancy: a rarity

    Directory of Open Access Journals (Sweden)

    Prabhleen Kaur

    2015-08-01

    Full Text Available Bilateral ectopic pregnancy is a rare twin gestation with only a few cases reported in the literature. We report a 30 year old woman without any high risk factor for ectopic pregnancy, who had concurrent bilateral ectopic pregnancy. A 30 year old female presented to the Gynecology emergency department complaining of vaginal bleeding and abdominal pain. The presumptive diagnosis of ruptured left sided ectopic pregnancy was made on basis of clinical findings and ultrasound finings. An emergency laparotomy was done revealed a hemoperitoneum of 1.5 liters, a ruptured left tubal pregnancy with active bleeding and right tubal un-ruptured ectopic was found. A bilateral salpingectomy was performed. Histopathology confirmed presence of chorionic villi in both tubes. In theory, laparoscopic salpingostomy is the best surgical approach in bilateral tubal pregnancy. However, bilateral salpingectomy may be necessary when both tubes are extensively damaged or are actively bleeding. Successful pregnancies have been reported after conservative surgical treatment of bilateral ectopic, but the risk of recurrence is high. Our decision for an emergency laparotomy followed by bilateral salpingectomy was based on the fact that the patient presented with acute abdomen and was haemodynamically unstable and there was extensive bilateral tubal damage. As the incidence of ectopic pregnancies is increasing concurrently with the incidences of pelvic inflammatory disease and use of assisted fertility techniques; it may be that these and ldquo;rare ectopics and rdquo; will become less uncommon. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1197-1199

  16. Acral osteolysis in bilateral compartment syndrome

    Directory of Open Access Journals (Sweden)

    Iram Saeed

    2008-08-01

    Full Text Available Carpal tunnel syndrome is a common neurological condition with rare yet potentially serious cutaneous and skeletal complications. We present a case of mutilating/ulcerating bilateral carpal tunnel syndrome in a 63 year old female. Radiographs showed symmetrical acral osteolysis in the index and middle fingers distal phalanges bilaterally. Carpal tunnel decompressions provided symptomatic relief.

  17. Simultaneous and spontaneous bilateral quadriceps tendons rupture.

    Science.gov (United States)

    Celik, Evrim Coşkun; Ozbaydar, Mehmet; Ofluoglu, Demet; Demircay, Emre

    2012-07-01

    Simultaneous and spontaneous bilateral quadriceps tendon rupture is an uncommon injury that is usually seen in association with multiple medical conditions and some medications. We report a case of simultaneous and spontaneous bilateral quadriceps tendon rupture that may be related to the long-term use of a statin. PMID:22561379

  18. International Standards: Past Free Trade Agreements and the Prospects in the Transatlantic Trade and Investment Partnership

    OpenAIRE

    Eliasson Leif Johan

    2015-01-01

    The Transatlantic Trade and Investment Partnership represents a strategic vision of transatlantic relations, including job creation, global leadership, and establishing high international standards. This paper discusses how three recent bi-lateral and regional agreements, along with positions adopted in transatlantic negotiations, convey respective side's acceptable parameters, and how international standards are emerging from and disseminated through agreements involving the European Union a...

  19. Participation, public policy-making, and legitimacy in the EU Voluntary Partnership Agreement process

    DEFF Research Database (Denmark)

    Wodschow, Astrid; Nathan, Iben; Cerutti, Paolo

    2016-01-01

    This paper discusses how participatory policy-making processes such as the Voluntary Partnership Agreement (VPA) negotiations are and should be organised to foster political legitimacy and support. The VPAs are bilateral agreements between the European Union (EU) and timber producing countries. V...

  20. Agreements concerning the employment of foreign black labour in South Africa.

    OpenAIRE

    Whiteside, Alan; Patel C

    1985-01-01

    ILO pub. Working paper, comparison of bilateral international agreements concerning black African migrant workers from countries of Southern Africa employed in South Africa R - covers recruitment, labour contracts, workers representation, remittances, tax deduction, administrative aspects of frontier crossing, health insurance, unemployment benefit, irregular migrants, and duration of agreements.

  1. The Guided Bilateral Filter: When the Joint/Cross Bilateral Filter Becomes Robust

    OpenAIRE

    Caraffa, Laurent; Tarel, Jean Philippe; Charbonnier, Pierre

    2015-01-01

    The bilateral filter and its variants such as the Joint/Cross bilateral filter are well known edge-preserving image smoothing tools used in many applications. The reason of this success is its simple definition and the possibility of many adaptations. The bilateral filter is known to be related to robust estimation. This link is lost by the ad hoc introduction of the guide image in the Joint/Cross bilateral filter. We here propose a new way to derive the Joint/Cross bilateral filter as a part...

  2. The DMT's agreements

    International Nuclear Information System (INIS)

    This paper summarizes the numerous collaboration agreements signed by the Department of Mechanics and Technology (DMT) from the Direction of Nuclear Reactors (DRN) of the CEA with foreign research organisms and universities. (J.S.)

  3. Trade Agreements PTI

    Data.gov (United States)

    Department of Homeland Security — The objective of the Trade Agreements PTI is to advance CBP’s mission by working with internal and external stakeholders to facilitate legitimate trade and address...

  4. Service level agreements.

    Science.gov (United States)

    Grimwood, A

    1998-02-01

    Service level agreements provide clearer descriptions of the services to be provided and the objectives to be met. In many instances it is the first time that services have been defined allowing their performance to be suitably measured. They should be output based and not too prescriptive on how the services are to be delivered. The emphasis should be on establishing outputs and the arrangements for monitoring achievement. Customer expectations can exceed available resources and arbitration may become necessary if agreement cannot be reached on internal service level agreements. The main requirements of customers for change through service level agreements is usually improved communications on job status that includes notification of any delays and that agreed response times will be met.

  5. International Fisheries Agreements

    DEFF Research Database (Denmark)

    Pintassilgo, Pedro; Kronbak, Lone Grønbæk; Lindroos, Marko

    2015-01-01

    This paper surveys the application of game theory to the economic analysis of international fisheries agreements. The relevance of this study comes not only from the existence of a vast literature on the topic but especially from the specific features of these agreements. The emphasis of the survey...... is on coalition games, an approach that has become prominent in the fisheries economics literature over the last decade. It is shown that coalition games were first applied to international fisheries agreements in the late 1990s addressing cooperative issues under the framework of characteristic function games...... and stability of international fisheries agreements. A key message that emerges from this literature strand is that self-enforcing cooperative management of internationally shared fish stocks is generally difficult to achieve. Hence, the international legal framework and regulations play a decisive role...

  6. The EU-China Partnership on Climat Change: Bilateralism Begetting Multilateralism in Promoting a Climate Change Regime?

    OpenAIRE

    Romano, Giulia

    2010-01-01

    On 5 September 2005, during the 8th EU-China Summit held in Beijing, the European Union and China signed an agreement to establish a bilateral Partnership on Climate Change. The two parties pledged to strengthen the dialogue on climate change policies, exchange views on key issues in climate change negotiations and develop concrete action to tackle climate change by carrying out specific cooperative projects. By presenting an analysis of the outcomes of this bilateral initiativ...

  7. AGREEMENTS CONCLUDED ELECTRONICALLY

    OpenAIRE

    Paul Popovici, József-Attila Forró

    2010-01-01

    The internet is not merely a means of communication but also an important instrument in operating commercial relations. The agreements concluded electronically have as legal frame the law nr. 365/2002 on electronic commerce. The present article outlines the main discussions generated by this type of agreements: pre-contractual obligation of information, time of conclusion, the relative nullity of contracts concluded by electronic means, the right to unilateral withdrawal of contract, long-dis...

  8. Free Trade in Airline Services: Assessing the Proposals to Liberalize the Canada – U.S. Air Transport Bilateral

    OpenAIRE

    Gillen, David W.; Hansen, Mark; Ramos, Robson

    1990-01-01

    In this paper we examine the consequences of changes to the bilateral agreement which regulates air transport between Canada and the United States. A hubbing competition model based on an n-player non-cooperative game is used to simulate six alternative bilateral scenarios including the current positions of Canada and the U.S.. We find that changes to the bilateral does not have a significant effect on the total amount of traffic but it does effect the distribution of traffic between countrie...

  9. Bilateral panophthalmitis in dengue fever

    Directory of Open Access Journals (Sweden)

    Sangeetha Sriram

    2015-01-01

    Full Text Available We report the case of a 25-year-old male patient who presented with bilateral panophthalmitis as the initial ocular manifestation of dengue fever. The diagnosis was a little confusing as he initially presented with features suggestive of retrobulbar hemorrhage secondary to his very low platelet count, which is a common feature of dengue fever. Ophthalmic complications are usually seen in young adults who often present at the nadir of thrombocytopenia. Ocular findings may include anterior uveitis, vitritis, retinal hemorrhages, retinal vascular sheathing, yellow subretinal dots, retinal pigment epithelium (RPE mottling, foveolitis that is clinically seen as a round subretinal yellowish lesion at the fovea, retinochoroiditis, choroidal effusion, optic disc swelling, optic neuritis, neuroretinitis, and oculomotor nerve palsy. [1] There is only one reported case of unilateral endogenous panophthalmitis due to dengue fever. Hence, clinicians and ophthalmologists have to be aware of this vision-threatening complication of dengue for early recognition and prompt treatment to save the vision of these young patients and prevent morbidity.

  10. Bilateral inferior petrosal sinus sampling

    Science.gov (United States)

    Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo

    2016-01-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing’s syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88–100% and 67–100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50–70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. PMID:27352844

  11. [True hermaphroditism with bilateral ovotestis].

    Science.gov (United States)

    Güitrón, A; Forsbach, G; González, J M; Garza, J G; Vázquez, J; Espinoza, G

    1998-01-01

    A nineteen years old woman with ambiguous external genitalia was studied. This condition had been previously identified as a newborn, but her parents refused medical attention and it was reared as a girl. At 12-years, she began spontaneous mammary development, appearing pubic and axillary hair, and clitoral enlargement. The menarche occurred at 15-years and it was followed by irregular periods. Physical examination, showed absence of hirsutism and acne, normal mammary development equivalent to grade V of Tanner. The external genitalia showed fused labio-scrotal folds with an small introitus. The urethral meatus was absent and was later located inside the introitus. There was a big phallus similar to an adult penis with a normal glans, flexed by a chordee. Hormonal determinations discarded congenital adrenal hyperplasia. The karyotype was 46,XX and testosterone levels were in adult male range. Pelvic ultrasonography disclosed a normal uterus and both gonads in confirmed by laparoscopy identifying bilateral ovotestis. Testicular tissue was removed and plastic reconstruction of female genitals was done. PMID:9528217

  12. Bilateral inferior petrosal sinus sampling.

    Science.gov (United States)

    Zampetti, Benedetta; Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo; Loli, Paola

    2016-07-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing's syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88-100% and 67-100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50-70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. PMID:27352844

  13. Bilateral inferior petrosal sinus sampling

    Directory of Open Access Journals (Sweden)

    Benedetta Zampetti

    2016-08-01

    Full Text Available Simultaneous bilateral inferior petrosal sinus sampling (BIPSS plays a crucial role in the diagnostic work-up of Cushing’s syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88–100% and 67–100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50–70% makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres.

  14. Bilateral Petit’s Triangle Hernia

    Directory of Open Access Journals (Sweden)

    Sanjay Kumar Bhasin, Arshad Bashir Khan, Sanjay Sharma

    2006-07-01

    Full Text Available Lumbar traingle hernia that occurs through lumbar triangles is very rare type of hernia. Only about 300 cases havebeen reported till date. Bilateral Petit’s triangle hernia find further rarity and the case under reference is probably thefirst ever reported case of Primary bilateral Petit’s triangle hernia. The present case is of a 46 years old married,multigravida female who presented with 1 year duration of LBA and subsequently notice of swelling both sides oflow back. FNAC revealed lipoma and on exploration it turned out to be rarest extra peritoneal bilateral Petit’s trianglehernia, fat as contents.

  15. The economic impact of the Australia-United States free trade agreement

    OpenAIRE

    Shiro Armstrong

    2015-01-01

    The Australia–United States free trade agreement (AUSFTA) came into effect in 2005. It was the second preferential trade agreement that Australia signed, after its agreement with Singapore, and marked a departure from the primacy of Australia’s previous trade policy of unilateral and multilateral trade liberalisation towards preferential liberalisation. This paper assesses the economic effects of AUSFTA by applying the Productivity Commission’s gravity model of trade from its Bilateral ...

  16. Can Trade Agreements Curtail Trade Creation and Prevent Trade Diversion

    OpenAIRE

    Juyoung Cheong; Do Won Kwak; Kam Ki Tang

    2014-01-01

    Despite recent theoretical literature highlighting the cross effects between preferential trade agreements (PTAs), like the domino effect and the competitive liberalization theory, little has been done to quantify their impact on bilateral trade flows. This paper investigates how preexisting PTAs dilute (shield) the trade creation (diversion) effect of new PTAs. Countries having pre-existing PTAs enjoy smaller gains in intra-bloc trade because of the dilution effect, and experience smaller lo...

  17. Impact of Free Trade Agreements on the Colombian Beef Sector

    OpenAIRE

    Gomez, Miguel I.; Frank, Julieta; Parra, Tatiana

    2010-01-01

    Colombia negotiated bilateral Trade Agreements (TAs) with the United States and with the MERCOSUR region (Argentina, Brazil, Paraguay, and Uruguay). Colombian cattle and beef interest groups argue that TAs hurt the local beef supply chain. We employ a partial equilibrium framework to assess the impact of these TAs on the welfare of cattle producers, beef marketers and meat consumers in Colombia. Our results suggest that with free imports of chicken parts from the U.S, beef consumption and ret...

  18. Bilateral areolar and periareolar pityriasis versicolor.

    Science.gov (United States)

    Sárdy, Miklós; Korting, Hans Christian; Ruzicka, Thomas; Wolff, Hans

    2010-08-01

    An adolescent boy presented with isolated, symmetrical, bilateral areolar and periareolar pityriasis versicolor. This extremely rare condition should be considered in the differential diagnosis of light brown patches on the areolae.

  19. FLOWING BILATERAL FILTER: DEFINITION AND IMPLEMENTATIONS

    Directory of Open Access Journals (Sweden)

    Maxime Moreaud

    2015-06-01

    Full Text Available The bilateral filter plays a key role in image processing applications due to its intuitive parameterization and its high quality filter result, smoothing homogeneous regions while preserving the edges of the objects. Considering the image as a topological relief, seeing pixel intensities as peaks and valleys, we introduce a way to control the tonal weighting coefficients, the flowing bilateral filter, reducing "halo" artifacts typically produced by the regular bilateral filter around a large peak surrounded by two valleys of lower values. In this paper we propose to investigate exact and approximated versions of CPU and parallel GPU (Graphical Processing Unit based implementations of the regular and flowing bilateral filter using the NVidia CUDA API. Fast implementations of these filters are important for the processing of large 3D volumes up to several GB acquired by x-ray or electron tomography.

  20. An unusual cause of bilateral diaphragmatic paralysis.

    OpenAIRE

    Pandit, A; Kalra, S.; Woodcock, A

    1992-01-01

    In a patient who had a sudden onset of bilateral diaphragmatic paralysis after forceful neck manipulation complete, though gradual, recovery in lung function and transdiaphragmatic pressures was seen over three years. This is a previously unrecognised risk of neck osteopathy.

  1. Sequential presentation of bilateral Brown syndrome.

    Science.gov (United States)

    Sekeroğlu, Hande Taylan; Türkçüoğlu, Peykan; Sanaç, Ali Şefik; Sener, Emin Cumhur

    2012-04-01

    Brown syndrome, characterized by a limitation of elevation in adduction and positive forced duction testing, is usually unilateral but occurs bilaterally in 10% of all cases. It may present as a congenital condition in one eye and develop in the other eye with no apparent cause. We present a case of bilateral Brown syndrome in which the right eye became involved within 1 year of surgery on the left eye for congenital Brown syndrome.

  2. Bilateral synchronous plasmacytoma of the testis.

    Science.gov (United States)

    Narayanan, Geetha; Joseph, Rona; Soman, Lali V

    2016-04-01

    Extramedullary plasmacytoma (EMP) is usually seen in the head and neck regions and in the upper respiratory, gastrointestinal, and central nervous systems. Testis is a rare site for EMP, and bilateral synchronous testicular plasmacytoma occurring as an isolated event at initial presentation has been reported only once previously. We present herein the second such report in a 70-year-old man who underwent bilateral orchidectomy. PMID:27034568

  3. Bilateral anophthalmia with septo-optic dysplasia

    Directory of Open Access Journals (Sweden)

    Manisha Jana

    2010-01-01

    Full Text Available Bilateral anophthalmia is a rare entity and association with septo-optic dysplasia is an even rare condition. The condition is characterized by absent eyeballs in the presence of eyelids, conjunctiva or lacrimal apparatus. Though anophthalmia can be diagnosed clinically, imaging plays a crucial role in delineating the associated anomalies. In addition, often clinical anophthalmia may prove to be severe microphthalmia on imaging. We describe the imaging findings in an infant with bilateral anophthalmia and septo-optic dysplasia.

  4. MODERN VIEWS ON BILATERAL BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Ye. A. Fesik

    2014-01-01

    Full Text Available Presented modern literature data on the features of the pathogenesis, course, clinical and morphological expression and tumor characteristics, parameters and nodal metastasis of hematogenous bilateral breast cancer. Highlight the results of domestic and foreign studies in recent years to determine the prognostic factors and recurrence of synchronous and metachronous bilateral breast cancer. It was revealed that the frequency of bilateral breast tumor lesions varies widely, ranging from 0.1 to 20%, with metachronous tumors recorded significantly higher (69.6% than the synchronous (22.7%. The probability of occurrence of metachronous breast cancer is higher in women with a family history, as well as if they have a gene mutation BRCA-1. Found that the most common histological type of breast tumor with bilateral lesions is invasive ductal. However, the incidence of invasive lobular cancer and non-invasive lobular cancer is slightly higher among synchronous bilateral cancer compared with unilateral disease. Studies have shown that in a double-sided synchronous breast cancer tumor, as a rule, has a lower degree of differentiation, and the higher the expression level of estrogen receptors and progesterone receptors. Relevance of the issue because the identification of patterns in the study of lymphatic and hematogenous features bilateral metastasis of mammary tumors provides a basis for speculation about the differences in the progression of neoplastic disease in these groups and is a cause for further detailed research in this area to identify and evaluate the prognosis and also the choice of tactics of such patients.

  5. Bilateral Keratectasia 34 Years after Corneal Transplant

    Directory of Open Access Journals (Sweden)

    Xavier Valldeperas

    2010-07-01

    Full Text Available We report the clinical findings of a patient with severe bilateral keratectasia 34 years after a penetrating keratoplasty (PK in both eyes. An otherwise healthy 67-year-old man complained of deterioration of the eyesight in both eyes over the last 6 months. The patient was diagnosed with bilateral keratoconus at the age of 32 years, and he underwent a bilateral PK. At presentation, visual acuity was 20/200 in the right eye and light perception in the left eye. A Pentacam pachymetric map revealed a central pachymetry of 720 µm in the right eye and of 710 µm in the left eye, as well as an average paracentral pachymetry of 436 and 270 µm in the 9-mm zone in the right and the left eye, respectively. Corneal topography revealed bilateral irregular and asymmetric bowing with generalized steepening and high corneal power. We describe a case of bilateral keratectasia 34 years after PK in a patient who was originally diagnosed with bilateral keratoconus.

  6. Agreement on African Venture

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Mining giant Rio Tinto and Chinese aluminum company Chalco say they are committed to an iron ore project in Guinea china’s biggest aluminum producer Aluminum Corp. China Ltd.(Chalco) signed a binding agreement with the world’s second largest mining company,Rio Tinto,on July 29 in Beijing.

  7. The Sicomines Agreement

    DEFF Research Database (Denmark)

    Jansson, Johanna

    of the global political economy have shifted, and that China’s position as a foreign policy actor is now consolidated. Continuity, since the 2009 amendment of the agreement, which came about partly as a result of China’s ambitions to take up an active role in the International Monetary Fund (IMF...

  8. Contract agreements via logic

    Directory of Open Access Journals (Sweden)

    Massimo Bartoletti

    2013-10-01

    Full Text Available We relate two contract models: one based on event structures and game theory, and the other one based on logic. In particular, we show that the notions of agreement and winning strategies in the game-theoretic model are related to that of provability in the logical model.

  9. Features and Agreement

    CERN Document Server

    Bayer, S; Bayer, Sam; Johnson, Mark

    1995-01-01

    This paper compares the consistency-based account of agreement phenomena in `unification-based' grammars with an implication-based account based on a simple feature extension to Lambek Categorial Grammar (LCG). We show that the LCG treatment accounts for constructions that have been recognized as problematic for `unification-based' treatments.

  10. WTO oversight over bilateral agreements: from a notification to an examination process?

    DEFF Research Database (Denmark)

    Mortensen, Jens Ladefoged

    2014-01-01

    . This contribution asks how the WTO can fulfill its task of ensuring that FTAs do not systematically undermine the multilateral trading order. It focuses on the issue of transparency in the current oversight process and discusses whether the WTO secretariat should be granted a stronger mandate to proactively...

  11. Bilateral agenesis of the anterior cruciate ligament: MRI evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Bedoya, Maria A.; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Radiology Department, Philadelphia, PA (United States); McGraw, Michael H. [Hospitalof theUniversityof Pennsylvania, Divisionof Orthopaedics, Philadelphia, PA (United States); Wells, Lawrence [The Children' s Hospital of Philadelphia, Division of Orthopaedics, Philadelphia, PA (United States)

    2014-09-15

    Bilateral agenesis of the anterior cruciate ligament (ACL) is extremely rare. We describe a 13-year-old girl who presented with bilateral knee pain without history of trauma; she has two family members with knee instability. Magnetic resonance imaging showed bilateral absence of the ACL, and medial posterior horn meniscal tears. Bilateral arthroscopic partial meniscectomy and anterior cruciate ligament reconstruction was performed. (orig.)

  12. Bilateral ovarian cystic teratomata mimicking bilateral pure ovarian hemangiomata: case report.

    Science.gov (United States)

    Feuerstein, I M; Aronson, B L; McCarthy, E F

    1984-01-01

    This report describes a case of bilateral, benign cystic ovarian teratomata which were composed predominantly of cavernous hemangiomatous elements. The right-sided lesion, in particular, mimicked a pure ovarian hemangioma. The clinical presentation, bilaterality of the lesions, the sizes of the hemangiomata, and the subsequent hemangioma of the leg are all of interest in this very rare lesion. PMID:6511164

  13. Bilateral electric energy contracts: return and risk

    Energy Technology Data Exchange (ETDEWEB)

    Gunn, Laura K.; Silva, Elisa B.; Correia, Paulo B. [State University of Campinas (UNICAMP), SP (Brazil). College of Mechanical Engineering

    2009-07-01

    In Brazil electricity is traded through three segments: the spot market that balances offer and demand, with prices calculated by a cost-based computational model; the regulated market , where prices are settled in public auctions, and the free market for bilateral contracts. As spot and regulated market prices are public information, a seller is able to calculate his opportunity price to trade a bilateral contract in the free market by using the non-arbitrage principle. Thus, the seller searches the price of a bilateral contract in the free market that balances his/her revenues with the value expected in case it were negotiated in the regulated and the spot market. Besides the expected revenue, the seller may also consider the CVaR to measure the risk of her/his bilateral contract in the free market. So this paper develops a binomial lattice approach to price bilateral contracts in the free market, considering the seller's opportunity of negotiations in both regulated and spot markets, and measuring the contract risk directly. (author)

  14. Chronic Bilateral Tibial Stress Fractures with Valgus Treated with Bilateral Intramedullary Nailing: A Case Report

    Directory of Open Access Journals (Sweden)

    Steven K Dailey

    2014-01-01

    Full Text Available Introduction: Stress fractures are overuse injuries most commonly seen in athletes, military recruits, and individuals with endocrine abnormalities. It has been demonstrated that chronic cases of anterior tibial stress fractures refractory to conservative management respond well to intramedullary nailing. To our knowledge, only one report has been published concerning patients with bilateral tibial stress fractures treated with bilateral intramedullary nailing. All patients in the series were high-level athletes. We present the case of a non-athletic patient with chronic bilateral tibial stress fractures and associated deformity successfully treated with bilateral intramedullary nails. Case Report: A 23-year-old Caucasian female full-time student presented with chronic bilateral shin pain for approximately five years. She had failed an extensive regimen of conservative management. She was diagnosed with chronic bilateral tibial stress fractures based on history, physical examination, and radiologic findings. She subsequently underwent sequential intramedullary nailing of her tibiae. Both tibiae were in valgus alignment; however, this did not preclude nail placement. The nails deformed upon insertion into the sclerotic canals to conform to the deformation. Post operatively the tibiae united and patient was relieved of her symptoms. Conclusion: Bilateral intramedullary nailing of chronic bilateral tibial stress fractures should be considered as a treatment option for all patients, not just high-level athletes, who fail a trial of conservative management. Additionally, mild to moderate tibial malalignment does not necessarily preclude tibial nailing as the smaller nails placed in sclerotic canals will likely deform on insertion and conform to the canal. Keywords: Bilateral intramedullary nailing, bilateral tibial stress fractures, valgus

  15. Prognosis of synchronous bilateral breast cancer

    DEFF Research Database (Denmark)

    Holm, Marianne; Tjønneland, Anne; Balslev, Eva;

    2014-01-01

    Currently, no consistent evidence-based guidelines for the management of synchronous bilateral breast cancer (SBBC) exist and it is uncertain how presenting with SBBC affects patients' prognosis. We conducted a review of studies analyzing the association between SBBC and prognosis. The studies...... that reported adjusted effect measures were included in meta-analyses of effect of bilaterality on breast cancer mortality. From 57 initially identified records 17 studies from 11 different countries including 8,050 SBBC patients were included. The quality of the studies varied but was generally low with small...... sample sizes, and lack of consistent, detailed histo-pathological information. When doing meta-analysis on the subgroup of studies that provided adjusted effect estimates on breast cancer mortality (nine studies including 3,631 SBBC cases), we found that bilaterality in itself had a negative impact...

  16. Bilateral Sequential Pneumolabyrinth Resulting from Nose Blowing.

    Science.gov (United States)

    Lee, Joong Seob; Kwon, Sae Young; Kim, Ji Heui; Kim, Hyung-Jong

    2015-12-01

    Pneumolabyrinth describes a condition with entrapped air in the labyrinth and usually occurs in temporal bone fractures that involve the otic capsule. While sporadic cases of bilateral pneumolabyrinth have been reported, cases lacking head trauma are very rare. We report the case of a 43-year-old man who had sudden hearing loss bilaterally after blowing his nose at an interval of 1 year. Although conservative management for the right ear and exploratory tympanotomy with sealing of the possible site of perilymphatic leakage in the left ear were performed, hearing outcome was poor in both ears. To our knowledge, this is the first case of bilateral pneumolabyrinth occurring as a result of nose blowing. PMID:26771019

  17. Langerhans Cell Histiocytosis in Bilateral Mastoid Cavity

    Directory of Open Access Journals (Sweden)

    Kazım Bozdemir

    2013-01-01

    Full Text Available A 39-year-old male was admitted to our clinic with symptoms of headache, dizziness, nausea, otalgia, otorrhea, tinnitus, and hearing loss in both ears for 3 weeks. Physical examination revealed edema in the tympanic membrane and external ear canal, and pain by palpation in the mastoid area bilaterally. There was no nystagmus, and the rest of the physical examination was otherwise normal. Temporal bone high resolution computed tomography (CT showed a lesion causing erosion in the mastoid cortex, tegmen tympani, ossicles, and in the bone covering the sigmoid sinus bilaterally. There was also erosion in the superior semicircular canal and petrous bone on the left side. Cortical mastoidectomy was performed under general anesthesia. Histopathologic examination of the tissue revealed Langerhans cell histiocytosis (LCH. In this paper a case with LCH, presenting with bilateral mastoid involvement which has been rarely reported in the literature, is discussed with the existing literature.

  18. Congenital bilateral perisylvian syndrome with hydrocephalus

    Directory of Open Access Journals (Sweden)

    Salih Hattapoğlu

    2012-12-01

    Full Text Available Congenital bilateral perisylvian syndrome (CBPS, whichis seen by indications of mental retardasyon, epilepsi,speech disorder and pseudobulbar palsy, is a diseasewhich comes up with genetic and non-genetic reasons.Revealing characteristic indications (like polymicrogyriawith MR imaging and clinic indications contributes makingdiagnosis. In present paper, we aimed to present 18month girl case report who diagnosed as CBPS with hydrocephaliindication. J Clin Exp Invest 2012; 3(4: 552-554Key words: Epilepsy, congenital bilateral perisylviansyndrome, polymicrogyria, hydrocephalus, pseudobulbarpalsy

  19. [Bilateral choroidal osteoma--a case report].

    Science.gov (United States)

    Jędrychowska-Jamborska, Justyna; Kulig-Stochmal, Agnieszka; Markiewicz, Anna; Jakubowska, Barbara; Romanowska-Dixon, Bożena

    2014-01-01

    Choroidal osteoma is a an extremely rare (especially located bilaterally), benign, intraocular tumor, the type of choristoma. It occurs between 2-3 decades of life, women are particularly vulnerable. The main complication in 1/3 cases is a subretinal neovascularization which may cause bleeding. The gradually progressive decalcification develops within the tumour over time, which causes atrophy of the retinal pigment epithelium and Bruch's membrane deformity. The article presents a case of a 26-year-old woman with bilateral choroidal osteoma complicated by subretinal hemorrhage; the diagnosis was based on clinical examination (biomicroscopy and indirect ophthalmoscopy) as well as specialised tests including: ultrasonography, optical coherence tomography, and fluorescein angiography.

  20. Bilateral hypertrophic olivary degeneration in Wilson disease

    Energy Technology Data Exchange (ETDEWEB)

    Otto, Josephin; Guenther, Pete; Hoffmann, Karl Titus [Leipzig University Hospital, Leipzig (Greece)

    2013-04-15

    Hypertrophic olivary degeneration resulting from lesions of the dento-rubro-olivary pathway, also called Guillain-Mollaret-triangle, has been described previously in a number of cases. Reports about bilateral hypertrophic olivary degeneration of the inferior olivary nuclei are very limited, and the magnetic resonance imaging findings of hypertrophic olivary degeneration in Wilson disease have not yet been described to the best of our knowledge. Herein, we present the first report of bilateral hypertrophic olivary degeneration diagnosed by magnetic resonance imaging in a patient suffering from Wilson disease.

  1. Interictal SPECT in the pre surgical evaluation in epileptic patients with normal MRI or bilateral mesial temporal sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Marques, Lucia H.N. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil). Dept. de Neurologia. Centro Cirurgico de Epilepsia; Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil); Ferraz-Filho, Jose R.L. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil); Lins-Filho, Mario L.M. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil). Dept. de Radiologia; Maciel, Marina G.; Yoshitake, Rafael; Filetti, Sarah V. [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil)

    2009-07-01

    The aim of this study was to evaluate the sensitivity of interictal compared to ictal SPECT in the lateralization of the epileptogenic focus in refractory temporal lobe epilepsy (TLE) patients that present with normal magnetic resonance imaging (MRI) or bilateral mesial temporal sclerosis (MTS). Thirty patients with TLE, for whom MRI examinations were normal or who presented with bilateral MTS, were retrospectively studied. Using a confidence interval of 95% and a level of significance for p-value <0.05, an estimated agreement rate of 73% with a minimum agreement rate of 57% was calculated comparing interictal and ictal SPECTs. In conclusion the interictal SPECT is only useful when associated with the ictal SPECT and does not substitute it in the localization of epileptogenic areas in patients with normal MRI or bilateral MTS. (author)

  2. Analysis and models of bilateral investment treaties using a social networks approach

    Science.gov (United States)

    Saban, Daniela; Bonomo, Flavia; Stier-Moses, Nicolás E.

    2010-09-01

    Bilateral investment treaties (BITs) are agreements between two countries for the reciprocal encouragement, promotion and protection of investments in each other’s territories by companies based in either country. Germany and Pakistan signed the first BIT in 1959 and since then, BITs are one of the most popular and widespread form of international agreement. In this work we study the proliferation of BITs using a social networks approach. We propose a network growth model that dynamically replicates the empirical topological characteristics of the BIT network.

  3. Bilateral Diabetic Papillopathy and Metabolic Control

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Lund-Andersen, Henrik; Sander, Birgit;

    2010-01-01

    patient-years of observation, bilateral diabetic papillopathy developed in 5 patients. During the year preceding this incident, all 5 patients had experienced a decrease in glycosylated hemoglobin A(1c) (HbA(1C)) at a maximum rate of -2.5 (mean) percentage points per quarter year, which was significantly...

  4. Bilateral breast cancer : mammographic and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Kyung; Oh, Ki Keun; Jun, Hwang Yoon; Lee, Byung Chan; Lee, Kyong Sik; Lee, Yong Hee [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-06-01

    To evaluate the mammographic and clinical features of bilateral breast cancer. We retrospectively reviewed clinical records(n=23) and mammograms (n=15) of 23 patients with bilateral breast cancer. Patients' age, location of the tumor and pathologic staging were determined from clinical records. Mammographic features were classified as spiculated mass, nonspiculated mass, mass with microcalcification, microcalcification only, asymmetric density, and normal. Of the 23 cases of bilateral breast cancer, 8(34.8%) were synchronous and 15(65.2%) were metachronous. Age at diagnosis of cancer in the first breast was between 27 and 59(mean 43) years ; there was no statistically significant difference in mean age between patients with synchronous and metachronous cancer. The mean interval between the diagnosis of each lesion of the metachronous pairs was 9.1 years. In 11 of 23 cases(48%), tumors were locaated in the same quadrant, and in the other 12 cases(52%), they were in different quadrant. At mammography, five of 15 metachronous cancers(33%) were similar in appearance and 10 pairs(67%) were different. In 4 of 23 cases(17%), cancer in the first breast was at stage 0 and stage 1, and in 13 of 23(57%), cancer in the second breast was at this same stage. In bilateral breast cancer, the two breasts frequently show different mammographic features. Cancer of the second breast was at an early stage; this suggest that regular examination and mammography are important and can allow early detection of contralateral breast cancer.

  5. Occipital seizures presenting with bilateral visual loss

    OpenAIRE

    Hadjikoutis S; Sawhney I

    2003-01-01

    Transient visual loss may occur with occipital seizures as an ictal or post-ictal phenomenon. Its duration varies from less than one minute to days, or can be permanent. We describe a 61-year-old man presenting with headache, vomiting and bilateral visual loss. EEG revealed persistent spike discharge in the occipital lobes suggesting occipital seizures. His vision improved with carbamazepine.

  6. Simulations of bilateral energy markets using MATLAB

    International Nuclear Information System (INIS)

    This paper presents simulation results of energy bilateral markets using MATLAB/SIMULINK. The algorithm for congestion management and transmission pricing is implemented by means of DC load flow. The simulation results show how elasticity of market participants to transmission usage charges can affect the overall network usage and its cost. (Author)

  7. Bilateral eyelid edema : Cutis laxa or blepharochalasis?

    NARCIS (Netherlands)

    Braakenburg, A; Nicolai, JPA

    2000-01-01

    A 59-year-old woman with massive bilateral edema of the upper and lower eyelids is presented. The edema occurred suddenly and without provocation. No cause could be identified despite a multitude of examinations. Initially the patient was diagnosed as having blepharochalasis, but later skin biopsy s

  8. A Bilateral Traumatic Hip Obturator Dislocation

    Science.gov (United States)

    Karaarslan, Ahmet Adnan; Acar, Nihat; Karci, Tolga; Sesli, Erhan

    2016-01-01

    A case of a bilateral simultaneous traumatic obturator dislocation of both hip joints in an 18-year-old young man following a traffic accident is presented. We reduced the dislocated femoral heads immediately under general anesthesia followed by passive and active exercises and early full-weight bearing mobilization. After 5 years, the result was excellent. PMID:26977327

  9. Bilateral synchronous rupture of the quadriceps tendon.

    LENUS (Irish Health Repository)

    Ellanti, P

    2012-09-01

    Bilateral simultaneous rupture of the quadriceps tendon is a rare entity. They are often associated with degenerative changes of the tendons and predisposing conditions such as diabetes or excessive steroid use. They most commonly tend to occur in patients of 40 years of age or older.

  10. Fast and Provably Accurate Bilateral Filtering.

    Science.gov (United States)

    Chaudhury, Kunal N; Dabhade, Swapnil D

    2016-06-01

    The bilateral filter is a non-linear filter that uses a range filter along with a spatial filter to perform edge-preserving smoothing of images. A direct computation of the bilateral filter requires O(S) operations per pixel, where S is the size of the support of the spatial filter. In this paper, we present a fast and provably accurate algorithm for approximating the bilateral filter when the range kernel is Gaussian. In particular, for box and Gaussian spatial filters, the proposed algorithm can cut down the complexity to O(1) per pixel for any arbitrary S . The algorithm has a simple implementation involving N+1 spatial filterings, where N is the approximation order. We give a detailed analysis of the filtering accuracy that can be achieved by the proposed approximation in relation to the target bilateral filter. This allows us to estimate the order N required to obtain a given accuracy. We also present comprehensive numerical results to demonstrate that the proposed algorithm is competitive with the state-of-the-art methods in terms of speed and accuracy. PMID:27093722

  11. Bilateral segmental neurofibromatosis diagnosed during pregnancy.

    Science.gov (United States)

    Maldonado Cid, P; Sendagorta Cudós, E; Noguera Morel, L; Beato Merino, M J

    2011-01-01

    Bilateral segmental neurofibromatosis is a rare subtype of neurofibromatosis type 1 defined by lesions affecting a single segment of the body and crossing the midline, with no systemic involvement. We present a case diagnosed during pregnancy because of the characteristic increase in size of the lesions during this period. PMID:21635828

  12. [Congenital lumbar hernia and bilateral renal agenesis].

    Science.gov (United States)

    Barrero Candau, R; Garrido Morales, M

    2007-04-01

    We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia.

