WorldWideScience

Sample records for bilateral giant internal

  1. Case Report: Carotid–cavernous fistula due to aneurysmal rupture in a case of aortoaortitis with bilateral giant internal carotid artery aneurysms

    International Nuclear Information System (INIS)

    Takayasu aortoarteritis (TA) rarely affects the nervous system, but when it does, it usually manifests as cerebral ischemia or stroke. These strokes have mainly been attributed to stenotic extracranial vessels. Stenoses of intracranial vessels, although rare in TA, can occur due to either embolization into the vessel or because of the vasculitic process itself. Intracranial aneurysms are very rare in patients with TA. Bilateral cavernous internal carotid artery (ICA) aneurysms are rarer. They have been reported following radiation therapy and in association with fibromuscular dysplasia and juvenile Paget disease. Bilateral mycotic intracavernous aneurysms also occur. Bilateral giant cavernous ICA aneurysms with carotid-cavernous fistula (CCF) consequent to rupture into the cavernous sinus in a case of TA are extremely unusual. We report a case that fulfilled both American College of Rheumatology and European League against Rheumatology criteria for TA. The patient had bilateral cavernous sinus giant aneurysms and CCF because the right-sided aneurysm had ruptured and was leaking into the cavernous sinus

  2. Bilateral internal laryngoceles mimicking asthma.

    Science.gov (United States)

    Aksoy, Elif A; Elsürer, Cağdaş; Serin, Gediz M; Unal, O Faruk

    2013-05-01

    Laryngocele is an air-filled, abnormal dilation of the laryngeal saccule that extends upward within the false vocal fold, in communication with the laryngeal lumen. A case of 43-year-old male with bilateral internal laryngoceles, who has been treated as asthma for 4 years, is presented. The patient had dyspnea, cough, and excessive phlegm for a month and a late onset stridor. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Although the incidence of internal laryngocele is rare, it should be remembered in the differential diagnosis of upper airway problems and diagnostic flexible nasopharnygolaryngoscopy is routinely indicated for airway evaluation in at-risk patients. PMID:24174956

  3. Bilateral internal laryngoceles mimicking asthma

    Directory of Open Access Journals (Sweden)

    Elif A Aksoy

    2013-01-01

    Full Text Available Laryngocele is an air-filled, abnormal dilation of the laryngeal saccule that extends upward within the false vocal fold, in communication with the laryngeal lumen. A case of 43-year-old male with bilateral internal laryngoceles, who has been treated as asthma for 4 years, is presented. The patient had dyspnea, cough, and excessive phlegm for a month and a late onset stridor. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Although the incidence of internal laryngocele is rare, it should be remembered in the differential diagnosis of upper airway problems and diagnostic flexible nasopharnygolaryngoscopy is routinely indicated for airway evaluation in at-risk patients.

  4. Bilateral giant femoropopliteal artery aneurysms: a case report

    Directory of Open Access Journals (Sweden)

    Perdikides Theodossios P

    2008-04-01

    Full Text Available Abstract Introduction Popliteal artery aneurysms are the most common peripheral arterial aneurysms, and are frequently bilateral. Acute limb ischemia, rupture and compression phenomena can complicate these aneurysms when the diameter exceeds 2 cm. Case Presentation We report an 82-year-old male patient with two giant femoropopliteal aneurysms, 10.5 and 8.5 cm diameters, managed in our institution. Both aneurysms were resected and a polytetrafluoroethylene (PTFE femoropopliteal interposition graft was placed successfully. Management and literature review are discussed. Conclusion We believe this is the first report in the medical literature of bilateral giant femoropopliteal aneurysms.

  5. Bilateral vertebral artery balloon occlusion for giant vertebrobasilar aneurysms

    International Nuclear Information System (INIS)

    We describe the clinical presentation, radiological and clinical results in six consecutive patients with a giant vertebrobasilar aneurysm treated by bilateral vertebral artery balloon occlusion. Five patients presented with headache and signs of brain-stem compression and one with subarachnoid haemorrhage. In all patients vertebral artery balloon occlusion was performed. In four, this followed successful test occlusion. In one patient, who did not tolerate the test occlusion, a bypass from the external carotid to the posterior cerebral artery preceded definitive vertebral artery occlusion. One patient underwent bypass surgery prior to test occlusion. At 6-22 months follow-up three patients had a good functional outcome and showed unchanged size or shrinkage of the aneurysm on MRI. Three other patients died; one from recurrent haemorrhage, and two probably from delayed brain-stem ischaemia. The presence of two large posterior communicating arteries predicted good functional outcome, which was also related to the clinical condition at presentation, and the degree of brain-stem compression and oedema on MRI. Bilateral vertebral artery balloon occlusion can be considered in patients with otherwise untreatable giant vertebrobasilar aneurysms. If test occlusion is not tolerated, a surgical bypass to the posterior circulation can be considered. (orig.)

  6. Giant congenital melanocytic nevus with developmental dysplasia of bilateral hip: A rare association

    OpenAIRE

    Sutsungkokla Imchen; Sangita Ghosh; Surabhi Dayal; Nisha Marwah; Nidhi Jindal; Shikha Sangal

    2013-01-01

    Giant congenital melanocytic nevi are rare congenital disfiguring benign neoplasms with a risk of transformation to malignant melanoma. They often present with various extra-cutaneous features. Here, we describe a case of giant melanocytic nevus with developmental dysplasia of bilateral hip, a novel association.

  7. Giant congenital melanocytic nevus with developmental dysplasia of bilateral hip: A rare association

    Directory of Open Access Journals (Sweden)

    Sutsungkokla Imchen

    2013-01-01

    Full Text Available Giant congenital melanocytic nevi are rare congenital disfiguring benign neoplasms with a risk of transformation to malignant melanoma. They often present with various extra-cutaneous features. Here, we describe a case of giant melanocytic nevus with developmental dysplasia of bilateral hip, a novel association.

  8. Giant Planet Formation, Evolution, and Internal Structure

    CERN Document Server

    Helled, Ravit; Podolak, Morris; Boley, Aaron; Meru, Farzana; Nayakshin, Sergei; Fortney, Jonathan J; Mayer, Lucio; Alibert, Yann; Boss, Alan P

    2013-01-01

    The large number of detected giant exoplanets offers the opportunity to improve our understanding of the formation mechanism, evolution, and interior structure of gas giant planets. The two main models for giant planet formation are core accretion and disk instability. There are substantial differences between these formation models, including formation timescale, favorable formation location, ideal disk properties for planetary formation, early evolution, planetary composition, etc. First, we summarize the two models including their substantial differences, advantages, and disadvantages, and suggest how theoretical models should be connected to available (and future) data. We next summarize current knowledge of the internal structures of solar- and extrasolar- giant planets. Finally, we suggest the next steps to be taken in giant planet exploration.

  9. Fine needle aspiration diagnosis of bilateral dysgerminoma with syncytiotrophoblastic giant cells

    Directory of Open Access Journals (Sweden)

    Chakrabarti Indranil

    2009-01-01

    Full Text Available Dysgerminoma accounts for only 1-3% of ovarian cancers and about 30-40% of all ovarian germ cell malignant tumors. Literature states that about 2% of nonpregnant patients with dysgerminomas present with elevated serum or urine levels of human chorionic gonadotropin (hCG. Here, we report a 34 year-old multiparous woman presenting with an abdominal lump, ascites, and abdominal pain with elevated urinary and serum hCG levels. An abdominal ultrasound showed bilateral ovarian mass. An ultrasound-guided, transabdominal fine needle aspiration revealed dysgerminoma with syncytiotrophoblastic giant cells. Bilateral oophorectomy was done and the diagnosis was confirmed on histopathology.

  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. 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.

  12. Do Giant Oilfield Discoveries Fuel Internal Armed Conflicts?

    OpenAIRE

    Lei, Yu-Hsiang; Michaels, Guy

    2012-01-01

    We use new data to examine the effects of giant oilfield discoveries around the world since 1946. On average, these discoveries increase per capita oil production and oil exports by up to 50 percent. But these giant oilfield discoveries also have a dark side: they increase the incidence of internal armed conflict by about 5-8 percentage points. This increased incidence of conflict due to giant oilfield discoveries is especially high for countries that had already experienced armed conflict...

  13. Internal rotation of red giants by asteroseismology

    Directory of Open Access Journals (Sweden)

    Christensen-Dalsgaard J.

    2013-03-01

    Full Text Available We present an asteroseismic approach to study the dynamics of the stellar interior in red giant stars by asteroseismic inversion of the splittings induced by the stellar rotation on the oscillation frequencies. We show preliminary results obtained for the red giant KIC4448777 observed by the space mission Kepler.

  14. Coronary bypass using bilateral internal mammary arteries in an achondroplast.

    Science.gov (United States)

    Alassal, Mohamed Abdulwahab; Youssef, Mostafa; Koudieh, Mohammed

    2015-01-01

    Coronary bypass grafting for ischemic heart disease in achondroplastic dwarfs is very rare. Shortage of veins and inadequate vein quality may cause difficulties during surgery. Only 2 cases of coronary bypass surgery in an achondroplastic dwarf, in which the left internal mammary artery and vein grafts were used, have been reported. We describe the case of a 55-year-old male achondroplastic dwarf who had triple-vessel coronary disease and underwent successful coronary bypass surgery using one saphenous vein graft and bilateral internal mammary artery grafts. The anatomic and surgical challenges in achondroplasia are highlighted. PMID:24887865

  15. Bilateral Internal Thoracic Artery Configuration for Coronary Artery Bypass Surgery

    Science.gov (United States)

    Boodhwani, Munir; Hanet, Claude; de Kerchove, Laurent; Navarra, Emiliano; Astarci, Parla; Noirhomme, Philippe; El Khoury, Gebrine

    2016-01-01

    Background— Bilateral internal thoracic arteries (BITA) have demonstrated superior patency and improved survival in patients undergoing coronary artery bypass grafting. However, the optimal configuration for BITA utilization and its effect on long-term outcome remains uncertain. Methods and Results— We randomly assigned 304 patients undergoing coronary artery bypass grafting using BITA to either in situ or Y grafting configurations. The primary end point was 3-year angiographic patency. Secondary end points included major adverse cardiac and cerebrovascular events (ie, death from any cause, stroke, myocardial infarction, or repeat revascularization) at 7 years. More coronary targets were able to be revascularized using internal thoracic arteries in patients randomized to Y grafting versus in situ group (3.2±0.8 versus 2.4±0.5 arteries/patient; PURL: http://www.clinicaltrials.gov. Unique identifier: NCT01666366. PMID:27406988

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

    DEFF Research Database (Denmark)

    Lampe, Markus

    2009-01-01

    This study contributes to a revised picture of nineteenth-century bilateralism. Employing a new disaggregated data set, it argues that bilateral treaties did not implement general free trade, but instead reduced tariffs unevenly through commodity-specific preferences, especially favoring manufact......This study contributes to a revised picture of nineteenth-century bilateralism. Employing a new disaggregated data set, it argues that bilateral treaties did not implement general free trade, but instead reduced tariffs unevenly through commodity-specific preferences, especially favoring...... 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....

  17. Building a better bypass with emphasis on bilateral internal mammary grafting

    NARCIS (Netherlands)

    T.M. Kieser (Teresa)

    2015-01-01

    markdownabstractAbstract The goals for this thesis are 1) to encourage the use of bilateral internal mammary artery (BIMA) grafting more frequently so that many more patients receive the ‘BIMA benefit’ and 2) to ensure that an increase in bilateral IMA grafting is achieved with accuracy and no grea

  18. Case report 504: Unusual bilateral calcified giant cysts (geodes) in rheumatoid arthritis

    International Nuclear Information System (INIS)

    An unusual case of calcified, giant geodes in a patient with longstanding rheumatoid arthritis affecting the knee joints is presented. The cause of the calcification remains unknown. Radiological and pathological findings have been described. (orig./GDG)

  19. Using temporal artery biopsy to diagnose giant cell arteritis in a patient with bilateral arm ischemia

    Directory of Open Access Journals (Sweden)

    Julia Glaser

    2015-01-01

    Conclusion: Giant cell arteritis can present in atypical forms, and should remain on the differential when atypical-appearing lesions are found, even in the absence of features usually associated with GCA.

  20. Giant aneurysms of the internal carotid artery: endovascular treatment and long-term follow-up

    International Nuclear Information System (INIS)

    We report the long-term follow-up of 18 patients with giant aneurysms of the internal carotid artery (ICA) referred for endovascular occlusion of the parent vessel. There were 10 aneurysms involving the infra- and/or supraclinoid cavernous segment, six the ophthalmic segment, one the petrous segment and one the bifurcation. One patient who did not tolerate test occlusion was treated medically. Clinical and imaging follow-up were obtained in 16 patients for a mean of 30 months, range 6-80 months. Endovascular treatment led to excellent clinical outcome in 16 patients. One 34-year-old woman, who presented with subarachnoid haemorrhage (SAH), died from bilateral middle cerebral artery infarcts due to severe vasospasm 4 days after treatment. The patient treated medically died from SAH. Long-term imaging follow-up in 16 patients revealed a markedly smaller aneurysm sac in all cases. (orig.)

  1. Bilateral traumatic proximal humerus fractures managed by open reduction and internal fixation with locked plates

    Institute of Scientific and Technical Information of China (English)

    Atin Jaiswal; Naiman Deepak Kachchhap; Rupak Chaterjee; Yashwant Singh Tanwar; Masood Habib; Satya Prakash Singh

    2013-01-01

    Fractures of the proximal humerus are uncommon in young patients.Although bilateral fracture of proximal humerus itself is rare,association with epilepsy and electrocution is frequent.Only one case of traumatic bilateral proximal humerus fracture has been reported in the literature.We report a rare case of bilateral traumatic displaced proximal humerus fractures in a 40 years old male patient,which was treated by means of open reduction and internal fixation with proximal humerus locked pates on both sides and obtained a good functional outcome.

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

    DEFF Research Database (Denmark)

    Tang, Yi Shin

    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...

  3. Unilateral and bilateral internal carotid artery stenosis or occlusion: a study of the secondary collateral circulation

    International Nuclear Information System (INIS)

    Objective: It's a study of the collateral circulation secondary to unilateral and bilateral internal carotid artery (ICA) severe stenosis or occlusion using digital subtract angiography (DSA) and magnetic resonance angiography (MRA). Methods: Ninty-five patients with ICA stenosis or occlusion were diagnosed by DSA or MRA. Forty-four patients were assessed by DSA, and fifty-one patients were evaluated by MRA, who were divided into two groups of the unilateral and bilateral involvement. DSA, MRA findings were analyzed, by which the patterns of the collateral circulation were comparatively studied. Results: The presence rate of anterior communicating artery (AcoA) in the unilateral group on DSA and MRA was significantly higher than that in the bilateral group (P0.05). On DSA, the presence rate of ophthalmic artery (OphA) in the unilateral and bilateral groups had no significant difference between the two groups. The augmentation rate of the OphA in the bilateral group was significantly higher than that in the unilateral group (P<0.05). The presence rate of leptomeningeal anastomosis in the bilateral group was significantly higher than that in the unilateral group on DSA and MRA (P<0.01). Conclusion: In patients with the unilateral and bilateral ICA stenosis or occlusion, the collateral circulation formats in different patterns. The major collateral pathways secondary to the unilateral ICA stenosis or occlusion are AcoA and ispilateral PCoA, while to the bilateral ICA stenosis or' occlusion are PCoA, OPhA, and leptomeningeal anastomosis. (authors)

  4. Bilateral Internal Carotid Artery Occlusion Associated with the Antiphospholipid Antibody Syndrome

    Directory of Open Access Journals (Sweden)

    Pria Anand

    2014-03-01

    Full Text Available A 39-year-old woman presented with a right-hemispheric stroke 1 year after she had suffered a left-hemispheric stroke. Her diagnostic workup was notable for bilateral occlusions of the internal carotid arteries at their origins and a positive lupus anticoagulant antibody test. There was no evidence of carotid dissection or another identifiable cause for her carotid occlusions. These findings suggest that the antiphospholipid antibody syndrome may be implicated in the pathological changes that resulted in occlusions of the extracranial internal carotid arteries. Young stroke patients who present with unexplained internal carotid artery occlusions may benefit from testing for the presence of antiphospholipid antibodies.

  5. Internal Disciplinary Procedures – Internet and Social Media. Dilemmas of Bilateral Relations

    OpenAIRE

    Berski, Adrian

    2016-01-01

    Nowadays, Social Media and the Internet are useful and powerful tools within society. It provides great convenience to conduct activities within the job market such as: free web advertising, talent hunting or collecting precious marketing data. However, in some cases, Social Media and the Internet can be a “bone of contention” between the employer and employee relationship. The main purpose of this essay is to demonstrate bilateral relations between internal disciplinary procedures between...

  6. Bilateral osteoma of the internal auditory canal: Case report and literature review

    International Nuclear Information System (INIS)

    Osteomas of the external auditory canal tend to be rather common; those of the internal auditory canal (IAC) are much rarer, though, with less than twenty cases reported in literature up to this very day. Bilateral IAC osteomas, as in this case, are extremely unusual. These benign bone tumors grow very slowly and this implies that the patient is very often asymptomatic. The diagnosis is generally made relatively late and it is, in many cases, absolutely incidental, with Computed Thomography (CT) scans of the temporal bones performed for other reasons. The manuscript describe the case of a patient complaining with progressive bilateral hearing impairment, worsening in the course of many years; we would like to point out the benefits brought by CT in the diagnosis and therapeutic choice, which is, still today, not yet subject to unanimous consensus. - Highlights: • CT imaging is essential technique for diagnosis of osteoma. • CT allows both a better definition of bone structures and MPR specific measurement. • This patient is the fourth case of bilateral internal auditory canal osteomas

  7. Sternal Healing after Coronary Artery Bypass Grafting Using Bilateral Internal Thoracic Arteries: Assessment by Computed Tomography Scan

    OpenAIRE

    Shin, Yoon Cheol; Kim, Sue Hyun; Kim, Dong Jung; Kim, Dong Jin; Kim, Jun Sung; Lim, Cheong; Park, Kay-Hyun

    2015-01-01

    Background This study aimed to investigate sternal healing over time and the incidence of poor sternal healing in patients undergoing coronary artery bypass graft (CABG) surgery using bilateral internal thoracic arteries. Methods This study enrolled 197 patients who underwent isolated CABG using skeletonized bilateral internal thoracic arteries (sBITA) from 2006 through 2009. Postoperative computed tomography (CT) angiography was performed on all patients at monthly intervals for three to six...

  8. Using Onyx in endovascular embolization of internal carotid artery large or giant aneurysms

    International Nuclear Information System (INIS)

    Background and purpose: Internal carotid artery (ICA) large or giant saccular aneurysms is challenging for endovascular coil embolization and surgical clipping with a high recanalization and rebleeding rate. We report our results using Onyx in the endovascular treatment of ICA large or giant saccular aneurysms. Methods: During 2008–2010, 5 patients with 5 large or giant saccular aneurysms in ICA were treated with a liquid embolic agent (Onyx; Micro Therapeutics, Irvine, CA). One aneurysm was small (<10 mm), 2 were large (≥10 mm, <25 mm) and 2 were giant saccular aneurysms (≥25 mm). Of 3 female and 2 male patients, 3 were incidental and 2 had bleeding. Selective embolization was performed with Onyx alone or a combination with coils. Clinical and anatomic outcomes were assessed with the Modified Glasgow Outcome Scale and follow-up angiography was performed at 4–21 months (mean 12.2 months). Results: Complete aneurysm occlusion was obtained in all of the aneurysms on immediate control angiogram. There was not any procedure-related complication. No recanalization was observed at the follow- up periods. There were 2 ICA occlusions in giant ICA aneurysms. The 5 patients were all clinically asymptomatic at follow-up. Conclusion: Endovascular embolization with Onyx is a useful treatment for ICA large or giant aneurysms, which is unsuitable for coiling or surgical treatment.

  9. Giant cervical internal carotid artery pseudoaneurysm in a child: endovascular treatment

    International Nuclear Information System (INIS)

    We report a child with a giant upper cervical internal carotid artery pseudoaneurysm presenting with dysphagia, respiratory distress and a sentinel mild epistaxis, then massive epistaxis. Rupture of the pseudoaneurysm during treatment occurred, as in one reported case. Prompt endovascular treatment yielded a good outcome. (orig.)

  10. Detailed Study of the Internal Structure of a Red-giant Star Observed with Kepler

    DEFF Research Database (Denmark)

    Di Mauro, M. P.; Ventura, R.; Cardini, D.; Catanzaro, G.; Barban, C.; Bedding, T. R.; Christensen-Dalsgaard, J.; De Ridder, J.; Hekker, S.; Huber, D.; Kallinger, T.; Kinemuchi, K.; Kjeldsen, H.; Miglio, A.; Montalbán, J.; Mosser, B.; Mullally, F.; Stello, D.; Still, M.; Uytterhoeven, K.

    2012-01-01

    main parameters of this star with a level of precision without precedents for a red giant. In addition, the excellent quality of the observations enabled us to define the location of the base of the convective envelope and to learn about the internal rotation, the helium abundance, the surface effects...

  11. Radiation-induced bilateral cystic temporal lobe necrosis: Reversal of memory deficit after fenestration and internal shunting. Case report

    International Nuclear Information System (INIS)

    The authors report a case in which bilateral cystic temporal lobe necrosis developed after treatment of nasopharyngeal lymphoepithelioma with 7000 cGy of external beam radiation. The patient presented with an isolated memory deficit that was documented by neuropsychological testing. After fenestration and internal shunting of both cysts, there was striking resolution of the lesions and of the memory deficit

  12. Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Nadgir, R.N.; Ahmed, T. [University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States); Loevner, L.A.; Moonis, G.; Slawek, K.; Imbesi, S. [Neuroradiology Section, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States); Chalela, J. [Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States)

    2003-05-01

    Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation. (orig.)

  13. Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature

    International Nuclear Information System (INIS)

    Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation. (orig.)

  14. The role of bilateral internal iliac arterial embolization in the treatment of hemorrhagic cystitis after bone marrow transplantation

    International Nuclear Information System (INIS)

    Objective: To evaluate the usefulness of bilateral internal iliac arterial embolization in the treatment of hemorrhagic cystitis after bone marrow transplantation. Methods: Among 28 patients with hemorrhagic cystitis, 7 patients experienced bilateral internal iliac artery embolization because of serious hemorrhage that could not be controlled by conservative treatments, including CML (n=3), AML (n=2), ALL(n=1), acute myelomonocytic leukemia (M4, n=1). Embolization of the target vessels was performed by using gelfoam particles for bilateral internal iliac arterial visceral branches. Results: Gross hematuria disappeared in 4 cases after embolization by gelfoam particles. The time of bleeding controlled continued 2-10 d (mean 6 d). No rebleeding was observed in all of the cases during the 12-82 days follow up. Gross hematuria markedly reduced in another 3 cases after embolization. But failure occurred in other two patients. No definite complication related to the procedure ws noted. Conclusion: Bilateral internal iliac arterial embolization is an effective, less invasive, and safe method for serious hemorrhagic cystitis after bone marrow transplantation. (authors)

  15. Barriers to the universal adoption of bilateral internal mammary artery grafting.

    Science.gov (United States)

    Umakanthan, Jeremiah; Jeyakumar, Panch; Umakanthan, Branavan; Jeyakumar, Nikeshan; Senthilkumar, Nadarajah; Saraswathy, Mathioli R; Umakanthan, Padminidevi; Umakanthan, Janani; Sial, Tamoor; Abrina, Sofia; Buendia, Frances M; Pan, Irene; Kamath, Ramadas K; Pathmarajah, Canagaratnam; Sivalingam, Kanagaratnam; Nathan, Shan A; Sunder, Shun K; Mahendra, Tom; Umakanthan, Ramanan

    2015-04-01

    The left internal mammary artery (LIMA) graft is considered the "gold standard" of coronary artery bypass grafting (CABG). This conduit provides increased survival, symptomatic relief, increased freedom from myocardial infarction, and increased freedom from re-intervention when compared to saphenous venous grafting. It has a remarkable long term patency rate with clinical and angiographic outcomes that are unmatched by other conduits. Given the fact that patients often require more than one graft during a coronary revascularization procedure, the prospect of bilateral internal mammary artery (BIMA) grafting has been very appealing to some surgeons. BIMA grafting has been extensively studied via multiple retrospective and prospective cohort studies and findings have indicated that BIMA grafting can have an increased survival benefit when compared to LIMA grafting alone. As a result, this technique has accrued increasing popularity over the course of the last decade. Yet, questions still remain on whether BIMA grafting is the optimal treatment modality for patients in terms of long-term prognosis. There is limited data at the present time from randomized controlled trials and only 4-12% of CABGs performed today utilize BIMA grafting. Concerns regarding perioperative complications, which patient subsets are at higher risks for complications from the technique, and the technical challenges involved in utilizing and teaching the technique have limited its widespread use. PMID:25644543

  16. Giant Serpentine Internal Carotid Artery Aneurysm: Endovascular Parent Artery Occlusion: A Pediatric Case Report

    OpenAIRE

    Prochazka, V.; Chmelova, J.; Cizek, V.; Skoloudik, D.; Hrbac, T.

    2007-01-01

    We report on a case of a 14-year-old boy with a giant serpentine aneurysm of the left internal carotid artery cavernous segment with symptoms of acute mass-effect cranial nerve dysfunction. After a balloon occlusion test of the collateral circulation, the patient underwent parent artery occlusion with platinum Guglielmi detachable coils and fibered coils. An optimal angiographic result and successful clinical outcome were achieved with resolution of IIIrd, IVth and Vlth cranial nerve ischemic...

  17. Nursing assistance for spring coil occlusion for the treatment of intracranial giant internal carotid artery aneurysms

    International Nuclear Information System (INIS)

    Objective: To discuss the importance of balloon occlusion test before interventional treatment of the intracranial giant internal carotid artery aneurysms and to sum up the nursing experience in assisting the procedure. Methods: Proper perioperative nursing measures were carried out for 12 patients, who suffered from intracranial giant internal carotid artery aneurysm and underwent spring coil occlusion treatment. Nursing measures included mental care, observation of the vital signs, prevention of the complications, etc. Results: Neither death nor exacerbation of the condition occurred in all the 12 patients. The patients were discharged from the hospital with a mean hospitalization of nine days. During a follow-up period ranged from 4 months to one year, seven patients had no disagreeable feeling, one patient complained of discomfort but no abnormality was found on follow-up DSA, and disappearance of the aneurysm was observed in 4 patients. Conclusion: The monitoring of the vital signs, the prevention of the complications and the standard nursing care are the key points for ensuring a successful operation in treating intracranial giant internal carotid artery aneurysms with spring coil occlusion. (authors)

  18. Cerebro-retinal ischemia after bilateral occlusion of internal carotid artery

    International Nuclear Information System (INIS)

    Six patients with occlusion of internal carotid arteries (ICAs) were prospectively followed during a mean period of 14 months. Prior to demonstration of occlusions, four patients suffered a mild stroke, and three isolated transient ischemic attacks (TIAs) or amaurosis fugax. All patients remained alive and with an unchanged functional ability. During follow-up, one patient suffered amaurosis fugax and TIAs followed by a mild stroke, three suffered isolated TIAs or amaurosis fugax, two suffered reversible cerebro-retinal ischemia of more than 24 hours, and one remained symptomfree. In three cases, delayed cerebro-retinal ischemia distal to one of the occluded ICAs was systematically triggered by orthostatic, cardiogenic or iatrogenic hypotension, and resolved after adequate medical treatment or restoration of a functional collateral circulation by endarterectomy of a tightly stenosed ipsilateral external carotid artery (ECA), suggesting hemodynamic phenomena. In three cases, micro-emboli originating from a stump or an ulcerated ipsilateral common carotid artery and migrating through well-developed ECA collateral channels explained delayed episodes of ipsilateral TIAs or amaurosis fugax, which disappeared in two cases after adequate anticoagulant therepy was introduced. Bilateral occlusion of ICA may be a relatively benign condition, if the patients are carefully controlled and treated. (orig.)

  19. Giant mycotic aneurysm of the internal carotid artery in a child: endovascular treatment

    International Nuclear Information System (INIS)

    We present a case of a giant mycotic aneurysm of the left internal carotid artery in a child, the result of direct extension of a deep neck space infection. This lesion is life threatening and may put the patient at risk of unwarranted biopsy or drainage if not recognized. Diagnosis and treatment planning rely heavily on cross-sectional imaging, and angiography is frequently necessary. This case is unique for two reasons: (1) we present for the first time the MRI findings and (2) we describe an alternative to surgical ligation -- neurointerventional embolotherapy. Minimally invasive transcatheter embolization was successfully performed on our patient to occlude the abnormal left internal carotid artery segment. (orig.)

  20. Robotically assisted multivessel minimally invasive direct coronary artery bypass grafting with the use of bilateral internal thoracic arteries.

    Science.gov (United States)

    Nishida, Satoru; Yasuda, Tamotsu; Watanabe, Go; Kikuchi, Yujiro; Shintani, Yoshiko; Ito, Shigeki; Tabata, Shigeki; Kawachi, Kenji

    2007-09-01

    This case report presents the robotically assisted multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB) technique using the bilateral internal thoracic arteries. A 54-year-old man with multivessel coronary artery disease was considered eligible for a robotically assisted myocardial revascularization. The bilateral internal thoracic arteries were harvested completely in a totally skeletonized fashion through three 1-2-cm-long incisions on the left thoracic wall. A small left anterior thoracotomy was then performed. The left internal thoracic artery was anastomosed to the left anterior descending coronary artery, and the composite radial artery graft from the right internal thoracic artery was sequentially anastomosed to the first diagonal branch, the obtuse marginal branch, and the distal right coronary artery on the beating heart without cardiopulmonary bypass. The harvesting time of the grafts was 66 min, and the total operative time was 5 h 58 min. Postoperative angiography revealed that all grafts were widely patent. The postoperative course was uneventful, and the patient was discharged 10 days after the operation. Robotically assisted MIDCAB using the bilateral thoracic arteries is a safe and effective means of myocardial revascularization for patients with multivesssel disease. PMID:17721036

  1. Asteroseismology Can Reveal Strong Internal Magnetic Fields in Red Giant Stars

    CERN Document Server

    Fuller, Jim; Stello, Dennis; Garcia, Rafael A; Bildsten, Lars

    2015-01-01

    Internal stellar magnetic fields are inaccessible to direct observations and little is known about their amplitude, geometry and evolution. We demonstrate that strong magnetic fields in the cores of red giant stars can be identified with asteroseismology. The fields can manifest themselves via depressed dipole stellar oscillation modes, which arises from a magnetic greenhouse effect that scatters and traps oscillation mode energy within the core of the star. The Kepler satellite has observed a few dozen red giants with depressed dipole modes which we interpret as stars with strongly magnetized cores. We find field strengths larger than $\\sim\\! 10^5 \\,{\\rm G}$ may produce the observed depression, and in one case we infer a minimum core field strength of $\\approx \\! \\! 10^7 \\,{\\rm G}$.

  2. Bilateral internal thoracic artery grafting in octogenarians: where are the benefits?

    Science.gov (United States)

    Gatti, Giuseppe; Dell'Angela, Luca; Benussi, Bernardo; Dreas, Lorella; Forti, Gabriella; Gabrielli, Marco; Rauber, Elisabetta; Luzzati, Roberto; Sinagra, Gianfranco; Pappalardo, Aniello

    2016-05-01

    The use of bilateral internal thoracic artery (BITA) grafting for myocardial revascularization is usually discouraged in the very elderly because of increased risk of perioperative complications. The aim of the study was to analyze early and late outcomes of BITA grafting in octogenarians. From January 1999 throughout February 2014, 236 consecutive octogenarians with multivessel coronary artery disease underwent primary isolated coronary bypass surgery at the authors' institution. Six of these patients underwent emergency surgery and were excluded from this retrospective study; consequently, 135 BITA patients were compared with 95 single internal thoracic artery (SITA) patients according to early and late outcomes. Between BITA and SITA patients, there was no significant difference in the operative risk (EuroSCORE II: 8 ± 7.7 vs. 7.6 ± 6.1 %, p = 0.65). There was a lower aortic manipulation in BITA patients. Hospital mortality (3 vs. 4.2 %, p = 0.44) and perioperative complications were similar except that only BITA patients experienced sternal wound infection (5.2 %, p = 0.022). The mean follow-up was 4.7 ± 3.3 years. There were no differences between the two groups in overall survival (p = 0.79), freedom from cardiac and cerebrovascular deaths (p = 0.73), major adverse cardiac and cerebrovascular events (p = 0.63) and heart failure hospital readmission (p = 0.64). Predictors of decreased late survival were diabetes (p = 0.0062) and congestive heart failure (p = 0.0004). BITA grafting can be routinely used in octogenarians with atherosclerotic ascending aorta without an increase in hospital mortality or major adverse cardiac and cerebrovascular complications. However, there is an increased risk of sternal wound infection without a demonstrable long-term benefit. PMID:25854622

  3. The value of an intercâmbio: brazilian student mobility, bilateralism & international education

    Directory of Open Access Journals (Sweden)

    Eric Spears

    2014-05-01

    Full Text Available Brazil’s emergence in the global economy as a member of the BRIC (Brazil, Russia, India, China, and South Africa states has prompted the federal government to establish the Brazilian Scientific Mobility Program (Science Without Borders in order to advance the country’s social capital and infrastructure in STEM (Science, Technology, Engineering, and Math related disciplines and industries. Public and private investment in the Scientific Mobility Program has transformed the way in which Brazilian government, universities, and citizenry places value the intercâmbio (student exchange experience in the United States. STEM-related disciplines are now disproportionately funded versus social sciences, humanities, and fine arts fields. This development has altered the way in which student mobility in the United States is given worth and changed the trajectory of international education in Brazil. This research provides a conceptual analysis of the Brazilian Scientific Mobility Program by using a critical political economy perspective. The essay conceptualizes the Science Without Borders initiative at global, national, and local levels. This research also explores what implications the bilateral U.S.-Brazil Educational Partnership may have on future policy, practice, and ultimately, funding of Brazilian student mobility. A emergência do Brasil no âmbito da economia mundializada como participante do BRIC (Brasil, Rússia, Índia, China e África do Sul mobilizou o governo federal brasileiro a estabelecer um programa estatal de mobilidade acadêmica (Programa Ciência sem Fronteiras de modo a fazer avançar o capital social do país (general intellect e a infraestrutura em STEM (Ciência, Tecnologia, Engenharia e Matemática relacionadas à indústria. Investimentos públicos e privados no programa de mobilidade acadêmica transformaram o modo como o governo brasileiro e as universidades valorizam o intercâmbio estudantil com os Estados Unidos. As

  4. Giant, thrombosed, sellar-suprasellar internal carotid artery aneurysm with persistent, primitive trigeminal artery causing hypopituitarism.

    Science.gov (United States)

    Tungaria, Arun; Kumar, Vijendra; Garg, Pallav; Jaiswal, Awadhesh K; Behari, Sanjay

    2011-05-01

    A rare case of a giant, thrombosed, sellar-suprasellar paraclinoid internal carotid artery (ICA) aneurysm with persistent primitive trigeminal artery (PPTA) causing hypopituitarism that manifested as hypogonadism, hypothyroidism, and hypocortisolism is reported. There were no visual/neurological deficits, diabetes insipidus, or episodes of subarachnoid hemorrhage. The alteration in the flow dynamics of the circle of Willis due to the presence of PPTA may have been responsible for both the genesis of the giant aneurysm as well as for the induction of thrombogenesis within its lumen. As the digital subtraction angiogram showed complete thrombosis within the aneurysm and hormonal replacement therapy was effective in ensuring complete normalization of symptoms, the patient was unwilling to undergo surgical clipping of the aneurysm and removal of the suprasellar clot in an attempt to restore pituitary functions. Hypopituitarism recurred when the patient stopped her hormonal supplementation therapy after 7 years, and she again became symptom-free on restarting the therapy. To the best of the authors' knowledge, this represents the first reported case in the literature of hypopituitarism consequent to a giant, thrombosed, sellar-suprasellar ICA aneurysm with an associated PPTA on the side of the aneurysm. PMID:21234615

  5. Bilateral internal carotid artery dissection associated with prior syphilis: a case report and review of the literature.

    Science.gov (United States)

    Marangi, Antonio; Moretto, Giuseppe; Cappellari, Manuel; Micheletti, Nicola; Tomelleri, Giampaolo; Bovi, Paolo

    2016-01-01

    Bilateral internal carotid artery dissection is a rare entity, and its presentation may include cerebral ischemia. We describe the case of a 69-year-old man with ischemic stroke and radiological evidence of intimal flap of both internal carotid arteries suggestive for dissection. During the hospitalization, our patient was found positive for a previous syphilis infection. We conducted a review of the literature, with evidence of a few cases of ischemic stroke presumably related to a prior syphilis. The absence of major cardiovascular risk factors in our patient leads us to believe that an etiopathogenetic link may exist between these two conditions. PMID:27354805

  6. Sequential CT findings on giant aneurysms of the intracranial internal carotid artery after carotid ligation

    International Nuclear Information System (INIS)

    Twenty one patients with giant aneurysms of the intracranial carotid artery were experienced from 1961 to the end of 1980. Three out of 21 were given no treatment and the remaining 18 were treated by indirect surgery. At follow-up, 15 cases were living useful lives; nine of these cases were treated by carotid ligation, five by carotid ligation with STA-MCA anastomosis and one had no surgical treatment. Fourteen out of 15 living cases were examined by CT scan. Sequential CT findings of the giant aneurysm were as follows. The cavity of the giant aneurysm was filled with clots within one week after ligation. Most of the cavity was thrombosed and a small residual cavity was visualized within 2 to 3 weeks after surgery. A thick mural thrombus was organized gradually between 4 and 6 weeks but a narrowed residual aneurysmal cavity still existed. Further organization and calcification of the thrombus and aneurysmal wall progressed for several years. More than 5 years following carotid ligation, a small residual cavity was thrombosed and the aneurysm could not be detected by CT scan. CT findings which prove the effectiveness of indirect surgical treatment were observed in 11 out of 13 patients (84.6%). However, complications after carotid ligation cannot be neglected. Therefore, combined therapy consisting of neck internal carotid ligation and STA-MCA anastomosis is recommended to prevent complications due to carotid ligation. Sequential CT scans are very useful for observation of the fate of the giant aneurysm after carotid ligation and the effectiveness of therapy, and for evolution of the prognosis of patients. (J.P.N.)