  13. Synchronous bilateral breast cancer in a male

    OpenAIRE

    Rubio Hernández, María Caridad; Díaz Prado, Yenia Ivet; Pérez, Suanly Rodríguez; Díaz, Ronald Rodríguez; Aleaga, Zaili Gutiérrez

    2013-01-01

    Male breast cancer, which represents only 1% of all breast cancers, is occasionally associated with a family history of breast cancer. Sporadic male breast cancers presenting with another primary breast cancer are extremely rare. In this article, we report on a 70-year-old male patient with bilateral multifocal and synchronous breast cancer and without a family history of breast cancer.

  14. Bilateral renal agenesis in an alpaca cria

    OpenAIRE

    Poulsen, Keith P; Gerard, Mathew P.; Spaulding, Kathy A.; Geissler, Kyleigh A.; Anderson, Kevin L.

    2006-01-01

    A 3-day-old male alpaca cria was presented for lack of vigor and failure to urinate since birth. Based on the history, laboratory data, ultrasonographs, surgical findings, and postmortem examination, the cria was diagnosed with bilateral renal agenesis and hypoplastic bladder, a congenital condition rarely seen in veterinary medicine.

  15. Bilateral Facial Nerve Palsy: A Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Sohil Pothiawala

    2012-01-01

    Conclusion. We reinforce the importance of considering the range of differential diagnosis in all cases presenting with bilateral FNP. These patients warrant admission and prompt laboratory and radiological investigation for evaluation of the underlying cause and specific further management as relevant.

  16. "Ostrich sign" indicates bilateral vertebral artery dissection.

    Science.gov (United States)

    Rose, David Z; Husain, M Rizwan

    2012-11-01

    Vertebral artery dissections (VADs) comprise about 2% of ischemic strokes and can be associated with trauma, chiropractic manipulation, motor vehicle collisions, whiplash, amusement park rides, golfing, and other motion-induced injuries to the neck. We present a case of bilateral extracranial VAD as a complication of conducting an orchestra. To our knowledge, this has not been documented in the literature. Conceivably, vigorous neck twisting in an inexperienced, amateur conductor may place excessive rotational forces upon mobile portions of the verterbral arteries, tear the intima, deposit subintimal blood that extends longitudinally, and cause neck pain and/or posterior fossa ischemic symptoms. Magnetic resonance angiography examinations of axially oriented slices of bilateral VADs resemble the face of an ostrich. This observation is similar to the "puppy sign," in which bilateral internal carotid artery dissections resemble the face of a dog. Craniocervical dissections of either the carotid or vertebral arteries have the potential to form an aneurysm, cause artery-to-artery embolism, or completely occlude the parent artery, resulting in an ischemic stroke. Because bilateral VADs in axial magnetic resonance angiographic sections stand out like the eyes of an ostrich, and because the fast identification of VADs is so critical, we eponymize this image the "ostrich sign."

  17. Severe Hyperkalemia and Bilateral Adrenal Metastasis

    Directory of Open Access Journals (Sweden)

    Michael Nagler

    2009-01-01

    Full Text Available Adrenal metastases are a common finding in metastatic lung and breast cancer. Often there are no clinical symptoms suggesting them. In this paper, we present a case of a 66-year-old man with metastatic lung cancer suffering from severe hyperkaliemia due to hypoaldosteronism as a result of bilateral adrenal metastasis.

  18. Bilateral carpal tunnel syndrome in Graves' disease.

    Science.gov (United States)

    Manganelli, P; Pavesi, G; Salaffi, F

    1987-01-01

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

  19. Laparoscopic total extraperitoneal repair of preoperatively diagnosed bilateral obturator and incidental bilateral femoral herniae.

    Science.gov (United States)

    Malik, Muhammad Usman; Connelly, Tara M; Hamid, Mustafa; Pretorius, Frederik

    2016-01-01

    Obturator hernia (OH), a rare type of hernia, is associated with high morbidity and mortality. Diagnosis is often delayed as clinical symptoms are typically non-specific. OH is frequently associated with other occult inguinopelvic herniae. Early diagnosis is vital to decrease morbidity and mortality. We report the case of a 75-year-old woman who presented to the surgical outpatients' department with non-specific bilateral groin pain radiating to the thighs. CT of the pelvis demonstrated bilateral OH with no radiological evidence of bowel obstruction. Semiurgent elective laparoscopic total extraperitoneal mesh repair was performed. Intraoperative findings confirmed bilateral obturator herniae as well as incidental bilateral femoral herniae. This case highlights the need for a high index of suspicion for such concomitant hernias that, in the presence of OH, may only be identified intraoperatively. PMID:27113790

  20. Bilateral Facial Paralysis Caused by Bilateral Temporal Bone Fracture: A Case Report and a Literature Review

    Directory of Open Access Journals (Sweden)

    Sultan Şevik Eliçora

    2015-01-01

    Full Text Available Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis.

  1. Labor clauses in regional trade agreements and effects on labor conditions : an empirical analysis

    OpenAIRE

    KAMATA Isao; 鎌田, 伊佐生

    2016-01-01

    An increasing number of bilateral or plurilateral trade agreements (or regional trade agreements: RTAs) include "labor clauses" that require or urge the signatory countries to commit to maintaining a certain level of labor standards. This paper performs an empirical analysis of the impacts of such labor clauses provided in RTAs on working conditions that laborers in the RTA signatory countries actually face, using macro-level data for a wide variety of countries. The paper first examines the ...

  2. Analysis of the Canada-European Union Comprehensive Economic and Trade Agreement (CETA)

    OpenAIRE

    Heilimo, Marika

    2010-01-01

    The recent global financial crisis has been the source of change in trade policies around the world with some governments, such as Washington, adopting protectionist policies, while others, such as Canada and the European Union seeking growth through increased trade facilitated by bilateral free trade agreements. If successful, the Canada-EU Comprehensive Economic and Trade Agreement (CETA), which is currently under negotiation, will be one of the most encompassing and comprehensive free trad...

  3. Seismic contracts and agreements

    International Nuclear Information System (INIS)

    Some points to consider regarding management of seismic projects within the Canadian petroleum industry were reviewed. Seismic projects involve the integration of many services. This paper focused on user-provider relationships, the project planning process, competitive bid considerations, the types of agreement used for seismic and their implications, and the impact that certain points of control may have on a company: (1) initial estimate versus actual cost, (2) liability, (3) safety and operational performance, and (4) quality of deliverables. The objective is to drive home the point that in today's environment where companies are forming, merging, or collapsing on a weekly basis , chain of command and accountability are issues that can no longer be dealt with casually. Companies must form business relationships with service providers with a full knowledge of benefits and liabilities of the style of relationship they choose. Diligent and proactive management tends to optimize cost, safety and liability issues, all of which have a bearing on the points of control available to the company

  4. Comparative analysis of bilateral memoranda on anti-human trafficking cooperation between Thailand and three neighboring countries : what do the origin and the destination states agree upon?

    OpenAIRE

    Yamada, Miwa

    2012-01-01

    In order to prevent, suppress and punish human trafficking, bilateral agreements between origin of victim countries and destination countries are crucial, because their cooperation involves cross-border activities such as repatriation of victims, extradition of criminals and information-sharing. This article analyzes three bilateral legal instruments between The Government of The Kingdom of Thailand and her three neighboring countries, namely The Royal Government of Cambodia, The Government o...

  5. VHA Data Sharing Agreement Repository

    Data.gov (United States)

    Department of Veterans Affairs — The VHA Data Sharing Agreement Repository serves as a centralized location to collect and report on agreements that share VHA data with entities outside of VA. It...

  6. Hardware Implementation of a Bilateral Subtraction Filter

    Science.gov (United States)

    Huertas, Andres; Watson, Robert; Villalpando, Carlos; Goldberg, Steven

    2009-01-01

    A bilateral subtraction filter has been implemented as a hardware module in the form of a field-programmable gate array (FPGA). In general, a bilateral subtraction filter is a key subsystem of a high-quality stereoscopic machine vision system that utilizes images that are large and/or dense. Bilateral subtraction filters have been implemented in software on general-purpose computers, but the processing speeds attainable in this way even on computers containing the fastest processors are insufficient for real-time applications. The present FPGA bilateral subtraction filter is intended to accelerate processing to real-time speed and to be a prototype of a link in a stereoscopic-machine- vision processing chain, now under development, that would process large and/or dense images in real time and would be implemented in an FPGA. In terms that are necessarily oversimplified for the sake of brevity, a bilateral subtraction filter is a smoothing, edge-preserving filter for suppressing low-frequency noise. The filter operation amounts to replacing the value for each pixel with a weighted average of the values of that pixel and the neighboring pixels in a predefined neighborhood or window (e.g., a 9 9 window). The filter weights depend partly on pixel values and partly on the window size. The present FPGA implementation of a bilateral subtraction filter utilizes a 9 9 window. This implementation was designed to take advantage of the ability to do many of the component computations in parallel pipelines to enable processing of image data at the rate at which they are generated. The filter can be considered to be divided into the following parts (see figure): a) An image pixel pipeline with a 9 9- pixel window generator, b) An array of processing elements; c) An adder tree; d) A smoothing-and-delaying unit; and e) A subtraction unit. After each 9 9 window is created, the affected pixel data are fed to the processing elements. Each processing element is fed the pixel value for

  7. A review of bilateral training for upper extremity hemiparesis.

    Science.gov (United States)

    Stoykov, Mary Ellen; Corcos, Daniel M

    2009-01-01

    Upper extremity hemiparesis is the most common post-stroke disability. Longitudinal studies have indicated that 30-66% of stroke survivors do not have full arm function 6 months post-stroke. The current gold standard for treatment of mild post-stroke upper limb impairment is constraint-induced therapy but, because of the inclusion criteria, alternative treatments are needed which target more impaired subjects. Bilateral arm training has been investigated as a potential rehabilitation intervention. Bilateral arm training encompasses a number of methods including: (1) bilateral isokinematic training; (2) mirror therapy using bilateral training; (3) device-driven bilateral training; and (4) bilateral motor priming. Neural mechanisms mediating bilateral training are first reviewed. The key bilateral training studies that have demonstrated evidence of efficacy will then be discussed. Finally, conclusions are drawn concerning clinical implications based on the reviewed literature. PMID:19517519

  8. Bilateral spontaneous pneumothorax with pulmonary metastases of synovial sarcoma

    International Nuclear Information System (INIS)

    The association of bilateral spontaneous pneumothorax with pulmonary tumor is uncommon and with pulmonary metastases is rare. The clinical and radiological features of bilateral spontaneous pneumothorax from a synovial sarcoma in a 14 years old boy are described. (author)

  9. Bilateral cerebellar activation in unilaterally challenged essential tremor

    Directory of Open Access Journals (Sweden)

    Marja Broersma

    2016-01-01

    Conclusions: Our results expand on previous findings of bilateral cerebellar involvement in ET. We have identified specific areas in the bilateral somatomotor regions of the cerebellum: lobules V, VI and VIII.

  10. Free Trade in Airline Services: Assessing the Proposals to Liberalize the Canada – U.S. Air Transport Bilateral

    OpenAIRE

    Gillen, David W.; Hansen, Mark; Ramos, Robson

    1990-01-01

    In this paper we examine the consequences of changes to the bilateral agreement which regulates air transport between Canada and the United States. A hubbing competition model based on an n-player non-cooperative game is used to simulate six alternative bilateral scenarios including the current positions of Canada and the U.S.. We find that changes to the bilateral does not have a significant effect on the total amount of traffic but it does effect the distribution of traffic between countrie...

  11. Tratamiento conservador en pacientes con retinoblastoma bilateral

    Directory of Open Access Journals (Sweden)

    Juan C. Suárez

    2008-11-01

    Full Text Available OBJETIVO: comparar el tratamiento convencional del retinoblastoma bilateral, usado hasta hace algunos años, consistente en radioterapia o enucleación bilateral, con el tratamiento conservador actual que incluye termoterapia transpupilar (TTT o TTT/quimioterapia al menos en un ojo, en niños con diagnóstico de retinoblastoma bilateral. DISEÑO: estudio retrospectivo descriptivo. MUESTRA: 20 pacientes con diagnóstico de retinoblastoma bilateral que consultaron al Hospital Universitario San Vicente de Paúl, de Medellín, Colombia, entre 1997 y 2007. MÉTODO: se hizo enucleación del ojo con el tumor de mayor tamaño. En el otro ojo se hizo tratamiento con TTT, con el láser diodo (810 nm, spot amplio, solo o combinado con otras terapias. RESULTADOS: se dividió a los pacientes en dos grupos: 16 pacientes (32 ojos en el grupo 1 tratados conservadoramente y 4 pacientes (8 ojos en el grupo 2 con tratamiento convencional. El rango de edad fue de 1-72 meses en el grupo 1 y de 1-12 meses en el grupo 2. El tiempo de seguimiento fue de 7-67 meses para el grupo 1 y de 13-73 meses para el grupo 2. En el grupo 1 se hizo enucleación de 16 ojos (50%, radioterapia externa de uno (3,1%, quimioterapia más termoterapia de 5 (15,6% y quimioterapia más termoterapia más crioterapia de 10 (31,3%. En todos los pacientes se logró preservar al menos un ojo. En el grupo 2, se enuclearon 7 ojos (87,5% y se hizo radioterapia externa más enucleación en un paciente (12.5%. Además, todos los pacientes recibieron quimioterapia. CONCLUSIÓN: la terapia conservadora actual consistente en tratamiento local (termoterapia, crioterapia o braquiterapia y quimiorreducción permite preservar al menos un ojo y en algunos casos de los dos, muchas veces con buena agudeza visual, en niños con retinoblastoma bilateral; se evitan así la enucleación bilateral y la radioterapia externa usada en el tratamiento convencional con todos sus efectos secundarios. La enucleación contin

  12. Recurrence of bilateral herpes simplex virus keratitis following bimatoprost use

    Directory of Open Access Journals (Sweden)

    Kothari Mihir

    2006-01-01

    Full Text Available A 76-year-old man presented with features of bilateral herpes simplex virus (HSV keratitis. It was found to be recurrence of bilateral HSV keratitis following the use of Bimatoprost eye drops for uncontrolled intraocular pressure in a case of bilateral primary open-angle glaucoma.

  13. Nocturnal seizure and simultaneous bilateral shoulder fracture-dislocation.

    Science.gov (United States)

    Sahbudin, Ilfita; Filer, Andrew

    2016-01-01

    An otherwise fit and well 27-year-old man presented with acute onset unexplained bilateral shoulder pain, and was found to have bilateral shoulder fractures and dislocations on imaging. Although features were atypical, a nocturnal seizure causing the bilateral shoulder fractures was suspected and EEG showed features compatible with epilepsy. PMID:26838296

  14. Predicting word sense annotation agreement

    DEFF Research Database (Denmark)

    Martinez Alonso, Hector; Johannsen, Anders Trærup; Lopez de Lacalle, Oier;

    2015-01-01

    High agreement is a common objective when annotating data for word senses. However, a number of factors make perfect agreement impossible, e.g. the limitations of the sense inventories, the difficulty of the examples or the interpretation preferences of the annotations. Estimating potential...... agreement is thus a relevant task to supplement the evaluation of sense annotations. In this article we propose two methods to predict agreement on word-annotation instances. We experiment with a continuous representation and a three-way discretization of observed agreement. In spite of the difficulty...

  15. Bilateral Nocardia Keratitis after Photorefractive Keratectomy

    Directory of Open Access Journals (Sweden)

    Amir Faramarzi

    2012-01-01

    Full Text Available Purpose: To report the clinical, confocal scan, and histopathologic features of Nocardia keratitis in a patient who developed bilateral infection following photorefractive keratectomy (PRK. Case Report: A 23-year-old woman underwent bilateral PRK for low myopia. On postoperative day 3, dense central stromal infiltrates were noticed in both eyes. Empirical antibiotic therapy was initiated which was converted into specific therapy after a definite diagnosis was made based on clinical features and confirmed by confocal scan and histopathologic findings. Clinical and confocal scan features were consistent with the diagnosis of Nocardia keratitis, and topical 2% amikacin eye drops were started. Because of poor response to medical therapy, lamellar keratectomy was performed in both eyes which shortened the treatment course. Histopathologic examination reconfirmed the initial diagnosis. Conclusion: Familiarity with clinical and confocal scan features facilitates early diagnosis of Nocardia keratitis leading to proper management and hence a rapid therapeutic response.

  16. Bilateral Nocardia Keratitis after Photorefractive Keratectomy

    Science.gov (United States)

    Faramarzi, Amir; Feizi, Sepehr; Javadi, Mohammad-Ali; Rezaei Kanavi, Mozhgan; Yazdizadeh, Forouzan; Moein, Hamid-Reza

    2012-01-01

    Purpose To report the clinical, confocal scan, and histopathologic features of nocardia keratitis in a patient who developed bilateral infection following photorefractive keratectomy (PRK). Case Report A 23-year-old woman underwent bilateral PRK for low myopia. On postoperative day 3, dense central stromal infiltrates were noticed in both eyes. Empirical antibiotic therapy was initiated which was converted into specific therapy after a definite diagnosis was made based on clinical features and confirmed by confocal scan and histopathologic findings. Clinical and confocal scan features were consistent with the diagnosis of Nocardia keratitis, and topical 2% amikacin eye drops were started. Because of poor response to medical therapy, lamellar keratectomy was performed in both eyes which shortened the treatment course. Histopathologic examination reconfirmed the initial diagnosis. Conclusion Familiarity with clinical and confocal scan features facilitates early diagnosis of Nocardia keratitis leading to proper management and hence a rapid therapeutic response. PMID:23275825

  17. Simultaneous bilateral patellar tendon rupture without

    Directory of Open Access Journals (Sweden)

    LU Hua-ding

    2012-04-01

    Full Text Available 【Abstract】There is a dearth of case reports de-scribing simultaneous bilateral patellar tendon ruptures in the medical literature. These ruptures are often associated with systemic disorders such as lupus erythematosus or chronic steroid use. The author describes a case of a 24-year-old man who sustained traumatic bilateral patellar ten-don ruptures without any history of systemic disease or steroidal medication. We repaired and reattached the rup-tured tendons to the patella and augmented our procedure with allogeneic tendon followed by wire loop reinforcement. One year after operation, the patient regained a satisfactory range of motion of both knees with good quadriceps strength and no extensor lag. The recurrent microtrauma from a history of intense sports activity and a high body mass index may have played an important role in this trauma event. Key words: Patella; Patellar ligament; Rupture; Ten-don injuries; Knee

  18. Bilateral Psoas Abscess in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Tomich, Eric B

    2009-11-01

    Full Text Available We present the case of a 45-year-old female who presented multiple times to the emergency department with acute low back pain and was subsequently diagnosed with bilateral psoas muscle abscess. Psoas abscess is an uncommon cause of acute low back pain that is associated with high morbidity and mortality. The onset of symptoms is frequently insidious and the clinical presentation vague. Proper diagnosis requires vigilance of the physician to recognize signs in the history and physical examination that are suggestive of a potentially serious spinal condition and initiate further workup. While most patients with acute low back pain have a benign etiology, this case report demonstrates the challenge of diagnosing a patient with bilateral psoas abscess who had few known risk factors and symptoms typical of mechanical low back pain.[West J Emerg Med. 2009;10(4:288-291.

  19. Marfan Syndrome Presenting with Bilateral Retinal Detachment

    OpenAIRE

    Subrata Chakrabarti; Koushik Pan

    2014-01-01

    Marfan syndrome is an autosomal dominant systemic disorder of the connective tissue. Marfan syndrome affects most organs and tissues, especially the skeleton, lungs, eyes, heart, and the large blood vessels. Eye involvement may be in the form of retinal detachment which is a potentially dangerous manifestation for its sight threatening nature .We report a case where a 17 year old male developed sudden blindness due to spontaneous bilateral retinal detachment. Examination revealed features...

  20. Frequency and causes of bilateral ocular trauma

    International Nuclear Information System (INIS)

    To determine the frequency and causes of bilateral ocular trauma. All patients coming to the hospital with bilateral eye trauma and requiring admission were recruited into the study. The details of patients demographics, risk factors, ocular examination, treatment offered and final visual acuity were noted and described as frequency and percentages. Out of a total of 1551 patients of hospitalized ocular trauma, 46 (2.9%, 92 eyes) had bilateral ocular trauma. The majority (54.3%) were due to landmine blast injuries followed by dynamite blast in 10.8%, coalmine blast and firearm injury in 6.5% each. Pressure cooker explosion and road traffic accident was the cause in 4.3% each. Gas cylinder and automobile battery explosion, alkali and acid burn, assault and incidental trauma occurred in 2.1%. Sixty three percent were between 16 and 40 years of age. Males were affected in 93.4%. Corneal and / or scleral repair was done in 58.6%, conjunctival and or corneal foreign body removal in 26% and extracapular cataract extraction with intraocular lens implantation in 16.3%. The visual acuity was in the range of 6/60 and perception of light in 54.3%, while in 21.7%, there was no perception of light at the time of admission. Due to severity of injury, the final visual acuity was poor and only 28.2% regained vision between 6/18 and 6/60. In this series, landmine, dynamite and coalmine blasts were the major causes of bilateral ocular trauma. Victims were usually young males. Due to severity of ocular trauma, majority had poor visual outcome. (author)

  1. BILATERAL LUXATIO ERECTA, A CASE REPORT

    OpenAIRE

    Acosta, César Augusto Xavier; da Silva Resch, Elemar; Rodrigues, Rafael

    2015-01-01

    Inferior shoulder dislocation (luxactio erecta) is a rare lesion affecting approximately 0.5% of dislocations of this joint. The vast majority of these cases occur unilaterally. In September 2004, a 43 year old man was brought to the emergency room of the University Hospital of Santa Maria (HUSM) complaining of bilateral shoulder pain and inability to lower the arms, as a result of a fall with the arms abducted, while carrying out work activities. After physical examination and radiological e...

  2. Erlotinib-related bilateral anterior uveitis

    OpenAIRE

    Ali, Kashif; Kumar, Indu; Usman-Saeed, Muniba; Usman Saeed, Muhammad

    2011-01-01

    The authors report the case of a 68-year-old woman with secondary adenocarcinoma of the lungs from an unknown primary. Erlotinib was started which produced symptoms suggestive of uveitis. Erlotinib was stopped and restarted a month later at a lower dose, which resulted in severe bilateral anterior uveitis. The uveitis settled after stopping erlotinib and treatment with topical steroids and cycloplegics. To the best of the authors’ knowledge, this is the first case of erlotinib-related anterio...

  3. Bilateral anterior uveitis secondary to erlotinib

    OpenAIRE

    Lim, Lik Thai; Blum, Robert Alexander; Cheng, Chee Peng; Hanifudin, Abdul

    2010-01-01

    Bilateral anterior uveitis secondary to erlotinib phone: +44-784-3617788 (Lim, Lik Thai) (Lim, Lik Thai) Ophthalmology Department, Gartnavel General Hospital - Great Western Road - G12 0YN - Glasgow - UNITED KINGDOM (Lim, Lik Thai) Ophthalmology Department, Gartnavel General Hospital - Great Western Road - G12 0YN - Glasgow - UNITED KINGDOM (Blum, Robert Alexander) Ophthalmology Department, Gartnavel General Hospital - Great Western Road - G12 0YN - G...

  4. Bilateral Pregnancy Luteoma: A Case Report

    OpenAIRE

    Annu Nanda; Uday A. Gokhale; G Rajasekharan Pillai

    2014-01-01

    Pregnancy luteoma is a non-neoplastic lesion of the ovary occurring during pregnancy and is usually discovered incidentally at the time of a cesarean section or during postpartum tubal ligation. An accurate diagnosis is important for the mother and the fetus as it can be confused with ovarian malignancy leading to unnecessary surgery. We report a case of a pregnant female who was discovered to have bilateral enlarged ovaries at the time of emergency cesarean section.

  5. Bilateral exposures and systemic solvency risk

    OpenAIRE

    Gouriéroux, Christian; Héam, Jean-Cyprien; Monfort, Alain

    2012-01-01

    By introducing a structure of the balance sheets of the banks, which takes into account their bilateral exposures in terms of stocks or lendings, we get a structural model for default analysis. This model allows us to distinguish the exogenous and endogenous default dependence. We prove the existence and uniqueness of the liquidation equilibrium, we study the consequences of exogenous shocks on the banking system and we measure contagion phenomena. This approach is illustrated by an applicati...

  6. Bilateral Filter Evaluation Based on Exponential Kernels

    OpenAIRE

    Al Ismaeil, Kassem; Aouada, Djamila; Mirbach, Bruno; Ottersten, Björn

    2012-01-01

    The well-known bilateral filter is used to smooth noisy images while keeping their edges. This filter is commonly used with Gaussian kernel functions without real justification. The choice of the kernel functions has a major effect on the filter behavior. We propose to use exponential kernels with L1 distances instead of Gaussian ones. We derive Stein's Unbiased Risk Estimate to find the optimal parameters of the new filter and compare its performance with the conventional one. We show that t...

  7. Erlotinib-related bilateral anterior uveitis

    Science.gov (United States)

    Ali, Kashif; Kumar, Indu; Usman-Saeed, Muniba; Usman Saeed, Muhammad

    2011-01-01

    The authors report the case of a 68-year-old woman with secondary adenocarcinoma of the lungs from an unknown primary. Erlotinib was started which produced symptoms suggestive of uveitis. Erlotinib was stopped and restarted a month later at a lower dose, which resulted in severe bilateral anterior uveitis. The uveitis settled after stopping erlotinib and treatment with topical steroids and cycloplegics. To the best of the authors’ knowledge, this is the first case of erlotinib-related anterior uveitis. PMID:22694887

  8. China-Pakistan Strengthen Bilateral Custom Cooperation

    Institute of Scientific and Technical Information of China (English)

    Guo Yan

    2008-01-01

    @@ Mr.Abdullah Yusuf,Secretary General/Chairman,Central Board Of Revenue of Pakistan,arrived Shenzhen on April 22 to meet with Mr.Sheng Guangzu,the Chinese Minister for Customs Administration for discussing the bilateral customs issues.During his two-day visit,China's Foreign Trade Magazine interviewed to Mr.Abdullah Yusuf in Beijing,he gave the high evaluation on this visit and China's great development in the recent years.

  9. Characteristics of immigrants and bilateral trade

    OpenAIRE

    José Vicente Blanes-Cristóbal

    2008-01-01

    This paper tests the impact of immigration on bilateral trade using Spanish data from 1995 to 2003. It also explores some possible mechanisms behind this link. It uses a gravity equation for trade augmented with an immigrant’s stock variable and a set of control variables. The immigrants variable enters the estimated equation in different ways depending on immigrant relevant characteristics both individual and non individualspecific. Results show that there is a positive link between immigrat...

  10. Bilateral Pseudoexfoliation Deposits on Intraocular Lens Implants

    OpenAIRE

    Elena Bonafonte Marquez; Sergio Bonafonte Royo

    2015-01-01

    We present a rare case of bilateral pseudoexfoliative deposits on both intraocular lens (IOL) implants in an 83-year-old woman with no other associated pathology, 5 years after cataract surgery. Pseudoexfoliation syndrome is the most common cause of secondary open-angle glaucoma worldwide and these deposits are usually found on the natural lens. The fact that pseudoexfoliative deposits have been found on IOL implants implies the need for a thorough examination in pseudophakic patients, for i...

  11. Psychosocial Outcomes after Bilateral Hand Transplantation

    OpenAIRE

    Singh, Mansher; Oser, Megan; Zinser, Jennifer; Sisk, Geoffroy; Carty, Matthew J; Sampson, Christian; Pribaz, Julian J.; Pomahac, Bohdan; Talbot, Simon G

    2015-01-01

    Background: Since the first successful hand transplantation in 1998, there have been multiple reports about surgical technique, transplant survival, and immunosuppression. However, very limited published data exist on psychosocial outcomes following hand transplantation. Methods: We report psychosocial outcomes in a patient with bilateral hand transplants at the midforearm level with serial follow-ups over 3.5 years. Different metrics used to study psychosocial outcomes included the following...

  12. A rare case of bilateral aspergillus endophthalmitis

    Directory of Open Access Journals (Sweden)

    Saurabh Gupta

    2015-12-01

    Full Text Available Aspergillus endophthalmitis is a devastating inflammatory condition of the intraocular cavities that may result in irreparable loss of vision and rapid destruction of the eye. Almost all cases in the literature have shown an identified source causing aspergillus endophthalmitis as a result of direct extension of disease. We present a rare case of bilateral aspergillus endophthalmitis. A 72-year-old woman with a history of diabetes mellitus, congenital Hirschsprung disease, and recent culture-positive candida pyelonephritis with hydronephrosis status post-surgical stent placement presented with difficulty opening her eyes. She complained of decreased vision (20/200 with pain and redness in both eyes – right worse then left. Examination demonstrated multiple white fungal balls in both retinas consistent with bilateral fungal endophthalmitis. Bilateral vitreous taps for cultures and staining were performed. Patient was given intravitreal injections of amphotericin B, vancomycin, ceftazidime, and started on oral fluconazole. Patient was scheduled for vitrectomy to decrease organism burden and to remove loculated areas of infection that would not respond to systemic antifungal agents. Four weeks after initial presentation, the fungal cultures revealed mold growth consistent with aspergillus. Patient was subsequently started on voriconazole and fluconazole was discontinued due to poor efficacy against aspergillus. Further workup was conducted to evaluate for the source of infection and seeding. Transthoracic cardiogram was unremarkable for any vegetation or valvular abnormalities. MRI of the orbits and sinuses did not reveal any mass lesions or bony destruction. CT of the chest was unremarkable for infection. Aspergillus endophthalmitis may occur because of one of these several mechanisms: hematogenous dissemination, direct inoculation by trauma, and contamination during surgery. Our patient's cause of bilateral endophthalmitis was through an

  13. Bilateral Brodie's abscess at the proximal tibia.

    Science.gov (United States)

    Buldu, Halil; Bilen, Fikri Erkal; Eralp, Levent; Kocaoglu, Mehmet

    2012-08-01

    Brodie's abscess is a form of subacute osteomyelitis, which typically involves the metaphyses of the long tubular bones, particularly in the tibia. The diagnosis is usually made incidentally, as there are no accompanying symptoms or laboratory studies. Bilateral involvement at the proximal tibia is unusual. However, orthopaedic surgeons should be aware of this entity, as it may present without symptoms. Checking the contralateral limb for concomitant Brodie's abscess is recommended.

  14. Latin American Agriculture in a World of Trade Agreements

    OpenAIRE

    Josling, Tim; Paggi, Mechel; Wainio, John; Yamazaki, Fumiko

    2014-01-01

    Latin American and Caribbean (LAC) countries have been among the most active participants in the negotiation of regional and bilateral FTAs. The countries of the region are members of 73 of the 259 FTAs notified to the WTO as currently in force, with 29 of these agreements containing tariff concessions made to one or more Latin American partners: the remaining 44 are between an LAC member country and a third country. Among LAC countries already linked by an FTA, a large percentage of agricult...

  15. High Performance, Three-Dimensional Bilateral Filtering

    Energy Technology Data Exchange (ETDEWEB)

    Bethel, E. Wes

    2008-06-05

    Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

  16. Bilateral limbic system destruction in man

    Science.gov (United States)

    Feinstein, Justin S.; Rudrauf, David; Khalsa, Sahib S.; Cassell, Martin D.; Bruss, Joel; Grabowski, Thomas J.; Tranel, Daniel

    2010-01-01

    We report here a case study of a rare neurological patient with bilateral brain damage encompassing a substantial portion of the so-called “limbic system.” The patient, Roger, has been studied in our laboratory for over 14 years and the current article presents his complete neuroanatomical and neuropsychological profiles. The brain damage occurred in 1980 following an episode of herpes simplex encephalitis. The amount of destroyed neural tissue is extensive and includes bilateral damage to core limbic and paralimbic regions, including the hippocampus, amygdala, parahippocampal gyrus, temporal poles, orbitofrontal cortex, basal forebrain, anterior cingulate cortex, and insular cortex. The right hemisphere is more extensively affected than the left, although the lesions are largely bilateral. Despite the magnitude of his brain damage, Roger has a normal IQ, average to above average attention, working memory, and executive functioning skills, and very good speech and language abilities. In fact, his only obvious presenting deficits are a dense global amnesia and a severe anosmia and ageusia. Roger's case presents a rare opportunity to advance our understanding of the critical functions underlying the human limbic system, and the neuropsychological and neuroanatomical data presented here provide a critical foundation for such investigations. PMID:19763994

  17. High Performance, Three-Dimensional Bilateral Filtering

    International Nuclear Information System (INIS)

    Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

  18. Bilateral femoral neck fractures following pelvic irradiation

    International Nuclear Information System (INIS)

    Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was found out, but thickness of the internal membrane and thrombogenesis were not recognized. Treatment should be performed according to degree of displacement of fractures. In this case, artificial joint replacement surgery was performed to the side of fracture of this time, because this case was bilateral femoral neck fractures and the patient had received artificial head replacement surgery in the other side of fracture formerly. (Tsunoda, M.)

  19. Bilateral spontaneous rupture of 'hale' kidneys

    International Nuclear Information System (INIS)

    A rare case of spontaneous bilateral rupture of the kidneys, occurring consecutively over a one-year period in a young male patient with 'hale' kidneys until then, is described. The patient's past history and thorough examination performed do not justify to assign the case under the heading of some of the etiological factors as the underlying cause of spontaneous kidney rupture. The literature survey on spontaneous bilateral non-tumor ruptures of kidneys shows that over a 20-year period, only 3 cases of bilateral spontaneous ruptures have been reported. It is pointed out that panarteritis nodosa followed by hemorrhagic fever with renal syndrome is the commonest underlying cause of such ruptures. Clinically spontaneous ruptures become manifest with emergency condition presenting severe renal colic, impaired to serious general condition, often with acute abdomen and hemodynamic breakdown, and no past history evidence of renal disease or injury. In the initial phase diagnosing is not always easy; it is usually made on the ground of physical examination and the full range of imaging studies used in urological practice and during operative treatment. Emphasis is laid on the fact that the imaging methods are not invariably sufficient to identify the exact etiological factor giving rise to such a severe condition, but nevertheless these methods have an essential practical bearing on diagnosing a rupture. (authors)

  20. A case misdiagnosed as bilateral abducens palsy

    International Nuclear Information System (INIS)

    A 66-year-old male was admitted to our neurosurgical floor because of double vision and gait disturbance. Neurological examinations revealed bilateral 6th nerve palsy with both eyes pointing toward the midline. Initially, using a tentative diagnosis of intracranial mass lesions, especially localized at the base of the skull, computerized tomography of the head, cerebral angiography, orbital venography, and metrizamide CT cisternography were performed; the findings were normal. An orbital CT scan showed an enlargement of the bilateral medial rectus muscles, and the thyroid functions of T3 and T4 and the T3 uptake were all elevated, which was compatible with the diagnosis of Graves' disease. The limitations of both eyeballs were considered to be due not to the 6th nerve palsy, but to the hypertrophy of the bilateral medial rectus muscles. We neurosurgeons should recall Graves' disease as well as intracranial lesions, cerebrovascular disease, and post-traumatic sequelae when examining a patient who presents limitations of external ocular movement. (author)

  1. Diagnosis and management of bilateral nasolabial cysts

    Directory of Open Access Journals (Sweden)

    Rajkumar Parwani

    2013-01-01

    Full Text Available Nasolabial cysts are painless, submucosal, non-odontogenic jaw cysts presenting as soft tissue swellings in the maxillary anterior mucolabial fold lateral to midline, leading to elevation of nasal ala. Present case documents bilateral nasolabial cysts in a 69-year-old Asian female patient. In the present case, extraoral swelling of maxillary lip and elevation of nasal ala was observed on right side of the face. Intraorally, soft and fluctuant bilateral cysts were observed. Straw-colored fluid was aspirated from the right cyst. Radiographically, erosion of bone in a "cupping" fashion was observed in the region of left cyst. The cysts were enucleated using intraoral approach. Histopathology of the right-sided cyst revealed a cystic cavity lined by stratified squamous cells along with a few mucosal cells. At few places, stratified squamous and pseudostratified columnar epithelia with many cilia and goblet cells were also evident. Capsule was loosely arranged with fibrous tissue and chronic inflammatory infiltrate. Left-sided cystic specimen showed two or more layered stratified squamous lining epithelium with thin capsule. Diagnosis of bilateral nasolabial/nasoalveolar cysts was confirmed.

  2. FEATURES OF BILATERAL BREAST CANCER NODAL METASTASIS

    Directory of Open Access Journals (Sweden)

    Ye. A. Fesik

    2014-01-01

    Full Text Available This article focuses on issues related to the identification and investigation of the lymph node metastases with bilateral breast cancer. The presence of metastases in the lymph nodes determines the stage of the disease, and introducing a form of tumor progression, characterizes the course and prognosis for the future in a specific patient. Thus, the identification of possible morphological and immunohistochemical characteristics of the tumor tissue and their comparison with the frequency and severity of regional lymph nodes would help to solve the problem of the identification of prognostic factors and markers associated with the risk of nodal metastasis in bilateral breast cancer. This work is relevant due to the fact that the literature on this issue to date are treated ambiguously, and answers to many questions, unfortunately, no.The authors performed a morphological study of the tumor tissue from 600 patients suffering from unilateral and bilateral breast cancer. To avoid false results were studied only cases corresponding to the histological type of invasive carcinoma of non-specific type. The study found that a greater number and a greater percentage of the affected lymph node metastases were observed in patients with bilaterally synchronous tumors. The patients of this group of metastatic lymph nodes was detected more frequently in the presence of infiltrative component of three or more types of structures with the presence of these discrete groups of tumor cells, and the observed maximum degree of inflammatory infiltration of the tumor stroma. In the group of patients with unilateral breast cancer nodal metastasis often detects when triple negative molecular genetic type of the lesion, with large amounts of tumor site, in the presence of infiltrative component of three or more types of structures with the obligatory presence of these microalveolar structures and discretely spaced groups of tumor cells and the highest severity of

  3. Agreements at the Pharmaceutical/University Interface.

    Science.gov (United States)

    Ku, Katherine

    1987-01-01

    Specific agreements that arise at the interface between universities and pharmaceutical companies are described including sponsored research agreements, license agreements, clinical study agreements, material transfer agreements, and patient consent forms with respect to commercialization rights. (Author/MLW)

  4. Radiation protection and radiation safety: CERN and its host states to sign a tripartite agreement.

    CERN Multimedia

    2010-01-01

    On 15 November CERN and its Host States will sign a tripartite agreement that replaces the existing bilateral agreements in matters of radiation protection and radiation safety at CERN. It will provide, for the first time, a single forum where the three parties will discuss how maximum overall safety can best be achieved in the specific CERN context.   CERN has always maintained close collaboration with its Host States in matters of safety. “The aim of this collaboration is especially to ensure best practice in the field of radiation protection and the safe operation of CERN’s facilities”, explains Ralf Trant, Head of the Occupational Health & Safety and Environmental Protection (HSE) Unit. Until today, CERN’s collaboration with its Host States was carried out under two sets of bilateral agreements: depending on which side of the French-Swiss border they were being carried out on, a different framework applied to the same activities. This approach has b...

  5. Economic Diplomacy in Africa: The Impact of Regional Integration versus Bilateral Diplomacy on Bilateral Trade

    DEFF Research Database (Denmark)

    Afesorgbor, Sylvanus Kwaku

    The paper examines the impact of two main instruments of economic diplomacy — regional integration and commercial diplomacy on export flows among African states. We test whether there is any evidence of a trade-off or complementary interaction between these two instruments in trade facilitation. We...... compare the effects of these two instruments of economic diplomacy on bilateral trade by employing a gravity model for 45 African states over the period 1980-2005. The results show that bilateral diplomatic exchange is a relatively more significant determinant of bilateral exports among African states...... that there exists a trade-off between regional integration and commercial diplomacy in facilitating exports or a lack of complementarity between these two instruments of economic diplomacy....

  6. Applying LU Decomposition of Matrices to Design Anonymity Bilateral Remote User Authentication Scheme

    Directory of Open Access Journals (Sweden)

    Xiong Li

    2013-01-01

    Full Text Available We apply LU decomposition of matrices to present an anonymous bilateral authentication scheme. This paper aims at improving security and providing more excellent performances for remote user authentication scheme. The proposed scheme can provide bilateral authentication and session key agreement, can quickly check the validity of the input password, and can really protect the user anonymity. The security of the proposed scheme is based on the discrete logarithm problem (DLP, Diffie-Hellman problem (DHP, and the one-way hash function. It can resist various attacks such as insider attack, impersonation attack, server spoofing attack, and stolen smart card attack. Moreover, the presented scheme is computationally efficient for real-life implementation.

  7. Labor Agreement Information System (LAIRS)

    Data.gov (United States)

    Office of Personnel Management — The Labor Agreement Information Retrieval System (LAIRS) is a database containing historical information on labor-management relations in the Federal Government. It...

  8. The Impact of an EU-US TTIP Agreement on Biofuel and Feedstock Markets

    OpenAIRE

    BEGHIN, JOHN C; Bureau, Jean-Christophe; Gohin, Alex

    2014-01-01

    We assess the impact of a potential TTIP bilateral free trade agreement on the EU and US bio-economies (feedstock, biofuels, by-products, and related competing crops) and major trade partners in these markets. The analysis develops a multi-market model that incorporates bilateral trade flows (US to EU, EU to US, and similarly with third countries) and is calibrated to OECD-FAO baseline for 2013–2022 to account for recent policy decisions. The major policy reforms from a TTIP involve tariff an...

  9. PENINDAKAN ILLEGAL FISHING DAN PERJANJIAN BILATERAL BIDANG PERIKANAN DENGAN NEGARA TETANGGA

    Directory of Open Access Journals (Sweden)

    Ms. Koesrianti

    2008-06-01

    Full Text Available Indonesia is the biggest maritim state in the world as two third of its area are ocean. In order to maximized its fisheries products, Indonesia has some policies regarding to the management of its waters, including eradicating illegal logging and reforming bilateral agreements with some neighbor countries. This policies, however, appear to be not yet optimal. The government in 1985 has ratified the UN Convention on the Law of the Sea (UNCLOS 1982 with the Act 17/1985. However, up to now, Indonesia has not ratified yet the United Nations Fish Stocks Agreement 1995 and the 1993 Compliance Agreement as the continued arrangements of UNCLOS 1982. Indonesia should conduct such ratification in order to optimize the Indonesian fisheries industry in which its natural resources, whether living or non-living can be explored and exploited. This is crucial as fisheries industries can provide fish stock as alternative healthy food for the people in Indonesia.

  10. The International Trade Policy for Technology Transfers: Legal and Economic Dilemmas on Multilateralism versus Bilateralism

    DEFF Research Database (Denmark)

    Tang, Yi Shin

    In the book, the Researcher addresses the importance of international technology transfers for economic development, as well as the underlying causes for the different institutional arrangements that promote such activity. The work provides a systematic interpretation of the wide range of interests...... among developed and developing countries, and how they affect the scope and content of international agreements dealing with technology transfers, especially given the anarchic structure of international trade relations. The research also finds that, contrary to the general view that bilateral trade...... agreements tend to undermine the effects of multilateral agreements, for the specific case of technology transfers these modalities seem to enjoy a mutually positive effect, and should thus be concurrently promoted...

  11. Ceratite bilateral por Acanthamoeba: relato de caso Bilateral Acanthamoeba keratitis: case report

    Directory of Open Access Journals (Sweden)

    Wilson Nahmatallah Obeid

    2003-12-01

    Full Text Available A ceratite por Acanthamoeba é uma infecção ocular grave que, apesar dos recentes progressos no diagnóstico e tratamento, ainda provoca prolongada morbidade e perda da acuidade visual. Relatamos um caso de ceratite bilateral por Acanthamoeba em usuário de lentes de contato, que é o primeiro caso descrito na literatura brasileira.Acanthamoeba keratitis is a severe ocular infection which even with recent progress in diagnosis and treatment still causes long morbidity and loss of visual acuity. We describe a case of bilateral Acanthamoeba keratitis in a user of contact lenses, which is the first case discussed in Brazilian literature.

  12. Bilateral inferior petrosal sinus sampling using vasopressin

    Directory of Open Access Journals (Sweden)

    Narendra Kotwal

    2016-01-01

    Full Text Available Context: Anatomical localization of pituitary adenoma can be challenging in adrenocorticotropic hormone (ACTH-dependent Cushing's syndrome, and bilateral inferior petrosal sinus sampling (BIPSS is considered gold standard in this regard. Stimulation using corticotrophin-releasing hormone (CRH improves the sensitivity of BIPSS, however, same is not easily available in India. Therefore, we undertook this study of BIPPS using vasopressin as agent for stimulation owing to its ability to stimulate V3 receptors present on corticotrophs. Aims: To study the tumor localization and lateralization in difficult to localize cases of ACTH-dependent Cushing's syndrome by bilateral inferior petrosal sinus sampling using vasopressin for corticotroph stimulation. Settings and Design: Prospective observational study. Subjects and Methods: Six patients (5 females meeting inclusion criteria underwent BIPSS using vasopressin for stimulation. Results: All six patients had nonsuppressible overnight and low dose dexamethasone suppression test with elevated plasma ACTH levels suggestive of ACTH-dependent Cushing's syndrome. High dose dexamethasone suppression test showed suppressible cortisol in two cases, and microadenoma was seen in two patients on magnetic resonance imaging pituitary. Contrast enhanced computed tomography of the abdomen showed left adrenal hyperplasia in one case and anterior mediastinal mass with bilateral adrenal hyperplasia another. Using BIPSS four patients were classified as having Cushing's disease that was confirmed histopathologically following surgery. Of the remaining two, one had primary pigmented nodular adrenocortical disease, and another had thymic carcinoid with ectopic ACTH production as the cause of Cushing's syndrome. No serious adverse events were noted. Conclusions: Vasopressin may be used instead of CRH and desmopressin for stimulation in BIPSS.

  13. Bilateral Pseudoexfoliation Deposits on Intraocular Lens Implants

    Directory of Open Access Journals (Sweden)

    Elena Bonafonte Marquez

    2015-01-01

    Full Text Available We present a rare case of bilateral pseudoexfoliative deposits on both intraocular lens (IOL implants in an 83-year-old woman with no other associated pathology, 5 years after cataract surgery. Pseudoexfoliation syndrome is the most common cause of secondary open-angle glaucoma worldwide and these deposits are usually found on the natural lens. The fact that pseudoexfoliative deposits have been found on IOL implants implies the need for a thorough examination in pseudophakic patients, for it could be the only sign of secondary glaucoma.

  14. Bilateral generating functions and operational methods

    Energy Technology Data Exchange (ETDEWEB)

    Dattoli, G. [ENEA, Divisione Fisica Applicata, Centro Ricerche Frascati, Frascati, RM (Italy)

    2000-07-01

    Bilateral generating functions are those involving products of different types of polynomials. It is showed that operational methods offer a powerful tool to derive these families of generating functions. Cases relevant to products of Hermite and Laguerre, Hermite and Legendre ... polynomials and propose further extensions of the method are studied in this report. [Italian] Le funzioni generatrici bilaterali sono quelle che coinvolgono prodotti di tipi differenti di polinomi, si dimostra che i metodi operazionali offrono uno strumento potente per derivare queste nuove famiglie di funzioni speciali. Si studiano casi relativi a prodotti di polinomi di Hermite e Laguerre, Hermite e Legendre. Si propongono infine possibili estensioni del metodo.

  15. Bilateral internuclear ophthalmoplegia following mild head injury.

    Science.gov (United States)

    Muthukumar, N; Veerarajkumar, N; Madeswaran, K

    2001-05-01

    A 7-year-old child presented with bilateral internuclear ophthalmoplegia (INO) following a trivial head injury. CT was normal. MRI revealed a pontine lesion. Two months after the injury the patient was neurologically normal. INO following head injury is rare. Rarer still is INO following mild head injury. To date, only four cases of INO had been reported following mild head injury; the present case is the fifth and the first in which the lesion was documented using MRI. The relevant literature is reviewed. PMID:11417420

  16. Bilateral maculopathy associated with Pierre Robin sequence.

    Science.gov (United States)

    Witmer, Matthew T; Vasan, Ryan; Levy, Richard; Davis, Jessica; Chan, R V Paul

    2012-08-01

    Pierre Robin sequence has been associated with a number of ocular complications, including myopia, strabismus, Möbius syndrome, nasolacrimal duct obstruction, glaucoma, cataract, microphthalmos, coloboma of choroid, and retinal detachment. We report a 10-day-old boy who presented with micrognathia, glossoptosis, and cleft palate as well as multiple congenital anomalies. Ophthalmic examination was notable for bilateral maculopathy, with focal areas of retinal and retinal pigment epithelial atrophy. The association of Pierre Robin sequence and maculopathy has been reported only twice previously.

  17. Bilateral akillesseneruptur efter behandling med ciprofloxacin

    DEFF Research Database (Denmark)

    Attarzadeh, Amir Pasha; Ryge, Camilla

    2013-01-01

    We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment with...... ciprofloxacin 500 mg twice daily and long-term treatment with prednisolon 10 mg once daily. This rare side effect caused by concurrent treatment with steroids and ciprofloxacin should be kept in mind. Any signs of tendinitis following this treatment should arouse the physicians' suspicion towards ciprofloxacin....

  18. Bilateral pulmonary sequestration: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Ja Hong; Jeon, Eui Yong; Seo, Heung Suk; Choi, Yo Won; Jeon, Seok Chol; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1995-05-15

    A 21-year-old woman presented with productive cough and hemoptysis. Chest radiograph shows a large thin-walled cystic lesion with an air-fluid level in medial portion of the left lower lung zone and opacity in paravertebral area of the right lower lung zone. Chest CT scan shows a thin-walled cavitary lesion in the posterior basal segment of left lower lobe with an air-fluid level. Area of consolidation containing air-filled cysts was also observed in medial aspect of right lower lobe. Selective angiogram obtained from aberrant artery arising from descending abdominal aorta showed two main branches of the artery supplying bilateral pulmonary lesions.

  19. Implementing the Kyoto Protocol. The role of environmental agreements

    Energy Technology Data Exchange (ETDEWEB)

    Torvanger, Asbjoern; Skodvin, Tora

    1999-09-01

    This report examines under what circumstances voluntary agreements to curb greenhouse gas emissions could be an attractive policy option from the government`s perspective. The report begins by defining the term Environmental Agreement (EA) and then explores EAs in three steps: (1) Advantages and disadvantages of EAs compared to other policy tools (direct regulation, taxes and tradable permits), based on theoretical studies and experience from practical use, (2) The potential of EAs as an international policy tool, either in a bilateral or regional setting, (3) The attractiveness of EAs to implement the Kyoto Protocol, and the relation to joint implementation and international emissions trading. The main conclusions are: (1) Experience from OECD countries suggests that EAs are most attractive as a supplement to traditional command and control, or to market-based policy tools. (2) Skillful design of EAs can improve their efficiency. (3) Bilateral EAs is an interesting policy option to regulate pollution from other countries. (4) Regional EAs are rare but could have important advantages. (5) EAs can play a role in a soft transition stage from traditional command and control to domestic emission trading, and further on to a Kyoto Protocol regime of emission trading and joint implementation. 52 refs., 2 figs., 2 tabs.

  20. Timpanismo bilateral de bolsa gutural em potro Bilateral tympany of a guttural pouch in foal

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Araújo Valadão

    2004-08-01

    Full Text Available Uma potra da raça Quarto de Milha com dois meses de idade apresentava aumento de volume bilateral na região da parótida desde algumas horas após o nascimento. Por exame radiográfico diagnosticou-se timpanismo bilateral de bolsa gutural. Realizou-se a abertura cirúrgica da bolsa gutural esquerda e fenestrou-se o septo medial das bolsas guturais. Adicionalmente, procedeu-se à ressecção parcial da mucosa na abertura do orifício guturo-faríngeo. A afecção foi debelada, sem recidivas.A 2-month old Quarter Horse filly presented, since few hours after birth, increased bilateral volume in the parotid gland region, with progressive enlargement. The radiographic examination revealed bilateral tympany of guttural pouch. Surgery was performed by medial septal fenestration. In addition, partial ressection of mucous membrane of the pharingeal orifice was performed. The disease was healed without recurrences.

  1. Unusual Bilateral Rim Fracture in Femoroacetabular Impingement

    Directory of Open Access Journals (Sweden)

    Claudio Rafols

    2015-01-01

    Full Text Available This is a report of one case of bilateral acetabular rim fracture in association with femoroacetabular impingement (FAI, which was treated with a hip arthroscopic procedure, performing a partial resection, a labral reinsertion, and a subsequential internal fixation with cannulated screws. Up to date, there are in the literature only two reports of rim fracture and “os acetabuli” in association with FAI. In the case we present, the pincer and cam resection were performed without complications; the technique used was published previously. With this technique the head of the screw lays hidden by the reattached labrum. We removed partially the fractured rim fragment and the internal fixation of the remaining portion was achieved with a screw. In the event of a complete resection of the fragment, it would have ended with a LCE angle of 18° and a high probability of hip instability. We believe that this bilateral case helps establish the efficacy and reproducibility of the technique described by Larson.

  2. A RARE CASE OF BILATERAL MICROSPHEREPHAKIA

    Directory of Open Access Journals (Sweden)

    Pandu

    2015-05-01

    Full Text Available Microspherophakia is rare bilateral congenital anamoly of the crystalline lens. The condition may be isolated , familial or it may be associated with systemic affections like Marfan's syndrome , Weil - Marchesani syndrome , hyperlysinemia and congenital rubella. Microspherophakia results in lenticular myopia , lens dislocation , usually inferiorly and inverse glaucoma. We present a case in a 8 year old child who presented with bilateral microspherophakia and anterior dislocation of lens of right eye. visual acuity in right eye was counting fingers close to face and i n left eye 6/60.IOP with perkins applanation tonometer was 30mmHg in right eye 22mmHg in left eye , cornea was hazy due to edema , anterior chamber was shallow in both eye patient was managed with emergency lens extraction of right eye and secondary ACIOL im plantation. Left eye was managed by laser peripheral iridotomy. IOP was within normal limits postoperatively in both eyes without any antiglaucoma medications. Postoperatively best corrected visual acuity in right was 6/18 and 6/9 in left eye.

  3. [Synchronous bilateral breast cancer in a male].

    Science.gov (United States)

    García-Mejido, José Antonio; Delgado-Jiménez, Carmen; Gutiérrez-Palomino, Laura; Sánchez-Sevilla, Miguel; Iglesias-Bravo, Eva; Caballero-Fernández, Virginia

    2013-01-01

    antecedentes: el cáncer de mama en el hombre es una enfermedad con baja incidencia, que se reduce aún más cuando es bilateral sincrónica. Existen pocas publicaciones en los últimos años. Objetivo: establecer pautas para el tratamiento de este cáncer, aunque sea infrecuente. Caso clínico: paciente masculino de 75 años de edad, con tumores en ambas mamas, que se le resecaron completamente con exéresis de ganglios palpables. El estudio histopatológico informó que se trataba de un carcinoma ductal infiltrante no especificado. Se indicó tratamiento adyuvante con tamoxifeno y radioterapia; en la actualidad está libre de enfermedad. Conclusiones: el carcinoma mamario bilateral sincrónico en el varón es una enfermedad poco frecuente. Su tratamiento principal es la cirugía, de ahí la importancia del diagnóstico temprano. En la mayoría de los casos se requiere quimioterapia y radioterapia adyuvante porque suelen diagnosticarse en un estadio avanzado.

  4. Bilateral Electrical Cataract: A Case Report

    Directory of Open Access Journals (Sweden)

    Selçuk Sızmaz

    2011-06-01

    Full Text Available To present a rare complication, such as bilateral cataracts, in a man who sustained a high-voltage electrical injury. A 35- year-old man was admitted with a complaint of decrease in visual acuity. He had a history of a contact with a power line carrying 30.000 volts of electricity while working at a construction site. Examination at a burn center revealed second-degree facial, neck and left foot burns. One month later, the patient underwent amputation of fourth and fifth toes of his left foot. During the next 6 months, he noted decreasing vision in both eyes. Ocular examination 1 year after the accident revealed that the patient’s visual acuity had deteriorated to 1/10 in both eyes. The cornea on the left eye showed superficial punctate opacities. The lenses in both eyes had anterior subcapsular cortical lens opacities and posterior subcapsular opacities. Uncomplicated bilateral phacoemulsification surgery with intraocular lens implantation was performed and the patient’s visual acuity returned to 10/10 in both eyes. We noted that the fundus remained normal in both eyes. Electrical cataracts are still a serious potential complication that may occur after electrical injury. Awareness of this by burn team members is important for providing optimal treatment to those who have suffered an electrical injury. (Turk J Ophthalmol 2011; 41: 197-9

  5. Hiatus Hernia Repair with Bilateral Oesophageal Fixation.

    Science.gov (United States)

    Mendis, Rajith; Cheung, Caran; Martin, David

    2015-01-01

    Background. Despite advances in surgical repair of hiatus hernias, there remains a high radiological recurrence rate. We performed a novel technique incorporating bilateral oesophageal fixation and evaluated outcomes, principally symptom improvement and hernia recurrence. Methods. A retrospective study was performed on a prospective database of patients undergoing hiatus hernia repair with bilateral oesophageal fixation. Retrospective and prospective quality of life (QOL), PPI usage, and patient satisfaction data were obtained. Hernia recurrence was assessed by either barium swallow or gastroscopy. Results. 87 patients were identified in the database with a minimum of 3 months followup. There were significant improvements in QOL scores including GERD HRQL (29.13 to 4.38, P < 0.01), Visick (3 to 1), and RSI (17.45 to 5, P < 0.01). PPI usage decreased from a median of daily to none, and there was high patient satisfaction (94%). 57 patients were assessed for recurrence with either gastroscopy or barium swallow, and one patient had evidence of recurrence on barium swallow at 45 months postoperatively. There was an 8% complication rate and no mortality or oesophageal perforation. Conclusions. This study demonstrates that our technique is both safe and effective in symptom control, and our recurrence investigations demonstrate at least short term durability. PMID:26065030

  6. Hiatus Hernia Repair with Bilateral Oesophageal Fixation

    Directory of Open Access Journals (Sweden)

    Rajith Mendis

    2015-01-01

    Full Text Available Background. Despite advances in surgical repair of hiatus hernias, there remains a high radiological recurrence rate. We performed a novel technique incorporating bilateral oesophageal fixation and evaluated outcomes, principally symptom improvement and hernia recurrence. Methods. A retrospective study was performed on a prospective database of patients undergoing hiatus hernia repair with bilateral oesophageal fixation. Retrospective and prospective quality of life (QOL, PPI usage, and patient satisfaction data were obtained. Hernia recurrence was assessed by either barium swallow or gastroscopy. Results. 87 patients were identified in the database with a minimum of 3 months followup. There were significant improvements in QOL scores including GERD HRQL (29.13 to 4.38, P<0.01, Visick (3 to 1, and RSI (17.45 to 5, P<0.01. PPI usage decreased from a median of daily to none, and there was high patient satisfaction (94%. 57 patients were assessed for recurrence with either gastroscopy or barium swallow, and one patient had evidence of recurrence on barium swallow at 45 months postoperatively. There was an 8% complication rate and no mortality or oesophageal perforation. Conclusions. This study demonstrates that our technique is both safe and effective in symptom control, and our recurrence investigations demonstrate at least short term durability.

  7. Bilateral acute retinal necrosis after herpetic meningitis

    Directory of Open Access Journals (Sweden)

    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  8. Influence of unilateral weight on bilateral cyclograms

    Science.gov (United States)

    Pellicer Costa, Juan José; Dusza, Jacek J.

    2014-11-01

    The paper presents the results of gait parameters as a function of unilateral weight. The object of the research was a woman walking on a stationary surface and carrying in his hand weights from 0 to 15 kg. Her movement was recorded by 6 cameras recording the location of 34 markers placed at appropriate points in the body. 3D reconstruction was performed for each of the reflecting markers. Tested signals were changes in the value the joint angles of ankle, knee and hip. On the basis of about 6 cycles of movement of each load, a model for the average gait cycle was developed. The result of the experiments are graphs of changes the joint angles as a function of time, bilateral cyclograms, synchronized bilateral cyclograms and regression lines. The conclusion of the study is to determine how one-sided load affects gait asymmetry. Simple and easy to interpret method of presentation of results were also shown. Studies were conducted using VICON system.

  9. A case of bilateral aldosterone-producing adenomas differentiated by segmental adrenal venous sampling for bilateral adrenal sparing surgery.

    Science.gov (United States)

    Morimoto, R; Satani, N; Iwakura, Y; Ono, Y; Kudo, M; Nezu, M; Omata, K; Tezuka, Y; Seiji, K; Ota, H; Kawasaki, Y; Ishidoya, S; Nakamura, Y; Arai, Y; Takase, K; Sasano, H; Ito, S; Satoh, F

    2016-06-01

    Primary aldosteronism due to unilateral aldosterone-producing adenoma (APA) is a surgically curable form of hypertension. Bilateral APA can also be surgically curable in theory but few successful cases can be found in the literature. It has been reported that even using successful adrenal venous sampling (AVS) via bilateral adrenal central veins, it is extremely difficult to differentiate bilateral APA from bilateral idiopathic hyperaldosteronism (IHA) harbouring computed tomography (CT)-detectable bilateral adrenocortical nodules. We report a case of bilateral APA diagnosed by segmental AVS (S-AVS) and blood sampling via intra-adrenal first-degree tributary veins to localize the sites of intra-adrenal hormone production. A 36-year-old man with marked long-standing hypertension was referred to us with a clinical diagnosis of bilateral APA. He had typical clinical and laboratory profiles of marked hypertension, hypokalaemia, elevated plasma aldosterone concentration (PAC) of 45.1 ng dl(-1) and aldosterone renin activity ratio of 90.2 (ng dl(-1) per ng ml(-1 )h(-1)), which was still high after 50 mg-captopril loading. CT revealed bilateral adrenocortical tumours of 10 and 12 mm in diameter on the right and left sides, respectively. S-AVS confirmed excess aldosterone secretion from a tumour segment vein and suppressed secretion from a non-tumour segment vein bilaterally, leading to the diagnosis of bilateral APA. The patient underwent simultaneous bilateral sparing adrenalectomy. Histopathological analysis of the resected adrenals together with decreased blood pressure and PAC of 5.2 ng dl(-1) confirmed the removal of bilateral APA. S-AVS was reliable to differentiate bilateral APA from IHA by direct evaluation of intra-adrenal hormone production. PMID:26538381

  10. The bilateral advantage for famous faces: interhemispheric communication or competition?

    Science.gov (United States)

    Baird, Lyndsay M; Burton, A Mike

    2008-04-01

    The bilateral advantage for the perception of famous faces was investigated using a redundant target procedure. In experiment 1 we compared simultaneous presentation of stimuli (a) bilaterally and (b) one above the other in the central field. Results showed a redundancy advantage, but only when faces were presented bilaterally. This result lends support to the notion of interhemispheric communication using cross-hemisphere representations. Experiment 2 examined the nature of such communication by comparing bilateral presentation of identical face images, with bilateral presentation of different images of the same person. When asked to make a familiar/unfamiliar face judgement, participants showed evidence for a redundancy advantage under both bilateral conditions. This suggests that the nature of the information shared in interhemispheric communication is abstract, rather than being tied to superficial stimulus properties.

  11. Notes on Agreement in Itelmen

    Directory of Open Access Journals (Sweden)

    Jonathan David Bobaljik

    2002-01-01

    Full Text Available Agreement in Itelmen is represented by means of both prefixes and suffixes. While the prefixes reference subjects (of both transitive and intransitive verbs, the suffixal agreement morphemes on a given verb may reference the subject, the object, or an oblique argument, or some combination of these. We propose that the proper characterization of the factors that determine which arguments control suffixal agreement involves a division of labour between morphology and a notion of discourse prominence/salience. In essence, we propose that the suffixal agreement morpheme is an object agreement marker, but the features of the subject are reflected in this position when the object lacks the relevant features (for example, we treat third person as the lack of a person feature, or is absent altogether (thus, intransitive verbs agree twice with their subjects. When a verb occurs with an oblique as well as a direct object, discourse salience will determine which of these non-subject arguments will control object agreement. In addition to providing a description of a complex range of facts from Itelmen, the paper sheds light on the nature of “multiple exponence” and the role of “competition” among affixes for a particular position in the verbal agreement system.

  12. Simultaneous bilateral spontaneous pneumothorax with congenital pleuro-pleural communication

    OpenAIRE

    HATA, YOSHINOBU; Suzuki, Takashi; Yokoi, Masahide; Yoshida, Shuji; Takeyama, Teruaki; Nakazaki, Haruhiro; Goto, Hidenori; Sato, Fumitomo; Takagi, Keigo; Otsuka, Hajime

    2013-01-01

    A single pleural space can lead to serious simultaneous bilateral pneumothorax in cases of congenital or acquired pleuro-pleural communication. Here we report a 35-year-old man with bilateral pneumothorax. Chest computed tomography scans revealed a small air space between the esophagus and aorta, suggesting pleuro-pleural communication. Bilateral thoracoscopic bullectomy was performed. Repeated inspection revealed a 2-cm-long pleural window between the aorta and esophagus, which was closed wi...

  13. Bilateral Traumatic Anterior Dislocation of Shoulder – a rare entity

    OpenAIRE

    Yashavantha Kumar C; Nalini K B; Lalit Maini; Prashanth Nagaraj

    2013-01-01

    Introduction: Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislo...

  14. Bilateral fat necrosis of the breast: report of a case.

    OpenAIRE

    Sonobe,Hiroshi; SATO, Yasuo; Suzuki,Yoshihide; Hayashi, Kazuhiko; Kawabata, Kenji

    1980-01-01

    A rare case of bilateral fat necrosis of the breast is reported. The patient was a 50-year-old unmarried woman having no history of trauma, disease or surgery of the breast. In the bilateral breasts, ill-defined, firm masses with skin retraction were noted. Bilateral breast cancer was diagnosed clinically. However, both lesions showed histologically chronic granulomatous inflammation with foci of fatty necrosis, infiltration of lymphocytes, plasma cells, lipid containing foamy cells, foreign ...

  15. Unilateral versus Bilateral Instrumentation in Spinal Surgery: A Systematic Review

    OpenAIRE

    Molinari, Robert W.; Saleh, Ahmed; Molinari, Robert; Hermsmeyer, Jeff; Dettori, Joseph R.

    2015-01-01

    Study Design Systematic review. Clinical Questions (1) What is the comparative efficacy of unilateral instrumentation compared with bilateral instrumentation in spine surgery? (2) What is the safety of unilateral instrumentation compared with bilateral instrumentation in spine surgery? Methods Electronic databases and reference lists of key articles were searched up to September 30, 2014, to identify studies reporting the comparative efficacy and safety of unilateral versus bilateral instrume...

  16. Bilateral pneumothoraces complicating reduction mammoplasty: a case report

    OpenAIRE

    Mavridis, Stylianos; Gnauk, Hans Georg; Schumacher, Martina; Wagner, Roland

    2013-01-01

    Background Bilateral pneumothoraces after cosmetic breast surgery are rare and sporadically reported in the literature. Case presentation A 65-year-old female patient developed bilateral pneumothoraces after bilateral breast reduction surgery. Emergent chest tube thoracostomy was performed on both sides. The chest drains were removed on the fourth day (left side) and sixth day (right side), and the patient was discharged after 7 days of hospitalization without any further complications. Concl...

  17. Federal Facility Agreement progress report

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-01

    The (SRS) Federal Facility Agreement (FFA) was made effective by the US. Environmental Protection Agency Region IV (EPA) on August 16, 1993. To meet the reporting requirements in Section XXV of the Agreement, the FFA Progress Report was developed. The FFA Progress Report is the first of a series of quarterly progress reports to be prepared by the SRS. As such this report describes the information and action taken to September 30, 1993 on the SRS units identified for investigation and remediation in the Agreement. This includes; rubble pits, runoff basins, retention basin, seepage basin, burning pits, H-Area Tank 16, and spill areas.

  18. Federal Facility Agreement progress report

    International Nuclear Information System (INIS)

    The (SRS) Federal Facility Agreement (FFA) was made effective by the US. Environmental Protection Agency Region IV (EPA) on August 16, 1993. To meet the reporting requirements in Section XXV of the Agreement, the FFA Progress Report was developed. The FFA Progress Report is the first of a series of quarterly progress reports to be prepared by the SRS. As such this report describes the information and action taken to September 30, 1993 on the SRS units identified for investigation and remediation in the Agreement. This includes; rubble pits, runoff basins, retention basin, seepage basin, burning pits, H-Area Tank 16, and spill areas

  19. Bilateral Filtering using Modified Fuzzy Clustering for Image Denoising

    Directory of Open Access Journals (Sweden)

    G.Vijaya,

    2011-01-01

    Full Text Available This paper presents a novel bilateral filtering using weighed fcm algorithm based on Gaussian kernel unction for image manipulations such as segmentation and denoising . Our proposed bilateral filteringconsists of the standard bilateral filter and the original Euclidean distance is replaced by a kernel – induced distance in the algorithm. We have applied the proposed filtering for image denoising with both the impulse and Gaussian random noise, which achieves better results than the bilateral filtering based denoising approaches, the Perona-Maliks anisotropic diffusion filter, the fuzzy vector median filter and the Non-Local Means filter.

  20. Corporate Integrity Agreement (CIA) documents

    Data.gov (United States)

    U.S. Department of Health & Human Services — OIG negotiates corporate integrity agreements (CIA) with health care providers and other entities as part of the settlement of Federal health care program...

  1. Bilateral pulmonary emboli after bilateral mastectomy in a 15-year-old boy with hypogonadism: A case report

    OpenAIRE

    Piggott, JR; Yazdani, Arjang

    2010-01-01

    Pulmonary emboli are rare, yet serious, complications of body contouring surgery. When they occur, they more often follow as complications of long, invasive procedures in adults. The present report details a case of bilateral pulmonary emboli in an obese 15-year-old boy with hypogonadism undergoing bilateral mastectomy for gynecomastia. The diagnosis of bilateral pulmonary emboli was made on the basis of clinical presentation and positive ventilation/perfusion scan. The patient responded well...

  2. Bargaining Agents in Wireless Contexts: An Alternating-Offers Protocol for Multi-issue Bilateral Negotiation in Mobile Marketplaces

    Science.gov (United States)

    Ragone, Azzurra; Ruta, Michele; di Sciascio, Eugenio; Donini, Francesco M.

    We present an approach to multi-issue bilateral negotiation for mobile commerce scenarios. The negotiation mechanism has been integrated in a semantic-based application layer enhancing both RFID and Bluetooth wireless standards. OWL DL has been used to model advertisements and relationships among issues within a shared common ontology. Finally, non standard inference services integrated with utility theory help in finding suitable agreements. We illustrate and motivate the provided theoretical framework in a wireless commerce case study.

  3. Marfan Syndrome Presenting with Bilateral Retinal Detachment

    Directory of Open Access Journals (Sweden)

    Subrata Chakrabarti

    2014-02-01

    Full Text Available Marfan syndrome is an autosomal dominant systemic disorder of the connective tissue. Marfan syndrome affects most organs and tissues, especially the skeleton, lungs, eyes, heart, and the large blood vessels. Eye involvement may be in the form of retinal detachment which is a potentially dangerous manifestation for its sight threatening nature .We report a case where a 17 year old male developed sudden blindness due to spontaneous bilateral retinal detachment. Examination revealed features of Marfan syndrome and was stamped as a case of Marfan syndrome by Ghent criteria . The point to stress upon is that a young male developing spontaneous retinal detachment, a diagnosis of underlying Marfan syndrome should be kept in mind if appropriate clinical stigmata are present. [Natl J Med Res 2014; 4(1.000: 104-105

  4. Bilateral Trade Flows and Income Distribution Similarity

    Science.gov (United States)

    2016-01-01

    Current models of bilateral trade neglect the effects of income distribution. This paper addresses the issue by accounting for non-homothetic consumer preferences and hence investigating the role of income distribution in the context of the gravity model of trade. A theoretically justified gravity model is estimated for disaggregated trade data (Dollar volume is used as dependent variable) using a sample of 104 exporters and 108 importers for 1980–2003 to achieve two main goals. We define and calculate new measures of income distribution similarity and empirically confirm that greater similarity of income distribution between countries implies more trade. Using distribution-based measures as a proxy for demand similarities in gravity models, we find consistent and robust support for the hypothesis that countries with more similar income-distributions trade more with each other. The hypothesis is also confirmed at disaggregated level for differentiated product categories. PMID:27137462

  5. Bilateral Trade Flows and Income Distribution Similarity.

    Science.gov (United States)

    Martínez-Zarzoso, Inmaculada; Vollmer, Sebastian

    2016-01-01

    Current models of bilateral trade neglect the effects of income distribution. This paper addresses the issue by accounting for non-homothetic consumer preferences and hence investigating the role of income distribution in the context of the gravity model of trade. A theoretically justified gravity model is estimated for disaggregated trade data (Dollar volume is used as dependent variable) using a sample of 104 exporters and 108 importers for 1980-2003 to achieve two main goals. We define and calculate new measures of income distribution similarity and empirically confirm that greater similarity of income distribution between countries implies more trade. Using distribution-based measures as a proxy for demand similarities in gravity models, we find consistent and robust support for the hypothesis that countries with more similar income-distributions trade more with each other. The hypothesis is also confirmed at disaggregated level for differentiated product categories. PMID:27137462

  6. CASE OF BILATERAL ANTERIOR SEGMENT TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Gopal Kishan

    2015-04-01

    Full Text Available Tuberculosis is an important cause of uveitis in our country. India has been declared the country with the highest tuberculosis burden with 25 % of the cases . (1 This is especially true in Andhra Pradesh and Telangana which have a high percentage of affected patients. However , tuberculous uveitis is usually a unilateral presen tation. We report a case of bilateral uveitis of tuberculous origin in a 55 year old woman. She presented with different tuberculous manifestations in the two eyes. While the RE showed non granulomatous uveitis with sclerosing keratitis , the LE showed gran ulomatous uveitis with mutton fat keratic precipitates. Systemic examination revealed an enlarged lymph node which was positive for tuberculosis on biopsy. She was hence diagnosed as extra pulmonary tuberculosis and was treated with ATT regimen. In this pa tient , uveitis was the initial manifestation and resulted in a systemic diagnosis.

  7. Bilateral adrenal hemorrhage in polycythemia vera.

    Science.gov (United States)

    Bhandari, Shruti; Agito, Katrina; Krug, Esther I

    2016-01-01

    Bilateral adrenal hemorrhage (BAH) is a rare complication typically seen in critically ill patients, which can lead to acute adrenal insufficiency and death unless it is recognized promptly and treated appropriately. We describe the case of a 64-year-old man with polycythemia vera found to be unresponsive with fever, hypotension, tachycardia, and hypoglycemia. Electrocardiogram showed ST-elevation with elevated troponin, hemoglobin, prothrombin time, and partial thromboplastin time. He required aggressive ventilator and vasopressor support. Despite primary coronary intervention, he remained hypotensive. Random cortisol level was low. He received stress dose hydrocortisone with immediate hemodynamic stability. BAH was highly suspected and was confirmed by non-contrast abdominal computed tomography. Prompt recognition and timely initiated treatment remain crucial to impact the mortality associated with acute adrenal insufficiency. PMID:27609733

  8. Bilateral adrenal hemorrhage in polycythemia vera

    Directory of Open Access Journals (Sweden)

    Shruti Bhandari

    2016-09-01

    Full Text Available Bilateral adrenal hemorrhage (BAH is a rare complication typically seen in critically ill patients, which can lead to acute adrenal insufficiency and death unless it is recognized promptly and treated appropriately. We describe the case of a 64-year-old man with polycythemia vera found to be unresponsive with fever, hypotension, tachycardia, and hypoglycemia. Electrocardiogram showed ST-elevation with elevated troponin, hemoglobin, prothrombin time, and partial thromboplastin time. He required aggressive ventilator and vasopressor support. Despite primary coronary intervention, he remained hypotensive. Random cortisol level was low. He received stress dose hydrocortisone with immediate hemodynamic stability. BAH was highly suspected and was confirmed by non-contrast abdominal computed tomography. Prompt recognition and timely initiated treatment remain crucial to impact the mortality associated with acute adrenal insufficiency.