  7. Sequential CT findings on giant aneurysms of the intracranial internal carotid artery after carotid ligation

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, S.; Kodama, N.; Suzuki, J. (Tohoku Univ., Sendai (Japan). School of Medicine)

    1982-04-01

    Twenty one patients with giant aneurysms of the intracranial carotid artery were experienced from 1961 to the end of 1980. Three out of 21 were given no treatment and the remaining 18 were treated by indirect surgery. At follow-up, 15 cases were living useful lives; nine of these cases were treated by carotid ligation, five by carotid ligation with STA-MCA anastomosis and one had no surgical treatment. Fourteen out of 15 living cases were examined by CT scan. Sequential CT findings of the giant aneurysm were as follows. The cavity of the giant aneurysm was filled with clots within one week after ligation. Most of the cavity was thrombosed and a small residual cavity was visualized within 2 to 3 weeks after surgery. A thick mural thrombus was organized gradually between 4 and 6 weeks but a narrowed residual aneurysmal cavity still existed. Further organization and calcification of the thrombus and aneurysmal wall progressed for several years. More than 5 years following carotid ligation, a small residual cavity was thrombosed and the aneurysm could not be detected by CT scan. CT findings which prove the effectiveness of indirect surgical treatment were observed in 11 out of 13 patients (84.6%). However, complications after carotid ligation cannot be neglected. Therefore, combined therapy consisting of neck internal carotid ligation and STA-MCA anastomosis is recommended to prevent complications due to carotid ligation. Sequential CT scans are very useful for observation of the fate of the giant aneurysm after carotid ligation and the effectiveness of therapy, and for evolution of the prognosis of patients.

  8. Syncope in Patient with Bilateral Severe Internal Carotid Arteries Stenosis/Near Occlusion: A Case Report and Literature Review

    Science.gov (United States)

    Miran, Muhammad Shah; Suri, M. Fareed K.; Qureshi, Mushtaq H.; Ahmad, Aamir; Suri, Mariam K.; Basreen, Rabia; Qureshi, Adnan I.

    2016-01-01

    Background Syncope is commonly worked up for carotid stenosis, but only rarely attributed to it. Considering paucity of such cases in literature, we report a case and discuss the pathophysiology. Design/methods We report a patient with high-grade bilateral severe internal carotid artery (ICA) stenosis who presented with syncopal episodes in the absence of stroke, orthostatic hypotension, significant cardiovascular disease, or vasovagal etiology. We reviewed all literature pertaining to syncope secondary to carotid stenosis and other cerebrovascular disease. Results A 67-year-old man presented with two brief syncopal episodes. History and physical examination was not suggestive of seizure or vasovagal syncope. Other workup was negative for any stroke or syncope secondary to cardiac or vasovagal etiology. Magnetic resonance angiography (MRA) revealed bilateral ICA severe stenosis. This was confirmed by transfemoral carotid vessels angiography. Internal carotid angioplasty and stenting was performed on one side. After this, the patient remained asymptomatic. After one month, carotid endarterectomy (CEA) of contralateral side was performed. Patient remained symptom free after that. On review of literature, we identified only 12 cases of syncope attributable to carotid stenosis and reviewed 24 cases attributable to other cerebrovascular disease. Conclusion Syncope secondary to carotid stenosis, especially in the absence of any focal ischemic events is rare. It can only be expected in those patients who have bilateral hemodynamically significant carotid disease, which is unlikely in the absence of any focal ischemic events. PMID:27403223

  9. The International Deep Planet Survey II: The frequency of directly imaged giant exoplanets with stellar mass

    CERN Document Server

    Galicher, Raphael; Macintosh, Bruce; Zuckerman, Ben; Barman, Travis; Konopacky, Quinn; Song, Inseok; Patience, Jenny; Lafreniere, David; Doyon, Rene; Nielsen, Eric L

    2016-01-01

    Radial velocity and transit methods are effective for the study of short orbital period exoplanets but they hardly probe objects at large separations for which direct imaging can be used. We carried out the international deep planet survey of 292 young nearby stars to search for giant exoplanets and determine their frequency. We developed a pipeline for a uniform processing of all the data that we have recorded with NIRC2/Keck II, NIRI/Gemini North, NICI/Gemini South, and NACO/VLT for 14 years. The pipeline first applies cosmetic corrections and then reduces the speckle intensity to enhance the contrast in the images. The main result of the international deep planet survey is the discovery of the HR 8799 exoplanets. We also detected 59 visual multiple systems including 16 new binary stars and 2 new triple stellar systems, as well as 2,279 point-like sources. We used Monte Carlo simulations and the Bayesian theorem to determine that 1.05[+2.80-0.70]% of stars harbor at least one giant planet between 0.5 and 14...

  10. Implications of Rapid Core Rotation in Red Giants for Internal Angular Momentum Transport in Stars

    CERN Document Server

    Tayar, Jamie

    2013-01-01

    Core rotation rates have been measured for red giant stars using asteroseismology. This data, along with helioseismic measurements and open cluster spin down studies, provide powerful clues about the nature and timescale for internal angular momentum transport in stars. We focus on two cases: the metal poor red giant KIC 7341231 ("Otto") and intermediate mass core helium burning stars. For both we examine limiting case studies for angular momentum coupling between cores and envelopes under the assumption of rigid rotation on the main sequence. We discuss the expected pattern of core rotation as a function of mass and radius. In the case of Otto, strong post-main-sequence coupling is ruled out and the measured core rotation rate is in the range of 23 to 33 times the surface value expected from standard spin down models. The minimum coupling time scale (.17 to .45 Gyr) is significantly longer than that inferred for young open cluster stars. This implies ineffective internal angular momentum transport in early f...

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2009-12-01

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

  13. Surgical treatment of a giant extracranial internal carotid artery aneurysm: A case report

    Directory of Open Access Journals (Sweden)

    Pasternak Janko

    2007-01-01

    Full Text Available Introduction. True aneurysms of the extracranial internal carotid artery are rare lesions. Surgical treatment is considered to be the best therapeutic option. However, the use of the intraluminal shunt remains controversial. Case report. We reported a case of a giant extracranial internal carotid artery aneurysm treated by reconstructive surgery. A 76-year-old woman was referred with a pulsatile mass inside her mouth, associated with dizziness and dysarthria. There was no history of cerebrovascular symptoms, neck pain, or cervical trauma. A magnetic resonance scan showed a 45 mm aneurysm of the internal carotid artery (ICA, and kinking of ICA. Angiography demonstrated a saccular ICA aneurysm, with a lengthening and tortuosity of the ICA. The aneurysm and the carotid artery branches were easily exposed through a standard anterior cervical incision. After resection of the aneurysm, a Javid shunt was inserted between the common and internal carotid arteries, and end-to-end repair of ICA was easily performed due to ICA redundancy. The aneurysm was of atherosclerotic origin. Four months after the operation, the patient showed a complete recovery from peripheral neurological deficit. Discussion. Our results show that surgical reconstruction is a satisfactory therapeutic choice in the management of extracranial carotid artery aneurysms in order to avoid rupture, thromboembolism and cerebrovascular insufficiency. To date, there has been little experience with endoluminal exclusion techniques and the long-term effectiveness is still uncertain. .

  14. The Latin American Giant Observatory: Contributions to the 34th International Cosmic Ray Conference (ICRC 2015)

    CERN Document Server

    Alvarez, W; Araujo, C; Areso, O; Arnaldi, H; Asorey, H; Audelo, M; Barros, H; Bertou, X; Bonnett, M; Calderon, R; Calderon, M; Campos-Fauth, A; Carramiñana, A; Carrasco, E; Carrera, E; Cazar, D; Cifuentes, E; Cogollo, D; Conde, R; Cotzomi, J; Dasso, S; De Castro, A; De La Torre, J; De León, R; Estupiñan, A; Galindo, A; Garcia, L; Berisso, M Gómez; González, M; Guevara, W; Gulisano, A M; Hernández, H; Jaimes, A; López, J; Mantilla, C; Martín, R; Martínez-Mendez, A; Martínez, O; Martins, E; Masías-Meza, J J; Mayo-García, R; Melo, T; Mendoza, J; Miranda, P; Montes, E; Morales, E; Morales, I; Moreno, E; Murrugarra, C; Nina, C; Núñez, L A; Núñez-Castiñeyra, A; Otiniano, L; Peña-Rodríguez, J; Perenguez, J; Pérez, H; Perez, Y; Perez, G; Pinilla-Velandia, S; Ponce, E; Quishpe, R; Quispe, F; Ramelli, M; Reyes, K; Rivera, H; Rodriguez, J; Rodríguez-Pascual, M; Romero, M; Rubio-Montero, A J; Salazar, H; Salinas, J; Sarmiento-Cano, C; Sidelnik, I; Haro, M Sofo; Suárez-Durán, M; Subieta, M; Tello, J; Ticona, R; Torres, I; Torres-Niño, L; Truyenque, J; Valencia-Otero, M; Vargas, S; Vásquez, N; Villasenor, L; Zamalloa, M; Zavala, L

    2016-01-01

    The Latin American Giant Observatory (LAGO) is an extended cosmic ray observatory composed by a network of water-Cherenkov detectors spanning over different sites located at significantly different altitudes (from sea level up to more than $5000$\\,m a.s.l.) and latitudes across Latin America, covering a huge range of geomagnetic rigidity cut-offs and atmospheric absorption/reaction levels. This detection network is designed to measure the temporal evolution of the radiation flux at ground level with extreme detail. The LAGO project is mainly oriented to perform basic research in three branches: high energy phenomena, space weather and atmospheric radiation at ground level. LAGO is built and operated by the LAGO Collaboration, a non-centralized collaborative union of more than 30 institutions from ten countries. These are the contributions of the LAGO Collaboration to the 34th International Cosmic Ray Conference, 30 July - 6 August 2015, The Hague, The Netherlands

  15. EU - China Bilateral Trade, a Consistent Source of International Exchanges [Comerţul bilateral UE - China, un filon consistent al schimburilor internaţionale

    OpenAIRE

    Pencea Sarmiza

    2013-01-01

    In just about one decade – of which the most recent five years were plagued by the global economic crisis – the EU - China bilateral trade developed swiftly and vigorously, by almost 400%, to become one of the most important commercial flows in global trade, with daily exchanges exceeding 1 billion euro. The paper looks at this development, both in quantitative and structural terms.

  16. [A case of abulia without memory disturbance due to infarction of the bilateral genua of the internal capsules].

    Science.gov (United States)

    Namekawa, M; Fujii, T; Nishizawa, M; Nakano, I

    1999-07-01

    A 68-year-old right handed man with treated hypertension presented with acute-onset somnolence without hemiparesis, dysarthria or sensory disturbance. Although he became laconic and his verbal responses were only in short terms, his replies were accurate and judgmental. A cranial MRI in axial, coronal, and sagittal section revealed small hemorrhagic infarcts essentially limited to the bilateral capsular genua without involvement of the inferior thalamic peduncles. A 123I-IMP single photon emission CT disclosed remarkable hypoperfusion in the bilateral frontal cortex. After a week of somnolence, he gradually became wakeful, but was still abulic. Neuropsychological examinations revealed no memory disturbance. We consider that disconnection of the thalamo-frontal projection at the genua of the internal capsules caused somnolence, apathy, and abulia in our case. The hitherto reported cases of the genu infarcts that showed memory disturbance had the lesion involving both the inferior thalamic peduncle and its nearby mamillothalamic tract. In contrast, our case without memory disturbance had infarcts confined to the genua apparently sparing the two tracts, implicating that memory function may be preserved when such structures are intact. PMID:10548918

  17. Endovascular Treatment of Isolated Bilateral Internal Ili- ac Artery Aneurysms with a Branched Endograft: A Case Report

    Directory of Open Access Journals (Sweden)

    SeyedEbrahim Kassaian

    2015-10-01

    Full Text Available Isolated bilateral internal iliac artery (IIA aneurysm is a rare and potentially lethal disease. Endovascular repair of this disorder is a matter of debate. A symptomatic 68-year-old male presented with severe pelvic pains. Computed tomography revealed a leaking 46-mm aneurysm in the right IIA, a 27-mm aneurysm in the left IIA, and ectatic changes at a diameter of 31 mm in the right common iliac artery (CIA. Due to lower rates of morbidity and mortality, an endovascular approach was chosen instead of open surgical repair. However, due to anatomical constraints, an endograft had to be implanted in a healthy aorta in order to support an iliac branch endograft in the left CIA. Subsequently, following coil embolization of the left IIA, an iliac stent graft was extended to the right external iliac artery (EIA. Two-year follow-up CT imaging showed complete exclusion of all the aneurysms and patency of the pelvic visceral arteries. The patient is currently asymptomatic.Endovascular repair of bilateral isolated IIAs can be a feasible treatment option. However, due to limited availability of sizes in iliac branch devices currently on the market, a main body device is sometimes required to be deployed in a healthy aorta for additional endograft support.

  18. Embryo impacts and gas giant mergers II: Diversity of Hot Jupiters' internal structure

    CERN Document Server

    Liu, Shang-Fei; Lin, D N C; Li, Shu-Lin

    2014-01-01

    We consider the origin of compact, short-period, Jupiter-mass planets. We propose that their diverse structure is caused by giant impacts of embryos and super-Earths or mergers with other gas giants during the formation and evolution of these hot Jupiters. Through a series of numerical simulations, we show that typical head-on collisions generally lead to total coalescence of impinging gas giants. Although extremely energetic collisions can disintegrate the envelope of gas giants, these events seldom occur. During oblique and moderately energetic collisions, the merger products retain higher fraction of the colliders' cores than their envelopes. They can also deposit considerable amount of spin angular momentum to the gas giants and desynchronize their spins from their orbital mean motion. We find that the oblateness of gas giants can be used to infer the impact history. Subsequent dissipation of stellar tide inside the planets' envelope can lead to runaway inflation and potentially a substantial loss of gas ...

  19. Off-pump sequential bilateral internal mammary artery grafting combined with selective arterialization of the coronary venous system

    Institute of Scientific and Technical Information of China (English)

    YU Yang; YAN Xiao-lei; WEI Hua; YANG Jun-feng; GU Cheng-xiong

    2011-01-01

    Background Off-pump coronary artery bypass surgery (OPCAB) has been widely applied in recent years as a less invasive method of myocardial revascularization. This study evaluated the sequential bilateral internal mammary artery grafting combined with selective arterialization of the coronary venous system during OPCAB.Methods From April 2004 to August 2010, patients with diffuse right coronary lesions were studied retrospectively and divided into two groups. Group 1 included seventeen patients who underwent this surgery while group 2 included twenty-one patients without right coronary artery surgical therapy. All patients presented with symptoms of angina. Blood flow of bridged vessels was measured. The perioperative ventricular parameters including left ventricular ejection fraction and end diastolic diameter were compared. During follow-up, myocardial nuclide imaging and coronary angiography were carried out.Results Off-pump coronary artery bypass was performed with an average of 3.6 grafts per patient. Hospital mortality was zero. At the time of follow-up, the patients in group 1 recovered better than in group 2 (P<0.05). In both groups, the mean New York Heart Association (NYHA) class and ejection fraction increased significantly (P<0.001) and the mean left ventricular end-diastolic diameter decreased significantly (P <0.05). Myocardial blood supply of inferior wall in group 1 was obviously improved by myocardial nuclide imaging. Coronary angiography for eight patients in group 1 verified that there was blood flow to myocardium in the arterialized vein.Conclusions Sequential bilateral internal mammary artery grafting combined with selective arterialization of the coronary venous system can be performed during OPCAB. A postoperative improvement in the cardiac functions and the quality of life was documented, increasing our expectation for extensive application.

  20. Protocol for the Arterial Revascularisation Trial (ART. A randomised trial to compare survival following bilateral versus single internal mammary grafting in coronary revascularisation [ISRCTN46552265

    Directory of Open Access Journals (Sweden)

    Flather Marcus

    2006-03-01

    Full Text Available Abstract Background Standard coronary artery bypass graft surgery uses a single internal mammary artery and supplemental vein or radial artery grafts. Several observational studies have suggested a survival benefit with two internal mammary artery grafts compared to a single internal mammary artery graft, but this has not been tested in a randomised trial. The Arterial Revascularisation Trial is a Medical Research Council and British Heart Foundation funded, multi-centre international trial comparing single internal mammary artery grafting versus bilateral internal mammary artery grafting. Methods/Design Twenty centres in the UK, Australia, Poland and Brazil are planning to randomise 3000 coronary artery bypass graft surgery patients to single or bilateral internal mammary artery grafting. Supplemental grafts may be either saphenous vein or radial artery. Coronary artery bypass grafting can be performed as an on-pump or off-pump procedure. The primary outcome is survival at 10 years and secondary end-points include clinical events, quality of life and cost effectiveness. The effect of age, left ventricular function, diabetes, number of grafts, vein grafts and off-pump surgery are pre-specified subgroups. Discussion The Arterial Revascularisation Trial is one of the first randomised trials to evaluate the effects on survival and other clinical outcomes of single internal mammary artery grafting versus bilateral internal mammary artery grafting, and will help to establish the best approach for patients requiring coronary artery bypass graft surgery.

  1. The bilateral approach to reducing international mobile roaming charges and the application of the GATS

    OpenAIRE

    Ryan, Michael H.

    2012-01-01

    Although it is generally acknowledged that international mobile roaming charges are too high, a successful formula for achieving reduction has so far proven elusive. Direct regulatory intervention to lower prices may be required. The success of such an approach depends upon the ability of countries to implement mutual reductions in the inter-operator tariffs (IOTs) that mobile operators charge each other for originating and terminating roaming calls. In the absence of a multilateral response,...

  2. Asteroseismic Analysis of the Internal Structure and Evolution of Red Giant Branch Bump Stars

    Science.gov (United States)

    Gai, Ning; Tang, Yanke

    2015-05-01

    The “bump” is a prominent feature of the red giant branch (RGB) luminosity function of stellar clusters. Through constructing a grid of models with different masses and metallicities to study the feature of the RGB bump luminosity we find that the luminosity increases almost monotonically with increasing mass for a given metallicity and decreases monotonically with increasing metallicity. Moreover, different stars have different shapes of the RGB bump. It is correlated with the sharpness of the H discontinuity, which is left over by the convection envelope during the first dredge-up. Using the periodicity in the small separations d01, d10 to probe the internal structure, we find that, at about half the acoustic radius, the sound speed has a sharp variation that is caused by a local depression of the first adiabatic exponent {{{Γ }}1} in the second helium ionization zone. It induces an oscillation modulation in d01, d10 with a period of 6.4 μ Hz. Meanwhile, in the same model, the base of the convective envelope is located at a relatively small acoustic radius {{t}envp}/T, which is about 10-1. It is too deep to detect the exact location of the bottom of the outer convective envelope. In order to discriminate the evolutionary status of different stars, we calculate the asymptotic g-mode period spacing {Δ }{{{\\Pi }}1}. We find that {Δ }{{{\\Pi }}1} decreases monotonically with evolution. It is a reliable parameter for distinguishing stars in different positions of the RGB bump.

  3. Seismic constraints on the radial dependence of the internal rotation profiles of six Kepler subgiants and young red giants

    CERN Document Server

    Deheuvels, S; Goupil, M J; Appourchaux, T; Benomar, O; Bruntt, H; Campante, T L; Casagrande, L; Ceillier, T; Davies, G R; De Cat, P; Fu, J N; García, R A; Lobel, A; Mosser, B; Reese, D R; Regulo, C; Schou, J; Stahn, T; Thygesen, A O; Yang, X H; Chaplin, W J; Christensen-Dalsgaard, J; Eggenberger, P; Gizon, L; Mathis, S; Molenda-Żakowicz, J; Pinsonneault, M

    2014-01-01

    Context : We still do not know which mechanisms are responsible for the transport of angular momentum inside stars. The recent detection of mixed modes that contain the signature of rotation in the spectra of Kepler subgiants and red giants gives us the opportunity to make progress on this issue. Aims: Our aim is to probe the radial dependance of the rotation profiles for a sample of Kepler targets. For this purpose, subgiants and early red giants are particularly interesting targets because their rotational splittings are more sensitive to the rotation outside the deeper core than is the case for their more evolved counterparts. Methods: We first extract the rotational splittings and frequencies of the modes for six young Kepler red giants. We then perform a seismic modeling of these stars using the evolutionary codes CESAM2k and ASTEC. By using the observed splittings and the rotational kernels of the optimal models, we perform inversions of the internal rotation profiles of the six stars. Results: We obtai...

  4. Sequential bilateral retinal artery occlusion

    Directory of Open Access Journals (Sweden)

    Padrón-Pérez N

    2014-04-01

    Full Text Available Noel Padrón-Pérez,1 Janny Rosario Aronés,2 Silvia Muñoz,1 Luis Arias-Barquet,1 Jorge Arruga1,31Department of Ophthalmology, Hospital Universitari de Bellvitge, 2Hospital de l'Esperança – Parc de Salut Mar, 3Institut Català de Retina, Barcelona, SpainAbstract: An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic embolic event. Initially, she presented a superior branch retinal artery occlusion in her right eye followed by a central retinal artery occlusion with cilioretinal artery sparing in her left eye. Some conservative maneuvers performed did not improve visual acuity in the left eye. Supra-aortic Doppler ultrasonography revealed mild right internal carotid artery stenosis and moderate left internal carotid artery stenosis with a small, smooth, and homogeneous plaque. The transthoracic echocardiography showed a severe calcification of the mitral valve with a mild-moderate rim of stenosis. Central retinal artery occlusion and branch retinal artery occlusion are characterized by painless monocular loss of vision. Clinical approach and management attempt to treat the acute event, find the source of the vascular occlusion, and prevent further vascular events from occurring. Giant cell arteritis is a potentially treatable cause of central retinal artery occlusion and should be excluded in every single patient over 50 years old.Keywords: loss of vision, branch retinal artery occlusion, central retinal artery occlusion, Hollenhorst plaque

  5. [Bilateral caudate head infarcts].

    Science.gov (United States)

    Kuriyama, N; Yamamoto, Y; Akiguchi, I; Oiwa, K; Nakajima, K

    1997-11-01

    We reported a 67-year-old woman with bilateral caudate head infarcts. She developed sudden mutism followed by abulia. She was admitted to our hospital 2 months after ictus for further examination. She showed prominent abulia and was inactive, slow and apathetic. Spontaneous activity and speech, immediate response to queries, spontaneous word recall and attention and persistence to complex programs were disturbed. Apparent motor disturbance, gait disturbance, motor aphasia, apraxia and remote memory disturbance were not identified. She seemed to be depressed but not sad. Brain CT and MRI revealed bilateral caudate head hemorrhagic infarcts including bilateral anterior internal capsules, in which the left lesion was more extensive than right one and involved the part of the left putamen. These infarct locations were thought to be supplied by the area around the medial striate artery including Heubner's arteries and the A1 perforator. Digital subtraction angiography showed asymptomatic right internal carotid artery occlusion. She bad had hypertension, diabetes mellitus and atrial fibrillation and also had a left atrium with a large diameter. The infarcts were thought to be caused by cardioembolic occlusion to the distal portion of the left internal carotid artery. Although some variations of vasculature at the anterior communicating artery might contribute to bilateral medial striate artery infarcts, we could not demonstrate such abnormalities by angiography. Bilateral caudate head infarcts involving the anterior internal capsule may cause prominent abulia. The patient did not improve by drug and rehabilitation therapy and died suddenly a year after discharge. PMID:9503974

  6. Sodium influxes in internally perfused squid giant axon during voltage clamp.

    Science.gov (United States)

    Atwater, I; Bezanilla, F; Rojas, E

    1969-05-01

    1. An experimental method for measuring ionic influxes during voltage clamp in the giant axon of Dosidicus is described; the technique combines intracellular perfusion with a method for controlling membrane potential.2. Sodium influx determinations were carried out while applying rectangular pulses of membrane depolarization. The ratio ;measured sodium influx/computed ionic flux during the early current' is 0.92 +/- 0.12.3. Plots of measured sodium influx and computed ionic flux during the early current against membrane potential are very similar. There was evidence that the membrane potential at which the sodium influx vanishes is the potential at which the early current reverses. PMID:5767887

  7. [Treatment of a ruptured giant internal carotid artery pseudoaneurysm following transsphenoidal surgery: case report and literature review].

    Science.gov (United States)

    Hattori, Itaro; Iwasaki, Koichi; Horikawa, Fumihiko; Tanji, Masahiro; Gomi, Masanori

    2006-11-01

    We report here a case of giant internal carotid artery (ICA) pseudoaneurysm as a complication of transsphenoidal surgery. This 50-year-old acromegalic male presented to our clinic with a status of hypovolemic shock due to serious epistaxis. Neuroradiological examinations at his admission revealed a giant aneurysm in the right cavernous portion projecting into the sphenoid sinus. Eight years before this presentation, he had undergone a transsphenoidal surgery for growth hormone producing pituitary tumor at the other clinic. Then intraoperative arterial bleeding was reported, probably as a result of carotid injury. His medical history and radiological findings suggested that his epistaxis resulted from a rupture of the iatrogenic pseudoaneurysm which had gradually grown after the ICA injury at the previous surgery over 8 years. Emergent coil embolization using Guglielmi detachable coils (GDCs) resulted in a successful homeostasis. Major part of the aneurysm dome was obliterated via the intervention, however small part of the aneurysm neck was unable to be obliterated due to a technical difficulty. His postoperative course was favorable, but he suffered from a recurrence of serious epitaxis 4 weeks after the embolization. Emergent angiography suggested a rupture of the un-obliterated aneurysm neck remnant. Thus, trapping of the aneurysm combined with high flow bypass was necessitated. Relevant literatures are reviewed, and possible therapeutic strategies for this rare lesion are discussed. PMID:17087269

  8. Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller coaster ride - case report and a review.

    Science.gov (United States)

    Ozkan Arat, Yonca; Volpi, John; Arat, Anıl; Klucznik, Richard; Diaz, Orlando

    2011-01-01

    We present the first case of a woman with no significant medical history who developed dissections of bilateral carotid and bilateral vertebral arteries, as well as a retinal artery occlusion, after a roller coaster ride. A 35-year-old woman developed right-sided neck pain followed by a frontal headache immediately after a roller coaster ride. Five days after the incident, she developed complete loss of vision in her right eye for two hours. Subsequently, the vision improved but remained significantly decreased. On presentation, her visual acuity was 20/200 in the right and 20/20 in the left eye. Her fundus exam revealed retinal edema in the superotemporal retinal artery distribution without any visible emboli. Her neurological exam was otherwise normal. The cerebral angiogram showed bilateral internal carotid and vertebral artery dissections. The patient remained stable with conservative therapy without further worsening of vision or any new neurological deficits. Outcomes for cervicocephalic arterial dissection are usually favorable, but early diagnosis is critical for initiation of appropriate treatment of possible complications. Physicians must have a high index of suspicion for arterial dissection when patients note any headache, neck pain or vertigo triggered by violent motion after leisure activities such as roller coaster rides. PMID:21341139

  9. Bilateral dacryoadenitis

    Directory of Open Access Journals (Sweden)

    Charlotte Derr

    2012-01-01

    Full Text Available Acute dacryoadenitis is an uncommon condition that involves inflammation of the lacrimal gland. In rare instances, dacryoadenitis may be bilateral. A delay in proper treatment of an otherwise simple case of dacryoadenitis may lead to significant soft tissue morbidity such as cellulitis, lacrimal gland abscess, or orbital abscess. We report the case of a 24-year-old male who presented to the emergency department with acute bilateral dacryoadenitis. The patient′s symptoms did not respond to oral antibiotics and he subsequently required admission for intravenous antibiotics. During his hospitalization the patient had diagnostic testing to try to determine the etiology for his symptoms. The unique aspects of managing a case of bilateral dacryoadenitis as well as treatment recommendations are discussed in this case report.

  10. Bilateral giant renal angiomyolipoma associated with hepatic lipoma in a patient with tuberous sclerosis Angiomiolipomas renais gigantes bilateralmente associados a lipoma hepático em pacientes com esclerose tuberosa

    Directory of Open Access Journals (Sweden)

    Edison Daniel Schneider-Monteiro

    2003-01-01

    Full Text Available OBJECTIVE: To report a case of bilateral giant renal angiomyolipoma associated with tuberous sclerosis, with successful treatment, and to review the literature concerning angiomyolipoma treatment. CASE REPORT: Patient with tuberous sclerosis and angiomyolipoma diagnosed by ultrasonography during her pregnancy. At that time, the angiomyolipoma on the right side was 9 cm in diameter. Conservative management was selected during her pregnancy. The patient returned 7 years later, with a 24.7 x 19.2 x 10.7 cm tumor on the right side and another of 13 x 11.5 x 6.5 cm on the left side, in addition to multiple small angiomyolipomas. A nephron-sparing surgery with tumoral enucleation was performed on the right side, and after 3 months, the tumor on the left side was removed. Renal function in the post-operative period was preserved, and contrast medium progression was uniform and adequate in both kidneys. CONCLUSION: We conclude that an angiomyolipoma larger than 4 cm should be removed surgically, since they have a greater growth rate and pose a risk of hemorrhage. Resection of smaller tumors is safe and has decreased morbidity. Tumoral enucleation is an effective treatment method that preserves kidney function.OBJETIVO: Relatar um caso de angiomiolipoma gigante, bilateral, associado a esclerose tuberosa, tratado com sucesso e revisar a literatura concernente ao tratamento do angiomiolipoma. RELATO DO CASO: Paciente portadora de esclerose tuberosa, com diagnóstico de angiomiolipoma realizado por ultra-sonografia durante gestação. O tumor apresentava 9cm de diâmetro, à direita. Optou-se por conduta conservadora durante a gestação, e a paciente retornou somente 7 anos após, com tumor de 24,7 x 19,2 x 10,7 cm à direita e outro à esquerda de 13 x 11,5 x 6,5 cm, além de múltiplos angiomiolipomas pequenos. Realizada inicialmente ressecção tumoral à direita, por enucleação, com preservação do parênquima renal, e 3 meses após à esquerda. A

  11. g-force induced giant efficiency of nanoparticles internalization into living cells

    Science.gov (United States)

    Ocampo, Sandra M.; Rodriguez, Vanessa; de La Cueva, Leonor; Salas, Gorka; Carrascosa, Jose. L.; Josefa Rodríguez, María; García-Romero, Noemí; Luis, Jose; Cuñado, F.; Camarero, Julio; Miranda, Rodolfo; Belda-Iniesta, Cristobal; Ayuso-Sacido, Angel

    2015-10-01

    Nanotechnology plays an increasingly important role in the biomedical arena. Iron oxide nanoparticles (IONPs)-labelled cells is one of the most promising approaches for a fast and reliable evaluation of grafted cells in both preclinical studies and clinical trials. Current procedures to label living cells with IONPs are based on direct incubation or physical approaches based on magnetic or electrical fields, which always display very low cellular uptake efficiencies. Here we show that centrifugation-mediated internalization (CMI) promotes a high uptake of IONPs in glioblastoma tumour cells, just in a few minutes, and via clathrin-independent endocytosis pathway. CMI results in controllable cellular uptake efficiencies at least three orders of magnitude larger than current procedures. Similar trends are found in human mesenchymal stem cells, thereby demonstrating the general feasibility of the methodology, which is easily transferable to any laboratory with great potential for the development of improved biomedical applications.

  12. g-force induced giant efficiency of nanoparticles internalization into living cells

    Science.gov (United States)

    Ocampo, Sandra M.; Rodriguez, Vanessa; de la Cueva, Leonor; Salas, Gorka; Carrascosa, Jose. L.; Josefa Rodríguez, María; García-Romero, Noemí; Luis, Jose; Cuñado, F.; Camarero, Julio; Miranda, Rodolfo; Belda-Iniesta, Cristobal; Ayuso-Sacido, Angel

    2015-01-01

    Nanotechnology plays an increasingly important role in the biomedical arena. Iron oxide nanoparticles (IONPs)-labelled cells is one of the most promising approaches for a fast and reliable evaluation of grafted cells in both preclinical studies and clinical trials. Current procedures to label living cells with IONPs are based on direct incubation or physical approaches based on magnetic or electrical fields, which always display very low cellular uptake efficiencies. Here we show that centrifugation-mediated internalization (CMI) promotes a high uptake of IONPs in glioblastoma tumour cells, just in a few minutes, and via clathrin-independent endocytosis pathway. CMI results in controllable cellular uptake efficiencies at least three orders of magnitude larger than current procedures. Similar trends are found in human mesenchymal stem cells, thereby demonstrating the general feasibility of the methodology, which is easily transferable to any laboratory with great potential for the development of improved biomedical applications. PMID:26477718

  13. Bilateral agreements

    International Nuclear Information System (INIS)

    Ten bilateral agreements are presented. These are: 1) Co-operation agreement relating to the peaceful uses of nuclear energy between Argentina and EURATOM (1996); 2) Agreement on co-operation in the peaceful uses of nuclear energy between Argentina and Greece (1997); 3) Implementing arrangement for technical exchange and co-operation in the area of peaceful uses of nuclear energy between Argentina and the United States (1997); 4) Agreement concerning co-operation in nuclear science and technology between Australia and Indonesia (1997); 5) Implementation of the 1985 Agreement for co-operation concerning the peaceful uses of nuclear energy between the People's Republic of China and the United States (1998); 6) Protocol of co-operation between France and Lithuania (1997); 7) Agreement on co-operation in energy research, science and technology, and development between Germany and the United States (1998); 8) Agreement on early notification of a nuclear accident and exchange of information on nuclear facilities between Greece and Romania (1997); 9) Agreement on early notification of nuclear accidents and co-operation in the field of nuclear safety between Hungary and the Ukraine (1997); 10) Agreement in the field of radioactive waste management between Switzerland and the United States (1997). (K.A.)

  14. Combined extracranial-intracranial bypass and balloon occlusion of internal carotid artery for the treatment of intracranial wide-neck giant aneurysms

    International Nuclear Information System (INIS)

    Objective: To present and evaluate the treatment and long-period follow-up of intracranial broad neck giant aneurysms treated by extracranial-intracranial bypass and balloon occlusion of internal carotid artery. Methods: Retrospectively analyze the treatment and long-period follow-up result of 2 wide neck giant aneurysms treated by combined extracranial-intracranial bypass and balloon occlusion of internal carotid artery during recent 4 years. Results: The aneurysm located at C1, C2 segment of L-ICA and M1 segment of L-MCA; the other involved petrosal segment from of R-ICA to M1 of R-MCA and A1 of R-ACA. The occlusion test in all 2 cases were positive. The authors first made bypass between the superficial temporal artery and ipsilateral MCA. The cranial angiography was followed the next day to prove the patency of the bypass. Then the proximal segment of the ipsilateral ICA was occluded by using detachable balloon. After treatment and during 4-year follow-up period, two patients showed no neurological deficits and CT scan showed thrombi within the lumens. The volume of one aneurysm decreased sharply. Cerebral angiography of the bypasses were patent and the no opacification of aneurysm any more. Conclusions: Combined extracranial-intracranial bypass and balloon occlusion of internal carotid artery is an alternative method for treating the aneurysm not to be cured by the interventional method and surgical operation

  15. Giant oilfields and civil conflict

    OpenAIRE

    Lei, Yu-Hsiang; Michaels, Guy

    2012-01-01

    We use new data to examine the effects of giant oilfield discoveries around the world since 1946. On average, these discoveries increase per capita oil production and oil exports by up to 50 percent. But these giant oilfield discoveries also have a dark side: they increase the incidence of internal armed conflict by about 5-8 percentage points. This increased incidence of conflict due to giant oilfield discoveries is especially high for countries that had already experienced armed conflicts o...

  16. 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...

  17. Superstars and Giant Gravitons

    CERN Document Server

    Myers, R C; Myers, Robert C.; Tafjord, Oyvind

    2001-01-01

    We examine a family of BPS solutions of ten-dimensional type IIb supergravity. These solutions asymptotically approach AdS_5 X S^5 and carry internal `angular' momentum on the five-sphere. While a naked singularity appears at the center of the anti-de Sitter space, we show that it has a natural physical interpretation in terms of a collection of giant gravitons. We calculate the distribution of giant gravitons from the dipole field induced in the Ramond-Ramond five-form, and show that these sources account for the entire internal momentum carried by the BPS solutions.

  18. Red giant seismology: Observations

    Directory of Open Access Journals (Sweden)

    Mosser B.

    2013-03-01

    Full Text Available The CoRoT and Kepler missions provide us with thousands of red-giant light curves that allow a very precise asteroseismic study of these objects. Before CoRoT and Kepler, the red-giant oscillation patterns remained obscure. Now, these spectra are much more clear and unveil many crucial interior structure properties. For thousands of red giants, we can derive from seismic data precise estimates of the stellar mass and radius, the evolutionary status of the giants (with a clear difference between clump and RGB stars, the internal differential rotation, the mass loss, the distance of the stars... Analyzing this amount of information is made easy by the identification of the largely homologous red-giant oscillation patterns. For the first time, both pressure and mixed mode oscillation patterns can be precisely depicted. The mixed-mode analysis allows us, for instance, to probe directly the stellar core. Fine details completing the red-giant oscillation pattern then provide further information on the interior structure, including differential rotation.

  19. 双侧内囊前肢毁损术治疗难治性焦虑症%Bilateral anterior internal capsulotomy for refractory anxiety disorders

    Institute of Scientific and Technical Information of China (English)

    孙发发; 潘宜新; 曹春燕; 李永超; 林国珍; 孙伯民; 占世坤

    2015-01-01

    Objective To study the clinical effect of bilateral anterior internal capsulotomy on patients with refractory anxiety disorders.Methods Twenty-one patients with anxiety disorders,failed to pharmacological and cognitive behavior therapies for 5 years and admitted to our hospital from November 2009 to January 2012,were chosen; they received MRI-guided stereotactic bilateral anterior capsulotomy.The coordinates of the lesion target were determined under high resolution MRI directly and confirmed by intra-operative impedance test and high frequency stimulation.The lesions were received radiofrequency at 80 ℃ for 60 seconds.Pre-and post-operative mini-mental state examination (MMSE),self-rating anxiety scale (SAS),Hamilton depression rating scale (HAMD) and Hamilton anxiety rating scale (HAMA) were performed by the same psychiatrists.Results In the 21 patients,8 had anxiety-free,10 had significant improvement,and 3 had no significant improvement.No serious surgery-related complications were noted.Nine patients had mild cognitive deficit and transient dysmnesia only at 1-2 weeks after operation.Personality changes,such as lack of motivation,apathy and indolence,appeared in 4 patients.Psychiatric evaluations demonstrated significant decrease of SAS,HAMD and HAMA scores after operation as compared with those before operation (P<0.05).However,the difference of MMSE scores between pre-and post-operation was not statistically significant (P>0.05).Conclusion MRI guided stereotactic bilateral capsulotomy is precise,safe and much an effective treatment for refractory anxiety disorders,whcih is promising to alleviate the symptoms of anxiety and depression,as well as improving the quality of life.%目的 分析立体定向下双侧内囊前肢毁损术治疗难治性焦虑症的临床疗效. 方法 收集上海交通大学附属瑞金医院功能神经外科自2009年11月至2012年1月收治的21例难治性焦虑症患者临床资料,所有患者均在MRI计算机工作

  20. Balloon occlusion of the internal carotid artery in 40 cases of giant intracavernous aneurysm: Technical aspects, cerebral monitoring, and results

    International Nuclear Information System (INIS)

    We have studied the results of carotid occlusion in the treatment of giant intracavernous carotid artery (ICA) aneurysms in 40 patients. Clinical, angiographic, Doppler and cerebral blood flow (CBF) criteria for tolerance of occlusion are discussed. The patients had headaches (47.5%), cranial nerve compression (87.5%), decreased visual acuity (20%), ruptured aneurysm (15%) and 5% were asymptomatic. Balloon occlusion tests were performed under light sedation anaesthesia; a successful test required perfect clinical tolerance and adequate angiographic collateral circulation in arterial, parenchymatous, and venous phases. Additional criteria included xenon 133 CBF measurements, and transcranial Doppler sonography of the middle cerebral artery. According to these criteria, 5 patients did not tolerate test occlusion and required an extra-intracranial (EC-IC) bypass. Mean follow-up was 4.7 years. All patients were radiologically cured of their aneurysm, and in 35 the symptoms resolved, although 3 had persistent ocular motor nerve palsies, and in 4 visual defects were unchanged. Complications were 1 permament and 3 transient neurological deficits. Balloon occlusion of the ICA is an effective, reliable form of treatment for intracavernous giant aneurysm and should replace surgical ligation of the cervical carotid artery. With CBF or Doppler monitoring, the risk of neurological deficit is diminished. EC-IC bypass prior to ICA occlusion is indicated if test occlusion is not tolerated. (orig.)

  1. Trombosis yugular interna bilateral asociada a trombofilia después de la inducción ovárica por infertilidad Bilateral internal jugular thrombosis associated with thrombophilia after ovarian induction for infertility

    Directory of Open Access Journals (Sweden)

    Fernando Vázquez

    2002-08-01

    Full Text Available Los eventos tromboembólicos son complicaciones poco frecuentes del tratamiento hormonal de la infertilidad y generalmente están asociados al síndrome de hiperestimulación ovárico (SHO. La trombosis venosa yugular es infrecuente y ante su presencia se debería sospechar la existencia de algún factor predisponente. Describimos una paciente de 31 años, sin antecedentes de importancia, no fumadora, a la cual se le realizó un único ciclo de estimulación hormonal para fertilización in vitro por esterilidad primaria con factor masculino. Durante la octava semana de embarazo gemelar desarrolló una trombosis yugular interna bilateral, en ausencia de SHO u otros factores predisponentes aparentes. En la evaluación para trombofilia se detectó la presencia del Factor V Leiden y la mutación del gen de la protrombina G 20210, que junto con el estímulo hormonal, se interpretaron como los factores predisponentes. Se anticoaguló con heparina de bajo peso molecular. No está recomendado el rastreo sistemático de trombofilia antes del tratamiento hormonal, pero podría ser considerado en pacientes de alto riesgo o en quienes desarrollan trombosis en ausencia de un factor predisponente claro.Thromboembolic events are an infrequent complication of hormonal treatment for infertility and are generally related to the hyperstimulated ovarian syndrome (HOS. Jugular vein thrombosis is an unusual site of thrombosis and when present one should look for a predisposing factor. We describe a 31-year-old woman, with no previous medical history, non-smoker, who received a single cycle of hormonal stimulation for in vitro fertilisation due to primary infertility. During her eighth week of a twin pregnancy, she consulted the emergency room where the diagnosis of bilateral jugular thrombosis was confirmed, in absence of HOS or any known predisposing factor. In subsequent studies, the presence of Factor V Leyden and a mutation of G 20210 prothrombin were found

  2. Endoscopic endonasal approach for the treatment of a large clival giant cell tumor complicated by an intraoperative internal carotid artery rupture

    International Nuclear Information System (INIS)

    Giant cell tumors (GCTs) are primary bone neoplasms that rarely involve the skull base. These lesions are usually locally aggressive and require complete removal, including the surrounding apparently healthy bone, to provide the best chance of cure. GCTs, as well as other lesions located in the clivus, can nowadays be treated by a minimally invasive fully endoscopic extended endonasal approach. This approach ensures a more direct route to the craniovertebral junction than other possible approaches (transfacial, extended lateral, and posterolateral approaches). The case reported is a clival GCT operated on by an extended endonasal approach that provides another contribution on how to address one of the most feared complications attributed to this approach: a massive bleed due to an internal carotid artery injury

  3. Giant Planets

    CERN Document Server

    Guillot, Tristan

    2014-01-01

    We review the interior structure and evolution of Jupiter, Saturn, Uranus and Neptune, and giant exoplanets with particular emphasis on constraining their global composition. Compared to the first edition of this review, we provide a new discussion of the atmospheric compositions of the solar system giant planets, we discuss the discovery of oscillations of Jupiter and Saturn, the significant improvements in our understanding of the behavior of material at high pressures and the consequences for interior and evolution models. We place the giant planets in our Solar System in context with the trends seen for exoplanets.

  4. The International Lunar Decade: A Giant Leap Forward in Understanding the Moon and Opportunities for its Development

    Science.gov (United States)

    Beldavs, Vid; Atvars, Aigars; Ubelis, Arnolds; Salmins, Kalvis; Crisafulli, Jim; Dunlop, David; Foing, Bernard

    2015-04-01

    In 1957 at the dawn of the space age the United Nations launched the International Geophysical Year which had a profound impact on collaboration among scientists around the globe. Its legacy includes several major scientific organizations as well as the beginnings of collaboration among nations that see themselves as competitors on Earth. The Soviet Union and the United States made many attempts at collaboration in space while building weapons systems to destroy each other. Space technologies have become the infrastructure for the ubiquitous smart phone with global telecommunications, navigation, weather forecasting, environmental monitoring, and hundreds of other applications. In 2015, the International Year of Light, several conferences will be held exploring the idea of an International Lunar Decade1 An informal group, the International Lunar Decade Working Group (ILDWG) has been formed to plan the launch of the International Lunar Decade in 2017, the 60th Anniversary of the International Geophysical Year. This report will cover the progress of the ILDWG covering conferences planned, international organizations involved and key publications. The activities of the ILDWG can be followed at http://2014giantleap.aerospacehawaii.info/. References [1] V. Beldavs, 2014 'The International Lunar Decade', The Space Review, http://www.thespacereview.com/article/2431/1

  5. Tuberous sclerosis with bilateral renal angiomyolipoma and wunderlich's syndrome

    International Nuclear Information System (INIS)

    This case describes a 47-year-old female with tuberous sclerosis associated with bilateral giant renal angiomyolipomas. She underwent an initial renal angioembolization in August 2006. After four months, she required emergency nephrectomy due to spontaneous hemorrhage from the angiomyolipoma (Wunderlich's syndrome). Life threatening Wunderlich's syndrome requires emergency nephrectomy, however, renal preservation can be achieved by elective nephron sparing surgery. (author)

  6. Bilateral lateral periodontal cyst

    OpenAIRE

    Govil, Somya; Gupta, Vishesh; Misra, Neeta; Misra, Pradyumna

    2013-01-01

    The bilateral lateral periodontal cyst is a rare nasological entity, which despite clinical and radiological presentation is being diagnosed by histological characteristics. It is asymptomatic in nature and is observed in routine radiography. The aim and objective of this article is to present a rare case of bilateral lateral periodontal cyst in a 14-year-old child. The clinical and radiographical findings, along with its management have been discussed. Enucleation of bilateral cyst without e...

  7. Accounting Relations in Bilateral Value Added Trade

    OpenAIRE

    Robert Stehrer

    2013-01-01

    Abstract The increasing international fragmentation of production has triggered the development of a number of widely used indicators accounting for value added flows in the world economy. This paper generalises these measures by simultaneously considering the import side and focusing on bilateral gross and value added trade flows. It discusses how these indicators relate to each other, the role of double counting in bilateral value added trade, and aggregation issues in global value added flows...

  8. Bilateral support programmes

    International Nuclear Information System (INIS)

    In the Russian Federation, serious consideration is being given to the safety of nuclear facilities and to security of nuclear material. One important factor in ensuring security of nuclear material and facilities is physical protection. The Ministry of Atomic Energy of the Russian Federation is making great efforts to improve physical protection of nuclear facilities. Some of the measures which are being implemented to improve physical protection are being carried out in the framework of international co-operation in this field. To date, the Russian Federation has established bilateral co-operation with the United States of America, Germany, Belgium, France and Finland, and has studied and taken account of the experience of foreign countries in the field of physical protection and nuclear material accounting and control. At present, over 20 enterprises of the Ministry of Atomic Energy of the Russian Federation representing all the main branches of the nuclear activities of the Ministry are involved in international co-operation on physical protection and nuclear material accounting and control. The main branches of this co-operation are as follows: Scientific and technical co-operation; production of a conceptual design to improve physical protection systems directly at nuclear risk facilities; swift improvement of physical protection (without developing design documentation for the nuclear risk facility as a whole); reinforcement of physical protection during the transport of nuclear material; and training of staff at nuclear risk facilities. During this work, many facilities were equipped with modern physical protection and with nuclear material accounting and control equipment. The Ministry of Atomic Energy of the Russian Federation is pleased with the results of this international co-operation and feels that it should continue. (author)

  9. Bilateral Congenital Diaphragmatic Hernia

    OpenAIRE

    Dhua, Anjan K; Aggarwal, Satish K; NB Mathur; GR Sethi

    2012-01-01

    Bilateral congenital diaphragmatic hernia (CDH) is a rare birth defect, with a poor prognosis. We describe a case of bilateral CDH discovered while repairing the right sided CDH. Diaphragmatic defect was repaired and a silo was applied on the abdominal wound to avoid abdominal compartment syndrome. The patient however died postoperatively due to severe pulmonary hypertension.

  10. A discrete chemo-dynamical model of the giant elliptical galaxy NGC 5846: dark matter fraction, internal rotation and velocity anisotropy out to six effective radii

    CERN Document Server

    Zhu, Ling; van de Ven, Glenn; Long, R J; Watkins, Laura L; Pota, Vincenzo; Napolitano, Nicola R; Forbes, Duncan A; Brodie, Jean; Foster, Caroline

    2016-01-01

    We construct a suite of discrete chemo-dynamical models of the giant elliptical galaxy NGC 5846. These models are a powerful tool to constrain both the mass distribution and internal dynamics of multiple tracer populations. We use Jeans models to simultaneously fit stellar kinematics within the effective radius $R_{\\rm e}$, planetary nebula (PN) radial velocities out to $3\\, R_{\\rm e}$, and globular cluster (GC) radial velocities and colours out to $6\\,R_{\\rm e}$. The best-fitting model is a cored DM halo which contributes $\\sim 10\\%$ of the total mass within $1\\,R_{\\rm e}$, and $67\\% \\pm 10\\%$ within $6\\,R_{\\rm e}$, although a cusped DM halo is also acceptable. The red GCs exhibit mild rotation with $v_{\\rm max}/\\sigma_0 \\sim 0.3$ in the region $R > \\,R_{\\rm e}$, aligned with but counter-rotating to the stars in the inner parts, while the blue GCs and PNe kinematics are consistent with no rotation. The red GCs are tangentially anisotropic, the blue GCs are mildly radially anisotropic, and the PNe vary from r...

  11. Amateur - professional collaborations in Giant Planets Atmospheres Research through the Planetary Virtual Observatory of the International Outer Planets Watch (PVOL - IOPW)

    Science.gov (United States)

    Hueso, R.; Legarreta, J.; Sánchez-Lavega, A.

    2015-10-01

    The atmospheres node of the International Outer Planets Watch (IOPW) maintains a large database of observations of the Giant Planets called Planetary Virtual Observatory Laboratory (PVOL) [1]. This image repository is contributed by amateur astronomers worldwide and its images keep a record of atmospheric activity on Jupiter, Saturn and Uranus over the years. PVOL was created as an unfunded project that has been online since 2004. Its data content has been growing ever since then, now containing about 25,000 image files that cover the period 2000-2015. The main characteristic of PVOL, when compared with other amateur images repositories, is that it is built as a database with different searching tools. This characteristic has made PVOL an important research tool over the years for various scientific teams. Here we update the description of the data in PVOL and we discuss new development plans in the context of the Virtual European Solar and Planetary Access (VESPA) collaboration which will bring life to a Virtual Observatory for Planetary Sciences. The database is available in the following address:

  12. US-GERMAN BILATERAL WORKING GROUP: AN INTERNATIONAL COLLABORATION IN REVITALIZING CONTAMINATED LAND IN PROCEEDINGS OF CABERNET 2005: THE INTERNATIONAL CONFERENCE ON MANAGING URBAN LAND, APRIL 13-15, 2005, BELFAST IRELAND

    Science.gov (United States)

    The U.S. Environmental Protection Agency (EPA) and the German Federal Ministry of Education and Research (BMBF) entered into a Bilateral partnership in 1990 to study each country's efforts in developing and demonstrating innovative tools, techniques and approaches in areas relate...

  13. The gravitational signature of internal flows in giant planets: Comparing the thermal wind approach with barotropic potential-surface methods

    Science.gov (United States)

    Kaspi, Y.; Davighi, J. E.; Galanti, E.; Hubbard, W. B.

    2016-09-01

    The upcoming Juno and Cassini gravity measurements of Jupiter and Saturn, respectively, will allow probing the internal dynamics of these planets through accurate analysis of their gravity spectra. To date, two general approaches have been suggested for relating the flow velocities and gravity fields. In the first, barotropic potential surface models, which naturally take into account the oblateness of the planet, are used to calculate the gravity field. However, barotropicity restricts the flows to be constant along cylinders parallel to the rotation axis. The second approach, calculated in the reference frame of the rotating planet, assumes that due to the large scale and rapid rotation of these planets, the winds are to leading order in geostrophic balance. Therefore, thermal wind balance relates the wind shear to the density gradients. While this approach can take into account any internal flow structure, it is limited to only calculating the dynamical gravity contributions, and has traditionally assumed spherical symmetry. This study comes to relate the two approaches both from a theoretical perspective, showing that they are analytically identical in the barotropic limit, and numerically, through systematically comparing the different model solutions for the gravity harmonics. For the barotropic potential surface models we employ two independent solution methods - the potential-theory and Maclaurin spheroid methods. We find that despite the sphericity assumption, in the barotropic limit the thermal wind solutions match well the barotropic oblate potential-surface solutions.

  14. 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”.

  15. 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...

  16. BILATERAL OVARIAN MASS COMPLICATING PREGNANCY

    OpenAIRE

    Arjumand; Triveni

    2015-01-01

    A 22 years old patient with 9 months of Amenorrhoea with a abdominal swelling was admitted to our institution with an Ultrasonography report of Bilateral ovarian mass (14.3x5.9cm in left ovary) and (9.5x7cm in right ovary) with internal vascularity with septations along with single live intrauterine fetus. She delivered by elective caesarean section in V/O breech presenta tion. Left side ovarian cystectomy done Right side ovarian puncture done. Histopathology showed left sid...

  17. Successful Reconstruction of Asymptomatic Bilateral External Carotid Artery Aneurysms.

    Science.gov (United States)

    Loja, Melissa N; Pevec, William C

    2016-04-01

    True aneurysms of the external carotid artery (ECA) are extremely rare with an unknown incidence and natural history. We present the successful operative management of an asymptomatic 65-year-old man found to have bilateral internal carotid artery stenosis and bilateral ECA aneurysms. His bilateral carotid arteries were reconstructed with bifurcated interposition grafts in a staged fashion. The patient recovered without sequelae and continues to be asymptomatic 1 year after reconstruction. We present the operative management of this rare case. PMID:26802292

  18. 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...

  19. Staged endovascular treatment with selective EC-IC bypass for symptomatic large-giant aneurysms in the cavernous portion of the internal carotid artery

    International Nuclear Information System (INIS)

    For the treatment of symptomatic large-giant aneurysm in the cavernous portion of the internal carotid artery (ICA), it is often necessary to occlude the ICA with or without extracranial-intracranial (EC-IC) bypass surgery. We report 11 patients with such symptomatic lesions treated between January 2004 and June 2008 by staged endovascular trapping of the aneurysm with detachable coils following selective EC-IC bypass placement. The necessity of the bypass was determined according to neurological conditions and radiological findings during the preoperative balloon test occlusion (BTO) of the ICA. When ischemic symptoms occurred during BTO, high-flow bypass was selected. Otherwise, findings on single-photon emission computed tomography were used for the bypass selection. Following completion of the bypass, dual antiplatelet therapy was induced. Then the confirmative BTO and endovascular ICA occlusion (ICA-O) under local anesthesia were planned several days after the bypass placement. A total of 4 high-flow bypasses with radial artery graft were placed before ICA-O, while 7 patients underwent endovascular ICA-O without bypass surgery. There were no perioperative complications related to the procedures in 10 cases, but 1 developed cerebral infarction 7 days after bypass placement possibly due to distal embolism from intraaneurysmal thrombus. No patients showed postoperative symptoms according to insufficient ipsilateral cerebral blood flow, and cranial nerve palsies improved in all patients. Favorable outcomes can be expected for patients with such aneurysms by staged endovascular ICA-O with selective EC-IC bypass. Although endovascular ICA-O can be safe and useful, understanding of adequate antithrombotic therapy and treatment timing are especially important in cases with bypass placement. (author)

  20. Bilateral popliteal arterial dissection.

    Science.gov (United States)

    Chen, Po-Liang; Ko, Shih-Yu; Tan, Ken-Hing

    2012-01-01

    A clinical feature of bilateral popliteal arterial dissection without involving the descending aorta, bilateral iliac, as well as femoral arteries has never been reported in the past literature. We report a 56-year-old man with hypertension and coronary artery disease who presented to our emergency department with complaints of bilateral knee pain after long-distance walking. Physical examination was notable for elevated blood pressure, but there was no palpable pulsation over dorsalis pedis arteries on his feet. Laboratory evaluation revealed a d-dimer level of 35.2 mg/L (FEU) on the day of the test and 1.2 mg/L one and a half months ago (normal level, <0.55). These findings were suggestive of a recent-onset peripheral arterial occlusive disorder. Computed tomography of the aorta showed bilateral popliteal arterial dissection with arterial intimal flap. Abdominal aorta, bilateral iliac, and femoral arteries remained intact with only arteriosclerotic change. Minimally invasive endovascular stent grafting was then performed. The patient had an uneventful recovery. PMID:21106320

  1. CLINICO-RADIOLOGIC FEATURES OF BILATERAL MANDIBULAR SWELLING – A CASE REPORT OF CHERUBISM AND LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Dysanoor Sujatha

    2012-09-01

    Full Text Available Cherubism is a rare hereditary non-neoplastic bone disease characterized by clinically evident bilateral, painless enlargements of the jaws, said to give the patient a cherubic appearance. Here we report the case of cherubism in a 5 year-old girl who complained of painless bilateral swelling, noticed by her parents three months back. Panoramic radiography and CT images exhibited bilateral multilocular radiolucent areas with cortical expansion. Histopathologic examination revealed proliferating fibrous connective tissue containing numerous multinucleated giant cells.

  2. 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.

  3. Summary of the conference with respect to national, bilateral, regional and international experience and efforts for strengthening control over radioactive sources

    International Nuclear Information System (INIS)

    The safety and security of sources is a global concern, but the responsibility (especially for security) is with national governments. The Code of Conduct on the Safety and Security of Radioactive Sources provides an internationally endorsed benchmark for States to work towards, and the IAEA Categorization of Radioactive Sources provides an internationally approved basis for risk informed decision making. Radioactive sources need to be safely and securely managed throughout their life cycle. States are giving priority to the safe management of high activity sources, and there is much work 'in progress' to supplement and further strengthen existing regulatory controls. A number of countries have implemented successful national source recovery campaigns, and thousands of vulnerable, orphan and disused sources have been recovered. Monitoring at national nodal points, such as scrap dealers and ports, has proved to be useful. Manufacturers are trying to help by taking back disused sources for recycling, but a safe and secure long term solution, supported by governments, is needed. Many countries have benefited from external support through multilateral, regional or international initiatives. A strategic approach is needed to ensure sustainable control over sources 'from cradle to grave'. This should be based on an effective licensing system with on-site inspections (including the physical verification of the location of sources), supported by a national source tracking system and a system of financial guarantees to ensure the safe and secure end-of-life management of sources

  4. Bilaterally Incarcerated Morgagni Hernia

    Directory of Open Access Journals (Sweden)

    Zuhal Demirhan Yananli

    2013-06-01

    Full Text Available Morgagni hernia is a rare congenital diaphragmatic hernia. It is seen rarely bilaterally. Patients are usually asymptomatic. Therefore, diagnosis may be delayed until adulthood. Significant morbidity can occur in case complications arise and diagnosis is delayed. The patient, a 74 year-old female, presented in this article, was admitted to the emergency department with abdominal pain, vomiting, and shortness of breath. The plain abdominal radiograph of the patient revealed bowel obstruction and suspicious appearence in favor of the diaphragmatic hernia on both sides of the sternum. Computed tomography revealed bilaterally incarcerated Morgagni hernia with strangulated omentum in the right side of the sternum and a part of colon in the left side of sternum. Incarcerated organs were withdrawn to peritoneal cavity and defects of hernia were sutured primarily on laparatomy. Because bilateral incarcerated Morgagni hernia can be seen rarely, this case was reported.

  5. Ice Giant Exploration

    Science.gov (United States)

    Rymer, A. M.; Arridge, C. S.; Masters, A.; Turtle, E. P.; Simon, A. A.; Hofstadter, M. D.; Turrini, D.; Politi, R.

    2015-12-01

    The Ice Giants in our solar system, Uranus and Neptune, are fundamentally different from their Gas Giant siblings Jupiter and Saturn, from the different proportions of rock and ice to the configuration of their planetary magnetic fields. Kepler space telescope discoveries of exo-planets indicate that planets of this type are among the most ubiquitous universally and therefore a future mission to explore the nature of the Ice Giants in our own solar system will provide insights into the nature of extra-solar system objects in general. Uranus has the smallest self- luminosity of all the planets, potentially related to catastrophic events early in the planet's history, which also may explain Uranus' large obliquity. Uranus' atmosphere is subject to extreme seasonal forcing making it unique in the Solar System. Neptune is also unique in a number of ways, notably its large moon Triton which is likely a captured Kuiper Belt Object and one of only two moons in the solar system with a robustly collisional atmosphere. Similar to Uranus, the angle between the solar wind and the magnetic dipole axis is subject to large-amplitude variations on both diurnal and seasonal timescales, but peculiarly it has one of the quietest magnetospheres of the solar system, at least according to Voyager 2, the only spacecraft to encounter Neptune to date. A comprehensive mission, as advocated in the Decadal Survey, would provide enormous science return but is also challenging and expensive. In this presentation we will discuss mission scenarios and suggest how collaboration between disciplines and internationally can help us to pursue a mission that includes Ice Giant exploration.

  6. Efficacy of bilateral pallidotomy.

    Science.gov (United States)

    Kim, R; Alterman, R; Kelly, P J; Fazzini, E; Eidelberg, D; Beric, A; Sterio, D

    1997-03-15

    Unilateral pallidotomy is a safe and effective treatment for medically refractory bradykinetic Parkinson's disease, especially in those patients with levodopa-induced dyskinesia and severe on-off fluctuations. The efficacy of bilateral pallidotomy is less certain. The authors completed 11 of 12 attempted bilateral pallidotomies among 150 patients undergoing pallidotomy at New York University. In all but one patient, the pallidotomies were separated by at least 9 months. Patients were selected for bilateral pallidotomy if they exhibited bilateral rigidity, bradykinesia, or levodopa-induced dyskinesia prior to treatment or if they exhibited disease progression contralateral to their previously treated side. The Unified Parkinson's Disease Rating Scale (UPDRS) and timed upper-extremity tasks of the Core Assessment Protocol for Intracerebral Transplantation (CAPIT) were administered to all 12 patients in the "off" state (12 hours without receiving medications) preoperatively and again at 6 and 12 months after each procedure. The median UPDRS and contralateral CAPIT scores improved 60% following the initial procedure (p = 0.008, Wilcoxon rank sums test). The second pallidotomy generated only an additional 10% improvement in the UPDRS and CAPIT scores ipsilateral to the original procedure (p = 0.05). Worsened speech was observed in two cases. In the 12th case, total speech arrest was noted during test stimulation. Speech returned within minutes after stimulation was halted. Lesioning was not performed. These results indicate that bilateral pallidotomy has a narrow therapeutic window. Motor improvement ipsilateral to the first lesion leaves little room for further improvement from the second lesion and the risk of speech deficit is greatly enhanced. Chronic pallidal stimulation contralateral to a previously successful pallidotomy may prove to be a safer alternative for the subset of patients who require bilateral procedures. PMID:15096015

  7. Rotation of Giant Stars

    OpenAIRE

    Kissin, Yevgeni; Thompson, Christopher

    2015-01-01

    The internal rotation of post-main sequence stars is investigated, in response to the convective pumping of angular momentum toward the stellar core, combined with a tight magnetic coupling between core and envelope. The spin evolution is calculated using model stars of initial mass 1, 1.5 and $5\\,M_\\odot$, taking into account mass loss on the giant branches. We also include the deposition of orbital angular momentum from a sub-stellar companion, as influenced by tidal drag along with the exc...

  8. Follicular Thyroid Carcinoma Presenting as Bilateral Cheek Masses

    OpenAIRE

    KIM Dong-Wook; Hah, J. Hun; An, Soo-Youn; Chang, Hak; Kim, Kwang Hyun

    2011-01-01

    Mandibular metastasis of thyroid carcinoma is extremely rare. We present the case of a 46-year-old woman who had bilateral huge cheek masses that had grown rapidly over several years. Intra-oral mucosal tissue biopsy and imaging work-up including computed tomography scan and magnetic resonance imaging were performed and the initial diagnosis was presumed to be central giant cell granuloma. Incidentally detected thyroid lesions were studied with ultra-sonography guided fine needle aspiration a...

  9. 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.

  10. Bilateral neck paragangliomas.

    Science.gov (United States)

    Mumoli, N; Cei, M; Pauletti, M; Ferrito, G; Scazzeri, F

    2009-10-01

    Paragangliomas of the head and neck are rare neoplasms presented as cervical mass, generally bilateral, that arise from chemoreceptors located at the carotid bifurcation (carotid body tumors), along the vagus nerve (vagal paragangliomas), and in the jugular fossa and tympanic cavity (jugulotympanic paragangliomas). They are typically asymptomatic at the beginning, highly vascular, slow-growing and compressing the surrounding anatomic structures. Only radical surgery is the curative treatment for paragangliomas. We present a case of a 62- year-old woman with a diagnosis of bilateral neck paragangliomas where surgical removal was judged burdened by excessive risk because of the size of the tumor. PMID:19622673

  11. 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...

  12. 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.

  13. Natural history of giant intracranial aneurysms

    International Nuclear Information System (INIS)

    The outcome of a consecutive series of 28 patients with giant aneurysm who had been followed without surgery from one month to 12 years after the diagnosis was made, are presented with reviewing their radiological and clinical features. Symptoms and signs were directly or indirectly attributable to the intracranial mass effect and nine patients (32 %) presented subarachnoid hemorrhage. Subarachnoid hemorrhage was frequently associated with intraventricular or intracerebral hemorrhage, a poor clinical grading at admission and a high mortality. Subarachnoid hemorrhage was most often recorded from the giant aneurysm at the supraclinoid portion of the internal carotid artery and the vertebro-basilar artery, but the rupture from the intracavernous giant aneurysm, completely thrombosed giant aneurysm and the fusiform type of giant aneurysm was rare. The mortality rate in 28 cases for the above follow up period was 46 % (13 in 28 cases) and major morbidity occured in 11 % (3 in 28 cases). The above outcome of non operated giant aneurysm cases may justify the surgical management of the giant aneurysm, but as the intracavernous giant aneurysm and thrombosed giant aneurysm are relatively harmless, surgical indication should be carefully decided, especially in the older patients. (author)

  14. Giant cystic parathyroid adenoma with thrombosis of internal jugular vein seen on CT and Tc-99m methoxy isobutyl isonitrile parathyroid scan

    International Nuclear Information System (INIS)

    Primary hyper-parathyroidism is attributed by a solitary parathyroid adenoma in 80-85% cases and mostly are non-palpable and needs imaging for localization. Cystic degeneration of parathyroid adenoma is rarely seen in primary hyperparathyroidism. We are presenting a case of giant cystic functioning parathyroid adenoma with associated localized co-morbids. (author)

  15. 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...

  16. 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.

  17. 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 that a...

  18. Bilateral lunate intraosseous ganglia

    International Nuclear Information System (INIS)

    An intraosseous ganglion is a relatively uncommon, benign, cyst-like lesion that occurs in young and middle-aged adults. Most commonly seen adjacent to the hip, ankle, knee, or wrist, they are histologically identical to their soft tissue counterparts. A review of the literature revealed only two previously reported examples of bilateral symmetrical ganglia of the lunate bones. (orig.)

  19. 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.)

  20. BILATERAL OVARIAN MASS COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Arjumand

    2015-06-01

    Full Text Available A 22 years old patient with 9 months of Amenorrhoea with a abdominal swelling was admitted to our institution with an Ultrasonography report of Bilateral ovarian mass (14.3x5.9cm in left ovary and (9.5x7cm in right ovary with internal vascularity with septations along with single live intrauterine fetus. She delivered by elective caesarean section in V/O breech presenta tion. Left side ovarian cystectomy done Right side ovarian puncture done. Histopathology showed left side – Mucinous cystadenoma. Right Side – Follicular cyst. Mucinous cystadenomas are benign epithelial ovarian tumors which tend to be unilateral, bilateral a nd multilocular with smooth surface and contain mucinous fluid, 75% of all mucinous tumors are benign, while 10% are borderline and 15% are invasive carcinomas. Benign mucinous tumors are most common in the third to fifth decades of life and may be 20 - 30 c ms in size. The incidence of ovarian cysts during pregnancy is less than 5% and most of them are benign in nature. G i ant cysts found in less than 1% of the cases of ovarian cysts with pregnancy.

  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. Spontaneous Bilateral Cervical Internal Carotid and Vertebral Artery Dissection in a Japanese Patient without Collagen Vascular Disease with Special Reference to Single-Nucleotide Polymorphisms.

    Science.gov (United States)

    Abe, Arata; Nito, Chikako; Sakamoto, Yuki; Nogami, Akane; Hokama, Hiroyuki; Takahashi, Shiro; Kirita, Kumiko; Ueda, Masayuki; Ishimaru, Yoshiro; Kimura, Kazumi

    2016-08-01

    Spontaneous cervical artery dissection (sCAD) is a major cause of ischemic stroke in young adults. Frequently, sCAD involves multiple neck arteries, accounting for 13%-28% of the total sCAD cases. However, little is known about factors related to multiple sCAD. In this case, a 52-year-old man was admitted due to headache without aura. There was a personal history of migraine with aura and a family history of similar symptoms. The patient's younger brother had a left vertebral artery (VA) dissecting aneurysm and underwent endovascular occlusion of his parent artery at the age of 48. Magnetic resonance imaging of our admitted patient showed hyperintensities in the right internal carotid artery (ICA) without acute infarction, and magnetic resonance angiography revealed a narrowing of the right ICA. Angiography was then performed, which showed a trace of dissection of the left ICA and both VAs as well as the right ICA. The patient did not fulfill any major criteria of collagen vascular disease such as Ehlers-Danlos syndrome type IV or Loeys-Dietz syndrome. The data in our patient are quite similar to those reported in patients with single-nucleotide polymorphism (SNP) of PHACTR1. Obtaining the patient's informed consent, we analyzed a common SNP variation in the rs9349379[G] allele (PHACTR1), which has been reported to be associated with a lower risk of sCAD. PMID:27216377

  3. Laparoscopic removal of a giant paratubal cyst complicated by hydronephrosis

    OpenAIRE

    LEANZA, V.; COCO, L.; Genovese, F; PAFUMI, C.; CIOTTA, L.; LEANZA, G.; ZANGHÌ, G.; INTAGLIATA, E.; Vecchio, R

    2013-01-01

    Paratubal cysts represent approximately 10% of all adnexal masses. In most cases they are very small, but very few cases are reported in the literature where they exceed 15 cm of diameter. Furthermore, giant paratubal cysts complicated by bilateral hydronephrosis are unique.

  4. 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.

  5. Bilateral ocular osseous choristomas

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Jeung Hee; Yoon, Dae Young; Choi, Chul Soon; Yoon, Eun Joo; Park, Sang Joon; Seo, Young Lan [Hallym University, Department of Radiology, Kangdong Sacred Heart Hospital, Seoul (Korea); Kim, Byoung Jin [Hallym University, Department of Ophthalmology, Kangdong Sacred Heart Hospital, Seoul (Korea)

    2005-11-01

    Choristoma is a benign tumour defined as normal tissue in an ectopic location. Osseous choristoma, one subtype of this entity, occurring within the orbit has rarely been reported in the world literature. We report a 6-year-old girl with bilateral ocular osseous choristomas who presented with palpable nodules protruding from both upper lids. The radiological and clinical findings are described and previous reports are reviewed. (orig.)

  6. Bilateral Integrative Medicine, Obviously

    OpenAIRE

    Shapiro, Simon J.; Stumpf, Steven H.

    2006-01-01

    Unstated and unacknowledged bias has a profound impact on the nature and implementation of integrative education models. Integrative education is the process of training conventional biomedical and traditional Chinese medicine practitioners in each tradition such that patient care may be effectively coordinated. A bilateral education model ensures that students in each tradition are cross-taught by experts from the ‘other’ tradition, imparting knowledge and values in unison. Acculturation is ...

  7. Bilateral lunate intraosseous ganglia

    Energy Technology Data Exchange (ETDEWEB)

    Pablos, J.M. [Department of Radiology, Hospital San Juan de Dios, Seville (Spain); Valdes, J.C. [Department of Radiology, Cemedi, Seville (Spain); Gavilan, F. [Department of Pathology, Hospital Universitario Virgen del Rocio, Seville (Spain)

    1998-12-01

    An intraosseous ganglion is a relatively uncommon, benign, cyst-like lesion that occurs in young and middle-aged adults. Most commonly seen adjacent to the hip, ankle, knee, or wrist, they are histologically identical to their soft tissue counterparts. A review of the literature revealed only two previously reported examples of bilateral symmetrical ganglia of the lunate bones. (orig.) With 3 figs., 10 refs.

  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. What Is Giant Cell Arteritis?

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ... What Is Giant Cell Arteritis? Giant Cell Arteritis Symptoms Who Is At Risk for Giant Cell Arteritis? Giant Cell Arteritis Diagnosis ...

  10. Bilateral caudate infarct--a case report.

    Science.gov (United States)

    Lim, J K; Yap, K B

    1999-07-01

    Caudate strokes comprise only a small proportion of all subtypes of strokes. Bilateral caudate infarcts are even rarer and only a few cases have been reported in the literature. We report an 86-year-old woman with bilateral caudate infarcts. She had no past medical history of note. She presented with headache for several days and drowsiness on day of admission. Clinical examination revealed abulia, inability to comprehend or verbalize (acute mutism), right-sided neglect and right-sided hemiparesis. Computed tomographic (CT) scan brain revealed decreased attenuation in both heads of both caudate nuclei with extension across the anterior limb of both internal capsules to involve the lentiform nuclei. Echocardiography showed aortic valve sclerosis, mild mitral and aortic regurgitation and normal left ventricular function. Carotid ultrasound revealed mild stenosis of proximal right internal carotid and left distal common carotid and adjacent proximal internal carotid arteries. She showed initial improvement in the first week, but subsequently had a progressive downward course despite rehabilitation and died 44 days after her stroke. A patient with bilateral caudate infarcts is likely to have poor prognosis for rehabilitation and survival. PMID:10561773

  11. A follow-up study of CT scan after the rupture of giant aneurysm of the bifurcation of an internal carotid artery

    International Nuclear Information System (INIS)

    A 42-year-old female with a giant intracranial aneurysm of the right IC bifurcation is reported. She had experienced severe headache with nausea and vomiting on July 6, 1984, and was admitted to a certain hospital. She was then transferred to our hospital on July 23; she was asymptomatic then. There was no neurological deficit, and a craniogram showed no abnormal findings. A plain CT scan, however, showed a round, homogenous, slightly high-density area on the right basal ganglia, and it was intensely enhanced by the infusion of a contrast medium. The right anterior horn was compressed to the anteromedial side. By the angiographical study, we found a large aneurysmal shadow with a bleb on its top, arising from the right IC bifurcation. While she waited for an operation, meanwhile undergoing reported Matas tests, the aneurysm began to bleed again. Suddenly generalized convulsions and the rapidly progressing left hemiparesis occurred, and she lost consciousness. The CT scan at that time showed a ring-shaped high-density area surrounding the aneurysms, accompanied by perifocal edema and a midline shift. An urgent operation was performed, but she died three days after the second attack. The autopsy showed a ruptured saccular aneurysm (3.5 x 4.0 x 4.0 cm in size) on the right IC bifurcation, with its neck extending to the M1 portion. There was neither calcification on the wall nor any organized thrombosis. Giant aneurysms usually affect the surrounding brain tissue as mass lesions. In this case, though, there was no sign or symptoms of any compression of the brain tissue or cranial nerves, though a CT scan soon after the rupture showed progressive perifocal edema. This suggests that there had been a previous disturbance of the autoregulation of the surrounding brain tissue, caused by the mass effect of the giant aneurysm. (author)

  12. Giant Cell Arteritis

    Science.gov (United States)

    Giant cell arteritis is a disorder that causes inflammation of your arteries, usually in the scalp, neck, and arms. ... arteries, which keeps blood from flowing well. Giant cell arteritis often occurs with another disorder called polymyalgia ...

  13. Bilateral Testicular Epidermoid Cysts

    OpenAIRE

    Norman Loberant; Shweta Bhatt; Edward Messing; Dogra, Vikram S.

    2011-01-01

    Testicular epidermoid cysts are the most common benign tumors of the testes, but account for only 1-2% of all testicular tumors. In a young man presenting with a testicular mass, a high index of suspicion must be maintained for the malignant testicular germ cell tumor, which is 50-times more common than testicular epidermoid cyst. Bilateral testicular epidermoid cysts are a very rare condition, with only a few reports in the literature. It is extremely important in this condition to make a co...