  9. Bilaterally Microstructured Thin Polydimethylsiloxane Film Production

    DEFF Research Database (Denmark)

    Vudayagiri, Sindhu; Yu, Liyun; Hassouneh, Suzan Sager;

    2015-01-01

    /S produces films with a one-sided microstructured surface only. It would be advantageous to produce a film with both surfaces microstructured, as this increases the film’s performance efficiency. The new technique introduced herein produces bilaterally microstructured film by combining an embossing method...... retain an imprint made on it. The preheated film at gel point is embossed between the rolls of a gravure lab coater, which corrugates the top surface of the film. The films are then heated, in order to cure completely. For the LSR systems used in this process, the optimum conditions for preheating...... are 110°C for 4–7 s, while for embossing the temperature is 110°C with 25 psi pressure between the rolls at a speed of 1.4 rpm. Scanning electron microscope (SEM) images confirm the formation of microstructures on both the surfaces of the film....

  10. Bilateral Trade Flows and Income Distribution Similarity.

    Science.gov (United States)

    Martínez-Zarzoso, Inmaculada; Vollmer, Sebastian

    2016-01-01

    Current models of bilateral trade neglect the effects of income distribution. This paper addresses the issue by accounting for non-homothetic consumer preferences and hence investigating the role of income distribution in the context of the gravity model of trade. A theoretically justified gravity model is estimated for disaggregated trade data (Dollar volume is used as dependent variable) using a sample of 104 exporters and 108 importers for 1980-2003 to achieve two main goals. We define and calculate new measures of income distribution similarity and empirically confirm that greater similarity of income distribution between countries implies more trade. Using distribution-based measures as a proxy for demand similarities in gravity models, we find consistent and robust support for the hypothesis that countries with more similar income-distributions trade more with each other. The hypothesis is also confirmed at disaggregated level for differentiated product categories.

  11. Bilateral Scapulohumeral Ankylosis after Prolonged Mechanical Ventilation.

    Science.gov (United States)

    van Lotten, Manon L; Schreinemakers, J Rieneke; van Noort, Arthur; Rademakers, Maarten V

    2016-09-01

    This case demonstrates a rarely reported bilateral scapulohumeral bony ankylosis. A young woman developed extensive heterotopic ossifications (HOs) in both shoulder joints after being mechanically ventilated for several months at the intensive care unit in a comatose status. She presented with a severe movement restriction of both shoulder joints. Surgical resection of the bony bridges was performed in 2 separate sessions with a significant improvement of shoulder function afterwards. No postoperative complications, pain, or recurrence of HOs were noted at 1-year follow-up. Mechanical ventilation, immobilization, neuromuscular blockage, and prolonged sedation are known risk factors for the development of HOs in the shoulder joints. Relatively early surgical resection of the HOs can be performed safely in contrary to earlier belief. Afterwards, nonsteroidal anti-inflammatory drugs and/or radiation therapy can be possible treatment modalities to prevent recurrence of HOs. PMID:27583120

  12. Bilateral stony lung: pulmonary alveolar microlithiasis.

    Science.gov (United States)

    Chandra, Subhash; Mohan, Anant; Guleria, Randeep; Das, Prasenjit; Sarkar, Chitra

    2009-01-01

    A 40-year-old male paddy field worker was referred for exertional shortness of breath and non-productive cough for 4 years. He had been treated for pulmonary tuberculosis twice. Chest radiograph showed extensive bilateral nodular opacities ("sandstorm-like") in the middle and lower lobe. Pulmonary function tests revealed a restrictive ventilatory defect. High resolution CT showed widespread nodular infiltration with "crazy paving" appearance and interrupted black pleura sign. This was confirmed as pulmonary alveolar microlithiasis (PAM) by trans-bronchial lung biopsy, which showed normal respiratory lining epithelium with dilated alveolar spaces containing many calcific bodies, some of which showed concentric calcification. The possibilities of silicosis (due to exposure to husk) and tuberculosis, both of which can mimic PAM clinically and radiologically, made this case a diagnostic challenge. PMID:21686505

  13. [Bilateral ovarian Burkitt's lymphoma. A case presentation].

    Science.gov (United States)

    Briseño-Hernández, Andrés Alejandro; Quezada-López, Deissy Roxana; Castañeda-Chávez, Agar; Dassaejv Macías-Amezcua, Michel; Pintor-Belmontes, Julio Cesar

    2014-01-01

    Antecedentes: el linfoma de Burkitt es una forma agresiva de los linfomas no Hodgkin de células B que ocurre con mayor frecuencia en niños y adultos jóvenes; el linfoma de ovario puede aparecer como lesión primaria o, más comúnmente, como una metástasis. Las lesiones primarias de ovario son manifestaciones raras que corresponden a 0.5% de los linfomas no Hodgkin y 1.5% de los tumores de ovario. Caso clínico: paciente femenina de 31 años de edad, con debilidad generalizada, incapacidad para la marcha, disnea, hiporexia, fiebre, diaforesis, pérdida de 20 kg de peso, abdomen plano, con dolor abdominal; Ca125 610 U/mL. La tomografía computada abdominal mostró un gran tumor de aspecto sólido que afectaba a la cavidad pélvica derecha. Se extirparon los tumores ováricos bilaterales. Desde el punto de vista microscópico ambas lesiones muestran una imagen en "cielo estrellado" compuesta por un patrón de infiltrado monótono de linfocitos mezclada con macrófagos de citoplasma amplio y claro, abundantes mitosis atípicas, zonas de necrosis y hemorragia. La inmunohistoquímica reveló positividad para CDI0 y CD20, negativo con CD3, índice de proliferación Ki67 alto. Se diagnosticó linfoma tipo Burkitt bilateral de ovario. Conclusiones: el linfoma de Burkitt de ovario bilateral es poco frecuente, con variabilidad de presentación; el dolor abdominal y los tumores abdominales son lo más frecuente. El pronóstico a corto plazo de las pacientes es malo, por lo que es necesario conocer esta afección para poder establecer el diagnóstico temprano.

  14. Conscious attention, meditation, and bilateral information transfer.

    Science.gov (United States)

    Bob, Petr; Zimmerman, Elizabeth M; Hamilton, Elizabeth A; Sheftel, Jenna G; Bajo, Stephanie D; Raboch, Jiri; Golla, Megan; Konopka, Lukasz M

    2013-01-01

    Recent findings indicate that conscious attention is related to large-scale information integration of various brain regions, including both hemispheres, that enables integration of parallel distributed modalities of processed information. There is also evidence that the level of information transference related to integration or splitting among brain regions, and between hemispheres, establishes a certain level of efficiency of the information processing. The level of information transference also may have modulatory influences on attentional capacity that are closely linked to the emotional arousal and autonomic response related to a stimulus. These findings suggest a hypothesis that changes in conscious attention, specifically during meditation could be reflected in the autonomic activity as the left-right information transference calculated from bilateral electrodermal activity (EDA). With the aim to compare conscious attention during meditation with other attentional states (resting state, Stroop task, and memory task), we performed bilateral EDA measurement in 7 healthy persons during resting state, Stroop task, neurofeedback memory test, and meditation. The results indicate that the information transference (ie, transinformation) is able to distinguish those attentional states, and that the highest level of the transinformation has been found during attentional processing related to meditation, indicating higher level of connectivity between left and right sides. Calculations other than pointwise transinformation (PTI) performed on EDA records, such as mean skin conductance level or laterality index, were not able to distinguish attentional states. The results suggest that PTI may present an interesting method useful for the assessment of information flow, related to neural functioning, that in the case of meditation may reflect typical integrative changes in the autonomic nervous system related to brain functions and focused attentional processing.

  15. Timpanismo bilateral de bolsa gutural em potro Bilateral tympany of a guttural pouch in foal

    OpenAIRE

    Carlos Augusto Araújo Valadão; Júlio Carlos Canola; Roberta Ferro de Godoy

    2004-01-01

    Uma potra da raça Quarto de Milha com dois meses de idade apresentava aumento de volume bilateral na região da parótida desde algumas horas após o nascimento. Por exame radiográfico diagnosticou-se timpanismo bilateral de bolsa gutural. Realizou-se a abertura cirúrgica da bolsa gutural esquerda e fenestrou-se o septo medial das bolsas guturais. Adicionalmente, procedeu-se à ressecção parcial da mucosa na abertura do orifício guturo-faríngeo. A afecção foi debelada, sem recidivas.A 2-month old...

  16. Simultaneous bilateral shoulder and bilateral central acetabular fracture dislocation: What to do?

    Institute of Scientific and Technical Information of China (English)

    Hardik Sheth; Abhijeet Ashok Salunke; Ramesh Panchal; Jimmy Chokshi; G.I.Nambi; Saranjeet Singh; Amit Patel

    2016-01-01

    Musculoskeletal injuries following seizures have a high morbidity and mortality.These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations.We report a case of 72 years old male with simultaneous bilateral central acetabular fracture dislocation and bilateral posterior shoulder fracture dislocation secondary to an epileptic seizure.Present study highlights the significance of clinical suspicion and clinico-radiological evaluation for diagnosis of a rare injury following episode of seizures.Simultaneous fracture dislocation of all four limbs treated with a holistic approach can lead to a good functional recovery.Surgical management with open reduction and internal fixation is preferred and replacement arthroplasty should be reserved for cases with implant failure and elderly patients.

  17. Paresia diafragmática bilateral idiopática Idiopathic bilateral diaphragmatic paresis

    Directory of Open Access Journals (Sweden)

    Mônica Corso Pereira

    2006-10-01

    Full Text Available Relata-se o caso de um paciente com dispnéia intensa ao se deitar, em que foram excluídas doenças pulmonares, neuromusculares ou cardíacas, cuja investigação revelou paresia diafragmática bilateral. Um sinal chave para o diagnóstico foi a evidência de respiração paradoxal com o doente em decúbito supino. Havia piora da oxigenação e da capacidade vital forçada com a mudança da posição ortostática para supina. A fluoroscopia ortostática foi normal. A pressão inspiratória máxima estava muito reduzida. A estimulação elétrica transcutânea do diafragma foi normal, e a eletroestimulação do nervo frênico mostrou ausência de resposta, permitindo o diagnóstico de paresia bilateral do diafragma.We report the case of a patient with severe dyspnea upon reclining. Lung disease, neuromuscular disorders and heart disease were ruled out. However, during the course of the investigation, bilateral diaphragmatic paresis was discovered. A key sign leading to the diagnosis was evidence of paradoxical respiration in the dorsal decubitus position. When the patient was moved from the orthostatic position to the dorsal decubitus position, oxygenation and forced vital capacity worsened. The orthostatic fluoroscopy was normal. Maximal inspiratory pressure was severely reduced. The responses to transcutaneous electric stimulation of the diaphragm were normal. However, electric stimulation of the phrenic nerve produced no response, leading to the diagnosis of bilateral diaphragmatic paresis.

  18. Proposed Rules of Origin in Emerging Asia-Pacific Preferential Trade Agreements: Will PTAs Promote Trade and Development?

    OpenAIRE

    William E. James

    2006-01-01

    World trade is increasingly being dominated by preferential trade agreements that have taken precedence over multilateral trade negotiations. Within Asia and the Pacific an explosion of bilateral deals is taking place that seems likely to produce a tangle of hub-spoke trade blocs centered on major Asian or Pacific countries.

  19. [Bilateral anterior uveiopapillitis, suspicious of Lyme disease--case report].

    Science.gov (United States)

    Nicula, Cristina; Nicula, D; Rusu, Ioana; Popescu, Raluca

    2013-01-01

    We present the case of a patient which associated bilateral anterior uveitis manifestations with those of bilateral anterior inflammatory optic neuropathy. We followed the evolution of the case under treatment and we discussed the differential diagnosis and the association of the two ocular pathologies.

  20. Bilateral Occipital Condyle Fracture: Report of Two Cases

    OpenAIRE

    Schrödel, Markus H.; Kestlmeier, Ralph; Trappe, Anna E.

    2002-01-01

    Occipital condyle fractures are a rare finding in trauma victims. Bilateral fractures are even more unusual and have typically been reported in autopsy studies. We treated two patients with bilateral occipital condyle fractures who had only minor symptoms. Anderson and Montesano's classification,1 possible cranial nerve palsies, diagnosis, and treatment of this rare fracture are discussed.

  1. Bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei

    DEFF Research Database (Denmark)

    Kaldau, Niels Christian; Brorson, Stig; Jensen, Poul Einar;

    2012-01-01

    We present a case of bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei, and review the literature on Candida osteomyelitis.......We present a case of bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei, and review the literature on Candida osteomyelitis....

  2. Hierarchical bilateral filtering based disparity estimation for view synthesis

    Science.gov (United States)

    Shin, Hong-Chang; Lee, Gwangsoon; Cheong, Won-Sik; Hur, Namho

    2016-06-01

    In this paper, we introduce a high efficient and practical disparity estimation using hierarchical bilateral filtering for real-time view synthesis. The proposed method is based on hierarchical stereo matching with hardware-efficient bilateral filtering. Hardware-efficient bilateral filtering is different from the exact bilateral filter. The purpose of the method is to design an edge-preserving filter that can be efficiently parallelized on hardware. The proposed hierarchical bilateral filtering based disparity estimation is essentially a coarse-to-fine use of stereo matching with bilateral filtering. It works as follows: firstly, the hierarchical image pyramid are constructed; the multi-scale algorithm then starts by applying a local stereo matching to the downsampled images at the coarsest level of the hierarchy. After the local stereo matching, the estimated disparity map is refined with the bilateral filtering. And then the refined disparity map will be adaptively upsampled to the next finer level. The upsampled disparity map used as a prior of the corresponding local stereo matching at the next level, and filtered and so on. The method we propose is essentially a combination of hierarchical stereo matching and hardware-efficient bilateral filtering. As a result, visual comparison using real-world stereoscopic video clips shows that the method gives better results than one of state-of-art methods in terms of robustness and computation time.

  3. Hansen′s disease with bilateral tarsal disorganisation

    OpenAIRE

    Nair Pradeep; Vijayadharan M; Yogirajan K; Suprakasan S; Rajasree P

    1999-01-01

    A 37-year old male patient with Hansen′s disease midborderline spectrum, presented with bilateral pedal edema. X-ray examination of the feet showed disorganisation and disintegration of the tarsal bones. Bilateral tarsal disorganisation which can develop in Hansen′s disease is usually not recognised by the clinician.

  4. Ultrasound Diagnosis of Bilateral Quadriceps Tendon Rupture After Statin Use

    Science.gov (United States)

    Nesselroade, Ryan D.; Nickels, Leslie Connor

    2010-01-01

    Simultaneous bilateral quadriceps tendon rupture is a rare injury. We report the case of bilateral quadriceps tendon rupture sustained with minimal force while refereeing a football game. The injury was suspected to be associated with statin use as the patient had no other identifiable risk factors. The diagnosis was confirmed using bedside ultrasound. PMID:21079697

  5. Gender agreement and multiple referents

    Science.gov (United States)

    Finocchiaro, Chiara; Mahon, Bradford Z.; Caramazza, Alfonso

    2010-01-01

    We report a new pattern of usage in current, spoken Italian that has implications for both psycholinguistic models of language production and linguistic theories of language change. In Italian, gender agreement is mandatory for both singular and plural nouns. However, when two or more nouns of different grammatical gender appear in a conjoined noun phrase (NP), masculine plural agreement is required. In this study, we combined on-line and off-line methodologies in order to assess the mechanisms involved in gender marking in the context of multiple referents. The results of two pronoun production tasks showed that plural feminine agreement was significantly more difficult than plural masculine agreement. In a separate study using offline judgements of acceptability, we found that agreement violations in Italian are tolerated more readily in the case of feminine conjoined noun phrases (e.g., la mela e la banana ‘the:fem apple:fem and the: fem banana: fem’) than masculine conjoined noun phrases (e.g., il fiore e il libro ‘the:mas flower: mas and the:mas book:mas’). Implications of these results are discussed both at the level of functional architecture within the language production system and at the level of changes in language use.* PMID:21037930

  6. Gender agreement and multiple referents.

    Science.gov (United States)

    Finocchiaro, Chiara; Mahon, Bradford Z; Caramazza, Alfonso

    2008-01-01

    We report a new pattern of usage in current, spoken Italian that has implications for both psycholinguistic models of language production and linguistic theories of language change. In Italian, gender agreement is mandatory for both singular and plural nouns. However, when two or more nouns of different grammatical gender appear in a conjoined noun phrase (NP), masculine plural agreement is required. In this study, we combined on-line and off-line methodologies in order to assess the mechanisms involved in gender marking in the context of multiple referents. The results of two pronoun production tasks showed that plural feminine agreement was significantly more difficult than plural masculine agreement. In a separate study using offline judgements of acceptability, we found that agreement violations in Italian are tolerated more readily in the case of feminine conjoined noun phrases (e.g., la mela e la banana 'the:fem apple:fem and the: fem banana: fem') than masculine conjoined noun phrases (e.g., il fiore e il libro 'the:mas flower: mas and the:mas book:mas'). Implications of these results are discussed both at the level of functional architecture within the language production system and at the level of changes in language use.

  7. Rare cause of paraparesis: bilateral obturator neuropathy after hysterosalpingectomy.

    Science.gov (United States)

    López-Blanco, Roberto; Mejía-Jiménez, Inmaculada; de Fuenmayor-Fernández de la Hoz, Carlos Pablo; Ruiz-Morales, Juan

    2015-01-01

    Bilateral obturator nerve injury during pelvic surgery is an infrequent cause of lower limb paraparesis. We report the case of a 45-year-old woman with a large uterine leiomyoma who underwent simple total hysterectomy and bilateral salpingectomy. At 24 h after the surgery, the patient noticed loss of muscle strength when adducting both legs. She had no problem with other movements and no sensory or sphincter abnormalities. Neurological examination confirmed that there was loss of strength only in the adductor muscles, with preserved sensory function and reflexes, suggesting bilateral obturator nerve involvement. Pelvic MRI showed a small postsurgical haematoma in the Douglas recess, but far from the obturator nerves. 2 weeks later, electromyography showed positive sharp waves and low motor unit recruitment in the adductor magnus muscles, confirming acute, bilateral obturator nerve neuropathy. The few cases of bilateral obturator neuropathy that have been reported were mostly related to abdominopelvic interventions. PMID:26689250

  8. Bilateral Clavicle Fractures: A Report of Three Cases.

    Science.gov (United States)

    Lakhotia, Devendra; Khatri, Kavin; Sharma, Vijay; Farooque, Kamran; Sharma, Swati

    2016-06-01

    Bilateral clavicle fractures are uncommonly reported in the literature with the incidence being less than 0.5% of all the clavicle fractures. Bilateral clavicle fractures are caused either by high-energy transfer of compression forces across both shoulder girdles or by a direct trauma to one clavicle followed by that to the other clavicle. These fractures could be missed due to their association with more severe chest injuries or a more symptomatically displaced fracture on one side or due to inadequate chest radiographs. We report three cases of traumatic bilateral clavicle fractures with three modes of injuries in different age groups. All the fractures were treated conservatively with good functional outcomes without any sequelae. Bilateral clavicle fractures should be actively sought by every trauma team with proper clinical examination and chest radiographs including both shoulder joints in high-energy trauma cases or with bilateral shoulder compression injuries. PMID:27504365

  9. MRI features of bilateral parotid haemangiomas of infancy

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, Savvas; Jadwat, Saaleeha [Institute of Child Health, University of Cape Town, Klipfontein Road, Rondebosch, 7700, Cape Town (South Africa); McHugh, Kieran; Linward, Jane [Department of Radiology, Great Ormond Street Hospital for Children, London, WC1N 3JH (United Kingdom)

    2003-04-01

    The aim of this article is to report the MRI features of bilateral parotid haemangiomas of infancy and highlight the diagnostic and prognostic value of MRI especially with regard to those lesions that may cause respiratory compromise. Retrospective review of MRI scans in six infants with bilateral parotid haemangiomas. The bilateral haemangiomas were symmetrical in all but one patient. On T1-weighted images the masses were isointense to muscle and on T2 they were hyperintense with numerous small vessels giving a septated appearance. There was vivid enhancement with gadolinium in all cases. In three patients, deep bilateral extensions were demonstrated involving the parapharyngeal spaces resulting in respiratory compromise which required tracheostomy. Bilateral parotid haemangiomas are rare, but when present may have deep extensions, which can result in respiratory compromise requiring tracheostomy. (orig.)

  10. Bilateral periventricular nodular heterotopia with megalencephaly: a case report.

    Science.gov (United States)

    Abe, Yu; Kobayashi, Satoru; Wakusawa, Keisuke; Tanaka, Soichiro; Inui, Takehiko; Yamamoto, Toshiyuki; Kunishima, Shinji; Haginoya, Kazuhiro

    2014-06-01

    Bilateral periventricular nodular heterotopia is a neuronal migration disorder characterized by gray matter cellular rests in the periventricular regions. Megalencephaly has not been reported in children with bilateral periventricular nodular heterotopia. No other disorder with a similar phenotype has been reported. Here we report the case of a 5-year-old Japanese boy with bilateral periventricular nodular heterotopia and megalencephaly. Relative macrocephaly was evident at birth, and bilateral periventricular nodular heterotopia and megalencephaly were noted on magnetic resonance imaging (MRI). However, no hydrocephalus or indication of cerebral cortical dysplasia was seen. A mild intellectual disability was present, but the patient had no history of seizures. Genetic analysis revealed no mutation on the capillary sequences for FLNA, and no pathogenic abnormalities were evident on array comparative genomic hybridization. This case could represent a new disease entity: bilateral periventricular nodular heterotopia with megalencephaly. PMID:23439715

  11. Bilateral Tubal Gestation Associated with Schistosomiasis in an African Woman

    Directory of Open Access Journals (Sweden)

    K. H. Odubamowo

    2014-01-01

    Full Text Available Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3+0 (3 alive woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days’ duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide. Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation.

  12. Trade flows between Australia and China: An opportunity for a free trade agreement

    OpenAIRE

    McDonald, Daniel; Nair, Roneel; Rodriguez, Gil; Buetre, Benjamin L.

    2005-01-01

    The seemingly high degree of trade complementarity between Australia and China indicates that freer trade between these two countries is likely to lead to mutual trade gains. In this paper, this complementarity was assessed based on the use of revealed comparative advantage (RCA) indices. It is likely that trade gains could be achieved by Australia and China by adopting a bilateral free trade agreement. General equilibrium models – such as ABARE’s global trade and environment model (GTEM) – h...

  13. Framework agreements in public procurement

    DEFF Research Database (Denmark)

    Andrecka, Marta; Telles, Pedro

    2015-01-01

    Interview with Dr. Marta Andrecka, Postdoctoral Fellow at the Department of Law at the University of Aarhus, where she is currently working on a project called "Dealing with legal loopholes and uncertainties within EU public procurement law regarding framework agreements" sponsored by the Carlsberg...... Foundation. Before taking up her present position she carried out her doctoral research in Denmark and Australia and worked at law offices in both Poland and the UK. The topic for today’s talk is framework agreements, a relatively popular way of undertaking public procurement...

  14. Comparative gait initiation kinematics between simulated unilateral and bilateral ankle hypomobility: Does bilateral constraint improve speed performance?

    Science.gov (United States)

    Delafontaine, A; Honeine, J-L; Do, M-C; Gagey, O; Chong, R K

    2015-08-31

    Improvement of motor performance in unilateral upper limb motor disability has been shown when utilizing inter-limb coupling strategies during physical rehabilitation. This suggests that 'default' bilateral central motor commands are facilitated. Here, we tested whether this bilateral motor control principle may be generalized to the lower limbs during gait initiation, which involves alternate bilateral actions. Disability was simulated by strapping to produce ankle hypomobility. Healthy adult subjects initiated gait at a self-paced speed with no ankle constraint (control), or with the stance, swing or bilateral ankles strapped. The duration of the anticipatory postural adjustments lengthened and the center of mass instantaneous progression velocity at foot-off decreased when the ankle was strapped. During the step execution phase, progression velocity at foot-contact was higher when both ankles were strapped compared to unilateral strapping of the stance ankle. These findings suggest that bilateral central motor commands are favored during walking tasks. Indeed, unilateral constraint of the stance ankle should compel the central nervous system to adapt specific commands to the constraint and normal sides whereas the 'default' bilateral motor commands would be utilized when both ankles are strapped leading to better kinematics performance. Bilateral in-phase upper limb coordination and bilateral alternating lower limb locomotor movements may share similar control mechanisms. PMID:26197055

  15. Bilateral comparison of an IPRT between KRISS and SIC

    Science.gov (United States)

    Yang, I.; Sánchez, C. A.

    2013-09-01

    As a follow-up of a memorandum of understanding signed in 2009 between KRISS of Korea and SIC of Colombia, the two national metrology institutes carried out a bilateral comparison of calibration of an industrial platinum resistance thermometer (IPRT). A protocol that was similar to that of APMP.T-S6 has been agreed and followed in the comparison. The method of the calibration at each laboratory was calibration by comparison against calibrated reference thermometers. The nominal temperatures of the comparison were nine temperatures, including the ice point, between -50 °C and 500 °C. One commercially-available IPRT with α ˜ 0.00385 °C-1 that was prepared by KRISS was calibrated by comparison firstly at KRISS, and then at SIC, and finally at KRISS to assess the drift of the artifact during the comparison. At KRISS, an ice-point bath, three liquid baths and a salt bath were used to provide isothermal environment for the comparison. At SIC, an ice-point bath, two liquid baths and a vertical furnace with a metal equalizing block were used. The claimed uncertainty with k=2 of the calibration at KRISS, excluding the longterm instability and hysteresis of the traveling IPRT, was 30 mK, and that at SIC was 120 mK. The capability of the calibration of the two laboratories from -50 °C to 500 °C showed a good agreement within the claimed uncertainty of the calibration. The largest deviation of the two calibration results was 75 mK at 500 °C.

  16. Form 6 - gas balancing agreement

    International Nuclear Information System (INIS)

    In 1988, a special Committee of the Rocky Mountain Mineral Law Foundation undertook a project to draft a model from gas balancing agreement. This project was initiated at the request of a number of Foundation members who felt that a model form gas balancing agreement would facilitate the negotiation of operating agreement, since gas balancing issues had become sticking points in the process. The Committee was composed of attorneys representing a wide cross-section of the oil and gas industry including both major and independent oil companies, production companies with interstate pipeline affiliates, and private practitioners. The Committee attempted to address the more controversial issues in gas balancing with optional provisions in the Form. To facilitate the negotiation process, the number of optional provisions was minimized. This form may be used as an Appendix to the new A.A.P.L. Form 610-1989 Model Form Operating Agreement. This book includes provision of this Form which are: Ownership of gas production; Balancing of production accounts; Cash balancing upon depletion; Deliverability tests; Nominations; Statements; Payment of taxes; Operating expenses; Overproducing allowable; Payment of leasehold burdens; Operator's liability; Successors and assigns; Audits; Arbitration; and Operator's fees

  17. The Bali Agreement: Implications for Development and the WTO

    Directory of Open Access Journals (Sweden)

    Christophe Bellmann

    2014-05-01

    Full Text Available At the most recent World Trade Organisation (WTO ministerial conference, in December 2013, in Bali, Indonesia, ministers from 160 countries concluded the first multilateral agreement ever negotiated under the auspices of the WTO. After five years of impasse in the moribund Doha Round of trade negotiations, the so-called “Bali package” was enthusiastically welcomed by the world’s governments and international press alike as a critical step towards restoring the credibility of the WTO as a negotiating forum. The centrepiece of the package is without doubt a new agreement on trade facilitation aimed at reducing red tape, and facilitating customs procedures in an effort to cut down the cost of doing business. Other — less far reaching — aspects of the deal focused on food security and a set of issues of particular interest to least developed countries including trade preferences or cotton subsidies. As the dust from the heated Bali negotiations settles, the main challenge for the WTO will now consist in building on this success to re-energise multilateral negotiations and ultimately close the Doha Round. In a world increasingly dominated by regional and bilateral free-trade agreements, members will have to confront the core issues that have divided them for nearly 15 years and find creative solutions to rehabilitate the WTO’s centrality in global trade governance.

  18. Interobserver agreement on the interpretation of automated whole breast ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Jeong; KIm, Sung Hun; Kang, Bong Joo; Kim, Yun Ju [Dept. of Radiology, Seoul St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    The purpose of this study was to prospectively evaluate the interobserver agreement on lesion characterization and the final assessment of automated whole breast ultrasonography (ABUS) images. Between March and August 2012, 172 women underwent bilateral ABUS before biopsy guided by handheld ultrasonography (HHUS) and mammography. A total of 206 breast lesions were confirmed histopathologically by biopsy. Three-dimensional volume data from ABUS scans were analyzed by two radiologists without the knowledge of HHUS results or patient clinical information. The two readers described the type, shape, orientation, margin, echogenicity, posterior acoustic features, and categorization of the final assessment of detected breast lesions. Kappa statistics were used to analyze the described characteristics of the breast lesions detected by both of the two readers. Of the 206 histopathologically confirmed lesions, reader 1 detected 166 lesions and reader 2 detected 150 lesions. A total of 145 lesions were detected by both readers using ABUS images. There was substantial agreement on shape (k=0.707), and moderate agreement on type, margin, mass orientation, echogenicity, and posterior acoustic features (k=0.592, 0.438, 0.472, 0.524, and 0.541, respectively). Breast Imaging Reporting and Data System final assessment values yielded a kappa value of 0.3971 when category subdivisions 4A, 4B, and 4C were included. With respect to the C2, C3, C4, and C5 categories, the interobserver agreement was moderate (k=0.505). ABUS is a promising diagnostic tool with a good interobserver agreement, comparable to that of HHUS.

  19. Bilateral Psoas Haematomata Complicating Renal Transplantation

    Directory of Open Access Journals (Sweden)

    Jacob A. Akoh

    2014-01-01

    Full Text Available Background. The challenge in managing patients undergoing renal transplantation is how to achieve optimum levels of anticoagulation to avoid both clotting and postoperative bleeding. We report a rare case of severe postoperative retroperitoneal bleeding including psoas haematomata complicating renal transplantation. Case Report. SM, a 55-year-old female, had a past history of aortic valve replacement, cerebrovascular event, and thoracic aortic aneurysm and was on long-term warfarin that was switched to enoxaparin 60 mg daily a week prior to her living donor transplantation. Postoperatively, she was started on a heparin infusion, but this was complicated by a large retroperitoneal bleed requiring surgical evacuation on the first postoperative day. Four weeks later, she developed features compatible with acute femoral neuropathy and a CT scan revealed bilateral psoas haematomata. Following conservative management, she made steady progress and was discharged home via a community hospital 94 days after transplantation. At her last visit 18 months after transplantation, she had returned to full fitness with excellent transplant function. Conclusion. Patients in established renal failure who require significant anticoagulation are at increased risk of bleeding that may involve prolonged hospitalisation and more protracted recovery and patients should be carefully counselled about this.

  20. BILATERAL OSSIFIED STYLOHYOID COMPLEX: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sarada Devi S

    2015-11-01

    Full Text Available : Mineralisation of all components of stylohyoid complex or chain, a 2nd branchial arch derivative is frequently reported. But bilateral occurrence of continuous bands of ossified tissue involving stylohyoid complex, are less commonly encountered. An adult skull specimen presented abnormally long osseous bands extending from base of skull in place of styloid process. On left side a band of 6.5cm long x1cm wide and 0.3cm in thickness, and on right side an irregularly rounded elongated structure of 7.5cm length were noticed. Lower end of the left process was fused to hyoid bone. Either abnormally long styloid process or this type of ossified stylohyoid complex may be a causative factor for severe pharyngeal pain, dysphagia, may be a cause for occasional swelling in submandibular region or may be associated with Eagle syndrome. Due to its close proximity to tonsillar bed, if elongated it may be felt during tonsillectomy in tonsillar fossa. In this backdrop reports of this type may be of interest to clinicians.

  1. Outcome of bilateral ureteroscopic retrieval of stones in a single session

    Directory of Open Access Journals (Sweden)

    Majid Mushtaque

    2012-01-01

    Conclusion: Bilateral same-session ureteroscopy is a safe and effective procedure in the management of bilateral ureteral stones. The results are comparable to unilateral or staged bilateral procedures.

  2. Synchronous Bilateral Solid Papillary Carcinomas of the Breast

    Directory of Open Access Journals (Sweden)

    Noriko Yoshimura

    2013-01-01

    Full Text Available We herein report a case of synchronous bilateral solid papillary carcinoma of the breast. A 73-year-old female had a mass that was detected in the right breast on mammography. An ultrasound examination revealed one intracystic tumor in the right breast and two tumors in the left breast. A fine-needle aspiration biopsy of these three tumors was performed, which revealed a diagnosis of malignancy. A magnetic resonance imaging examination of the breasts showed diffuse small nodules surrounding these tumors bilaterally. Bilateral partial mastectomy and a sentinel lymph node biopsy were performed. Lymph node metastasis was detected in the right axilla, and additional lymph node dissection was performed. The pathological diagnosis was synchronous bilateral breast cancer, invasive ductal carcinoma NOS of the right breast, mucinous carcinomas of the left breast, and bilateral SPCs. A wide range of surgical margins were positive for SPCs, and additional bilateral total mastectomy was then performed. To the best of our knowledge, little is known about synchronous bilateral SPCs. Our case indicates that some SPCs can be widely scattered and make up a variety of invasive carcinomas. It is difficult to make a correct preoperative evaluation in such cases.

  3. A 72-year-old patient with bilateral Maisonneuve fractures

    Directory of Open Access Journals (Sweden)

    Thomas Dienstknecht

    2012-07-01

    Full Text Available Maisonneuve fractures result from a disruption of the medial ankle structures and a proximal fibular fracture. Patient complaints can be misleading and there is a significant rate of delayed diagnosed injuries. We present a case of bilateral Maisonneuve fractures after a fall due to a syncopal collapse. A precise clinical examination led to this rare diagnosis. The injuries were treated with syndesmotic screw fixation, removal of hardware followed after 6 weeks. The patient was asymptomatic at threemonths follow up. Patients with bilateral injuries undergoing standard surgical treatment can gain full recovery, but high suspicion in clinical examination is needed to detect this uncommon bilateral injury.

  4. Geleophysic dysplasia associated with bilateral angle closure glaucoma

    Directory of Open Access Journals (Sweden)

    Murat Sinan Saricaoglu

    2013-01-01

    Full Text Available In this case report, we present occurrence of bilateral angle closure glaucoma in a 9-year-old girl with geleophysic dysplasia. Bilateral YAG laser iridotomy was applied, but intraocular pressure (IOP remained at high levels, necessitating bilateral trabeculectomy with mitomycin C. On her follow-up examinations for 3 years, IOP remained in the mid-20s with no need for further intervention or antiglaucoma medication. There are few reports describing the ocular findings of geleophysic dysplasia in literature. To our knowledge, this is the first case report describing an application of glaucoma surgery and its results at geleophysic dysplasia.

  5. Bilateral Ota nevus in a 15 years old patient

    Directory of Open Access Journals (Sweden)

    Savaş Öztürk

    2013-12-01

    Full Text Available Nevus of Ota is a dermal melanocytosis, clinically localizedon skin that is innervated by the first and secondbranches of the trigeminal nerve. It occurs almost entirelyin Asian people. The clinical manifestations are usuallyunilateral; only 5% of cases are bilateral. In this article,due to rarity of the case, a 15-year-old patient, who was diagnosedwith bilateral ota nevus, without having any dermatologicalcomplaints other than cosmetic appearenceand stains in her eyes and around was presented.Key words: Bilateral ota nevus, child, melanocytosis

  6. Bilateral Tibial Tubercle Sleeve Fractures in a Skeletally Immature Patient

    Directory of Open Access Journals (Sweden)

    Rasesh R. Desai

    2013-01-01

    Full Text Available Tibial tubercle sleeve fracture is a rare injury. In concept, it is similar to the patellar sleeve fracture in a skeletally immature patient. We describe a unique case of simultaneous bilateral tibial tubercle sleeve fractures in a 12-year-old boy. Radiographs and MRI confirmed the injury. The patient underwent open surgical repair of bilateral sleeve fractures with suture anchor fixation. At the final followup, 3 years after his initial injury, the patient demonstrated full knee function bilaterally without radiographic evidence of growth disturbances.

  7. Early morbidity after simultaneous and staged bilateral total knee arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Jørgensen, Christoffer Calov; Husted, Henrik;

    2015-01-01

    PURPOSE: The aim of this nationwide study was to investigate the early morbidity after bilateral simultaneous and staged total knee arthroplasty (TKA) in order to clarify potential benefits of a well-established fast-track regime. METHODS: The Danish National Patient Registry was searched for all...... with 14 % (CI 11.5-20.1) after bilateral staged TKA within 7-18 months. CONCLUSIONS: The results from this nationwide study indicate that bilateral simultaneous TKA can safely be performed in a fast-track set-up....

  8. Haptic Manipulation of Deformable Objects in Hybrid Bilateral Teleoperation System

    Directory of Open Access Journals (Sweden)

    Juan Manuel Ibarra-Zannatha

    2007-01-01

    Full Text Available The aim of this work is the integration of a virtual environment containing a deformable object, manipulated by an open kinematical chain virtual slave robot, to a bilateral teleoperation scheme based on a real haptic device. The virtual environment of this hybrid bilateral teleoperation system combines collision detection algorithms, dynamical, kinematical and geometrical models with a position–position and/or force–position bilateral control algorithm, to produce on the operator side the reflected forces corresponding to the virtual mechanical interactions, through a haptic device. Contact teleoperation task over the virtual environment with a flexible object is implemented and analysed.

  9. BILATERAL ANOMALOUS MUSCLE IN THE POPLITEAL FOSSA & ITS CLINICAL SIGNIFICANCE

    Directory of Open Access Journals (Sweden)

    Sowmya S

    2014-10-01

    Full Text Available Muscle variation may occur due to genetic or developmental causes. Some variations may compromise the vascular, muscular or nervous system in the region. Bilateral muscle variation in popliteal fossa is very rare. In present study an instance of bilateral muscle variation in popliteal fossa, arising from different muscles like gastrocnemius and from biceps femoris is recorded. There is no report of such variations. These observations are rare of its kind because of bilateral asymmetrical presence and difference in the origins in different legs. This is the first report as for the literatures available. Clinical and functional importance of such variation is discussed with the morphological aspects of this anomalous muscle.