  14. 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......] and the class of multivariate matrix-exponential distributions of [9]. We prove a characterization theorem stating that a random variable has a bilateral multivariate distribution if and only if all linear combinations of the coordinates have a univariate bilateral matrix-exponential distribution. As...... an application we demonstrate that certain multivariate disions, which are governed by the underlying Markov jump process generating a phasetype distribution, have a bilateral matrix-exponential distribution at the time of absorption, see also [4]....

  15. Two Giants, A Global Arena

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    At the core of current China-U.S. relations are post-Cold War experiences and major differences when it comes to politics, economy and security. But despite these issues and the rhetoric that surrounds them, the potential for cooperation remains great In an article published by Global Times, Wu Xinbo, Deputy Principal of the International Relations and Public Affairs College of Shanghai Fudan University, shares his analysis of bilateral ties. Excerpts follow:

  16. Achondroplasia Associated with Bilateral Keratoconus

    OpenAIRE

    Samar A. Al-Swailem; Al Bin Ali, Ghada Y.; Al Katan, Hind M.; Al Mahmood, Ammar M.

    2012-01-01

    We report a rare case of bilateral keratoconus in association with achondroplasia. A 26-year-old male, with a known case of achondroplasia, complained of bilateral gradual deterioration in vision for the past few years. Slit lamp biomicroscopy showed bilateral central corneal protrusion and stromal thinning at the apex consistent with keratoconus. a trial of hard contact lens fitting failed to improve VA in the left eye (LE). Right eye (RE) improved to 20/25. The patient underwent penetrating...

  17. O valor de um intercâmbio: mobilidade estudantil brasileira, bilateralismo & internacionalização da educação. The value of an intercâmbio: brazilian student mobility, bilateralism & international education

    Directory of Open Access Journals (Sweden)

    Eric Spears

    2014-05-01

    Full Text Available Brazil’s emergence in the global economy as a member of the BRIC (Brazil, Russia, Índia, China, and South Africa states has prompted the federal government to establish the Brazilian Scientific Mobility Program (Science Without Borders in order to advance the country’s social capital and infrastructure in STEM (Science, Technology, Engineering, and Math related disciplines and industries. Public and private investment in the Scientific Mobility Program has transformed the way in which Brazilian government, universities, and citizenry places value the intercâmbio (student exchange experience in the United States. STEM-related disciplines are now disproportionately funded versus social sciences, humanities, and fine arts fields. This development has altered the way in which student mobility in the United States is given worth and changed the trajectory of international education in Brazil. This research provides a conceptual analysis of the Brazilian Scientific Mobility Program by using a critical political economy perspective. The essay conceptualizes the Science without Borders initiative at global, national, and local levels. This research also explores what implications the bilateral U.S.-Brazil Educational Partnership may have on future policy, practice, and ultimately, funding of Brazilian student mobility. A emergência do Brasil no âmbito da economia mundializada como participante do BRIC (Brasil, Rússia, Índia, China e África do Sul mobilizou o governo federal brasileiro a estabelecer um programa estatal de mobilidade acadêmica (Programa Ciência sem Fronteiras de modo a fazer avançar o capital social do país (general intellect e a infraestrutura em STEM (Ciência, Tecnologia, Engenharia e Matemática relacionadas à indústria. Investimentos públicos e privados no programa de mobilidade acadêmica transformaram o modo como o governo brasileiro e as universidades valorizam o intercâmbio estudantil com os Estados Unidos. As

  18. Squashed giants: bound states of giant gravitons

    International Nuclear Information System (INIS)

    We consider giant gravitons in the maximally supersymmetric type IIB plane-wave, in the presence of a constant NSNS B-field background. We show that in response to the background B-field the giant graviton would take the shape of a deformed three-sphere, the size and shape of which depend on the B-field, and that the giant becomes classically unstable once the B-field is larger than a critical value Bcr. In particular, for the B-field which is (anti-)self-dual under the SO(4) isometry of the original giant S3, the closed string metric is that of a round S3, while the open string metric is a squashed three-sphere. The squashed giant can be interpreted as a bound state of a spherical three-brane and circular D-strings. We work out the spectrum of geometric fluctuations of the squashed giant and study its stability. We also comment on the gauge theory which lives on the brane (which is generically a noncommutative theory) and a possible dual gauge theory description of the deformed giant. (author)

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. Laser treatment of giant xanthelasma palpebrarum.

    Science.gov (United States)

    Corradino, Bartolo; Di Lorenzo, Sara; Triolo, Antonio; Moschella, Francesco

    2015-11-01

    Xanthelasma palpebrarum is the most common cutaneous xanthoma. It typically presents in middle-aged and older adults, most often around the eyelids. The diagnosis is made clinically. Giant xanthelasmas palpebrarum are xanthelasmas that extensively affect the superior and inferior bilateral eyelids. Many techniques have been put forward for treating these lesions (surgical, laser, and chemical techniques), but we describe our experience in the treatment of giant xanthelasmas by ultrapulsed CO2 laser. Between 2009 and 2012, in the Division of Plastic and Reconstructive Surgery at the University of Palermo, 12 patients with giant xanthelasmas were treated using a CO2 laser. The laser parameters are as follows: frequency 20 Hz, energy 75 mJ, and power 1.5 W. Each laser session lasts 15 min; the treatment consists of three or four sessions that are carried out at intervals of 15 days. Patients were followed up after 2, 6, and 12 months. This technique is rapid and it is accepted very well by patients. The only disadvantage is a long healing time (10-15 days). The ultrapulsed CO2 laser, in experienced hands, is an excellent device that enables the complete removal of giant xanthelasmas with a minimally invasive but very effective technique. PMID:25252796

  4. Lyme carditis mimicking giant cell arteritis

    Directory of Open Access Journals (Sweden)

    Krati Chauhan

    2015-10-01

    Full Text Available Presenting an interesting case of a patient who complained of myalgias, fatigue, headache, jaw claudication and scalp tenderness. Patient’s physical examination was unremarkable. Laboratory findings showed elevated erythrocyte sedimentation rate and C-reactive protein, bilateral temporal artery biopsy results were negative and first degree atrioventricular block was seen on electrocardiogram. Serology for Borrelia burgdorferi was positive; patient was diagnosed with Lyme carditis and treated with doxycycline. Lyme is a tick-borne, multi-system disease and occasionally its presentation may mimic giant cell arteritis. On follow-up there was complete resolution of symptoms and electrocardiogram findings.

  5. 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.

  6. 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.

  7. 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, originati...... with bilateral symptoms. Our management, including successful pre-operative planning, enabled one-step total removal of both tumours and rapid patient recovery....... 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...... bilateral 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...

  8. Dynamos of giant planets

    OpenAIRE

    F. H. Busse; Simitev, R.

    2009-01-01

    Possibilities and difficulties of applying the theory of magnetic field generation by convection flows in rotating spherical fluid shells to the Giant Planets are outlined. Recent progress in the understanding of the distribution of electrical conductivity in the Giant Planets suggests that the dynamo process occurs predominantly in regions of semiconductivity. In contrast to the geodynamo the magnetic field generation in the Giant Planets is thus characterized by strong radial conductivity v...

  9. Nanodielectrics with giant permittivity

    Indian Academy of Sciences (India)

    S K Saha

    2008-06-01

    Nanodielectrics is an emerging area of research because of its potential application in energy storage and transducers. One-dimensional metallic nanostructures with localized electronic wave functions show giant dielectric constant. Following the prediction, during the last couple of years we have investigated the effect of giant permittivity in one-dimensional systems of conventional metals and conjugated polymer chains. In this article, we have tried to summarize the works on giant permittivity and finally the fabrication of nanocapacitor using metal nanowires, which shows giant permittivity is also discussed.

  10. 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

  11. 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.)

  12. The Gaia-ESO Survey: A simple explanation for the Li-rich giant problem

    DEFF Research Database (Denmark)

    Casey, Andrew R.; Ruchti, G.; Masseron, T.;

    2016-01-01

    The discovery of lithium-rich giants contradicts expectations from canonical stellar evolution. Although multiple scenarios have been proposed to preserve or produce Li, no model can explain the ensemble properties of Li-rich giants. We report on the serendipitous discovery of 20 Li-rich giants o...... minority population of evolved metal-poor Li-rich giants which are explainable by internal mixing processes associated with late evolutionary stages, or mass transfer from more evolved AGB stars....

  13. Greatest International ANtiinfective Trial (GIANT with moxifloxacin in the treatment of acute exacerbation of  chronic bronchitis: subanalysis of Chinese data of a global, multicenter, noninterventional study

    Directory of Open Access Journals (Sweden)

    Yulin Feng

    2010-03-01

    Full Text Available Yulin Feng1, Faguang Jin2, Shuang Mu3, Hong Shen4, Xiaohong Yang5, Yuling Wang6, Zhenshan Wang7, Yingjun Kong8, Zuke Xiao9, Qiming Feng101Respiratory Department, West China Hospital, Sichuan University, China; 2Respiratory Department, Tang Du Hospital, China; 3Respiratory Department, Peking University People’s Hospital, China; 4Emergency Department, The General Hospital of the People’s Liberation Army, China; 5Respiratory Department, Xinjiang People’s Hospital, China; 6Respiratory Department, Shi Jiazhuang First Hospital, China; 7Respiratory Department, The Second Affiliated Hospital of Dalian Medical University, China; 8Respiratory Department, The First Clinical College of Harbin Medical University, China; 9Respiratory Department, The Jiangxi Provincial People’s Hospital, China; 10Emergency Department, Shanghai Sixth People’s Hospital, ChinaBackground and objective: A single infective acute exacerbation of chronic bronchitis (AECB has a sustained effect on health status. Although a number of clinical investigations have demonstrated the efficacy of antibiotics in AECB, increased bacterial resistance has caused concern about the efficacy of currently available antibiotic therapies. This subanalysis of a global noninterventional study aimed to evaluate the impact of AECB on the patient and the community and the effectiveness and safety of a treatment with moxifloxacin (MXF tablets in daily life clinical practice in China.Methods: This prospective, noninterventional, noncontrolled, multicenter observational study, which started in China in April 2004 and ended in February 2007, was part of the global GIANT study. Patients with a diagnosis of mild to severe AECB were treated with MXF tablets 400 mg for a period at the physician’s discretion. The observation period for each patient covered a complete treatment period with MXF. For each patient, the physician documented data at an initial visit (baseline and at least one follow-up visit

  14. 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 ...

  15. Bilateral Symmetrical Parietal Extradural Hematoma

    OpenAIRE

    Agrawal, Amit

    2011-01-01

    The occurrence of bilateral extradural hematomas (EDH) is an uncommon consequence of craniocerebral trauma, and acute symmetrical bilateral epidural hematomas are extremely rare. We discuss the technique adopted by us for the management of this rare entity. A 55-year-old patient presented with history of fall of branch of tree on her head. She had loss of consciousness since then and had multiple episodes of vomiting. Examination of the scalp was suggestive of diffuse subgaleal hematoma. Her ...

  16. 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...

  17. Teflon strip pneumostasis for excision of giant emphysematous bullae.

    OpenAIRE

    Parmar, J M; Hubbard, W G; Matthews, H. R.

    1987-01-01

    Excision of giant emphysematous bullae commonly results in a persistent air leak that requires prolonged intercostal drainage and delays recovery. To minimise this we have used Teflon (polytetrafluoroethylene) strips to buttress the suture line and secure pneumostasis. During 1976-84 eight bullae were excised in seven patients. One patient had bilateral staged thoracotomies. All chest drains were removed within eight days (mean 4.5 days) and no patient developed pulmonary complications. At lo...

  18. 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

  19. Simultaneous Bilateral Ophthalmic Artery Chemosurgery for Bilateral Retinoblastoma (Tandem Therapy)

    Science.gov (United States)

    Abramson, David H.; Marr, Brian P.; Francis, Jasmine H.; Dunkel, Ira J.; Fabius, Armida W. M.; Brodie, Scott E.; Mondesire-Crump, Ijah; Gobin, Y. Pierre

    2016-01-01

    Objective Report on the 7-year experience with bilateral ophthalmic artery chemosurgery (OAC-Tandem therapy) for bilateral retinoblastoma. Design Retrospective, single institution study. Subjects 120 eyes of 60 children with bilateral retinoblastoma treated since March 2008. Methods Retrospective review of all children treated at Memorial Sloan Kettering with bilateral ophthalmic artery chemosurgery (Melphalan, Carboplatin, Topotecan, Methotrexate) delivered in the same initial session to both naïve and previously treated eyes. Main Outcome Measures Ocular survival, metastatic disease, patient survival from metastases, second cancers, systemic adverse effects, need for transfusion of blood products, electroretinogram before and after treatment. Results 116 eyes were salvaged (4 eyes were enucleated: 3 because of progressive disease, 1 family choice). Kaplan Meier ocular survival was 99.2% at one year, 96.9% at 2 and 3 years and 94.9% for years 4 through 7. There were no cases of metastatic disease or metastatic deaths with a mean follow-up of 3.01 years. Two children developed second cancers (both pineoblastoma) and one of them died. Transfusion of blood products was required in 3 cases (4 transfusions), 1.9%. Two children developed fever/neutropenia requiring hospitalization (0.95%). ERGs were improved in 21.6% and unchanged after treatment in 52.5% of cases (increase or decrease of less than 25μV). Conclusions Bilateral ophthalmic artery chemosurgery is a safe and effective technique for managing bilateral retinoblastoma-even when eyes are advanced bilaterally, and if both eyes have progressed after systemic chemotherapy. Ocular survival was excellent (94.9% at 8 years), there were no cases of of metastatic disease and no deaths from metastatic disease, but children remain at risk for second cancers. In 21.6% of cases ERG function improved. Despite using chemotherapy in both eyes in the same session, systemic toxicity was low. PMID:27258771

  20. Rotation of Giant Stars

    CERN Document Server

    Kissin, Yevgeni

    2015-01-01

    The internal rotation of post-main sequence stars is investigated, in response to the convective pumping of angular momentum toward the stellar core, combined with a tight magnetic coupling between core and envelope. The spin evolution is calculated using model stars of initial mass 1, 1.5 and $5\\,M_\\odot$, taking into account mass loss on the giant branches and the partitioning of angular momentum between the outer and inner envelope. We also include the deposition of orbital angular momentum from a sub-stellar companion, as influenced by tidal drag as well as the excitation of orbital eccentricity by a fluctuating gravitational quadrupole moment. A range of angular velocity profiles $\\Omega(r)$ is considered in the deep convective envelope, ranging from solid rotation to constant specific angular momentum. We focus on the backreaction of the Coriolis force on the inward pumping of angular momentum, and the threshold for dynamo action in the inner envelope. Quantitative agreement with measurements of core ro...

  1. 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

  2. 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.

  3. 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.

  4. 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…

  5. 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.

  6. 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.

  7. Effect comparison of unilateral and bilateral internal fixation combined with nucleus pulposus removal of intervertebral fusion operation treating lumbar disc herniation%单侧和双侧内固定联合髓核摘除椎间融合术治疗腰椎间盘突出症的效果比较

    Institute of Scientific and Technical Information of China (English)

    王宁

    2015-01-01

    Objective To compare the effect of unilateral and bilateral internal fixation combined with nucleus pulposus removal of intervertebral fusion operation treating lumbar disc herniation. Methods 49 cases with single gap lumbar disc herniation treated with nucleus pulposus removal of intervertebral fusion operation from January 2010 to December 2012 in our hospital were retrospectively analyzed. Based the fixed way,patients were divided into unilateral fixation group and bilateral fixation group.The surgery time,intraoperative bleeding amount,hospital stay,hospital expense,VAS score of pain,Oswestry disability index (ODI) score,fusion rate and incidence rate of complication between two groups was compared respectively. Results Before operation,there was no statistical difference of VAS,ODI score between two groups (P>0.05),and VAS,ODI score of two groups was significantly reduced respectively at the last follow-up (P0.05).The surgery time in unilateral fixation group was ob-viously shorter than that of bilateral fixation group,intraoperative bleeding amount in unilateral fixation group was obvi-ously less than that of bilateral fixation group,hospital expense in unilateral fixation group was obviously lower than that of bilateral fixation group (P0.05). Conclusion The curative efficacy of unilateral and bilateral internal fixation interverte-bral fusion for single gap lumbar disc herniation is almost the same,but unilateral internal fixation has shorter operation time,less intraoperative bleeding amount and lower hospital expense.%目的:比较单侧和双侧内固定联合髓核摘除椎间融合术治疗腰椎间盘突出症的效果。方法回顾性分析本院2010年1月~2012年12月行髓核摘除椎间融合固定术治疗的49例单间隙腰椎间盘突出症患者。依据固定方式将患者分为单侧内固定组和双侧内固定组。比较两组的手术用时、术中出血量、住院时间、住院费用、疼痛VAS评分、Oswestry功能障碍

  8. Concomitant bilateral testicular epidermoid cysts

    International Nuclear Information System (INIS)

    Epidermoid cyst of the testis is a rare benign germ tumor, comprising 1-2% of all resected benign testicular masses. Approximately 300 cases have been reported to date. Unilateral involvement has often been reported in the English literature. However, bilateral occurrence is very rare and to the best of our knowledge, there only 3 previous reports of bilateral testicular epidermoid cysts. The fact that they are completely benign makes them amenable to treatment by local excision, thereby saving patient from orchidectomy. Recognition of their characteristic ulatrsonographic features is very important to avoid unnecessary intervention. We present here, a case of bilateral epidermoid cyst in which characteristic ultrasound (US) findings allowed testis-sparing enucleation instead of radical orchiectomy. (author)

  9. Early Deprivation Impairs the Development of Balance and Bilateral Coordination

    OpenAIRE

    Roeber, Barbara J.; Gunnar, Megan R.; Pollak, Seth D.

    2013-01-01

    This study examined balance and bilateral coordination skills in a sample of internationally adopted, post-institutionalized (PI) children. We compared the performance of these PI children to two age-matched groups. One was a group of children who were internationally adopted from foster care (FC). The second group consisted of non-adopted children being raised in their birth families, who served as controls (Control). Both PI and FC children scored lower than control children on balance, whi...

  10. Sequential bilateral retinal artery occlusion

    OpenAIRE

    Padrón-Pérez N; Aronés JR; Muñoz S; Arias-Barquet L; Arruga J

    2014-01-01

    Noel Padrón-Pérez,1 Janny Rosario Aronés,2 Silvia Muñoz,1 Luis Arias-Barquet,1 Jorge Arruga1,31Department of Ophthalmology, Hospital Universitari de Bellvitge, 2Hospital de l'Esperança – Parc de Salut Mar, 3Institut Català de Retina, Barcelona, SpainAbstract: An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic...

  11. 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...

  12. Seismology of Giant Planets

    CERN Document Server

    Gaulme, Patrick; Schmider, Francois-Xavier; Guillot, Tristan

    2014-01-01

    Seismology applied to giant planets could drastically change our understanding of their deep interiors, as it has happened with the Earth, the Sun, and many main-sequence and evolved stars. The study of giant planets' composition is important for understanding both the mechanisms enabling their formation and the origins of planetary systems, in particular our own. Unfortunately, its determination is complicated by the fact that their interior is thought not to be homogeneous, so that spectroscopic determinations of atmospheric abundances are probably not representative of the planet as a whole. Instead, the determination of their composition and structure must rely on indirect measurements and interior models. Giant planets are mostly fluid and convective, which makes their seismology much closer to that of solar-like stars than that of terrestrial planets. Hence, helioseismology techniques naturally transfer to giant planets. In addition, two alternative methods can be used: photometry of the solar light ref...

  13. Giants in Transmedia

    Directory of Open Access Journals (Sweden)

    Mare Kõiva

    2016-06-01

    Full Text Available The purpose of this article is to discuss transmedia narratives based on giant lore, which is described by means of examples from folkloristics and transmedia dissemination. Giant lore, particularly the epic Kalevipoeg, a core text of Estonian culture, has generated numerous transmedially circulating texts and various contemporary forms. Through their connections with media, texts about giants continue to participate in the national cultural space; in previous eras, they have been carriers of Estonian identity or, alternatively, have held an important place in the creation of local identities. The latter can be observed today in printed matter, advertisements, and products marketed to the homeland public. However, texts about giants can also be used as a self-characterising image directed beyond national space. The article provides a closer look at ways in which stories connected with Kalevipoeg and Suur Tõll are engaged in different levels of media, as well as necessary contextual cultural knowledge for understanding contemporary media clips.

  14. Metaphyseal giant cell tumor

    International Nuclear Information System (INIS)

    Three cases of metaphyseal giant cell tumor are presented. A review of the literature is done, demostrating the lesion is rare and that there are few articles about it. Age incidence and characteristics of the tumor are discussed. (Author)

  15. Metaphyseal giant cell tumor

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, L.F.; Hemais, P.M.P.G.; Aymore, I.L.; Carmo, M.C.R. do; Cunha, M.E.P.R. da; Resende, C.M.C.

    Three cases of metaphyseal giant cell tumor are presented. A review of the literature is done, demostrating the lesion is rare and that there are few articles about it. Age incidence and characteristics of the tumor are discussed.

  16. Giant primary cerebral hydatid cyst: A rare cause of childhood seizure

    OpenAIRE

    Shilpa Khanna Arora; Anju Aggarwal; Varsha Datta

    2014-01-01

    We report a 9-year-old girl who presented with focal seizures, hemiparesis, headache, vomiting and bilateral optic atrophy. CT scan revealed a giant solitary cyst in the left parietal lobe. Serology and histopathology of the excised cyst confirmed the diagnosis of neurohydatidosis which is a rare cause of childhood seizure.

  17. Giant peritoneal loose bodies

    Directory of Open Access Journals (Sweden)

    Chris van Zyl

    2015-03-01

    Full Text Available Giant peritoneal loose bodies are rare lesions, originating from auto-amputated appendices epiploicae. They may cause urinary or gastrointestinal obstruction and, should the radiologist not be familiar with the entity, can potentially be confused with malignant or parasitic lesions.Familiarity with their characteristic computed tomographic features is essential to prevent unnecessary surgery in the asymptomatic patient. We present a case of a 70-year-old man diagnosed with two giant peritoneal loose bodies.

  18. Giant adrenal myelolipoma

    OpenAIRE

    Fernandes Gwendolyn; Gupta Rajib; Kandalkar Bhuvaneshwari

    2010-01-01

    Adrenal myelolipoma is a rare benign tumor composed of adipose and hematopoietic tissue. Most tumors are small in size and incidentally detected. We report a case of giant adrenal myelolipoma weighing 2200 gms which was diagnosed on radiology as a liposarcoma. This case is unusual in view of the large size and presence of bony spicules. To the best of our knowledge, not more than 10 giant adrenal myelolipoma cases have been reported in literature.

  19. 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.

  20. Bilateral posterior cerebral artery infarction

    OpenAIRE

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA

  1. 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.

  2. 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

  3. 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

  4. 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

  5. Acute Isolated Bilateral Mydriasis: Case Reports and Review of the Literature

    OpenAIRE

    Sato, Hiromasa; Naito, Kosuke; Hashimoto, Takao

    2014-01-01

    Isolated bilateral internal ophthalmoplegia is a rare and problematic condition affecting activities of daily living. Herein, we describe the cases of 2 patients with postinfectious isolated bilateral internal ophthalmoplegia, i.e., mydriasis without external ophthalmoplegia. One patient demonstrated no other neurological symptom, while the other patient showed mild gait ataxia. Magnetic resonance imaging revealed no abnormal findings in the brain or brainstem. Light-near dissociation of the ...

  6. Infectious mononucleosis presenting as bilateral acute dacryocystitis.

    OpenAIRE

    Atkinson, P L; Ansons, A M; Patterson, A.

    1990-01-01

    A case of infectious mononucleosis presenting as bilateral acute dacryocystitis in a 7-year-old girl is reported. Acute dacryocystitis is uncommon in this age group, and an underlying systemic illness should be suspected particularly when it is bilateral.

  7. Asteroseismology of red giant stars: The potential of dipole modes

    Directory of Open Access Journals (Sweden)

    Montalbán J.

    2013-03-01

    Full Text Available Since the detection of non-radial solar-like oscillation modes in red giants with the CoRoT satellite, the interest in the asteroseismic properties of red giants and the link with their global properties and internal structure is increasing. Moreover, more and more precise data are being collected with the space-based telescopes CoRoT and Kepler. Particularly relevant has been the detection of mixed modes in a large number of G-K red giants. In this contribution we discuss the potential of these dipole mixed modes to provide information on core extra-mixing and transport of angular momentum.

  8. Bilateral ovarian tumour in a young girl

    OpenAIRE

    2013-01-01

    Bilateral ovarian tumour in a girl presents the dilemma of conservative versus aggressive approach towards these tumours. When faced with suspicious tumour and complete replacement of the ovaries bilaterally, bilateral oophorectomy is a viable option, though the certain possibility of infertility and lifelong hormonal supplementation is unavoidable. We report a case of bilateral ovarian masses in a young girl, which on histopathological examination showed mature teratoma with aggregates of pr...

  9. 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...

  10. 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...

  11. 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...

  12. The possibility of giant dielectric materials for multilayer ceramic capacitors

    OpenAIRE

    Ishii, Tatsuya; Endo, Makoto; Masuda, Kenichiro; Ishida, Keisuke

    2013-01-01

    There have been numerous reports on discovery of giant dielectric permittivity materials called internal barrier layer capacitor in the recent years. We took particular note of one of such materials, i.e., BaTiO3 with SiO2 coating. It shows expressions of giant electric permittivity when processed by spark plasma sintering. So we evaluated various electrical characteristics of this material to find out whether it is applicable to multilayer ceramic capacitors. Our evaluation revealed that the...

  13. Decay of giant resonances

    International Nuclear Information System (INIS)

    With energies of the order of 10 to 20 MeV giant resonances are the fastest known vibrations of a many-body system. Their typical widths of a few MeV show that these resonances are strongly damped. It is clearly of interest to study the nature of the damping mechanism. For that purpose it is important that excitation energies associated with giant resonances in general are sufficiently high to allow for decay by emission of nucleons or α- particles or -in heavy nuclei- by fission. In other words, giant resonances rank among the few known structures embedded in the nuclear continuum. This makes it possible and interesting to study their properties by coincidence experiments where excitation by inelastic scattering and decay by particle emission are simultaneously registered. It is the purpose of this article to review the brief history of such experiments, their analysis and interpretation. 219 refs, figs and tabs

  14. Bilateral diffuse pigmented villonodular synovitis of the knee.

    Science.gov (United States)

    Klammer, Georg; Betz, Michael; Delaloye, Barbara; Farshad, Mazda; Peter, Koch P

    2013-12-01

    Pigmented villonodular synovitis (PVNS) is a proliferative disease of synovial tissue characterized by lipid-laden macrophages, multinucleated giant cells, and hemosiderin deposits. PVNS presents either in a localized form with minimal rates of recurrence after surgical resection or in a diffuse form with an expansive growth pattern showing formation of osseous erosions and extra-articular manifestation. In the diffuse form high recurrence rates occur as a result of the challenge of achievement of total synovectomy. Typically only one single joint, being the knee in 80% of cases, is involved with diffuse PVNS. Reports of bi- or multiarticular manifestation are at best rare. Here, a case of a 16-year-old girl with bilateral diffuse PVNS of the knee allows discussion of diagnostic and treatment considerations. PMID:23288770

  15. International

    International Nuclear Information System (INIS)

    This rubric reports on 10 short notes about international economical facts about nuclear power: Electricite de France (EdF) and its assistance and management contracts with Eastern Europe countries (Poland, Hungary, Bulgaria); Transnuclear Inc. company (a 100% Cogema daughter company) acquired the US Vectra Technologies company; the construction of the Khumo nuclear power plant in Northern Korea plays in favour of the reconciliation between Northern and Southern Korea; the delivery of two VVER 1000 Russian reactors to China; the enforcement of the cooperation agreement between Euratom and Argentina; Japan requested for the financing of a Russian fast breeder reactor; Russia has planned to sell a floating barge-type nuclear power plant to Indonesia; the control of the Swedish reactor vessels of Sydkraft AB company committed to Tractebel (Belgium); the renewal of the nuclear cooperation agreement between Swiss and USA; the call for bids from the Turkish TEAS electric power company for the building of the Akkuyu nuclear power plant answered by three candidates: Atomic Energy of Canada Limited (AECL), Westinghouse (US) and the French-German NPI company. (J.S.)

  16. Bilateral posterior cerebral artery infarction.

    Science.gov (United States)

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA infarction, no aetiological cause was identified. Unlike the transient nature of symptoms in some cases following unilateral infarction, his deficits persisted on 2-month follow-up. PMID:22798298

  17. China's Bilateral Currency Swap Lines

    OpenAIRE

    Zhitao, Lin; Wenjie, Zhan; Cheung, Yin-Wong

    2016-01-01

    We study the determinants of China’s bilateral local currency swap lines that were established since the recent global finance crisis. It is found that economic factors, political considerations, and institutional characteristics including trade intensity, economic size, strategic partnership, free trade agreement, corruption, and stability affect the decision of signing a swap line agreement. Once a swap line agreement decision is made, the size of the swap line is then mainly affected by tr...

  18. Bilateral monopolies and location choice

    OpenAIRE

    Brekke, Kurt R.; Straume, Odd Rune

    2002-01-01

    We analyse how equilibrium locations in location-price games à la Hotelling are affected when firms acquire inputs through bilateral monopoly relations with suppliers. Assuming a duopoly downstream market, we consider the case of two independent input suppliers bargaining with both downstream firms. We find that the presence of input suppliers changes the locational incentives of downstream firms in several ways, compared with the case of exogenous production costs. Bargaining induces downstr...

  19. 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 ...

  20. Giant perigenital seborrheic keratosis.

    Science.gov (United States)

    Bandyopadhyay, Debabrata; Saha, Abanti; Mishra, Vivek

    2015-01-01

    Seborrheic keratosis (SK) is a very common benign epidermal proliferation that is prevalent in all races. Most commonly occurring on the trunk, face, scalp, and the extremities, they can occur anywhere on the body except the palms and soles. The most common appearance is that of a very superficial verrucous plaque which appears to be stuck on the surface. Giant lesions are very rare, and their location on the genital area is rarer still. We report here a case of multiple giant SK lesions in a 59-year-old man. PMID:25657917

  1. Giant perigenital seborrheic keratosis

    Directory of Open Access Journals (Sweden)

    Debabrata Bandyopadhyay

    2015-01-01

    Full Text Available Seborrheic keratosis (SK is a very common benign epidermal proliferation that is prevalent in all races. Most commonly occurring on the trunk, face, scalp, and the extremities, they can occur anywhere on the body except the palms and soles. The most common appearance is that of a very superficial verrucous plaque which appears to be stuck on the surface. Giant lesions are very rare, and their location on the genital area is rarer still. We report here a case of multiple giant SK lesions in a 59-year-old man.

  2. Giant perigenital seborrheic keratosis

    OpenAIRE

    Debabrata Bandyopadhyay; Abanti Saha; Vivek Mishra

    2015-01-01

    Seborrheic keratosis (SK) is a very common benign epidermal proliferation that is prevalent in all races. Most commonly occurring on the trunk, face, scalp, and the extremities, they can occur anywhere on the body except the palms and soles. The most common appearance is that of a very superficial verrucous plaque which appears to be stuck on the surface. Giant lesions are very rare, and their location on the genital area is rarer still. We report here a case of multiple giant SK lesions in a...

  3. An innocent giant

    Directory of Open Access Journals (Sweden)

    Lakhan Singh Solanki

    2014-01-01

    Full Text Available A cutaneous horn (cornu cutaneum is a protrusion from the skin composed of a cornified material. It may be associated with a benign, premalignant, or malignant lesion at the base, masking numerous dermatoses. In a 24-year-old female, a giant cutaneous horn arising from a seborrheic keratosis located on the leg is presented. This case has been reported to emphasize that a giant cutaneous horn may also occur in young patients, even in photoprotected areas, and are not always associated with malignancy.

  4. Giant cutaneous horn

    Directory of Open Access Journals (Sweden)

    Kumaresan M

    2008-01-01

    Full Text Available A 53-year-old male presented with a giant cutaneous horn over the left leg. Cutaneous horn was excised and primary closure of the defect was done under spinal anesthesia. Histopathology showed underlying seborrheic keratosis. Cutaneous horn has been noticed on top of many clinical conditions of diverse etiology, such as actinic keratoses, wart, molluscum contagiosum, seborrheic keratoses, keratoacanthoma, basal cell and squamous cell carcinoma. We report a patient with giant cutaneous horn on the leg successfully treated by excision and wound closure.

  5. 单双侧椎弓根钉内固定结合椎间融合术治疗腰椎椎间盘突出症初期疗效比较%Early clinical effects of internal fixation with unilateral versus bilateral transpedicle screws combined with intervtebral fusion in lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    夏才伟; 王生介; 厉晓龙; 刘伟峰; 刘俊; 杨雷; 蒋小军

    2011-01-01

    Objective To compare the early clinical effects of internal fixation with unilateral versus bilateral transpedicle screws combined with intervertebral fusion in lumbar disc herniation. Methods From March 2008 to June 2009, 40 patients with L4/L5 disc herniation were treated by internal fixation with unilateral ( n = 16 ) or bilateral ( n = 24) transpedicle screws combined with intervertebral fusion. The pre- and postoperative data of patients were compared between the 2 techniques, such as visual analog scale (VAS) and Oswestry disability index (ODI) scores, operation time, blood loss, hospital days, cost of hospitalization, fusion rate and incidence rate of complications. Results The differences of the preoperative VAS and ODI scores between patients with different operation had no statistic significance ( P > 0. 05 ), and neither had the differences of VAS and ODI scores, fusion rate, and incidence rate of complications at the last follow-up (P>0. 05). The postoperative data of all patients were better than those before surgery. The operation time, blood loss and cost of hospitalization of patients with unilateral instruments were better than those of patients with bilateral instruments. Conclusion The internal fixation with unilateral transpedicle screws combined with intervertebral fusion is as effective as with bilateral instruments in L4/L5 disc herniation, which is lower cost, less operation time and blood loss during the operation.%目的 探讨单侧椎弓根钉内固定结合椎间融合术治疗L4/L5椎间盘突出症的初期临床疗效及优势.方法 2008年3月~2009年6月行内固定椎体间融合术治疗L4/L5椎间盘突出症患者40例,其中单侧内固定16例,平均随访22.1个月;双侧内固定24例,平均随访20.8个月.比较2种手术患者术前疼痛视觉模拟量表(visual analog scale,VAS)和Oswestry功能障碍指数(Oswestry disability index,ODI)评分、手术时间、术中出血量、术后住院天数、住院费用

  6. Finite Size Giant Magnon

    CERN Document Server

    Ramadanovic, Bojan

    2008-01-01

    The quantization of the giant magnon away from the infinite size limit is discussed. We argue that this quantization inevitably leads to string theory on a Z_M-orbifold of S^5. This is shown explicitly and examined in detail in the near plane-wave limit.

  7. Giant prolactinomas in women

    DEFF Research Database (Denmark)

    Delgrange, Etienne; Raverot, Gerald; Bex, Marie;

    2014-01-01

    OBJECTIVE: To characterise distinctive clinical features of giant prolactinomas in women. DESIGN: A multicentre, retrospective case series and literature review. METHODS: We collected data from 15 female patients with a pituitary tumour larger than 4 cm and prolactin levels above 1000 μg/l and id...

  8. A giant ureteric calculus.

    Science.gov (United States)

    Rathod, Rajiv; Bansal, Prashant; Gutta, Srinivas

    2013-07-01

    Ureteric stones are usually small and symptomatic. We present a case of a 35-year old female who presented with minimally symptomatic right distal ureteric calculus with proximal hydroureteronephrosis. Laparoscopic right ureterolithotomy was performed and a giant ureteric calculus measuring 11 cm Χ 1.5 cm, weighing 40 g was retrieved. PMID:24082453

  9. A giant ureteric calculus

    OpenAIRE

    Rathod, Rajiv; Bansal, Prashant; Gutta, Srinivas

    2013-01-01

    Ureteric stones are usually small and symptomatic. We present a case of a 35-year old female who presented with minimally symptomatic right distal ureteric calculus with proximal hydroureteronephrosis. Laparoscopic right ureterolithotomy was performed and a giant ureteric calculus measuring 11 cm Χ 1.5 cm, weighing 40 g was retrieved.

  10. Giant urethral calculus

    OpenAIRE

    Kotkar, Kunal; Thakkar, Ravi; Songra, MC

    2011-01-01

    Primary urethral calculus is rarely seen and is usually encountered in men with urethral stricture or diverticulum. We present a case of giant urethral calculus secondary to a urethral stricture in a man. The patient was treated with calculus extraction with end to end urethroplasty.

  11. Giant solitary trichoepithelioma

    DEFF Research Database (Denmark)

    Jemec, B; Løvgreen Nielsen, P; Jemec, G B;

    1999-01-01

    The giant solitary trichoepithelioma is a rare trichogenic tumor with potential for local recurrence. Only nine cases have been previously described in the literature, and one additional case without recurrence during the first 3.5 years of observation is presented stressing that the rate of...

  12. Fear and panic in humans with bilateral amygdala damage

    OpenAIRE

    Feinstein, Justin S.; Buzza, Colin; Hurlemann, Rene; Follmer, Robin L.; Dahdaleh, Nader S.; Coryell, William H.; Welsh, Michael J.; Tranel, Daniel; Wemmie, John A.

    2013-01-01

    Decades of research have highlighted the amygdala’s influential role in fear. Surprisingly, we found that inhalation of 35% CO2 evoked not only fear, but also panic attacks, in three rare patients with bilateral amygdala damage. These results indicate that the amygdala is not required for fear and panic, and make an important distinction between fear triggered by external threats from the environment versus fear triggered internally by CO2.

  13. Bilateral posterior shoulder dislocation after electrical shock: A case report

    OpenAIRE

    Ismail Emre Ketenci; Tahir Mutlu Duymus; Ayhan Ulusoy; Hakan Serhat Yanik; Serhat Mutlu; Mehmet Oguz Durakbasa

    2015-01-01

    Introduction: Posterior dislocation of the shoulder is a rare and commonly missed injury. Unilateral dislocations occur mostly due to trauma. Bilateral posterior shoulder dislocations are even more rare and result mainly from epileptic seizures. Electrical injury is a rare cause of posterior shoulder dislocation. Injury mechanism in electrical injury is similar to epileptic seizures, where the shoulder is forced to internal rotation, flexion and adduction. Presentation of case: This report...

  14. 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...