  10. Luxatio erecta bilateral: um relato de caso Bilateral luxatio erecta, a case report

    OpenAIRE

    César Augusto Xavier Acosta; Elemar da Silva Resch; Rafael Rodrigues

    2012-01-01

    O deslocamento inferior do ombro (luxatio erecta) é uma lesão rara, acometendo aproximadamente 0,5% dos deslocamentos dessa articulação. A grande maioria desses casos ocorre unilateralmente. Em setembro de 2004, um homem de 43 anos chegou ao pronto-socorro do Hospital Universitário de Santa Maria (HUSM) com queixa de dor bilateral no ombro e incapacidade de abaixar os braços, em consequência de uma queda com os braços abduzidos, enquanto desempenhava sua atividade laboral. Após o exame físico...

  11. Luxatio erecta bilateral: um relato de caso Bilateral luxatio erecta, a case report

    Directory of Open Access Journals (Sweden)

    César Augusto Xavier Acosta

    2012-02-01

    Full Text Available O deslocamento inferior do ombro (luxatio erecta é uma lesão rara, acometendo aproximadamente 0,5% dos deslocamentos dessa articulação. A grande maioria desses casos ocorre unilateralmente. Em setembro de 2004, um homem de 43 anos chegou ao pronto-socorro do Hospital Universitário de Santa Maria (HUSM com queixa de dor bilateral no ombro e incapacidade de abaixar os braços, em consequência de uma queda com os braços abduzidos, enquanto desempenhava sua atividade laboral. Após o exame físico e radiológico constatou- se que o indivíduo apresentava uma luxação inferior bilateral dos ombros. O paciente foi então encaminhado ao bloco cirúrgico onde foi realizada redução incruenta das luxações sob anestesia através da técnica de tração e contra-tração. No dia seguinte recebeu alta com imobilização tipo Velpeau mantendo os ombros totalmente aduzidos e rotados internamente, com orientação de manter a imobilização por três semanas. Foi orientado também a realizar fisioterapia.Inferior shoulder dislocation (luxactio erecta is a rare lesion affecting approximately 0.5% of dislocations of this joint. The vast majority of these cases occur unilaterally. In September 2004, a 43 year old man was brought to the emergency room of the University Hospital of Santa Maria (HUSM complaining of bilateral shoulder pain and inability to lower the arms, as a result of a fall with the arms abducted, while carrying out work activities. After physical examination and radiological exams, it was found that the patient had a bilateral inferior shoulder dislocation. He was referred to the surgical ward and after intravenous sedation, both shoulders were reduced by closed reduction using the traction-countertraction maneuver. The patient was discharged the day after the reduction. Both arms were immobilized with a velpeau sling in total adduction and intrarotation, with instructions to maintain immobilization for three weeks. The patient was

  12. Bilateral Tarsal Tunnel Syndrome Due To Bilateral Lipoma: A Case Report

    Directory of Open Access Journals (Sweden)

    C. Eren CANSÜ, İstemi YÜCEL, Kutay ÖZTURAN

    2010-11-01

    Full Text Available Tarsal tunnel syndrome is an entrapment neuropathy of posterior tibial nerve under the flexorretinaculum. Patients generally present with paresthesias on the plantar side of foot and fingersand in the distal kruris.The causes of tarsal tunnel syndrome are space occupying lesions within or around the tunnelwhich exert pressure to the nerve, ankle deformities, systemic illnesses, trauma or lesions ofthe nerve itself.In this study a case of tarsal tunnel syndrome due to bilateral lipoma which was treated surgicallyis presented.

  13. Offeree silence and contractual agreement.

    OpenAIRE

    Austen-Baker, Richard

    2006-01-01

    This article considers the mechanics of acceptance in the law of contract, focusing on the question of whether the silence of an offeree can effect acceptance. It finds the rule in Felthouse v Bindley (1862) alive and well, but creating problems for judges anxious to find agreements in place. The article considers whether there is, as sometimes suggested, a ‘duty to speak’ and dismisses this, along with any other supposed exceptions to the rule, concluding that silence cannot effect acceptanc...

  14. Managing Enterprise Service Level Agreement

    OpenAIRE

    Yang Li

    2010-01-01

    The continued trend of globalization and technology improvement like the internet and transportation have spawned an increasing number of complex service chains that span across local, regional and national boundaries. Service level agreement (SLA) plays a crucial role in gluing service chains together. In that regard, this paper provides a complete guidance of end-to-end lifecycle management of SLA, including SLA-aware service modelling and terms optimization, contract drafting and complianc...

  15. Bilateral versus unilateral thyroid eye disease

    Directory of Open Access Journals (Sweden)

    Mohsen Bahmani Kashkouli

    2011-01-01

    Full Text Available Aims: The aim of this study was to compare demographics, clinical manifestations, associated systemic and ocular factors, severity and activity of patients with unilateral thyroid eye disease (U-TED versus bilateral thyroid eye disease (B-TED. Materials and Methods: In a cross-sectional study, all patients with Graves′ hyperthyroidism and primary hypothyroidism seen in an endocrinology clinic were included from September 2003 to July 2006. Demographics, complete eye examination, severity score (NOSPECS, total eye score, and clinical activity score were recorded and compared in the B-TED and U-TED groups of patients. Results: From 851 patients with thyroid disorders, 303 (35.6% had TED. Thirty-two patients (32/ 303, 10.56% were found to have U-TED. Patients with U-TED (mean age 31.6 ± 11.6 years were significantly younger than patients with B-TED (mean age 37.7 ± 14.7 years. Monovariate analysis (Chi-square and independent sample t-test showed a significantly higher severity score in B-TED (U-TED 4.09±4.05, B-TED: 6.7±6.3; P= 0.002 and more activity score in B-TED (U-TED= 1.03±0.96, B-TED: 1.74±1.6, P= 0.001. However, multivariate analysis did not show any significant difference between the two groups in terms of age, gender, type of thyroid disease, duration of thyroid disease and TED, severity and activity of TED, smoking habit, and presentation of TED before or after the presentation of thyroid disease (0.1

  16. Luxação lateral bilateral isolada do cotovelo Elbow bilateral lateral dislocation

    Directory of Open Access Journals (Sweden)

    Leandro José Reckers

    2006-01-01

    Full Text Available Os autores apresentam um caso de luxação lateral bilateral isolada de cotovelo em uma paciente do sexo feminino de 48 anos. Optou-se pelo tratamento conservador através de redução fechada sob anestesia geral. Ambos os cotovelos foram imobilizados com gesso axilo-palmar e mantidos a 90º de flexão por três semanas, quando se iniciou a reabilitação. No seguimento de dezoito meses observou-se boa estabilidade e recuperação do arco de movimento de ambos os cotovelos.The authors present an isolated case of bilateral lateral dislocation of the elbow joint in a 48-year old female patient. The conservative treatment was chosen, through closed reduction under general anesthesia. Both elbows were placed in an axillopalmar splint cast and held at a 90 degree angle of flexion for three weeks when rehabilitation began. In the eighteen-month follow-up period, good stability as well as the recovery of the range of motion was observed in both elbows

  17. Mielolipoma adrenal bilateral em um cão Bilateral adrenal myelolipoma in a dog

    Directory of Open Access Journals (Sweden)

    Silvia de Araújo França

    2008-08-01

    Full Text Available O presente relato descreve um caso de mielolipoma adrenal bilateral em uma cadela Poodle de 13 anos de idade. O cão morreu por peritonite séptica aguda, decorrente de ulceração e perfuração intestinal por corpo estranho linear. O neoplasma foi achado incidentalmente durante a necropsia. Macroscopicamente, as adrenais estavam redondas e com volume e aumentados. Ao corte elas eram friáveis, vermelho-amarronzadas, intercaladas por áreas branco-amareladas levemente proeminentes. Histologicamente, extensas áreas do parênquima continham adipócitos bem diferenciados, células hematopoéticas e macrófagos com hemossiderina, achados característicos de mielolipoma adrenal.A case of bilateral adrenal myelolipoma in a 13-year-old female Poodle is reported. Acute septic peritonitis due to intestinal ulceration and perforation caused by a linear foreign body was the cause of death. The adrenal neoplasm was an incidental necropsy finding. The adrenal glands were grossly rounded, enlarged and friable, and had red-brownish parenchyma interwoven by slightly prominent white-yellowish foci. Histologically, the findings of differentiated adipocytes in large areas of the parenchyma, in association to hematopoietic cells and macrophages with hemosiderin were consistent with the diagnosis of adrenal myelolipoma.

  18. Delayed-onset bilateral abducens paresis after head trauma

    Directory of Open Access Journals (Sweden)

    Pravin Salunke

    2012-01-01

    Full Text Available Bilateral sixth nerve paresis following closed head injury, though rare, is a known entity. However, delayed-onset post-traumatic bilateral abducens paresis is extremely rare. We present two cases. The first patient had onset of bilateral abducens paresis 2 weeks after closed head injury and the second patient after 3 days. The cause in the former was detected to be chronic subdural hematoma and in the latter is speculated to be edema/ischemia due to injury to soft tissue structures housing these nerves. The delayed onset of bilateral abducens paresis following head injury may vary according to the cause. There may be another mechanism of injury apart from direct trauma. Though rare, it needs to be evaluated and may have a treatable cause like elevated intracranial pressure.

  19. Bilateral Teleoperation in Cartesian Space with Time-Varying Delay

    Directory of Open Access Journals (Sweden)

    Zhang Chen

    2012-10-01

    Full Text Available The bilateral control of a teleoperator in Cartesian space with time‐varying delay is studied in this paper. Compared with the traditional joint‐space teleoperation mode, bilateral control in Cartesian space has advantages when dealing with the kinematically dissimilar (KDS teleoperation systems. A Cartesian space‐based PD‐like bilateral controller with dissipation factors is designed. Considering the fact that attitude errors derived by rotation matrix cannot be directly used for PD control, a quaternion‐based approach is adopted to calculate the attitude errors in Cartesian space. In order to overcome the instability brought about by communication delay, local damping components are employed at both ends of the teleoperator system. The variation of time delay may generate extra energy and influence the stability of the system, thus dissipation factors are introduced into the controller. The stability of the proposed bilateral controller is proved and the simulations show the effectiveness of the approach.

  20. A case of bilateral primary fallopian tube carcinoma

    Directory of Open Access Journals (Sweden)

    Manisha Sahu

    2014-09-01

    Full Text Available A 60 years old postmenopausal woman was presented with complaints of intermittent watery discharge from vagina, and of cramping pain at the lower abdomen. On pelvic examination, blood tinged watery discharge was seen coming out of os. But, ultrasonography revealed bilateral adenexal masses and pyometra. The serum CA-125 level in blood was raised. Cervical smear showed inflammatory changes, but endometrial histopathology was negative for malignant cells. Suspecting ovarian malignancy, laparotomy was done that revealed the bilateral tubal growth with normal ovaries; the right adenexal mass was of the size (6.8×4.8 cm while, the left adenexal mass was the size of (4.2×2.6 cm. Histopathology study revealed bilateral serous cyst adenocarcinoma of fallopian tubes. The case of bilateral primary fallopian tube carcinoma was presented here for its rarity.

  1. Surgical Management of Bilateral Limbal Stem Cell Deficiency.

    Science.gov (United States)

    Vazirani, Jayesh; Mariappan, Indumathi; Ramamurthy, Shreyas; Fatima, Saba; Basu, Sayan; Sangwan, Virender S

    2016-07-01

    Limbal stem cell deficiency (LSCD) is now established as a distinct entity with a spectrum of clinical manifestations. Bilateral LSCD presents a unique set of challenges to the clinician dealing with ocular surface disease, due to the underlying causes, clinical presentation, and adnexal status, as well as lack of a source of autologous limbal stem cells. Various surgical modalities have been described to achieve visual rehabilitation in patients with bilateral LSCD. These can primarily be divided into cell-based therapies and implantation of keratoprostheses. In this review, the surgical options for management of bilateral LSCD, including autologous and allogeneic cell-based therapies and different types of keratoprostheses are described and classified. The indications, prerequisites, technique, results and complications of each modality are discussed. Based on the status of the ocular surface, an algorithm for choosing appropriate surgical management for vision restoration in bilateral LSCD has been proposed. PMID:27151421

  2. Pneumomediastinum, simultaneous bilateral spontaneous pneumothorax and subcutaneous emphysema following burn

    Directory of Open Access Journals (Sweden)

    Dixit Ramakant

    2006-01-01

    Full Text Available Simultaneous bilateral spontaneous pneumothorax and pneumomediastinum with subcutaneous emphysema following burn is unreported in the literature. We de-scribe such case in an 18-year-old male patient with possible mechanism of such presentation.

  3. Bilateral hematoma of sternocleidomastoid muscles. A case presentation.

    Directory of Open Access Journals (Sweden)

    Zoe Quintero Delgado

    2005-08-01

    Full Text Available Presentation of the case of an infant with bilateral congenital torticollis which development was followed by ultrasound. Homeopathy and physiotherapy were used for its treatment. This is an infrequent disease scarcely reported in medical literature.

  4. Australia and China: A Joint Report on the Bilateral Relationship

    Institute of Scientific and Technical Information of China (English)

    Liu Junhong; Guo Chunmei; Richard Rigby; Sang Ye

    2012-01-01

    After China and Australia established diplomatic ties in 1972, bilateral relations developed rapidly. People-to-people links, politicalexchanges and trade and economic cooperation played an increasingly larger part in the foreign policies of the two countries. In the post global financial crisis era, bilateral relations have remained positive and played an imPortant role in ensuring the stability and prosperity of the Pacific region. There have been several unavoidable misunderstandings and even disagreements between the two countries, which has influenced mutual trust and policies. This article will aim to analyze the history and current situation of the Sino-Australian relationship in an objective and comprehensive way; to look ahead to future bilateral relations, and make policy recommendations for the further development of bilateral ties to increase mutual understanding and promote a more positive future for Sino-Australian relations.

  5. Bilateral Efforts in Seizing Opportunities for Better Relations

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    @@ General improvement of the Japan-ROK relations started after the end of the Cold War. Although the Japanese wrongdoings over the history-related issues have caused fluctuations in the bilateral relations, no substantial damage has occurred.

  6. Unilateral and bilateral dental transpositions in the maxilla

    DEFF Research Database (Denmark)

    Danielsen, Jakob Christian; Karimian, K; Ciarlantini, R;

    2015-01-01

    AIM: This was to elucidate dental and skeletal findings in individuals with unilateral and bilateral maxillary dental transpositions. MATERIAL AND METHODS: The sample comprised of radiographic materials from 63 individuals with maxillary dental transpositions from the Departments of Odontology at...

  7. Bilateral SMAS rhytidectomy in parotid recurrent pleomorphic adenoma

    OpenAIRE

    A. Baj; BELTRAMINI, G.A.; Demarchi, M; V.A. Combi; A. Giannì

    2011-01-01

    SUMMARY A case is presented of a young female with parotid recurrent pleomorphic adenoma and skin infiltration treated with subtotal parotidectomy combined with a bilateral superficial muscular aponeurotic system rhytidectomy.

  8. Effect of pediatric bilateral cochlear implantation on language development

    NARCIS (Netherlands)

    Boons, Tinne; Brokx, Jan; Frijns, Johan; Peeraer, Louis; Philips, Birgit; Vermeulen,; Wouters,; Wieringen, van

    2012-01-01

    Objective: To examine spoken language outcomes in children undergoing bilateral cochlear implantation compared with matched peers undergoing unilateral implantation. Design: Case-control, frequency-matched, retrospective cross-sectional multicenter study. Setting: Two Belgian and 3 Dutch cochlear im

  9. Neonatal bilateral diaphragmatic paralysis caused by brain stem haemorrhage.

    OpenAIRE

    Blazer, S; Hemli, J A; Sujov, P O; Braun, J

    1989-01-01

    We describe a neonate with severe bilateral diaphragmatic paralysis caused by haemorrhage in the lower brain stem. To our knowledge this association has not been previously reported in the English medical literature.

  10. Osteochondritis dissecans in bilateral lateral femoral condyle in knees

    Directory of Open Access Journals (Sweden)

    Ari Zekcer

    2013-12-01

    Full Text Available The osteochondritis dissecans (OCD is a disease of unknown cause that classically affects the knee lateral border of the medial femoral condyle. We present a rare case of OCD in bilateral lateral femoral condyle.

  11. Bilateral compared with unilateral sacral nerve stimulation for faecal incontinence

    DEFF Research Database (Denmark)

    Duelund-Jakobsen, J; Buntzen, S; Lundby, L;

    2015-01-01

    % improvement were eligible. Twenty-seven patients who accepted to enter the trial were bilaterally implanted with two permanent leads and pacemakers. Patients were randomized into three periods of four weeks stimulation including unilateral right, unilateral left and bilateral. Symptoms scores and bowel habit...... incontinence is not superior to standard unilateral stimulation in the short term. Equal functional results can be obtained regardless the side of implantation. This article is protected by copyright. All rights reserved....

  12. Bilateral Traumatic Anterior Dislocation of Shoulder – a rare entity

    Directory of Open Access Journals (Sweden)

    Yashavantha Kumar C

    2013-01-01

    Full Text Available Introduction: Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislocation of shoulder without associated fracture in a 45 old women without any predisposing pathoanatomy.Case Report: A 45-year-old women presented to casualty with sudden onset of pain and restriction of movement in both shoulders fallowing trauma. Immediately post trauma she had severe pain and restriction of both shoulders. On examination arms were abducted and externally rotated. Bilateral shoulder movements were painful and restricted . There was loss of round contour of shoulder with increased vertical diameter of axilla anteriorly. Radiological examination revealed bilateral anterior dislocation of the shoulders without any associated fractures. Closed reduction done by Milch technique after intraraticular lignocaine injection. MRI of bilateral shoulder showed no pathological lesion. Both shoulders were immobilized with a shoulder immobilizer for three weeks.Conclusion: Most of the bilateral shoulder dislocations are posterior type seen in seizure disorders. Bilateral traumatic anterior shoulder dislocations are rare and are seen as a result of unique mechanism of injury. In our case patient had a fall on her elbows causing forced extension. If diagnosed and treated promptly completely normal function of the shoulders can be restored.

  13. Bilateral thecoma presenting as premenopausal hirsutism: Laproscopic removal

    OpenAIRE

    Ramkumar, S; V P Jyotsna; Mallick, S.; Garima Kachhawa; Kandasamy, D; A Kriplani; Ammini, A.C.

    2013-01-01

    Hyperandrogenism is a common disorder among women in the reproductive age group. One of the rare causes for androgen excess is sex cord- stromal tumors of the ovary. These are usually unilateral. Here we report case of a 48 year old woman who presented with hyperandrogenism due to bilateral ovarian thecoma. Androgen levels normalized following resection of the tumor. This, to the best of our knowledge, is the first case of bilateral thecoma presenting as hirsutism in a premenopausal woman.

  14. Bilateral thecoma presenting as premenopausal hirsutism: Laproscopic removal

    Directory of Open Access Journals (Sweden)

    S Ramkumar

    2013-01-01

    Full Text Available Hyperandrogenism is a common disorder among women in the reproductive age group. One of the rare causes for androgen excess is sex cord- stromal tumors of the ovary. These are usually unilateral. Here we report case of a 48 year old woman who presented with hyperandrogenism due to bilateral ovarian thecoma. Androgen levels normalized following resection of the tumor. This, to the best of our knowledge, is the first case of bilateral thecoma presenting as hirsutism in a premenopausal woman.

  15. Stage 4S Bilateral Adrenal Neuroblastoma in a Newborn

    Directory of Open Access Journals (Sweden)

    Rahul Gupta

    2014-02-01

    Full Text Available Stage 4S bilateral adrenal neuroblastoma presenting in the neonatal period is extremely rare. A 1-day-old male with 4S bilateral adrenal neuroblastoma complicated by marked hepatomegaly managed by chemotherapy is being reported. The provisional diagnosis of neuroblastoma was made in the fetal life during the last trimester of pregnancy. Cardiomyopathy due to doxorubicin cytotoxicity developed over ensuing years, which is being treated.

  16. Amyad's hernia while reparing the bilateral inguinal hernia

    Directory of Open Access Journals (Sweden)

    Arif Aslaner

    2015-01-01

    Full Text Available Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  17. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    OpenAIRE

    Patil, Mallanagouda N

    2013-01-01

    Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand). He complained of...

  18. Bilateral fracture dislocation of the shoulder (Presentation of a Case)

    OpenAIRE

    Kuzgun, Unal; Baskir, Orhan; Temelli, Yener; Yazicioglu, Onder; Temocin, Bahattin O.; Kokino, Misel

    2004-01-01

    The largest portion of the dislocations encountered in the adults comprises shoulder dislocations and 2.16% of these dislocations constitute posterior dislocations. It is possible to detect that a dislocation develops secondary to convulsions due to immediate loss of consciousness in the history of most of the posterior dislocations of the shoulder. Approximately 20 cases have been so far reported in literature regurding bilateral dislocations of the shoulder. Bilateral dislocation associated...

  19. Cooled Radiofrequency Ablation for Bilateral Greater Occipital Neuralgia

    OpenAIRE

    Tiffany Vu; Akhil Chhatre

    2014-01-01

    This report describes a case of bilateral greater occipital neuralgia treated with cooled radiofrequency ablation. The case is considered in relation to a review of greater occipital neuralgia, continuous thermal and pulsed radiofrequency ablation, and current medical literature on cooled radiofrequency ablation. In this case, a 35-year-old female with a 2.5-year history of chronic suboccipital bilateral headaches, described as constant, burning, and pulsating pain that started at the subocci...

  20. Bilateral diffuse uveal melanocytic proliferation: a management dilemma

    OpenAIRE

    Alrashidi, Salah; Aziz, Ayman A; Krema, Hatem

    2014-01-01

    A female patient suffered from gradual decline of vision for few months. She presented with bilateral multiple pigmented choroidal tumours, associated with overlying retinal changes. The clinical presentation suggested bilateral diffuse uveal melanocytic proliferation (BDUMP) syndrome, which is a paraneoplastic disease, although there was no evidence of any concurrent malignancy. The periodic systemic surveillance that was undertaken for the following 4 years failed to reveal any occult cance...

  1. Cardiovascular disease risk in adults with spastic bilateral cerebral palsy

    OpenAIRE

    Slot, Wilma; Roebroeck, Marij; Nieuwenhuijsen, Channah; Bergen, Michael; Stam, Henk; Burdorf, Alex; Berg-Emons, Rita

    2013-01-01

    textabstractObjective: To explore: (i) cardiovascular disease risk factors and the 10-year clustered risk of a fatal cardiovascular event in adults with spastic bilateral cerebral palsy; and (ii) relationships between the 10-year risk and body fat, aerobic fitness and physical activity. Design: Cross-sectional study. Subjects: Forty-three adults with spastic bilateral cerebral palsy without severe cognitive impairment (mean age 36.6 years (standard deviation 6); 27 men). Methods: Biological a...

  2. Bilateral adrenal hemorrhage and primary antiphospholipid antibody syndrome

    International Nuclear Information System (INIS)

    Bilateral adrenal hemorrhage is an uncommon entity that is difficult to diagnose given the ambiquity of the clinical signs. Computerized tomography plays a major role in the diagnosis, disclosing enlarged adrenal glands presenting the hyperdense aspect that characterizes this disorders. We present a case of bilateral adrenal hemoorrhage in a patient diagnosed as having primary antiphospholipid antibody syndrome, which is a less common cause of adrenal hemorrhage than those classically reported, such as anticoagulant therapy, sepsis, shock and abdominal injury. (Author) 8 refs

  3. Reversible tobramycin-induced bilateral high-frequency vestibular toxicity.

    Science.gov (United States)

    Walsh, R M; Bath, A P; Bance, M L

    2000-01-01

    We report an unusual case of tobramycin-induced bilateral high-frequency vestibular toxicity with subsequent clinical and objective evidence of functional recovery. In those patients with a clinical presentation suggestive of aminoglycoside-induced bilateral vestibular toxicity (ataxia and oscillopsia) and normal low-frequency (ENG-caloric) responses, high-frequency rotation chair testing should be performed to exclude a high-frequency vestibular deficit. PMID:10810261

  4. Fast and Accurate Bilateral Filtering using Gauss-Polynomial Decomposition

    OpenAIRE

    Chaudhury, Kunal N.

    2015-01-01

    The bilateral filter is a versatile non-linear filter that has found diverse applications in image processing, computer vision, computer graphics, and computational photography. A widely-used form of the filter is the Gaussian bilateral filter in which both the spatial and range kernels are Gaussian. A direct implementation of this filter requires $O(\\sigma^2)$ operations per pixel, where $\\sigma$ is the standard deviation of the spatial Gaussian. In this paper, we propose an accurate approxi...

  5. An unusual triad: Bilateral dilated odontoma, hypodontia and peg laterals

    Directory of Open Access Journals (Sweden)

    Alphy Alphonsa Sebastian

    2013-01-01

    The aim of this case report is to present a rare case of bilateral dilated odontoma affecting a microdontic permanent lateral incisor in a 30 year old female patient with hypodontia and peglateral teeth with its clinical, radiological and histological features, which has yet been not reported. Bilateral presence of dilated odontoma is not a common occurrence, although a single tooth involvement in each case has been reported in the literature.

  6. A Bilateral Advantage for Storage in Visual Working Memory

    OpenAIRE

    Umemoto, Akina; Drew, Trafton; Ester, Edward F.; Awh, Edward

    2010-01-01

    Various studies have demonstrated enhanced visual processing when information is presented across both visual hemifields rather than in a single hemifield (the bilateral advantage). For example, reported that observers were able to track twice as many moving visual stimuli when the tracked items were presented bilaterally rather than unilaterally, suggesting that independent resources enable tracking in the two visual fields. Motivated by similarities in the apparent capacity and neural subst...

  7. Binaural integration abilities in bilateral cochlear implant user

    Institute of Scientific and Technical Information of China (English)

    Chie Obuchi; Masae Shiroma; Sayaka Ogane; Kimitaka Kaga

    2015-01-01

    Bilateral Cochlear implants (CIs) improved speech intelligibility, speech perception in background noise, and sound localization in quiet and noisy situations. However, it is unclear whether these advantages essentially result in binaural integration of acoustic stimuli from each ear. In this study, we investigated the effectiveness of binaural integration by bilateral CIs placement using binaural hearing tests and subjective auditory perceptual assessment. A 61-year-old bilateral CIs subject underwent the following four tests:the Japanese Hearing in Noise Test (HINT-J), the dichotic listening test (DLT), the Rapidly Alternating Speech Perception (RASP) test, and subjective auditory perceptual assessment. The HINT-J score was significantly higher for bilateral CIs than for a unilateral CI. However, DLT and the RASP test revealed contradictory results. Subjective auditory perceptual assessment revealed active and bright impressions for bilateral hearing, which were also noisy and strong compared with those for unilateral hearing. The results of this study revealed that bilateral CIs improved speech perception in background noise and an improved auditory impression, although the bilateral integration abilities were not improved. This was probably because the patient was required to combine information from the two ears into a single perception in DLT and the RASP test. More longitudinal data should be collected and analyzed in future studies to evaluate the long-term effects of bilateral CIs. Copyright © 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  8. Prolapsed bilateral ureteroceles leading to intermittent outflow obstruction.

    LENUS (Irish Health Repository)

    Stunell, H

    2012-02-01

    A ureterocele refers to a cystic dilatation of the distal ureter. It may be unilateral or bilateral and may be associated with a duplex system in some cases. We present an unusual case where a young patient was found to have large bilateral ureteroceles which prolapsed into the urethra, causing intermittent incontinence and obstruction. We discuss the case and review the literature concerning this rare anomaly.

  9. Ultrasound Diagnosis of Bilateral Quadriceps Tendon Rupture After Statin Use

    Directory of Open Access Journals (Sweden)

    Nesselroade, Ryan D

    2010-09-01

    Full Text Available Simultaneous bilateral quadriceps tendon rupture is a rare injury. We report the case of bilateral quadriceps tendon rupture sustained with minimal force while refereeing a football game. The injury was suspected to be associated with statin use as the patient had no other identifiable risk factors.The diagnosis was confirmed using bedside ultrasound. [West J Emerg Med. 2010; 11(4:306-309.

  10. Bilateral practice improves dominant leg performance in long jump.

    Science.gov (United States)

    Focke, Anne; Spancken, Sina; Stockinger, Christian; Thürer, Benjamin; Stein, Thorsten

    2016-10-01

    Benefits of bilateral practice both for the non-dominant and for the dominant body side have been shown in several studies. Thereby, most of the studies included movement tasks of the upper extremity or investigated sports games in which the ability of acting bilaterally is an essential basis for success and, thus, a bilateral practice is reasonable anyway. Individual unilaterally performed sports including movement tasks of the lower extremity are rarely investigated. Therefore, the aim of our study was to test if contralateral transfer due to bilateral practice can be found in an unilaterally performed sport including the lower extremity. We trained and tested 61 adolescent athletes in long jump to compare the jumping performance of the dominant leg after a 12-week practice period between two groups: a bilateral practice group that practiced specific long jump exercises with both the dominant and non-dominant leg and an unilateral practice group that practiced specific long jump exercises only with the dominant leg. Results showed a superior effect of bilateral practice compared to unilateral practice regarding the jumping performance of the dominant leg. The performance increase at post-test and retention-test for the dominant limb was significantly higher for the bilateral practice group (pre-to-post: 5.2%, pre-to-retention: 7.4%) compared to the unilateral practice group (pre-to-post: 3.4%, pre-to-retention: 4.5%). Thus, bilateral practice should be established in the early practice programmes of track and field athletes to improve the performance of the dominant take-off leg. PMID:26864045

  11. Bilateral intramuscular pseudotumor in a body-builder.

    OpenAIRE

    Ardies, L; Beule, T.; Degroote, T; Vanhoenacker, F M; Vanhoenacker, P K

    2012-01-01

    A 29-year-old bodybuilder presented with a bilateral palpable and painful soft tissue mass in the deltoid region. CT scan showed a bilateral intramuscular mass within the deltoid muscle with intralesional fat (not shown). For further differentiation and exclusion of a fat-containing sarcomatous lesion, MRI of both shoulders was performed. Axial T1-weighted images (WI) of the right shoulder showed a heterogeneous mass lesion containing multiple fatty components (Fig. A, arrows). Axial T1-WI of...

  12. Amyad's hernia while reparing the bilateral inguinal hernia

    OpenAIRE

    Arif Aslaner; Tuğrul Çakır; Umut Rıza Gündüz; Burhan Mayir; Nurullah Bülbüller

    2015-01-01

    Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  13. Bilateral keratocystic odontogenic tumor: A report of two cases.

    Science.gov (United States)

    Srivatsan, K S; Kumar, Vikas; Mahendra, Ashish; Singh, Preeti

    2014-01-01

    The designation "keratocyst" was used to describe any jaw cyst in which keratin was formed to a large extent. A rare incidence of bilateral mandibular cysts (odontogenic keratocysts) was related to third molar teeth. Herein, we report two cases of bilateral keratocystic odontogenic tumor in a 22-year-old male and 15-year-old female, which was diagnosed by a series of investigations and treated appropriately.

  14. The General Unenforceability of Collective Agreements under Nigerian Labour Jurisprudence: The Paradox of Agreement without Agreement

    Directory of Open Access Journals (Sweden)

    Vincent Iwunze

    2013-12-01

    Full Text Available This study considers the status of collective agreements under Nigerian labour law, examining the extent of their enforceability under the extant laws. It considers the emerging trends in some more advanced jurisdictions of the world in that regard and comparatively portrays the anachronisms of the Nigerian law on the point. It takes the position that the current legal climate as regards the legal status of collective agreements under Nigerian law is potentially disruptive of industrial peace and harmony and is bound to occasion serious hardship on employees. The work suggests among others a jurisprudential shift in paradigm if the Nigerian labour jurisprudence must meet and be reflective of modern socio-economic realities.

  15. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Mallanagouda N Patil

    2013-04-01

    Full Text Available Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand. He complained of pain and difficulty in moving both the shoulders. On clinical examination, patient’s both upper limbs were abducted and externally rotated. Bilaterally shoulder contour was lost with flattening. Other classical signs of shoulder dislocation viz, Bryants test, Callway sign, Hamilton’s ruler test were positive. Diagnosis was confirmed on X rays. Both shoulders were reduced in emergency operation theater under general anaesthesia by Kocher’s method and were immobilised in sling. Conclusion: Though bilateral shoulder dislocations are commonly posterior, usually either secondary to convulsions or electric shock, anterior dislocation has to be kept in mind , especially in post traumatic injuries. This bilateral dislocation also presents with practical problems immobilization and day to day care of patients. Keywords: Simultaneous, bilateral, shoulder dislocation, traumatic.

  16. Sense of smell in patients with bilateral nasal polyposis

    Directory of Open Access Journals (Sweden)

    Savović Slobodan N.

    2004-01-01

    Full Text Available Introduction Sense of smell is susceptible to various changes, both in physiological and in numerous pathological conditions. Of quantitative disorders of smell, hyposmia and anosmia are quite common, whereas of qualitative disorders parosmia is most frequent. The aim of this paper was to examine impact of bilateral nasal polyposis on olfactory function. Material and methods The research was carried out at the Nose, Ear and Throat Clinic in Novi Sad. It included 80 examinees, 40 (20 male, 20 female with bilateral nasal polyposis, while 40 examinees belonged to the control group (20 male, 20 female without symptoms of nasal polyposes. Fortunato-Niccolini olfactometer was used for this examination. Results and discussion In patients with bilateral nasal polyposis the average perception threshold values for examined odors were 15.50 ccm of odorous air, while in the control group they were 10,20 ccm of odorous air. The average identification threshold values for examined odors in patients with bilateral nasal polyposis were 18.80 ccm of odorous air, while in the control group they were 13.55 ccm of scented air. T-test showed that values of both tresholds were statistically significantly higher (p< 0,01 in patients with bilateral nasal polyposis in relation to the control group. Conclusion Olfactory deficit in patients with bilateral nasal polyposis is explained by difficult or impossible passage of odors into the olfactory region.

  17. Simultaneous vs staged bilateral video-assisted thoracoscopic surgery.

    Science.gov (United States)

    Yim, A P

    1996-10-01

    It is generally thought that simultaneous bilateral chest surgery carries a high morbidity. We reviewed the results of simultaneous (under one anesthesia) vs staged bilateral video-assisted thoracoscopic surgery (VATS) from a single institution over a 35-month period. From September 1992 to July 1995, we performed simultaneous bilateral VATS on 37 patients (31 males, six females, age ranging from 15 to 55 years) with spontaneous pneumothorax (20) for bleb resections and pleurodesis; thoracodorsal sympathectomy (12) for palmar hyperhidrosis and vasospastic disease; and metastatic sarcomas (five) for wedge lung resections. During the same period, nine patients with metachronous bilateral spontaneous pneumothorax had staged procedures, as did two with digital ischemic ulcers for sympathectomy and three with metastatic pulmonary osteosarcomas for resection. Mean postoperative hospital stays in days for the simultaneous groups were 3.3 for spontaneous pneumothorax, 2.1 for sympathectomy, and 1.5 for wedge resection, compared to 2.9, 2.5, and 2.2 for the staged groups, respectively (p > 0.05 by Mann-Whitney U tests). Likewise, pain assessment by visual analogue scale as well as analgesic requirement showed no significant difference between the simultaneous and the staged groups. We conclude that simultaneous VATS is not associated with increased morbidity or prolonged hospital stay compared to the staged counterparts and provides an attractive alternative to the median sternotomy, bilateral posterolateral thoracotomy, or transternal (clam-shell) thoracotomy for selected cases of simultaneous bilateral lung surgery. PMID:8864102

  18. Bilateral Traumatic Globe Luxation with Optic Nerve Transection

    Directory of Open Access Journals (Sweden)

    Levent Tok

    2014-12-01

    Full Text Available Purpose: The purpose of this study was to document clinical findings and management of a patient with bilateral globe luxation and optic nerve transection. Materials and Methods: A 25-year-old female patient was admitted to the emergency department with bilateral traumatic globe luxation following a motor vehicle accident. Results: Visual acuity testing showed no light perception. The right pupil was dilated and bilaterally did not react to light. The globes were bilaterally intact. A computed tomography scan revealed Le Fort type II fractures, bilateral optic nerve transection and disruption of all extraocular muscles. The globes of the patient were bilaterally reduced into the orbit. However, the patient developed phthisis bulbi in the right eye at month 3. Conclusion: Globe luxation presents a dramatic clinical picture, and may lead to the development of severe complications due to the concomitance of complete optic nerve dissection and multiple traumas. Even if the luxated globe is repositioned into the orbit, there is still an increased risk of the development of phthisis due to ischemia.

  19. Neuralgia do trigêmeo bilateral: relato de caso Neuralgia del trigémino bilateral: relato de caso Bilateral trigeminal neuralgia: case report

    OpenAIRE

    Caio Marcio Barros de Oliveira; Luis Gustavo Baaklini; Adriana Machado Issy; Rioko Kimiko Sakata

    2009-01-01

    JUSTIFICATIVA E OBJETIVOS: A neuralgia do nervo trigêmeo é uma condição intensamente dolorosa, caracterizada por surtos de dor lancinante e súbita, tipo choque, com duração de poucos segundos a dois minutos e geralmente unilateral. Sua incidência anual é de cerca de 4,3 em 100.000 na população geral, tendo manifestação bilateral em apenas 3% desses casos. O objetivo deste artigo foi descrever um caso raro de neuralgia do trigêmeo primário bilateral. RELATO DO CASO: Paciente de 61 anos, maranh...

  20. Relative intensity of bilateral trade flows, regional integration, and trade performance: the case of Brazil, 1984-1998

    Directory of Open Access Journals (Sweden)

    Silva Valquiria da

    2003-01-01

    Full Text Available The objective of this research is to identify the component of trade that results specifically from bilateral relations and evaluate how the creation of trading blocs affects trade relations between countries. The trirapport coefficient of the relative intensity of bilateral agricultural sector trade flows between Brazil and other countries from 1984 and 1998 is used in the evaluation. In general, the results show that relative trade intensity between Brazil and its non-MERCOSUL trade partners fell after their entry into regional trade agreements (extra-bloc effect. The intra-bloc effect (trade expansion is reflected by changes in trade intensity between Brazil and the other MERCOSUL members and changes in trade intensity between NAFTA members Mexico, Canada, and the United States.

  1. Technical recommendations for bilateral comparison in diagnosis radiology: part 1; Protocolo tecnico da comparacao bilateral em radiologia diagnostica: parte 1

    Energy Technology Data Exchange (ETDEWEB)

    Peixoto, J.G.P., E-mail: guilherm@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Almeida, C.E.V. de [Universidade do Estado do Rio de Janeiro (LCR/IBRAG/UERJ), Rio de Janeiro, RJ (Brazil). Lab. de Ciencias Radiologicas

    2015-07-01

    By data from www.datasus.gov.br, then need each diagnostic quality dissemination should be periodically verify, therefore the bilateral comparison between calibration laboratory will be mandatory to quality services guarantee. (author)

  2. 25 CFR 163.71 - Agreement funding.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Agreement funding. 163.71 Section 163.71 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER GENERAL FORESTRY REGULATIONS Cooperative Agreements § 163.71 Agreement funding. In cooperative agreements, the Secretary is authorized to advance...

  3. 7 CFR 947.111 - Marketing agreement.

    Science.gov (United States)

    2010-01-01

    ... Definitions § 947.111 Marketing agreement. Marketing agreement means Marketing Agreement No. 114, as amended. ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing agreement. 947.111 Section 947.111 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE...

  4. The high price of "free" trade: U.S. trade agreements and access to medicines.

    Science.gov (United States)

    Lopert, Ruth; Gleeson, Deborah

    2013-01-01

    The United States' pursuit of increasingly TRIPS-Plus levels of intellectual property protection for medicines in bilateral and regional trade agreements is well recognized. Less so, however, are U.S. efforts through these agreements to influence and constrain the pharmaceutical coverage programs of its trading partners. Although arguably unsuccessful in the Australia- U.S. Free Trade Agreement (AUSFTA), the U.S. nevertheless succeeded in its bilateral FTA with South Korea (KORUS) in establishing prescriptive provisions pertaining to the operation of coverage and reimbursement programs for medicines and medical devices, which have the potential to adversely impact future access in that country. More recently, draft texts leaked from the current Trans Pacific Partnership Agreement (TPPA) negotiations show that U.S. objectives include not only AUSFTA-Plus and KORUS-Plus IP provisions but also ambitious inroads into the domestic health programs of its TPPA partners. This highlights the apparent conflict between trade goals - pursued through multilateral legal instruments to promote economic "health"- and public health objectives, such as the development of treatments for neglected diseases, the pursuit of efficiency and equity in priority setting, and the procurement of medicines at prices that reflect their therapeutic value and facilitate affordable access. PMID:23581666

  5. Bilateral type emphysematous pyelonephritis: imaging evaluation; Pielonefritis enfisematosa bilateral tipo I. Evaluacion por la imagen

    Energy Technology Data Exchange (ETDEWEB)

    Salvador Cueto-Alvarez, L.; Piriz-Campos, E.; Ruiz-Garcia, T.; Roldan-Lora, F. [Hospital Universitario Virgen Macarena. Sevilla (Spain)

    2000-07-01

    Emphysematous pyelonephritis (EPN) is a serious infectious disease that occurs more frequently in diabetic patients. Radiological studies are indispensable for distinguishing between the two types since each is associated with a markedly different prognosis. We present a case of bilateral EPN diagnosed as type I on the basis of computed tomography findings, differentiating it from type II EPN, taking into account the prognostic value of this distinction. Type I EPN is characterized by the destruction of the renal parenchyma, a mottled or linear gas pattern and the absence of renal and perirenal fluid collection. Type II EPN is characterized by a loculated or bubbly gas pattern, the existence of fluid collection and less marked renal destruction. Type I is more aggressive and is associated with high rate of mortality. (Author) 7 refs.

  6. Bilateral naso labial cyst: report of two cases; Cisto nasolabial bilateral: relato de dois casos

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Rodrigo de; Haetinger, Rainer Guilherme [Hospital Beneficencia Portuguesa de Sao Paulo, SP (Brazil). Med Imagem; Sales, Marcelo Augusto Oliveira [Universidade Federal da Paraiba (UFPB), Joao Pessoa, PB (Brazil). Hospital Universitario Lauro Wanderley; Fonseca, Luciana Cardoso [Pontificia Universidade Catolica de Belo Horizonte, MG (Brazil). Faculdade de Odontologia; Cavalcanti, Marcelo Gusmao Paraiso [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Estomatologia]. E-mail: mgpcaval@usp.br

    2007-07-01

    The nasolabial cyst is defined as nonodontogenic soft tissue lesion, rare and with occurrence in sagittal plane, between midline and nasal cartilage. Because its soft tissue composition, there is no radiographic presentation in conventional radiographic examination, being indicated evaluation through computed tomography and magnetic resonance imaging. In the present study, two cases are discussed, being one in white female subject, 72-year-old, and other in a black male subject, 24-year-old. The authors discuss about relevant aspects related to differential diagnosis through computed tomography and magnetic resonance imaging, as well as atypical features founded in one of the cases, like bilateral occurrence with different signal intensity in magnetic resonance imaging and determinant factors for differential diagnosis of soft tissues pathologies of maxillofacial complex, as fissure cysts with central occurrence (sagittal cysts), as dermoid cysts, palatine and nasopalatine and lateral fissure cysts. (author)

  7. Simultaneous Bilateral Carotid Stenting for Symptomatic Bilateral High-Grade Carotid Stenosis: A Retrospective Clinical Investigation

    Science.gov (United States)

    Ye, Ziming; Liu, Ying; Deng, Xiao; Chen, Xiangren; Lin, Cuiting; Tang, Yanyan; Su, Ying; Fang, Lanji; Wu, Yuan; Qin, Chao

    2016-01-01

    Background This retrospective clinical investigation aimed to evaluate the short-term effectiveness and safety of SBCAS for symptomatic bilateral high-grade CS. Material/Methods From 2009 to 2014, 145 patients were recruited. Among them, 70 underwent SBCAS, and other 75 patients underwent SAMM and served as controls. The immediate postprocedural complications and postprocedural neurological evaluation, as well as restenosis at 6-month and 1-year follow-ups in the SBCAS group are reported. Additionally, baseline risk factors for ischemic stroke, adverse effects of drugs, and outcomes at 30-day, 6-month, and 1-year follow-ups were compared between the 2 groups. Results Our data did not reveal significant differences between the 2 groups in baseline risk factors for ischemic stroke. In the SBCAS group, both HPS (5.7%) and HD (40%) occurred, but they were not very severe, and no patients had postprocedural neurological deficit. Moreover, restenosis only occurred in 3 patients at 3 stent placement sites (4.3%) at 1-year follow-up. Adverse effects of drugs did not occur in SBCAS group, but adverse effects of Bayer aspirin and Lipitor occurred in 4 patients (5.4%) and 18 patients (24.3%), respectively, at 6-month follow-up in the control group. Furthermore, there were significant differences in outcomes between the 2 groups at 30-day, 6-month, and 1-year follow-ups, in that NIHSS, CS ratio, and incidence of endpoint events, as well as 1-year cumulative probability of endpoint events, were all lower in the SBCAS group than in the control group (p<0.05). Conclusions Compared to SAMM, we found that SBCAS was more effective and safer for symptomatic bilateral high-grade CS. PMID:27542158

  8. Bilateral anterior shoulder fracture-dislocation : A case report and a review of the literature

    OpenAIRE

    Dinopoulos, H. T.; Giannoudis, P. V.; Smith, R. M.; Matthews, S.J.

    1999-01-01

     We report an unusual case of bilateral anterior shoulder dislocation following trauma. Previously reported cases were either of bilateral dislocations or bilateral fracture dislocations. In our case the patient suffered bilateral anterior dislocation with a three part fracture dislocation on the right. A review of the literature is presented.

  9. Single-Session Radiofrequency Ablation of Bilateral Lung Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Palussiere, Jean, E-mail: palussiere@bergonie.org; Gomez, Fernando; Cannella, Matthieu; Ferron, Stephane; Descat, Edouard [Institut Bergonie, Department of Radiology, Regional Cancer Centre (France); Fonck, Marianne [Institut Bergonie, Department of Digestive Oncology (France); Brouste, Veronique [Institut Bergonie, Clinical and Epidemiological Research Unit (France); Avril, Antoine [Institut Bergonie, Department of Surgery (France)

    2012-08-15

    Purpose: This retrospective study examined the feasibility and efficacy of bilateral lung radiofrequency ablation (RFA) performed in a single session. Methods: From 2002-2009, patients with bilateral lung metastases were treated by RFA, where possible in a single session under general anesthesia with CT guidance. The second lung was punctured only if no complications occurred after treatment of the first lung. Five lung metastases maximum per patient were treated by RFA and prospectively followed. The primary endpoint was the evaluation of acute and delayed complications. Secondary endpoints were calculation of hospitalization duration, local efficacy, median survival, and median time to tumor progression. Local efficacy was evaluated on CT or positron emission tomography (PET) CT. Results: Sixty-seven patients were treated for bilateral lung metastases with RFA (mean age, 62 years). Single-session treatment was not possible in 40 due to severe pneumothoraces (n = 24), bilateral pleural contact (n = 14), and operational exclusions (n = 2). Twenty-seven (41%) received single-session RFA of lesions in both lungs for 66 metastases overall. Fourteen unilateral and four bilateral pneumothoraces occurred (18 overall, 66.7%). Unilateral (n = 13) and bilateral (n = 2) chest tube drainage was required. Median hospitalization was 3 (range, 2-8) days. Median survival was 26 months (95% confidence interval (CI), 19-33). Four recurrences on RFA sites were observed (4 patients). Median time to tumor progression was 9.5 months (95% CI, 4.2-23.5). Conclusions: Although performing single-session bilateral lung RFA is not always possible due to pneumothoraces after RFA of first lung, when it is performed, this technique is safe and effective.

  10. Bilateral adrenal masses: a single-centre experience

    Science.gov (United States)

    Bandgar, Tushar; Khare, Shruti; Jadhav, Swati; Lila, Anurag; Goroshi, Manjunath; Kasaliwal, Rajeev; Khadilkar, Kranti; Shah, Nalini S

    2016-01-01

    Background Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenal masses are limited. Aims To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses. Methods Retrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India (2002–2015). Results The most common aetiology was pheochromocytoma (40%), followed by tuberculosis (27.1%), primary adrenal lymphoma (PAL) (10%), metastases (5.7%), non-functioning adenomas (4.3%), primary bilateral macronodular adrenal hyperplasia (4.3%), and others (8.6%). Age at presentation was less in patients with pheochromocytoma (33 years) and tuberculosis (41 years) compared with PAL (48 years) and metastases (61 years) (PAI) (95%). The presenting symptoms for PAL were AI (57%) and abdominal pain (43%), whereas all cases of metastasis had abdominal pain. Mean size of adrenal masses was the largest in lymphoma (5.5cm) followed by pheochromocytoma (4.8cm), metastasis (4cm) and tuberculosis (2.1cm) (P<0.001). Biochemically, most patients with pheochromocytoma (92.8%) had catecholamine excess. Hypocortisolism was common in tuberculosis (100%) and PAL (71.4%) and absent with metastases (P<0.001). Conclusion In evaluation of bilateral adrenal masses, age at presentation, presenting symptoms, lesion size, and biochemical features are helpful in delineating varied underlying aetiologies. PMID:27037294

  11. US findings of bilateral primary breast cancer: Retrospective study

    International Nuclear Information System (INIS)

    Background: For women with breast cancer, the contralateral breast is at high risk. The bilateral cancers may be synchronous or metachronous. If the bilateral breast cancers have similar ultrasonography (US) appearances, the US findings of the first breast cancer (index cancer) might lead to early detection of the contralateral cancer. The purpose of this study was to identify the US characteristics of bilateral breast cancer and to determine whether bilateral breast cancers have similar US appearances and whether the US findings for one breast cancer might be predictive of the contralateral breast cancer. Methods: We retrospectively reviewed the US manifestations of 58 patients with surgically proven bilateral primary breast cancer and compared the contralateral cancer with the index cancer by evaluation the margin, shape, inside echoes, posterior attenuation, calcification and color flow signals of 58 lesion pairs to investigate whether the bilateral breast cancers have similar US appearances. Results: Bilateral primary breast cancers were more located in upper outer quadrant, frequently spiculation, taller than wide shape, with irregular margin, heterogeneous internal echo and acoustic shadowing, containing microcalcification and abundant color flow signals. The most common US appearances were taller than wide shape (75.0%, 87/116), irregular margins (79.3%, 92/116) and heterogeneous internal echo (86.2%, 100/116). Of the total 58 lesion pairs, 18 (31.0%) pairs had similar US characteristics, whereas 40 (69.0%) pairs had different US characteristics. Conclusions: US signs of the index cancer do not indicate the most likely appearance of the second cancer in the contralateral breast. Evaluation of the contralateral cancer should be performed without regard for the US findings for the index cancer

  12. Bilateral Ramsay Hunt syndrome in a diabetic patient

    Directory of Open Access Journals (Sweden)

    Goyal Amit

    2004-12-01

    Full Text Available Abstract Background Herpes zoster oticus accounts for about 10% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. Bilateral herpes zoster oticus can sometime occur in immunocompromised patients, though incidence is very rare. Case presentation Diabetic male, 57 year old presented to us with bilateral facial palsy due to herpes zoster oticus. Patient was having bilateral mild to moderate sensorineural hearing loss. Patient was treated with appropriate metabolic control, anti-inflammatory drugs and intravenous acyclovir. Due to uncontrolled diabetes, glucocorticoids were not used in this patient. Significant improvement in hearing status and facial nerve functions were seen in this patient. Conclusions Herpes zoster causes severe infections in diabetic patients and can be a cause of bilateral facial palsy and bilateral Ramsay Hunt syndrome. Herpes zoster in diabetic patients should be treated with appropriate metabolic control, NSAIDS and intravenous acyclovir, which we feel should be started at the earliest. Glucocorticoids should be avoided in diabetic patients.

  13. Breast MRI after bilateral mastectomy: is it indicated?

    Science.gov (United States)

    Vanderwalde, Lindi H; Dang, Catherine M; Tabrizi, Robert; Saouaf, Rola; Phillips, Edward H

    2011-02-01

    Little is known about the use of breast MRI as a diagnostic or surveillance tool in patients after bilateral mastectomy. The objective of this study was to evaluate breast MRI after bilateral mastectomy. Participants consisted of 48 women with prior bilateral mastectomy who underwent breast MRI between 2003 and 2009. Seventy-nine breast MRIs were obtained. The median time between mastectomy and first MRI was 36 months. MRI was ordered most often by a medical oncologist (71%). Median age at bilateral mastectomy was 49 years (range, 33 to 72 years). Reasons for obtaining MRI included surveillance in 60 (76%), mass in eight (10%), lymph nodes in four (5%), pain in three (4%), and abscess in one (1%). Overall, 68 (86%) MRIs showed benign imaging findings only. Within the surveillance group, six patients had MRIs with findings that changed management; four patients had some residual breast tissue, and two patients had findings outside the breast that were better evaluated by CT or bone scan and were ultimately benign. MRI confirmed locoregional recurrence in two patients with highly suspicious physical findings. Overall, postmastectomy breast MRI had limited use, finding no unsuspected recurrences within our study group. Although MRI can be helpful to establish the presence of residual breast tissue after bilateral mastectomy, subsequent routine screening breast MRI should be questioned if no residual breast tissue is identified. PMID:21337876

  14. Successful management of bilateral patellar tendon rupture in a dog.

    Science.gov (United States)

    Shipov, A; Shahar, R; Joseph, R; Milgram, J

    2008-01-01

    A seven-year-old, 41 kg, intact, cross breed dog, was presented with a history of bilateral hind limb lameness after falling from a height of 1 m. Clinical and radiographic findings were consistent with bilateral patellar tendon rupture. Surgical repair was performed bilaterally. The tendons were sutured primarily, and an internal splint of nylon leader was added. Good apposition of the severed tendon ends had been achieved intraoperatively; however, post operative radiographs showed supra-trochlear displacement of both patellae. The casts used to immobilize the stifle joints slipped distally and three days post operatively the tendon repair had broken down, bilaterally. Revision surgery was undertaken and the tendons were re-sutured. Nylon leader was placed through holes that had been drilled in the patellae and tibiae. The stifle joints were immobilized with type I external skeletal fixators (ESFs). Both freeform polymethylmethacrylate (PMMA) connecting bars were found to be broken at the level of the stifle joints two days later, without any disruption of the primary tendon repair. Each connecting bar was replaced with two connecting bars of PMMA reinforced with 3 mm steel wire. The dog was fully weight-bearing with a reduced range of motion in flexion immediately after removal of the ESFs at six weeks and was still sound 18 months post-operatively. Primary tendon repair in combination with adequate immobilization allowed for an excellent outcome in a complicated bilateral pathology. PMID:18545725

  15. Association of Cryptogenic Organizing Pneumonia in Bilateral Anterior Uveitis

    Directory of Open Access Journals (Sweden)

    Kaori Fujimoto

    2014-11-01

    Full Text Available Two female patients with histories of cancer who showed cryptogenic organizing pneumonia (COP complications and bilateral anterior uveitis with hypopyon were examined. Both patients had suffered from COP and received intermitted systemic corticosteroid administration (SCA. The first patient, a 65-year-old woman with a history of breast cancer, showed bilateral uveitis with hypopyon. The topical corticosteroid treatment was ineffective. After SCA for the treatment of COP was started, the hypopyon gradually dissipated. Upon termination of SCA, uveitis relapses were controlled by renewed SCA. The other patient, a 69-year-old woman with a history of ovarian cancer, showed bilateral anterior uveitis with hypopyon. Her intraocular outcome did not improve by the topical corticosteroid administration, but SCA that was applied to treat COP led to remission of uveitis. Imaging examinations, biochemical analysis, symptoms or HLA-B27 antigen screenings in either patient did not explain the development of uveitis. Bilateral anterior uveitis is commonly related to autoimmune disease or systemic syndrome. We report two cases with COP that developed bilateral anterior uveitis with hypopyon resistant to topical administration but responsive to systemic administration of corticosteroid. These findings suggest that COP can be associated with the etiology of anterior uveitis.

  16. Bilateral persistent trigeminal artery variants diagnosed by MR angiography.

    Science.gov (United States)

    Uchino, Akira

    2011-12-01

    A persistent trigeminal artery (PTA) is the most common anastomosis between the carotid and vertebrobasilar system. A PTA variant (PTAV) is a rare anomaly in which the cerebellar artery arises from the internal carotid artery (ICA) without connection with the basilar artery (BA). I present what I believe is the first report of bilateral PTAVs diagnosed using magnetic resonance (MR) angiography and briefly discuss the embryology of this rare anomaly. An 81-year-old woman with small infarctions underwent cerebral MR imaging and MR angiography with a 1.5-tesla imager for the evaluation of brain lesions. An MR angiography was obtained using the standard noncontrast three-dimensional time-of-flight technique. The MR angiographic demonstration of bilateral anterior inferior cerebellar arteries arising from the precavernous segment of the ICA without anastomosis to the BA indicated bilateral PTAVs. This is the first report of bilateral PTAVs diagnosed by MR angiography. The literature review indicates that an estimated prevalence of bilateral PTAVs is about 0.0012%. PMID:21544587

  17. Policy review: Japan-Philippines Economic Partnership Agreement (JPEPA)--analysis of a failed nurse migration policy.

    Science.gov (United States)

    Yagi, Nozomi; Mackey, Tim K; Liang, Bryan A; Gerlt, Lorna

    2014-02-01

    In 2008, the bilateral Japan-Philippines Economic Partnership Agreement took effect. Contained within this regional free trade agreement are unique provisions allowing exchange of Filipino nurses and healthcare workers to work abroad in Japan. Japan's increasing need for healthcare workers due to its aging demographic and the Philippines need for economic development could have led to shared benefits under the Japan-Philippines Economic Partnership Agreement. However, 4 years following program implementation, results have been disappointing, e.g., only 7% of candidates passing the programs requirements since 2009. These disappointing results represent a policy failure within the current Japan-Philippines Economic Partnership Agreement framework, and point to the need for reform. Hence, amending the current Japan-Philippines Economic Partnership Agreement structure by potentially adopting a USA based approach to licensure examinations and implementing necessary institutional and governance reform measures may be necessary to ensure beneficial healthcare worker migration for both countries.

  18. An analytical model for predicting dryout point in bilaterally heated vertical narrow annuli

    Institute of Scientific and Technical Information of China (English)

    AYE Myint; TIAN Wen-Xi; JIA Dou-Nan; LI Zhi-Hui; LI Hao

    2005-01-01

    Based on the droplet-diffusion model by Kirillov and Smogalev (1969, 1972), a new analytical model of dryout point prediction in the steam-water flow for bilaterally and uniformly heated narrow annular gap was developed. Comparisons of the present model predictions with experimental results indicated that a good agreement in ac curacy for the experimental parametric range (pressure from 0.8 to 3.5 MPa, mass flux of 60.39 to 135.6 kg·m-2·s-1 and heat flux of 5 to 50 kW·m-2). Prediction of dryout point was experimentally investigated with deionized water upflowing through narrow annular channel with 1.0 mm and 1.5 mm gap heated by AC power supply.

  19. Bilateral sudden sensorineural hearing loss in Staphylococcus aureus endocarditis.

    Science.gov (United States)

    Lau, Joanne Wai Ling; Ceranic, Borka; Harris, Robert; Timehin, Elwina

    2015-09-14

    This case highlights the diagnostic challenges in patients presenting with bilateral sudden sensorinueral hearing loss (SNHL). The aetiology of bilateral sudden SNHL may span several medical disciplines. Therefore, clinicians should be mindful of such presentations, and consider aetiologies beyond otological and neurological causes. We present a case of a previously healthy 51-year-old woman who presented with coryzal symptoms and sudden audiovestibular failure. Examination revealed fever, tachycardia, bilateral profound hearing loss and nystagmus. Following investigations, an initial working diagnosis of vasculitis was made. Later, blood cultures revealed methicillin-sensitive Staphylococcus aureus (MSSA) and a transoesophageal echocardiogram confirmed endocarditis. The patient made a good recovery, but the hearing loss was permanent and managed with a cochlear implant.

  20. Empirical Analysis of Xinjiang's Bilateral Trade: Gravity Model Approach

    Institute of Scientific and Technical Information of China (English)

    CHEN Xuegang; YANG Zhaoping; LIU Xuling

    2008-01-01

    Based on the basic trade gravity model and Xinjiang's practical situation, new explanatory variables (GDP,GDPpc and SCO) are introduced to build an extended trade gravity model fitting for Xinjiang's bilateral trade. Fromthe empirical analysis of this model, it is proposed that those three variables affect the Xinjiang's bilateral trade posi-tively. Whereas, geographic distance is found to be a significant factor influencing Xinjiang's bilateral trade negatively.Then, by the extended trade gravity model, this article analyzes the present trade situation between Xinjiang and itsmain trade partners quantitatively in 2004. The results indicate that Xinjiang cooperates with its most trade partnerssuccessfully in terms of present economic scale and developing revel. Xinjiang has established successfully trade part-nership with Central Asia, Central Europe and Eastern Europe, Western Europe, East Asia and South Asia. However,the foreign trade development with West Asia is much slower. Finally, some suggestions on developing Xinjiang's for-eign trade are put forward.

  1. Bilateral fat necrosis of the breast: report of a case.

    Directory of Open Access Journals (Sweden)

    Sonobe,Hiroshi

    1980-11-01

    Full Text Available A rare case of bilateral fat necrosis of the breast is reported. The patient was a 50-year-old unmarried woman having no history of trauma, disease or surgery of the breast. In the bilateral breasts, ill-defined, firm masses with skin retraction were noted. Bilateral breast cancer was diagnosed clinically. However, both lesions showed histologically chronic granulomatous inflammation with foci of fatty necrosis, infiltration of lymphocytes, plasma cells, lipid containing foamy cells, foreign body giant cells engurfing choresterol-crystals, and calcification. "Paraffinoma" was thus suspected, but there was no history of cosmetic mammoplasty and histochemical studies failed to demonstrate saturated lipid indicating paraffin or other mineral oils

  2. Constipation following bilateral of internal iliac artery aneurysms

    Directory of Open Access Journals (Sweden)

    S Morita

    2012-09-01

    Full Text Available A 72-year-old man presented with constipation. He was hypertensive and suffered from chronic constipation. On arrival, the patient was fully conscious, and his vital signs were stable. He requested an enema because this treatment had proved effective in the past. On physical examination, a hard palpable mass was detected in the lower abdomen. Computed tomography was performed with contrast media. It revealed an abdominal aortic aneurysm (AAA and bilateral internal iliac artery aneurysms (IIAAs; the latter obstructing the sigmoid colon. We believe that this obstruction was the cause of constipation. The patient underwent Y-graft replacement for the treatment of the AAA and bilateral IIAAs. The surgery was successful, and constipation has not recurred since. As constipation is the most common digestive disorder in the general population, all physicians should be aware that chronic constipation can be caused by bilateral IIAAs.

  3. Bilateral macular injury from a green laser pointer

    Directory of Open Access Journals (Sweden)

    Dirani A

    2013-10-01

    Full Text Available Ali Dirani,1,2 Elias Chelala,2 Ali Fadlallah,1,2 Rafic Antonios,1 George Cherfan11Beirut Eye Specialist Hospital, 2Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon Abstract: We report the case of a 13-year-old boy who had a bilateral macular injury after playing with a green laser pointer for a duration of 1 minute. Clinical examination revealed a decrease in visual acuity and macular injury in both eyes, and imaging investigations revealed a bilateral macular lesion due to exposure to the laser pointer. At 3 months' follow up, visual function had improved but remained partially impaired. This case emphasizes the importance of cautious and appropriate use of laser pointer devices because of the potential vision-threatening hazards induced by mishandling of these devices. Keywords: green laser pointer, bilateral, macular injury

  4. Introduction of a Case of Bilateral Pheochromocytoma Tumor

    Directory of Open Access Journals (Sweden)

    M Zare

    2009-01-01

    Full Text Available Summary: Pheochromocytoma is an adrenal tumor characterized by symptoms of hypertension, headache, increased sweating, and tachycardia .In one third of patients, the tumor is discovered incidentally during radiological evaluation of the abdomen. In this article a case of bilateral pheochromocytoma is reported. The patient, a twelve years old boy, referred with complaints of headache, flushing, palpitation and blurring of vision. He had a blood pressure of 200/120 mmHg and after investigation, coarctation of aorta was excluded. On abdominal ultrasound, bilateral adrenal mass was diagnosed, followed by serial measurements of urinary vanillyl mandellic acid (VMA which was found to be elevated. Meta- Iodio benzyl glunidin (MIBG scan showed increased uptake in both adrenals. Patient underwent laparotomy and bilateral adrenalectomy with the diagnosis of pheochromocytoma. Pathologic report confirmed the diagnosis

  5. 22 CFR 124.1 - Manufacturing license agreements and technical assistance agreements.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Manufacturing license agreements and technical... ARMS REGULATIONS AGREEMENTS, OFF-SHORE PROCUREMENT AND OTHER DEFENSE SERVICES § 124.1 Manufacturing... manufacturing license agreements, technical assistance agreements, distribution agreements, or...

  6. Sensory-motor transformations for speech occur bilaterally.

    Science.gov (United States)

    Cogan, Gregory B; Thesen, Thomas; Carlson, Chad; Doyle, Werner; Devinsky, Orrin; Pesaran, Bijan

    2014-03-01

    Historically, the study of speech processing has emphasized a strong link between auditory perceptual input and motor production output. A kind of 'parity' is essential, as both perception- and production-based representations must form a unified interface to facilitate access to higher-order language processes such as syntax and semantics, believed to be computed in the dominant, typically left hemisphere. Although various theories have been proposed to unite perception and production, the underlying neural mechanisms are unclear. Early models of speech and language processing proposed that perceptual processing occurred in the left posterior superior temporal gyrus (Wernicke's area) and motor production processes occurred in the left inferior frontal gyrus (Broca's area). Sensory activity was proposed to link to production activity through connecting fibre tracts, forming the left lateralized speech sensory-motor system. Although recent evidence indicates that speech perception occurs bilaterally, prevailing models maintain that the speech sensory-motor system is left lateralized and facilitates the transformation from sensory-based auditory representations to motor-based production representations. However, evidence for the lateralized computation of sensory-motor speech transformations is indirect and primarily comes from stroke patients that have speech repetition deficits (conduction aphasia) and studies using covert speech and haemodynamic functional imaging. Whether the speech sensory-motor system is lateralized, like higher-order language processes, or bilateral, like speech perception, is controversial. Here we use direct neural recordings in subjects performing sensory-motor tasks involving overt speech production to show that sensory-motor transformations occur bilaterally. We demonstrate that electrodes over bilateral inferior frontal, inferior parietal, superior temporal, premotor and somatosensory cortices exhibit robust sensory-motor neural

  7. 78 FR 68444 - Notice of Agreements Filed

    Science.gov (United States)

    2013-11-14

    ... . Agreement No.: 010071-040. Title: Cruise Lines International Association Agreement. Parties: AMA Waterways.... By Order of the Federal Maritime Commission. Karen V. Gregory, Secretary. BILLING CODE 6730-01-P...

  8. 75 FR 31438 - Notice of Agreements Filed

    Science.gov (United States)

    2010-06-03

    ... Lines Joint Service Agreement. Filing Party: Tara L. Leiter, Esq.; Blank Rome, LLP; Watergate; 600 New... Service Agreement. Filing Party: Tara L. Leiter, Esq.; Blank Rome, LLP; Watergate; 600 New...

  9. 75 FR 74732 - Notice of Agreements Filed

    Science.gov (United States)

    2010-12-01

    ... after November 24, 2010. Agreement No.: 012111. Title: Hainan PO Shipping Co., Ltd. and TS Lines Ltd. Slot Charter Agreement. Parties: Hainan PO Shipping Co., Ltd. and T.S. Lines Ltd. Filing Party: Neal...

  10. Bilateral macrostomia associated with aqueductal stenosis and glial heterotopias.

    Science.gov (United States)

    Pepe, Ernesto; Petricig, Paola; Peretta, Paola; Cinalli, Giuseppe

    2007-09-01

    We report on an Italian boy, born to normal and nonconsanguineous parents with a prenatal diagnosis of ventriculomegaly and subependymal glial heterotopias. At birth bilateral macrostomia was diagnosed without other evident facial anomalies. Magnetic resonance imaging (MRI) showed triventricular hydrocephalus and aqueductal stenosis and confirmed the nodules of glial heterotopia. The bilateral macrostomia was surgically corrected with the vermilion square flap method and W-plasty technique and follow up MRI at 6 months showed mild increase of ventricular dilatation without signs of active hydrocephalus. The association between macrostomia and hydrocephalus has been reported only in rare cases of complex malformative syndromes but never with isolated macrostomia.

  11. Bilateral transaction bargaining between independent utilities under incomplete information

    International Nuclear Information System (INIS)

    A new approach to designing bilateral power transaction bargaining models between two independent utilities in a deregulated electricity market is proposed. In the paper it is assumed that each utility (a seller or a buyer) knows its own operating costs but does not know those of its opponent. The bilateral power transaction problem is then considered as non-cooperative bargaining under incomplete information. Each participant develops its own bargaining strategy based on estimates of the opponent's operating costs and bargaining strategy. Two bargaining models are developed and examples are employed for demonstration. (Author)

  12. Bilateral hypoplasia of the internal carotid arteries with basilar aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Briganti, F.; Tortora, F.; Elefante, A. [Universita di Napoli Federico II, Dipartimento di Scienze Neurologiche, Cattedra di Neuroradiologia, 80131, Napoli (Italy); Maiuri, F. [Universita di Napoli Federico II, Department of Neurological Sciences, Neurosurgery Service, Napoli (Italy)

    2004-10-01

    We report a rare case of bilateral hypoplasia of the internal carotid arteries with an associated aneurysm of the basilar tip, studied by CT angiography, MR angiography and digital angiography. The patient became symptomatic with an episode of loss of consciousness, likely due to reduced blood perfusion. The other 20 reported cases of bilateral carotid hypoplasia (only four of which with an associated aneurysm) are reviewed. The findings of noninvasive procedures (including narrowing of the carotid canals on CT) may lead to a correct diagnosis before angiography is performed; they may also help to differentiate angiographic narrowing of the hypoplastic internal carotids from the string sign often observed in some acquired conditions. (orig.)

  13. Bilateral Control Using Master/Slave Simulator for Haptic Communication

    Science.gov (United States)

    Yokokura, Yuki; Katsura, Seiichiro; Ohishi, Kiyoshi

    A bilateral controller is used to transmit and share haptic information between a master system and a slave system. In a transmission system, the bilateral controller encounters problems in the event of data packet loss and/or disconnections. In this study, a master/slave simulator and environmental data memory are used to solve the problems. In the case of normal operation, the environmental data memory stores force data in a remote side. The control system is operated by the environmental data memory and master/slave simulator when the communication lines are disconnected.

  14. Bilateral ectopic tubal pregnancy, following in vitro fertilisation (IVF.

    Directory of Open Access Journals (Sweden)

    Wojciech Grzybowski

    2010-01-01

    Full Text Available This is a case report of a 33 year-old-woman who underwent in vitro fertilization, because of primary infertility caused by fallopian tube factor. The patient underwent three trials of frozen embryo transfers (ET-CRYO. On the 26th day after the third probe of ET-CRYO she suffered from pelvic pain and vaginal bleeding. Transvaginal ultrasonographic scan revealed bilateral tubal ectopic pregnancy without fluid in the Douglas pouch and no gestational sac in the uterus. Laparoscopic bilateral salpingectomy was performed on the next day after admission. The postoperative course was uneventful.

  15. Bilateral lingual-facial trunk: anatomic and clinical implications.

    Science.gov (United States)

    Troupis, T; Michalinos, A; Kakisis, J; Natsis, K; Sofidis, G; Skandalakis, P

    2015-01-01

    Common origin of lingual and facial artery is a relatively frequent anatomic varia-tion. Instead, bilateral lingual-facial trunk has been described only sparsely in the literature. In this report authors describe and analyse a case of bilateral common lingual-facial trunk in the context of its anatomical, clinical and embryological implications. We also describe possible consequences in performance of elective and emergent surgical operations and modification in surgical techniques that should be considered. We believe that surgeons should be suspicious for this variation's existence and keep alternative solutions in their armentarium.

  16. A rare entity in adults: Bilateral Hutch diverticulum with calculi.

    Science.gov (United States)

    Telli, Onur; Guclu, Adil Gucal; Haciyev, Perviz; Burgu, Berk; Gogus, Cagatay

    2015-01-01

    Congenital bladder diverticulum (CBD) is a very uncommon entity in adults. CBD could be unilateral or bilateral and is caused by a congenital weakness in the bladder musculature. CBD is differentiated from the paraureteral or Hutch type of diverticula. A 42-year-old male presented with bilateral Hutch diverticulum and multiple diverticulum calculus on intravenous pyelography. Cystoscopy revealed bladder diverticulum just medial to the left ureteral orifice with multiple calculi; the patient successfully underwent endoscopic laser cystolithotripsy with resolution of his urinary tract infection. To the best of our knowledge, this is the first case report presenting stone formation of CBD in an adult. PMID:26029313

  17. Bilateral type of nevus of Ota presenting as agminated lentigines.

    Science.gov (United States)

    Kang, Hee Young; Kang, Won Hyoung

    2003-01-01

    We report a 30-year-old female patient with a history of hyperpigmented macules of the face since the age of 7 years. The clinical appearance, brown macules in multiple segmental or grouped patterns, was suggested to be agminated lentigines. However, histologic examination of the pigmented macule revealed scattered melanocytes within the dermis. We diagnosed this lesion as a bilateral type of nevus of Ota presenting as agminated lentigines. The differential diagnosis from acquired bilateral nevus of Ota-like macules was made.

  18. Bilateral macular injury from a green laser pointer

    OpenAIRE

    Fadlallah, Ali

    2013-01-01

    Ali Dirani,1,2 Elias Chelala,2 Ali Fadlallah,1,2 Rafic Antonios,1 George Cherfan11Beirut Eye Specialist Hospital, 2Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon Abstract: We report the case of a 13-year-old boy who had a bilateral macular injury after playing with a green laser pointer for a duration of 1 minute. Clinical examination revealed a decrease in visual acuity and macular injury in both eyes, and imaging investigations revealed a bilateral macular lesion due to expo...

  19. Bilateral macular injury from a green laser pointer.

    Science.gov (United States)

    Dirani, Ali; Chelala, Elias; Fadlallah, Ali; Antonios, Rafic; Cherfan, George

    2013-01-01

    We report the case of a 13-year-old boy who had a bilateral macular injury after playing with a green laser pointer for a duration of 1 minute. Clinical examination revealed a decrease in visual acuity and macular injury in both eyes, and imaging investigations revealed a bilateral macular lesion due to exposure to the laser pointer. At 3 months' follow up, visual function had improved but remained partially impaired. This case emphasizes the importance of cautious and appropriate use of laser pointer devices because of the potential vision-threatening hazards induced by mishandling of these devices. PMID:24204114

  20. Bilateral macular injury from a green laser pointer

    OpenAIRE

    Dirani A; Chelala E; Fadlallah A; Antonios R; Cherfan G

    2013-01-01

    Ali Dirani,1,2 Elias Chelala,2 Ali Fadlallah,1,2 Rafic Antonios,1 George Cherfan11Beirut Eye Specialist Hospital, 2Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon Abstract: We report the case of a 13-year-old boy who had a bilateral macular injury after playing with a green laser pointer for a duration of 1 minute. Clinical examination revealed a decrease in visual acuity and macular injury in both eyes, and imaging investigations revealed a bilateral macular lesion due to expos...