  15. 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

  16. 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

  17. Immediate Sequential Bilateral Cataract Surgery

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper

    2015-01-01

    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......-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...

  18. 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

  19. A Diagnostic for Localizing Red Giant Differential Rotation

    CERN Document Server

    Klion, Hannah

    2016-01-01

    We present a simple diagnostic that can be used to constrain the location of the differential rotation in red giants with measured mixed mode rotational splittings. Specifically, in red giants with radii $\\sim 4R_\\odot$, the splittings of p-dominated modes (sound wave dominated) relative to those of g-dominated modes (internal gravity wave dominated) are sensitive to how much of the differential rotation resides in the outer convection zone versus the radiative interior of the red giant. An independently measured surface rotation rate significantly aids breaking degeneracies in interpreting the measured splittings. We apply our results to existing observations of red giants, particularly those of Kepler-56, and find that most of the differential rotation resides in the radiative region rather than in the convection zone. This conclusion is consistent with results in the literature from rotational inversions, but our results are insensitive to some of the uncertainties in the inversion process and can be readi...

  20. Recurrent giant hypogastric artery aneurysms--a case report.

    Science.gov (United States)

    Golden, R L; Bauman, J; Johnstone, M; Pindyck, F

    1988-07-01

    Aneurysms of the hypogastric artery are rare occurrences that are frequently asymptomatic until the time of rupture. When signs and symptoms are present, a pulsatile pelvic mass, frequently detected by rectal or vaginal examination, may produce compression symptoms with urologic, gastrointestinal, and neurologic manifestations. In addition to classical invasive methods of detection such as angiography, newer noninvasive imaging techniques, including ultrasonography, computerized tomography, and magnetic resonance imaging, may be employed to establish the diagnosis. Proximal ligation of the hypogastric artery is the usual method of treatment. A case of bilateral, giant hypogastric artery aneurysms with successful surgical management is reported. PMID:3044197

  1. [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

  2. Multiresolution Bilateral Filtering for Image Denoising

    OpenAIRE

    Zhang, Ming; Gunturk, Bahadir K.

    2008-01-01

    The bilateral filter is a nonlinear filter that does spatial averaging without smoothing edges; it has shown to be an effective image denoising technique. An important issue with the application of the bilateral filter is the selection of the filter parameters, which affect the results significantly. There are two main contributions of this paper. The first contribution is an empirical study of the optimal bilateral filter parameter selection in image denoising applications. The second contri...

  3. Trade of permits for greenhouse gas emissions: Bilateral trade need not be the answer

    OpenAIRE

    Burguet, Roberto; Sempere, Jaume

    2010-01-01

    The Kyoto Protocol sets national quotas on GHG emissions and allows international trade of these quotas. Taking terms-of-trade effects into account, we argue that this trade is characterized by asymmetric, identity-dependent externalities, and show that bilateral trade of permits may not be sufficient for an efficient allocation of emissions. We derive conditions under which bilateral trade does improve the allocation of permits. The conditions are strong. In this sense, we argue that, for em...

  4. Multispin giant magnons

    International Nuclear Information System (INIS)

    We investigate giant magnons from classical rotating strings in two different backgrounds. First we generalize the solution of Hofman and Maldacena and investigate new magnon excitations of a spin chain which are dual to a string on RxS5 with two nonvanishing angular momenta. Allowing string dynamics along the third angle in the five sphere, we find a dispersion relation that reproduces the Hofman and Maldacena one and the one found by Dorey for the two spin case. In the second part of the paper we generalize the two 'spin' giant magnon to the case of β-deformed AdS5xS5 background. We find agreement between the dispersion relation of the rotating string and the proposed dispersion relation of the magnon bound state on the spin chain

  5. Giant duodenal ulcers

    Institute of Scientific and Technical Information of China (English)

    Eric Benjamin Newton; Mark R Versland; Thomas E Sepe

    2008-01-01

    Giant duodenal ulcers (GDUs) are a subset of duodenal ulcers that have historically resulted in greater morbidity than usual duodenal ulcers. Until recently,few cases had been successfully treated with medical therapy. However, the widespread use of endoscopy,the introduction of H-2 receptor blockers and proton pump inhibitors, and the improvement in surgical techniques all have revolutionized the diagnosis,treatment and outcome of this condition. Nevertheless,GDUs are still associated with high rates of morbidity,mortality and complications. Thus, surgical evaluation of a patient with a GDU should remain an integral part of patient care. These giant variants, while usually benign, can frequently harbor malignancy. A careful review of the literature highlights the important differences when comparing GDUs to classical peptic ulcers and why they must be thought of differently than their more common counterpart.

  6. Bilateral ovarian tumour in a young girl

    Directory of Open Access Journals (Sweden)

    Krishna Kumar Govindarajan

    2013-01-01

    Full Text Available Bilateral ovarian tumour in a girl presents the dilemma of conservative versus aggressive approach towards these tumours. When faced with suspicious tumour and complete replacement of the ovaries bilaterally, bilateral oophorectomy is a viable option, though the certain possibility of infertility and lifelong hormonal supplementation is unavoidable. We report a case of bilateral ovarian masses in a young girl, which on histopathological examination showed mature teratoma with aggregates of proliferating capillary and cavernous sized vessels in the tumour wall. Such associations are rare and must be differentiated from a vascular neoplasm.

  7. Bilateral Clavicle Fracture in two Newborn Infants

    Directory of Open Access Journals (Sweden)

    Ali Kanik

    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.

  8. 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.

  9. Boom goes the price : giant resource discoveries and real exchange rate appreciation

    OpenAIRE

    Harding, Torfinn; Stefanski, Radoslaw (Radek); Toews, Gerhard

    2016-01-01

    We estimate the effect of giant oil and gas discoveries on bilateral real exchange rates. The size and plausibly exogenous timing of such discoveries make them ideal for identifying the effects of an anticipated resource boom on prices. We find that a giant discovery with the value of a country's GDP increases the real exchange rate by 14% within 10 years following the discovery. The appreciation is nearly exclusively driven by an appreciation of the prices of non-tradable goods. We show that...

  10. Giant Otters in Peru

    Directory of Open Access Journals (Sweden)

    Schenk C.

    1992-02-01

    Full Text Available We are in the second year of fieldwork surveying for Giant Otters in the southeastern rainforest of Peru, in three areas with differing levels of legal protection. While there is some illegal hunting still happening outside the protected areas, the main threat to the otters is badly-conducted tourism. Well-organised tourism can be a promising argument for establishing protected areas like national parks.

  11. Giant Mediastinal Teratoma

    OpenAIRE

    Ilkay Albayrak

    2013-01-01

    The most of mediastinal germ cell tumors are teratomas. The main purpose of the treatment of immature and mature teratomas is completly resection of the mass. However, surgical problems may be occur due to proximity with vital structures. In this case, subtotal resection can be performed. Recurrence is rare, and the prognosis is usually very good. In this report, a case of the giant mediastinal mature cystic teratoma that applied subtotal resection due to pericardial adhesions is presented.

  12. Intraoral giant condyloma acuminatum

    Directory of Open Access Journals (Sweden)

    Gupta R

    2001-09-01

    Full Text Available A case of intraoral giant condyloma acuminatum is reported in a 50- year- old Indian. He did not respond to topical application of podophyllin 20% but responded partially to electric cauterisation. Surgical excision was done to get rid of the warty growh completely. Since there were no skin or genital lesions and no history of marital or extramarital sexual contact the lesion was probably acquired from environmental sources. Nonsexual transmission should be considered especially when the lesions are extragenital.

  13. Giant Otters in Peru

    OpenAIRE

    Schenk C.; Staib E.

    1992-01-01

    We are in the second year of fieldwork surveying for Giant Otters in the southeastern rainforest of Peru, in three areas with differing levels of legal protection. While there is some illegal hunting still happening outside the protected areas, the main threat to the otters is badly-conducted tourism. Well-organised tourism can be a promising argument for establishing protected areas like national parks.

  14. Lipomas gigantes Giants lipomas

    Directory of Open Access Journals (Sweden)

    Pietro Accetta

    1998-10-01

    Full Text Available The authors report two cases of giants lipomas in the gluteal region with 3,9 and 3,1 kg. They make a brief epidemiological presentation and consider diagnosis and treatment. They believe that CT scan is the best image method, as it provides more information about size and relationship with surrounding structures. They are against biopsies and lipoaspiration but stand up for the total exeresis as the best option of treatment.

  15. A Case Report of Bilateral Mirror Clubfeet and Bilateral Hand Polydactyly

    OpenAIRE

    Nguyen, Mai P; Lawler, Ericka A.; Morcuende, Jose A.

    2014-01-01

    We report a rare case of a patient with bilateral mirror clubfeet and bilateral hand polydactyly. The patient presented to our orthopaedic clinic with bilateral mirror clubfeet, each with eight toes, and bilateral hands with six fingers and a hypoplastic thumb. The pattern does not fit any described syndrome such as Martin or Laurin-Sandrow syndrome. Treatments by an orthopaedic pediatric surgeon and an orthopaedic pediatric hand surgeon are described. The patient achieved excellent functiona...

  16. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation

    OpenAIRE

    Rajendra Nehete; Anita Nehete; Sandeep Singla; Harshad Adhav

    2012-01-01

    In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally s...

  17. 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.

  18. Bilateral Auricular Milia en Plaque

    Directory of Open Access Journals (Sweden)

    Savaş

    2011-12-01

    Full Text Available Milia en plaque (MEP is an extremely rare form of milia that is characterized by a number of milia-like cysts on an erythematous base and histologically exhibits features of keratin cysts. The etiology is not exactly known. MEP is generally seen among middle-aged women and especially on the head and neck region. Many of the diagnosed cases are localized in the retroauricular region, eyelids and the nose region. To date, no case of MEP in the auricula has been reported in the literature. In this article, we present the case of a 71-year-old female patient clinically and histologically diagnosed with bilateral auricular milia en plaque (in the external ear canal in the light of current literature. (Turk­derm 2011; 45: 216-8

  19. 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.

  20. 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.

  1. BILATERAL OVARIAN TORSION: A CASE REPORT

    OpenAIRE

    Manohar; Gopalakrishna; Kavyashree; Kala; Karthik

    2014-01-01

    : Bilateral ovarian torsion is a rare event with only a few cases reported in literature in women using ovarian stimulation drugs and in pre-menarchal age group with synchronous and asynchronous ovarian tumors. We hereby present a case of bilateral ovarian torsion in a 16 year old girl who presented as an acute pain abdomen and was diagnosed intra operatively.

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. Bilateral microperc in a severe kyphoscoliosis

    Science.gov (United States)

    Dağgülli, Mansur; Penbegül, Necmettin; Dede, Onur; Utanğaç, Mehmet Mazhar

    2016-01-01

    Percutaneous nephrolithotomy is the standard modality for large renal calculi in normal and abnormal renal anatomic situations. This case report describes a 57-year-old male patient who presented with bilateral kidney stones and severe kyphoscoliosis. He had successfully been treated with a bilateral microperc technique. PMID:27011881

  7. 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.

  8. 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...

  9. Bilateral programmes of cooperation in the safety review and enhancement of the operating NPPs with RBMK reactors

    International Nuclear Information System (INIS)

    International cooperation in the safety review and enhancement of the operating NPPs with RBMK reactors is realized both within the frame of multilateral international projects such as CEC sponsored TACIS programme, the IAEA Extrabudgetary Programme on RBMK safety and EBRD Nuclear Safety Account, and on the bilateral basis. Among the countries participating in the bilateral projects on RBMK safety are the USA, Japan, Germany, Italy, Switzerland, Great Britain, Sweden, France, Canada and others. It should be emphasized that multilateral and bilateral programmes are mutually complementary

  10. A rare case of giant leiomyosarcoma in a filarial scrotum: a case report

    Directory of Open Access Journals (Sweden)

    Kallianpur Ashwin A

    2011-02-01

    Full Text Available Abstract Giant leiomyosarcoma of scrotum is a rare tumour. A case of scrotum leiomyosarcoma is presented in a 67 year old patient with scrotal filariasis which was managed successfully with total scrotectomy with bilateral orchidectomy, degloved penis reconstructed with rotation advancement supra pubic fasciocutaneous flap. We made a literature search proving the rarity of this lesion type. Only 36 cases have been described and the first case in a filarial scrotum

  11. Giant Cardiac Cavernous Hemangioma.

    Science.gov (United States)

    Unger, Eric; Costic, Joseph; Laub, Glenn

    2015-07-01

    We report the case of an asymptomatic giant cardiac cavernous hemangioma in a 71-year-old man. The intracardiac mass was discovered incidentally during surveillance for his prostate cancer; however, the patient initially declined intervention. On presentation to our institution 7 years later, the lesion had enlarged significantly, and the patient consented to excision. At surgery, an 8 × 6.5 × 4.8 cm intracardiac mass located on the inferior heart border was excised with an intact capsule through a median sternotomy approach. The patient had an uneventful postoperative course. We discuss the diagnostic workup, treatment, and characteristics of this rare cardiac tumor. PMID:26140782

  12. Giant infantile pulmonary hemangioma

    International Nuclear Information System (INIS)

    We present a very unusual case of giant infantile pulmonary hemangioma presenting as a large solitary pulmonary mass. This was successfully managed with surgical resection. Histological examination revealed that the mass was positive for GLUT-1 receptor, a marker for infantile hemangioma. To our knowledge only a few cases of pulmonary hemangioma have been described previously in the literature. Pulmonary hemangiomas are very rare lesions, most of them presenting as a pulmonary mass. This case emphasizes the fact that this rare lesion should be considered in the differential of an enhancing pulmonary mass in an infant. (orig.)

  13. GIANT PROSTHETIC VALVE THROMBUS

    Directory of Open Access Journals (Sweden)

    Prashanth Kumar

    2015-04-01

    Full Text Available Mechanical prosthetic valves are predisposed to bleeding, thrombosis & thromboembolic complications. Overall incidence of thromboembolic complications is 1% per year who are on oral anticoagulants, whereas bleeding complications incidence is 0.5% to 6.6% per year. 1, 2 Minimization of Scylla of thromboembolic & Charybdis of bleeding complication needs a balancing act of optimal antithrombotic therapy. We are reporting a case of middle aged male patient with prosthetic mitral valve presenting in heart failure. Patient had discontinued anticoagulants, as he had subdural hematoma in the past. He presented to our institute with a giant prosthetic valve thrombus.

  14. Multispin Giant Magnons

    OpenAIRE

    Bobev, N. P.; Rashkov, R. C.

    2006-01-01

    We investigate giant magnons from classical rotating strings in two different backgrounds. First we generalize the solution of Hofman and Maldacena and investigate new magnon excitations of a spin chain which are dual to a string on $R\\times S^5$ with two non-vanishing angular momenta. Alowing string dynamics along the third angle in the five sphere, we find a dispersion relation that reproduces the Hofman and Maldacena and the one found by Dorey for the two spin case. In the second part of t...

  15. Giant Ulcerative Dermatofibroma

    Directory of Open Access Journals (Sweden)

    Turgut Karlidag

    2013-01-01

    Full Text Available Dermatofibroma is a slowly growing common benign cutaneous tumor characterized by hard papules and nodules. The rarely seen erosions and ulcerations may cause difficulties in the diagnosis. Dermatofibrosarcoma protuberans, which is clinically and histopathologically of malignant character, displays difficulties in the diagnosis since it has similarities with basal cell carcinoma, epidermoid carcinoma, and sarcomas. Head and neck involvement is very rare. In this study, a giant dermatofibroma case, which is histopathologically, ulcerative dermatofibroma, the biggest lesion of the head and neck region and seen rarely in the literature that has characteristics similar to dermatofibrosarcoma protuberans, has been presented.

  16. Giant Pandas and Their Conservation

    Institute of Scientific and Technical Information of China (English)

    GarethDavey

    2004-01-01

    IT is paradoxical that themost well-known conservation symbol in the world,the giant panda, is a criti-cally endangered species.The estimated 1,600 thatremain live in the high-altitude for-ests of southwest China (within theprovinces of Sichuan, Gansu andShaanxi). Giant pandas are popularand elicit affection and admiration

  17. Famine Threatens the Giant Panda

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Large swathes of arrow bamboo groves at and above 2,700 meters in the Piankou Nature Reserve in Sichuan's Mianyang are producing purple blooms, and some groves have started to wither and die. An absence of bamboo means famine for giant pandas living there. Sichuan has consequently activated its giant panda contingency plan.

  18. Juno and Cassini Proximal: Giant Steps Towards Understanding Giant Planets

    Science.gov (United States)

    Stevenson, D. J.

    2014-12-01

    In 2016-17, Juno and Cassini Proximal will provide comparable large advances in our understanding of the interiors of Jupiter and Saturn. Both will provide high accuracy gravity and magnetic field data, while Juno will in addition determine the water abundance deep in the Jovian atmosphere, essential for understanding of giant planet formation and the density of the outer envelope (needed to construct interior models). Although Jupiter and Saturn are both gas giants, they differ in important ways (magnetic field, strength of zonal flows, enrichment in heavy elements, and probably the distribution of helium within). The opportunity to contrast and compare will be invaluable. Juno and Cassini are expected to determine the gravity field to about a part in 109 though with different spatial coverage and with less accurate determination near the poles. The determination of Jupiter's likely central concentration of heavy elements is particularly challenging because it is only a few percent at most of the total mass and yet important for understanding Jupiter's formation, which in turn likely determined the architecture of our solar system. This determination will be done from gravity, water determination and magnetic field and also aided by advances in our understanding of material properties. The corresponding determination for Saturn may prove easier (because the heavy element enrichment is a larger fraction of the mass) though complicated by lack of knowledge of water abundance and the need to identify a more precise value for the deep rotation of the planet (difficult for Saturn because of the lack of a measurable magnetic dipole tilt thus far). For both planets, the higher harmonics of gravity will likely be controlled by differential rotation (the zonal flows) and this will tell us their depth, an issue of major interest in the dynamics of these bodies. The magnetic field structure for Jupiter will be determined to higher accuracy than the Earth's core field (since

  19. Giant solitary trichoepithelioma

    Directory of Open Access Journals (Sweden)

    Bhavuray Teli

    2015-01-01

    Full Text Available Adnexal tumors like giant solitary trichoepitheliomas are uncommon to most of us to permit a ready familiarity with them. Information regarding the genesis, clinical profile, behavior, and management options for this tumor is limited. There are 18 cases reported in the world literature till date. This review attempts to provide insight to this rare tumor. Our search included indexed literature from Pubmed, Directory of Open Access Journals, Health Inter Network Access to Research Initiative and Google databases in addition to standard dermatology texts. Giant solitary trichoepithelioma is a rare trichogenic tumor with potential for local recurrence. It has predilection for the older age, but may present at any age including at birth. It has close resemblance to basal cell carcinoma and other skin adnexal tumors - clinically, cytologically, and histologically. CD10, CD 34, PHLDA1 but not p75NTR are useful adjunct markers. Surgical excision is the standard treatment. Recurrence and possible transformation into BCC cautions follow up at regular intervals.

  20. Giant solitary trichoepithelioma.

    Science.gov (United States)

    Teli, Bhavuray; Thrishuli, P B; Santhosh, R; Amar, D N; Rajpurohit, Shravan

    2015-01-01

    Adnexal tumors like giant solitary trichoepitheliomas are uncommon to most of us to permit a ready familiarity with them. Information regarding the genesis, clinical profile, behavior, and management options for this tumor is limited. There are 18 cases reported in the world literature till date. This review attempts to provide insight to this rare tumor. Our search included indexed literature from Pubmed, Directory of Open Access Journals, Health Inter Network Access to Research Initiative and Google databases in addition to standard dermatology texts. Giant solitary trichoepithelioma is a rare trichogenic tumor with potential for local recurrence. It has predilection for the older age, but may present at any age including at birth. It has close resemblance to basal cell carcinoma and other skin adnexal tumors - clinically, cytologically, and histologically. CD10, CD 34, PHLDA1 but not p75NTR are useful adjunct markers. Surgical excision is the standard treatment. Recurrence and possible transformation into BCC cautions follow up at regular intervals. PMID:25839021

  1. 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.

  2. Bilateral symmetry across Aphrodite Terra

    International Nuclear Information System (INIS)

    There are three main highland areas on Venus: Beta Regio, Ishtar Terra and Aphrodite Terra. The latter is least known and the least mapped, yet existing analyses of Aphrodite Terra based on available Pioneer-Venus orbiter data suggest that it may be the site of extensive rifting. Some of the highest resolution (30 km) PV data (SAR) included most of the western half of Aphrodite Terra. Recent analysis of the SAR data together with Arecibo range-doppler topographic profiling (10 X 100 km horizontal and 10 m vertical resolution) across parts of Aphrodite, further characterized the nature of possible tectonic processes in the equatorial highlands. The existence of distinct topographic and radar morphologic linear discontinuities across the nearly east-west strike of Aphrodite Terra is indicated. Another prominent set of linear features is distinctly parallel to and orthogonal to the ground tracks of the PV spacecraft and are not included because of the possibility that they are artifacts. Study of the northwest trending cross-strike discontinuities (CSD's) and the nature of topographic and morphologic features along their strike suggest the presence of bilateral topographic and morphologic symmetry about the long axis of Aphrodite Terra

  3. What Determines Bilateral Trade Flows?

    OpenAIRE

    Marianne Baxter; Michael A. Kouparitsas

    2006-01-01

    This paper undertakes an exhaustive search for robust determinants of international trade, where "robustness" is tested using three popular empirical methods. The paper is frankly atheoretical: our goal is solely to establish statistically robust relationships. Along the way, however, we relate our results to the empirical results obtained by prior researchers and to the received theory of international trade. We find that robust variables include a measure of the scale of factor endowments; ...

  4. 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.

  5. Bilateral facial palsy associated with leptospirosis

    Directory of Open Access Journals (Sweden)

    Andressa Alves da Silva

    2009-08-01

    Full Text Available Leptospirosis is a zoonosis of worldwide occurrence caused by the spirochete Leptospira interrogans. It is an acute feverish disease with a broad clinical spectrum and follows a characteristic biphasic course. Bilateral facial palsy is a rare clinical condition and the differential diagnosis of its causes is extensive. The objective of this exploratory study, presented as a case report, is to describe the occurrence of bilateral facial palsy as an unusual manifestation of leptospirosis. This suggestion should not be overlooked when analyzing the causes for bilateral facial palsy, and should be considered with other possible differential diagnoses, some of which are potentially fatal.

  6. Bilateral persistent primitive trigeminal arteries associated with trigeminal neuralgia.

    Science.gov (United States)

    Son, B; Yang, S; Sung, J; Lee, S

    2013-03-01

    Persistent carotid-vertebrobasilar anastomoses (PCVBA) include the primitive trigeminal artery (PTA), the primitive otic artery (POA), the primitive hypoglossal artery and proatlantal arteries (ProAs). The PTA is the most commonly seen of these accounting for approximately 80-85% of PCVBAs. The PTA which connects the internal carotid artery (ICA) to the basilar artery (BA) may occasionally connect to the superior or posterior inferior cerebellar arteries without interposition to the BA. It is then referred to as a persistent trigeminal artery variant (PTAV), an anomalous carotid-cerebellar anastomosis. Bilateral occurrence of PTA is extremely rare. During vertebral artery (VA) development the anterior radicular artery of segment C1 from the proatlantal artery of Padget evolves into the intradural component of the VA (V4 segment) plus a short extradural segment (distal V3 segment). Agenesis of a single anterior radicular artery of ProA results in the absence of one distal VA associated with an unremarkable contralateral VA and the BA. Absence or hypoplasia of the terminal portion of one VA is a commonly observed anatomic variant. However, absence of the terminal portions of both VAs is exceptional. A rare case of bilateral PTAs is presented with unilateral PTA and a contralateral PTAV causing trigeminal neuralgia. Furthermore, the bilateral PTAs were associated with the absence of the proximal portion of the BA in addition to the bilateral lack of a distal VA. This finding comes as a logical consequence of the developmental anatomy of the vertebrobasilar junction and is consistent with the assumed congenital nature of the anatomic variant. PMID:22113402

  7. Prenatal Diagnosis of Bilateral Pulmonary Agenesis: a Case Report

    International Nuclear Information System (INIS)

    We report a case of bilateral pulmonary agenesis (BPA), which was suspected during a prenatal US examination and diagnosed by fetal magnetic resonance imaging (MRI). BPA is an extremely rare congenital anomaly and, although many fetal structural defects can be detected with a high degree of confidence after introducing high-resolution US, the prenatal diagnosis of BPA remains problematic. Other thoracic abnormalities, such as a congenital diaphragmatic hernia, congenital cystic adenomatoid malformation, and pulmonary sequestration, should be excluded from the list of possible diagnoses before coming to the conclusion of BPA, because BPA is absolutely incompatible with extrauterine life, and an accurate internal diagnosis can prevent a futile intervention from being performed

  8. 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.

  9. 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.

  10. Giant magnetofossils and hyperthermal events

    Science.gov (United States)

    Chang, Liao; Roberts, Andrew P.; Williams, Wyn; Fitz Gerald, John D.; Larrasoaña, Juan C.; Jovane, Luigi; Muxworthy, Adrian R.

    2012-10-01

    Magnetotactic bacteria biomineralize magnetic minerals with precisely controlled size, morphology, and stoichiometry. These cosmopolitan bacteria are widely observed in aquatic environments. If preserved after burial, the inorganic remains of magnetotactic bacteria act as magnetofossils that record ancient geomagnetic field variations. They also have potential to provide paleoenvironmental information. In contrast to conventional magnetofossils, giant magnetofossils (most likely produced by eukaryotic organisms) have only been reported once before from Paleocene-Eocene Thermal Maximum (PETM; 55.8 Ma) sediments on the New Jersey coastal plain. Here, using transmission electron microscopic observations, we present evidence for abundant giant magnetofossils, including previously reported elongated prisms and spindles, and new giant bullet-shaped magnetite crystals, in the Southern Ocean near Antarctica, not only during the PETM, but also shortly before and after the PETM. Moreover, we have discovered giant bullet-shaped magnetite crystals from the equatorial Indian Ocean during the Mid-Eocene Climatic Optimum (˜40 Ma). Our results indicate a more widespread geographic, environmental, and temporal distribution of giant magnetofossils in the geological record with a link to "hyperthermal" events. Enhanced global weathering during hyperthermals, and expanded suboxic diagenetic environments, probably provided more bioavailable iron that enabled biomineralization of giant magnetofossils. Our micromagnetic modelling indicates the presence of magnetic multi-domain (i.e., not ideal for navigation) and single domain (i.e., ideal for navigation) structures in the giant magnetite particles depending on their size, morphology and spatial arrangement. Different giant magnetite crystal morphologies appear to have had different biological functions, including magnetotaxis and other non-navigational purposes. Our observations suggest that hyperthermals provided ideal conditions for

  11. Giant Congenital Melanocytic Nevus

    DEFF Research Database (Denmark)

    Rasmussen, Bo Sonnich; Henriksen, Trine Foged; Kølle, Stig-Frederik Trojahn;

    2015-01-01

    , and 25% versus 44% required unplanned additional surgery, respectively. Complications were noted in 25% and 67% of the patients, respectively. Cosmetic result was satisfying in 76% of patients without difference between the groups. No malignant transformation was found during a mean follow-up of 11......Giant congenital melanocytic nevi (GCMN) occur in 1:20,000 livebirths and are associated with increased risk of malignant transformation. The treatment of GCMN from 1981 to 2010 in a tertiary referral center was reviewed evaluating the modalities used, cosmetic results, associated complications......, and malignant transformation. Of 35 patients, 25 underwent surgery. Curettage was most frequently used (64%) followed by excision and tissue expansion (20%). Six percent of the patients treated with curettage, and 78% of the patients who received excision surgery required more than 1 planned procedure...

  12. Two giant stellar complexes

    Science.gov (United States)

    Efremov, Yu. N.; Efremov, E. Yu.

    Common star complexes are huge (0.3-1 kpc in diameter) groups of relatively young stars, associations and clusters. The complexes usually form regular chains along spiral arms of grand design galaxies, being evidently formed and supported by magneto- gravitational instability developing along an arm. Special attention is given to a few large complexes which have signatures of gravitational boundness, such as round shape and high central density. Concentrations of stars and clusters in such a complex in M51 galaxy were found in this paper; we concluded it is possible to suggest that the complex is gravitationally bound. It is also stressed that some properties of the giant complex in NGC 6946 (such as its semicircular and sharp Western edge) are still enigmatic.

  13. Lumbar discal cyst causing bilateral radiculopathy

    OpenAIRE

    Hyung-Jun, Kwak; Dae-Yong, Kim; Tae-Ho, Kim; Ho-Sang, Park; Jae-Sung, Kim; Jae-Won, Jang; Jung-Kil, Lee; Pawl, Ron; Nancy E Epstein; Bydon, Ali

    2011-01-01

    Background: Discal cyst is a rare lesion that can result in clinical symptoms typical of disc herniation manifesting as a unilateral single nerve root lesion. To the best of the authors’ knowledge, this is the first reported case of discal cyst resulting in bilateral radiculopathy. Case Description: A 48-year-old female presented with bilateral sciatica and neurogenic claudication for 3 months. Magnetic resonance imaging revealed an extradural cystic lesion compressing the ventral aspect of t...

  14. Diagnosis and management of bilateral nasolabial cysts

    OpenAIRE

    Rajkumar Parwani; Simran Parwani; Sangeeta Wanjari

    2013-01-01

    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...

  15. Bilateral Hypertrophic Olivary Degeneration in Wilson Disease

    OpenAIRE

    Otto, Josephin; Guenther, Peter; Hoffmann, Karl-Titus

    2013-01-01

    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...

  16. 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

  17. Superpixel Convolutional Networks using Bilateral Inceptions

    OpenAIRE

    Gadde, Raghudeep; Jampani, Varun; Kiefel, Martin; Gehler, Peter V.

    2015-01-01

    In this paper we propose a CNN architecture for image segmentation. We introduce a new "bilateral inception" layer that is used on top of a convolutional architecture. The bilateral inception performs a filtering between superpixels in an image. This addresses two problems that arise with CNN segmentation architectures. First, this layer propagates information between (super) pixels while respecting image edges, thus using the structured information of the problem for improved results. Second...

  18. Bilateral lipoma arborescens associated with early osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Al-Ismail, Khalid; Torreggiani, William C.; Keogh, Ciaran; Munk, Peter L. [Department of Radiology, Vancouver General Hospital, 855 West 12th Avenue, Vancouver, BC, Canada V5Z 1M9 (Canada); Al-Sheikh, Fahad [Department of Radiology, Riyadh Military Hospital (Saudi Arabia)

    2002-11-01

    Lipoma arborescens is a rare disease that has generally been considered to be unilateral. We report a case of bilateral disease in a patient with associated marked premature osteoarthritis of the knees. We postulate a possible association between these two conditions and explain a possible underlying mechanism. We suggest that lipoma arborescens be considered as a rare underlying cause of young patients with bilateral premature osteoarthritis, and recommend MRI as the definitive imaging modality. (orig.)

  19. Complementarity between Bilateral Trade and Financial Integration

    OpenAIRE

    Shin, Kwanho; Yang, Doo Yong

    2006-01-01

    This paper explores the complementarities between bilateral trade in goods and financial assets. By utilizing a gravity model specification with an extended dataset in terms of time span and asset classification as well as alternative instrumental variables, we confirm the existence of positive evidence for complementarities. We find that common factors such as bilateral distance and other economic size variables that determine both cross-border trade and financial flows contribute to complem...

  20. Giant prolactinoma: the sound of silence

    Directory of Open Access Journals (Sweden)

    Shira R. Saul

    2014-06-01

    Full Text Available Prolactinomas typically present with oligoamenorrhea or galactorrhea in woman and headaches, visual changes or impotence in men with auditory symptoms being a rare presentation. We describe a case of a man who presented with bilateral hearing loss and was found to have a giant prolactinoma. Initial audiogram indicated an air-bone conduction gap suggesting a mixed sensorineural and conductive hearing loss. Measured prolactin was 3711.0 ng/mL and an a magnetic resonance revealed a 3.0×3.0×3.3 cm heterogeneously enhancing mass arising from the sella turcica compressing the left half of the optic chiasm. Several months after treatment, prolactin was 26 ng/mL and the patient reported marked improvement in his vision with mild improvement of his hearing. Although prolactinomas typically present with classic symptoms, one must be aware of unusual presentations. Further investigation is needed to access the correlation between prolactin and hearing loss, which may impact potential audiology screening for those with elevated prolactin.

  1. 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.

  2. 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.

  3. A Case Report of Bilateral Mirror Clubfeet and Bilateral Hand Polydactyly

    Science.gov (United States)

    Nguyen, Mai P; Lawler, Ericka A; Morcuende, Jose A

    2014-01-01

    We report a rare case of a patient with bilateral mirror clubfeet and bilateral hand polydactyly. The patient presented to our orthopaedic clinic with bilateral mirror clubfeet, each with eight toes, and bilateral hands with six fingers and a hypoplastic thumb. The pattern does not fit any described syndrome such as Martin or Laurin-Sandrow syndrome. Treatments by an orthopaedic pediatric surgeon and an orthopaedic pediatric hand surgeon are described. The patient achieved excellent functional and cosmetic outcomes at four year follow-up. PMID:25328478

  4. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation

    Directory of Open Access Journals (Sweden)

    Rajendra Nehete

    2012-01-01

    Full Text Available In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally symmetric and aesthetically superior to the osteoplastic reconstruction. The technical details are discussed, and the long term functional and aesthetic results are presented.

  5. Giant hepatic cavernous hemangioma. Findings on computed helical tomography

    International Nuclear Information System (INIS)

    Objective: To describe computed helical tomography characteristics of the giant hepatic cavernous hemangioma. Method: During five years, we evaluated 21 patients with 21 giant hepatic cavernous hemangiomas with computed helical and multislice tomography. We included 18 women (86%) and 3 men (14%) with a mean age of 45 years. Results: The mean size of hemangiomas was 10.4 cm. Non enhanced computed tomography Showed 21 hemangiomas with lower density than adjacent hepatic parenchyma , all hemangiomas showed a central cleft area with low density. None hemangioma showed calcifications neither internal septa. In enhanced helical tomography all lesions demonstrated a globular, peripheral enhancing pattern with centripetal filling that begin in the arterial phase and continued in portal and delayed phases. None of the lesions showed complete filling. Conclusion: giant hepatic cavernous hemangiomas showed low attenuation in non enhanced computed tomography. central cleft area was very frequently seen. The enhancement pattern is characteristic, starting at the periphery with centripetal filling but it was never complete.

  6. Embryonic development and organogenesis of Chinese giant salamander, Andrias davidianus

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The morphology and organogenesis of Chinese giant salamander, Andrias davidianus, in its different developmental periods and stages are described in detail, which provides an intact criterion for distinguishing different stages of its developmental process.Based on the external morphological and internal histological features, six periods including 20 stages of organogenesis of Chinese giant salamander are established, which are cleavage period, blastula period, gastrula period, neurula period, organogenesis stage and hatching stage. Generally, the embryonic development of Chinese giant salamander is consistent with those of Eastern newt, Cynops orientalis,and Black spots frog, R. nigromaculata. However, they have some differences in the early cleavage process and the development of digestive system. The cleavage of Chinese giant salamander, A. davidianus is not a discoidal division type, which is different from other species reported. And the first three cleavages being meridional and a retardant development of its digestive system without halter and sucker existing are the evident features of the embryonic development of Chinese giant salamander.

  7. Landscape of the lost giants

    Science.gov (United States)

    2013-09-01

    The Pleistocene megafauna extinction erased a group of remarkable animals. Whether humans had a prominent role in the extinction remains controversial, but it is emerging that the disappearance of the giants has markedly affected the environment.

  8. Collective motion and giant resonances

    International Nuclear Information System (INIS)

    The report contains 15 papers devoted to problems of giant collective excitations of nuclei, heavy-ion induced reactions and their bearing on various aspects of nuclear structure. In some of them the numerical data are given. (A.S.)

  9. 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.)

  10. Are giant resonances harmonic vibrations?

    International Nuclear Information System (INIS)

    Giant resonances are understood as the first quantum of collective vibrations. The non-linear response of a quantum anharmonic oscillator is investigated as a model for the excitation of giant resonances in heavy ion collisions. It is shown that the introduction of small anharmonicities and non-linearities can double the predicted cross section for the excitation of the two-phonon states. (R.P.)

  11. Rotation rates of giant stars

    International Nuclear Information System (INIS)

    The rotation rates and macroturbulence dispersion of 14 G and K giants were measured using Fourier reduction of spectral-line profiles. The high-spectral-resolution, high-signal-to-noise observations were taken with the Coude Echelle Spectrometer of the European Southern Observatory. Good agreement was found between the present results and previous investigations, showing that no large systematic differences are introduced by using different spectrographs and detectors. The results generally confirm the low rotation seen for cool giants. 14 refs

  12. Kuiper Prize: Giant Planet Atmospheres

    Science.gov (United States)

    Ingersoll, Andrew P.

    2007-10-01

    The study of giant planet atmospheres is near and dear to me, for several reasons. First, the giant planets are photogenic; the colored clouds are great tracers, and one can make fantastic movies of the atmosphere in motion. Second, the giant planets challenge us with storms that last for hundreds of years and winds that blow faster the farther you go from the sun. Third, they remind us of Earth with their hurricanes, auroras, and lightning, but they also are the link to the 200 giant planets that have been discovered around other stars. This talk will cover the past, present, and future (one hopes) of giant planet research. I will review the surprises of the Voyager and Galileo eras, and will discuss what we are learning now from the Cassini orbiter. I will review the prospects for answering the outstanding questions like: Where's the water? What is providing the colors of the clouds? How deep do the features extend? Where do the winds get their energy? What is the role of the magnetic field? Finally, I will briefly discuss how extrasolar giant planets compare with objects in our own solar system.

  13. 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

  14. A Rare Clinical Presentation of Giant Bilateral Labial Fibroepithelial Stromal Polyps in Patient with Psoriasis Disease

    Directory of Open Access Journals (Sweden)

    Ayse Filiz Avsar

    2016-01-01

    Full Text Available Fibroepithelial polyps (FEPs are rarely seen lesions of the lower female genital tract with polypoid proliferations of stroma. These tumors usually present in the vulvovaginal region of the reproductive aged women. In this presentation, we report a case of a psoriatic woman who developed unusual multiple polypoid lesions approximately 15 cm in size arising from both left and right labia minora and unique connection of FEPs with psoriasis disease.