  1. Cerebral potentials preceding unilateral and simultaneous bilateral finger movements.

    Science.gov (United States)

    Kristeva, R; Keller, E; Deecke, L; Kornhuber, H H

    1979-08-01

    Cerebral potentials preceding voluntary bilateral simultaneous finger movements were investigated in 19 right-handed young adult subjects, and were compared with unilateral right-sided finger m n the same experiment. With bilateral movements, the Bereitschaftspotential (BP) was not symmetrical or larger over the dominant hemisphere, but surprisingly, it was larger over the minor hemisphere. The BP averaged -3.66 microV (S.D. 1.96) over the left precentral region and -4.82 microV (S.D. 3.73) over the right precentral region in this condition. The difference was significant at 2P less than 0.01. This difference was pronounced in precentral leads but very small and almost missing in parietal leads. The pre-motion positivity (PMP) was well developed and even larger with bilateral than with unilateral (right-sides) movements. At the vertex it averaged +1.33 microV (S.D.4.16) with bilateral movements and only +0.15 microV (S.D. 1.42) with right-sided unilateral movements (2P less than 0.05). With bilateral movements the PMP could be observed in any record, but with unilateral movements it was missing at the left precentral lead, in accordance with previous publications (Deecke et al. 1969, 1976). The motor potential (MP), measured in a bipolar record from left and right precentral leads, was larger with unilateral (-1.25 microV, S.D. 1.33) than with bilateral movements (-0.36 microV, S.D. 0.92). Onset time differences of the BP preceding unilateral and bilateral movements were very small. However, there was a tendency towards earlier onset with unilateral than with bilateral movements (1031 msec, S.D. 358, as compared with 951 msec, S.D. 305). The averaged EMG revealed differences in movement onset. Muscular contraction tended to be earlier in the right than in the left m. flexor indicis in our right-handed subjects, on the average by 16 msec (S.D. 15). With unilateral right-sided movements, the left m. flexor indicis was not silent but showed an abortive mirror activity

  2. Bilateral adrenal [corrected] nodules due to histoplasmosis in an elderly.

    Science.gov (United States)

    Carvalho, Flávio Pedreira de Freitas de; Curiati, José Antônio Esper; Mauad, Thaís; Incerti, Milena Mendes; Jacob Filho, Wilson

    2007-02-01

    We report a case history of an 84-year-old elderly male patient that presented with a clinical picture suggestive of adrenal failure and bilateral adrenal nodules detected by abdominal computed tomography. A fine needle-guided biopsy was inconclusive for achieving a final diagnosis. The patient died due to septic shock and the autopsy disclosed histoplasmosis with extensive bilateral necrosis of the adrenal glands. Although the adrenal involvement in chronic disseminated histoplasmosis has been described, there have been few reports of the infection being associated with adrenal insufficiency.

  3. Bilateral afrenal nodules due to histoplasmosis in an elderly

    Directory of Open Access Journals (Sweden)

    Flávio Pedreira de Freitas de Carvalho

    2007-02-01

    Full Text Available We report a case history of an 84-year-old elderly male patient that presented with a clinical picture suggestive of adrenal failure and bilateral adrenal nodules detected by abdominal computed tomography. A fine needle-guided biopsy was inconclusive for achieving a final diagnosis. The patient died due to septic shock and the autopsy disclosed histoplasmosis with extensive bilateral necrosis of the adrenal glands. Although the adrenal involvement in chronic disseminated histoplasmosis has been described, there have been few reports of the infection being associated with adrenal insufficiency.

  4. Bilateral s-shaped kidneys: A rare congenital malformation.

    Science.gov (United States)

    Ranjan, Nikhil; Singh, Rana P; Upadhyay, Rohit; Kumar, Vijoy

    2015-01-01

    A bilateral S-shaped kidney is a rare anomaly in which both the kidneys are in their normal position, in contrast to the commonly reported S-shaped fusion anomaly, in which the contralateral kidney crosses the midline to fuse with opposite kidney leaving the ipsilateral renal fossa empty. Here we present the diagnosis and management of a case of bilateral S-shaped renal anomaly with associated left pelviureteric junction obstruction and nonfunctioning kidney and right renal stones. Left kidney was managed by open nephrectomy and right kidney by PNL. PMID:26166977

  5. Bilateral renal infarction: an uncommon presentation of fibromuscular dysplasia.

    Science.gov (United States)

    Ayach, Taha; Kazory, Amir

    2013-12-01

    While fibromuscular dysplasia (FMD) is an established cause of secondary hypertension, its association with renal infarction is less well recognized. We report a middle-aged man who presented with complaints of loin pain and severe hypertension. Computed tomography angiography of the abdomen revealed bilateral renal infarction with multiple short-segment arterial dissection compatible with FMD in the absence of systemic vasculitis and other risk factors for thromboembolic events. Bilateral renal infarction complicating FMD is extremely rare and has so far been reported only in a handful of cases. Physicians encountering cases of otherwise unexplained renal infarction/ischemia need to be aware of this complication.

  6. The administrative review of concession agreements

    OpenAIRE

    Fatmira Hajdari

    2014-01-01

    Concession agreements represent the most utilized and preferred legal option in the exercise of public functions by private entities. Before entering into a concessionary agreement, there is a special procedure that takes place, and that is one of the distinctive characteristics of this type of contract vis-a-vis other civil contracts. This procedure is provided for under the Public procurement law. Consequently, all agreements stemming from the exercise of the concession agreement are regula...

  7. Legal risks at foreign business agreements

    OpenAIRE

    Leppäkoski, Mika

    2015-01-01

    Abstract: The primary objective of this study is to understand the framework how to build an inter-national business agreements, complexity of agreements in the multinational trade and its' regulation, laws and finally evaluate and discuss the potential legal risks which may occur in these international agreements. Objectives: Objectives for this study has been that find an answer to a question: "How to make an international business agreements according to international and loca...

  8. TRIPs Agreement, Important Multilateral WTO Treaty

    Directory of Open Access Journals (Sweden)

    Oana-Maria Florescu

    2006-08-01

    Full Text Available This article aims at presenting the content and the frame of the TRIPs. Agreement. It starts by introducing the reader to the terms that defined the world economical climate by the time of the Agreement negociation. Also, it explains the need of having an Agreement on intellectual property rights with impact on the business world. Moreover, the article reviews the main provisions of the Agreement and the most important intellectual property rights.

  9. The Pros and Cons of Petroleum Agreements.

    Science.gov (United States)

    Lipton, Charles J.

    1980-01-01

    A mineral agreements expert discusses the options open to tribes, from the most standard lease form to arrangements as yet untried by Indian Nations. Discussion covers 18 basic provisions for inclusion in agreements, tax considerations, and basic forms of petroleum agreements (leases, joint ventures, production sharing, and service contracts).…

  10. 46 CFR 356.41 - Management agreements.

    Science.gov (United States)

    2010-10-01

    ... which the management company provides marketing services, consulting services or other services that are... 46 Shipping 8 2010-10-01 2010-10-01 false Management agreements. 356.41 Section 356.41 Shipping..., Management Agreements and Exclusive or Long-Term Contracts § 356.41 Management agreements. (a) An owner...

  11. 7 CFR 966.111 - Marketing Agreement.

    Science.gov (United States)

    2010-01-01

    ... and Regulations Definitions § 966.111 Marketing Agreement. Marketing Agreement means Marketing... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing Agreement. 966.111 Section 966.111 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE...

  12. 7 CFR 946.101 - Marketing agreement.

    Science.gov (United States)

    2010-01-01

    ... WASHINGTON Rules and Regulations Definitions § 946.101 Marketing agreement. Marketing agreement means... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing agreement. 946.101 Section 946.101 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE...

  13. 7 CFR 917.101 - Marketing agreement.

    Science.gov (United States)

    2010-01-01

    ... CALIFORNIA Rules and Regulations Definitions § 917.101 Marketing agreement. Marketing agreement means... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing agreement. 917.101 Section 917.101 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE...

  14. 50 CFR 81.3 - Cooperative Agreement.

    Science.gov (United States)

    2010-10-01

    ...) the recovery potential of the species; (3) the taxonomic status, e.g., giving full species priority... Project Agreement can be approved for endangered or threatened species projects. A cooperative agreement... SPECIES OF FISH, WILDLIFE, AND PLANTS-COOPERATION WITH THE STATES § 81.3 Cooperative Agreement....

  15. 49 CFR 1325.2 - Credit agreements.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Credit agreements. 1325.2 Section 1325.2... OF TRANSPORTATION (CONTINUED) CARRIER RATES AND SERVICE TERMS EXTENSION OF CREDIT TO CANDIDATES FOR FEDERAL OFFICE OR THEIR REPRESENTATIVES § 1325.2 Credit agreements. (a) All agreements to extend credit...

  16. 48 CFR 1819.7209 - Credit agreements.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Credit agreements. 1819... ADMINISTRATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS NASA Mentor-Protégé Program 1819.7209 Credit agreements. (a) The credit permits the mentor to include the cost it expends on a mentor-protégé agreement...

  17. 47 CFR 27.602 - Lease agreements.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Lease agreements. 27.602 Section 27.602... Lease agreements. Guard Band licensees may enter into spectrum leasing arrangements under part 1... following conditions: (a) The spectrum lease agreement between the licensee and the spectrum lessee...

  18. 7 CFR 900.109 - Mediation agreement.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Mediation agreement. 900.109 Section 900.109 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing... Mediation agreement. An agreement arrived at by mediation shall not become effective until approved by...

  19. 77 FR 71001 - Notice of Agreements Filed

    Science.gov (United States)

    2012-11-28

    .... Agreement No.: 012188-000. Title: Matson/Kyowa Space Charter Agreement. Parties: Matson Navigation Company, Inc. (``Matson'') and Kyowa Shipping Co., Ltd. (``Kyowa''). Filing Party: Sloan White; Matson; 555...: Matson/Kyowa Space Charter Agreement for Guam and Pacific Islands. Parties: Matson Navigation...

  20. Bilateral malignant teratoma of the mediastinum: case report; Teratome malin bilateral du mediastin: a propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Ousehal, A.; Skalli, A.; Kadiri, R.; Nejjar, M.; Belaabidia, B. [Centre Hospitalier Universitaire Ibn Rochd, Casablanca (Morocco)

    2001-02-01

    The authors report a case of bilateral malignant teratoma of the mediastinum in a 40 year old female presenting with chest pain. Two separate bilateral soft tissue masses were noted in the mediastinum at imaging. On the right side, the mass was heterogeneous with large calcification and infiltration of the pericardium. On the left side, the mass was well defined heterogeneous and without evidence of local invasion. The analysis of samples obtained by US guided puncture biopsy and surgical specimen of the two masses confirmed the diagnosis of pluri-cellular malignant teratoma. Mediastinal malignant teratomas represent 1 to 5% of all mediastinal tumors. To our knowledge, no case of synchronous bilateral mediastinal teratoma has never been reported. (authors)

  1. Source index B. Agreements under international law and treaties with the GDR

    International Nuclear Information System (INIS)

    This source index B covers the agreements under international law concluded by the Federal Republic of Germany and its legal predecessors, and announced in the Federal Law Gazette, the Federal Gazette and their predecessors, as far as these agreements are still valid or otherwise of practical significance. Source index B refers to: (a) Bilateral treaties with states, communities or organisations, given in alphabetical order. Agreements on capital aid or financial cooperation are given in tables, due to their large number. (b) Multilateral treaties, presented in chronological order. This means all treaties with more than two states being party to the treaty, i.e. also those where one party is one state, and the other party comprises several states. The bilateral treaties with the German Democratic Republic have been compiled in a separate, subsequent section because of their special nature. The third section covers declarations of the FRG of significance in international law. There is a chronological survey of the multilateral treaties, a subject index of the treaties (nuclear energy, environment) with a preceding classification scheme, and a keyword index. (orig./HP)

  2. U.S. Free Trade Agreements in East Asia: Politics, Economics, and Security Policy in the Bush Administration

    OpenAIRE

    Hoadley, Stephen

    2007-01-01

    The Bush Administration has initiated nearly two dozen bilateral and bi-multilateral free trade agreements (FTAs) in the past six years. These FTAs are valued as not only advancing U.S. economic interests but also serving foreign policy and security interests. Their perceived utility as new foreign policy instruments emerged in the wake of the stagnation of multilateral trade liberalization deliberations in the WTO forum and was amplified by the exigencies of the U.S. war on terro...

  3. Do patients with incidentally discovered bilateral adrenal nodules represent an early form of ARMC5-mediated bilateral macronodular hyperplasia?

    Science.gov (United States)

    Emms, Holly; Tsirou, Ioanna; Cranston, Treena; Tsagarakis, Stylianos; Grossman, Ashley B

    2016-09-01

    Bilateral adrenal macronodular hyperplasia (BMAH) is a rare form of Cushing's syndrome characterised by the presence of bilateral secretory adrenal nodules and hypercortisolism. Familial studies support a genetic basis for BMAH, and the disease has been linked to mutations in ARMC5, a gene shown to have a tumour suppressor-like action in the development of adrenal nodules. This study aimed to investigate whether ARMC5 mutations play a role in the development of incidentally discovered bilateral adrenal nodules. We investigated 39 patients with incidentally discovered bilateral adrenal nodules >0.8 cm in diameter who underwent extensive biochemical testing to look for signs of subclinical hypercortisolism. Genomic DNA was analysed by Sanger sequencing, using primers targeted to ARMC5 transcripts. Of the 39 patients included in our study, three were identified as having variants in ARMC5. Two of these are unlikely to be clinically significant, but there is evidence that the third mutation, Chr16:g.31476122;c.1778G>C (p.Arg593Pro), may be pathogenic. Another variant, affecting the same amino-acid residue c.1777C>T (p.Arg593Trp), has been identified previously in two studies of BMAH patients, where it has been shown to segregate with disease in one BMAH family. This patient had biochemical evidence of hypercortisolism in the absence of overt Cushing's syndrome, and underwent bilateral adrenalectomy separated in time. The presence of a probably clinically significant mutation in ARMC5 in one patient with bilateral adrenal incidentalomas adds to the growing body of evidence in support of ARMC5 as a critical mediator of adrenal nodule development. In addition, the absence of significant ARMC5 mutations in 38 of our patients represents an important negative finding, demonstrating the degree of variability within the pathogenesis of adrenal nodule development. PMID:27306888

  4. Luxação glenoumeral anterior bilateral: caso clínico Bilateral anterior glenohumeral dislocation: clinical case

    Directory of Open Access Journals (Sweden)

    Luís Pires Silva

    2011-01-01

    Full Text Available A luxação glenoumeral anterior bilateral é uma ocorrência rara. Apresentamos um caso de luxação glenoumeral anterior bilateral com origem após uma queda da própria altura. O interesse desta publicação reside no fato de se tratar de uma raridade clínica com poucos casos descritos na literatura. Paciente do sexo feminino com 89 anos recorre ao serviço de urgência (SU após queda referindo dor intensa e incapacidade de mobilização de ambos os ombros. Ao exame objetivo apresentava sinais clínicos suspeitos de luxação glenoumeral anterior bilateral confirmados por radiografia. Ambas as luxações foram reduzidas no SU pela técnica de Milch modificada, com sucesso. Quando existe uma força simétrica e síncrona sobre os ombros e estes se apresentarem dolorosos e com limite funcional significativo, a suspeita de luxação glenoumeral bilateral, embora rara, é um diagnóstico diferencial a ter em conta.Bilateral anterior glenohumeral dislocation is a rare occurrence. We present a case of bilateral anterior glenohumeral dislocation caused by a fall. The interest in publishing this case is that this is a clinical rarity with few cases reported in the literature. An 89-year-old female patient was brought to the emergency department after a fall, complaining of intense pain in both shoulders and inability to move them. Objective examination showed clinical signs giving the suspicion of bilateral anterior glenohumeral dislocation, which was confirmed by x-ray imaging. Both dislocations were successfully reduced in the emergency department using the modified Milch technique. When a synchronous and symmetrical force has acted on both shoulders and these are painful with significant functional limitation, the suspicion of bilateral glenohumeral dislocation is a differential diagnosis to be considered, even though it is rare.

  5. China-ASEAN investment agreement negotiations

    Institute of Scientific and Technical Information of China (English)

    CHEN Huiping

    2006-01-01

    China and the ASEAN are negotiating to establish a free trade area and an investment agreement is an integral part of it.The ongoing investment agreement negotiations have achieved some basic consensus as to specific contents of the agreement.However,due to the procedural obstacles and substantive controversies,the negotiations have become stagnant.In order to reach a final and successful conclusion of the investment agreement,the procedural obstacles should be' overcome and the substantive controversies be settled since the agreement has economic and political implications for both China and the ASEAN.

  6. Decree n. 2004-153 of the 11 february 2004 for the publication of the bilateral cooperation agreement between the French Republic Government and the Government of the Republic of Chili on the climatic change, signed at Santiago the 9. december 2003 (1). NOR: MAEJ0430007D; Decret n. 2004-153 du 11 fevrier 2004 portant publication de l'accord de cooperation bilaterale entre le Gouvernement de la Republique francaise et le Gouvernement de la Republique du Chili sur le changement climatique, signe a Santiago le 9 decembre 2003 (1). NOR: MAEJ0430007D

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This agreement aims to facilitate the development and the implementing of projects of greenhouse gases emissions reduction and sequestration in Chili and the transfer to french operators of the agreed part of certified unities of emissions reduction resulting from these activities. These projects will contribute to the sustainable development in Chili. (A.L.B.)

  7. Security cost allocation under combined bilateral-pool market dispatch

    International Nuclear Information System (INIS)

    Most electricity markets around the world are a combination of bilateral and pool markets, such as NordPool and NYPOOL. In these models, market participants bid into the pool and also make bilateral contracts with each other. This paper addressed the issue of congestion management and security cost allocation in a power pool market model. The basic idea of security cost allocation is to divide the incurred security cost due to congestion relief into pool and bilateral market based on their flow contribution to the congested line. A newly proposed security cost allocation strategy of the combined bilateral-pool market was also presented along with case studies using IEEE-14 bus system that tested the proposed method. Using the proposed method, it was shown that security costs are allocated to market participants at different prices which reflect the load contribution to the security problem. This solves the problem of the uniform security cost allocation in a pure pool market system having uniform pricing, and provides a proper security signal to market participants. 11 refs., 3 tabs., 4 figs

  8. Age-Related Differences in Bilateral Asymmetry in Cycling Performance

    Science.gov (United States)

    Liu, Ting; Jensen, Jody L.

    2012-01-01

    Bilateral asymmetry, a form of limb laterality in the context of moving two limbs, emerges in childhood. Children and adults show lateral preference in tasks that involve the upper and lower limbs. The importance of research in limb laterality is the insight it could provide about lateralized functions of the cerebral hemispheres. Analyzing…

  9. Effects of Bilateralism and the MFN Clause on International Trade

    DEFF Research Database (Denmark)

    Lampe, Markus

    2009-01-01

    manufactured goods. Gravity model estimates show that specific liberalizations increased exports of corresponding items, but not overall trade. Exporters from countries whose governments used bilateralism strategically to bring down partner tariffs benefitted most. Hence, the network in form and outcome...... is more properly identified with reciprocal liberalization practiced by the French than with British free-trade ideology....

  10. Candidacy for Bilateral Hearing Aids: A Retrospective Multicenter Study

    NARCIS (Netherlands)

    M. Boymans; S.T. Goverts; S.E. Kramer; J.M. Festen; W.A. Dreschler

    2009-01-01

    Purpose: The goal of this study was to find factors for refining candidacy criteria for bilateral hearing aid fittings. Clinical files of 1,000 consecutive hearing aid fittings were analyzed. Method: Case history, audiometric, and rehabilitation data were collected from clinical files, and an extens

  11. Bilateral acrometastasis in a case renal cell carcinoma

    Science.gov (United States)

    Vaishya, Raju; Vijay, Vipul; Vaish, Abhishek

    2014-01-01

    We present a unique case of bilateral skeletal metastasis below the knee in a patient with renal cell carcinoma. In this rarest of rare cases, bony metastases were the first presentation of a primary tumour. Incidentally, the primary tumour (renal cell carcinoma) involved the solitary kidney of the patient and the same patient also had coexisting carcinoma of the prostate. PMID:25368128

  12. Pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema complicating acute silicosis

    OpenAIRE

    Ramakant Dixit; Manoj Meena; Patil, Chetan B

    2015-01-01

    A case of acute silicosis complicating as spontaneous pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema is described in a 35-year-old male engaged in stone crusher unit. Diagnosis was established on clinical and radiological assessment and supported by occupational history of the patient. This case is unique one as all these 3 complications at the same time are very uncommon in acute silicosis.

  13. Proksimal bilateral humerusfraktur med posterior luksation af caput

    DEFF Research Database (Denmark)

    Kristensen, W; Osther, P

    1990-01-01

    Seizures as the cause of skeletal fractures are well recognized. The commonest is fracture of the humerus. Bilateral fractures are rare and extremely rare in combination with posterior dislocation of the shoulder joint. Two cases of this condition with very unusual etiology are described here. The...

  14. Radiotherapy for Langerhans Cell Histiocytosis of Bilateral Eyelids

    Science.gov (United States)

    Bourque, Jean-Marc; Lukovic, Jelena; Dar, A. Rashid

    2016-01-01

    Langerhans cell histiocytosis (LCH) is a rare disorder with numerous clinicopathological variants with differing clinical courses, treatment methods, and prognoses. We report one patient with atypical LCH of the bilateral lower eyelids and subsequent successful treatment with local radiation therapy. PMID:27004151

  15. Bilateral multiligament injury of knee caused by entangled dupatta.

    Science.gov (United States)

    Vaidya, Shrinand V; Mathesul, Ambarish A; Panghate, Atul N; Wade, Roshan; Sonawane, Dhiraj V

    2012-03-01

    We report a rare case of bilateral multiligament knee injury in an 18-year-old female employed in garment industry. Patient was wearing salwar kameez and dupatta while operating an electric laundry machine. In this case we discuss a peculiar mechanism of injury caused due to wearing dupatta near working site and suggest simple preventive measures.

  16. Bilateral multiligament injury of knee caused by entangled dupatta

    Directory of Open Access Journals (Sweden)

    Shrinand V Vaidya

    2012-01-01

    Full Text Available We report a rare case of bilateral multiligament knee injury in an 18-year-old female employed in garment industry. Patient was wearing salwar kameez and dupatta while operating an electric laundry machine. In this case we discuss a peculiar mechanism of injury caused due to wearing dupatta near working site and suggest simple preventive measures.

  17. Bilateral breast cancer, synchronous and metachronous; differences and outcome

    NARCIS (Netherlands)

    Jobsen, J.J.; Palen, van der J.; Ong, F.; Riemersma, S.; Struikmans, H.

    2015-01-01

    The aims of this study were twofold: to analyze the incidence of patients having synchronous or metachronous bilateral invasive breast cancer (SBBC and MBBC) and to assess the characteristics and outcome compared to those having unilateral breast cancer (UBC). The used data were obtained from our pr

  18. Bilateral Rhegmatogenous Retinal Detachment during External Beam Radiotherapy

    Directory of Open Access Journals (Sweden)

    Takako Hidaka

    2016-06-01

    Full Text Available Herein, we report a case of nontraumatic bilateral rhegmatogenous retinal detachment (RRD during external beam radiotherapy for nonocular tumor, presented as an observational case study in conjunction with a review of the relevant literature. A 65-year-old male was referred to our hospital due to bilateral RRD. He underwent a biopsy for a tumor of the left frontal lobe 4 months prior to presentation, and the tumor had been diagnosed as primary central nerve system B-cell type lymphoma. He received chemotherapy and external beam radiotherapy for 1 month. There were no traumatic episodes. Bilateral retinal detachment occurred during a series of radiotherapies. Simultaneous nontraumatic bilateral retinal detachment is rare. The effects of radiotherapy on ocular functionality, particularly in cases involving retinal adhesion and vitreous contraction, may include RRD. Thus, it is necessary to closely monitor the eyes of patients undergoing radiotherapy, particularly those undergoing surgery for retinal detachment and those with a history of photocoagulation for retinal tears, a relevant family history, or risk factors known to be associated with RRD.

  19. Recurrence of recipient Langerhans' cell histiocytosis following bilateral lung transplantation

    OpenAIRE

    Habib, S.; Congleton, J; Carr, D; Partridge, J; Corrin, B.; Geddes, D; Banner, N.; Yacoub, M; Burke, M.

    1998-01-01

    Langerhans' cell histiocytosis may cause irreversible respiratory failure due to progressive destruction of lung parenchyma and widespread cystic change. Transplantation offers a therapeutic option. A case is described of recurrence of Langerhans' cell histiocytosis which was associated with deterioration in lung function four years following bilateral lung transplantation. Patients transplanted for Langerhans' cell histiocytosis should be followed up with this complication in min...

  20. Radiotherapy for Langerhans Cell Histiocytosis of Bilateral Eyelids.

    Science.gov (United States)

    Leveson, James; Bourque, Jean-Marc; Lukovic, Jelena; Dar, A Rashid

    2016-01-01

    Langerhans cell histiocytosis (LCH) is a rare disorder with numerous clinicopathological variants with differing clinical courses, treatment methods, and prognoses. We report one patient with atypical LCH of the bilateral lower eyelids and subsequent successful treatment with local radiation therapy. PMID:27004151

  1. Bilateral multiligament injury of knee caused by entangled dupatta

    OpenAIRE

    Shrinand V Vaidya; Mathesul, Ambarish A; Panghate, Atul N; Roshan Wade; Sonawane, Dhiraj V

    2012-01-01

    We report a rare case of bilateral multiligament knee injury in an 18-year-old female employed in garment industry. Patient was wearing salwar kameez and dupatta while operating an electric laundry machine. In this case we discuss a peculiar mechanism of injury caused due to wearing dupatta near working site and suggest simple preventive measures.

  2. Market Power in Bilateral Oligopoly Markets with Nonexpendable Infrastructure

    NARCIS (Netherlands)

    Funaki, Y.; Houba, H.E.D.; Motchenkova, E.

    2012-01-01

    Abstract: We consider price-fee competition in bilateral oligopolies with perfectly-divisible goods, non-expandable infrastructures, concentrated agents on both sides, and constant marginal costs. We define and characterize stable market outcomes. Buyers exclusively trade with the supplier with whom

  3. Bilateral chondrolysis of the hip following liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Chechik, Ofir; Dekel, Samuel [Tel Aviv Sourasky Medical Center, Department of Orthopedic Surgery ' B' , Tel Aviv (Israel)]|[Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel)

    2009-03-15

    A 32-year-old woman with bilateral hip chondrolysis diagnosed 2 years following allogeneic liver transplantation is described. Severe osteoarthritis was demonstrated on physical examination, serial radiographs and magnetic resonance imaging. Only four cases of chondrolysis in solid organ recipients have been described in the literature. (orig.)

  4. Amnesia due to bilateral hippocampal glioblastoma. MRI finding

    Energy Technology Data Exchange (ETDEWEB)

    Shimauchi, M.; Wakisaka, S.; Kinoshita, K. (Miyazaki Medical Coll., Kiyotake (Japan). Dept. of Neurosurgery)

    1989-11-01

    The authors report a unique case of glioblastoma which caused permanent amnesia. Magnetic resonance imaging showed the lesion to be limited to the hippocampal formation bilaterally. Although glioblastoma extends frequently into fiber pathways and expands into the opposite cerebral hemisphere, making a 'butterfly' lesion, it is unusual for it to invade the limbic system selectively to this extent. (orig.).

  5. Muscle Activity during Unilateral Vs. Bilateral Battle Rope Exercises

    DEFF Research Database (Denmark)

    Calatayud, J.; Martin, F.; Colado, J. C.;

    2015-01-01

    Calatayud, J, Martin, F, Colado, JC, Benitez, JC, Jakobsen, MD, and Andersen, LL. Muscle activity during unilateral vs. bilateral battle rope exercises. J Strength Cond Res 29(10): 2854-2859, 2015High training intensity is important for efficient strength gains. Although battle rope training is m...

  6. North-South FDI and Bilateral Investment Treaties

    NARCIS (Netherlands)

    Falvey, R.; Foster-McGregor, N.

    2015-01-01

    Bilateral Investment Treaties (BITs) have become increasingly popular as a means of encouraging FDI from developed to developing countries. We adopt a matched difference-in-difference estimation to deal with the problem of endogeneity when estimating the effects of BITs on inward FDI. Our results in

  7. Reduced Misinformation Effects Following Saccadic Bilateral Eye Movements

    Science.gov (United States)

    Parker, Andrew; Buckley, Sharon; Dagnall, Neil

    2009-01-01

    The effects of saccadic bilateral (horizontal) eye movements on memory for a visual event narrative were investigated. In the study phase, participants were exposed to a set of pictures accompanied by a verbal commentary describing the events depicted in the pictures. Next, the participants were asked either misleading or control questions about…

  8. Spanish Bilateral Initiatives for Education in Latin America

    Science.gov (United States)

    Cortina, Regina; Sanchez, Maria Teresa

    2007-01-01

    The research presented in this article concerns la Agencia Espanola de Cooperacion Internacional (Spanish Agency for International Cooperation--AECI) and its growing presence in Latin America since the late 1990s. The aim is to evaluate the transformative potential that bilateral funding can have on educational reform in the region. The article…

  9. Bilateral spontaneous rupture of flexor digitorum profundus tendons.

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    Spontaneous tendon rupture is an unusual condition usually associated with underlying disease processes such as rheumatoid arthritis, chronic renal failure or bony abnormalities of the hand. We report a case of spontaneous, non-concurrent bilateral rupture of flexor profundus tendons in an otherwise healthy individual. Treatment was successful and consisted of a two-stage reconstruction of the ruptured tendon.

  10. A RETROSPECTIVE STUDY OF BILATERAL ALVEOLAR BONE GRAFTING

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. To evaluate the treatment results of bilateral alveolar bone grafting (BABG) in patients with bilateral complete clefts of lip and palate.Methods. A retrospective study was performed in 66 bilateral complete cleft lip and palate patients who received the procedure of BABG, among them 15 were primary BABG and 51 were secondary BABG. The patients were further divided into three groups according to age and eruption stage of the canine at the time of surgery. The result of BABG was evaluated on the radiographs. Results. (1)The overall success rate of BABG was 75.0%, with 83.3% and 72.5% for primary and secondary BABG respectively; (2)The marginal bone level was found to be significantly higher in the youngest age group than in the other groups both for primary and secondary BABG; (3)For both primary and secondary BABG, Group C (patients' age more than 16 years) had the least optimal success rate, with 66.7% and 65.4% respectively. Conclusion. Simultaneous primary palate repair and BABG is safe and feasible procedure for treating unoperated bilateral complete cleft lip and cleft palate patients. For both primary and secondary BABG, significantly better results can be achieved if the operation is performed before eruption of the canine.

  11. Oclusão de ramo arterial retiniano bilateral

    Directory of Open Access Journals (Sweden)

    Luiz Guilherme Azevedo de Freitas

    2013-08-01

    Full Text Available Os autores relatam o caso de uma paciente que apresentou quadro bilateral de oclusão de ramos arteriais da retina sem causas sistêmicas identificáveis para o aparecimento da doença.

  12. BILGO: Bilateral greedy optimization for large scale semidefinite programming

    KAUST Repository

    Hao, Zhifeng

    2013-10-03

    Many machine learning tasks (e.g. metric and manifold learning problems) can be formulated as convex semidefinite programs. To enable the application of these tasks on a large-scale, scalability and computational efficiency are considered as desirable properties for a practical semidefinite programming algorithm. In this paper, we theoretically analyze a new bilateral greedy optimization (denoted BILGO) strategy in solving general semidefinite programs on large-scale datasets. As compared to existing methods, BILGO employs a bilateral search strategy during each optimization iteration. In such an iteration, the current semidefinite matrix solution is updated as a bilateral linear combination of the previous solution and a suitable rank-1 matrix, which can be efficiently computed from the leading eigenvector of the descent direction at this iteration. By optimizing for the coefficients of the bilateral combination, BILGO reduces the cost function in every iteration until the KKT conditions are fully satisfied, thus, it tends to converge to a global optimum. In fact, we prove that BILGO converges to the global optimal solution at a rate of O(1/k), where k is the iteration counter. The algorithm thus successfully combines the efficiency of conventional rank-1 update algorithms and the effectiveness of gradient descent. Moreover, BILGO can be easily extended to handle low rank constraints. To validate the effectiveness and efficiency of BILGO, we apply it to two important machine learning tasks, namely Mahalanobis metric learning and maximum variance unfolding. Extensive experimental results clearly demonstrate that BILGO can solve large-scale semidefinite programs efficiently.

  13. Bilateral optic neuritis in a boy - More than the eyes.

    Science.gov (United States)

    Loh, M A; Alex Khoo, P C; Chong, M F

    2016-04-01

    Neuromyelitis optica (NMO) is a rare disorder in children with variable presentation. We report a 7-year-old boy who presented with bilateral retrobulbar optic neuritis and responded very well to treatment. He was also positive for aquaporin 4 (AQP4) antibodies, which is part of an emerging endophenotype within autoimmune neurological disorders in childhood. PMID:27326949

  14. A Bilateral Advantage for Storage in Visual Working Memory

    Science.gov (United States)

    Umemoto, Akina; Drew, Trafton; Ester, Edward F.; Awh, Edward

    2010-01-01

    Various studies have demonstrated enhanced visual processing when information is presented across both visual hemifields rather than in a single hemifield (the "bilateral advantage"). For example, Alvarez and Cavanagh (2005) reported that observers were able to track twice as many moving visual stimuli when the tracked items were presented…

  15. Bilateral adaptive deep brain stimulation is effective in Parkinson's disease

    Science.gov (United States)

    Little, Simon; Beudel, Martijn; Zrinzo, Ludvic; Foltynie, Thomas; Limousin, Patricia; Hariz, Marwan; Neal, Spencer; Cheeran, Binith; Cagnan, Hayriye; Gratwicke, James; Aziz, Tipu Z; Pogosyan, Alex; Brown, Peter

    2016-01-01

    Introduction & objectives Adaptive deep brain stimulation (aDBS) uses feedback from brain signals to guide stimulation. A recent acute trial of unilateral aDBS showed that aDBS can lead to substantial improvements in contralateral hemibody Unified Parkinson’s Disease Rating Scale (UPDRS) motor scores and may be superior to conventional continuous DBS in Parkinson’s disease (PD). We test whether potential benefits are retained with bilateral aDBS and in the face of concurrent medication. Methods We applied bilateral aDBS in 4 patients with PD undergoing DBS of the subthalamic nucleus. aDBS was delivered bilaterally with independent triggering of stimulation according to the amplitude of β activity at the corresponding electrode. Mean stimulation voltage was 3.0±0.1 volts. Motor assessments consisted of double-blinded video-taped motor UPDRS scores that included both limb and axial features. Results UPDRS scores were 43% (p=0.04; Cohen’s d=1.62) better with aDBS than without stimulation. Motor improvement with aDBS occurred despite an average time on stimulation (ToS) of only 45%. Levodopa was well tolerated during aDBS and led to further reductions in ToS. Conclusion Bilateral aDBS can improve both axial and limb symptoms and can track the need for stimulation across drug states. PMID:26424898

  16. China-Japan-Korea FTA: A Dual Track Approach to a Trilateral Agreement

    OpenAIRE

    Madhur, Srinivasa

    2013-01-01

    This paper argues that a China-Japan-Korea Free Trade Agreement (CJK FTA) will have large benefits to the three Northeast Asian countries and significant implications for global multilateral trade. However, several hurdles seem to make an expeditious completion of a CJK FTA, or even bilateral FTAs between Japan and China or between Japan and Korea extremely difficult. Thus, a pragmatic approach would be to follow a dual-track approach in which China and Korea fast-track the completion of a bi...

  17. EVOLUTION OF SYNCHRONOUS BILATERAL BREAST CARCINOMA IN A YOUNG PATIENT.

    Science.gov (United States)

    Manea, Elena; Munteanu, Anca

    2016-01-01

    Bilateral breast cancer incidence is appreciated to be between 0.3 to 12% and is determined either by a hereditary load associated with chromosomal instability under the effect of environmental factors, or by the evolution in a particular hormonal context which gives biological aggressiveness. We present the case of a patient, aged 38 years, clinically, imagistic and bioptic diagnosed with left axillary lymph node metastases of breast carcinoma NST invasive G3, IHC-RE = 60%, RP = 30%, HER2neu = 2 +, Ki67 = 20%, in August 2013. Patient followed neoadjuvant chemotherapy treatment during September-October 2013. In December 2013 she was clinically and imaging diagnosed with bilateral breast cancer, for which surgical intervention was done which consisted of bilateral radical Madden mastectomy with bilateral axillary lymphadenectomy. BAP-invasive carcinoma NST: left breast-pT2mN3a G2, right breast--pT3mN3a G2, IHC-RE = 90%, RP =70% HER2neu = 2 +, Ki67 = 50%. During the period of January-March 2014, the patient followed adjuvant chemotherapy and Herceptin. Bilateral breast ultrasound assessment in April 2014 revealed: left axilla--liquid blade 29 / 6mm; right axilla--oval ganglion 9/5 mm. Abdominal and pelvic ultrasound: empty uterine cavity, bosselated contour; at left ovary level multiple cystic formations. During the period of May-June 2014, adjuvant radiation therapy and ovarian irradiationwas administered to the patient. Subsequently hormone therapy was initiated. Following CHT / ovarian irradiation patient continues to experience intermittent uterine bleeding, which is why a total hysterectomy with bilateral ovariectomy was done, and BAP: cervical, endometrialand left ovary with tumor multifocal infiltration with histopathological aspect of invasive breast carcinoma NST. Periodic imaging evaluations do not reveal local or distant recurrence. The particularity of this case is synchronous bilateral breast cancer diagnosis in a young patient complicated in its

  18. Retinoblastoma bilateral de aparecimento tardio: relato de caso Late presentation of bilateral retinoblastoma: case report

    Directory of Open Access Journals (Sweden)

    Maria Cecília Santos Cavalcanti Melo

    2008-06-01

    Full Text Available É relatado um caso de retinoblastoma de aparecimento tardio, com características pouco freqüentes, com o objetivo de melhorar o controle da afecção. Em 1993, SJMMF, nove meses, masculino, leucodermo, apresentou tumor na retina esquerda. O paciente tinha história familiar de retinoblastoma. A enucleação foi realizada, comprovando-se retinoblastoma. Os exames para estadiamento sistêmico foram normais. O olho direito evoluiu normal por dez anos. Em exame de rotina, foram constatadas três lesões de retinoblastoma na retina nasal. Foi feita termoterapia transpupilar, com laser de diodo de 810 nm. Após 30 dias, as lesões regrediram. Após 60 dias houve recidiva na borda da lesão, onde foi realizada crioterapia transescleral, com regressão do tumor por seis meses. Durante o controle, observaram-se condensações próximas à lesão tumoral atrófica (sementes vítreas. Foi feito braquiterapia com Iodo125, havendo desaparecimento das mesmas após 30 dias. Novas sementes surgiram três meses pós-braquiterapia, depositadas na superfície retiniana, sendo tratadas com crioterapia transescleral e termoterapia transpupilar, havendo regressão. O paciente evoluiu com nova semente vítrea após seis meses, a qual, após depositar-se na superfície da retina, foi tratada com termoterapia transpupilar. Está em seguimento há 38 meses desde o aparecimento do tumor bilateral, mantendo acuidade visual de 20/20 e exames clínicos normais. Considera-se importante este caso pela pouca freqüência de aparecimento da doença nesta idade. Julga-se necessário o alerta para os casos de retinoblastoma já considerados curados.A case of retinoblastoma with uncommon features is reported, aiming at improving follow-up. In 1993, SJMMF, 9-month-old white boy, presented a squint in the left eye. A retinal tumor was detected. The patient had a family history of retinoblastoma. Enucleation was performed and retinoblastoma was proved. The patient underwent

  19. Canada and the North American Free Trade Agreement: Between globalization and regional integration

    Directory of Open Access Journals (Sweden)

    Caterina García Segura

    1995-07-01

    Full Text Available The aim of the present article is to analize, from Canada’s perspective, the choice regarding the model of state as well as of economic and commercial policy which the decision to participate in the North American Free Trade Agreement (NAFTA implies. The debatewhich NAFTA provoked in Canada expresses in concrete terms that debate which, in much larger terms, takes place at the international level regarding the multilateralization and/or the regionalization of commercial exchanges. It is a reflection of the tension between theintegrating forces (process of globalization and the fragmenting ones (processes of regionalization which characterize the dynamics of the contemporary international system. The hypothesis of this work is that in spite of being a commercial agreement, the Canadian government’s decision to participate in NAFTA was a decision of a political nature which was not determined exclusively by the reality of the existing commercial exchanges between Canada and Mexico or by the perspectives of improving them inthe short term. The immediate objective of Canada was to avoid that a possible bilateral agreement between its prinicipal economic member, the United States, and Mexico would empty out the contents of the existing Free Trade Agreement (FTA between Canada and the United States. In this sense, NAFTA was the possible remedy to an unwanted situation (the negotiation of a US-Mexico bilateral agreement. The objective in the medium and long term is use the platform of regional integration as a trampoline from where the Canadian economy can be reorientated and driven in order to attain international competitiveness. In this sense, Canada’s true option had already beenrealised with the FTA.

  20. ¿Como se negocia un TLC en Colombia? / How does Colombian negotiate its free trade agreements?

    Directory of Open Access Journals (Sweden)

    Cecilia López Montaño

    2007-06-01

    Full Text Available Colombia is currently involved in the second phase of globalization, characterized by trade agreements. Contrary to common belief, bilateral trade negotiations are more political than technical. Thus, the author argues that the defense of the interests of the weak demands a more political focus, under the assumption that politicians do not defend the interests of the powerful but those of the poor. However, the analysis that the article offers of the negotiation of the free trade agreement with the United States shows that the way in which President Alvaro Uribe led this process caused the country to cede too much on strategic issues affecting the interests of Colombian society.

  1. Bilateral adrenalectomy for Cushing's syndrome: Pros and cons

    Directory of Open Access Journals (Sweden)

    O P Prajapati

    2015-01-01

    Full Text Available Aim: To assess the outcome of patients undergoing bilateral adrenalectomy for Cushing's syndrome (CS. Methods: All patients who underwent bilateral adrenalectomy for CS at the Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences hospital between 1991 and 2013 were included. Medical records were reviewed to obtain patient characteristics and follow-up data. Results: Twenty-seven patients were studied. Mean age was 28.74 ± 12.95 years (range 9–60, male:female ratio was 1.7:1. About half that is, 48.19% were of Cushing's disease (failed trans-sphenoidal surgery [TSS], 37.04% were of ectopic CS (ECS, and 14.81% were of CS due to bilateral adrenal pathology. Median follow-up period was 80.5 months. Before surgery, 74.1% patients had body mass index > which after surgery declined to <25 in 75% of them. Hypertension was present in 85.2% and after surgery resolved in 40%. Diabetes mellitus was present in 44.4% and after surgery resolved in 33% of them. Hirsutism and proximal muscle weakness were present in 55.6% and 70.4% patients, respectively, and after surgery improved markedly in all patients. Adrenal crisis developed in 36.3% and Nelson's syndrome in 41.7% patients during follow-up. Three patients died in perioperative period while three succumbed to the disease during follow-up. Two patients developed recurrence of endogenous cortisol production during the follow-up period. Conclusions: Bilateral adrenalectomy is a valid treatment option for palliating severe symptoms in Pituitary Cushing's with failed TSS and unlocalized ECS but the procedure is curative for CS due to bilateral adrenal disease. Overall morbidity and mortality is higher than other endocrine operations. Co-morbidities tend to be more severe and are a risk factor for mortality during the time patient survives.

  2. Bilateral desmoid tumor of the breast: case seriesand literature review

    Science.gov (United States)

    Wongmaneerung, Phanchaporn; Somwangprasert, Areewan; Watcharachan, Kirati; Ditsatham, Chagkrit

    2016-01-01

    Background Desmoid tumor of the breast is very rare and locally aggressive but has no distant metastasis. Bilateral lesions are extremely rare, found in only 4% of patients. Two cases of bilateral desmoid tumor of the breast are reported. The clinical presentation, diagnosis, imaging, treatment, and follow-up outcomes of recurrence as well as a brief literature review are provided. Case reports Case 1 is a 31-year-old woman who presented with nipple retraction. An ultrasound revealed BIRAD V in both breasts. She underwent a bilateral excisional biopsy under ultrasound mark with the pathology result of extra-abdominal desmoid tumor in both breasts. The patient had a bilateral mastectomy with silicone implantation due to the involved margins by excision. She remained tumor free after 7-year follow-up. Case 2 is a 28-year-old woman who presented with a lump on her right breast that she had discovered ~2 months earlier. An ultrasound showed a spiculated mass in the right breast and some circumscribed hypoechoic masses in both breasts. A bilateral breast excision was done. The pathology result was an extra-abdominal desmoid tumor. She had recurrence on both sides and underwent a mastectomy and silicone implantation. The tumor has not recurred after 1-year follow-up. Conclusion Imaging cannot distinguish between benign breast lesions and malignancy. Pathology results are helpful in making a definitive diagnosis. Given that the desmoid tumor is locally aggressive, a local excision with clear margins is recommended. Chemotherapy and hormonal treatment are controversial. PMID:27578999

  3. Note: Unshielded bilateral magnetoencephalography system using two-dimensional gradiometers

    Science.gov (United States)

    Seki, Yusuke; Kandori, Akihiko; Ogata, Kuniomi; Miyashita, Tsuyoshi; Kumagai, Yukio; Ohnuma, Mitsuru; Konaka, Kuni; Naritomi, Hiroaki

    2010-09-01

    Magnetoencephalography (MEG) noninvasively measures neuronal activity with high temporal resolution. The aim of this study was to develop a new type of MEG system that can measure bilateral MEG waveforms without a magnetically shielded room, which is an obstacle to reducing both the cost and size of an MEG system. An unshielded bilateral MEG system was developed using four two-dimensional (2D) gradiometers and two symmetric cryostats. The 2D gradiometer, which is based on a low-Tc superconducting quantum interference device and wire-wound pickup coil detects a magnetic-field gradient in two orthogonal directions, or ∂/∂x(∂2Bz/∂z2), and reduces environmental magnetic-field noise by more than 50 dB. The cryostats can be symmetrically positioned in three directions: vertical, horizontal, and rotational. This makes it possible to detect bilateral neuronal activity in the cerebral cortex simultaneously. Bilateral auditory-evoked fields (AEF) of 18 elderly subjects were measured in an unshielded hospital environment using the MEG system. As a result, both the ipsilateral and the contralateral AEF component N100m, which is the magnetic counterpart of electric N100 in electroencephalography and appears about 100 ms after the onset of an auditory stimulus, were successfully detected for all the subjects. Moreover, the ipsilateral P50m and the contralateral P50m were also detected for 12 (67%) and 16 (89%) subjects, respectively. Experimental results demonstrate that the unshielded bilateral MEG system can detect MEG waveforms, which are associated with brain dysfunction such as epilepsy, Alzheimer's disease, and Down syndrome.

  4. Localization ability with bimodal hearing aids and bilateral cochlear implants

    Science.gov (United States)

    Seeber, Bernhard U.; Baumann, Uwe; Fastl, Hugo

    2004-09-01

    After successful cochlear implantation in one ear, some patients continue to use a hearing aid at the contralateral ear. They report an improved reception of speech, especially in noise, as well as a better perception of music when the hearing aid and cochlear implant are used in this bimodal combination. Some individuals in this bimodal patient group also report the impression of an improved localization ability. Similar experiences are reported by the group of bilateral cochlear implantees. In this study, a survey of 11 bimodally and 4 bilaterally equipped cochlear implant users was carried out to assess localization ability. Individuals in the bimodal implant group were all provided with the same type of hearing aid in the opposite ear, and subjects in the bilateral implant group used cochlear implants of the same manufacturer on each ear. Subjects adjusted the spot of a computer-controlled laser-pointer to the perceived direction of sound incidence in the frontal horizontal plane by rotating a trackball. Two subjects of the bimodal group who had substantial residual hearing showed localization ability in the bimodal configuration, whereas using each single device only the subject with better residual hearing was able to discriminate the side of sound origin. Five other subjects with more pronounced hearing loss displayed an ability for side discrimination through the use of bimodal aids, while four of them were already able to discriminate the side with a single device. Of the bilateral cochlear implant group one subject showed localization accuracy close to that of normal hearing subjects. This subject was also able to discriminate the side of sound origin using the first implanted device alone. The other three bilaterally equipped subjects showed limited localization ability using both devices. Among them one subject demonstrated a side-discrimination ability using only the first implanted device.

  5. Technical recommendations for bilateral comparison in diagnosis radiology: part 2; Protocolo tecnico da comparacao bilateral em radiologia diagnostica: parte 2

    Energy Technology Data Exchange (ETDEWEB)

    Peixoto, J.G.P., E-mail: guilherm@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Almeida, C.E.V. de [Universidade do Estado do Rio de Janeiro (LCR/IBRAG/UERJ), Rio de Janeiro, RJ (Brazil). Lab. de Ciencias Radiologicas

    2015-07-01

    The conventional radiology (≈70%), mammography(≈4%) and Computer Tomography (≈2%) will be in charge of this bilateral comparison. We could found the users ionization chambers, reference and radiations conditions, agenda and the comparison budget. The partial results will be presentation at metrology and medical physics congress. (author)

  6. Technical recommendations for bilateral comparison in diagnosis radiology: part 3; Protocolo tecnico da comparacao bilateral em radiologia diagnostica: parte 3

    Energy Technology Data Exchange (ETDEWEB)

    Peixoto, J.G.P., E-mail: guilherm@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Almeida, C.E.V. de [Universidade do Estado do Rio de Janeiro (LCR/IBRAG/UERJ), Rio de Janeiro, RJ (Brazil). Lab. de Ciencias Radiologicas

    2015-07-01

    Uncertainty and results homogeneity need to following the technical procedure to bilateral comparison, then we select the equipment used, reference conditions and the data file to be used for all participant laboratory. The partial results will be presentation at metrology and medical physics congress. (author)

  7. Amputee Mobility Predictor-Bilateral: A performance-based measure of mobility for people with bilateral lower-limb loss

    Directory of Open Access Journals (Sweden)

    Michele A. Raya, PhD, PT, SCS, ATC

    2013-10-01

    Full Text Available The Amputee Mobility Predictor (AMP is an outcome measure designed to assess mobility and functional capabilities for people with unilateral lower-limb amputation. No comparable measure exists for those with bilateral lower-limb amputation (BLLA. The purpose of this study was to examine the utility of the AMP-Bilateral (AMP-B to measure the ability to perform functional tasks related to participation in advanced skill activities in those with BLLA and to determine whether AMP-B scores correlated with 6-minute walk test (6MWT performance. Twenty-six male servicemembers (SMs completed the study: 12 with bilateral transtibial amputation (BTTA, 7 with bilateral transfemoral amputation (BTFA, and 7 with combination transtibial and transfemoral amputation (TTA/TFA. Significant differences existed between the AMP-B scores (p < 0.001, AMP scores (p < 0.001, and 6MWT distance (p < 0.05 for SMs with BTTA and TTA/TFA and SMs with BTTA and BTFA but not between those with BTFA and TTA/TFA. Scoring of five AMP items was modified because they necessitate at least one intact knee joint to generate the necessary torque requirements to perform the activity without upper-limb assistance. Minor modifications in scoring of the AMP do not alter total score and allow clinicians to determine the mobility and functional capabilities of SMs with BTFA and TFA/TTA.

  8. A Longitudinal Study in Adults with Sequential Bilateral Cochlear Implants: Time Course for Individual Ear and Bilateral Performance

    Science.gov (United States)

    Reeder, Ruth M.; Firszt, Jill B.; Holden, Laura K.; Strube, Michael J.

    2014-01-01

    Purpose: The purpose of this study was to examine the rate of progress in the 2nd implanted ear as it relates to the 1st implanted ear and to bilateral performance in adult sequential cochlear implant recipients. In addition, this study aimed to identify factors that contribute to patient outcomes. Method: The authors performed a prospective…

  9. Canada-United States air quality agreement : progress report 2006

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    This biennial progress report highlighted actions undertaken by Canada and the United States in the last 2 years to address transboundary air pollution within the context of the Air Quality Agreement regarding acid rain and ground-level ozone. The report was divided into 3 sections. The first section provided information concerning commitments to emission reductions in acid rain and ozone annexes. Section 2 provided details of related air quality efforts. Section 3 presented information on scientific and technical cooperation and research, which included details of health effects and acid deposition effects, recovery efforts and critical loads and exceedances. The progress report also included the third 5-year comprehensive review of the Air Quality Agreement, which was organized in a question and answer format to address requirements in the agreement and public comments on the 2004 progress report. In October 2006, Canada's federal government tabled the Clean Air Act as a new legislation that would expand the government's authorities to take action to reduce air emissions of greenhouse gases and other air pollutants. The Notice of Intent to develop and implement regulations and other measures to reduce air emissions was also revealed. The regulations would address anthropogenic sources of air pollution, including fossil-fuel electricity production, petroleum industry, smelters, forest products, chemicals production and transportation. The report showed that over the last 2 years, both countries have reduced their emissions of sulfur dioxide (SO{sub 2}) and nitrogen oxides (NO{sub x}), and have made progress in meeting the requirements of the Ozone Annex to reduce emissions of NO{sub x} and volatile organic compounds (VOCs). Actions have focused on reducing emissions from major sources such as electric generating units, industrial sources, and on-road and nonroad transportation. It was concluded that to date, the agreement has provided opportunities for

  10. 22 CFR 124.6 - Termination of manufacturing license agreements and technical assistance agreements.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Termination of manufacturing license agreements... Termination of manufacturing license agreements and technical assistance agreements. The U.S. party to a manufacturing license or a technical assistance agreement must inform the Directorate of Defense Trade...

  11. U.S.-CHINA RADIOLOGICAL SOURCE SECURITY PROJECT: CONTINUING AND EXPANDING BILATERAL COOPERATION

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Zhixuan; Zhou, Qifu; Yang, Yaoyun; Huang, Chaoyun; Lloyd, James; Williams, Adam; Feldman, Alexander; Streeper, Charles; Pope, Noah G.; Hawk, Mark; Rawl, Rick; Howell, Randy A.; Kennedy, Catherine

    2009-10-07

    The successful radiological security cooperation between the U.S. and China to secure at-risk sites near venues of the 2008 Beijing Summer Olympics has led to an expanded bilateral nonproliferation cooperation scope. The U.S. Department of Energy’s National Nuclear Security Administration, the Chinese Atomic Energy Authority and the China Ministry of Environmental Protection are continuing joint efforts to secure radiological sources throughout China under the U.S.-China Peaceful Uses of Nuclear Technology (PUNT) Agreement. Joint cooperation activities include physical security upgrades of sites with International Atomic Energy Agency (IAEA) Category 1 radiological sources, packaging, recovery, and storage of high activity transuranic and beta gamma sources, and secure transportation practices for the movement of recovered sources. Expansion of cooperation into numerous provinces within China includes the use of integrated training workshops that will demonstrate methodologies and best practices between U.S. and Chinese radiological source security and recovery experts. The fiscal year 2009 expanded scope of cooperation will be conducted similar to the 2008 Olympic cooperation with the Global Threat Reduction Initiative taking the lead for the U.S., PUNT being the umbrella agreement, and Los Alamos, Sandia, and Oak Ridge National Laboratories operating as technical working groups. This paper outlines the accomplishments of the joint implementation and training efforts to date and discusses the possible impact on future U.S./China cooperation.

  12. Analyzing rater agreement manifest variable methods

    CERN Document Server

    von Eye, Alexander

    2014-01-01

    Agreement among raters is of great importance in many domains. For example, in medicine, diagnoses are often provided by more than one doctor to make sure the proposed treatment is optimal. In criminal trials, sentencing depends, among other things, on the complete agreement among the jurors. In observational studies, researchers increase reliability by examining discrepant ratings. This book is intended to help researchers statistically examine rater agreement by reviewing four different approaches to the technique.The first approach introduces readers to calculating coefficients that allow one to summarize agreements in a single score. The second approach involves estimating log-linear models that allow one to test specific hypotheses about the structure of a cross-classification of two or more raters'' judgments. The third approach explores cross-classifications or raters'' agreement for indicators of agreement or disagreement, and for indicators of such characteristics as trends. The fourth approach compa...

  13. Effect of unilateral and simultaneous bilateral cochlear implantation on tinnitus : A randomized controlled trial

    NARCIS (Netherlands)

    van Zon, Alice; Smulders, Yvette E; Ramakers, Geerte G J; Stegeman, Inge; Smit, Adriana L; Van Zanten, Gijsbert A; Stokroos, Robert J; Hendrice, Nadia; Free, Rolien H; Maat, Bert; Frijns, Johan H M; Mylanus, Emmanuel A M; Huinck, Wendy J; Topsakal, Vedat; Tange, Rinze A; Grolman, Wilko

    2015-01-01

    OBJECTIVES/HYPOTHESIS: To determine the effect of cochlear implantation on tinnitus perception in patients with severe bilateral postlingual sensorineural hearing loss and to demonstrate possible differences between unilateral and bilateral cochlear implantation. STUDY DESIGN: Prospective study. MET

  14. Multicentre prospective evaluation of implant-assisted mandibular bilateral distal extension removable partial dentures: patient satisfaction

    NARCIS (Netherlands)

    D. Wismeijer; A. Tawse-Smith; A.G.T. Payne

    2013-01-01

    Objective To compare the levels of patient satisfaction with either conventional mandibular bilateral distal extension partial dentures or those assisted by bilateral distal implants. Materials and methods Forty-eight participants who were dissatisfied with their existing conventional mandibular dis

  15. Plasma rennin activity: Early indicator of renal injury in bilateral pelviureteric junction obstruction in children

    Directory of Open Access Journals (Sweden)

    Amit Singh

    2014-01-01

    Conclusion: In bilateral PUJO where DRF and SFU grading of hydronephrosis did not correctly reflect renal injury, PRA showed a significant relationship with renal histopathologic grade and could be an early indicator of renal injury in bilateral PUJO.

  16. Bilateral superficial peroneal nerve entrapment secondary to anorexia nervosa: a case report

    OpenAIRE

    Doğramacı Yunus; Kalacı Aydıner; Sevinç Teoman; Yanat Ahmet

    2008-01-01

    Abstract We report a case of severe weight loss secondary to anorexia nervosa causing bilateral superficial peroneal nerve entrapment in a young female patient who was treated successfully by bilateral surgical decompression.

  17. The clinical comparison of simultaneous bilateral total knee arthroplasty in treatment of osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    Jun Hu; Dunming Guo; Zheng Lü; Jie Liu; Xialin Yu; Zhongnan Zhang

    2008-01-01

    Objective: To evaluate the risk and efficacy of simultaneous bilateral total knee arthroplasty(TKA) in treatment of osteoarthritis when compared with sequential bilateral TKA and unilateral TKA. Methods:A retrospective analysis was performed on 162 patients who underwent TKA from 2003 to 2006. The analyses were adjusted for demographics, preexisting medical conditions, and osteoarthritis diagnosis. Results:Patients undergoing simultaneous bilateral TKA had significantly lower amounts of blood loss, shorter surgical time, shorter hospitalization time, less hospital charges and lower rates of perioperative complications compared with patients undergoing sequential bilateral TKA. No significant difference was found with regard to postoperative complications between the simultaneous bilateral and the unilateral TKA groups. Patient's knee range of motion and the postoperative Hospital for Special Surgery scores(HSS) were similar for the three groups. Conclusion:When there arc adequate indications for bilateral TKA, simultaneous bilateral TKA is beneficial to patients compared with sequential bilateral or unilateral TKA.

  18. The cross-border cooperation agreement

    OpenAIRE

    Cătălin-Silviu SĂRARU

    2011-01-01

    This study aims to achieve a short analysis of cross-border cooperation agreements between territorial-administrative units in the border areas of Romania and similar structures in neighboring states. The article investigates the form they takes these agreements – contract or treaty –, the role of multinational enterprises and the law applicable to transnational contracts, the cross-border cooperation agreement governed by Law no. 215/2001 on local public administration and its legal nature. ...

  19. Semantic gender agreement: Dutch and German compared

    OpenAIRE

    Kraaikamp, M. Van

    2016-01-01

    This paper compares pronominal gender agreement in Dutch and German. Pronouns do not always agree with the gender of their antecedent: instead of agreeing with the lexical gender of the noun, they show semantic gender agreement. This is known to occur with human referents in both Dutch and German. In Dutch, pronouns can agree semantically with non-human referents as well, based on their degree of individuation. This type of agreement has been found in several Germanic varieties. It has been s...

  20. Bilateral ureteropelvic disruption following blunt abdominal trauma: Case report

    Directory of Open Access Journals (Sweden)

    Kikuchi Hiroko

    2011-07-01

    Full Text Available Abstract Background Ureteral injury occurs in less than 1% of blunt abdominal trauma cases, partly because the ureters are relatively well protected in the retroperitoneum. Bilateral ureteral injury is extremely rare, with only 10 previously reported cases. Diagnosis may be delayed if ureteric injury is not suspected, and delay of 36 hours or longer has been observed in more than 50% of patients with ureteric injury following abdominal trauma, leading to increased morbidity. Case presentation A 29-year-old man was involved in a highway motor vehicle collision and was ejected from the front passenger seat even though wearing a seatbelt. He was in a preshock state at the scene of the accident. An intravenous line and left thoracic drain were inserted, and he was transported to our hospital by helicopter. Whole-body, contrast-enhanced computed tomography (CT scan showed left diaphragmatic disruption, splenic injury, and a grade I injury to the left kidney with a retroperitoneal haematoma. He underwent emergency laparotomy. The left diaphragmatic and splenic injuries were repaired. Although a retroperitoneal haematoma was observed, his renal injury was treated conservatively because the haematoma was not expanding. In the intensive care unit, the patient's haemodynamic state was stable, but there was no urinary output for 9 hours after surgery. Anuresis prompted a review of the abdominal x-ray which had been performed after the contrast-enhanced CT. Leakage of contrast material from the ureteropelvic junctions was detected, and review of the repeat CT scan revealed contrast retention in the perirenal retroperitoneum bilaterally. He underwent cystoscopy and bilateral retrograde pyelography, which showed bilateral complete ureteral disruption, preventing placement of ureteral stents. Diagnostic laparotomy revealed complete disruption of the ureteropelvic junctions bilaterally. Double-J ureteral stents were placed bilaterally and ureteropelvic

  1. 76 FR 64944 - Notice of Agreements Filed

    Science.gov (United States)

    2011-10-19

    ...: Hamburg-Sud (``HSDG''); Alianca Navegacao e Logistica Ltda. e CIA (``Alianca''); Compania Sud Americana de...-010. Title: Maritime Credit Agreement. Parties: Alianca Navegacao e Logistica Ltda. & Cia.;...

  2. AN IMPROVED AUTHENTICATED KEY AGREEMENT PROTOCOL

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    In 1999, Seo and Sweeney proposed a simple authenticated key agreement protocol that was designed to act as a Diffie-Hellman key agreement protocol with user authentication.Various attacks on this protocol are described and enhanced in the literature. Recently, Ku and Wang proposed an improved authenticated key agreement protocol, where they asserted the protocol could withstand the existing attacks. This paper shows that Ku and Wang's protocol is still vulnerable to the modification attack and presents an improved authenticated key agreement protocol to enhance the security of Ku and Wang's protocol. The protocol has more efficient performance by replacing exponentiation operations with message authentication code operations.

  3. Long-term functional outcome of bilateral spontaneous and simultaneous Achilles tendon ruptures.

    LENUS (Irish Health Repository)

    Ellanti, Prasad

    2012-10-01

    Bilateral simultaneous ruptures are rare comprising less than 1% of all Achilles tendon ruptures. Risk factors for bilateral ruptures include chronic diseases and medications such as corticosteroids and fluoroquinolones. There is little in the literature on the long-term functional outcome of bilateral Achilles tendon ruptures. This article present a series of 3 cases of simultaneous and spontaneous bilateral Achilles tendon ruptures with a minimum of 5-year follow up suggesting a good functional outcome.

  4. Bilateral occipital lobe infarction with altitudinal field loss following radiofrequency cardiac catheter ablation

    OpenAIRE

    Chen Celia S; Lee Andrew W; Luu Susie T

    2010-01-01

    Abstract Background Bilateral stroke following radiofrequency catheter ablation is an unusual complication and may result in bilateral altitudinal visual field defects. Bilateral altitudinal visual field defects usually result from prechiasmal pathology causing damage to both retinas or optic nerves and rarely from bilateral symmetric damage to the post chiasmal visual pathways. Case presentation A 48-year-old man complained of visual disturbance on wakening following radiofrequency catheter ...

  5. Locked bilateral posterior fracture-dislocation of the shoulder in an epileptic patient: case report

    OpenAIRE

    CAUTERO, ENRICO; GERVASI, ENRICO

    2014-01-01

    Bilateral posterior dislocation of the shoulder, often secondary to seizures, is uncommon, while bilateral posterior fracture-dislocations is rarer still: 0.6 cases among a population of 100,000 people per year. The scientific literature contains very few published reports of cases of bilateral posterior fracture-dislocation of the shoulder, a condition that tends to be sustained by epileptic patients during seizures. The authors presented a case of bilateral posterior fracture-dislocation of...

  6. Bilateral Anterior Shoulder Dislocation with Symmetrical Greater Tuberosity Fracture following Seizure

    OpenAIRE

    Suryavanshi, Ashish; Mittal, Amber; Dongre, Snehal; Kashyap, Neeti

    2012-01-01

    Introduction: Majority of bilateral shoulder dislocations are posterior. Simultaneous bilateral anterior shoulder dislocations and bilateral anterior fracture-dislocations are rare and mostly of traumatic origin. We present a rare case of bilateral anterior shoulder dislocation with symmetrical greater tuberosity fracture following an episode of seizure with an unusual injury mechanism which was treated conservatively. Case Report: A 45 year old office worker presented to the Casualty of our ...

  7. Concurrent cases of bilateral anterior shoulder dislocation: our observations in three cases

    OpenAIRE

    Orhan Akinci; Yavuz Akalin; Ali Otuzbir; Alpaslan Oztürk

    2016-01-01

    Bilateral anterior shoulder dislocations are  rarely seen and usually occur due to the same mechanism arising from traumatic injuries. In here, we discussed three cases of traumatic bilateral anterior shoulder dislocation , one had an additional patella fracture, and the other one had bilateral tuberculum majus fracture. All of the patients were female and our first case that presented here was 65-year-old and given a closed reduction for isolated bilateral anterior shoulder dislocation that ...

  8. Salvage Gamma Knife Radiosurgery after failed management of bilateral trigeminal neuralgia

    OpenAIRE

    Raval, Ami B.; Jennifer Salluzzo; Tomas Dvorak; Lori Lyn Price; Mignano, John E.; Wu, Julian K.

    2014-01-01

    Background: The incidence of bilateral trigeminal neuralgia (TN) is 1-6% of total number of TN cases. Gamma Knife Radiosurgery (GKRS) is effective in treating unilateral TN; however, outcomes of bilateral TN treated by GKRS have not been well evaluated. The purpose of this study is to evaluate the long-term GKRS outcomes of bilateral TN at our institution and compare with our published treatment outcomes of unilateral TN. Methods: Between 2000 and 2006, eight patients with bilateral TN we...

  9. Horizontal localization with bilateral hearing aids: without is better than with

    OpenAIRE

    Van den Bogaert, Tim; Klasen, Thomas; Moonen, Marc; Van Deun, Lieselot; Wouters, Jan

    2006-01-01

    This paper studies the effect of bilateral hearing aids on directional hearing in the frontal horizontal plane. Localization tests evaluated bilateral hearing aid users using different stimuli and different noise scenarios. Normal hearing subjects were used as a reference. The main research questions raised in this paper are: (i) How do bilateral hearing aid users perform on a localization task, relative to normal hearing subjects? (ii) Do bilateral hearing aids preserve localization cues, an...

  10. Multiple and bilateral benign cystic teratomas of ovary with broad ligament leiomyoma: a case report

    OpenAIRE

    Choukimath S.M; Ramalingappa C.A

    2012-01-01

    Background: Benign cystic teratoma is the most common tumor of ovary. Though bilateralism is seen in 10-15% of the cases, bilateral and multiple benign cystic teratomas are rare and very few cases have been reported in the literature. Aim: We present a case of bilateral and multiple benign cystic teratomas with a broad ligament leiomyoma. Case findings: A 38 –year- old female presented with lower abdominal pain of 5 months duration. Ultrasonography of abdomen showed bilateral multiple adnexal...

  11. The Origin, Evolution and Development of Bilateral Symmetry in Multicellular Organisms

    OpenAIRE

    Werner, Eric

    2012-01-01

    A computational theory and model of the ontogeny and development of bilateral symmetry in multicellular organisms is presented. Understanding the origin and evolution of bilateral organisms requires an understanding of how bilateral symmetry develops, starting from a single cell. Bilateral symmetric growth of a multicellular organism from a single starter cell is explained as resulting from the opposite handedness and orientation along one axis in two daughter founder cells that are in equiva...

  12. CT findings of bilateral congenital absence of the long process of the incus

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, A. [Kasaoka Daiichi Hospital, Department of Neurosurgery, Okayama (Japan); Okayama (Japan); Miyashima, H. [Kasaoka Daiichi Hospital, Department of Pediatrics, Okayama (Japan); Kobashi, T. (Kasaoka Daiichi Hospital, Department of Radiology, Okayama, japan); Take, K. [Take Otolaryngolgy Hospital, Department of Otolaryngology, Okayama (Japan)

    2004-10-01

    Bilateral conductive deafness due to congenital absence of the long process of the incus (CALPI) is rare. The authors present the case of a patient with bilateral CALPI. To the best of our knowledge, this is the first reported case preoperatively diagnosed as bilateral CALPI by computed tomography. Multislice computed tomography is very useful for the diagnosis of minute abnormalities of the ossicles. (orig.)

  13. Double Trouble: A Rare Case of Bilateral Upper Pole Ureteropelvic Junction Obstruction

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    Craig A. Peters

    2014-09-01

    Full Text Available A 16-year-old girl presented with bilateral back pain caused by bilateral upper pole ureteropelvic junction obstructions; an extremely rare phenomenon. Bilateral robotically assisted upper pole pyeloplasties were preformed at the same setting with an excellent clinical response. Although rare, upper pole ureteropelvic junction obstruction is a defined entity that urologists should be aware of.

  14. Fears and Strategies: The EU, China and their Free Trade Agreements in East Asia

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    Maria Garcia

    2010-11-01

    Full Text Available The stalemate at the WTO Doha Round sparked a new wave of bilateral preferential and free trade agreements (FTAs. Nowhere has this been more evident than in the Asia Pacific region. Whilst there are economic reasons for FTAs, these are less efficient and more complex than multilateral agreements and most have had fairly small economic impacts. This paper compares the strategies of a newcomer to the FTA arena, China, and the actor with the most cumulative FTAs, the EU. It ponders on the different reasons informing their strategies and on how these may be affecting each other. It also considers the role of competitive fears and competitive diffusion in the formulation of their policies.

  15. An unusual triad: Bilateral dilated odontoma, hypodontia and peg laterals.

    Science.gov (United States)

    Sebastian, Alphy Alphonsa; Ahsan, Auswaf; George, Ahkin John; Aby, John

    2013-09-01

    The dilated odontoma is an infrequent developmental alteration that appears in any area of the dental arches and can affect deciduous, permanent and supernumerary tooth. Dens invaginatus is a developmental anomaly resulting from invagination of a portion of crown forming within the enamel organ during odontogenesis. The most extreme form of dens invaginatus is known as dilated odontoma. The aim of this case report is to present a rare case of bilateral dilated odontoma affecting a microdontic permanent lateral incisor in a 30 year old female patient with hypodontia and peglateral teeth with its clinical, radiological and histological features, which has yet been not reported. Bilateral presence of dilated odontoma is not a common occurrence, although a single tooth involvement in each case has been reported in the literature. PMID:24348628

  16. Convulsive Movements in Bilateral Paramedian Thalamic and Midbrain Infarction

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    Kazuo Yamashiro

    2011-11-01

    Full Text Available Although some previous reports have described convulsive movements in bilateral paramedian thalamic and midbrain infarction, little is known about their nature. A 71-year-old man presented with impaired consciousness and clonic movements of both arms. Each series of movements lasted 10 to 20 s and occurred at 2- to 3-min intervals, which disappeared after intravenous administration of diazepam and phenytoin. Magnetic resonance imaging showed acute bilateral paramedian thalamic and midbrain infarction. A review of the literature revealed that convulsive movements were observed mostly at the onset of infarction. Clonic movements appeared frequently in the limbs, particularly in both arms. Clinical observations and results of animal experiments suggest that these seizures might originate from the mesencephalic reticular formation. Physicians should recognize this condition, because not only seizure control but also early management of ischemic stroke is required.

  17. Anesthetic management of a child undergoing bilateral laparoscopic adrenalectomy

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    Mediha Turktan

    2016-03-01

    Full Text Available Pheochromocytoma is a rare catecholamine secreting neuroendocrine tumor in children. It is usually localized unilaterally in adults but often bilaterally in children. The symptoms are variable related to the level of secreted catecholamine. The most common symptoms are hypertension, tachycardia and headache. Beta blockers, alcohol consumption, injection of contrast substance and surgical procedures may lead to attacks. The most effective treatment is surgical resection. In recent years, laparoscopic surgery has been more preferred. Anesthetic management is very important in this cases. Especially, sudden hemodynamic changes may be observed during laparoscopic adrenalectomy. In our case, the control of hemodynamic changes with esmolol and norepinephrine infusion were discussed during bilaterally laparoscopic adrenalectomy in a 14-year old child with pheochromocytoma. [Cukurova Med J 2016; 41(1.000: 171-174

  18. A Case of Spontaneously Resolved Bilateral Primary Spontaneous Pneumothorax

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    Hasan Kahraman

    2014-03-01

    Full Text Available A condition of intrapleural air-space accumulation in individuals without any history of trauma or lung disease is called as primary spontaneous pneumothorax (PSP. Sixteen-years-old male patient admitted with complains of chest pain and dyspnea beginning 3 day ago. On physical examination, severity of breath sounds decreased on right side. Chest radiograph was taken and right-sided pneumothorax was detected and tube thoracostomy was inserted. Two months ago the patient referred to a doctor with similar complaints and physical examination and chest radiograph were reported as normal. The radiograph was retrospectively examined and bilateral PSP was detected. We presented the case duo to spontaneous recovery of bilateral PSP is seen very rarely and so contributes data to the literature. In patients admitted to the clinic with chest pain and shortness of breath, pneumothorax should be considered at differential diagnosis.

  19. A Case with Bilateral Periventricular Nodular Heterotopia Diagnosed as Depression

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    Melek Kandemir

    2010-06-01

    Full Text Available Periventricular nodular heterotopia is a form of neuronal migration abnormality. Periventricular nodular heterotopia can easily be recognized by cranial magnetic resonance imaging. The most common clinical appearance is epileptic seizures. In some cases, symptoms are accompanied with psychiatric complaints. In this article, we report a 33-year-old female with complaints of left-sided paresthesia induced by emotional stress. She had been followed at an outpatient psychiatry clinic for about 10 years with the diagnosis of somatization disorder. Her electroencephalography recordings -awake as well as during sleep- were found to be normal. The cranial magnetic resonance imaging showed bilateral periventricular nodular heterotopia. Her seizures were controlled with carbamazepine treatment. Partial epileptic seizures might also be observed, even though the cerebral heterotopic lesions are bilateral. When a history is obtained from a patient with somatoform complaints, it should be kept in mind that these symptoms might be seizures, and the patient should be questioned accordingly.

  20. Bilateral orbital bone infarction in sickle-cell disease.

    Science.gov (United States)

    Ghafouri, Roya H; Lee, Irene; Freitag, Suzanne K; Pira, Tony N

    2011-01-01

    This is a case of a 2-year-old boy with sickle cell disease who presented with bilateral eyelid swelling, limited extraocular motility, and lateral subperiosteal fluid collection associated with bilateral lateral orbital wall infarctions on MRI. The patient was managed medically with intravenous fluids, analgesics, broad-spectrum antibiotics, systemic steroids, and clinically improved. Patients with sickle cell disease are susceptible to infarction of the orbital bones during vaso-occlusive crises. Orbital wall infarction can lead to acute proptosis and restricted extraocular motility. Orbital wall infarction should be considered in sickle cell patients with orbital diseases so that appropriate treatment can be instituted promptly to prevent the serious sequelae of orbital compression syndrome. PMID:20577135