  15. 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)

  16. Bilateral cooperation in the field of nuclear non-proliferation

    International Nuclear Information System (INIS)

    It is noted, than key role in organization of international assesment in the field of nuclear non-proliferation in Kazakhstan played bilateral agreements between Kazakhstan and USA in the framework of 'Cooperative Threat Reduction' (CTR) program initiated by US Senators - S.Nann and R.Lugar. Conversion projects in the framework of CTR program were fulfilled (total project sum - $154,328,000). Nann-Lugar program in Kazakhstan achieved it's own purpose of total nuclear weapons liquidation. But now there are number a humanitarian problems (population health rehabilitation and contaminated areas re cultivation) which should be solved. Now Kazakhstan can not solving of these problems because lack of means. Authors note, that it is necessary international support similar to Nann-Lugar program initiative for solving of these urgent tasks

  17. Imaging Extrasolar Giant Planets

    CERN Document Server

    Bowler, Brendan P

    2016-01-01

    High-contrast adaptive optics imaging is a powerful technique to probe the architectures of planetary systems from the outside-in and survey the atmospheres of self-luminous giant planets. Direct imaging has rapidly matured over the past decade and especially the last few years with the advent of high-order adaptive optics systems, dedicated planet-finding instruments with specialized coronagraphs, and innovative observing and post-processing strategies to suppress speckle noise. This review summarizes recent progress in high-contrast imaging with particular emphasis on observational results, discoveries near and below the deuterium-burning limit, and a practical overview of large-scale surveys and dedicated instruments. I conclude with a statistical meta-analysis of deep imaging surveys in the literature. Based on observations of 384 unique and single young ($\\approx$5--300~Myr) stars spanning stellar masses between 0.1--3.0~\\Msun, the overall occurrence rate of 5--13~\\Mjup \\ companions at orbital distances ...

  18. Giant high occipital encephalocele

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2016-03-01

    Full Text Available Encephaloceles are rare embryological mesenchymal developmental anomalies resulting from inappropriate ossification in skull through with herniation of intracranial contents of the sac. Encephaloceles are classified based on location of the osseous defect and contents of sac. Convexity encephalocele with osseous defect in occipital bone is called occipital encephalocele. Giant occipital encephaloceles can be sometimes larger than the size of baby skull itself and they pose a great surgical challenge. Occipital encephaloceles (OE are further classified as high OE when defect is only in occipital bone above the foramen magnum, low OE when involving occipital bone and foramen magnum and occipito-cervical when there involvement of occipital bone, foramen magnum and posterior upper neural arches. Chiari III malformation can be associated with high or low occipital encephaloceles. Pre-operatively, it is essential to know the size of the sac, contents of the sac, relation to the adjacent structures, presence or absence of venous sinuses/vascular structures and osseous defect size. Sometimes it becomes imperative to perform both CT and MRI for the necessary information. Volume rendered CT images can depict the relation of osseous defect to foramen magnum and provide information about upper neural arches which is necessary in classifying these lesions.

  19. Bringing Low the Giants

    CERN Multimedia

    2001-01-01

    Their work goes on unseen, because they a hundred metres beneath your feet. But while the race against the clock to build the LHC has begun on the surface, teams underground are feverishly engaged to dismantle LEP and its experiments. Four months after the start of dismantling, the technical coordinators of the different experiments discuss the progress of work. Little men attack the giant ALEPH. The barrel and its two endcaps have been removed to the end of the cavern and stripped of their cables. The breaking up of the detector can now begin. At ALEPH, counting rooms removed all in one go Jean-Paul Fabre, technical coordinator at ALEPH:'After making safe the structure, the first step was to remove the wiring and cables. Some 210 cubic metres were brought out. Then the counting rooms all round the detector were taken out. They were brought up from the cavern all in one go, up through the shaft, which is 10 metres wide and 150 metres deep. They made it with 15 centimetres to spare. They have been emptied of...

  20. Guillain-Barre Syndrome Presenting With Bilateral Facial Nerve Palsy

    Directory of Open Access Journals (Sweden)

    Soroor INALOO

    2014-01-01

    paralysis: case presentation and discussion of differential diagnosis. J Gen Intern Med 2006; 21(7:C7-10.Kamaratos A, Kokkoris S, Protopsaltis J, Agorgianitis D, Koumpoulis H, Lentzas J et al. Simultaneous Bilateral Facial Palsy in a Diabetic Patient. Diabetes Care 2004; 27 (2: 623-24.Magliocca KR, Leung EM, Desmond JS. Parotid swelling and facial nerve palsy: an uncommon presentation of sarcoidosis. Gen Dent 2009; 57(2:180-2.Atsumi M, Kitaguchi M, Nishikawa S, Susuki K. A variant of Guillain-Barré syndrome with prominent bilateral peripheral facial nerve palsy-facial diplegia and paresthesias. Rinsho Shinkeigaku 2004 Aug; 44(8:549-52.Narayanan RP, James N, Ramachandran K, Jaramillo MJ. Guillain-Barré Syndrome presenting with bilateral facial nerve paralysis: a case report. Cases J 2008 Dec 8;1(1:379.Azarisman SMS, Shahrin TCA, Marzuki AO, Fatnoon NNA, Rathor MY. Bilateral facial nerve palsy secondary to an atypical presentation of Guillain-Barré syndrome. IMJ 2009; 8(1:41-4.Sethi NK, Torgovnick J, Arsura E, Johnston A, Buescher E. Facial diplegia with hyperreflexia--a mild Guillain-Barre Syndrome variant, to treat or not to treat? J Brachial Plex Peripher Nerve Inj 2007; 10(2:9.Burina A, Sinanović O, Smajlović D, Vidovic. Bilateral Oculomotor Nerve Palsy in Guillain-barre Syndrome. Med Arh 2008; 62 (2:119-120.Verma R, Chaudhari TS, Giri P. Unilateral facial palsy in Guillain-Barre syndrome (GBS: a rare occurrence. BMJ Case Rep 2012 Oct 19; 2012. pii: bcr2012007077. doi: 10.1136/bcr-2012-007077.Susuki K, Koga M, Hirata K, Isogai E, Yuki N.A Guillain-Barré syndrome variant with prominent facial diplegia. J Neurol 2009; 256(11: 1899-1905.

  1. 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

  2. Will You Buy My Peg? the Credibility of a Fixed Exchange Rate Regime As a Determinant of Bilateral Trade

    OpenAIRE

    Emilia Magdalena Jurzyk; Bernhard Fritz-Krockow

    2004-01-01

    This paper examines the relationship between fixed exchange rate arrangements and trade using a gravity model of international trade together with bilateral trade data from 24 countries from the Caribbean and Latin America for the period 1960-2001. The analysis indicates that a credible fixed peg has a positive impact on the value of bilateral trade. Moreover, the positive impact on trade is more pronounced with a stricter definition of the fixed peg or a longer duration of the peg. This supp...

  3. A unique advantage for giant eyes in giant squid.

    Science.gov (United States)

    Nilsson, Dan-Eric; Warrant, Eric J; Johnsen, Sönke; Hanlon, Roger; Shashar, Nadav

    2012-04-24

    Giant and colossal deep-sea squid (Architeuthis and Mesonychoteuthis) have the largest eyes in the animal kingdom [1, 2], but there is no explanation for why they would need eyes that are nearly three times the diameter of those of any other extant animal. Here we develop a theory for visual detection in pelagic habitats, which predicts that such giant eyes are unlikely to evolve for detecting mates or prey at long distance but are instead uniquely suited for detecting very large predators, such as sperm whales. We also provide photographic documentation of an eyeball of about 27 cm with a 9 cm pupil in a giant squid, and we predict that, below 600 m depth, it would allow detection of sperm whales at distances exceeding 120 m. With this long range of vision, giant squid get an early warning of approaching sperm whales. Because the sonar range of sperm whales exceeds 120 m [3-5], we hypothesize that a well-prepared and powerful evasive response to hunting sperm whales may have driven the evolution of huge dimensions in both eyes and bodies of giant and colossal squid. Our theory also provides insights into the vision of Mesozoic ichthyosaurs with unusually large eyes. PMID:22425154

  4. 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 on...

  5. 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.

  6. Bilateral Supernumerary Kidney: A Very Rare Presentation

    International Nuclear Information System (INIS)

    To our knowledge, bilateral supernumerary kidney is a very rare renal abnormality and there are five cases presented in the literature. It is difficult to diagnose supernumerary kidney and clinicians have not detected most cases preoperatively. Laboratory and imaging studies were acquired and carefully examined. The normal laboratory tests were found. Emergency ultrasonography was performed and they revealed no signs of parenchymal abnormality in both kidneys. Serial imaging study including enhanced computed tomography (CT) was performed. An imaging study identified bilateral supernumerary kidney with expanded collecting systems. On each side, significant rotation anomaly was found. In addition, there were two different renal arteries originating from the aorta. This report presents radiological determinations of supernumerary kidney bilaterally in a young man. We think that CT commonly appears to be enough for the diagnosis of supernumerary kidneys

  7. Danish Exports and Danish Bilateral Aid

    DEFF Research Database (Denmark)

    Hansen, Henrik; Rand, John

    was much higher in the 1980s compared to in particular the most recent decade. This may be related to factors such as untying of aid in the same period. The econometric analysis has two important limitations. First of all, the model can only give information about marginal changes in aid. As a...... 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......; increasing recipient income where higher income leads to higher imports, and decreased trade costs, say due to improved information about cultural and administrative customs and practices. Thus, as for preferential trade arrangements, bilateral aid has two potential economic effects; trade creation working...

  8. Reactive direction control for a mobile robot: A locust-like control of escape direction emerges when a bilateral pair of model locust visual neurons are integrated

    OpenAIRE

    Yue, Shigang; Santer, Roger D; Yamawaki, Yoshifumi; Rind, F. Claire

    2010-01-01

    Locusts possess a bilateral pair of uniquely identifiable visual neurons that respond vigorously to the image of an approaching object. These neurons are called the lobula giant movement detectors (LGMDs). The locust LGMDs have been extensively studied and this has lead to the development of an LGMD model for use as an artificial collision detector in robotic applications. To date, robots have been equipped with only a single, central artificial LGMD sensor, and this triggers a...

  9. Bilateral subepidermal calcified nodules of the eyelid

    OpenAIRE

    Malki, Salem Al; Al-Faky, Yasser H.; Al-Rikabi, Ammar C

    2010-01-01

    A subepidermal calcified nodule (SCN) is an uncommon benign lesion, which usually develops in early childhood and is typically solitary. A rare form of this lesion has been reported in the eyelid. We report here a case of a 12-year-old girl with bilateral nodules of the right upper eyelid and a left lower eyelid simulating epidermal cyst. The histopathologic examination of the excised nodule confirmed the diagnosis. To our knowledge, this may be the first bilateral case of eyelid SCN reported...

  10. 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

  11. Bilateral hydronephrosis caused by vaginal prolapse

    Directory of Open Access Journals (Sweden)

    Begliomini Helio

    2003-01-01

    Full Text Available INTRODUCTION: Even though it is uncommon, uterine prolapse can cause compression of ureters and bilateral hydronephrosis, predisposing to arterial hypertension and renal failure. Hydronephrosis consequent to cystocele and to vaginal prolapse is even rarer. CASE REPORT: This paper reports on a 59 year-old patient, Caucasian, obese and hysterectomized who presented complete vaginal prolapse with bilateral hydronephrosis and slight alteration in serum urea and creatinine. Patient underwent correction of vaginal prolapse by endoscopic suspension technique with improvement of hydronephrosis and normalization of renal function. This work emphasizes the rarity of such case and the requirement of surgical approach.

  12. Bilateral Petit’s Triangle Hernia

    OpenAIRE

    Sanjay Kumar Bhasin, Arshad Bashir Khan, Sanjay Sharma

    2006-01-01

    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 a...

  13. 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.

  14. Bilateral Diabetic Papillopathy and Metabolic Control

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Lund-Andersen, Henrik; Sander, Birgit; Hvidt-Nielsen, Ditte; Larsen, Michael

    2010-01-01

    -six patients with type 1 diabetes. METHODS: Review of clinical, photographic, and clinical chemistry records from a large diabetology and ophthalmology unit between 2001 and 2008. MAIN OUTCOME MEASURES: Simultaneous, bilateral diabetic papillopathy. RESULTS: The mean follow-up was 4.9 years. During 10 020...... 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...

  15. Case Study: Giant Cell Arteritis with Vertebral Artery Stenosis

    Science.gov (United States)

    Daniel Chomlak, R.; Ghazanfari, Farshad; Datta, Mineesh

    2016-01-01

    In giant cell arteritis (GCA), involvement of the vertebral arteries is rare with reported rates of 3%–4% for ischemic events secondary to vertebral artery stenosis or occlusion for those patients with GCA. This case study describes a patient who initially presented with acute onset of vertigo but was also found to have transient, side-alternating upper limb neurological findings. While initial imaging showed no vascular abnormalities, it was not until GCA was eventually confirmed with a temporal artery biopsy that the initial scans were shown to have bilateral narrowing of the vertebral arteries. While rare, vertebral artery involvement is an important complication to consider in the setting of GCA due to the high rate of associated mortality, despite immunosuppressive therapy. PMID:27279753

  16. Giant Cervico-mediastinal Well-differentiated Liposarcoma.

    Science.gov (United States)

    Rena, Ottavio; Davoli, Fabio; Pia, Francesco; Roncon, Alberto; Papalia, Esther; Casadio, Caterina

    2015-07-01

    Liposarcomas are rare entities and those located in the neck and mediastinum are exceptional. We report the case of a 58 year-old Caucasian male who presented with dysphonia, mild dysphagia to solids, dyspnoea at exertion and cough due to a giant mass of the neck originating from the deep cervical space at C6 vertebral level spreading into the posterior mediastinum. The lesion, that was associated with a right vocal cord palsy, caused severe lateral displacement of the trachea and oesophagus. The case has been managed by complete surgical resection through a combined cervical and thoracic approach associated with a tracheostomy due to the risk of bilateral recurrent nerve dysfunction at the end of the intervention. The tumour was diagnosed as a encapsulated low-grade liposarcoma. Six months after surgery the tracheostomy was closed. At 24 months clinical and radiological follow-up the patient is doing well and disease free. PMID:25837020

  17. Symptomatic giant adrenal myelolipoma associated with cholelithiasis: Two case reports

    Directory of Open Access Journals (Sweden)

    Shahina Bano

    2012-01-01

    Full Text Available In this article, we have discussed about two cases of adrenal myelolipoma and aim to discuss the role of imaging in their diagnosis and their management. Different imaging techniques such as ultrasound, computed tomography and magnetic resonance imaging were used to aid in diagnosis in each of the cases. The findings have been highlighted here. In each of the cases, the diagnosis could be confirmed by imaging, and there was cholelithiasis seen associated with unilateral adrenal myelolipoma. Adrenal myelolipomas are rare, benign, non-functional tumors of adrenal gland. Most tumors are unilateral and small; bilateral, giant myelolipomas are extremely rare. The association of adrenal myelolipoma with gallstones is uncommon. To our knowledge only two cases of such an association have been reported in the literature. However, the possibility does exist and steps should be taken to ensure a complete diagnosis. Also, it is important to understand the key points which help us in diagnosing adrenal myelolipomas by imaging.

  18. The interiors of the giant planets - 1983

    International Nuclear Information System (INIS)

    The last few years brought progress in understanding the interiors of the giant planets especially of the two larger ones which have been visited by Pioneer and Voyager spacecraft. An analysis of the formation of the giant planets also helped to clarify certain important common features. The presently available model of Jupiter is still based on certain somewhat bothersome approximations but it appears to satisfy the main observational constraints. Saturn's interior is much better understood than it was previously although the quantitative aspects of the role of the miscibility gap in the hydrogen-helium system have not yet been entirely resolved. Much attention has been directed at the interiors of Uranus and Neptune and the outstanding question appears to be the location and the amount of ices and methane present in their outer layers. Both the two- and the three-layer models are moderately successful. Serious difficulties arise from the considerable uncertainties concerning the rotational periods of both planets. Also the estimates of the internal heat fluxes and of the magnetic fields of both planets are not sufficiently certain. It is hoped that the forthcoming flyby of these two planets by a Voyager spacecraft will provide important new data for a future study of their interiors. (Auth.)

  19. Aneurisma gigante do segmento intracavernoso da carótida interna associado a doença renal policística autossômica dominante: relato de caso Giant aneurysm of the intracavernous internal carotid artery associated with autosomal dominant polycystic kidney disease: case report

    Directory of Open Access Journals (Sweden)

    Keven F. Ponte

    2006-09-01

    Full Text Available Apresenta-se o caso de mulher de 60 anos com doença renal policística autossômica dominante (DRPAD que desenvolveu quadro de cefaléia e oftalmoplegia completa à direita. A TC levantou a hipótese de um aneurisma gigante do segmento intracavernoso da carótida interna direita, o que foi confirmado pela arteriografia. Realizou-se, então, tratamento endovascular por oclusão do vaso parental com molas destacáveis no segmento supraclinóideo. A paciente evoluiu com a interrupção da cefaléia e com redução parcial da ptose e da oftalmoplegia. Neste artigo, enfatiza-se a relação entre DRPAD e aneurismas intracranianos. Comenta-se a história natural dos aneurismas originados no segmento intracavernoso da artéria carótida interna e comparam-se as opções terapêuticas no manejo destas lesões.We report the case of a 60 years-old woman with autosomal dominant polycystic kidney disease (ADPKD that presented with headache and right complete ophthalmoplegia. The CT scan raised the possibility of a giant aneurysm of the right intracavernous internal carotid artery, confirmed by angiography. The patient underwent endovascular occlusion of parent vessel with detachable coils, then she presented interruption of headache and partial recovery of ptosis and ophthalmoplegia. We emphasize the relationship between ADPKD and intracranial aneurysms. We also discuss the natural history and compare the therapeutic options for the management of giant aneurysms of the cavernous portion of the carotid artery.

  20. Pituitary Insufficiency and Hyperprolactinemia Associated with Giant Intra- and Suprasellar Carotid Artery Aneurysm

    OpenAIRE

    Gungor, A.; Gokkaya, N.; Bilen, A.; H. Bilen; Akbas, E. M.; Y. Karadeniz; Eren, S

    2015-01-01

    Pituitary insufficiency secondary to internal carotid artery (ICA) aneurysm is a very rare condition. Its prevalence is reported as 0.17% (Heshmati et al., 2001). We present a case of pituitary insufficiency and hyperprolactinemia secondary to suprasellar giant intracranial aneurysm. A 71-year-old man was admitted to our clinic with symptoms of hypopituitarism, hyperprolactinemia, and visual field defect. His pituitary MRI and cerebral angiography revealed a giant saccular aneurysm filling su...

  1. First Isolation of a Giant Virus from Wild Hirudo medicinalis Leech: Mimiviridae isolation in Hirudo medicinalis

    OpenAIRE

    Mondher Boughalmi; Isabelle Pagnier; Sarah Aherfi; Philippe Colson; Didier Raoult; Bernard La Scola

    2013-01-01

    Giant viruses and amoebae are common in freshwater, where they can coexist with other living multicellular organisms. We screened leeches from the species Hirudo medicinalis for giant viruses. We analyzed five H. medicinalis obtained from Tunisia (3) and France (2). The leeches were decontaminated and then dissected to remove internal parts for co-culture with Acanthamoeba polyphaga. The genomes of isolated viruses were sequenced on a 454 Roche instrument, and a comparative genomics analysis ...

  2. Giant cell arteritis: a review

    Directory of Open Access Journals (Sweden)

    Patil P

    2013-03-01

    Full Text Available Pravin Patil,1 Niral Karia,2 Shaifali Jain,3 Bhaskar Dasgupta1 1Department of Rheumatology, 2Department of Ophthalmology, 3Department of Radiology, Southend University Hospital, Westcliff, Essex, United Kingdom Abstract: Giant cell arteritis is the most common vasculitis in Caucasians. Acute visual loss in one or both eyes is by far the most feared and irreversible complication of giant cell arteritis. This article reviews recent guidelines on early recognition of systemic, cranial, and ophthalmic manifestations, and current management and diagnostic strategies and advances in imaging. We share our experience of the fast track pathway and imaging in associated disorders, such as large-vessel vasculitis. Keywords: giant cell arteritis, diagnosis, treatment, polymyalgia rheumatica

  3. Bilateral Pulmonary Cyst in a Child

    OpenAIRE

    Ravinder K Gupta, Ritu Gupta

    2008-01-01

    A four year old male child presented with history of cough for last six months. Chest skiagram and CTscan of mediastinum revealed bilateral pulmonary hydatid cyst. Serology did authenticate diagnosis. Thechild was prescribed albendazole for 6 months and was advised to come for follow up. The case ofbilateral pulmonary hydatid cyst is being presentated because of rarity.

  4. Bilateral Odontogenic Keratocyst of the Mandible

    OpenAIRE

    Ram, Hari; Mohammad, Shadab; Husain, Nuzhat; Gupta, Shalini; Kumar, Ajay

    2011-01-01

    Odontogenic keratocyst (OKC) is a cyst of dental origin with an aggressive clinical behavior, having high recurrence rate. Multiple cysts are associated with bifid-rib basal cell nevus syndrome (Gorlin syndrome). We present a case of bilateral odontogenic keratocyst in a cleft lip patient.

  5. Bilateral Pulmonary Cyst in a Child

    Directory of Open Access Journals (Sweden)

    Ravinder K Gupta, Ritu Gupta

    2008-04-01

    Full Text Available A four year old male child presented with history of cough for last six months. Chest skiagram and CTscan of mediastinum revealed bilateral pulmonary hydatid cyst. Serology did authenticate diagnosis. Thechild was prescribed albendazole for 6 months and was advised to come for follow up. The case ofbilateral pulmonary hydatid cyst is being presentated because of rarity.

  6. 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.

  7. Problems in severe bilateral urinary tract anomalies

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens

    1989-01-01

    Management of children with severe infravesical or bilateral ureterovesical obstruction with or without reflux is difficult. Our experience over 10 years includes 29 such children, 19 of whom presented in the first 3 months of life. At the time of diagnosis, 13 had severe disturbance of renal...

  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. 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

  10. 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

  11. 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.

  12. 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.

  13. A RARE CASE OF BILATERAL MICROSPHEREPHAKIA

    OpenAIRE

    Pandu; Arunkumar B.; Sujatha; Srinivas; Muthukumaran

    2015-01-01

    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 bil...

  14. Amnesia due to bilateral hippocampal glioblastoma

    International Nuclear Information System (INIS)

    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.)

  15. 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)

  16. Bilateral median nerve palsy in a cyclist.

    OpenAIRE

    Braithwaite, I J

    1992-01-01

    Cyclists are prone to a number of sport-related musculoskeletal injuries, mainly of the lower limb. Nerve compression injuries are relatively rare, though in the hand ulnar nerve compression is well described. We describe a case of bilateral median nerve compression caused by cycling.

  17. 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

  18. Spontan bilateral ekstrauterin graviditet efter kejsersnit

    DEFF Research Database (Denmark)

    Petersen, Jesper Friis; Ekelund, Charlotte; Settnes, Annette

    2015-01-01

    We describe a rare case of bilateral tubal pregnancy following natural conception in a woman with no other known risk factor than two former caesarean sections. Intraabdominal adhesions following the caesarean sections complicated the salpingectomy thus diminishing certainty of a healthy...

  19. 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.

  20. Giant Condyloma Acuminatum of Rectum

    International Nuclear Information System (INIS)

    Condyloma acuminatum, a benign disease caused by a filtrable virus, occurs predominantly in the perianal and genital areas. The lesions are noninvasive but are subject to recurrence. In rare instances, a more aggressive from of this disease, known as 'giant condyloma acuminatum' or 'Buschke-Lowenstein tumor', occurs. In this form, infiltration of the lesion into surrounding structures takes place. This tumor has been reported to occur principally in the genitourinarv tract. The authors experienced a case of giant condyloma acuminatum originating from rectum in 67 years old male patient which recurred 3 months after electrofulguration.

  1. Giant fields in southwest Mexico

    Energy Technology Data Exchange (ETDEWEB)

    1981-07-20

    According to Petroleos Mexicanos southeastern Mexico's Isthmus Saline basin holds five new giant fields - Tonala-El Burro, El Plan, Cinco Presidentes, Oraggio, and Magallanes - producing oil and gas from Tertiary sandstones. Numerous normal faults resulting from salt intrusion have given rise to multiple blocks, each with its own reservoir conditions. Previously discovered basins in the area include the Macuspana, which holds three giant gas- and condensate-producing fields: Jose Colomo, Chilapilla, and Hormiquero. The 3100-mi/sup 2/ Campeche marine platform, extending offshore nearby, contains the Cantarell complex, Mexico's most productive hydrocarbon province.

  2. Imaging of giant pituitary adenomas

    International Nuclear Information System (INIS)

    We present five proven giant pituitary adenomas studied by CT and MRI, and review the clinical and imaging findings. Our aim was to examine the radiologic appearances and to search for criteria useful in distinguishing these tumors from other sellar and suprasellar tumours, mainly craniopharyngioma. The main differences from small adenomas were high prevalence of macrocysts, a more invasive behaviour and a clinical picture dominated by mass effect rather than endocrine disturbance. Factors supporting the diagnosis of pituitary adenoma in a giant intra- and suprasellar mass include: infrasellar extension, absence of calcification and presence of low-signal cysts on T1-weighted images. (orig.) (orig.)

  3. You Don’t Have to Be A Giant:

    OpenAIRE

    Borrus, Michael; Zysman, John

    2010-01-01

    Globalism has become an emblem for a whole series of dramatic changes in the international economy. The hyperbole in the media and popular novels that suggests a whirling era of giant companies, shifting money, and hapless governments, often hides the distinctive features of changing markets. This paper proposes that recent changes in the organization of production and product development are altering the terms of competition in many world markets and creating significant globa...

  4. Charting the Giants

    Science.gov (United States)

    2004-06-01

    zero expansion asymptotically after an infinite time and has a flat geometry). All three observational tests by means of supernovae (green), the cosmic microwave background (blue) and galaxy clusters converge at a Universe around Ωm ~ 0.3 and ΩΛ ~ 0.7. The dark red region for the galaxy cluster determination corresponds to 95% certainty (2-sigma statistical deviation) when assuming good knowledge of all other cosmological parameters, and the light red region assumes a minimum knowledge. For the supernovae and WMAP results, the inner and outer regions corespond to 68% (1-sigma) and 95% certainty, respectively. References: Schuecker et al. 2003, A&A, 398, 867 (REFLEX); Tonry et al. 2003, ApJ, 594, 1 (supernovae); Riess et al. 2004, ApJ, 607, 665 (supernovae) Galaxy clusters are far from being evenly distributed in the Universe. Instead, they tend to conglomerate into even larger structures, "super-clusters". Thus, from stars which gather in galaxies, galaxies which congregate in clusters and clusters tying together in super-clusters, the Universe shows structuring on all scales, from the smallest to the largest ones. This is a relict of the very early (formation) epoch of the Universe, the so-called "inflationary" period. At that time, only a minuscule fraction of one second after the Big Bang, the tiny density fluctuations were amplified and over the eons, they gave birth to the much larger structures. Because of the link between the first fluctuations and the giant structures now observed, the unique REFLEX catalogue - the largest of its kind - allows astronomers to put considerable constraints on the content of the Universe, and in particular on the amount of dark matter that is believed to pervade it. Rather interestingly, these constraints are totally independent from all other methods so far used to assert the existence of dark matter, such as the study of very distant supernovae (see e.g. ESO PR 21/98) or the analysis of the Cosmic Microwave background (e

  5. Cabergoline Treatment in Invasive Giant Prolactinoma

    OpenAIRE

    Sadeem Alsubaie; Almalki, Mussa H.

    2014-01-01

    Patients with invasive giant prolactinoma suffer from a constellation of symptoms including headache, blurred vision, lethargy, and sexual dysfunction. Cabergoline, a potent dopamine agonist, is a known medication prescribed for the treatment of invasive giant prolactinoma. Here, we report a case of invasive giant prolactinoma in a 52-year-old Saudi male with dramatic response to cabergoline treatment clinically, biochemically, and radiologically.

  6. Giant lumbosacral schwannoma in a child

    OpenAIRE

    Rashim Kataria; Dhruba Jyoti Kurmi; Jayanti Mehta; Virendra Deo Sinha

    2012-01-01

    Small spinal intradural extramedullary schwannoma are a common occurrence in the middle aged. However, giant schwannoma in pediatric age group is rare. We report one such case of giant extradural lumbosacral schwannoma in an 8-year-old child. Clinical features, histopathology and management of giant schwannoma is discussed and the present literature reviewed.

  7. The asymmetric impact of natural disasters on China's bilateral trade

    Science.gov (United States)

    Meng, Y.; Yang, S.; Shi, P.; Jeager, C. C.

    2015-10-01

    Globalization and technological revolutions are making the world more interconnected. International trade is an important approach linking the world. Since the 2011 Tohoku earthquake and tsunami in Japan shocked the global supply chain, more attention has been paid to the global impact of large-scale disasters. China is the second largest trader in the world and faces frequent natural disasters. Therefore, this study proposes a gravity model for China's bilateral trade tailored to national circumstances and estimates the impact of natural disasters in China and trading partner countries on Chinese imports and exports. We analyzed Chinese and trading partner statistical data from 1980 to 2012. Study results show the following: (1) China's natural disasters have a positive impact on exports but have no significant impact on imports; (2) trading partner countries' natural disasters reduce Chinese imports and exports; (3) both development level and land area of the partners are important in determining the intensity of natural disaster impacts on China's bilateral trade. The above findings suggest that the impact of natural disasters on trade is asymmetric and significantly affected by other factors, which demand further study.

  8. Scintigraphy of incidentally discovered bilateral adrenal masses

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the patterns of iodine-131 6β-iodomethylnorcholesterol (NP-59) imaging and the correlation with CT-guided adrenal biopsy and follow-up in patients with bilateral adrenal masses. To this end we investigated a consecutive sample of 29 euadrenal patients with bilateral adrenal masses discovered on CT for reasons other than suspected adrenal disease. Adrenal scintigraphy was performed using 1 mCi of NP-59 injected i.v., with gamma camera imaging 5-7 d later. In 13 of the 29 patients bilateral adrenal masses were the result of metastatic involvement from lung carcinoma (5), lymphoma (3), adrenocarcinoma of the colon (3), squamous cell carcinoma of the larynx (1), and anaplastic carcinoma of unknown primary (1). Among these cases the NP-59 scan demonstrated either bilaterally absent tracer accumulation (8, all with bilateral metastases) or marked asymmetry of adrenocortical NP-59 uptake (5). Biopsy of the adrenal demonstrating the least NP-59 uptake documented malignant involvement of that gland in five of five patients. In two patients an adenoma was found simultaneously in one adrenal with a contralateral malignant adrenal mass. In each of these cases, the adenoma demonstrated the greatest NP-59 uptake. In 16 patients diagnosis of adenoma was made on the basis of CT-guided adrenal biopsy of the gland with the greatest NP-59 uptake of the pair (n=4), or adrenalectomy (n=2), or absence of change in the size of the adrenal mass on follow-up CT scanning performed 6 months to 3 years later (n=10). (orig./MG)

  9. Rotation Rates of the Giant Planets (Invited)

    Science.gov (United States)

    Schubert, G.; Helled, R.; Anderson, J. D.

    2009-12-01

    It has been generally believed that a rotation period could be assigned to each of the giant planets. Accepted values of these periods, till now, are 9h 55m 29s, 10h 39m 22s, 17h 14m 24s, and 16h 06m 36s for Jupiter, Saturn, Uranus, and Neptune, respectively. The rotation period of Jupiter is based on the periodic variations in the planet’s kilometric radiation and magnetic field, periodicities that have been unchanged since the Voyager flybys. The association of these periodicities with Jupiter’s internal rotation period is based on the idea that the radio and magnetic phenomena are tied to the planet’s magnetic field lines anchored deep within Jupiter. The periodic variations of the Saturnian Kilometric Radiation (SKR), unlike those of Jupiter, have not been rock solid, however; the periodicity has changed from 10h 39m 22s at the time of Voyager to 10h 45m 45s at the time of Cassini. Clearly, the SKR period does not represent the internal rotation period of Saturn, and it raises the possibility that the rotation periods of the other giant planets are uncertain. In fact, we must seriously reconsider whether the interiors of the giant planets are in solid body rotation with a single period. Even for Jupiter, the 9h 55m 29s rotation period might represent only the rotation of the region in which the magnetic field is generated. The dynamo region could extend from some unknown inner radius out to about 0.9 Jovian radius. The deeper Jovian interior could be rotating with a different period. A recent attempt to model the interior of Jupiter with new equation of state data concluded that the gravitational coefficients of Jupiter could not be fit unless Jupiter’s internal rotation rate was constant on cylinders parallel to the rotation axis (Militzer, B., W.B. Hubbard, J. Vorberger, I. Tamblyn, and S.A. Bonev, A massive core in Jupiter predicted from first-principles simulations, 2008, ApJ, 688, L45-L48 [doi: 10.1086/594364]). For Saturn, two studies of the

  10. The magnetodiscs and aurorae of giant planets

    CERN Document Server

    Achilleos, Nicholas; Arridge, Chris; Badman, Sarah; Delamere, Peter; Grodent, Denis; Kivelson, Margaret; Louarn, Philippe

    2016-01-01

    Readers will find grouped together here the most recent observations, current theoretical models and present understanding of the coupled atmosphere, magnetosphere and solar wind system. The book begins with a general discussion of mass, energy and momentum transport in magnetodiscs. The physics of partially ionized plasmas of the giant planet magnetodiscs is of general interest throughout the field of space physics, heliophysics and astrophysical plasmas; therefore, understanding the basic physical processes associated with magnetodiscs has universal applications. The second chapter characterizes the solar wind interaction and auroral responses to solar wind driven dynamics. The third chapter describes the role of magnetic reconnection and the effects on plasma transport. Finally, the last chapter characterizes the spectral and spatial properties of auroral emissions, distinguishing between solar wind drivers and internal driving mechanisms. The in-depth reviews provide an excellent reference for future re...

  11. 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

  12. 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.

  13. A giant called globalization is knocking at my humble door

    OpenAIRE

    Holler Sotomayor, Pamela

    2007-01-01

    International trade is connecting the world’s frontiers. Economic growth is being achieved by opening up to exterior markets and many countries are nowadays unified by bilateral and multilateral agreements which enable the global market to conduct a freer trade without restrictions. Trade negotiations are supervised by the World Trade Organization whose intention is to eliminate the obstacles in trade between countries. The liberalization process of a freer trade has however failed in certain...

  14. 78 FR 70601 - International Mail Contract

    Science.gov (United States)

    2013-11-26

    ... From the Federal Register Online via the Government Publishing Office POSTAL REGULATORY COMMISSION International Mail Contract AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service filing concerning a bilateral rate and service agreement with...

  15. On high brightness temperature of pulsar giant pulses

    CERN Document Server

    Kontorovich, V M

    2009-01-01

    Giant pulses observed in a number of pulsars show a record brightness temperature which corresponds to the high energy density of 10^15 erg/cm^3. Comparable densities of energy in the radio-frequency region are attainable in a cavity-resonator being the pulsar internal vacuum gap. Energy emission through the breaks accidentally appearing in the magnetosphere of open field lines corresponds to the giant pulses. The emitted energy is defined by the break area, which causes a power dependence of break occurrence probability. The observed localization of giant pulses as to the average pulse is explained by radiation through a waveguide near the magnetic axis or through a slot on the border of the open field lines. Separate discharges may be superimposed on the radiation through the breaks forming the fine structure of giant pulses with duration up to some nanoseconds. Coulomb repulsion of particles in the puncture spark in the gap leads to spark rotation around its axis in the crossed fields, which provokes the a...

  16. Magnetic braking of stellar cores in red giants and supergiants

    Energy Technology Data Exchange (ETDEWEB)

    Maeder, André; Meynet, Georges, E-mail: andre.maeder@unige, E-mail: georges.meynet@unige.ch [Geneva Observatory, Geneva University, CH-1290 Sauverny (Switzerland)

    2014-10-01

    Magnetic configurations, stable on the long term, appear to exist in various evolutionary phases, from main-sequence stars to white dwarfs and neutron stars. The large-scale ordered nature of these fields, often approximately dipolar, and their scaling according to the flux conservation scenario favor a fossil field model. We make some first estimates of the magnetic coupling between the stellar cores and the outer layers in red giants and supergiants. Analytical expressions of the truncation radius of the field coupling are established for a convective envelope and for a rotating radiative zone with horizontal turbulence. The timescales of the internal exchanges of angular momentum are considered. Numerical estimates are made on the basis of recent model grids. The direct magnetic coupling of the core to the extended convective envelope of red giants and supergiants appears unlikely. However, we find that the intermediate radiative zone is fully coupled to the core during the He-burning and later phases. This coupling is able to produce a strong spin down of the core of red giants and supergiants, also leading to relatively slowly rotating stellar remnants such as white dwarfs and pulsars. Some angular momentum is also transferred to the outer convective envelope of red giants and supergiants during the He-burning phase and later.

  17. 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

  18. 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)

  19. 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.

  20. 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

  1. Bilateral Thoracic Ganglion Cyst : A Rare Case Report

    OpenAIRE

    Kazanci, Burak; Tehli, Ozkan; Türkoglu, Erhan; Guclu, Bulent

    2013-01-01

    Ganglion cysts usually arise from the tissues around the facet joints. It is usually associated with degenerative cahanges in facet joints. Bilateral thoracic ganglion cysts are very rare and there is no previous case that located in bilateral intervertebral foramen compressing the L1 nerve root associated with severe radiculopathy. We report a 53 years old woman who presented with bilateral groin pain and severe numbness. Magnetic resonance imaging revealed bilateral cystic mass in the inter...

  2. Acute bilateral isolated foot drop: Report of two cases

    OpenAIRE

    Kertmen, H.; Gürer, B.; Yimaz, E. R.; Sekerci, Z.

    2015-01-01

    Foot drop is defined as the weakness of the foot and ankle dorsiflexion. Acute unilateral foot drop is a well-documented entity, whereas bilateral foot drop is rarely documented. Slowly progressing bilateral foot drop may occur with various metabolic causes, parasagittal intracranial pathologies, and cauda equina syndrome. Acute onset of bilateral foot drop due to disc herniation is extremely rare. Here we present two cases of acute bilateral foot drop due to disc herniation. The first patien...

  3. Michigan has a sleeping giant

    CERN Multimedia

    Brock, Raymond; Nichols, Sue

    2007-01-01

    "That giant is 750 miles of fiber optic cable that lassoes its three biggest research universities and Van Andel Institute to the future. Its mission: to uncover the nature of the Big Bang by connecton U.S. physicists to their huge experiment ATLAS in Geneva.." (4 pages)

  4. A Giant or a Dwarf?

    DEFF Research Database (Denmark)

    Schmid, Herman

    2005-01-01

    EU may appear to be a giant when it can act on behalf of a united Europe, but usually it is hampered by conflicting member state interests. The EU economic and administrative resources for foreign and trade policy are quite small (on level with one of its major member states) and the hopes in many...

  5. Giant lipomas of the hand

    Directory of Open Access Journals (Sweden)

    Gokce Yildiran

    2015-04-01

    Conclusion: Giant lipomas of the hand are very rare and may cause compressions and other complications. Thus, they require a careful preoperative evaluation in order to make a proper differential diagnosis. [Hand Microsurg 2015; 4(1.000: 8-11

  6. Giant superior mesenteric artery aneurysm

    OpenAIRE

    Temiz, Ahmet; Bostan, Mehmet; Şatıroğlu, Ömer; Çetin, Mustafa; Bozkurt, Engin

    2011-01-01

    Aneurysm of the superior mesenteric artery (SMA) is a rare condition and most of them are symptomatic. Gradu­ally increasing abdominal pain, intestinal ischemic symp­toms and rupture are the most common symptoms. We herein report a giant SMA aneurysm detected in a patient with complaint of abdominal discomfort.

  7. Damping of multiphonon giant resonances

    CERN Document Server

    Dinh Dang, N; Arima, A

    2000-01-01

    The phonon damping model (PDM) is applied to derive the equations that describe the damping of three-, and n -phonon giant resonances. As examples of the application of this approach, the results of numerical calculations for the double giant resonance (DGDR) (n=2) and triple giant dipole resonance (TGDR) (n=3) in sup 9 sup 0 Zr, sup 1 sup 2 sup 0 Sn and sup 2 sup 0 sup 8 Pb are discussed and compared with those obtained by folding independent giant dipole resonances (GDRs) (the folding results). For the DGDR in the double magic nucleus sup 2 sup 0 sup 8 Pb, we found that these results are very close to the folding results. In the open-shell nuclei sup 9 sup 0 Zr and sup 1 sup 2 sup 0 Sn, a clear deviation from the folding results is observed in calculations in agreement with the experimental trend. The results for the integrated strength and energy of TGDR are found to be much closer to the folding results in all three nuclei. The TGDR widths in the open shell nuclei are found to be larger than the folding r...

  8. Guiding the Giant

    Science.gov (United States)

    1998-08-01

    New ESO Survey Provides Targets for the VLT Giant astronomical telescopes like the ESO Very Large Telescope (VLT) must be used efficiently. Observing time is expensive and there are long waiting lines of excellent research programmes. Thus the work at the telescope must be very well prepared and optimized as much as possible - mistakes should be avoided and no time lost! Astronomers working with the new 8-m class optical/infrared telescopes must base their observations on detailed lists of suitable target objects if they want to perform cutting-edge science. This is particularly true for research programmes that depend on observations of large samples of comparatively rare, distant objects. This type of work requires that extensive catalogues of such objects must be prepared in advance. One such major catalogue - that will serve as a very useful basis for future VLT observations - has just become available from the new ESO Imaging Survey (EIS). The Need for Sky Surveys Astronomers have since long recognized the need to carry out preparatory observations with other telescopes in order to "guide" large telescopes. To this end, surveys of smaller or larger parts of the sky have been performed by wide-field telescopes, paving the way for subsequent work at the limits of the largest available ground-based telescopes. For instance, a complete photographic survey of the sourthern sky (declination joint European project that is conducted at the 1-m ESO telescope by a consortium of 20 astronomical institutes. More information Further information about EIS is available at http://www.eso.org/eis. From this site, it is possible to visit the EIS release page and to browse through pictures of the distant Universe and of individual objects, some of which will be observed with the VLT in the future. Notes [1] The home institutes of the astronomers involved in EIS include the European Southern Observatory, Osservatorio Astronomico di Trieste (Italy), Leiden Observatory (The

  9. 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

  10. Bilateral tarsometatarsal joint injuries: An unusual mechanism producing unusual variants.

    Science.gov (United States)

    Young, P S; Clement, V L; Lomax, A; Badhesha, J; Miller, R J; Mahendra, A

    2015-06-01

    Tarsometatarsal (Lisfranc) joint injuries are rare but potentially devastating conditions requiring anatomical reduction and internal fixation or arthrodesis. We describe an unusual mechanism involving forced eversion and dorsiflexion on both fully supinated feet resulting in bilateral tarsometatarsal joint injury. The injury pattern involved incongruity between the medial and middle columns extending between the cuneiform bones with associated fracture of the cuboid on the right and the cuboid, os calcis and talus on the left. Operative fixation is discussed and the clinical outcome was good at 4 years post-operatively. We believe this introduces an additional and potentially serious mechanism of injury and pattern of ligamentous and osseous disruption into the pantheon of injuries classed as Lisfranc, which surgeons should be aware of. Furthermore, we recommend attention to the mechanism of injury in consideration with classification to aid in operative reduction and fixation. PMID:25510168

  11. Bilateral Carotid Artery Dissection after High Impact Road Traffic Accident

    Directory of Open Access Journals (Sweden)

    Michael Kelly

    2008-11-01

    Full Text Available A 58 year old man was involved in a high impact road traffic incident and was admitted for observation. Asymptomatic for the first 24 hours, he collapsed with symptoms and signs consistent with a cerebrovascular accident. Computed tomography angiogram (CTA and Magnetic resonance angiogram (MRA demonstrated bilateral internal carotid artery dissections and a left middle cerebral artery infarct. It was not considered appropriate to attempt stenting or other revascularistation. The patient was treated with heparin prior to starting warfarin. He made a partial recovery and was discharged to a rehabilitation facility. This case is a reminder of carotid dissection as an uncommon but serious complication of high speed motor vehicle accident, which may be silent initially. Literature Review suggests risk stratification before relevant radiological screening at risk patients. Significant advances in CTA have made it the diagnostic tool of choice, but ultrasound is an important screening tool.

  12. Cryptogenic organising pneumonia presenting with bilateral hilar and mediastinal lymphadenopathy

    OpenAIRE

    Kahraman, Hasan; Tokur, Mahmut; Hamide SAYAR; Inci, Mehmet Fatih

    2013-01-01

    Cryptogenic organising pneumonia is not considered in the differential diagnosis of bilateral hilar and mediastinal lymphadenopathy. We submitted a patient presenting with bilateral hilar and mediastinal lymphadenopathy. We suspected diagnosis of sarcoidosis, but the patient was diagnosed as cryptogenic organising pneumonia with the histological result. This is the second case report of cryptogenic organising pneumonia presenting with bilateral hilar and mediastinal lymphadenopathy.

  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. HORSE SHOE KIDNEY WITH BILATERAL STAGHORN CALCULUS: A RARE PRESENTATION

    OpenAIRE

    Khalid,; Mahendra; Sangeeta; Vijoy; Ahsan; Vijayanand,

    2014-01-01

    Horseshoe kidney (HSK) is the most common renal anomalies. Bilateral staghorn calculi in HSK are rare and management is challenging. Anatomic consideration is important in choosing treatment modality. We report a case of bilateral staghorn calculus and its management. We report a case of bilateral staghorn calculus due to its rarity and challenge associated with its management.

  15. HORSE SHOE KIDNEY WITH BILATERAL STAGHORN CALCULUS: A RARE PRESENTATION

    Directory of Open Access Journals (Sweden)

    Khalid

    2014-05-01

    Full Text Available Horseshoe kidney (HSK is the most common renal anomalies. Bilateral staghorn calculi in HSK are rare and management is challenging. Anatomic consideration is important in choosing treatment modality. We report a case of bilateral staghorn calculus and its management. We report a case of bilateral staghorn calculus due to its rarity and challenge associated with its management.

  16. Giant hydronephrosis mimicking progressive malignancy

    Directory of Open Access Journals (Sweden)

    Heidenreich Axel

    2003-10-01

    Full Text Available Abstract Background Cases of giant hydronephroses are rare and usually contain no more than 1–2 litres of fluid in the collecting system. We report a remarkable case of giant hydronephrosis mimicking a progressive malignant abdominal tumour. Case presentation A 78-year-old cachectic woman presented with an enormous abdominal tumour, which, according to the patient, had slowly increased in diameter. Medical history was unremarkable except for a hysterectomy >30 years before. A CT scan revealed a giant cystic tumour filling almost the entire abdominal cavity. It was analysed by two independent radiologists who suspected a tumour originating from the right kidney and additionally a cystic ovarian neoplasm. Subsequently, a diagnostic and therapeutic laparotomy was performed: the tumour presented as a cystic, 35 × 30 × 25 cm expansive structure adhesive to adjacent organs without definite signs of invasive growth. The right renal hilar vessels could finally be identified at its basis. After extirpation another tumourous structure emerged in the pelvis originating from the genital organs and was also resected. The histopathological examination revealed a >15 kg hydronephrotic right kidney, lacking hardly any residual renal cortex parenchyma. The second specimen was identified as an ovary with regressive changes and a large partially calcified cyst. There was no evidence of malignant growth. Conclusion Although both clinical symptoms and the enormous size of the tumour indicated malignant growth, it turned out to be a giant hydronephrosis. Presumably, a chronic obstruction of the distal ureter had caused this extraordinary hydronephrosis. As demonstrated in our case, an accurate diagnosis of giant hydronephrosis remains challenging due to the atrophy of the renal parenchyma associated with chronic obstruction. Therefore, any abdominal cystic mass even in the absence of other evident pathologies should include the differential diagnosis of a

  17. Bilateral Diabetic Papillopathy and Metabolic Control

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Lund-Andersen, Henrik; Sander, Birgit; Hvidt-Nielsen, Ditte; Larsen, Michael

    2010-01-01

    OBJECTIVE: The pathogenesis of diabetic papillopathy largely is unknown, but case reports suggest that it may follow rapidly improved metabolic control. The present study was designed to investigate this hypothesis. DESIGN: Retrospective case-control study. PARTICIPANTS: Two thousand sixty......-six patients with type 1 diabetes. METHODS: Review of clinical, photographic, and clinical chemistry records from a large diabetology and ophthalmology unit between 2001 and 2008. MAIN OUTCOME MEASURES: Simultaneous, bilateral diabetic papillopathy. RESULTS: The mean follow-up was 4.9 years. During 10 020...... 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...

  18. 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

  19. 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.

  20. 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

  1. Bilateral Pial siderosis and hearing loss

    International Nuclear Information System (INIS)

    Seven adult patients with bilateral progressive hearing loss (six male, one female; aged 40-74 years) were studied with a high-field strength (1.5-T) magnetic resonance (MR) system after previous negative workup with either air contrast or intravenous contrast medium-enhanced computed tomography (CT). In all instances, the patients showed extensive evidence of pial siderosis outlining the posterior fossa subarachnoid space. The siderosis was manifested (on long repetition time images) as an increasing susceptibility effect (hypointensity) with a prolongation of echo time. The results of this study indicate that a negative CT examination is inadequate in patients with bilateral hearing loss and that when evidence of siderosis is found on MR images, an etiology for prior subarachnoid hemorrhage must be pursued

  2. Bilateral breast cancer after cured Hodgkin's disease

    International Nuclear Information System (INIS)

    Three patients developed bilateral breast cancer at 10 to 24 years after mantle irradiation for locally or systemically advanced Hodgkin's disease (HD). Four of the six cancers in the three patients were detected only by mammography. Pathologically, five of the cancers were intraductal carcinomas (four with an invasive component) with one being a lobular carcinoma. Five of the six lesions were Stage I pathologically without evidence of axillary nodal involvement. It is recommended that female patients with Hodgkin's disease who have received mantle irradiation as part of the therapy for their Hodgkin's disease and who are observed for 10 or more years after completion of mantle irradiation be considered at risk for the development of breast cancer. Such patients should be monitored appropriately by routine bilateral mammograms to increase the early detection of early stage lesions

  3. A rare case of bilateral aspergillus endophthalmitis

    Science.gov (United States)

    Gupta, Saurabh; Loudill, Cameron; Tammara, Anita; Chow, Robert T.

    2015-01-01

    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 unknown iatrogenic seed

  4. Bilateral Parotid Swelling in Polycystic Ovarian Syndrome.

    Science.gov (United States)

    Yakubov, Yakov; Mandel, Louis

    2016-05-01

    Polycystic ovarian syndrome (PCOS) is recognized by the presence of polycystic ovaries, irregular menstruation, and increased androgen levels. Many patients have insulin resistance or impaired glucose tolerance and an associated development of type 2 diabetes mellitus. A patient with PCOS is presented whose cosmetic concerns centered on the prolonged existence of substantial bilateral parotid swelling. The pathophysiology, diagnosis, and therapy of sialosis are discussed. PMID:26657398

  5. 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)

  6. 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...

  7. 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...

  8. Bilateral Globus Pallidus Ischemia: Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Hizir Akdemir

    2014-03-01

    Karbonmonoksit zehirlenmesi ile iliskili serebral lezyonlar BT ve MRG ile tespit edilebilir. Karbonmonoksit zehirlenmesi sonrasi serebral korteks, derin beyaz cevher, bazal gangliyonlar ve hipokampal bölgede lezyonlar ortaya çikabilir. Radyolojik bulgularin ortaya çikisi farkli zamanlarda olabilir. Karbonmonoksit zehirlenmelerinde en sik beyaz cevher degisiklikleri görülür. Siklikla derin beyaz cevher ve sentrum semiovale düzeyinde bilateral diffüz radyolojik etkilenim saptanir.

  9. 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...

  10. 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...

  11. A rare case of bilateral aspergillus endophthalmitis.

    Science.gov (United States)

    Gupta, Saurabh; Loudill, Cameron; Tammara, Anita; Chow, Robert T

    2015-01-01

    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 unknown iatrogenic seed

  12. Expectation Damages and Bilateral Cooperative Investments

    OpenAIRE

    Göller, Daniel

    2012-01-01

    We examine the efficiency of the standard breach remedy expectation damages in a setting of bilateral cooperative investment by a buyer and a seller. Contracts may specify a required quality level and an upper bound to the cost of production. We find that it is optimal to write an augmented Cadillac contract that sets one threshold such that it cannot be met with positive probability together with an extreme price. Then, one of the parties becomes a residual claimant of the trade relationship...

  13. 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...

  14. 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

  15. 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...

  16. Methanol intoxication with bilateral basal ganglia infarct

    International Nuclear Information System (INIS)

    Methanol is a toxic agent that affects the central nervous system, especially the optic nerves and basal ganglia. Symmetrical hypodense lesions in the basal ganglia, which can be demonstrated by CT or MRI, is accepted as the most characteristic radiological feature of the disease. A case of a patient with bilateral putaminal hypodense infarcts due tomethanol intoxication is presented. Copyright (2001) Blackwell Science Pty Ltd

  17. Bilateral Ossiculoplasty in 1 Case of Achondroplasia

    OpenAIRE

    Jung, Jongyoon; Yang, Chulwon; Lee, Sunkyu; Choi, June

    2013-01-01

    Achondroplasia is the most common skeletal dysplasia and it combines various complications with normal longevity. Hearing disturbance due to otitis media or an ossicular anomaly is one of the most common complications. Conductive hearing loss is suggested as the most common form of hearing loss. Temporal bone and middle ear structures are distorted in achondroplasia because of rotational change of the skull base. Authors experienced a case of an achondroplastic patient with bilateral hearing ...

  18. 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...

  19. Surgical treatment of patients with bilateral cataracts

    Directory of Open Access Journals (Sweden)

    I.E. Ioshin

    2013-02-01

    Full Text Available ABSTRACT The Determination of the tactics for surgical cataract treatment in the fellow eye in patients with bilateral cataracts did not received any unambiguous solution till now and the periods of operation performance are interpreted differently. The authors analyzed the results of treatment in 486 patients with bilateral cataracts. The authors identified a possible favorable interval between first and second operations in case of bilateral cataract, which was based on the clinical, functional and immunological parameters. Phacoemulsifications with peri-operative antibiotic prophylaxis were carried out not later than 4 days after the operation on the first eye, if there were no complications intra-operatively and in post-operative period in the first eye. Recommended time of surgery in the fellow eye in 114 patients of the main group allowed to reveal high functional results (0.7-1.0 in 90.4% in the first eye and in 85.1% of cases in the fellow eye, that promoted the restoration of binocular functions in 98 % of cases after surgery in the shortest possible time. In all patients of the main group the clear vision at different distances were achieved after surgery with bilateral implantation of multifocal IOLs in both eyes in the maximum shortest time. Selected dates of cataract surgery in both eyes taking into account the general and associated ocular pathology allows to reduce the emotional cost, time and organizational problems in preparation for the operation, adding the benefits of quality of early rehabilitation after surgery in both eyes.

  20. 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.

  1. 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...

  2. 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.

  3. International safeguards

    International Nuclear Information System (INIS)

    Since the start of the post-war era, international safeguards were considered essential to ensure that nuclear materials should not be diverted to unauthorised uses. In parallel, it was proposed to set up an international atomic energy agency within the United Nations through which international cooperation in nuclear matters would be channelled and controlled. Created in 1957, the IAEA was authorized to administer safeguards in connection with any assistance it provided as well as at the request of Member State and of any party to bilateral or multilateral arrangements in its ambit. Today, there are two international treaties requiring that its parties should accept Agency safeguards unilaterally, the Latin America Tlatelolco Treaty of 1967, and the Treaty on the Non-Proliferation of Nuclear Weapons (NPT), operative since 1970, which requires in particular that non-nuclear weapon states should accept Agency safeguards on its peaceful nuclear activities. Thus while NPT covers peaceful nuclear activities indiscriminately in a country, the Agency's original safeguards system is applied according to specific agreements and to given facilities. A basic conflict has now emerged between commercial interests and the increasing wish that transfer of nuclear equipment and know-how should not result in proliferation of military nuclear capacity; however, serious efforts are currently in progress to ensure universal application of IAEA safeguards and to develop them in step with the uses of nuclear energy. (N.E.A.)

  4. Bilateral femoral head dysplasia and osteochondritis

    International Nuclear Information System (INIS)

    Multiple epiphyseal dysplasia tarda (MEDT) and spondylo-epiphyseal dysplasisa tarda (SEDT) are genetically transmitted conditions affecting the hips, which may resemble bilateral Legg-Perthes disease (LPD). Misdiagnoses are not uncommon, with serious implications for treatment, prognosis and genetic counseling. An epidemiologic study of MEDT and SEDT in a well-defined population of 453 921 persons in Denmark was performed. A population prevalence of 0.7 per 100 000 inhabitants with SEDT and 4.0 per 100 000 inhabitants with MEDT was found. Distinguishing features between MEDT, SEDT and bilateral LPD based on radiologic findings in the hips, other joints, and spine were ascertained. Bilateral LPD is always asymmetric, exhibits patches of increased density in the epiphyses and often metaphyseal cyst-like changes. No spinal lesion or affection of other joints is present, and the acetabula are normal. In MEDT and SEDT the capital femoral epiphyses are symmetrically flattened, fragmented and uniformly slightly sclerotic. Generalised platyspondyly is a constant finding in SEDT. (orig.)

  5. Medical Image Denoising Using Bilateral Filter

    Directory of Open Access Journals (Sweden)

    Devanand Bhonsle

    2012-07-01

    Full Text Available Medical image processing is used for the diagnosis of diseases by the physicians or radiologists. Noise is introduced to the medical images due to various factors in medical imaging. Noise corrupts the medical images and the quality of the images degrades. This degradation includes suppression of edges, structural details, blurring boundaries etc. To diagnose diseases edge and details preservation are very important. Medical image denoising can help the physicians to diagnose the diseases. Medical images include MRI, CT scan, x-ray images, ultrasound images etc. In this paper we implemented bilateral filtering for medical image denoising. Its formulation & implementation are easy but the performance of bilateral filter depends upon its parameter. Therefore for obtaining the optimum result parameter must be estimated. We have applied bilateral filtering on medical images which are corrupted by additive white Gaussian noise with different values of variances. It is a nonlinear and local technique that preserves the features while smoothing the images. It removes the additive white Gaussian noise effectively but its performance is poor in removing salt and pepper noise.

  6. 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.

  7. 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)

  8. 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.

  9. 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.

  10. 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)

  11. Malignant Mesothelioma Presenting as a Giant Chest, Abdominal and Pelvic Wall Mass

    Energy Technology Data Exchange (ETDEWEB)

    Shao, Zhi Hong; Gao, Xiao Long; Yi, Xiang Hua; Wang, Pei Jun [Tongji Hospital of Tongji University, Shanghai (China)

    2011-11-15

    Malignant mesothelioma (MM) is a relatively rare carcinoma of the mesothelial cells, and it is usually located in the pleural or peritoneal cavity. Here we report on a unique case of MM that developed in the chest, abdominal and pelvic walls in a 77-year-old female patient. CT and MRI revealed mesothelioma that manifested as a giant mass in the right flank and bilateral pelvic walls. The diagnosis was confirmed by the pathology and immunohistochemistry. Though rare, accurate investigation of the radiological features of a body wall MM may help make an exact diagnosis.

  12. Transient Palsy of Recurrent Laryngeal Nerve Postresection of Giant Substernal Goiter

    OpenAIRE

    Muhoozi, Rwakaryebe; Yu, Fenglei; Tang, Jingqun; Wang, Xiang

    2014-01-01

    We report a case of a female patient aged 46 years with a history of nodular goiter for which she had a subtotal thyroidectomy 31 years ago. She was referred to the emergency department of our hospital because of dyspnea and chest pain for 20 days, then developed cyanosis and edema of the head and upper extremities. Chest X-ray revealed tracheal repulsion. Cervical and thoracic computed tomography showed a giant solid and a cystic mass in the anterior mediastinum and bilateral pleural effusio...

  13. Giant invasive prolactinomas

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, F.Y.; Vesely, D.L.; Jordan, R.M.; Flanigan, S.; Kohler, P.O.

    1987-11-01

    Two of the largest prolactinomas ever documented that have been followed for nine and 10 years, respectively, demonstrate how aggressive prolactinomas may become and how difficult invasive prolactinomas are to treat. One of these prolactinomas invaded both internal auditory canals and simultaneously grew inferiorly, reducing the bony support of the skull and necessitating the patient to utilize both hands to hold his head up. The second patient's prolactinoma invaded the sphenoidal, ethmoidal, and cavernous sinuses. Both of these patients had neurosurgical debulking of their tumors followed by radiation therapy. Neither patient's prolactin levels decreased significantly during their first five years post-surgically, at which time bromocriptine was added. Since then, there has been a gradual lowering of serum prolactin levels and a decrease in the size of these tumors. These cases demonstrate that prolonged treatment and very large doses of bromocriptine may be necessary for tumor reduction in patients with invasive prolactinomas.

  14. 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

  15. Iatrogenic “buffalo chest” bilateral pneumothoraces following unilateral transbronchial lung biopsies in a bilateral lung transplant recipient

    Directory of Open Access Journals (Sweden)

    Leith Sawalha

    2015-01-01

    Full Text Available We present a 54 year old male patient who had a bilateral lung transplant sixteen years ago for Alpha-1 Antitrypsin Deficiency-related emphysema. He was referred for flexible bronchoscopy with transbronchial biopsies to evaluate new mild exertional dyspnea and worsening of his FEV1. Eight transbronchial biopsies were done from the right middle lobe and the right lower lobe. Post procedure he developed bilateral pneumothoces that required emergent bilateral pleural ‘pigtail’ catheters. To our knowledge, this is the first reported case of bilateral pneumothoraces that developed after a unilateral procedure in a bilateral lung transplant recipient relatively late after the transplant.

  16. Recurrent giant cell fibroblastoma: Malignancy predisposition in Kabuki syndrome revisited.

    Science.gov (United States)

    Karagianni, Paraskevi; Lambropoulos, Vassilios; Stergidou, Dorothea; Fryssira, Helena; Chatziioannidis, Ilias; Spyridakis, Ioannis

    2016-05-01

    Kabuki syndrome is a genetic condition characterized by distinctive facial phenotype, mental retardation, and internal organ malformations. Mutations of the epigenetic genes KMT2D and KDM6A cause dysregulation of certain developmental genes and account for the multiple congenital anomalies of the syndrome. Eight cases of malignancies have been reported in young patients with Kabuki syndrome although a causative association to the syndrome has not been established. We report a case of a 12-year-old girl with Kabuki syndrome who developed a tumor on the right side of her neck. A relapsing tumor 19 months after initial excision, proved to be giant cell fibroblastoma. Τhis is the first report of giant cell fibroblastoma -a rare tumor of childhood- in a patient with Kabuki syndrome. © 2016 Wiley Periodicals, Inc. PMID:26898171

  17. Magnetic braking of stellar cores in red giants and supergiants

    CERN Document Server

    Maeder, Andre

    2014-01-01

    Magnetic configurations, stable on the long term, appear to exist in various evolutionary phases, from Main-Sequence stars to white dwarfs and neutron stars. The large scale ordered nature of these fields, often approximately dipolar, and their scaling according to the flux conservation scenario favor the model of a fossil field (Duez et al. 2010). We make some first estimates of the magnetic coupling between the stellar cores and the outer layers in red giants and supergiants. Analytical expressions of the truncation radius of the field coupling are established for a convective envelope and for a rotating radiative zone with horizontal turbulence. The timescales of the internal exchanges of angular momentum are considered. Numerical estimates are made on the basis of recent model grids. The direct magnetic coupling of the core to the extended convective envelope of red giants and supergiants appears unlikely. However, we find that the intermediate radiative zone is fully coupled to the core during the He-bur...

  18. Magnetar giant flares and afterglows as relativistic magnetized explosions

    CERN Document Server

    Lyutikov, M

    2006-01-01

    (Abridged) We propose that giant flares on Soft Gamma-Ray Repeaters produce relativistic, strongly magnetized, weakly baryon loaded magnetic clouds, somewhat analogous to solar coronal mass ejection (CME) events. Flares are driven by unwinding of internal non-potential magnetic fields which leads to slow build-up of magnetic energy outside of the neutron star. For large magnetospheric currents, corresponding to a large twist of external magnetic field, magnetosphere becomes dynamically unstable on \\Alfven crossing times scale of inner magnetosphere, $t_A \\sim R_{NS}/c \\sim 30 \\mu$sec. Released magnetic energy results in formation of a strongly magnetized, pair-loaded, quasi-spherically expanding flux rope, topologically connected by magnetic field to the neutron star during the prompt flare emission. Magnetic stresses of the tied flux rope lead to late collimation of the expansion, on time scales longer than giant flare duration. Relativistic bulk motion of the expanding magnetic cloud, directed at an angle $...

  19. [Giant intradiploic infratentorial epidermoid cyst].

    Science.gov (United States)

    Alberione, F; Caire, F; Fischer-Lokou, D; Gueye, M; Moreau, J J

    2007-10-01

    Epidermoid cysts are benign, uncommon lesions (1% of all intracranial tumors). Their localization is intradiploic in 25% of cases, and exceptionally subtentorial. We report here a rare case of giant intradiploic infratentorial epidermoid cyst. A 74-year old patient presented with recent diplopia and sindrome cerebellar. CT scan and MR imaging revealed a giant osteolytic extradural lesion of the posterior fossa (5.2 cm x 3.8 cm) with a small area of peripheral enhancement after contrast injection. Retrosigmoid suboccipital craniectomy allowed a satisfactory removal of the tumor, followed by an acrylic cranioplasty. The outcome was good. Neuropathological examination confirmed an epidermoid cyst. We review the literature and discuss our case. PMID:18008017

  20. Proteorhodopsin genes in giant viruses

    Directory of Open Access Journals (Sweden)

    Yutin Natalya

    2012-10-01

    Full Text Available Abstract Viruses with large genomes encode numerous proteins that do not directly participate in virus biogenesis but rather modify key functional systems of infected cells. We report that a distinct group of giant viruses infecting unicellular eukaryotes that includes Organic Lake Phycodnaviruses and Phaeocystis globosa virus encode predicted proteorhodopsins that have not been previously detected in viruses. Search of metagenomic sequence data shows that putative viral proteorhodopsins are extremely abundant in marine environments. Phylogenetic analysis suggests that giant viruses acquired proteorhodopsins via horizontal gene transfer from proteorhodopsin-encoding protists although the actual donor(s could not be presently identified. The pattern of conservation of the predicted functionally important amino acid residues suggests that viral proteorhodopsin homologs function as sensory rhodopsins. We hypothesize that viral rhodopsins modulate light-dependent signaling, in particular phototaxis, in infected protists. This article was reviewed by Igor B. Zhulin and Laksminarayan M. Iyer. For the full reviews, see the Reviewers’ reports section.

  1. Giant viruses come of age.

    Science.gov (United States)

    Fischer, Matthias G

    2016-06-01

    Viruses with genomes up to a few megabases in length are a common occurrence in nature, even though they have escaped our notice until recently. These giant viruses infect mainly single-celled eukaryotes and isolation efforts concentrating on amoebal hosts alone have spawned hundreds of viral isolates, featuring viruses with previously unseen virion morphologies and the largest known viral genomes and particles. One of the challenges that lie ahead is to analyze and categorize the available data and to establish an approved classification system that reflects the evolutionary relationships and biological properties of these viruses. Extensive sampling of Acanthamoeba-infecting mimiviruses and initial characterization of their virophage parasites have provided a first blueprint of the genetic diversity and composition of a giant virus clade that will facilitate the taxonomic grouping of these fascinating microorganisms. PMID:26999382

  2. Idiopathic giant right atrial aneurysm

    International Nuclear Information System (INIS)

    A 2-year-old boy with an incidental finding of massive cardiomegaly on a chest X-ray was diagnosed with a giant right atrial aneurysm upon further investigation with echocardiography. The patient underwent successful surgical reduction of the right atrium and closure of the patent foramen ovale to prevent thromboembolic complications and to lower the risk of atrial arrhythmias. The resected atrium had paper-thin walls and pathological features of interstitial fibrosis with endocardial thickening

  3. Observed Properties of Giant Cells

    Science.gov (United States)

    Hathaway, David H.; Upton, Lisa; Colegrove, Owen

    2014-01-01

    The existence of Giant Cells has been suggested by both theory and observation for over 45 years. We have tracked the motions of supergranules in SDO/HMI Doppler velocity data and find larger (Giant Cell) flows that persist for months. The flows in these cells are clockwise around centers of divergence in the north and counter-clockwise in the south. Equatorward flows are correlated with prograde flows - giving the transport of angular momentum toward the equator that is needed to maintain the Sun's rapid equatorial rotation. The cells are most pronounced at mid- and high-latitudes where they exhibit the rotation rates representative of those latitudes. These are clearly large, long-lived, cellular features, with the dynamical characteristics expected from the effects of the Sun's rotation, but the shapes of the cells are not well represented in numerical models. While the Giant Cell flow velocities are small (<10 m/s), their long lifetimes should nonetheless substantially impact the transport of magnetic flux in the Sun's near surface layers.

  4. Giant magnetostriction in magnetite nanoparticles

    International Nuclear Information System (INIS)

    Highlights: ► Giant magnetostriction in iron oxide nanoparticles. ► A 4% relative change in dimension of the particle. ► Small angle X-ray scattering (SAXS) as a tool for magnetostriction. ► Magnetoelastic coupling between surface spins and external magnetic field. ► There is a surface structure–property relationship. - Abstract: Typically the value of the magnetostrictive coefficient (λ) observed for bulk magnetic materials such as cubic ferrites is 10−6. However, giant magnetostriction (λ ≤ 10−3) is only observed in a few bulk intermetallic materials based on alloys of rare earth and iron such as TbFe, TbFe2, DyFe2 and Terefenol-D. While giant magnetostriction is known in nanostructured films, we show for the first time, this phenomenon occurs in magnetic nanoparticles. By using in-field small angle X-ray scattering (SAXS) as a tool, we demonstrate that a 4% relative change in dimension of the particle can be observed in 5.0 nm Fe3O4 nanoparticles at room temperature with 1 kG magnetic field. Also, we propose that the observed values are due to interaction effects and magnetoelastic coupling of particle magnetic moments and external magnetic field.

  5. Kepler rapidly rotating giant stars

    CERN Document Server

    Costa, A D; Bravo, J P; Paz-Chinchón, F; Chagas, M L das; Leão, I C; de Oliveira, G Pereira; da Silva, R Rodrigues; Roque, S; de Oliveira, L L A; da Silva, D Freire; De Medeiros, J R

    2015-01-01

    Rapidly rotating giant stars are relatively rare and may represent important stages of stellar evolution, resulting from stellar coalescence of close binary systems or accretion of sub-stellar companions by their hosting stars. In the present letter we report 17 giant stars observed in the scope of the Kepler space mission exhibiting rapid rotation behavior. For the first time the abnormal rotational behavior for this puzzling family of stars is revealed by direct measurements of rotation, namely from photometric rotation period, exhibiting very short rotation period with values ranging from 13 to 55 days. This finding points for remarkable surface rotation rates, up to 18 times the Sun rotation. These giants are combined with 6 other recently listed in the literature for mid-IR diagnostic based on WISE information, from which a trend for an infrared excess is revealed for at least a half of the stars, but at a level far lower than the dust excess emission shown by planet-bearing main-sequence stars.

  6. Narratives and Bilateral Relations : Rethinking the "History Issue" in Sino-Japanese Relations

    OpenAIRE

    Gustafsson, Karl

    2011-01-01

    The overarching aim of the thesis is to present a framework that makes possible an understanding of bilateral relations that challenges mainstream International Relations (IR) approaches through a study of the “history issue” in Sino-Japanese relations. A secondary aim is to provide an alternative understanding of this issue. Discussions of the issue are often highly influenced by the objectivism, rationalism, state-centrism and agent-centrism common in mainstream IR theory. This has several ...

  7. 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.

  8. Risk Factors for Giant Retinal Tears

    Directory of Open Access Journals (Sweden)

    Morteza Mehdizadeh

    2010-01-01

    Full Text Available Purpose: To evaluate the risk factors associated with giant retinal tears. Methods: This retrospective study was performed on medical records of 150 patients who had undergone retinal detachment surgery. Age, sex, history of trauma, lens status (phakic, pseudophakic, or aphakic, and high myopia were evaluated in association with giant retinal tears. Results: Of 150 patients with retinal detachments, 99 subjects (66% were older than 30 years while 51 (34% were 30 years of age or younger. Overall, 26 (17.3% patients had giant retinal tears. Controlling for all variables, only age had a significant correlation with giant retinal tears. Each year of advancing age was associated with a 6% decrease in the incidence of giant retinal tears. Conclusion: Young age is a significant risk factor for development of giant retinal tears.

  9. International cooperation

    International Nuclear Information System (INIS)

    Europe is certainly the part of the world where the largest number of international arrangements have been established for dealing with international cooperation in cases of major oil spills at sea. Let me list the most important of these multilateral arrangements: Bonn Agreement: covers the North Sea Contracting Parties: riparian states and the EEC Barcelona Convention: (protocol for emergency situations) covers the Mediterranean Sea Contracting Parties: riparian states and the EEC; Helsinki Convention: covers the Baltic Sea Contracting Parties: riparian states and (soon) the EEC; Lisbon Agreement: covers the NE Atlantic Contracting Parties: France, Spain, Portugal, Morocco and the EEC; Community Action Plan: covers the whole community waters; EEC; Members States participate in this plan. It should be underlined that, in addition to these large multilateral agreements a number of bilateral or trilateral arrangements have been set up, such as the Copenhagen Agreement, Denger Plan, Manche Plan, etc. The Commission involvement in these international frameworks is very important: as an example, it is presently chairing the Bonn Agreement Contracting Parties meeting. In addition, being the only contracting party to all these agreements, it is able to play a unique role of coordination and information to avoid duplications and contradictions. Having given this overview, I would now focus on the Community Action Plan

  10. Testing planet formation theories with Giant stars

    OpenAIRE

    Pasquini, Luca; Doellinger, M. P.; Hatzes, A.; Setiawan, J.; Girardi, L.; Da Silva, L.; de Medeiros, J. R.

    2008-01-01

    Planet searches around evolved giant stars are bringing new insights to planet formation theories by virtue of the broader stellar mass range of the host stars compared to the solar-type stars that have been the subject of most current planet searches programs. These searches among giant stars are producing extremely interesting results. Contrary to main sequence stars planet-hosting giants do not show a tendency of being more metal rich. Even if limited, the statistics also suggest a higher ...

  11. Solitary ulcerated congenital giant juvenile xanthogranuloma

    Directory of Open Access Journals (Sweden)

    Su Yuen Ng

    2015-01-01

    Full Text Available A 3-month-old female patient with a giant ulcerated nodule over the back since birth was diagnosed as congenital giant juvenile xanthogranuloma (JXG based on clinical and histopathological examination. Congenital giant JXG with ulceration at birth is a rare presentation of JXG and commonly misdiagnosed. This case emphasizes the importance of being aware of the myriad presentations of JXG in order to make a correct diagnosis and avoid unnecessary investigations or treatment.

  12. Rapid Formation of Ice Giant Planets

    CERN Document Server

    Boss, A P; Haghighipour, N; Boss, Alan P.; Wetherill, George W.; Haghighipour, Nader

    2002-01-01

    The existence of Uranus and Neptune presents severe difficulties for the core accretion model for the formation of ice giant planets. We suggest an alternative mechanism, namely disk instability leading to the formation of gas giant protoplanets, coagulation and settling of dust grains to form ice/rock cores at their centers, and photoevaporation of their gaseous envelopes by a nearby OB star, as a possible means of forming ice giant planets.

  13. Giant cell tumor of the mandible

    OpenAIRE

    Giri, G V V; Gheena Sukumaran; Ravindran, C.; Malathi Narasimman

    2015-01-01

    Giant cell tumor (GCT) of bone is a distinctive neoplasm characterized by abundance of multinucleated giant cells scattered throughout the stroma of mononuclear cells. Its importance lies in recognizing and differentiating the characteristic histology, which at times may mimic several other bone tumors and endocrine disorders ranging from locally aggressive giant cell granulomas to hyperparathyroidism to malignant tumors. The jaw bones account for less than 1% of the lesion.In a literature se...

  14. Giant Cane and Southeastern Indian Baskets

    OpenAIRE

    Julia A. Jordan

    2004-01-01

    Among the wide variety of natural materials suitable for basket making, one of the most attractive is giant cane (Figure 1), an Oklahoma native plant. Taxonomically, giant cane is in the genus Arundinaria, and the family Poaceae (grasses). This genus comprises the only native species of bamboo in the continental United States. Hitchcock (1971) recognized one genus: Arundinaria Michx. (cane) and two species: Arundinaria macrosperma Michx., giant cane, and Arundinaria tecta Walt. Muhl., switch ...

  15. 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.

  16. Primary Amenorrhea with Bilateral Endometriotic Cysts

    International Nuclear Information System (INIS)

    Primary amenorrhea is a common problem. Diagnosis is usually by going through systematic approach of history, examination and investigations. This case had bilateral large endometriotic cysts in the adnexal region. Uterus was normal sized with well-formed endometrium. She underwent laparotomy followed by drainage of endometriotic cysts, stripping and reconstruction of ovaries was performed. Patient was given a trial of combined oral contraceptive pills for two consecutive cycles to observe withdrawal bleeding, but it failed. Till now we are unable to find out such case in literature. Exact case of primary amenorrhea could not be found. (author)

  17. Bilateral lipoma arborescens of the subdeltoid bursa

    International Nuclear Information System (INIS)

    Lipoma arborescens is a rare cause of chronic monoarticular arthritis. It is most commonly seen in the knees, but only a few cases involving other joints, especially the subdeltoid bursa, have been described. To our knowledge, this is the first reported case of lipoma arborescens involving bilateral subdeltoid bursae. Although it is associated with joint effusion, synovial cysts and erosions, the presence of reactive bone formation has not been reported. Magnetic resonance imaging is a very effective method for the diagnosis of this rare condition because of its ability to do tissue characterization

  18. Bilateral pulmonary sequestration: a case report

    International Nuclear Information System (INIS)

    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. Familial extensive idiopathic bilateral pleural fibrosis.

    Science.gov (United States)

    Azoulay, E; Paugam, B; Heymann, M F; Kambouchner, M; Haloun, A; Valeyre, D; Battesti, J P; Tazi, A

    1999-10-01

    The authors report three sisters with bilateral isolated apical pleural fibrosis of unknown origin, which did not respond to empirical antituberculosis therapy and oral corticosteroids. The disease evolved in an unrelenting fashion producing pleural fibrosis at the lung bases and leading to the death of two sisters and to lung transplantation in the other one. There was no history of other familial disease or consanguinity. The particular features of these cases and the differences from other reports of apparently cryptogenic pleural fibrosis are outlined. PMID:10573252

  20. Bilateral Supernumerary Breast. A Case Report

    Directory of Open Access Journals (Sweden)

    Martha Yudey Rodríguez Pino

    2014-04-01

    Full Text Available Incidence of polymastia in the general population ranges from 0.4 to 6%. Accessory breasts are often considered a purely cosmetic problem; however various benign and malignant alterations may occur in these structures, as in any other breast tissue. A case of a patient who developed a painless mass in both axillary regions during pregnancy is presented. Her family physician interpreted it as lymphadenopathy. During the immediate puerperium, a greater enlargement in the axillary regions and pain, evident on physical examination, were found. Hence, a mammography and ultrasound were performed. Bilateral supernumerary breast and duct ectasia of the left breast were diagnosed.

  1. Bilateral Kimura's disease of the eyelids.

    OpenAIRE

    Kennedy, S.M.; Pitts, J F; Lee, W. R.; Gibbons, D C

    1992-01-01

    A case of Kimura's disease affecting the eyelids bilaterally is reported in a 5-year-old boy of Afro-Caribbean extraction who has been followed for 12 years with repeat biopsies. He initially presented at 5 years of age with swelling of the left upper eyelid, left cervical lymphadenopathy, and eosinophilia. One year later he developed swelling of the right upper eyelid. There has been no change in the clinical appearance over the next 12 years. Repeated biopsies of the eyelids showed a diffus...

  2. 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

  3. 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....

  4. Bilateral sequential Propionibacterium acnes exogenous endophthalmitis.

    Science.gov (United States)

    Saffra, Norman; Moriarty, Emily; Milman, Tatyana

    2016-12-01

    A 68-year-old man underwent uncomplicated sequential cataract extractions performed more than a year apart. He presented 6 months after the second surgery with persistent intraocular inflammation in both eyes. Cultures from both eyes grew Propionibacterium acnes and he responded well to treatment. Suspicion for delayed-onset post-operative endophthalmitis must remain high in uveitis cases that fail to resolve with anti-inflammatory treatments. The authors believe this is the first reported case of bilateral sequential P. acnes exogenous endophthalmitis. PMID:27220771

  5. The Orbital Evolution of Gas Giant Planets around Giant Stars

    OpenAIRE

    Villaver, Eva; Livio, Mario

    2009-01-01

    Recent surveys have revealed a lack of close-in planets around evolved stars more massive than 1.2 Msun. Such planets are common around solar-mass stars. We have calculated the orbital evolution of planets around stars with a range of initial masses, and have shown how planetary orbits are affected by the evolution of the stars all the way to the tip of the Red Giant Branch (RGB). We find that tidal interaction can lead to the engulfment of close-in planets by evolved stars. The engulfment is...

  6. 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

  7. Giant cavernous carotid aneurysm with spontaneous ipsilateral ICA occlusion: Report of 2 cases and review of literature

    Directory of Open Access Journals (Sweden)

    Savitr BV Sastri

    2013-01-01

    Full Text Available Giant aneurysms of the cavernous carotid artery are rare entities which present predominantly with features of compression of the adjacent neural structures, most commonly the III, IV, VI and V cranial nerves. Historically, treatment options included occlusion of the feeding vessel, direct surgery on the aneurysm, bypass procedures and in recent times, the use of endovascular devices. While intramural thrombus formation is commonly seen in giant aneurysms, we present 2 cases of giant cavernous aneurysms which on evaluation were found to have spontaneous occlusion of the feeding internal carotid artery secondary to thrombus formation, and review the available literature regarding the same.

  8. Artificial radioactivity in edible parts of giant clam mollusc from Mururoa atoll from 1967 to 1990. Health physics aspect

    International Nuclear Information System (INIS)

    Radionuclides concentration by giant clams is associated with feeding habit. It's also a main food for polynesian atolls inhabitants, elsewhere than Mururoa island because this mollusc is not consumed like all the other fishery products from this atoll lagoon. Nevertheless measurements of ten artificial radionuclides are performed in edible parts of giant clams fished from Mururoa lagoon since the beginning of nuclear tests. The decay of radionuclides concentration is described versus time. To go further on we have computed the dose-equivalent for internal exposure of an eventual giant clams eater. It is estimated that the resulting risk of malignancy is below than 1 per 10 000

  9. Bilateral based robust load frequency control

    International Nuclear Information System (INIS)

    Load frequency control (Lc) has been one of the major subjects in electric power system design/operation and is becoming much more significant today in accordance with increasing size and the changing structure and complexity of interconnected power systems. In practice, power systems use simple proportional-integral (PI) controllers for frequency regulation and load tracking. However, since the PI controller parameters are usually tuned based on classical or trial and error approaches, they are incapable of obtaining good dynamical performance for a wide range of operating conditions and various load changes scenarios in a restructured power system. This paper addresses a new decentralized robust Lc design in a deregulated power system under a bilateral based policy scheme. In each control area, the effect of bilateral contracts is taken into account as a set of new input signals in a modified traditional dynamical model. The Lc problem is formulated as a multi-objective control problem via a mixed H2/H∞ control technique. In order to design a robust PI controller, the control problem is reduced to a static output feedback control synthesis, and then, it is solved using a developed iterative linear matrix inequalities algorithm to get a robust performance index close to a specified optimal one. The proposed method is applied to a 3 control area power system with possible contract scenarios and a wide range of load changes. The results of the proposed multi-objective PI controllers are compared with H2/H∞ dynamic controllers

  10. Bilateral high division of sciatic nerve

    Directory of Open Access Journals (Sweden)

    K. Shwetha

    2014-08-01

    Full Text Available Sciatic nerve is the thickest nerve in the body formed by the sacral plexus from L4 to S3 in the lesser pelvis. It emerges through the greater sciatic foramen below the piriformis and enter the gluteal region. Then the nerve passes on the back of the thigh and at the level of superior angle of popliteal fossa it terminates by dividing into tibial and common peroneal nerve. The knowledge of anatomical variations in the division of nerve is important for various surgical and anaesthetic procedures. During routine dissection in the department of anatomy, Mysore Medical College and Research Institute, Mysore, a rare bilateral high division of sciatic nerve was observed in a female cadaver aged about 40 years. In the present case there was bilateral high division of sciatic nerve. The nerve was seen dividing into two branches before it emerges through the greater sciatic foramen. The tibial nerve was entering the gluteal region below the piriformis muscle and common peroneal nerve was entering by piercing the piriformis. The knowledge of this variation is important as the nerve may get compressed with surrounding anatomical structures resulting in non discogenic sciatica. The awareness of variations is important for surgeons during various procedures like fracture, posterior dislocation of hip joint and hip joint replacement. The anatomical variations are important during deep intramuscular injections in gluteal region and also for anaesthetists during sciatic nerve block. [Int J Res Med Sci 2014; 2(4.000: 1785-1787

  11. 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.

  12. Bilateral tension pneumothorax following equipment improvisation.

    Science.gov (United States)

    Zambricki, Christine; Schmidt, Carol; Vos, Karen

    2014-02-01

    This case report describes an unexpected event that took place as a result of using improvised equipment. The patient, a 16-year-old female undergoing complex oral surgery, suffered bilateral pneumothorax following the improper use of an airway support device. During the immediate postoperative period with the patient still intubated, oxygen tubing was attached to a right angle elbow connector with the port closed and 10 L/minute oxygen flow was administered to the patient in a manner that did not allow the patient to exhale. Within seconds, pneumothorax was apparent as the patient's vital signs deteriorated, visible swelling was noted in the shoulders and neck, and there was an absence of breath sounds on auscultation. This case study has application beyond the immediate discussion of bilateral pneumothorax, serving as a caution about the unintended consequences of equipment improvisation. In addition to highlighting the hazards of providing patient care with a non-standard device, this study also provides a powerful example of the human factors that can contribute to medical errors in the healthcare setting. PMID:24654348

  13. Bilateral Single-Session Retrograde Intrarenal Surgery for the Treatment of Bilateral Renal Stones

    Directory of Open Access Journals (Sweden)

    Gokhan Atis

    2013-06-01

    Full Text Available Purpose The aim of the study was to evaluate the efficacy and safety of bilateral single-session retrograde intrarenal surgery in the treatment of bilateral renal stones. Materials and Methods From December 2008 to February 2012, 42 patients who had undergone bilateral single-session retrograde intrarenal surgery (RIRS and laser lithotripsy were included in the study. The procedures were performed in the lithotomy position on an endoscopy table under general anesthesia, beginning on the side in which the stone size was smaller. Plain abdominal radiography, intravenous urograms (IVU, renal ultrasonography (USG and / or non-contrast tomography (CT scans were conducted for all patients. The success rate was defined as patients who were stone-free or only had residual fragment less than 4 mm. Results A total of 42 patients (28 male, 14 female with a mean age 39.2 ± 14.2 were included in the present study. The mean stone size was 24.09 ± 6.37 mm with a mean operative time of 51.08 ± 15.22 minutes. The stone-free rates (SFR were 92.8% and 97.6% after the first and second procedures, respectively. The average hospital stay was 1.37 ± 0.72 days. In two patients (4.7%, minor complications (Clavien I or II were observed, whereas no major complications (Clavien III-V or blood transfusions were noted in the studied group. Conclusions Bilateral single-session RIRS and laser lithotripsy can be performed safely and effectively with a high success rate and low complication rate in patients with bilateral renal stones.

  14. 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...

  15. Bilateral Foot Pain in a Collegiate Distance Runner

    OpenAIRE

    Denegar, Craig R.; Siple, Bonnie J.

    1996-01-01

    A 19-year-old, white female, college freshman cross-country runner presented to the athletic training center complaining of bilateral plantar foot pain 1 week into the cross-country season. She had been treated for bilateral plantar fasciitis twice in the previous 3 years, and initial evaluation suggested a recurrence. A failure to respond to treatment led us to suspect other causes. Subsequent diagnostic imaging (bone scan, CT scan) revealed bilateral navicular stress fractures. Navicular st...

  16. Bilateral leukocoria in a patient with homozygous protein C deficiency

    International Nuclear Information System (INIS)

    We describe a bilateral leukocoria and neonatal purpura fulminans in a male infant, born at full term after an unremarkable pregnancy to a healthy consanguineous married couple. Multiple hemorrhagic skin bullae were found at birth on various parts of the body with bilateral leukocoria, organized vitreous hemorrhage, retinal detachment, and intracranial hemorrhage with undetectable levels of protein C activity. We report a clinical case of homozygous protein-C deficiency with severe purpura fulminans and bilateral leukocoria. (author)

  17. 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 ...

  18. 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...

  19. Complete bilateral horizontal gaze paralysis disclosing multiple sclerosis

    OpenAIRE

    MILEA, D; Napolitano, M.; Dechy, H; Le Hoang, P.; Delattre, J.; Pierrot-Deseillig..., C

    2001-01-01

    Two women presented with bilateral internuclear ophthalmoplegia evolving in a few days to complete bilateral horizontal gaze paralysis. Convergence and vertical eye movements were normal. Cerebral MRI showed a few small white matter lesions in the lateral ventricle regions, and, at the brainstem level, a single, small, bilateral lesion affecting the posterior part of the medial pontine tegmentum and responsible for the clinical syndrome. The condition gradually improved in b...

  20. Bilateral panuveitis associated with Whipple disease – case report

    OpenAIRE

    Lisboa, Maria; Domingues, Isabel; Pamplona, Jaime; Barata, Pedro; Morgado, Joana; Brotas, Vítor

    2014-01-01

    [english] Purpose: To describe a clinical case and literature review of Whipple disease.Methods: A 65-year-old male with bilateral decreased visual acuity for 3 weeks as well as bilateral hypoacusia, vertigo, disequilibrium, headache and decreased strength in the right upper limb for 4 months. The clinical work-up revealed a bilateral panuveitis and an ischemic cerebellar stroke.Result: The diagnosis of Whipple disease was confirmed by histopathological analysis of adenopathy. The patient was...

  1. Bilateral inverted and impacted maxillary third molars: a case report

    OpenAIRE

    Abu-Mostafa, Nedal; Barakat, Ali; Al Turkmani, Tareq; Al Yousef, Abdulaziz

    2015-01-01

    Bilateral inverted third molar impaction is an extremely rare condition. We reported the case of a 50-year-old female patient with bilateral inverted and impacted maxillary third molars. Both were asymptomatic and pathology free clinically and radiographically. Surgical extraction of these inverted third molars with inaccessible positions requires an aggressive bone removal on the tuberosity bilaterally. Moreover, it contains a high risk of displacement of the inverted third molar into the ma...

  2. 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...

  3. 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...

  4. Bilateral angiosarcoma of breast in a young lady

    Directory of Open Access Journals (Sweden)

    Sanjoy Roy

    2011-01-01

    Full Text Available We report a young lady with bilateral angiosarcoma of breast because of its rarity. A 29 year old unmarried female presented with bilateral breast lump. She underwent bilateral mastectomy with axillary dissection histopathology of which showed low grade angiosarcoma of left breast and high grade angiosarcoma of right breast. CT Thorax revealed right hilar and right mediastenal lymph nodes. She was treated with radiotherapy and chemotherapy postoperatively.

  5. Bilateral Carotid and Vertebral Rete Mirabile Presenting with a Prominent Anterior Spinal Artery Mimicking a Spinal Dural AV Fistula at MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Young; Cha, Sang Hoon [Chungbuk National University College of Medicine, Iksan (Korea, Republic of)

    2011-11-15

    Bilateral carotid and vertebral rete mirabile (CVRM) is a very rare condition. We report a new case of CVRM initially detected by magnetic resonance imaging (MRI) of the cervical spine. MRI demonstrated tortuous vascular signal voids limited to the anterior cerebrospinal fluid space mimicking spinal dural arteriovenous fistula. A diagnosis of CVRM was confirmed on the basis of angiographic findings of rete formation associated with bilateral aplasia of the cavernous internal carotid and vertebral arteries without abnormal arteriovenous connection.

  6. Bilateral Carotid and Vertebral Rete Mirabile Presenting with a Prominent Anterior Spinal Artery Mimicking a Spinal Dural AV Fistula at MRI

    International Nuclear Information System (INIS)

    Bilateral carotid and vertebral rete mirabile (CVRM) is a very rare condition. We report a new case of CVRM initially detected by magnetic resonance imaging (MRI) of the cervical spine. MRI demonstrated tortuous vascular signal voids limited to the anterior cerebrospinal fluid space mimicking spinal dural arteriovenous fistula. A diagnosis of CVRM was confirmed on the basis of angiographic findings of rete formation associated with bilateral aplasia of the cavernous internal carotid and vertebral arteries without abnormal arteriovenous connection.

  7. Expand and extend bilateral and multilateral cooperation

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Focusing on her major business subject, at the same time, NSFC strived to promote international fundamental research cooperations, seriously implemented the new-era policies, and achieved great progress in exploring international cooperation channels, organizing international cooperative projects, attracting overseas talent resources,designing the Eleventh Five-Year Plan for international cooperation, establishing constitution and exploring political strategy etc. In 2005, NSFC granted 1593 cooperation projects with a total investment of 89.7716 million RMB.

  8. Bilateral cystic neuroblastoma: imaging features and differential diagnoses

    International Nuclear Information System (INIS)

    Neuroblastoma is one of the most common malignant tumors of childhood, with 40 % arising in the adrenal glands. Bilateral adrenal involvement from synchronous development or metastatic spread of the tumor is seen in less than 10 % of children with neuroblastoma [1[. Neuroblastoma rarely presents as a cystic suprarenal mass that is difficult to differentiate from adrenal hemorrhage, extralobar sequestration, or dilated upper-pole renal calyces. To our knowledge, bilateral cystic neuroblastoma has not been previously reported. We present a case of bilateral cystic adrenal neuroblastoma to demonstrate the imaging features of this unusual entity, and to expand the differential diagnosis of bilateral cystic suprarenal masses in an infant. (orig.). With 2 figs

  9. Lithium in Open Cluster Red Giants Hosting Substellar Companions

    CERN Document Server

    Carlberg, Joleen K; Cunha, Katia; Carpenter, Kenneth G

    2015-01-01

    We have measured stellar parameters, [Fe/H], lithium abundances, rotation, and 12C/13C in a small sample of red giants in three open clusters that are each home to a red giant star that hosts a substellar companion (NGC2423 3, NGC4349 127, and BD+12 1917 in M67). Our goal is to explore whether the presence of substellar companions influences the Li content. Both 12C/13C and stellar rotation are measured as additional tracers of stellar mixing. One of the companion hosts, NGC2423 3, is found to be Li-rich with A(Li)_NLTE=1.56 dex, and this abundance is significantly higher than the A(Li) of the two comparison stars in NGC2423. All three substellar companion hosts have the highest A(Li) and 12C/13C when compared to the control red giants in their respective clusters; however, except for NGC2423 3, at least one control star has similarly high abundances within the uncertainties. Higher A(Li) could suggest that the formation or presence of planets plays a role in the degree of internal mixing on or before the red...

  10. Miscibility calculations for water and hydrogen in giant planets

    CERN Document Server

    Soubiran, François

    2015-01-01

    We present results from ab initio simulations of liquid water-hydrogen mixtures in the range from 2 to 70 GPa and from 1000 to 6000 K, covering conditions in the interiors of ice giant planets and parts of the outer envelope of gas giant planets. In addition to computing the pressure and the internal energy, we derive the Gibbs free energy by performing a thermodynamic integration. For all conditions under consideration, our simulations predict hydrogen and water to mix in all proportions. The thermodynamic behavior of the mixture can be well described with an ideal mixing approximation. We suggest a substantial fraction of water and hydrogen in giant planets may occur in homogeneously mixed form rather than in separate layers. The extend of mixing depends on the planet's interior dynamics and its conditions of formation, in particular on how much hydrogen was present when icy planetesimals were delivered. Based on our results, we do not predict water-hydrogen mixtures to phase separate during any stage of th...

  11. Giant bubble pinch-off

    OpenAIRE

    Bergmann, Raymond; Meer, Van Der; Stijnman, Mark; Sandtke, Marijn; Prosperetti, Andrea; Lohse, Detlef

    2006-01-01

    Self-similarity has been the paradigmatic picture for the pinch-off of a drop. Here we will show through high-speed imaging and boundary integral simulations that the inverse problem, the pinch-off of an air bubble in water, is not self-similar in a strict sense: A disk is quickly pulled through a water surface, leading to a giant, cylindrical void which after collapse creates an upward and a downward jet. Only in the limiting case of large Froude numbers does the purely inertial scaling h(-l...

  12. [Aortitis in giant cell arteritis].

    Science.gov (United States)

    Schmidt, J; Duhaut, P

    2016-04-01

    Aortitis is a frequent complication of giant cell arteritis. Imaging techniques can reveal the inflammation of the aortic wall. CT-scan can show circumferential aortic wall thickening, or TEP-scan can show aortic FDG-uptake. Aortic aneurysm and dissection is a feared but probably rare complication of the inflammation of the aortic wall during GCA. Screening for aortitis could be proposed for patients with symptoms of aortic involvement, for patients with signs of large vessels involvement (limb claudication, bruit) or for patients with incomplete response to treatment. The best follow-up and treatment are to be determined for the patients with aortitis related to GCA. PMID:26781692

  13. Totally thrombosed giant anterior communicating artery aneurysm

    Directory of Open Access Journals (Sweden)

    V R Roopesh Kumar

    2015-01-01

    Full Text Available Giant anterior communicating artery aneurysmsarerare. Apatient presented with visual dysfunction, gait ataxia and urinary incontinence. MRI showed a giant suprasellar mass.At surgery, the lesion was identified as being an aneurysm arising from the anterior communicating artery.The difficulty in preoperative diagnosis and relevant literature are reviewed.

  14. Solitary subependymal giant cell astrocytoma: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kashiwagi, Nobuo; Yoshihara, Wataru; Shimada, Nobumitu; Tanaka, Hisashi; Fujita, Norihiko; Hirabuki, Norio; Watanabe, Yoshiyuki E-mail: kashiwagi@kanrou.net; Nakamura, Hironobu

    2000-01-01

    In this report, we describe a case of subependymal giant cell astrocytoma in a patient lacking clinical symptoms of tuberous sclerosis. The absence of any features of tuberous sclerosis initially dissuaded us from including subependymal giant cell astrocytoma in our differential diagnosis.

  15. Direct-decay properties of Giant Resonances

    CERN Document Server

    Urin, M H

    2008-01-01

    A semi-microscopic approach based on the continuum-RPA method and a phenomenological treatment of the spreading effect is developed and applied to describe direct-decay properties of a few isovector giant resonances. Capabilities of the approach to describe giant-resonance gross properties are also checked.

  16. 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...

  17. Gravity modes as a way to distinguish between hydrogen- and helium-burning red giant stars

    DEFF Research Database (Denmark)

    Bedding, Timothy R.; Mosser, Benoit; Huber, Daniel;

    2011-01-01

    . Asteroseismology offers a way forward, being a powerful tool for probing the internal structures of stars using their natural oscillation frequencies. Here we report observations of gravity-mode period spacings in red giants that permit a distinction between evolutionary stages to be made. We use high...

  18. Giant cells tumor of radius distal end and bone reconstruction

    International Nuclear Information System (INIS)

    This is the case of a black women aged 40 presenting with a tumor of distal end of right radium with histological diagnosis of low-grade malignancy giant cells tumor and proposal of limb amputation. A conservative surgery was performed with a two-steps total exeresis of lesion sparing the oncologic margin. A fibular free-graft was used and wrist arthrodesis and internal fixation of graft using AO system. There was a good graft consolidation and an active incorporation of patient to social activities. The diagnosis, treatment, follow-up, rehabilitation and case prognosis are exposed

  19. Mass Transfer from Giant Donors

    CERN Document Server

    Pavlovskii, K

    2014-01-01

    The stability of mass transfer in binaries with convective giant donors remains an open question in modern astrophysics. There is a significant discrepancy between what the existing methods predict for a response to mass loss of the giant itself, as well as for the mass transfer rate during the Roche lobe overflow. Here we show that the recombination energy in the superadiabatic layer plays an important and hitherto unaccounted-for role in he donor's response to mass loss, in particular on its luminosity and effective temperature. Our improved optically thick nozzle method to calculate the mass transfer rate via $L_1$ allows us to evolve binary systems for a substantial Roche lobe overflow. We propose a new, strengthened criterion for the mass transfer instability, basing it on whether the donor experiences overflow through its outer Lagrangian point. We find that with the new criterion, if the donor has a well-developed outer convective envelope, the critical initial mass ratio for which a binary would evolv...

  20. [Unilateral to bilateral pleurisy: Pleural tuberculosis?].

    Science.gov (United States)

    Ben Ameur, S; Smaoui, S; Kamoun, F; Chabchoub, I; Kamoun, T; Messaadi, F; Aloulou, H; Hachicha, M

    2016-04-01

    Pleural tuberculosis is the first or second most common form of extrapulmonary tuberculosis as well as the main cause of pleural effusion in many countries. It is rare in young infants and is more common in children over 10 years of age. We report the case of a 19-month-old girl admitted for prolonged fever with unilateral pleural effusion. The mother reported a history of lymph node tuberculosis 6 years previously. Intravenous antibiotics with cefotaxime and vancomycin were started. Thoracocentesis yielded a serosanguinous exudate fluid with a lymphocyte predominance. The tuberculin skin test and PCR GeneXpert(©) on pleural fluid were negative. The initial outcome was favorable, but the chest X-rays 10 days after discharge showed bilateral pleural effusion. Pleural biopsy was proposed but the culture of pleural fluid was positive for Mycobacterium tuberculosis. The child was put under standard treatment for tuberculosis. The outcome was favorable. PMID:26922570

  1. Rare case of bilateral carotic chemodectoma

    International Nuclear Information System (INIS)

    Glomus tumor (chemodectomy, paraganglion) is a rarely occurring tumor built of paraganglia, most often located in the common carotid artery division. This slowly increasing tumor develops mostly between the ages of 45 and 50, and more or less evenly in male and female patients. This article describes the characteristics of tumors such as chemodectomy, diagnostic methods, and procedures for medical treatment. The article describes a case of tumor in the common carotid artery bifurcation diagnosed as chemodectomy with a very rare bilateral locus. The tumor was accidentally discovered during ultrasonography, and confirmed in computer tomography examination. The first examination should be ultrasonography, complemented with color Doppler. A standard angiographic examination should be performed in the case of planned surgery, with one-time-only embolization of tumor vascularization. Computer tomography examination in the angio-CT option with RT3D reconstruction is an adequate method of imaging a tumour such as chemodectomy. (author)

  2. Computed tomography findings in bilateral perinephric lymphangiomatosis

    Directory of Open Access Journals (Sweden)

    Hakeem Aijaz

    2010-01-01

    Full Text Available Perinephric lymphangioma is rare disorder that may be confused with various forms of renal cystic diseases and urinomas. In this disorder a developmental malformation results in failure of developing lymphatic tissue to establish normal communication with the rest of lymphatic system. Once there is restricted drainage of lymphatic fluid the lymphatic channels dilate to form cystic masses that may be unilocular or multilocular and may be seen unilaterally or bilaterally .This condition presents with various signs and symptoms or can be just an incidental finding which in presence of misleading clinical history may be confused with other diseases. CT scan with delayed cuts and USG guided aspiration with biochemical analysis of fluid will help us in arriving to final diagnosis.

  3. Patient with bilateral breast enlargement and hypospadias.

    Science.gov (United States)

    Ali, A A; Ahmed, T; Rashid, M M

    2009-01-01

    A 20 year old man was admitted in the surgical unit of Dhaka Medical College Hospital on August 2007 presented with Hypospadias & underdeveloped penis from childhood, gradual enlargement of both breasts for the last 10 years, absence of axillary and pubic hair from puberty & painful swelling of both testes for the last 3 years. The patient was regarded as a female upto the age of 10 years. He has got no voice change since puberty. On examination he had average body built, there was bilateral gynaecomastia, hypospadias, rudimentary penis & absence of pubic and axillary hair. His testosterone level, serum prolactin level, serum progesterone level, serum estradiol level was done. Cytology on buccal smear done and ultrasonography revealed no ovary and uterus. Ultimately patient was diagnosed as a case of androgen insensitivity syndrome (AIS). The case is reported for clinical awareness & to share our experience. PMID:19182761

  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. Bilaterally Microstructured Thin Polydimethylsiloxane Film Production

    DEFF Research Database (Denmark)

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

    2015-01-01

    Thin PDMS films with complex microstructures are used in the manufacturing of dielectric electro active polymer (DEAP) actuators, sensors and generators, to protect the metal electrode from large strains and to assure controlled actuation. The current manufacturing process at Danfoss Polypower A...... with the existing manufacturing process. In employing the new technique, films with microstructures on both surfaces are successfully made with two different liquid silicone rubber (LSR) formulations: 1) pure XLR630 and 2) XLR630 with titanium dioxide (TiO2). The LSR films (∼70 μm) are cast on a....../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...

  6. 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

  7. 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

  8. Fetal goiter and bilateral ovarian cysts

    DEFF Research Database (Denmark)

    Lassen, Pernille; Sundberg, Karin; Juul, Anders; Skibsted, Lillian

    2008-01-01

    A unique case of fetal goiter accompanied by bilateral ovarian cysts in a mother treated with methimazole for Graves'disease is reported. The abnormal findings were detected by ultrasound at 31 weeks of gestation. Umbilical fetal blood sampling revealed elevated serum TSH, normal concentrations of...... each injection and followed by a gradual reduction of fetal goiter as well as the left ovarian cyst. The right cyst ruptured spontaneously. At 36 weeks + 4 days, the patient underwent elective caesarean section and gave birth to a female, weighing 2,880 g with 1- and 5-min Apgar scores of 10. The...... thyroid gland appeared normal in size, and cord blood TSH and free T 4 were both within normal limits. At ultrasound control6 days later, the right ovarian cyst was not visible, while the left cyst was still present. Thus, our report supports previous findings that fetal goiter can be treated successfully...

  9. Fetal goiter and bilateral ovarian cysts

    DEFF Research Database (Denmark)

    Lassen, Pernille; Sundberg, Karin; Juul, Anders; Skibsted, Lillian

    2008-01-01

    A unique case of fetal goiter accompanied by bilateral ovarian cysts in a mother treated with methimazole for Graves'disease is reported. The abnormal findings were detected by ultrasound at 31 weeks of gestation. Umbilical fetal blood sampling revealed elevated serum TSH, normal concentrations of...... each injection and followed by a gradual reduction of fetal goiter as well as the left ovarian cyst. The right cyst ruptured spontaneously. At 36 weeks + 4 days, the patient underwent elective caesarean section and gave birth to a female, weighing 2,880 g with 1- and 5-min Apgar scores of 10. The...... thyroid gland appeared normal in size, and cord blood TSH and free T 4 were both within normal limits. At ultrasound control 6 days later, the right ovarian cyst was not visible, while the left cyst was still present. Thus, our report supports previous findings that fetal goiter can be treated...

  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. PMID:27137462

  11. Intensity modulated radiotherapy (IMRT) in bilateral retinoblastoma

    International Nuclear Information System (INIS)

    External beam radiotherapy (EBRT) for retinoblastoma has traditionally been done with conventional radiotherapy techniques which resulted high doses to the surrounding normal tissues. A 20 month-old girl with group D bilateral retinoblastoma underwent intensity modulated radiotherapy (IMRT) to both eyes after failing chemoreduction and focal therapies including cryotherapy and transpupillary thermotherapy. In this report, we discuss the use of IMRT as a method for reducing doses to adjacent normal tissues while delivering therapeutic doses to the tumour tissues compared with 3-dimensional conformal radiotherapy (3DCRT). At one year follow-up, the patient remained free of any obvious radiation complications. Image guided IMRT provides better dose distribution than 3DCRT in retinoblastoma eyes, delivering the therapeutic dose to the tumours and minimizing adjacent tissue damage

  12. Bilateral type emphysematous pyelonephritis: imaging evaluation

    International Nuclear Information System (INIS)

    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

  13. Bilateral mandibular fracture related to osteoradionecrosis.

    Science.gov (United States)

    Goyal, Shikha; Mohanti, Bidhu Kalyan

    2015-01-01

    Mandible is the most frequently affected bone during head and neck irradiation. Late changes in the mandible may manifest in the form of reduced bone density, dental caries, loss of spongiosa trabeculations, delayed healing following dental extraction, pathologic fractures, osteoradionecrosis, trismus, growth defects in children or second malignancies. Pathologic fractures of mandibular bone are rare and may be spontaneous or traumatic (following dental extraction). We report the case of a 55-year lady, who had undergone surgery and adjuvant radiotherapy for carcinoma oral tongue T2N0M0 on a cobalt-60 unit and was disease-free. After a follow-up of 8 years post-irradiation, she presented with sudden onset oral pain and inability to open mouth. Pantomogram showed fracture at the junction of body and ramus of the mandible bilaterally. PMID:26097342

  14. BILATERAL STEROID INDUCED GLAUCOMA IN VERNAL KERATOCONJUNCTIVITIS

    Directory of Open Access Journals (Sweden)

    Bangal Surekha V, Bankar Mahima S, Bhandari Akshay J, Kalkote Prasad R

    2015-01-01

    Full Text Available Vernal Keratoconjunctivits (VKC is a bilateral recurrent allergic interstitial conjunctival inflammation with a periodic seasonal incidence and of self limiting nature, mainly affecting the younger population. Patients of VKC on steroid therapy are at higher risk of developing steroid induced glaucoma. Raised intraocular pressure due to steroids typically occurs within few weeks of starting steroid therapy and comes back to normal on immediate stoppage of steroids. A case of steroid induced glaucoma in a 30 years old female with vernal keratoconjunctivitis. She was on topical steroids for 3-4 years. She was incompliant with the instructions to stop steroids. She eventually developed steroid induced glaucoma and glaucomatous optic neuropathy with tunnel vision.

  15. 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

  16. Bilateral foveal retinoschisis accompanying unilateral peripheral retinoschisis

    Directory of Open Access Journals (Sweden)

    Nilufer Kocak

    2014-01-01

    Full Text Available X-linked juvenile retinoschisis is a rare hereditary retinal disease characterized by a tangential splitting of the neurosensory retina which may cause early-onset visual impairment. Existence of the retinal neurosensory layer splitting on cross-sectional images of optical coherance tomography (OCT and the absence of leakage on fluorescein angiography (FA help confirming the diagnosis. Such diagnostic tests are also helpful in determining the management of the disease. However, most of the retinoschisis cavities remain stable and rarely extend to the posterior pole, many authors suggest laser prophylaxis to avoid the potential risk of retinal detachment due to holes in the outer retinal layer. Herein, we report a case with bilateral foveal retinoschisis accompanying unilateral peripheral retinoschisis who was evaluated with detailed ophthalmologic examination. Visual acuity, fundoscopy, OCT, and FA remained stable in the second year of follow-up after prophylactic argon laser treatment.

  17. Wind responses of Giant Magellan telescope

    Science.gov (United States)

    Irarrazaval, Benjamin; Buleri, Christine; Johns, Matt

    2014-08-01

    The Giant Magellan Telescope (GMT) is 25 meter diameter extremely large ground based infrared/optical telescope being built by an international consortium of universities and research institutions. It will be located at the Las Campanas Observatory in Chile. The GMT primary mirror consists of seven 8.4 meter diameter borosilicate mirror segments. Two seven segment Gregorian secondary mirror systems will be built; an Adaptive Secondary Mirror (ASM) to support adaptive optics modes and a Fast-steering Secondary Mirror (FSM) with monolithic segments to support natural seeing modes when the ASM is being serviced. Wind excitation results in static deformation and vibration in the telescope structure that affects alignment and image jitter performance. The telescope mount will reject static and lower frequency windshake, while each of the Faststeering Secondary Mirror (FSM) segments will be used to compensate for the higher frequency wind-shake, up to 20 Hz. Using a finite element model of the GMT, along with CFD modeling of the wind loading on the telescope structure, wind excitation scenarios were created to study the performance of the FSM and telescope against wind-induced jitter. A description of the models, methodology and results of the analyses are presented.

  18. Giant Otters and Ecotourism in Peru

    Directory of Open Access Journals (Sweden)

    Staib E.

    1994-03-01

    Full Text Available Giant otters are the most endangered otters in the world, threatened by rainforest destruction, over fishing, the contamination of the water systems with mercury in areas of gold miners, illegal hunting and, possible infections with diseases of domestic animals. Numbers are so low that every otter is valuable. A new and increasing threat is tourism. Tourists find these animals very memorable and attractive, and guides lead their clients to find them. This disturbs otters, especially in places where tourist visits are irregular, and this can lead to them abandoning an area completely. We presented recommendations to mitigate this at the International Theriological Congress in Australia, 1993: the need for education of tourist guides; the prohibition of tourist groups accompanied by unlicensed guides; co­ordination among tourist agencies to stagger visits; provision of better information to tourists on conduct in the area and their likely impact on the environment; the provision of alternative attractions to relieve pressure on the lakes; limiting the number of lakes that may be visited by tourists and leaving the others undisturbed; and suggestions to improve administration and regulations.

  19. International co-operation

    International Nuclear Information System (INIS)

    Within the Union Nations (UN) framework, the Slovak Republic participated in following activities on environment protection co-operation: UN European Economic Commission, UN Industrial Development Organization, UN Development Programme, UN Human Habitat Organization, UN Environment Programme, and UN Commission on Sustainable Development. Relevant activities of the Slovak Republic in these co-operations as well as in European Union and OECD activities are reviewed. International conventions and other forms of multilateral co-operation, bilateral co-operation, and international programmes and projects in which the Slovak Republic took participate are presented

  20. Bilateral adrenal histoplasmosis in an immunocompetent man Histoplasmose adrenal bilateral em um homem imunocompetente

    Directory of Open Access Journals (Sweden)

    Carlos Frederico Lopes Benevides

    2007-04-01

    Full Text Available Histoplasmosis is a fungal disease that is endemic in Brazil. It may present as chronic pulmonary infection or in disseminated form. Disseminated histoplasmosis frequently affects the adrenal gland; however, unilateral involvement in immunosuppressed patients is the usual presentation. We report a case of an elderly immunocompetent male with history of weight loss, fever and bilateral adrenal mass who was successfully treated with itraconazole.Histoplasmose é uma doença fúngica endêmica no Brasil que pode se apresentar como infecção pulmonar crônica ou na forma disseminada. A histoplasmose disseminada freqüentemente acomete a glândula adrenal; entretanto, ocorre mais em pacientes imunossuprimidos e de forma unilateral. Relatamos um caso de um homem idoso imunocompetente com história de perda de peso, febre e massa adrenal bilateral que foi tratada com itraconazol, com sucesso.